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Heart disease is the leading cause of death in women in Australia and has been for more than two decades. But despite ongoing educational campaigns and medical recommendations – Australian women are still risking their long-term health with bad habits.

A chest x-ray of a woman with heart disease. Photo: Shutterstock

A University of Melbourne study published in PLOS ONE, a peer-reviewed open access scientific journal published by the Public Library of Science, found the vast majority of women, around 80 per cent, are not eating enough fruit and vegetables. While 70 per cent are not getting enough weekly physical activity. And more than half are overweight.

This puts them at risk of some of our biggest killers.

The study, called the Healthy Ageing Project, obtained data on over 20,000 women aged from 18 to 98-years-old from around Australia. It paints a dire picture of the overall health of Australian women.

Professor Cassandra Szoeke, who is the Director of the Women’s Healthy Ageing Project at the University of Melbourne, says there is a lack of awareness about women’s health, even amongst women themselves.

“The recent Alzheimer’s Association report showed that of all cases of dementia, two thirds are women. And last year the Hidden Hearts report showed heart disease was more common in women than men. Yet when asked, women most feared getting breast cancer despite the fact they had twice the lifetime chance of getting dementia - a terminal disease,” says Professor Szoeke, who led the study.

Professor Martha Hickey, Professor of Obstetrics and Gynaecology at the University of Melbourne, agrees that raising awareness is a key issue.

“The health and wellbeing of women is critical to the health of our whole society. This study provides critical new information about modifiable factors contributing to health and survival in older women. This data can be used to target novel prevention programs to improve the health of women worldwide.”

I can’t help myself

Most of the risks attached to developing diseases like heart disease and dementia can be reduced by developing healthy habits like reduction of alcohol consumption, smoking cessation, maintaining a healthy weight, exercising, and having at least five serves of fruit and vegetables a day.

“The top two leading causes of death in women are heart disease and dementia. That healthy lifestyles prevent heart disease is well known and recently The Lancet (Neurology) published a study that suggested addressing modifiable risk factors could halve the cases of dementia worldwide, and yet we are not achieving health targets in women,” says Professor Szoeke.

So why are Australian women not getting the message when it comes to these health recommendations?

The research found that bad habits like company. Many of those women not exercising enough are two and a half times more likely to have poor nutrition.

And this is further complicated by stress.

Women are reportedly more fearful of breast cancer than a disease like dementia. Photo: Shutterstock

“A novel aspect of this study was the inclusion of mood variables revealing those who were stressed were less likely to comply with recommendations,” says Professor Szoeke.

The survey revealed that women who reported not coping well with the pressures of home or work life had significantly more health risks. More than 60 percent of women were identified as having three or more total health risks – increasing their risk of developing serious diseases.

This supports previous research that psychological stress is detrimental to health and wellbeing, and can increase the likelihood of unhealthy behaviours.

Professor Szoeke says that it is crucial to address these impediments to having healthy lifestyles in order to prevent disease.

“Prevention will always be better than the cure: particularly for diseases like dementia where we have no cure.”

But there is some good news.

CHANGING THE OUTLOOK

“Although we found some unhealthy habits are more likely to result in other unhealthy habits, the same applies to healthy habits,” says Professor Szoeke.

“We need programs to support healthy living. When we are talking about lifestyle change – one size doesn’t fit all, particularly for lifestyle which is largely socially based - a single approach doesn’t serve the needs of either sex.”

Vascular disease, stroke and dementia all have a strong lifestyle component and studies suggests that many are preventable with lifestyle modification.

“We know that women over 45 with two risk factors have a 30 per cent chance of having heart disease by the age of 80, and those with no risk factors have only a four percent chance of having heart disease by the same age,” says Professor Szoeke.

“There appears to be a focus on the fact women live a few more years than men. But research has shown us that 90 percent of the gains in life expectancy for women is spent with a disability. Women are more likely to have a chronic illness, multiple disabilities and have higher health service use.”

But, says Professor Szoeke, this is not just an Australian phenomenon.

“Internationally, the US, UK and Europe all show a tendency toward unhealthy habits in women. Global prevention of so many of these diseases has been successful in men, now we need to make the same gains in women.”

And this, she says, presents us with an opportunity.

A CALL TO ACTION

The World Health Organisation (WHO) estimates that 80 per cent of vascular diseases are preventable. Although Australia has signed up to the WHO Global Action Plan for chronic disease, these targets to increase compliance with healthy behaviours have not been met. Reporting shows that less than 50 per cent of women attain the right levels of physical activity, nutritional and weight targets.

Around 70 per cent of Australian women are not getting enough weekly physical activity. Photo: Ed Yourdon/Flickr

“We also need to address the lack of awareness and provide guidelines relevant to people for health, rather than different guidelines to prevent different diseases,” says Professor Szoeke.

Ms Christa Dang, a PhD student in the Healthy Ageing Program and co-author of the paper, agrees that “current programs to support healthy living need to be reviewed and revised to reduce the prevalence of unhealthy lifestyle factors and thus reduce the burden of vascular disease and dementia in women.”

The UK Department of Health has estimated that a vascular health check program could prevent at least 9500 heart attacks and strokes a year. Programs improving awareness and prioritising research in the United States have led to a reduction in female deaths from vascular disease.

And Professor Szoeke says that the implementation of such programs in Australia would be widely beneficial.

“I really want to be discussing a different kind of study, one showing the dramatic improvement in Australian women’s health”.

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