Womens Health Initiative -- Health Heroines: The Faces of America

The Faces of America

"They've got some nerve," Dolores Buckley of Worcester, Massachusetts, recalls thinking more than 15 years ago when she read about a study of Breast Cancer conducted solely on men. "When I saw a notice about a study only for women, I thought, That's for me."

She jumped at the chance to join more than 161,000 volunteers in the Women's Health Initiative (WHI), one of the largest-ever clinical studies of women's health. Buckley, 76, a social worker who's earned a master's degree in English since retiring, was one of the WHI's first volunteers. "I never missed a single meeting. I wanted to do everything I could."

The 15-year investigation of the major killers and cripplers of women "has changed the course of women's health," says Elizabeth Nabel, MD, director of the National Heart, Lung and Blood Institute, which funded the groundbreaking research. It is best known for its blockbuster findings on hormone therapy. "It was the shock heard round the world," says Marcia Stefanick, PhD, head of the WHI's steering committee. "Hormones had been viewed as the fountain of youth, and our findings were very different from what everyone had been led to believe."

lifestyle changes, the various WHI studies have shown, are the key to staying healthy as women age (see box, opposite, with the WHI's latest recommendations). Exercise, reports JoAnn Manson, MD, principal investigator at Brigham and Women's Hospital in Boston, lowers the risk of heart disease, Diabetes and osteoporosis.

Walking proved just as effective as more vigorous workouts. Now WHI is releasing the initial results of its clinical trials of a low-fat, high-fiber diet, and of calcium and vitamin D supplements. And dozens of other studies, including a five-year follow-up and analysis of DNA and blood samples from the volunteers, are underway.

"The WHI is proving to be far, far more valuable than we even anticipated," says Vivian Pinn, MD, director of the Office of Research on Women's health, who describes its "real heroines" as the volunteers, the most diverse group of women ever studied.

"The faces of the WHI are the faces of America. They are your neighbors, your mothers, your teachers, your grocery clerks. We all owe a debt to them for their courage and commitment."

The WHI offered women ages 50 to 79 a unique opportunity. "If women didn't want to keep getting the same treatments as men, they had to step up and volunteer," says Timothy Johnson, MD, chair of obstetrics and gynecology at the University of Michigan. His mother joined the study.

A Gift to the Future

To Norma Bowlin, 65, of Paragould, Arkansas, such intensive female-only research seemed long overdue. "I've been married to my husband for 47 years, and we don't even think alike, much less have the same type of bodies," the retired grandmother quips. "Why would anyone assume women are just like men?"

Dorothy Latham, 77, of Milton, Massachusetts, feels healthier today than when she retired as an education specialist 13 years ago. "I want to live as long as possible, of course, and I volunteered for the WHI to learn the good things to do and the bad things not to do," she says. As one of the 48,000 women in WHI's low-fat diet study, she kept a daily food record, attended frequent nutrition seminars, cut back on fat, learned to read labels and ate more fruits, vegetables and whole grains.

"I used to buy and cook whatever I felt like without thinking," she says. "Now I look at food in a different way. I keep track of fat, cholesterol, sodium and sugar." She also exercises regularly, works part-time as an usher for the Boston Symphony Orchestra and is "always finding positive things to do. People say they'd never guess my age by looking at me, and I feel younger too."

Latham personifies the WHI's single most important message to women: Take charge of your health. "You can't put your faith in a magic pill to keep you young and prevent disease," explains Dr. Nabel. "The good news is that there's a great deal women can do to stay healthy. Whatever your age, lifestyle modification is the best investment you can make in your future health."

The fact that so many WHI volunteers, about 90 percent of those in the clinical trials, stuck with the study testifies to another powerful force: the support of other women. At many of the 40 centers around the country, volunteers formed enduring friendships. The Worcester group organized a chapter of the Red Hat Society (a national network of women celebrating life after 50) and dubbed themselves the Number-One Low-Fat Red Hatters. Others made quilts, with each contributing a block representing her reason for joining the WHI or what the study had meant to her. (To view them, visit www.whi.org/quilts.)

"The theme for our quilt was, 'You're a Star,' " says Elfrieda DeLany, 73, of Sacramento, a retired nurse and an accomplished quilter. "Most of us didn't volunteer for ourselves but for our children and grandchildren. It was our gift to the future."

The study also infused volunteers with renewed zest for their own futures. "I don't see age as an impediment to doing what I want to do," explains Gloria Grant, 61, of Washington, D.C., who enrolled in seminary at age 56 and became a minister at 59.

"These days women in their 50s, 60s and 70s are leading exciting lives. Because of the WHI, we have more reason to celebrate, not just getting older but getting better every year." And that's good news for women of all ages.

The WHI Way to Women's health

Know your numbers, including BMI, blood pressure and cholesterol, and work with your doctor to create a plan to reduce your risks of a heart attack or stroke.

Get moving. "Even moderate- intensity exercise, such as a brisk walk, 30 minutes a day for a total of three hours a week, produces a tremendous benefit and reduces risk of heart disease by 30 to 40 percent," says JoAnn Manson, MD, principal investigator at Brigham and Women's Hospital in Boston.

Protect your bones. To guard against bone loss or fractures, women over 50 should take 1200-1500 mg of calcium and 400-800 IU of vitamin D daily.

Cut the fat. Although the WHI's dietary trial focused on reducing total fat, saturated fat is considered the greatest health danger.

Don't take hormone therapy to prevent disease. If you choose hormone therapy for moderate to severe menopausal symptoms, such as night sweats and hot flashes, take the lowest possible dose for the shortest possible time.