The Women’s Health Initiative continues to provide a wealth of nutritional knowledge

The Women’s Health Initiative (WHI), a landmark study of 161,808 postmenopausal women ongoing for more than 40 years, continues to contribute a wealth of knowledge to the advancement of nutrition science. Special issue of Journal of the Academy of Nutrition and Dietetics (JAND) on the Women’s Health Initiative, published by Elsevier, reviews the history of the WHI and adds to the body of knowledge, with the goal of improving health through risk factor research, prevention, and early detection of serious health conditions in postmenopausal women. women.

Co-Guest Editor Yasmin Mossavar-Rahmani, PhD, RDN, CDN, Division of Health Behavior Research and Implementation Science, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, says, “This special issue celebrates the WHI’s contribution to the field of nutrition and dietetics. JAND has documented findings from the WHI, publishing more than 32 related articles that contribute to the evolving nutrition science in this area. The WHI is one of the largest studies of postmenopausal women in the United States and should be considered a national treasure.”

Its editor-in-chief JANDLinda G. Snetselaar, PhD, RDN, FAND, LD, professor in the Department of Epidemiology at the University of Iowa, who has been a member of the WHI since its inception, adds, “WHI is the the most important randomized controlled trial ever conducted among women in the United States. The WHI provided and continues to support the field of nutrition with an unprecedented resource that continues to contribute to women’s health, and JAND has been at the forefront of communicating the WHI results to dietitians.”

The WHI began as an initiative of the National Institutes of Health (NIH) in 1991 under the leadership of Dr. Bernadine Healy, the first female director of the NIH. The WHI program includes a multifaceted randomized controlled clinical trial among 68,132 participants and an accompanying prospective observational study among 93,676 participants. All participants were postmenopausal and aged 50 to 79 years at enrollment. The program focuses on improving health through risk factor research, prevention and early detection of serious health conditions in postmenopausal women.

The WHI included a Diet Modification Trial (DMT), which was the largest long-term dietary trial ever conducted among 48,835 postmenopausal women to investigate whether a low-fat dietary pattern with increased fruits, vegetables, and grains reduces cancer risk breast, colon. cancer and heart disease.

Co-guest editor Ross L. Prentice, PhD, Fellow Emeritus and former Director of the Department of Public Health Sciences, Fred Hutchinson Cancer Center, says, “One of the main findings of DMT was that there was a significant reduction in breast cancer mortality in the intervention group as a whole. Other notable goals of the WHI were to evaluate the impact of hormone replacement therapy and calcium/vitamin D clinical trials on reducing the risks of heart disease and hip fracture respectively, among other goals, the WHI research has already had an impact on women’s lives Trial of Treatment Data from the study continue to provide useful information on women’s health, especially on healthy aging and many other research areas of population science.”

The special issue features “Effect of consumption of unfermented soy products on blood lipids in postmenopausal women: A systematic review and meta-analysis of randomized controlled trials.”

Lead researcher Lirong Guo, MD, School of Nursing, Department of Rehabilitation, Jilin University, Changchun, explains, “Our study of 29 randomized controlled trials involving 2,457 participants found that consumption of unfermented soy products reduced total cholesterol and triglycerides and significantly increased high-density lipoprotein levels in postmenopausal women. Therefore, we conclude that consumption of soy products that unfermented can be considered as a potential nutritional approach to help manage blood lipids in postmenopausal women.”

Another article, “Diet Quality and Epigenetic Aging in the Women’s Health Initiative,” assessed whether diet quality is related to the biology of aging among postmenopausal American women. Commenting on the study findings, lead researcher Lindsay M. Reynolds, PhD, Division of Public Health Sciences, Department of Epidemiology and Prevention, Wake, Forest University School of Medicine, says: “Individuals with higher dietary quality had significantly lower biological age, as measured by epigenetic clocks, than individuals with lower dietary quality, in a subset of the Women’s Health Initiative cohort.”

JAND covering the WHI for over 40 years:

• 1993-2004:

  • Papers focused on the study protocol and preliminary findings.
  • The articles highlighted the value of motivating, rather than persuading, people to adopt healthier eating habits.

• 2004-2019:

  • A shift to focus on outcomes of interventions and studies beyond nutrition.
  • Topics ranged from nutrition to psychosocial aspects to the cost-effectiveness of interventions.

• 2020-present:

  • New topics such as precision nutrition. nutritional components that can benefit health specific to an individual’s profile at the molecular level.
  • Hyperaging: there are currently 12,623 participants aged 90 and over in the Long-Life Study being tracked at the WHI.

Looking at possible avenues for future research, Dr. Mossavar-Rahmani notes, “There is an opportunity to study the environment (eg pollutants and home environment) and perhaps even the generation of offspring. Can a healthy diet mitigate the effects of pollutants? Which diet is best for preventing hearing loss or preserving vision? Examining all data simultaneously (ie, physical activity, emotions, diet, cognition, and environment) and using ecological momentary assessment are other future areas for investigation that could provide a more holistic understanding of the context.”