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Newsletter Archive

Newsletters

Summer 1997

This page was reviewed or revised on Monday, June 09, 1997 3:56 PM

Table of Contents

Women's Health and Food Estrogens

Have One for the Heart

Promoting Sexual Health for Youth - "Am I gay?"

Sexual Risk Behaviours of Canadians

Acellular Pertussis Vaccine Is Here

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Women's Health and Food Estrogens

Women living in the Western world have a number of specific health concerns including breast cancer, osteoporosis, and symptoms of menopause. All these conditions are related in varying extents to diet. In some cases, that relationship is fairly well understood. In others, researchers are only beginning to uncover the diet-causation link.

Epidemiological studies have reported that Japanese women, whose diets are packed with plant-derived estrogens (particularly in soybeans) have less menopausal discomfort. Because soybeans contain phytoestrogens (also called isoflavones) which possess weak estrogen-like activity, there is increasing interest in the role that soy foods can play in women’s health.

The estrogenic activity of soybean isoflavones may help to offset the effects of reduced estrogen production by the ovaries. The question remains as to whether the estrogenic activity in soybeans is sufficient to provide a "natural estrogen" alter-native for hormone replacement therapy. Is it simply the estrogenic activity in tofu that eases the Asian woman through menopause or is it the genetic predisposition, in addition to lifestyle variables such as physical activity and the consumption of a low-fat diet, that are critical factors?

Research is currently underway to further understand the connections between phytoestrogens and specific health concerns in women. At present, more research is needed before a definitive health recommendation can be given. Besides the connection to menopause, it is known that certain phytoestrogens may offer some protection against cardiovascular disease by inhibiting platelet aggregation and reducing serum cholesterol levels. There is also recent evidence that soy products may exert some anti-cancer effect through an antioxidant mechanism. Studies that examine the effects of a diet high in soy foods will provide a clearer understanding of the links between diet and health.

An example of a soy food is tofu, which is widely available in the produce section of most grocery stores. While research will provide further insights into the use of soy foods, they are already considered to be economical, low in fat, high in fibre, and they remain as an excellent alternative to meat products. Soy products are a great addition to any meal plan.

Laure Perrier, Nutritionist

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Have One for the Heart?

Recently there have been many reports in the media touting the benefits of moderate alcohol consumption. There is accumulating evidence that shows a link between moderate drinking and decreased deaths from, coronary heart disease (CHD) in both sexes over the age of 35-40 years, but especially among middle aged men. However, don't expect public health recommendations to "have one for the heart". Despite its benefits for the heart and possibly reducing cancer risk, the ill effects of alcohol are too formidable to consider it a "heart medicine".

Benefits of Moderate Alcohol Consumption

Modest alcohol consumption seems to reduce risks of death from CHD by 40-50 percent. Various studies have shown the cardio-protective effect occurs with peak protection at levels of two or fewer drinks per day. The research suggests that as little as one drink every other day may give heart-protecting effects in both sexes over age 35.

Resveratrol, an antioxidant in grape skin and red wine has been shown to lower levels of cholesterol, block the formation of artery clogging cholesterol and reduce the tendency of the blood to clot. Resveratrol may also interfere with the development of cancer. However, Resveratrol has been tested in laboratory and animal studies, the study results cannot be automatically assumed for humans.

Studies show that abstainers and heavy drinkers have higher death rates from all causes than people who consume alcohol in moderation. However, critics argue that studies that show abstainers are at greater risk for heart disease can be misleading. For example this group can be made up of ex-alcoholics or heavy drinkers who have quit, or those in poor health who were told not to drink at all.

In addition, surveys show that abstainers tend to be of low socio-economic status and often in poor health. When studies have tried to control confounding factors, however, the cardio-protective influence of moderate drinking remains.

What is moderate drinking?

Low-risk drinking suggests no more than one to two standard alcoholic drinks a day for women, no more than two a day for men. Abstainers should not begin drinking to protect their heart!

The possible benefits of moderate drinking must be balanced against the fact that there is no level of alcohol consumption without some adverse effects. Moderate drinking increases death rates from violence, auto collisions, trauma, fire and water injuries. In addition, health problems such as hyper-tension can be increased with moderate drinking.

Key Heart Health Messages

  • The best ways to promote heart health are smoking cessation, regular daily physical activity and a low-fat diet. These actions are far more powerful heart protectors than drinking alcohol!
  • With regards to alcohol, moderation is key — no more than one to two drinks per day, but not every day.
  • Endorse Canada’s Food Guide to Healthy Eating recommendation of consuming 5 to 10 servings of vegetables and fruit daily. Vegetables and fruit are low in fat, high in complex carbohydrates, fibre, several vitamins, minerals, antioxidants and phytochemicals - all important factors for reducing the risks of heart disease and certain cancers, without the risks associated with alcohol.

References:

1. "Is Moderate Drinking Good For You?" University of Toronto Faculty of Medicine Health News. 1996 April; 13(2):1-4

2. 'Antioxidant Vitamins and Health" National Institute of Nutrition, 1996 Winter Review#25; 11(1): 1-5

For further information, please contact the Healthy Lifestyles Department at 383-8331 Ext. 603.

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Promoting Sexual Health for Youth - "Am I gay?"
 

A 14-year-old boy asks "am I gay?" "I’ve sometimes felt attracted to other guys. Does that mean I’m gay?"

"Never tell a young person they are, or are not, gay," states Robb Travers, one of the coordinators of the Lesbian Gay Bisexual program at Central Toronto Youth Services. "That’s something they have to come to themselves."

Teens are struggling with their identity, experimenting, fantasizing, and trying to sort out who they are. The response of the adult they choose to talk to about their concerns may have a profound impact.

Travers suggests that an adult faced with a young person asking about this issue personally, keep a positive tone and try to find out just what the youth’s concerns are.

The young person who comes to you won’t have their sexual orientation shifted no matter what you say, Travers observes. But you might be able to help them maintain a positive self-image no matter what that orientation is.

Because young people have observed examples of societal homophobia, it can be a big challenge to accept gay or lesbian orientation in themselves. Even if they feel certain that their orientation is gay or lesbian, Travers says, they are likely to feel great confusion over how they can accept themselves this way, and what family and friends will say.

"With teens, the pressure to be like everyone else is enormous," states Travers. "At that age, we’re still developing."

There are three things an adult should never say to a young person seeking help with this issue, according to Travers. They include first of all, "How do you know?" What they are saying indicates that their romantic and erotic desires are for people of their own sex, and it is terribly embarrassing to be asked to get specific about that. Secondly, "You’re too young to make a decision like that." This is a horrible thing to be told, Travers says, and people say it all the time. By age 12 or 13, it’s possible for people to be certain of their sexual orientation. Thirdly, "You haven’t had sex with someone of the opposite sex, so you can’t know for sure."

How can an adult best react if a young teen confides that he/she is uncertain of sexual orientation, but suspects they are gay/lesbian?

"It can be helpful to practice active listening, rephrasing what you’ve heard and reflecting it back to the youth to show that you understand and accept what’s being said without judgment."

Be Positive

There are three things you can do for such a young person that can be positive and helpful.

First, show support for the young person through the anxieties and concerns they are feeling and expressing.

Secondly, challenge their stereotypes with accurate information about homosexuality. You can say something like: "We don’t see this as an illness any longer," or whatever best suits the situation.

And thirdly, offer the youth validation or normalization. Recognize that what they’ve told you was difficult for them, and remind them that many gay and lesbian people lead very full and satisfying lives.

"We often try to slow them a bit if they are really struggling with coming out," Travers notes. "The decision they’re making is: Will I accept this in myself, or will I try to pretend to the outside world that I’m straight? They know in some ways there’s no turning back once you’ve come out."

They need time to sort out issues such as who it is appropriate to tell, in both daily life and in special situations such as applying for a job.

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Sexual Risk Behaviours of Canadians

Sexual behaviour is one of the main determinants of the transmission of HIV (the AIDS virus) in Canada. Therefore, it is important to understand sexual behaviour at the population level to assess the potential for the spread of HIV and to help target and evaluate prevention programs.

This report updates information on the sexual behaviour of the general Canadian population and the implications for prevention of HIV infection.

Multiple partners and condom use in the general population: Room for improvement

  • Recent Canadian surveys of adults aged 20-45 show that 12-19% of men and 6-7% of women had two or more sex partners in the past year.
  • Of those who reported sexual intercourse with a non-regular partner in the previous year, only 26% of men and 19% of women reported that they always used condoms with non-regular partners. The remainder either never used condoms or used them inconsistently.

Adolescent sexual behaviour: An area of concern

  • Approximately 50% of Canadian 17-year-olds have had sexual inter-course.
  • A 1992 survey in Western Canada found that 55% of 17 year old boys have had sexual intercourse and of those, 33% have had 4 or more partners. Fifty-two percent of 17 year old girls have had sexual intercourse and 30% of this group had 4 or more partners.
  • 57% of 17 year old boys and 45% of 17 year old girls used a condom the last time they had sexual intercourse.
  • As the HIV epidemic evolves, more and more infections are occurring in young people. The Bureau of HIV/AIDS and STD has estimated that between 1975 and 1984, the median age of HIV infection in Canada was 29.6 years. Between 1985 and 1990, the median age of infection was estimated to be 24.5 years.
  • Surveillance data on the incidence of other sexually transmitted diseases can also provide a measure of the extent of unprotected sexual behaviour in a population. Over 36,000 cases of chlamydia were reported in Canada in 1995. Among women, girls aged 15-19 have the highest rates of infection for chlamydia and gonorrhea.

 Groups with higher-risk sexual behaviour

  • For men who have sex with men, a national survey in 1991-92 showed that 15% had engaged in unprotected receptive anal intercourse in the past year.
  • In a recent study in Vancouver of young men who have sex with men (age range 18 to 30 years), 40% reported having unprotected receptive anal intercourse in the past year.
  • 60-80% of injection drug users did not always use a condom in the past six months when having sexual intercourse with opposite-sex partners.
  • Recent studies of street youth indicated that 85-98% have had sexual intercourse, with over 60% having had their first sexual intercourse before the age of 13. In addition, 52-78% have had six or more sexual partners since they began having sexual intercourse.

Comment

Although most people report having had only one sexual partner in the past year, many people report having had two or more partners. As well, there is still a significant amount of unprotected sex, particularly among adolescents. This places individuals at potential risk for HIV and other sexually transmitted diseases.

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Acellular Pertussis Vaccine Is Here

PENTACEL has just been launched in Canada by Pasteur Merieux Connaught. This combination vaccine for infants and children contains acellular pertussis vaccine and replaces the current PENTA product for the infant series and 18 month booster.

Connaught's acellular pertussis vaccine was very successful in two randomized trials in Sweden involving more than 90,000 infants. It showed high efficacy (>85%) and outperformed whole cell vaccine, while also producing significantly fewer side effects.