2003

Overweight and obesity have increased greatly in the U.S. in recent decades and are a particular problem for Black women. We used BWHS data on weight and childbearing collected during the first four years of follow-up, 1995 to 1999, to assess whether having a child was associated with increased long-term weight gain. We found that women who had a first child gained more weight than women who had a second or later child, and that the weight gain of all three groups was more than that of women who did not have a child. The difference in weight gain between women who had a child and women who did not was greatest for women who were overweight to begin. The results indicate that childbearing is an important contributor to weight gain among Black women. link to online article

Systemic lupus erythematosus (lupus) affects Black women more frequently than other women in the U.S. The assessment of potential causes of lupus has been hindered by the difficulty in identifying women with the illness. We assessed whether use of a symptom list filled out by BWHS participants on the 1997 questionnaire might be helpful in distinguishing between women with and without lupus. The study involved review of medical records of women with and without symptoms who reported having received a diagnosis of lupus. The symptom list was not helpful, but we found that women reported lupus with a satisfactory degree of accuracy, particularly those taking medications for the illness. A paper based on BWHS data has linked smoking to an increased risk of lupus, and other studies are in progress. link to online article

Systemic lupus erythematosus (lupus) occurs more commonly in African-American than white women. BWHS data indicate that cigarette smoking is associated with an increased occurrence of lupus. Previous studies suggested that alcohol consumption might be protective. Those studies had flaws that were overcome in the BWHS. BWHS data indicate that there is no relation between alcohol consumption and lupus. The data on smoking provide yet another reason for women to not smoke. link to online article

Experiences of racial discrimination may act as stressors that increase the occurrence of hypertension. We assessed this possibility using BWHS data. There were some small increases in risk of hypertension associated with responses to some of the questions about discrimination, but mostly the results suggest no association.

Alcohol consumption and caffeine consumption have been suggested to be risk factors for uterine fibroids. Preliminary analysis of BWHS data suggested a slightly greater risk of fibroids in drinkers, but little difference according to caffeine consumption. Smokers had a slightly lower risk of uterine fibroids than nonsmokers.

Uterine fibroids occur commonly among premenopausal African-American women. In an assessment of BWHS data on newly occurring fibroids, we found that fibroids occurred more often in women who were overweight, and that weight gain since age 18 was also associated with a greater occurrence.

Hormone replacement therapy has been used by millions of women. Data on white women indicate that hormone supplements increase the risk of breast cancer. BWHS data are the first concerning Black women. They indicate that breast cancer risk is increased among women who use hormone supplements, especially estrogen together with progesterone, that the risk increases as the duration of use increases, and that the effect is more evident in thinner women.

Black women have a higher incidence of breast cancer than white women before age 45, and a lower incidence after age 45. BWHS results indicate that parity has a dual effect on the occurrence of breast cancer, depending upon a woman’s age. Before 45 years of age, women who have had several children appear to have a higher risk of breast cancer than women who have had few children. At older ages, however, the incidence among women who have had several children is lower than among women with few children or none at all. These results will be useful in helping to explain the mechanism of breast cancer occurrence, and they also help explain the Black-white crossover in breast cancer incidence. link to online article

Age at menopause affects the occurrence of breast cancer, osteoporosis, and other illnesses. Factors related to the onset of natural menopause in Black women have not received much study. These analyses of BWHS data were based on follow-up of participants from 1995 to 1999. Overweight women had a later menopause than thinner women and women who used oral contraceptives had a later menopause than nonusers. However, the strongest determinant of the occurrence of natural menopause was cigarette smoking – current and ex-smokers reached menopause earlier than nonsmokers. Factors not significantly related to the onset of natural menopause were age at start of menstrual periods, education, childbearing, physical activity, and experiences of racism. link to online article

This paper presents the results of the BWHS diet validation study. There was a good correlation between the reporting of most nutrients on the BWHS 1995 questionnaire with food diaries and 24-hour diet recalls provided by BWHS participants in the diet validation study. These results give promise that analyses of diet in relation to various illnesses will be informative. link to online article