Risk Factors for Uterine Fibroids Among Black Women

Overview of Stress: Stress significantly affects health, contributing to disease development and burdening healthcare systems considerably. It is a significant factor in various ongoing health issues, particularly cardiovascular diseases, which are often impaired by everyday psychosocial pressures, such as work-related stress. The following are the roles of stress in disease development.

Gender Differences in Stress Responses: Gender plays a vital role in how individuals experience and manage stress. Research reports that women are more likely to develop mood disorders and autoimmune. At the same time, men tend to have higher rates of early substance abuse, infectious disease, mortality, and antisocial behavior. Unsuccessful stress management can lead to severe physical and mental health consequences for both individuals and communities.

Physiological Responses to Stress: The study reports that stressful events can trigger emotional responses such as anxiety and worry, impacting the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic-adrenal-medullary (SAM) system, which may lead to unhealthy lifestyle choices, comprising poor sleep, alcohol consumption, decreased physical activity and increased smoking thereby increase the risk of diseases.

Chronic Stress in Specific Environments: Chronic stress in educational settings and workplaces impacts mental and physical health noticeably. Also, it indicates that occupational stress significantly affects mental well-being.

Traumatic Events as a Stress Source: Traumatic events are a prevalent source of stress that affects a large portion of the population. The study reports that In North America, about 60% to 75% of individuals will experience a traumatic event in their lifetime, including serious accidents, exposure to war, sexual assault, chronic childhood abuse, or neglect.

Coronary Heart Disease (CHD) is a chronic and intricate ailment associated with substantial morbidity and mortality, primarily attributed to atherosclerotic lesions in coronary vessels, ultimately leading to myocardial infarction (MI) and stroke. Unhealthy eating habits, often influenced by chronic inflammation, are closely linked to CHD (Wu et al., 2022). Also, According to CDC (2019), various health conditions, lifestyle choices, as well as your age and family history can elevate the risk of developing heart disease; approximately 47% of Americans have at least one of the three primary risk factors for heart disease: high blood pressure, elevated cholesterol levels, and smoking. Certain risk factors for heart disease, such as age or family history, are beyond your control. However, you can proactively reduce your risk by changing the factors you can control.

Behaviors that heighten the risk for heart disease are

• Smoking: The Food & Drug Administration (FDA) estimates that cardiovascular disease causes 800,000 deaths and 400,000 premature deaths per year (Brown et al., 2023). About one-fifth and one-third of these result from smoking, respectively. Additionally, research reported that smoking resulted in a 51% increased risk of coronary heart disease in patients with diabetes (Brown et al., 2023). According to the CDC (2019), Cigarette smoking has the potential to harm the heart and blood vessels, amplifying the risk for heart conditions like atherosclerosis and heart attacks. Even nonsmokers face an increased risk of heart disease when exposed to secondhand smoke.
• Excessive alcohol consumption can elevate blood pressure and elevate the risk of heart disease. It also leads to increased triglyceride levels, a fatty substance in the blood associated with an elevated risk of heart disease.
• Sedentary lifestyle: Insufficient physical activity is a precursor to heart disease and can strengthen the likelihood of other medical conditions that serve as risk factors, including obesity, high blood pressure, high cholesterol, and diabetes. Engaging in regular physical activity can effectively decrease the risk of heart disease.
• Unhealthy Eating Habits: A diet rich in saturated fats, trans fats, and cholesterol has been associated with heart disease and related conditions like atherosclerosis (CDC,2019). Recent research has provided more explicit evidence that trans-fat significantly raises the risk of cardiovascular disease by adversely affecting lipids, endothelial function, insulin resistance, and inflammation. For each 2% increase in calories consumed from trans-fat, there is a 23% higher risk of coronary artery disease (Brown et al., 2023). Recent studies and systematic reviews have focused on red and processed meat consumption. The research consistently demonstrates an increased risk of coronary heart disease and cardiovascular events. The risk ranges from 15% to 29% higher with red meat consumption and 23% to 42% higher with processed meat consumption (Brown et al., 2023).

Measures for Reducing the Risk of Coronary Heart Disease

•  Educating children and adolescents about the dangers of smoking to deter the initiation of tobacco use. The Food & Drug Administration (FDA) reported that the risk of coronary artery disease decreases to the level of lifetime nonsmokers within four years of quitting and within ten years. 
• The DASH, Mediterranean, and vegetarian diets have the most evidence for cardiovascular disease prevention. The DASH diet has been shown to lower systolic blood pressure by up to 11.5 mmHg in adults with hypertension. Additionally, reported findings indicate a 21% reduction in coronary artery disease risk with adopting the DASH diet (Brown et al., 2023).
•  The American Heart Association suggests substituting saturated fat with polyunsaturated and monounsaturated fats. A 5% shift from saturated fat to polyunsaturated fat consumption is linked to a 10% lower risk of coronary artery disease (Brown et al., 2023).
• Engaging in about 150 minutes per week of moderate-intensity aerobic activity significantly lowers the risk of cardiovascular disease. Moderate-intensity aerobic exercise is characterized by activity that maintains a heart rate between 50 to 70 percent of the individual’s maximum heart rate, calculated as 220 beats per minute minus the person’s age (Brown et al., 2023).

Citations

Wu, L., Shi, Y., Kong, C., Zhang, J., & Chen, S. (2022). Dietary Inflammatory Index and Its Association with the Prevalence of Coronary Heart Disease among 45,306 US Adults. Nutrients, 14(21), 4553. https://doi.org/10.3390/nu14214553

CDC. (2019, December). Know Your Risk for Heart Disease | cdc.gov. Centers for Disease Control and Prevention. https://www.cdc.gov/heartdisease/risk_factors.htm#print

Brown, J. C., Gerhardt, T. E., & Kwon, E. (2023, January 23). Risk Factors For Coronary Artery Disease. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK554410/

Uterine fibroids (UFs) are the most common benign tumors found in women of reproductive age, with a disproportionate impact on women of color. These disparities are believed to be combined with environmental, genetic, and socio-economic factors.

 Some of the lifestyle changes that can help prevent or reduce the development of uterine fibroids are;

1. Decreasing Alcohol consumption: It’s advised that women decrease their alcohol consumption to reduce the risk of developing uterine fibroids (UFs). Studies have reported an association between alcohol intake and an increased likelihood of UFs. Studies believe that alcohol may alter hormone levels and disrupt hormonal balance, contributing to the formation of UFs. It is advisable to consult with a healthcare professional for personalized advice based on unique health occurrences. By being mindful of alcohol consumption and adhering to recommended limits, proactive steps can be taken to lower the risk of UFs.
2. Engage in at least four hours of vigorous physical activity per week: Research has found a significant association between an increased BMI and the risk of UFs. Obesity is believed to be a contributing factor to UF. Studies believe that women who engage in at least four hours of vigorous physical activity per week are more likely to encounter a decrease in the risk factors of UFs.
3. Consuming more fruits, Vegetables, and dietary fibers:  High intake of processed and refined foods, unhealthy fats, and sugary drinks, and low consumption of fruits, vegetables, and fiber-rich foods may contribute to hormonal imbalances, inflammation and oxidative stress, thereby encouraging the growth of UFs as indicated in the research. Additionally, a lack of fruits, vegetables, and fiber-rich foods has been reported to be associated with an elevated risk of UFs. Fruits, vegetables, and fiber-rich food are excellent sources of antioxidants, vitamins, and minerals that help combat oxidative stress and inflammation. Specifically, Dietary fiber has been indicated to have protective impacts against UFs by supporting hormonal balance and improving regular bowel movements. Hence, adopting a healthy and balanced diet with whole grains, fruits, vegetables, lean proteins, and healthy fats is essential.
4. Managing stress:  Studies have found that chronic psychological stress could increase the risk of uterine fibroids and indicated a significant link between chronic psychological stress and an elevated risk of UFs, predominantly among non-Hispanic Black women. Eating healthy, exercising regularly, getting enough sleep, relaxing, connecting with friends and family, and practicing mindfulness are some ways to manage stress.

Developing new, healthier habits could shield you against life-threatening conditions like diabetes and obesity. Creating new routines that include regular exercise and a healthy diet may also help you lose weight and feel more energized. Here are six strategies to maintain good physical and mental well-being.

1. Make regular exercise a part of your daily routine.: Regular exercise depends on maintaining a healthy weight, building stronger bones and muscles, and enhancing cardiovascular health. On most days of the week, try to get at least 30 minutes of moderate-intensity exercise. Look for things to do that you enjoy, like biking, swimming, dancing, walking, and running.
2. Seek routine medical examinations: See your doctor regularly to ensure preventive care and early detection of potential health issues. Make regular check-up appointments with your physician and abide by their recommendation regarding tests and screenings.
3. Make getting enough sleep a priority: Your body needs rest to rejuvenate and heal. Aim for 7 to 8 hours of sound sleep every night. Make a soothing bedtime ritual, stick to a regular sleep schedule, and abstain from caffeine and screen time right before bed.
4. Manage stress effectively: Your physical and mental health may suffer if you experience persistent stress. Try healthy stress-reduction strategies, like working out, practicing relaxation, or going outside. Consider getting professional assistance if you’re struggling to manage your stress alone.
5. Establish a Support Network: Tell your loved ones, a support group, or friends about your health objectives. Support networks can offer accountability, inspiration, and encouragement. Look for a friend or workout partner who shares your health objectives to foster connections and increase the enjoyment of activities.
6. Prioritize a wholesome diet: Achieve this by managing a healthy weight, enhancing your immune system, and relying on a well-balanced, nutrient-rich diet to supply your body with the essential nutrients needed for optimal functioning.

Limit processed foods, sugar-filled beverages, and high amounts of unhealthy and saturated fats. Instead, concentrate on eating abundant fruits, vegetables, and whole grains.

Research reports that American women are disproportionately affected, with the highest obesity rates among all groups in the U.S. About 80% are classified as overweight or obese.

Disparities in weight loss

Research indicates that African American (AA) women tend to lose less weight compared to their Caucasian counterparts.

Contributing Factors

The contributing factors to the disparities are;

• Limited access to nutritious food
• Inadequate health insurance
• Lack of safe spaces for physical activity

Barriers to Weight Management

Challenges that hinder weight management efforts include:

• Personal beliefs
• Limited time
• Family dynamics
• Lack of motivation
• Financial constraints

Cultural Influence on Body Image

Cultural norms within the AA community, which often embrace larger body sizes and promote a positive body image, can also influence health behaviors. While fostering a positive body image has psychological benefits, it may reduce motivation to maintain a healthy weight. In Black culture, obesity and being overweight are often considered acceptable and carry little to no stigma. Cultural perspective may partially explain why general health promotion efforts are less effective in this community. The study reports that many Black female students aim to embody the culturally valued “thick and curvy” figure, consuming specific foods to shape their bodies while avoiding activities that might result in weight loss.

Why it may be difficult to seek care

A deep-rooted distrust of the healthcare system makes it difficult for many AA women to seek medical advice or treatment.

Physical inactivity as a health risk factor

Underestimating body weight can reduce engagement in healthy behaviors, such as regular physical activity. Physical inactivity is a major contributor to non-communicable diseases and mortality, emphasizing the need to address these issues within the AA community.

As we know, obesity stands as a significant health concern affecting the lives of African Americans. It is imperative to grasp the barriers that contribute to the rising rates of obesity within this population.

Obesity is characterized by excessive body fat accumulation influenced by environmental and genetic factors and poses various health risks, including specific cancers, type 2 diabetes, hypertension, osteoarthritis, hyperlipidemia, and cardiovascular disease. Omondi & Freysteinson (2023) estimated annual medical expenses related to obesity issues in the United States to be around $147 billion. Research reveals that obesity prevalence is notably high among African Americans, with rates around 49.6%, surpassing non-Hispanic Whites at 42.2%. Mainly, obesity rates are higher among African American women, reaching 56.9%, compared to 41.1% among African American men (Lofton et al., 2023).

Access to nutritious foods is limited for African Americans, who often consume less nutritious diets with high levels of added sugars and fried foods. Multiple obstacles hinder healthy eating habits, including limited knowledge, the cost of nutritious foods, time constraints for meal preparation, reliance on transportation to access stores, and communication barriers with healthcare providers regarding dietary habits.

Similarly, opportunities for physical activity are restricted, exacerbating the obesity issue. Reduced physical activity levels and increased sedentary behaviors like gaming or screen time have been associated with higher body mass index (BMI). African Americans facing obesity encounter various challenges in engaging in physical activity, including a lack of awareness regarding effective exercise methods, limited access to affordable exercise programs, inadequate facilities, transportation limitations, and health concerns.

References

Omondi, H., & Freysteinson, W. M. (2023). Understanding Obesity in African American Women Using Leininger’s Theory. Nursing Science Quarterly, 37(1), 71–75. https://doi.org/10.1177/08943184231207383

Lofton, H., Ard, J. D., Hunt, R. R., & Knight, M. G. (2023). Obesity among African American people in the United States: A review. Obesity, 31(2), 306–315. https://doi.org/10.1002/oby.23640

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