On the 1995 health survey, BWHS participants answered more than 60 questions on what they ate. Preliminary analyses of this information suggest that women who ate a more “prudent” diet, which is high in fruits and vegetables, whole grains, fish and poultry , may have a lower risk of developing breast cancer, and women who ate more of a “Western” diet, high in meat, refined grains, and sweets, may have a higher risk.

Current recommendations are that women go for screening mammograms for breast cancer on a regular basis once they reach age 40. The hope is that finding breast cancers early will result in more effective treatment and better survival. We used information reported on the 1997, 1999, and 2001 health surveys to find out what factors affect regular mammography use in the BWHS. Having health insurance was the most important predictor of whether women went for mammograms on a regular basis. The loss of health insurance is an increasing problem; women who do not have insurance may be able to find federal or state programs to pay for their screening mammogram. link to online article

Black babies are born preterm (premature) more frequently than white babies and known causes do not explain the difference. Hair relaxers are often used by Black women, and these preparations contain unknown substances that might be harmful and possibly lead to premature birth. Based on reports of babies born to BWHS participants from 1995 to 2001, we assessed whether hair relaxer use was related to the occurrence of preterm birth. We found that use was not related to preterm birth, even use that had lasted many years and was frequent. link to online article

Type 2 (or adult onset) diabetes is increasing and is twice as high among Black women as white women. Based on data collected in the BWHS, women with a body mass index of 45 or greater developed diabetes 21 times more often than women with a body mass index less than 23. These results clearly show the large harmful impact of overweight and obesity on the occurrence of diabetes.

Obesity is a known cause of hypertension but few studies have evaluated the effects of very high levels of obesity. Based on BWHS data, we found that the incidence of hypertension increased as women’s body mass index increased. The incidence of hypertension in women with a body mass index of 45 or more was 7.7 times greater than that among women with a body mass index of 20-22. A body mass index of 20-24 is considered to be a “healthy” weight; 25-29 is considered to be “overweight”; and 30 or greater is “obese”.

Physical activity has beneficial effects on many conditions, but its effect on depression is less clear. In 1999, BWHS participants filled out 20 questions about how they were feeling, the CES-D scale, which measures symptoms of depression. Women who exercised vigorously had fewer symptoms than women who did not exercise, which suggests that leisure-time physical activity may reduce depressive symptoms.

Little is known about factors that influence whether women return for mammography screening on a regular basis. We assessed data on mammography use and other factors reported by BWHS participants on the 1997, 1999, and 2001 health surveys. The most important predictor of regular attendance for mammography screening in the BWHS was having health insurance.

A few studies have reported that women who smoke heavily and who started smoking at a young age may have an increased risk of breast cancer. In analyses of BWHS data collected from 1995 to 2003, cigarette smoking was not associated with breast cancer risk overall. However, there was a suggestion in the data that risk might be increased for women who smoked for many years and began at a young age. Further data will need to be collected to confirm whether this is so.

Uterine fibroids occur 2-3 times more often in Black women than white women. They can cause pain and bleeding and lead to hysterectomy. We assessed the influence of body size and body fat distribution on the occurrence of uterine fibroids, using data from the BWHS collected from 1997 to 2001. During that time period, 2,146 premenopausal women reported having been diagnosed with a fibroid through ultrasound or hysterectomy. All women with a body mass index (BMI) of 20 or greater had a higher risk of fibroids than women with a BMI <20. (BMI <20 is defined as thin, 20-24.9 as appropriate weight, 25-29.9 as overweight, and 30 or greater as obese). The risk of having a fibroid increased as BMI increased, to a peak at BMI 27.5-29.9 and then decreased. Weight gain since age 18 was positively associated with risk among women who had had children but not among women who had never had a child. Waist and hip circumference were not associated with risk of fibroids. These finding indicate that there is a complex relationship between BMI and risk of uterine fibroids, but that risk is lowest for thin women. link to online article

Data reported on uterine fibroids by BWHS participants from 1997 to 2001 were used to calculate incidence rates. The overall incidence rate of uterine fibroids was 34 per 1000 women per year—that is, 34 women out of each 1000 who had not had fibroids before developed uterine fibroids. The incidence rate was highest among women who were 40-44 years of age. The incidence rate of uterine fibroids in U.S. Black women is 2 to 3 times higher than the rate in white women; reasons for the difference are unknown. link to online article