I am Woman - hear me - Please!

Pediatricians are fond of saying that children are not just small adults – that their physiology and response to diseases are different. In the same way, women are not just men with different sex organs. Every cell in women is different than the corresponding cell in men, due to the difference in chromosomes.

Thus, women, as we have learned, often describe different symptoms when they are having a heart attack – and as a result, the diagnosis is often missed or delayed. Women have many more “auto-immune” diseases such as lupus and thyroiditis. Women obviously have unique diseases related to the menstrual cycle, such as endometriosis or polycystic ovary syndrome.

Women’s health issues are severely under-studied. Even though women make up 55% of patients hospitalized with acute coronary disease, they make up only 25% of participants in clinical trials of coronary disease.

Because women are considered at lower risk for coronary disease (even though as noted, they are over half the patients admitted with acute coronary symptoms), they are less likely to be prescribed statins, a proven life-saving therapy for patients with coronary disease.

Even though 70% of women take at least one prescription drug during pregnancy, only 5% of these drugs have been tested and shown safe during pregnancy.

Why this disparity? Throughout history, medical research and practices have primarily focused on men. This stems from outdated beliefs that women's health issues were either insignificant or simply variations of men's conditions. Many clinical trials specifically do not enroll women of child-bearing age, even those these same women may be given the treatments after the drugs are approved.

Women often complain of being “gas-lighted:” having their complains ignored. Unconscious biases among healthcare providers can influence the quality of care provided to women. These biases may lead to symptoms being dismissed, pain being downplayed, or concerns being trivialized, all of which can result in delayed or inadequate treatment. For the same painful conditions, women are less likely than men to be prescribed pain medication.

Certain health issues specific to women, such as menstrual disorders or menopause-related symptoms, are dismissed as "normal." This can lead to healthcare providers dismissing or minimizing these concerns, further perpetuating the cycle of inadequate care for women.

Addressing these issues requires a multi-faceted approach that includes raising awareness, advocating for gender-inclusive research and healthcare policies, providing education and training on gender-sensitive care for healthcare providers, and ensuring equitable access to healthcare services for all. By recognizing and actively working to dismantle these barriers, we can strive towards a healthcare system that provides equitable and compassionate care for everyone, regardless of gender.


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Protein - panacea or problem?

Protein is everywhere on the grocery and pharmacy shelves these days. There are protein shakes, protein bars, high protein cereals – you name it.

One reason for this emphasis on protein is that in the 1980s and 90s we were taught to fear fat, and in the 2000s we were told carbohydrates were bad – so that only leaves protein!

We do indeed need protein for health. There are a number of essential nutrients (specific amino acids) that the body does not manufacture and which come from dietary protein.

How much protein do we really need, and is too much bad for us?

The recommended amount of protein an average adult should eat is 0.8 grams per kilogram of body weight. Almost every adult in western countries gets this much or more. For an adult weighing 165 pounds, this translates to 60 Gm protein/day. If you are trying to maintain or gain muscle mass, or if pregnant or nursing, you should increase this by 25%. This would include most older adults, who often lose muscle with aging.

Protein is available from a variety of foods, with fish, fowl and meat the most obvious but far from the only or even the best source. Dairy products, eggs, beans and lentils and nuts provide quality protein, as does soy. What should you avoid? Fatty cuts of meat and most processed meats (cold cuts, sausages, bacon, hot dogs) are bad for your heart and best minimized. If you are choosing hamburger, go for the 90+% lean packages.

Since all of the foods providing protein also provide different additional nutrients that we need, balance is key. Fish provides omega-3 fatty acids; meat provides iron; dairy products provide calcium and vitamins; legumes provide fiber and minerals.

Can you eat too much protein? Clearly yes, for a few reasons. Protein is our only source of nitrogen and tends to make the body acidic; the kidneys eliminate these toxins. If you have any degree of kidney impairment, excess protein can over-tax the body’s ability to cleanse the blood. Excess animal protein can lead to kidney stones. If you increase your protein intake without increasing exercise you will probably take in too many calories and put on weight.

Most experts agree that the maximum an average adult should eat is 2 grams/Kg body weight. For our average 165 lb adult, this is 150 Gm/day. Take a look at your intake, and if you are way over this, probably wise to cut back.

And be sure to get your nutrition from a variety of sources. Protein, carbohydrates and healthy fats are all necessary for good health.


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