Can women expect to live healthier, longer lives than previous generations or is modern living taking a toll all of its own on the health of Britain’s female population? 

Modern medicine means we’re better equipped than ever to do battle against lifethreatening illnesses. Living longer has been one of the wonders of the last century or so, and women still have the lead on men in having a longer average life expectancy than them. But although this is good news, there is much work to be done in improving women’s health, with one particular cause for concern among health experts being the expansion of women’s waistlines.

Various newspaper headlines have blared the news that British women are among the largest in Europe. “The average female waist has increased by over six inches in the last 60 years,” says Tam Fry, spokesperson for the National Obesity Forum. “To put perspective on the speed at which the obesity epidemic is rising, two of those six inches have been added in the last decade.” This is a “truly tragic” state of affairs, he says, because fat sitting around the tummy can trigger a number of diseases, including type 2 diabetes and heart disease.

Excess weight is also linked to an increased risk of several types of cancer, including cancers of the breast (in postmenopausal women), bowel and womb. Indeed, women who go up a skirt size every 10 years from their mid-20s onwards have a 33 per cent increased risk of breast cancer after their menopause, researchers at University College London reported recently. Being overweight appears to be increasingly regarded as the norm, however. A recent Cancer Research UK study, published in BMJ Open, found that the majority of obese people in Britain would not describe themselves as ‘obese’ and many wouldn’t even describe themselves as being ‘very overweight’.

Fewer than 10 per cent of those who were clinically obese accepted that they had a serious weight problem, the study found. As bigger sizes become the new ‘normal’, people are less likely to recognise that they are at increased risk of a number of health problems because of their weight, the researchers warned. The chief medical officer for England, Professor Dame Sally Davies, has also voiced her concerns that ‘size inflation’ means that clothes with the same size label have become larger in the last few decades and that people may have a false idea of what being overweight is.

The average female waist has increased by over six inches in the last 60 years 

Tam believes that Professor Davies is right to be concerned. “Millions of overweight women appear oblivious to the warnings and have simply shifted up a dress size and accepted that as normal,” he says. “Men have upped their trouser size to match.” Many of the habits of modern living – including new technology – are blamed. “A lot of the increase [in weight] has to do with the ever-growing tendency to snack and graze through the day on energy dense convenience foods, such as cereal bars and shop-bought sandwiches, watching more telly and taking minimal exercise,” explains Tam. “To this sedentary lifestyle, add the convenience of labour-saving devices that have freed women from energy-burning housework.

“Research has shown that, on average, women burn up to 200 calories less per day than 50 years ago by not having to use a broom to clean the house, washing the sheets manually and slaving over a hot stove. If they are not compensating by eating less and working out more, the excess calories will stay with them.”

 

Women watch out

So what are the main health conditions posing a risk to women today? It may surprise many of your customers that the leading causes of death in the female population are coronary heart disease (CHD), stroke and dementia. Much work needs to be done in cutting the number of female lives lost to these problems. There’s a tendency for heart disease to be regarded as very much a male problem, but this misconception needs to be erased, as more women die of heart and circulatory disease every year than men.

“My feeling is that that stereotype has always been there,” says Maureen Talbot, a senior cardiac nurse at the British Heart Foundation (BHF), “and although we have done a lot of work to raise awareness around the fact that it is a big issue for women too, there is no denying, from the calls that we get to our helpline, that the misconception still exists and that many women don’t realise that heart disease is something that can happen to women.” The BHF says that CHD kills nearly three times more women than breast cancer and that there are more than 900,000 women living with CHD in the UK.

However, because many women don’t realise that they can be at risk from heart disease, they may be slow to pick up on symptoms and so delay getting help. The fact that heart disease is a problem that affects women isn’t new, but modern living appears to be fuelling the problem. “Fewer women are dying from heart disease than they did 50 years ago, but heart disease is still a big issue for women and this is because the risk factors have changed,” says Maureen. “Fifty years ago, more women were dying of heart disease because many women smoked and also there were no treatments available when they had a heart attack. Now, women are more likely to develop heart disease because, apart from smoking, they are also obese or overweight or have high cholesterol and are physically inactive.”

By eating healthily, maintaining a healthy weight, being active and not smoking, most people can significantly reduce their risk of heart disease, she says. “Women can do a lot to protect their heart health, and ideally they should be learning to think about their heart health while still at school.”

Making healthy choices may have a positive impact on health as we age

At a stroke

Misconceptions about the risk of stroke is also an issue that women need to address. Stroke is the third leading cause of death in women in the UK, but a poll carried out by the Stroke Association for World Stroke Day last October found that one in eight women in the UK wrongly believe that a stroke could never happen to them. The Stroke Association says that one in five women will have a stroke in their lifetime and that 61 per cent of all stroke deaths are among females.

It wants to see women of all ages being more aware and better informed of the steps they can take to reduce their risk of stroke. Each year, more women have strokes than men, says Dr Madina Kara, research awards manager at the Stroke Association. This is partly because the risk of stroke increases as we get older and women generally live longer than men.

“However, there are also a number of stroke risk factors unique to women, including pregnancy, birth control pills and hormone replacement therapy (HRT),” she says. Statistics show that strokes now happen to men and women at a younger age than previously, too. “There is speculation that this rise could be down to the prevalence of diabetes, unhealthy cholesterol levels, obesity and cigarette smoking,” says Dr Kara.

“It is thought up to 80 per cent of all strokes can be prevented by living a healthy lifestyle.” Simple lifestyle changes, such as keeping blood pressure under control, taking regular exercise and stopping smoking can significantly lower women’s likelihood of having a stroke, says Dr Kara. “Smoking alone doubles a person’s risk of stroke and 53 per cent of UK smokers are female.” Recent research published in the online edition of Neurology, the medical journal of the American Academy of Neurology, suggested that having a healthy diet and lifestyle – including moderate alcohol consumption, never smoking, being physically active and having a healthy body mass index – could reduce a woman’s chances of having a stroke by half.

 

Surprising figures

Making healthy lifestyle choices could also help to reduce the risk from another big issue for women and their health – dementia. Recent figures from the Office for National Statistics show that dementia is the leading cause of death in women in England and Wales. This came as a surprise to some, not least because dementia has tended to be regarded as an inevitable part of ageing rather than a disease in itself.

As Gavin Terry, policy manager at the Alzheimer’s Society, comments: “For too long, dementia has been wrongly seen by many clinicians as a natural part of ageing and, as such, they have failed to record it as a cause of death. Increasing awareness of the condition has started to combat this, and these figures are likely to be a product of that.” The fact that we are now living longer also plays a part. “Age is the biggest risk factor in the development of dementia and women do tend to live longer than men,” says Jessica Smith, research officer at the Alzheimer’s Society.

“This is mirrored in the findings that dementia is the leading cause of death in women and third in men.” Age is not the only risk factor, however. Research has identified other risk factors, including obesity, high blood pressure and high cholesterol. “Considerable research suggests that what is good for your heart is also good for your head,” says Jessica. “The best way to reduce the risk of developing the condition is to exercise regularly, eat a Mediterranean diet and not to smoke.”

Women (and men) would be wise to pay heed to this advice sooner in life rather than later. “Mid-life lifestyle factors may play a role in determining risk,” warns Jessica. “There is a lot of evidence pointing to the fact that the pathology of dementia starts to develop many years, possibly even decades, before people experience symptoms. We have yet to see how mid-life risk factors today will affect the number of people developing the condition in the future.”

Only time will tell what impact modern lifestyles will have on women’s long-term health, but by making healthy choices, women can reduce their risk of life-shortening diseases it seems, with the back up of modern medicines that their greatgrandmothers could have only dreamed of.

 

Signposting

• The Stroke Association
• Alzheimer's Society National Dementia Helpline: 0300 222 11 22 helpline@alzheimers.org.uk.