Risk Factors for Uterine Fibroids Among Black Women

Sleep is essential for the health and well-being of children, adolescents, and adults. Quality sleep supports emotional well-being, metabolic health, cognitive function, mental health, and cardiovascular and cerebrovascular health. Additionally, getting sufficient, high-quality sleep helps reduce the risk of fatigue-related accidents and injuries, such as motor vehicle accidents and workplace incidents.

Recommended Sleep Duration

The American Academy of Sleep Medicine (AASM) and the Sleep Research Society (SRS) recommend that adults aim for at least 7 hours of sleep each night to promote optimal health. Similarly, the National Sleep Foundation (NSF) advises adults to get 7 to 9 hours of sleep per night, with older adults requiring 7 to 8 hours.

Prevalence of Sleep Disorders and Mental Health Impacts

About one-third of the population experiences insomnia symptoms, such as difficulty falling or staying asleep. Additionally, 4% to 26% of individuals report excessive sleepiness, and 2% to 4% have obstructive sleep apnea. Insomnia is associated with a significantly increased likelihood of mental health issues; individuals with insomnia are 10 times more likely to experience clinically significant depression and 17 times more likely to experience anxiety compared to those without insomnia. Poor sleep is also linked to post-traumatic stress, eating disorders, and psychosis spectrum experiences, such as delusions and hallucinations.

Improving sleep Quality

Improving sleep quality benefits mental health, and research reports that sleep plays a causal role in mental health challenges. Better sleep positively affects future mental health, even those without clinical symptoms.

Strategies for Improving Sleep Quality

• Creating a relaxing sleep environment
• Limiting daytime naps
• Managing stress and worries
• Being mindful of food and drink choices
• Sticking to a consistent sleep schedule
• Incorporating physical activity into daily routines.

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.

Introduction

One of man’s best inventions is drugs, especially disease-specific ones. Drugs are substances other than food, which can prevent, relieve the symptoms, or cure an abnormality or disease. Globally, the cost of drugs has soared over the years, resulting in a situation whereby low-income earners are unable to buy branded medications. In underdeveloped and developing countries where food and drug agencies have poor capacity to perform their regulatory functions optimally, we tend to see the proliferation of substandard or fake drugs. So many times, this ugly trend is energized by not just greed but by the market demands for affordable medications.

Why Medication exceeds expiry date

 To mitigate the challenge of not being able to buy drugs, when necessary, people from resource-limited settings stack up some essential medications in their homes, which eventually exceed the best before or expiry dates on them. Sometimes, doctors could change a patient’s prescription because of reactions, allergies, or inability to purchase the drug, which could result in leftover drugs that eventually exceed the expiration date. Also, big pharmacies and patent-drug stores cannot sell all their stock, leading to the expiration of some drugs. This situation has raised many questions about the safety of these drugs after their expiration or beyond the “best before” date. Because of the importance of drugs and the health risks involved when taken wrongly, people have always consciously discarded unused drugs when it’s past the expiration date, even one day.

How Safe is a drug after the expiry date?

The debate about drugs being safe after their expiration date has persisted over the years, as many people still hold the opinion that pharmaceutical companies deliberately label their drugs with short shelf lives to guarantee steady patronage. Eventually, most of these unused drugs are discarded. The context that drugs can still be safe for a long time after expiration has gained several affirmations. In a recent study by Benjamin Davido and others titled ‘Efficacy of Expired Antibiotics: A Real Debate in the Context of Repeated Drug Shortages’ published in MDPI Journal “Antibiotics”, it was reported that when appropriately stored in line with the expected conditions, no expired antibiotics tested failed to be potent after one year of expiration. In another study by Sushil Sharma and others, titled ‘A study to investigate the chemical potency, physical stability, and efficacy of analgesic agents over a period of two years post their expiry date’ published in the “Medical Journal Armed Forces India”, it was seen that drugs such as Diclofenac, Piroxicam, and Ibuprofen retained their stability, analgesic efficacy, chemical active ingredients and by implication their potency up to a duration of two years after expiration.

Important factors to consider

However, the issues of proper storage and handling can play a big role, especially in the tropical climate of West Africa and other geographical regions. Hence, people in the tropics may have to rely on their capacity to store their drugs in the required condition in deciding whether to use a drug past the expiration date or not.

Conclusion

This article doesn’t advocate for the use of expired medication but to reduce anxiety about accidental use. It is essential to understand factors that impact drug stability.

(Written by Ebenezer Dic-Ijiewere PhD.)

NB: Always consult your healthcare professionals regarding expired medications to ensure medication safety and effectiveness.

Our connections with family, friends, and colleagues are crucial. Individuals who have strong social connections and supportive relationships are more likely to adopt healthy lifestyles and effectively cope with stress, anxiety, and depression, especially during difficult times. A supportive network of family members, close friends, and colleagues provides a sense of belonging and emotional support.

  Ways to create meaningful impacts are;

1.Showing kindness: Providing a listening ear, checking in on them, offering assistance, or simply sharing a smile can profoundly influence the overall well-being of others.

2. Promoting physical activity: Encouraging others to participate in physical activities such as organizing sports events, walking or running together, or engaging in group activities can enhance physical and social well-being.

3. Spreading awareness and education: Educating others about healthy lifestyle choices, including proper nutrition, exercise, and stress management, can empower them to make positive life changes.

4. Promoting a healthy diet: Sharing recipes, discussing healthy eating habits, organizing cooking classes, and advocating for nutritious foods can encourage healthier dietary choices.

5. Supporting access to healthcare: Being present for others during difficult times is crucial and can significantly improve their lives. Providing transportation to healthcare facilities encourages them to seek professional help when needed, and assisting with paperwork can make access easier.

6. Advocating for policy changes: Supporting policies and initiatives that promote public health, such as mental health services, water regulation, and access to healthcare, can have a broad impact on the well-being of entire communities.

7. Assisting those with chronic illnesses: Offering understanding and support to individuals with chronic health conditions can help them manage their conditions and enhance their quality of life.

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/