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Empowered Women Leading Business

Freda Miriklis

BPW International President

28th BPW INTERNATIONAL CONGRESSJEJU - KOREA

23-27 MAY 2014

Welcome to this workshop organized by the Health Committee titled:

“When women are well, business & economy do better”.

When women are well, business & economy do better

Luisa Monini

BPW International Health Committee Chairperson

L. Monini - When women are well, business & economy do better


OURPANELIST


BPW INTERNATIONAL HEALTH COMMITTEE

• Increased levels of savings for investment

• Levels of education and vocational training

• Job possibilities

• Productivity

Women’s Health status may have effects on the economic

system through different modalities but closely connectedone to each other:


THE WELL-BEING OF THE

POPULATION AND THE WELFARE OF THE NATION ARE

BASED ON:

THE CORNERSTONES OF A STRONG ECONOMY

INVESTEMENT IN HEALTH

ECONOMIC GROWTH

HEALTHY POPULATION


In coordination with our President Freda Miriklis I have

been supporting the Women’s Empowerment Principles

outlined by UNIFEM from the Health point of view, and in

particular WEPs 2, 3 and 4:

N.2 Treat all women and men fairly at work –Respect and support human rights and nondiscrimination

N.3 Ensure the health, safety and wellbeing of all

women and men workers

N.4 Promote education, training and professional development for women


Primary education is the key to achieve the Millennium Development Goals by 2015. Still

today, however, there are more than 70 million children out of school, half of whom live in

sub-Saharan Africa and are mostly girls. Education for thousands of girls means salvation

from everything that lack of which means lack of awareness of themselves, of their own

rights, of access to cure, of safeguard of their own children, of becoming an integral part of

their own country’s social- economic life and, in the end, of becoming real citizens of the

world.

Csw, United Nations Headquarters, New York, 2007


Freda Mirikilis

BPW International President

Empowered Women Leading Business

Luisa Monini Brunelli

BPW International Health Committee Chairperson

When women do well business and economy do better

TRIENNIUM REPORT

HEALTH COMMITTEE

2011-2014

EMPOWERED WOMEN LEADING BUSINESS


International Health Committee BPW Italy

- Rosamaria LaScola - Fidapa-BPW Italy Sicilia

- Anna Parrini - Fidapa-BPW Italy Toscana

- Paola Sbisà - Fidapa-BPW Italy Friuli Venezia-Giulia

THE RED BELT PROJECT


InternationalContributionsThe Red Belt

Nicole AlleyneBPW Barbados

Kathryn CiccoliniBPW USA

Anastasia SafarianBPW USA

Sara LouzanBPW Argentina


Diet and physical activity provide a risk reduction equal to 33% and also

reduce abdominal obesity levels, lipid and blood pressure levels. If you also

stop smoking you can reach a value of 50% of potential global risk reduction.

You also reduce the risk of developing diabetes.

The American Heart Association (AHA) stressed the importance of early

prevention, the earliest the better.

THE RED BELT: FIDAPA-BPW ITALY- BPW INTERNATIONAL PROJECT & NFI:

“The Red Belt“

Today we talk more about cardiovascular diseases as compared to other

fearsome diseases because they are responsible, with bronco-pulmonary

pathologies, for 85% of deaths around the world and for 70% of disability.

Notable figures who have a significant impact on GDP of all countries by

direct medical costs and indirectly in terms of lack of productivity. Direct and

indirect healthcare costs for cardiovascular diseases in 2010 were $ 450 billion

and it is estimated that in 2030 will reach $ 1 trillion. On the other hand the

increasing of 5 years in the life expectancy of the population determines an

increase of 0.3%-0.5% in the growth rate of GDP


CAUSES OF FEMALE CARDIOVASCULAR RISK

The causes of increased female cardiovascular risk include:

It is essential to activate and intensify preventive strategies,

specifically aimed at women

It is therefore mandatory to spread to all women targeted information and

easy-to-use tools that allow them to check in a completely autonomous way

simple but important parameters for prevention and care.

• low academic attention to a disease

the frequency of which is

underestimated in females

• less female attention to major factors

that determine CVR

• low risk awareness in women


That is… Everybody must know their cardiovascular risk

In order to achieve this important goal we must promote in every single person

a conscious prevention. Everyone should know:

• Blood Lipid Levels

• Blood Glucose Levels

• Blood pressure


“The Red Belt“

The Red Belt Project is based on rigorous scientific research; this project

aimed at empowering women with the tools to monitor their Cardiovascular

risk in a simple, quick and cheap manner.


• EDUCATIONAL LEAFLETS FOR PARTICIPANTS


“The Red Belt“

GOLDEN GOAL

WOMEN'S HEALTH MUST BE PROTECTED AND PROMOTED GLOBALLY

• INVESTING IN HEALTH LEADS TO REDUCED

DISABILITY AND LOWERING LOSS OF PRODUCTIVITY

• CAUSES OF FEMALE CARDIOVASCULAR RISK NEED

TO BE BETTER KNOWN

• BETTER INDICATORS FOR ASSESSMENT OF

CARDIOVASCULAR RISK ARE NEEDED

• INFORMATION ON PREVENTING FEMALE

CARDIOVASCULAR RISK

• CALCULATION AND EPIDEMIOLOGY OF WSR

(WAIST/STATURE RATIO) A NEW PARAMETER TO

MEASURE THE CARDIOVASCULAR RISK

STRATEGIES

TOOLS: INNOVATIVE

FORCE OF THE PROJECT


INDICATORS FOR ASSESSMENT OF CARDIOVASCULAR RISK

Several epidemiological studies have confirmed the importance

of abdominal circumference (waistline), and of its relationship

with the height (WSR, or waist/stature ratio) as an indicator of

abdominal fat and cardiovascular risk, more effective and trustedthan body mass index ( BMI ), which describes the relationship

between weight and height without considering the distribution of

body fat.

Practically speaking:

If height is shorter than double our abdominal circumference

The cardiovascular risk is increased

The relationship between waist circumference and height, proposed by American

authors, plays a better role, from a predictive standpoint, than BMI; this parameter

should be below 0.50.

To obtain the value simply divide the waist by the height, and if it is above 0.5 (i.e., the

waist is more than half the height) the abdominal fat is in excess and therefore the

person is at risk of developing cardiovascular disease.


Intra-abdominal adiposity is closely correlated with abdominal obesity

Waist circumference (cm)

300

200

100

0

r = 0.80

60 80 100 120

IAA

(c

m2)

IAA: intra-abdominal adiposity; CT : computed tomography; MRI: magnetic resonance imaging

To assess IAA, the simplest measure of abdominal

obesity is waist circumference, which is strongly

correlated with direct measurement of IAA by CT

scan or MRI, considered to be the gold standard

Visceral adipose tissue

Subcutaneous adipose

tissue


SO, GENERALLY SPEAKING, THE LESS VISCERAL FAT YOU HAVE, THE BETTER IT IS.


INFORMATION ON PREVENTING FEMALE CARDIOVASCULAR RISK

To promote a better and wider knowledge of cardio-metabolic risk and thus

contributing to the prevention of heart failure and stroke.

The BPW International Commission for Health,in partenership with NFI (Nutrition

Foundation of Italy)

PROMOTED

The project launched in Sorrento during the 14th BPW European Congress, has

been expanded to the BPW International countries across five Regions.

Measuring a new CV risk factor

Spreading information

Data gatherig. Statistical analysis

BPW-Women’s Health Day, for:


Doctors, Nurses or BPW International affiliates collected information about age,

job, weight, waist, height, blood pressure, medical history, lifestyle of women

(smoke – alcool) of all ages in city squares and assessed the presence of

cardiovascular risk factors.

What distinguishes this initiative is the assesment of two parameters that make it

possible to tell women, in any context and instantly, what is their metabolic and

cardiovascular risk.

HeightWaistline


Women participants have been given ad hoc information (gadgets,

leaflets) and have been provided with guidance on cardiovascular

prevention and on the importance of controlling abdominal fat toreduce cardio-metabolic risk.

The leaflets highlighted the benefits of adopting a proper diet and an active

lifestyle to keep waist height ratio under 0.5

Two types of leaflets, according to waist-height ratio, have been

distributed:

• Leaflets for women with

optimal ratio (≤ 0.5 )

• Leaflets for women with

high ratio (> 0.5 )


THE RED BELT TOOLKIT

1)The advertising video you saw and a longer one, in Italian and in English where

Dr.Andrea Poli explains the scientific reasoning behind The Red Belt Project

2)The Power Point Presentation, with explanatory notes

3)The Abstract

4)The two Information pamphlets in various languages for at-risk and not-at-risk women

5)Data gathering forms

The Red Belt Project provided any BPW member interested in contributing with

a complete downloadable toolkit, which I developed personally and

distributed free of copyright and free of charge, to make it as accessible as

possible. It consists of a fully annotated presentation with all the scientific

explanations BY MEANS


WE ONLY NEED A RIBBON METER!

BUT HOW CAN WE KNOW IF WE ARE AT RISK?


Cardiometabolic Risk

How to measure Waist Circumference

Locate upper hip bone and top of

right iliac crest

Place measuringtape in horizontal

plane aroundabdomen at iliac

crest

Ensure tape is snug; but does not

compress the skin

Tape should be parallel to floor

Record measurement at the

end of a normalexpiration


ENGLISH

1) measure (standing) the circunference of your waist at the navel

2) measure your height

3) divide your waist circunference by your height

4) check the result :

5) if it is less or equal to 0,5 that means you are right. If it is more than 0,5 you are at

cardiovascular risk.

FRANCAIS

1) mesure en te tenant droit la circonference de ta taille au nombril

2) mesure ton hauteur

3) divise la circunference de la taille par l'hauteur

4) controle le resultat

5) si il est moin de 0,5 tu es bien, s'il est plus que 0,5 tu es a risque cardiovasculair

ESPANOL

1) mesura la circunferencia de la talle a l'ombligo

2) mesura tu altura

3) divide la circunferencia por l'altura

4) controla el resultado

5) si esta menos que 0,5 , todo va bien. Si esta mas que 0,5 tu es a risgo

cardiovascular


DEUTSCH

1) messen daine Taillenweite

2) messen daine Grosse

3) viertein das Taillenweite durch das Grosse

4) kontrollieren das Resultat

5) wenn weniger als 0.5,in Ordnuung, wenn mehr als 0,5 Sie Gefahr laufen

(Herzkranker)

ITALIANO

1) Da stazione eretta, misura la tua circonferenza vita, all'altezza dell'ombelico.

2) Misura la tua altezza

3) Dividi la misura della circonferenza vita con la misura della tua altezza

4) Controlla il risultato

Se minore uguale a 0.5 vuol dire che stai bene

Se maggiore di 0.5 vuol dire che sei a rischio cardiovascolare


The data, collected by NFI, have been used to evaluate the distribution

of two cardio-metabolic risk factors: waist circumference and waist-

height ratio.

As of March 2013, NFI had received data from three of the five BPW

Regions: Europe, South America and North America.

This sample is still too small for doing a complete and detailed statistical

analysis.

Nevertheless it’s still possible to observe some interesting results


Italy North America Argentina

City/club Trieste San Vincenzo Canicattì

(n) (n=39) (n=28) (N=14) (n=51) (n=93)

Age (y) 46.7 54.6 60.1 45-54 70.8

Age range (y, min-max)

23-79 46-69 35-86 >18, 75+ 50-89

Children (yes) 20 23 9 29

Schooling

Middle school 4 12 1 0

High school 24 10 5 5

University 11 6 8 46

Smokers 8 6 0 2

Alchol (yes) 0 6 2 38

Weight (kg) 66.28 62.82 63.48 69.85 70.79

Height (m) 1.63 1.65 1.60 1.65 1.60

Waist (cm) 81.15 86.57 85.36 82.09 87.59

BMI 24.84 23.07 25.01 25.59 27.82

Waist/Height 0.50 0.53 0.54 0.50 0.55

SBP (mm Hg) 126 124 129 115

DBP (mm Hg) 75 79 78 71


South America had the highest average W/H ratio (0.55) and also the highest BMIs and highest average BMI.

North America had an average W/H ratio that fell exactly at 0.5, our threshold betweenrisk and non-risk, yet it had an average BMI in the “overweight” scale. Note that bloodpressure, both systolic and diastolic, was on average lower in North America thanelsewhere. This suggests that the Northamerican women risk is actually overestimated byBMI, and that using the W/H ratio some overweight person would be more properlyclassified at normal risk.

In Centre Europe we found an average W/H ratio that is 0.5, the ratio was slightly higherin Southern Europe. Compared to North America, which gave similar W/H ratios, BMI arelower. Yet blood pressure is higher.

Characteristics of the five population groups


10%7%

5%

11%

20%14%

33%Coronary heart desease

Stroke

Other CVD

Cancer

Neuropsychiatric Disorders

Injuries

All other causes

CORONARY HEART DESEASE 10%

STROKE 7%

OTHER CVD 5%

CANCER 11%

NEUROPSYCHIATRIC DISORDERS 20%

INJURIES 14%

ALL OTHER CAUSES 33%

Heart failure is, statistically, the first cause of death in women. Half of allunnecessary early deaths in the Western countries are due to

cardiovascular diseases. And those who don’t die, risk serious

impairment.


The Red Belt Project will not finish here in Jejù. I hope that it will be

used to continue monitoring BPW Women’s Health and that of our children bypresenting it in schools as a scientific monitoring system against childhoodobesity and all it entails.

Dear Ladies in Red


FAT EXCESS

Fat excess is measured by B.M.I. (body mass index ) that is equal to

weight divided by squared height.

(bmi 25-30 )=Overweight

(bmi 30-35 )=Mild Obesity

(bmi 35-40)=Medium Obesity

(bmi>40 )=Serious Obesity

Height 1,70 m Weight 62 kg:



“The Red Belt“

SCIENCE BANISH BMI TO THE LOFT



Subcutaneous adipose tissue

INTRA-ABDOMINAL (VISCERAL) OBESITY


Cardiometabolic Risk

How to measure Waist Circumference

Locate upper hip bone and top of

right iliac crest

Placemeasuring tape in horizontal

plane around abdomen at iliaccrest

Ensure tape is snug; but does not

compress the skin

Tape should be parallel to floor

Record measurement at the end of

a normal expiration


I.A.A. is a major contributor to increased cardiometabolic risk

Kershaw EE et al, 2004; Lee YH et al, 2005; Boden G et al, 2002

Associated withinflammatory markers

(C-reactive protein)

Free fattyacids

Inflammation

Insulin

resistance

Dyslipidaemia

Increased

cardiometabolic

risk

IAA = high risk fat

Secretion ofadipokines(↓ adiponectin)

IAA: intra-abdominal adiposity


Life-Style Modification: Is it Important?

Exercise

Weight loss

Goals

Improves CV fitness, weight control,

sensitivity to insulin, reduces incidence of

diabetes

Improves lipids, insulin sensitivity, BP

levels, reduces incidence of diabetes

Brisk walking - 30 min./day

10% reduction in body wt.



“The Red Belt“

All of this has enormous direct and indirect costs on governments. Think

of how much money is spent treating the diseases and caring for the

invalids, and think of how much money is lost when these women and

men die prematurely. All of this is preventable. Identifiable risk factors

account for 90% of global risk. Diet and physical activity alone account

for 33%. Add smoking and you reach 50%. And there can be noeconomic growth without a healthy population.


• More fatty acids to the liver

• More triglycerides in blood

• Less “good” HDL cholesterol

• More inflammation

• More Insulin resistance

MORE CARDIOVASCULAR DISEASES


Subcutaneous adipose tissue

INTRA-ABDOMINAL (VISCERAL) OBESITY


Screening/Public Health Approach

Public Education

• Blood Sugar

• Lipids

• Blood pressure

• Tobacco use

• Body type

• Family history

Screening for at risk individuals:


The Red Belt Project provided any BPW member interested in contributing with a

complete downloadable toolkit; which I developed personally and distributed free of

copyright and free of charge, to make it as accessible as possible. It consists of a fully

annotated presentation with all the scientific explanations, the advertising video yousaw

and longer one, in Italian and in English, with a clear, concise scientific analysis of the

research; pamphlets in various languages for at-risk and not-at-risk women; and data

gathering forms.


THE RED BELT TOOLKIT


NFI agreed to cooperate, as scientific partners with BPW-International in defining the

aims of the project, in presenting the project to the Congress in Sorrento and in

preparing informative material, which has been set up on the basis of international

guidelines in terms of prevention and control of cardiovascular risk factors.

THE NFI EFFORTS CONSISTED IN:

• preparation of questionnaires to be administered during the International Day

BPW-NFI CO-OPERATION

• processing of data posted no later than May 2013

• preparation of information materials on women's cardiovascular prevention (leaflet andposter)

• gadget definition

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