Women Are From Venus: The Case for Gender Specific Lifestyle Medicine
If we are going to develop a truly personalized approach to predictive and preventative medicine we need to pay more attention to gender differences. When it comes to female metabolic and health responses to dietary and lifestyle interventions, men may as well be from Mars.
Women have “differential metabolic risks, chronological manifestations, and responses to lifestyle changes that strongly support a gender nutrition approach within predictive, preventive, and personalized medicine” says, Niva Shapira, from the Institute for Nutritional Research, Beilinson Hospital, Israel in a recent review.
The central theme is that there is an important gender relationship between chronic disease risk and metabolic responses to environmental risk factors. Further, research has often shown differential effects between women and men questioning the generalization of diet and lifestyle interventions across the sexes.
Some key points from the review include:
• Though women still outlive men throughout the world, their life expectancy advantage is now declining, especially in Western countries.
• Women have an earlier and greater predisposition to obesity, and are trending toward leading the obesity epidemic.
• Differences in body composition and fat distribution mean that women’s body mass index (BMI) may partially mask obesity and thus not be an appropriate assessment for women.
• Cumulative lifetime risk of cardiovascular disease may be underestimated in women because of delayed manifestation to postmenopausal age.
• A low calorie diet + exercise significantly improves insulin action in men but not to the same extent in women who appear to respond better to exercise independent of diet or weight loss.
• Women’s fat loss (primarily subcutaneous vs. intra-abdominal in men) yields much smaller improvements in cardiovascular risk factors compared to men.
• Metabolic response to reductions in fat intake and increases in dietary carbohydrate may be detrimental in women vs. men.
• High intake of high glycemic index (GI) and glycemic load carbohydrate may adversely affect disease risk in women more than men.
• A higher protein diet may be more effective in women for weight loss, preserving muscle mass and improving metabolic disease risk factors.
• There are gender (and age) related differences in metabolism of polyunsaturated fatty acids, suggesting difference in dietary requirements between men and women across the lifespan.
• Women have a higher exercise-related benefit and reduction morbidity and mortality, independent of BMI or weight loss, compared to men.
“As cardiovascular disease prevention shares recommendations with those of cancer as well as other chronic Western diseases, women’s approach may be better based on their specific metabolic risks, biomarkers, and chronological patterns across the spectrum of conditions, beyond specific diagnosis, prevention, and intervention,” concludes the author. “Much epidemiological study and clinical research are needed, including interventional trials for attaining women-specific understanding of metabolic risks and epidemiological evidence-based recommendations for designing targeted nutritional strategies within the context of gender nutrition and the predictive, preventive and personalised medicine approach to healthcare.”
Shapira N. Women's higher health risks in the obesogenic environment: a gender nutrition approach to metabolic dimorphism with predictive, preventive, and personalised medicine. EPMA J. 2013 Jan 12;4(1):1. [Epub ahead of print]