Wise Choices, Healthy Bodies:
Diet for the Prevention of Women's Diseases

By Sally Fallon and Mary G Enig, PhD

Wommen desyren to have sovreyntee
—Chaucer, The Book of the Duchess

And sovereignty they have achieved, in many fields. While barriers remain, women have taken their proper place in the work force, in education, in law and in politics. Yet in the field of health, sovereignty is elusive. In fact, the recent increase in women's diseases—from breast cancer to infertility—undermines the advances that women have gained in other areas. The demands on career women with families are great, requiring excellent health and stamina. Even minor health problems make it difficult to fulfill the dual role of homemaker and wage earner. Severe health problems pose the specter of catastrophic disruption to family life and to economic solvency.

As the incidence of women's diseases has increased, so have the number of books on the subject. Peruse the shelves of any bookstore and you will find dozens of works on women's health. Some merely present allopathic treatments for women's diseases. Others describe alternative therapies—like exercise, yoga, acupuncture, aromatherapy, art therapy, biofeedback, positive thinking, meditation, light therapy, massage, herbs, homeopathy, hydrotherapy, vitamins and Chinese medicine. All of these therapies have their place and may be helpful, but only when practiced in conjunction with a diet that supports the female reproductive system. Unfortunately, the dietary advice dished out in the various books on women's diseases is appalling—simplistic, fatuous and dangerous—consisting mostly of prescripts to consume lots of soy foods, whole grains, legumes, fruits and vegetables with warnings against animal foods, particularly dairy fats and red meats.
Dangers of Vegetarianism

Writers on women's issues may denigrate animal foods with insouciance but, in fact, the scientific literature offers very little in the way of long-term studies on the value of a vegetarian diet. Dr. Russell Smith, a statistician, analyzed the existing studies on vegetariansim1 and discovered that while there have been ample investigations which show, quite unsurprisingly, that vegetarian diets significantly decrease blood cholesterol levels, studies evaluating the effects of vegetarian diets on mortalities continue to be few in number. In fact, Smith speculated that the available data from the many existing prospective studies are being shelved because they reveal no benefits of vegetarianism. For example, mortality statistics are strangely absent from the Tromso Heart Study in Norway which showed that vegetarians had slightly lower blood cholesterol levels than nonvegetarians.2

In a review of some 3,000 articles in the scientific literature, Smith found only two that compared mortality data for vegetarians and nonvegetarians. One was a 1978 study of Seventh Day Adventists (SDAs). Two very poor analyses of the data were published in 1984, one by H. A. Kahn and one by D. A. Snowden.3 The publication by Kahn rather arbitrarily threw out most of the data and considered only subjects who indicated very infrequent or very frequent consumption of the various foods. They then computed "odds ratios" which showed that mortality increased as meat or poultry consumption increased (but not for cheese, eggs, milk or fat attached to meat.)

When Smith analyzed total mortality rates from the study as a function of the frequencies of consuming cheese, meat, milk, eggs and fat attached to meat, he found that the total death rate decreased as the frequencies of consuming cheese, eggs, meat and milk increased. He called the Kahn publication "yet another example of negative results which are massaged and misinterpreted to support the politically correct assertions that vegetarians live longer lives."

The analysis by Snowden published mortality data for coronary heart disease (CHD), rather than total mortality data, for the 21-year SDA study. Since he did not eliminate the intermediate frequencies of consumption data on meat, but did so with eggs, cheese and milk, this represents further evidence that both Kahn and Snowden based their results on arbitrary, after-the-fact analysis and not on pre-planned analyses contingent on the design of their questionnaire. Snowden computed relative risk ratios and concluded that CHD mortality increased as meat consumption increased. However, the rates of increase were trivial at 0.04 percent and 0.01 percent respectively for males and females. Snowden, like Kahn, also found no relationship between frequency of consumption of eggs, cheese and milk and CHD mortality "risk."

Citing the SDA study, other writers have claimed that nonvegetarians have higher all-cause mortality rates than vegetarians4 and that, "There seems little doubt that SDA men at least experience less total heart disease than do others. . ."5 The overpowering motivation to show that a diet low in animal products protects against CHD (and other diseases) is no better exemplified than in the SDA study and its subsequent analysis. While Kahn and Snowden both used the term "substantial" to describe the effects of meat consumption on mortalities, it is more obvious that "trivial" is the appropriate descriptor. It is also interesting that throughout their analyses, they brushed aside their totally negative findings on foods which have much greater quantities of fat, saturated fat and cholesterol.

The second study was published by Burr and Sweetnam in 1982.6 It was shown that annual CHD death rate among vegetarians was only 0.01 percent lower than that of nonvegetarians, yet the authors indicated that the difference was "substantial."

The table below presents the annual death rates for vegetarians and nonvegetarians which Smith derived from the raw data in the seven-year Burr and Sweetnam study. As can be seen, the "marked" difference between vegetarian and nonvegetarian men in Ischemic Heart Disease (IHD) was only .11 percent. The difference in all-cause death rate was in the opposite direction, a fact that Burr and Sweetnam failed to mention. Moreover, the IHD and all-cause death rates among females were actually slightly greater for heart disease and substantially greater for all causes in vegetarians than in nonvegetarians.

Annual Death Rates of
Vegetarians and Nonvegetarians

IHD
All-Cause
Male vegetarians .22% .93%
Male nonvegetarians .33% .88%
Female vegetarians .14% .86%
Female nonvegetarians .10% .54%

These results are absolutely not supportive of the proposition that vegetarianism protects against either heart disease or all-cause mortalities. In fact, they indicate that vegetarianism is more dangerous for women than for men.

The claim that vegetarians have lower rates of cancer compared to nonvegetarians has been squarely contradicted by a 1994 study comparing vegetarians with the general population.7 Researchers found that although vegetarian Seventh Day Adventists have the same or slightly lower cancer rates for some sites, for example 91 percent instead of 100 percent for breast cancer, the rates for numerous other cancers are much higher than the general US population standard, especially cancers of the reproductive tract. SDA females had more Hodgkins disease (131 percent), more brain cancer (118 percent), more malignant melanoma (171 percent), more uterine cancer (191 percent), more cervical cancer (180 percent) and more ovarian cancer (129 percent) on average.
Hormones and Health

The female reproductive cycle is governed by two hormones—estrogen and progesterone. For a period of about two weeks, from the end of menses until ovulation, the ovaries secrete relatively large quantities of estrogen. Estrogen stimulates new growth, more blood vessels and more nutritive supply to the endometrium, the lining of the uterus, thus preparing the womb for the implantation of the egg should fertilization take place. During the second phase, estrogen production decreases while progesterone, the other female hormone, increases. Progesterone causes a decrease in the blood supply to the endometrium so that, if no fertilization occurs, the endometrium is expelled during menstruation, ten to fourteen days later.

The secretion of these hormones is cyclical and governed by complex factors, including other hormones from the thyroid, adrenal and pituitary glands. Thus, the entire endocrine system is involved and requires nourishment in order for the menses to occur with regularity and ease.

In order to produce estrogen and progesterone as required for the reproductive cycle, the body needs adequate amounts of cholesterol, because all the sex hormones are made from this vital substance. For this reason alone vegetarian diets for women are unwise as vegetarian diets will lower cholesterol. Furthermore, in order to avoid animal fats, vegetarians are likely to consume large amounts of trans fatty acids found in "cholesterol-free" margarine, spreads and vegetable shortenings. There is considerable evidence that trans fatty acids interfere with reproduction,8 possibly because they disrupt the action of the P450 cytochrome enzyme systems needed for the conversion of progesterone into the various types of estrogens.9
Thyroid Function

The thyroid gland is intimately involved in the female reproductive cycle. As early as 1899, physicians were successfully treating menstrual and fertility problems with natural thyroid supplements.10 Dietary factors that contribute to healthy thyroid function include adequate protein and iodine (thyroid hormone is composed of iodine and tyrosine, a protein found in animal foods); trace elements such as iron, zinc and selenium (needed to prevent anemia and for key enzymes to make hormonal conversions); B vitamins, including B12; vitamin C; and, above all, adequate vitamin A from animal sources.11 Many substances in the modern diet depress thyroid function, including soy foods,12 fluoride13 and possibly even aspartame, the artificial sweetener found in nutrasweet.14 Pesticides and other pollutants may also depress thyroid function.

The condition of hypothyroidism is widespread. The American Association of Clinical Endocrinologists estimates that 1 in 20 Americans or 13 million people are afflicted with thyroid disorder. Many researchers feel that this number reflects only the tip of the iceberg and that it is actually three or four times as high. Thyroid disorders affect women more often than men and tend to flair up during middle and late middle age. Symptoms include weight gain, fatigue, headaches, constipation, cold hands and feet and depression, in addition to disorders of the reproductive system. A surprising indication of thyroid disorder is high HDL, the so-called "good" cholesterol.15

Adequate thyroid function is particularly critical for women during their childbearing years. Children born to mothers with low thyroid function score lower in intelligence tests.16
The Fat-Soluble Activators

In his pioneering studies of isolated primitive peoples, Dr. Weston Price discovered that the diets of healthy population groups contained much higher levels of the fat-soluble vitamins A and D than the American population of his day.17 In fact, foods rich in these factors, such as butterfat from cows eating rapidly growing green grass, liver and other organ meats, cod liver oil, fish, shellfish and fish eggs, were considered important for reproductive health and great effort was expended to provide these foods to prospective parents, pregnant and nursing women and growing children. Sadly, these are the very foods that women tend to avoid as they are seduced by the false promises of vegetarianism.

Modern medicine has largely ignored Price's research, even though recent studies have provided a complete vindication of his findings. Vitamin A is now recognized to be essential for normal reproduction and endocrine function, particularly for a healthy thyroid gland. Adequate vitamin A during the growing years is necessary for sexual maturation. Deficiencies in adolescent girls can result in infertility, excessive bleeding during menstruation, anemia and retarded growth.18 Vitamin A stores are depleted by stress, including the stress of pregnancy. Women in particular need to consume vitamin-A-rich foods including butter and cream from grass fed cows, eggs, liver and cod liver oil.

As for vitamin D, researchers now recommend 4000 IU vitamin D daily for optimum health, or ten times the current RDA.19 Vitamin D supports the production of estrogen and has been used successfully to treat PMS.20 Low levels of vitamin D are associated with menstrual migraines, infertility and breast cancer.21 Research is accumulating that indicates that vitamin D is essential for full reproductive function in both sexes.22 Food sources of vitamin D include cod liver oil, oily fish, shellfish and lard from pigs allowed to spend time in the sunlight.