June 16, 2010

Strong Women, Head to Toe

Miriam Nelson’s latest book is a guide to health focused on total well-being

By Julie Flaherty

When it comes to health, men and woman are different, and not just in the obvious ways.

Women are more resistant to many types of infection, but are three times more likely to develop autoimmune disease. Women tend to have more persistent and more severe pain, but also manage it better, even though painkillers like ibuprofen don’t work as well in women. Women make more stress hormones and have a harder time turning them off. Even mental illnesses fall along gender lines, with women more often reporting depression, anxiety and eating disorders, while men are more susceptible to schizophrenia and alcohol or drug addiction.

“My method for my books has been if people are informed and they understand—without diving into all the nitty-gritty details—it’s easier to make changes,” says Miriam Nelson. Photo: Alonso Nichols

In her new book, The Strong Women’s Guide to Total Health (Rodale), Miriam Nelson, director of the John Hancock Research Center on Physical Activity, Nutrition and Obesity Prevention at Tufts, makes the case that understanding those differences—and a little bit of the science behind the female body—are the first steps in protecting and preserving your health.

“My method for my books has been if people are informed and they understand—without diving into all the nitty-gritty details—it’s easier to make changes,” says Nelson, who is also an associate professor at the Friedman School.

Take bones, which too often grow brittle as women age. Estrogen boosts the activity of bone-building cells called osteoblasts, while also curbing the tendencies of bone-dissolvers called osteoclasts. That is one reason bone mass declines when estrogen levels drop during menopause. Exercise, however, can temper the damage by building muscle that stimulates osteoblasts.

Putting It All Together

The idea for this, Nelson’s ninth book in the Strong Women series, came from readers who were asking questions about things like skin creams, hair removal and libido, questions that seemed—at least at first—to have little to do with her area of expertise, which is exercise and nutrition.

But in practice, “those two pieces of the puzzle have downstream effects on mental health, on reproduction, on your skin, your eyes,” Nelson says. In the case of eyes, for example, she and co-author Jennifer Ackerman discuss Tufts research that found people who eat a lot of simple carbohydrates, like white bread and sugar, have a higher risk of developing age-related macular degeneration and cataracts.

So in addition to in-depth discussions of the heart, lungs and joints, for example, the book has sections on sexual health, mental health and beauty. Although that last one is short, and emphasizes sun protection more than make-up application, Nelson said it filled a need she saw in focus groups while compiling the book. “It was amazing how many people were clueless about sunscreen and vitamin D,” she says. “There was a lot of confusion.” She draws on interviews with experts in a variety of fields to flesh out the answers.

The “Total Health” in the title represents not only the encompassing scope of the book, but a philosophy. Too often people concentrate on a fad diet, the latest vitamin in the news or a lab test number, Nelson says, when they should really get to know their body in all its complexity.

“If you only focus on, say, cholesterol, and you only take a statin, you aren’t getting the benefits of how you should be lowering your cholesterol,” she says. “You won’t be eating well and you won’t be physically active, and those things will impact your whole health.”

Spreading the Word

As in all her previous books, Nelson shares her personal stories: how one of her staff members pointed out she wasn’t practicing what she preached when she stayed chained to her desk all day without an exercise break; how she personally dealt with entering menopause; and how mental health counseling has helped her weather the bouts of depression and anxiety she has had most of her life.

She also tells the story of the day her husband sat in on a talk she gave about the obesity epidemic, only to later say: “I know you have been working hard for the past two decades, but what the heck have you been doing? Things seem to be getting worse.”

It is something, she says, she thinks about all the time, and the primary reason the research center she directs changed its focus eight years ago from studying individuals in the laboratory to studying interventions in real-world settings. A large part of this research revolves around the Strong Women Program, a community-based exercise regimen for older women that Nelson developed. It now has chapters in 40 states, including more than 40,000 women in Arkansas alone.

Her books, she says, are a way to fuel interest in these community programs. She is already working on her next one, which will look at what we’re eating, how our culture has worked against our health and how women can help change the system.

“Our research is trying to get women to understand some of the important things about their health and the health of their communities,” she says. “We need to build a cadre of women who are going to scream out and yell and change the world.”

Julie Flaherty can be reached at julie.flaherty@tufts.edu.

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