Women

1
Womens Health Initiative

• Linda Snetselaar, PhD, RD
• Professor
• Interim Chair of the Department of Community and
  Behavioral Health
• College of Public Health
• University of Iowa

2
Background

• 15- year, 625 million national health study
  funded by NHLBI
• Focused on chronic disease prevention in
  postmenopausal women of all races
• Heart disease
• Breast cancer
• Colorectal cancer
• Osteoporotic fractures
• 161,808 women aged 50-79

3
WHI Sites

• 40 clinics throughout the US
• Three locations in Iowa
• Iowa City
• Davenport
• Des Moines

4
Two Main Study Components

• Randomized clinical trial
• 3 prevention strategies-women could enroll in any
  or all (if eligible)
• Hormone therapy
• Dietary modification
• Calcium and Vitamin D
• Observational study
• Examines relationships between lifestyle, health,
  risk factors, and disease outcomes

5
Hormone Therapy Trials

• Estrogen plus progestin
• Estrogen alone
• Placebo
• Hormone groups stopped treatment early, but all
  participants continued to be followed until the
  end of the study

6
Dietary Modifications (DM) Trial

• Evaluated impact of diet on prevention of breast
  and colorectal cancer and heart disease
• Low fat
• High fruit
• High vegetable
• High grain

7
DM Comparison Group

• Follow regular eating habits
• Keep a food record a few days each year
• Attend a clinic visit one time each year

8
Dietary Change Group

• Attend nutrition sessions to
• Lower fat (20 kcal from fat)
• Increase fruits and vegetables
  
  
  
  
  (gt 5 servings per day)
• Increase grains
  
  
  
  
  (gt 6 servings per day)
• Frequently keep a food record
• One clinic visit per year
  
  
  
  
  

9
DM Nutrition Sessions

• The first year
• 18 nutrition classes
• Once a week for 6 weeks
• Every other week for 6 weeks
• Once a month for 9 months
• 1 clinic and 1 phone visit
• The second year and beyond
• 4 nutrition classes each year
• 1 clinic and 1 phone visit
  

10
Calcium and Vitamin D Trial

• Evaluated the effect of calcium and vitamin D
  supplementation on osteoporotic fractures and
  colorectal cancer
• Calcium and vitamin D supplements group
• Placebo group

11
Observational Study Group

• Completed questionnaires reporting changes in
  health and activities over time
• No other required study activities

12
Women's Health Initiative

• Video