Women on the Verge of Health
The Vital Role of Food

Women, it can be safely said, are all-too-often overlooked, misunderstood, underrepresented and patronized by the American medical establishment. The most natural of acts, childbirth, which women have performed for thousands of years, is often treated as if it were a disease. Half of all American women will have a hysterectomy in their lifetimes, despite only 10 percent of these procedures being medically imperative.[1] Many of the long-suffering diseases that affect women exclusively are inadequately researched for lack of sufficient funding. In short, women especially depend on a viable alternative approach to health care to ensure their well-being and vitality.

At EarthSave, we believe that self-care—making wise lifestyle and food choices—is central to this alternative approach. As part of our ongoing effort to help people take control of their lives by taking control of their health, we focus our attention here on some of the most prevalent and pressing health concerns facing women in North America, and we provide you updated information on the role that a healthful plant-based diet can play in combating them.

Every year in the US roughly 925,000 people die from heart disease.[2] There is a common misconception that heart disease strikes men in much greater numbers than women. While it's true that heart disease generally occurs in women about 10-12 years later in life than in men,[3] the fact remains that heart disease—not cancer—is the number one killer of women in North America.[4]

As is true with any illness, with heart disease, an ounce of prevention is worth a pound of cure. And a diet rich in plant foods is a pivotal part of any preventive plan. One study found that vegetarians have 24 percent less heart disease and that people eating a vegan diet (one free of meat and dairy products) experience 57 percent less heart disease than people who eat meat.[5]

A plant-based diet not only helps prevent heart disease, it can also be instrumental in treating and reversing it. According to famed heart researcher Dean Ornish, MD, the conventional approach to dealing with heart disease—with surgical procedures and cholesterol-lowering drugs—treats only the disease's physical manifestations without addressing the more fundamental causes. Such measures, Ornish explains, "will provide only temporary relief."[6]

Ornish is also critical of the American Heart Association's recommended 30-percent fat diet. In his research, people eating this diet actually saw their coronary blockages worsen.[7]

Patients following the Ornish plan eat a vegetarian diet with 10 percent of calories from fat. Using this approach along with exercise and stress management, Ornish was able to reverse heart disease in 82 percent of patients in one year.[8] (Ornish even reports recent success in reversing heart disease in two patients who were awaiting heart transplant surgery.) Similarly, Caldwell Esselstyn, MD, was able to reverse the severe heart disease in 70 percent of his high-risk patients using a strict low-fat vegetarian diet and judicious use of cholesterol-lowering drugs.[9]

More than 500,000 people die from cancer each year, roughly half of them women.[10] Very few medical practitioners stress or even mention to their patients the importance of eating a plant-centered diet in order to reduce the risk of ever getting cancer. Yet experts now agree that many plant foods contain substances that can help us avoid cancer, and that a low-fat, plant-based diet can slow or reverse tumor growth and bolster the body's natural resistance to disease. There is also growing evidence suggesting that a plant-based diet can be effective in treating cancer and improving the survival rate of cancer patients.[11]

Breast cancer is the second-most commonly diagnosed cancer in the US, striking 182,000 women each year and killing more than 46,000.[12] That nearly equals the number of Americans killed during the entire Vietnam War. Currently about one of every eight women will contract the disease during their lifetime.[13] Over the past several decades, however, the number of women diagnosed with breast cancer has increased by an alarming 1-2 percent per year.[14] Meanwhile, public attention remains focused on detecting breast cancer with mammograms and self-exams rather than on prevention.

There are many reasons for women to be eating a low-fat, plant-based diet, and reducing one's risk of breast cancer is one of them. "We have consistent evidence that an affluent, Western diet is associated with higher risk [of breast cancer]," says Regina Ziegler, a nutritional epidemiologist at the National Cancer Institute.[15]

It must be said, however, that the evidence linking diet and breast cancer is not yet as conclusive as with heart disease and some other cancers. While many studies have discovered a connection between a high-fat diet and breast cancer, several prominent studies show no such link.

According to T. Colin Campbell, PhD, one of the foremost nutrition scientists in the world, it's not enough to simply focus, as most diet-related breast cancer studies have, on the amount of fat consumed. To prevent breast cancer, Campbell believes the emphasis should be on the protective effects of a low-fat plant-based diet.[16]

"There are a large number of factors in plant-based diets that combine to reduce the risk of the disease," says Campbell, including, for example, the protective phytochemicals found abundantly in plant foods and the environmental toxins found largely in animal foods. "This is very likely the reason why removing only small amounts of fat from an animal-based diet will not significantly reduce this serious disease."[17]

Numerous studies support this view, showing that breast cancer is many times more common in Western countries where diets are meat-centered. "Breast cancer is essentially a dietary disease, just as lung cancer is essentially a smoking-related disease," says Robert Kradjian, MD, a breast surgeon for nearly 30 years and author of Save Yourself From Breast Cancer. "[18] If you want to avoid breast cancer, then learn to live like the billions of women on this earth who will avoid the disease. Eat as the women in protected countries do—a diet high in protective vegetables, fruits, and fiber—a plant-based diet."[19]

Roughly 57,000 Americans die each year from colon and rectal cancer. Again, contrary to popular belief, nearly half the victims are women.[20] Colon cancer is the second-most-common cancer in the US, and probably one of the most preventable.

The link between a meat-centered diet and the high incidence of colon cancer is nearly irrefutable. International studies suggest that fully 95 percent of colon cancer cases have a nutrition connection.[21] In 1992, researchers found that women who ate about 6-10 servings of fruits and vegetables per day had a 38 percent lower risk of fatal colon cancer than women eating the least number of servings.[22] In one study involving more than 88,000 women, researchers found that those eating the most animal fat were nearly twice as likely to develop colon cancer as those eating the least animal fat. Study director Walter Willet, MD, PhD, concluded, "If you step back and look at the data, the optimum amount of red meat you eat should be zero."[23]

In 1994, ovarian cancer killed 13,600 American women and uterine cancer claimed another 5,900 lives.[24]

Like the breast, the ovaries and uterus are strongly influenced by sex hormones, particularly estrogen.[25] Studies have demonstrated that women who eat a vegetarian diet have significantly lower circulating estrogen levels than women eating a non-vegetarian diet. This result is believed to be correlated directly with consumption of saturated fat from animal foods. Indeed, a 1994 study in the Journal of the National Cancer Institute found that saturated fat intake was associated with increasing risk of ovarian cancer.[26] Similarly, a 1996 study found that the higher a woman's cholesterol level (remember: no plant foods contain cholesterol), the greater her risk of ovarian cancer.[27]

Because dietary fat (especially animal fat) may well be a contributory factor in the development of hormone-related cancers including ovarian and uterine cancer, physicians like Neal Barnard, MD, President of the Physicians Committee for Responsible Medicine, recommend a low-fat, vegetarian diet as "the best prescription for preventing the hormonal elevations that encourage cancer."[28]

The mysterious disease endometriosis is among the most commonly misdiagnosed. Estimated to affect roughly five million women annually,[29] endometriosis occurs when the tissue that lines the uterus grows outside of the uterine cavity, in or out of the pelvic area.[30] Symptoms include pelvic pain, abnormal menstrual cycles, heavy bleeding, nausea, vomiting and infertility. Since the most noticeable of these symptoms (pelvic cramping and pain during menstruation) resemble many other medical conditions, the average woman can expect to visit five doctors before proper diagnosis.[31]

Fibroid tumors are benign growths in the uterus that occur to some degree in more than 50 percent of all women.[32] They are most commonly asymptomatic and never life-threatening. Nevertheless, as Christiane Northrup, MD, notes in Women's Bodies, Women's Wisdom, "they are the number-one reason for hysterectomy in this country."[33] Women with small fibroids are told that an early hysterectomy is advisable because if the fibroids grow, the hysterectomy will be riskier and more complicated. According to Northrup, "there is little or no justification for this."[34] In some cases, fibroids grow and cause bleeding, and this is the most common problem related to them.

Much like endometriosis, there is no known cause of fibroids and they can tend to run in families. Conventional treatments for both include drugs and surgery—endometriosis is second only to fibroids as the most common justification for hysterectomy.[35] But there is much cause for optimism. Northrup has had marked success in treating both conditions with dietary changes. "Endometriosis symptoms often disappear completely...when women follow a low-fat, high-fiber diet free of all dairy products." The same diet, she adds, "can halt the growth of fibroids and in some cases, result in their disappearance."[36]

Estrogen replacement therapy (ERT) presents a difficult decision for women entering menopause. As Science News observed in 1996, "Women contemplating hormone therapy have a right to be confused."[37]

By making up for declining estrogen levels, estrogen supplements can ease menopausal symptoms and help retard osteoporosis. They can also reduce the risk of heart disease in some women. But estrogen supplements are not without side effects and risks. Most importantly, estrogen supplements have been linked to elevated risk of breast and uterine cancers. "I am very concerned about the risk of breast cancer in estrogen replacement therapy," says Christiane Northrup.[38] An analysis by the Centers for Disease Control of 16 studies found that women using hormones for more than 10 years had a 40 percent increase in their risk of breast cancer.[39] Hormone replacement therapy can have other side effects as well, including weight gain, bloating, depression, nausea and breast tenderness.[40]

Diet and lifestyle can make a profound difference in the way a woman's body adjusts to menopause. Asian women, who eat a diet rich in soyfoods and who have lower estrogen levels than American women, experience very little discomfort associated with menopause. "Japanese women do not have a word for hot flashes," observes Herman Adlercreutz, MD, PhD, of the University of Helsinki. Asian women also have half the rate of breast cancer.[41]

Michael Klaper, MD, a general practitioner for more than 25 years, has seen many women who eat a strictly plant-based diet pass through menopause largely unfazed. "Most of them seem to breeze through with nary a flash or flush. Their much more pleasant experience may be a result of very-low-fat diets."[42]

Women needn't resort to hormone replacement therapy for its promised benefits, says Northrup, but many face great pressure to do so. Physicians now routinely warn women about the risks of not using estrogen replacement, she says.[43] In 1995, Time magazine reported, "Doctors are handing out estrogen replacement prescriptions with gleeful enthusiasm."[44] Currently eight million American women take the most common estrogen supplement, Premarin (which is derived from the urine of pregnant horses), making it one of the most widely prescribed drugs.[45]

What women are not generally hearing from physicians, Northrup explains, is that "there are a number of ways in which menopausal women can accomplish symptom relief, maintain a healthy heart, and keep their bones strong without conventional estrogen replacement if they are motivated to do so. Dietary change, exercise, classical osteopathy, acupuncture, and homeopathic and herbal remedies are some of the ways in which my patients have supported their transition through menopause," Northrup adds. "It makes perfect sense that healthy, well-nourished women can have a satisfying and enlightening transition through menopause and that each woman's treatment must be individualized."[46]

Osteoporosis is the loss of bone tissue that weakens bones and heightens the likelihood of fracture. It affects more than 20 million American women. Bone health and osteoporosis are closely linked to diet, and to other important factors including exercise, smoking, alcohol and body weight.

Calcium's role in osteoporosis has been hotly debated for some time, especially calcium loss due to the consumption of animal protein, which tends to leach calcium from the bones. (One recent study found that eliminating animal protein from the diet can cut urinary calcium losses in half.)[47] A number of top researchers now believe that calcium losses are more important to overall calcium balance than how much of the mineral we consume. "Logic may tell us that calcium intake ought to be important, but the evidence is weak," says Mark Hegsted, PhD, a highly respected calcium researcher from Harvard University.[48]

Hegsted's conclusion is supported by numerous studies showing that countries with the highest calcium intake (also the countries with the highest intake of protein-rich animal foods) have among the highest rates of hip fracture.[49] What's more, it's well known that in many parts of the world, women often reach their 80s and 90s with strong bones while eating appreciably less calcium than women in the West. "The best approach to building bone health is a holistic one in which we look at all the dietary, environmental, and genetic factors related to osteoporosis development," says Northrup. "Eating a balanced, mostly vegetarian diet rich in greens such as kale, collards and broccoli is the first step."[50]

As the debate over calcium continues, almost all researchers advise women to err on the side of caution and aim to meet the Recommended Dietary Allowance for calcium, 800 mgs. However, contrary to what the dairy and milk industry would have you believe, this can be achieved by eating an array of calcium-rich plant foods and without resorting to milk and cheese.

Scientists aren't exactly sure why vegetarian diets are protective against so many of the chronic degenerative diseases common in the West. Is it the abundance of fiber, antioxidants and phytochemicals in plant foods, the absence of disease-promoting animal foods, or some combination of both? As T. Colin Campbell observes, despite the incomplete picture, "the transition toward a plant-based diet offers benefits too powerful to be ignored, no matter what stage of life or health you're in."[51]

Indeed, the role of a plant-based diet in helping women reclaim their health is too obvious to overlook any longer. "There's no question that largely vegetarian diets are as healthy as you can get," agrees Marion Nestle, PhD, chair of the nutrition department at New York University. "The evidence is so strong and overwhelming and produced over such a long period of time that it's no longer debatable."[52]

[1] John Robbins, Reclaiming Our Health (Tiburon, CA: HJ Kramer, 1996), p121.

[2] American Heart Association, 1995. Most recent figures are for 1992: 479,236 women and 444,180 men died of cardiovascular disease.

[3] Journal of the American Dietetic Association 1993;9:987-993.

[4] Ann Japenga, "Mending the Female Heart," Health, March 1996.

[5] American Journal of Clinical Nutrition 1988;48:830-32.

[6] Ann Japenga, as per note 4.

[7] Ibid.

[8] Lancet 1990;336:129-33.

[9] Journal of Family Practice 1995;41:(6):560-568.

[10] American Cancer Society, Cancer Facts and Figures-1995.

[11] Ann Japenga as per note 4. Also, Bonnie Liebman, "Plants for Supper?", Nutrition Action Healthletter, Oct 1996, and Amy O'Connor, "Nutritional War on Cancer," Vegetarian Times, May 1996.

[12] American Cancer Society, Cancer Facts and Figures-1995.

[13] Science News, July 31, 1993, p77.

[14] Cancer Causes and Control 1991;2:67-74.

[15] "Breast Cancer," Nutrition Action Healthletter, Jan/Feb 1996.

[16] T. Colin Campbell, "Avoiding Breast Cancer With Diet," Nutrition Advocate, July 1995, p3.

[17] Ibid.

[18] Robert Kradjian, MD, Save Yourself From Breast Cancer (New York: Berkley Books, 1994), p67.

[19] Ibid, p184.

[20] American Cancer Society, Cancer Facts and Figures-1995.

[21] Meghan Flynn, MS, RD, "Colon Cancer: Diet May Hold Key to Prevention," Environmental Nutrition, July 1995.

[22] Journal of the National Cancer Institute 1992; 84:1461.

[23] Gina Kolata, "Major Study Links Animal Fats to Cancer of Colon," New York Times, December 13, 1990.

[24] Preventive Medicine 1995;24;646-655.

[25] Neal Barnard, MD, "Surviving Cancer," Good Medicine, Summer 1993, p13.

[26] Journal of the National Cancer Institute 1994, Sept 21.

[27] Journal of the National Cancer Institute 1996;88:32-7.

[28] Neal Barnard, as per note 25.

[29] Endometriosis Association Newsletter and Fact Sheet, Vol 17, No 3, 1996

[30] Christiane Northrup, MD, Women's Bodies, Women's Wisdom (New York: Bantam, 1994), p157.

[31] Ibid, p159.

[32] John Robbins, as per note 1, p130.

[33] Christiane Northrup, as per note 30, p168-170, 174.

[34] Ibid, p172-174.

[35] John Robbins, as per note 1, p131.

[36] Christiane Northrup, as per note 29, p166, 185.

[37] Lisa Seachrist, "What Risk Hormones?", Science News, Vol. 148, Aug 5, 1995.

[38] Christiane Northrup, as per note 29, p466.

[39] Adriene Fugh-Berman, MD, "Managing Menopause," Vegetarian Times, July 1995, p72.

[40] Christiane Northrup, as per note 29, p468.

[41] Jody Godfrey Meisler, MS, RD, "Soy: The Bean Most Likely to Succeed in Fending Off Cancer, Heart Disease," Environmental Nutrition, May 1994.

[42] Sharon Gleason, "Menopause: It's Not a Disease," Good Medicine, Spring 1994, p9.

[43] Christiane Northrup, as per note 29.

[44] "Estrogen: Every Woman's Dilemma," Time, June 26, 1995.

[45] Sharon Gleason, as per note 41.

[46] Christiane Northrup, as per note 29, p469.

[47] American Journal of Clinical Nutrition 1994;59:1356-61.

[48] Judy Krizmanic, "Riding the Calcium Roller Coaster," Vegetarian Times, July 1995, p63.

[49] Ibid, and Calcified Tissue International, 1992;50:14-18.

[50] Christiane Northrup, as per note 29, p602.

[51] T. Colin Campbell, "A New Path to Better Health," New Century Nutrition, Special Edition, 1996, p3.

[52] Bonnie Liebman, as per note 10.