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Women’s Health: Beyond the 
Noise 
Stephan Esser MD, USPTA
Disclosures 
• I am NOT a woman 
• I have never been a woman 
• I will NEVER fully understand women
Women’s Health?
What Matters 
• Health 
– Breast/Ovarian/Uterine 
– Heart 
– Stress 
– Osteoporosis Other: Amazing things 
• Image: 
– Clothes/Skin/Image 
– Body Type/Shape 
– Exercise Types
Goals 
• What Kills Women 
• What Sickness affects Women 
• What Stresses Women 
• What do Women Prioritize 
How Plant Based 
Nutrition is Part of the 
How Plant Based 
Nutrition is Part of the 
Answer 
Answer
1 in 4 Women will die of Heart 
1 in 4 Women will die of Heart 
Disease 
Disease
Obesity 
3322--5500%%
12.2 
High Blood Pressure 
38.4 
54.1 
70.8 
24.4 
38.8 
53.2 
65.4 64.6 
6.6 
90 
80 
70 
60 
50 
40 
30 
20 
10 
pre Prevalence of high blood pressssuurree iinn AAdduullttss aaggee 2200 aanndd oollddeerr,, bbyy aaggee aanndd sseexx 
((NNHHAANNEESS:: 22000033--22000066)).. SSoouurrccee:: NNCCHHSS aanndd NNHHLLBBII.. 
77.3 
16.2 
0 
20-34 35-44 45-54 55-64 65-74 75+ 
Percent of Population 
Men Women
1155%%
Cancer deaths per year
Cancer Risk 
Total 
1:3 
BBrreeaasstt 11::88 
UUtteerruuss 11::3377 
CCeerrvviixx 11::111177
Obesity
Plants and Risk of…… 
• Obesity 
– Health aspects of vegetarian diets JT Dwyer 1988 
– Diet and body mass index in 38 000 EPIC-Oxford 
meat-eaters, fish-eaters, vegetarians and vegans 
International Journal of Obesity (2003) 27, 728–734. 
•Vegans had the lowest weight gain per year 
•Least weight gain was in those who adopted 
more plant based eating during the time 
•Vegans had the lowest weight gain per year 
•Least weight gain was in those who adopted 
more plant based eating during the time
Heart Disease
Plants and Risk of…… 
• Heart Disease 
– Inc plants = Lower Heart disease risk 
No Face, no No Face, no MMootthheerr == NNoo CChhoolleesstteerrooll 
• Reduced Cholesterol: LDL/Trigl and Tchol 
• If Unprocessed = < Na 
– Eg: Total Calories > Total mg Na 
• Inc Fiber/Phytonutrients = Powerful protective effects 
– Blood Vessels 
– Intestinal Tract 
– Kidneys 
BBrraacchhiiaall AArrtteerryy IInnddeexx
Diabetes
Diabetes 
• Does a vegetarian diet reduce the occurrence of 
diabetes? American Journal of Public Health, Vol. 75, Issue 5 507-512 
– 25,698 adult White Seventh-day Adventists identified in 1960 followed for 21 years 
– vegetarians had a substantially lower risk than non-vegetarians of diabetes as an 
underlying or contributing cause of death 
• Fruit and Vegetable Consumption and Diabetes 
Mellitus Incidence among U.S. Adults Preventive Medicine Vol 32 Iss 
1 January 2001. Pages 33-39 
– Appr. 10, 000 participants, highest fruit and vegetable consumption = lowest risk of 
T2D 
• Dietary Patterns and the Incidence of Type 2 
Diabetes Am. J. Epidemiol. (2005) 161 (3): 219-227. 
– 4,000 Finnish en and women, followed 23 years 
– Highest consumption of fruits/vegetables in prudent diet resulted in decreased risk
A Low-Fat Vegan Diet Improves Glycemic Control 
and Cardiovascular Risk Factors in a Randomized 
Clinical Trial in Individuals With Type 2 Diabetes 
Diabetes Care August 2006 vol. 29 no. 8 1777-1783 
– 100 people randomized vegan vs ADA diet 22 weeks 
– 43% VG 26% ADA reduced diabetes medications. 
– HbA1c (A1C)  0.96 points VG 0.56 points in the ADA group 
– Excluding those who changed medications, A1C fell 1.23 
points in the vegan group compared with 0.38 points in the 
ADA group 
– Body weight  6.5 kg VG and 3.1 kg ADA 
– LDL cholesterol  21.2% in the vegan group and 10.7% in 
the ADA group (P = 0.02). 
– urinary albumin reductions 15.9 mg/24h VG than in the ADA 
group 10.9 mg/24 h
A low-fat vegan diet and a conventional diabetes 
diet in the treatment of type 2 diabetes: a 
randomized, controlled, 74-wk clinical trial 
Clin Nutr May 2009 vol. 89 no. 5 1588S-1596S 
Weight loss was significant within each diet group but not significantly different between groups 
(−4.4 kg in the vegan group and −3.0 kg in the conventional diet group, P = 0.25) and related 
significantly to Hb A1c changes (r = 0.50, P = 0.001). Hb A1c changes from baseline to 74 wk 
or last available values were −0.34 and −0.14 for vegan and conventional diets, respectively 
(P = 0.43). Hb A1c changes from baseline to last available value or last value before any 
medication adjustment were −0.40 and 0.01 for vegan and conventional diets, 
respectively (P = 0.03). In analyses before alterations in lipid-lowering medications, total 
cholesterol decreased by 20.4 and 6.8 mg/dL in the vegan and conventional diet 
groups, respectively (P = 0.01); LDL cholesterol decreased by 13.5 and 3.4 
mg/dL in the vegan and conventional groups, respectively (P = 0.03).Conclusions: Both diets 
were associated with sustained reductions in weight and plasma lipid concentrations. In an 
analysis controlling for medication changes, a low-fat vegan diet appeared to improve 
glycemia and plasma lipids more than did conventional diabetes diet recommendations. 
Whether the observed differences provide clinical benefit for the macro- or microvascular 
complications of diabetes remains to be established.
Toward Improved Management of NIDDM: A 
Randomized, Controlled, Pilot Intervention 
Using a Low-fat, Vegetarian Diet 
Preventive Medicine, Volume 29, Number 2, August 1999 , pp. 87-91(5) 
28% mean reduction in fasting serum glucose of the 
experimental group, from 10.7 to 7.75 mmol/L (195 
to 141 mg/dl), was significantly greater than the 12% 
decrease, from 9.86 to 8.64 mmol/L (179 to 157 
mg/dl), for the control group (P < 0.05). The mean 
weight loss was 7.2 kg in the experimental group, 
compared to 3.8 kg for the control group (P < 0.005).
Cancer
Plants and Risk of…… 
• Cancers 
– Vegans have a lower risk of Cancer Vegetarian Diets and the Incidence of 
Cancer in a Low-risk Population Cancer Epidemiol Biomarkers Prev February 2013 22; 286 
– Red and Processed Meat Intake increase risk of: 
• Colon Cancer: Meat consumption and risk of colorectal cancer: A meta-analysis of prospective studies 
International Journal of Cancer 2006 
• Breast Cancer: Meat consumption and risk of breast cancer in the UK Women's Cohort Study British 
Journal of Cancer (2007) 96, 1139–1146 
• Lung Cancer: Meat consumption and risk of lung cancer; a case-control study from Uruguay Lung 
Cancer 1996 
• Uterine Cancer: Diet, Body Size, Physical Activity, and the Risk of Endometrial Cancer1Cancer Res 
November 15, 1997 57; 507
•Other
Plant Based Nutrition and… 
• Athletic Performance 
• Accelerate Recovery/Reduce Muscle 
Damage/Fatigue/Oxidative Stress and Pain 
– Blueberries: Effect of NewZealand blueberry consumption.Journal of the International Society of Sports Nutrition 2012 
– Tart Cherries: The role of cherries in exercise and health Scandinavian Journal of Medicine & 
Science in Sports 2014 
– Purple Sweet Potato Leaves: Effect of purple sweet potato leaves consumption on 
exercise-induced oxidative stress and IL-6 and HSP72 levels Journal of Applied Physiology 2010 
– Ginger: Effects of ginger (Zingiber officinale Roscoe) supplementation and resistance training on 
some blood oxidative stress markers in obese men Journal of Exercise Science & Fitness 2014 
• Plants appear to have a positive affect
Plant Based Nutrition and…. 
• Premenstrual Symptoms 
Arachidonic Acid 
• Water retention, weight gain, Moodiness, 
Dysmennorhea 
 
– Diet and Sex-Hormone Binding Globulin, Dysmenorrhea, and Premenstrual Symptoms 
Obstetrics & Gynecology 2000 
– Soy, fat and other dietary factors in relation to premenstrual symptoms in Japanese 
women BJOG 2004 
– Anecdote 
Arachidonic Acid 
 
Prostaglandins 
Prostaglandins 
PGf2α 
PGf2α 
CCooxx 1 1-2-2
Plant Based Nutrition and….. 
• Menopause 
• Average Age: 51 
– Reduction in Hot Flashes/Vaginal Dryness 
• Short-term Effects of Phytoestrogen-rich Diet on Postmenopausal Women Menopause 1997
Plant Based Nutrition and… 
• Gallstones 
– Fruit and Vegetable Consumption and Risk of Cholecystectomy 
in Women The American Journal of Medicine 2006 
– ½ of the risk 
• Dietary factors in the aetiology of gall stones: a case 
control study. Gut 1988 
– No benefit 
• The effect of alcohol, tobacco and caffeine 
consumption and vegetarian diet on gallstone 
prevalence European Journal of Gastroenterology & 
Hepatology 2010
• Conclusion
Conclusion 
• Plant Based Nutrition 
• Reduces the Risk of 
– Obesity 
– Heart Disease: High Blood Pressure/High Cholesterol 
– Most Cancers 
– Diabetes 
– Gallstones..? 
• Enhances 
– Athletic Performance 
• May Improve 
– Premenstrual/Postmenopausal Symptoms
Conclusion 
• Whole Food Plant Based Nutrition 
– Can make you… 
• Feel Lighter 
• Feel Cleaner 
• Look “brighter” 
• Smell Better 
• Taste Better 
• 
Plant Based Nutrition 
• To maximize health and vitality 
• To reduce primary disease risk 
• To engage life most fully
wwwwww..EEsssseerrHHeeaalltthh..ccoomm
Thank You!

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Women's Health: Beyond The Noise

  • 1. Women’s Health: Beyond the Noise Stephan Esser MD, USPTA
  • 2. Disclosures • I am NOT a woman • I have never been a woman • I will NEVER fully understand women
  • 4. What Matters • Health – Breast/Ovarian/Uterine – Heart – Stress – Osteoporosis Other: Amazing things • Image: – Clothes/Skin/Image – Body Type/Shape – Exercise Types
  • 5. Goals • What Kills Women • What Sickness affects Women • What Stresses Women • What do Women Prioritize How Plant Based Nutrition is Part of the How Plant Based Nutrition is Part of the Answer Answer
  • 6. 1 in 4 Women will die of Heart 1 in 4 Women will die of Heart Disease Disease
  • 8. 12.2 High Blood Pressure 38.4 54.1 70.8 24.4 38.8 53.2 65.4 64.6 6.6 90 80 70 60 50 40 30 20 10 pre Prevalence of high blood pressssuurree iinn AAdduullttss aaggee 2200 aanndd oollddeerr,, bbyy aaggee aanndd sseexx ((NNHHAANNEESS:: 22000033--22000066)).. SSoouurrccee:: NNCCHHSS aanndd NNHHLLBBII.. 77.3 16.2 0 20-34 35-44 45-54 55-64 65-74 75+ Percent of Population Men Women
  • 10.
  • 12. Cancer Risk Total 1:3 BBrreeaasstt 11::88 UUtteerruuss 11::3377 CCeerrvviixx 11::111177
  • 14. Plants and Risk of…… • Obesity – Health aspects of vegetarian diets JT Dwyer 1988 – Diet and body mass index in 38 000 EPIC-Oxford meat-eaters, fish-eaters, vegetarians and vegans International Journal of Obesity (2003) 27, 728–734. •Vegans had the lowest weight gain per year •Least weight gain was in those who adopted more plant based eating during the time •Vegans had the lowest weight gain per year •Least weight gain was in those who adopted more plant based eating during the time
  • 16. Plants and Risk of…… • Heart Disease – Inc plants = Lower Heart disease risk No Face, no No Face, no MMootthheerr == NNoo CChhoolleesstteerrooll • Reduced Cholesterol: LDL/Trigl and Tchol • If Unprocessed = < Na – Eg: Total Calories > Total mg Na • Inc Fiber/Phytonutrients = Powerful protective effects – Blood Vessels – Intestinal Tract – Kidneys BBrraacchhiiaall AArrtteerryy IInnddeexx
  • 18. Diabetes • Does a vegetarian diet reduce the occurrence of diabetes? American Journal of Public Health, Vol. 75, Issue 5 507-512 – 25,698 adult White Seventh-day Adventists identified in 1960 followed for 21 years – vegetarians had a substantially lower risk than non-vegetarians of diabetes as an underlying or contributing cause of death • Fruit and Vegetable Consumption and Diabetes Mellitus Incidence among U.S. Adults Preventive Medicine Vol 32 Iss 1 January 2001. Pages 33-39 – Appr. 10, 000 participants, highest fruit and vegetable consumption = lowest risk of T2D • Dietary Patterns and the Incidence of Type 2 Diabetes Am. J. Epidemiol. (2005) 161 (3): 219-227. – 4,000 Finnish en and women, followed 23 years – Highest consumption of fruits/vegetables in prudent diet resulted in decreased risk
  • 19. A Low-Fat Vegan Diet Improves Glycemic Control and Cardiovascular Risk Factors in a Randomized Clinical Trial in Individuals With Type 2 Diabetes Diabetes Care August 2006 vol. 29 no. 8 1777-1783 – 100 people randomized vegan vs ADA diet 22 weeks – 43% VG 26% ADA reduced diabetes medications. – HbA1c (A1C)  0.96 points VG 0.56 points in the ADA group – Excluding those who changed medications, A1C fell 1.23 points in the vegan group compared with 0.38 points in the ADA group – Body weight  6.5 kg VG and 3.1 kg ADA – LDL cholesterol  21.2% in the vegan group and 10.7% in the ADA group (P = 0.02). – urinary albumin reductions 15.9 mg/24h VG than in the ADA group 10.9 mg/24 h
  • 20. A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, 74-wk clinical trial Clin Nutr May 2009 vol. 89 no. 5 1588S-1596S Weight loss was significant within each diet group but not significantly different between groups (−4.4 kg in the vegan group and −3.0 kg in the conventional diet group, P = 0.25) and related significantly to Hb A1c changes (r = 0.50, P = 0.001). Hb A1c changes from baseline to 74 wk or last available values were −0.34 and −0.14 for vegan and conventional diets, respectively (P = 0.43). Hb A1c changes from baseline to last available value or last value before any medication adjustment were −0.40 and 0.01 for vegan and conventional diets, respectively (P = 0.03). In analyses before alterations in lipid-lowering medications, total cholesterol decreased by 20.4 and 6.8 mg/dL in the vegan and conventional diet groups, respectively (P = 0.01); LDL cholesterol decreased by 13.5 and 3.4 mg/dL in the vegan and conventional groups, respectively (P = 0.03).Conclusions: Both diets were associated with sustained reductions in weight and plasma lipid concentrations. In an analysis controlling for medication changes, a low-fat vegan diet appeared to improve glycemia and plasma lipids more than did conventional diabetes diet recommendations. Whether the observed differences provide clinical benefit for the macro- or microvascular complications of diabetes remains to be established.
  • 21. Toward Improved Management of NIDDM: A Randomized, Controlled, Pilot Intervention Using a Low-fat, Vegetarian Diet Preventive Medicine, Volume 29, Number 2, August 1999 , pp. 87-91(5) 28% mean reduction in fasting serum glucose of the experimental group, from 10.7 to 7.75 mmol/L (195 to 141 mg/dl), was significantly greater than the 12% decrease, from 9.86 to 8.64 mmol/L (179 to 157 mg/dl), for the control group (P < 0.05). The mean weight loss was 7.2 kg in the experimental group, compared to 3.8 kg for the control group (P < 0.005).
  • 23. Plants and Risk of…… • Cancers – Vegans have a lower risk of Cancer Vegetarian Diets and the Incidence of Cancer in a Low-risk Population Cancer Epidemiol Biomarkers Prev February 2013 22; 286 – Red and Processed Meat Intake increase risk of: • Colon Cancer: Meat consumption and risk of colorectal cancer: A meta-analysis of prospective studies International Journal of Cancer 2006 • Breast Cancer: Meat consumption and risk of breast cancer in the UK Women's Cohort Study British Journal of Cancer (2007) 96, 1139–1146 • Lung Cancer: Meat consumption and risk of lung cancer; a case-control study from Uruguay Lung Cancer 1996 • Uterine Cancer: Diet, Body Size, Physical Activity, and the Risk of Endometrial Cancer1Cancer Res November 15, 1997 57; 507
  • 25. Plant Based Nutrition and… • Athletic Performance • Accelerate Recovery/Reduce Muscle Damage/Fatigue/Oxidative Stress and Pain – Blueberries: Effect of NewZealand blueberry consumption.Journal of the International Society of Sports Nutrition 2012 – Tart Cherries: The role of cherries in exercise and health Scandinavian Journal of Medicine & Science in Sports 2014 – Purple Sweet Potato Leaves: Effect of purple sweet potato leaves consumption on exercise-induced oxidative stress and IL-6 and HSP72 levels Journal of Applied Physiology 2010 – Ginger: Effects of ginger (Zingiber officinale Roscoe) supplementation and resistance training on some blood oxidative stress markers in obese men Journal of Exercise Science & Fitness 2014 • Plants appear to have a positive affect
  • 26. Plant Based Nutrition and…. • Premenstrual Symptoms Arachidonic Acid • Water retention, weight gain, Moodiness, Dysmennorhea  – Diet and Sex-Hormone Binding Globulin, Dysmenorrhea, and Premenstrual Symptoms Obstetrics & Gynecology 2000 – Soy, fat and other dietary factors in relation to premenstrual symptoms in Japanese women BJOG 2004 – Anecdote Arachidonic Acid  Prostaglandins Prostaglandins PGf2α PGf2α CCooxx 1 1-2-2
  • 27. Plant Based Nutrition and….. • Menopause • Average Age: 51 – Reduction in Hot Flashes/Vaginal Dryness • Short-term Effects of Phytoestrogen-rich Diet on Postmenopausal Women Menopause 1997
  • 28. Plant Based Nutrition and… • Gallstones – Fruit and Vegetable Consumption and Risk of Cholecystectomy in Women The American Journal of Medicine 2006 – ½ of the risk • Dietary factors in the aetiology of gall stones: a case control study. Gut 1988 – No benefit • The effect of alcohol, tobacco and caffeine consumption and vegetarian diet on gallstone prevalence European Journal of Gastroenterology & Hepatology 2010
  • 30. Conclusion • Plant Based Nutrition • Reduces the Risk of – Obesity – Heart Disease: High Blood Pressure/High Cholesterol – Most Cancers – Diabetes – Gallstones..? • Enhances – Athletic Performance • May Improve – Premenstrual/Postmenopausal Symptoms
  • 31. Conclusion • Whole Food Plant Based Nutrition – Can make you… • Feel Lighter • Feel Cleaner • Look “brighter” • Smell Better • Taste Better • 
  • 32. Plant Based Nutrition • To maximize health and vitality • To reduce primary disease risk • To engage life most fully

Editor's Notes

  1. Unfortunately 1 million plus American’s die from cancer every year as well. And of these you can see the break down on the side. Notice the distribution. Although breast cancer was far more common than Lung cancer, lung cancer tends to be much more aggressive cancer and causes greater mortality as a result.
  2.  Probability of Developing Invasive Cancers Within Selected Age Intervals by Gender, United States, 1996-1998a