HEALTH FOR WOMAN

The health commandments all women should know based on research examining more than a MILLION of us


Even a small glass of wine a day increases the risk of breast cancer. That was the shocking news for women earlier this month from the Million Women Study, a survey of female health involving 1.3 million British women aged 50 and over.


Run by Oxford University scientists, it was set up in 1996 to examine the effects of HRT and possible links to cancer and other diseases. Already the study has produced key findings about health issues - from the Pill to alcohol consumption and childbearing.


Combined with other women's health research, all this information works as a blueprint for women's future wellbeing. Here VICTORIA LAMBERT reveals some of the important things all women should know...

DON'T BE TOO CLEAN
Around 30 per cent of British women don't wash their hands enough for good hygiene, according to studies by the London School of Tropical Medicine and Hygiene.

However, soap and water are sufficient - and using too many high-tech anti-bacterial products can be counter-productive.

Not only will they not stop colds and flu (which are transmitted by viruses, not bacteria), but they could affect the delicate balance of bacteria in our bodies, allowing stronger bugs to become dominant, says leading American microbiologist Dr Mary Ruebush, author of Why Dirt Is Good.

Most micro-organisms cause no problem, and many, like the ones that normally live in the digestive tract and produce life-sustaining nutrients, are essential to good health - these are the ones, she says, that are usually wiped out by anti-bacterial agents.


GO ON THE PILL
It will dramatically cut your risk of ovarian cancer, the silent killer, as the Million Women Study found. Furthermore, you will continue to be protected for at least 30 years after you stop. The study has shown that for every five years a woman has been on the Pill, her relative risk of ovarian cancer is cut by 20 per cent.

Those who take it for 15 years cut their risk by half.


DRINK TEA
Gum disease is emerging as a major factor in heart disease. The germs in the mouth create thousands of tiny blood clots, which can cause a narrowing of the arteries, a common cause of heart attacks.

With cardiovascular disease killing more women a year than breast cancer, it's essential to keep gum disease at bay. One of the best ways to fight cavities and reduce plaque - a precursor to gum disease - is drinking black tea. American researchers have found compounds in it not only kill cavity-causing bacteria in dental plaque, but affect an enzyme - glucosyltranferase - which helps convert sugars into the sticky material plaque uses to stick to teeth.

On exposure to black tea, bacteria also lose their ability to form clumps with other bacteria in plaque, thereby reducing the total mass of the dental plaque.


TAKE FOLIC ACID
It's a supplement most women associate with preventing birth defects - you should take 400 mcgs for at least the first 12 weeks of pregnancy. But it also reduces the risk of age-related macular degeneration (AMD) in women. AMD is a progressive eye disorder which is often untreatable, and leads to blindness.

Now the world-renowned Harvard Medical School has shown folic acid taken with vitamins B6 and B12 reduced the risk of this debilitating condition by a staggering 41 per cent. 'The beneficial effect of treatment began to emerge at approximately two years of follow-up and persisted throughout the sevenyear trial,' said the researchers.

In the trial, participants (who were aged over 40) took a daily 2.5 milligrams of folic acid, 50 mgs of vitamin B6 and 1 mg of vitamin B12.


Relax with a cup of tea: It helps protect against gum disease, which is a major factor governing our risk of a heart attack

AVOID COLA DRINKS
Diet colas often contain phosphate in the form of phosphoric acid, used to improve the flavour (it's labelled as E338 on the ingredients list). But phosphoric acid has been shown to interfere with calcium absorption.

According to the highly regarded Framingham Osteoporosis Study, there is a particular link between colas and low bone mineral density in older women. The research found bone density in women who consumed just five carbonated drinks (including four colas) a week was 4 per cent lower.

'This is quite significant when you are talking about the skeleton,' said Katherine Tucker, at the Human Nutrition Research Centre on Ageing at Tufts University. The National Osteoporosis Society recommends women cut their intake of fizzy drinks.

DON'T GET TOO THIN
According to the Million Women Study, the ideal body mass index (BMI) is about 24. For a woman of 5ft 4in (the average national height) this would mean weighing ten stone. While the adverse effects of obesity have been well documented (it is a risk factor for breast cancer, heart disease and diabetes), less well known is the effect of being underweight.

However, it is known to affect fertility, for instance: women with a BMI below 18.5 are less likely to conceive. Underweight women (BMI under 19) are more likely to develop osteoporosis.


AVOID HRT
Over the past few years there have been various scare stories about hormone replacement therapy. The bottom line seems to be that it protects against some conditions - heart disease, osteoporosis, leg ulcers and bowel cancer.

However, the Million Women study found the combined form of oestrogen and progestogen heightens your risk of breast cancer (although this extra risk goes once you stop taking it). The oestrogen-only form of HRT is not as risky.

The oestrogen-only form increases the risk of endometrial cancer, while both forms raise the risk of ovarian cancer.



DON'T SMOKE
Not only will this protect you against lung cancer, but perhaps surprisingly, against cervical cancer, too.Women who smoke are twice as likely to get the disease.


Cervical cancer is linked to infection with the human papilloma virus (HPV). The theory is that nicotine accumulates in cervical mucus and subsequently impairs the local defences against HPV, and cancer. It may also be that smoking also depresses the immune system.

So while the death of Jade Goody has led to a rise in the number of women asking for cervical smears, stopping smoking is also important.

SOAK UP THE SUN IF YOU WANT BABIES...
A major cause of infertility in women is polycystic ovary syndrome (PCOS) which can cause erratic ovulation. Many women who are suffering from it or who are not ovulating for unexplained reasons are deficient in vitamin D, says fertility consultant Zita West. She has just conducted a one-year clinic audit, and found 50 per cent of women tested were deficient - only 12 per cent were in the ideal range.

Researchers at the Yale University School of Medicine found when women with irregular periods were given extra vitamin D, the risk of developing PCOS and abnormal ovulation fell dramatically (by 99 and 93 per cent respectively).


While anxiety about skin damage, or even skin cancer, might put many women off spending time in the sun, UV rays are our main source of vitamin D; 20 minutes a day can be enough to help our bodies make this vitamin.

Start young: Have two babies in your twenties to help stop breast cancer

...BUT WATCH YOUR MEDICINES
Some common prescription drugs, as well as over-the-counter medications, can make the skin more sensitive to sunlight, leading it to burn.


These include antibiotics, types of cholesterol, high blood pressureand diabetes medication, birth control pills, non-steroidal anti-inflammatories (NSAIDS) including ibuprofen, and even acne medication such as Accutane (isotretinoin). Take extra care if in the sun.


EAT MORE BANANAS
A quarter of middle-aged women suffer from depression or anxiety, according to the Mental Health foundation.


Depression is linked to low levels of serotonin, the 'happy hormone'.


A serotonin deficiency is often caused by a lack of the amino acid tryptophan - which the body cannot make itself.

Dr Caroline Longmore, author of The Serotonin Secret, believes the best way to stock up on serotonin is by eating lots of tryptophan-rich foods such as turkey, cottage cheese and bananas - and even plums. She suggests eating between four to 11 bananas a week.

DON'T DRINK A DROP
One of the key findings of the Million Women Study was that even one glass of wine a day can raise the risk of breast cancer from 9.5 per cent to

10.6 per cent (researchers estimate 5,000 cases of breast cancer annually are attributable to alcohol).

The study also revealed the risk of any type of cancer increased with increasing alcohol consumption, with the scientists concluding there was effectively no safe lower limit.

HAVE AT LEAST TWO CHILDREN IN YOUR 20s
the Million Women Study found that having children in your 20s reduces the risk of developing breast cancer by 7 per cent compared with other women. It concluded that if women had 2.5 children on average and breastfed each child for 12 months longer than they currently do, approximately 11 per cent (50,000) of breast cancers would be prevented annually.

The reduced exposure to oestrogen is probably a key factor (as pregnancy and breastfeeding reduce the amount of oestrogen, a hormone that can 'feed' cancer). The longer you breastfeed, the lower your risk.

For every 12 months of breastfeeding, your relative risk of breast cancer is reduced by 4.3 per cent, according to work by Cancer Research UK. Breastfeeding also reduces the risk of gallbladder disease by 7 per cent for each year.

A recent Swedish study also found long-term breastfeeding of one baby (more than 13 months) halved a woman's chance of rheumatoid arthritis. Even breastfeeding for a month lessened the chance by 25 per cent, although researchers were yet unable to say why.

TAKE UP WEIGHT TRAINING
As many as 70 per cent of women suffer from back pain some time in their lives, according to the British Chiropractic Association.

If you suffer lower back pain, your best hope of treating it comes through weight-bearing exercise such as dumb-bells and bar bells.

A recent American study found a 60 per cent improvement in pain and function levels for people with chronic backache who took part in a 16-week exercise programme of resistance training (compared with just 12 per cent for those doing aerobic exercise such as jogging or walking on a treadmill).

Weight training helps strengthen the entire body, including the abdominal muscles, so providing better support for the lower back.

BEWARE OF BLOATING
It's not just unsightly and uncomfortable - a bloated stomach could indicate a real health concern such as irritable bowel syndrome, suffered by about 10 per cent of the population, according to the Gut Trust, or Crohn's disease, a chronic inflammatory disease which may require surgery and life-long management.

Crucially, it can also be a symptom of ovarian cancer - known as the silent killer - for in 70-75 per cent of cases, it has spread to other parts of the abdomen before it is detected.

But a recent study by Dr Clare Bankhead, a research lecturer in the Department of Public Health and Primary Care, found that as many as 86 per cent of women diagnosed by a specialist with ovarian cancer turned out to have had persistent distension of the abdomen - bloating - in advance of referral. Presence of persistent abdominal distension raised the risk.

HAVE SEX 200 TIMES A YEAR
American cardiologist Professor Mehmet Oz, of Columbia University, says: 'If you have more than 200 orgasms a year, you can reduce your physiologic age by six years.'

This extraordinary statistic is based on a survey looking at frequency of sex and overall health. Adds Professor Oz: 'Sexual activity... seems to offer some survival benefit.'