Wednesday, November 14, 2018

New Evidence for Health Benefits of Physical Activity



Being physically active is one of the most important actions individuals of all ages can engage in to improve their health. In the United States, an estimated $117 billion in annual health care costs and about 10% of premature mortality are associated with inadequate physical activity (not meeting the existing aerobic physical activity guideline).1-3 The evidence reviewed by the Physical Activity Guidelines Advisory Committee4 for the newly released Physical Activity Guidelines for Americans, 2nd edition5 (PAG) is clear—physical activity fosters normal growth and development and can make people feel better, function better, sleep better, and reduce the risk of many chronic diseases. Health benefits newly identified since the release of the previous 2008 Physical Activity Guidelines for Americans6 are listed in Box 1.
Box 1.

New Evidence for Health Benefits of Physical Activity

  • Improved bone health and weight status for children aged 3 through 5 years
  • Improved cognitive function for youth aged 6 to 13 years
  • Reduced risk of cancer at additional sites
  • Brain health benefits, including improved cognitive function, reduced anxiety and depression risk, and improved sleep and quality of life
  • Reduced risk of fall-related injuries for older adults
  • For pregnant women, reduced risk of excessive weight gain, gestational diabetes, and postpartum depression
  • For people with various chronic medical conditions, reduced risk of all-cause and disease-specific mortality, improved function, and improved quality of life
Some health benefits begin immediately after exercising, and even short episodes or small amounts of physical activity are beneficial. In addition, research shows that virtually everyone benefits: men and women of all races and ethnicities, young children to older adults, women who are pregnant or postpartum, people living with a chronic condition or a disability, or people who want to reduce their risk of disease. The evidence about the health benefits of regular physical activity is well established (Box 2), and research continues to provide insights into what works to increase physical activity, at both the individual and the community level.
Box 2.

Health Benefits Associated With Regular Physical Activity

Children and Adolescents
  • Improved bone health (ages 3 through 17 years)
  • Improved weight status (ages 3 through 17 years)
  • Improved cardiorespiratory and muscular fitness (ages 6 through 17 years)
  • Improved cardiometabolic health (ages 6 through 17 years)
  • Improved cognition (ages 6 to 13 years)
  • Reduced risk of depression (ages 6 to 13 years)
Adults and Older Adults
  • Lower risk of all-cause mortality
  • Lower risk of cardiovascular disease mortality
  • Lower risk of cardiovascular disease (including heart disease and stroke)
  • Lower risk of hypertension
  • Lower risk of type 2 diabetes
  • Lower risk of adverse blood lipid profile
  • Lower risk of cancers of the bladder, breast, colon, endometrium, esophagus, kidney, lung, and stomach
  • Improved cognition
  • Reduced risk of dementia (including Alzheimer disease)
  • Improved quality of life
  • Reduced anxiety
  • Reduced risk of depression
  • Improved sleep
  • Slowed or reduced weight gain
  • Weight loss, particularly when combined with reduced calorie intake
  • Prevention of weight regain after initial weight loss
  • Improved bone health
  • Improved physical function
  • Lower risk of falls (older adults)
  • Lower risk of fall-related injuries (older adults)
The information in the PAG is necessary because of the importance of physical activity to the health of people living in the United States, whose current inactivity puts them at unnecessary risk for chronic diseases and conditions. Healthy People 2020 established objectives for increasing the level of physical activity among US residents over the decade from 2010 to 2020.7 Although the latest federal monitoring data shows some improvements in physical activity levels among US adults (Figure 1), as of 2016 (adults) and 2015 (adolescents), only 26% of men, 19% of women, and 20% of adolescents report performing sufficient activity. Sufficient physical activity is defined as at least 150 minutes of moderate-intensity aerobic physical activity and 2 days per week of muscle-strengthening activity for adults and at least 60 minutes of moderate-intensity aerobic physical activity and 3 days per week of muscle-strengthening activity for youth (Figure 2).8

Recommendations  The PAG provides information and guidance on the types and amounts of physical activity to improve a variety of health outcomes for multiple population groups. Preschool-aged children (3 through 5 years) should be physically active throughout the day to enhance growth and development. Children and adolescents aged 6 through 17 years should do 60 minutes or more of moderate-to-vigorous physical activity daily. Adults should do at least 150 minutes to 300 minutes a week of moderate-intensity, or 75 minutes to 150 minutes a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity. They should also do muscle-strengthening activities on 2 or more days a week. Older adults should do multicomponent physical activity that includes balance training as well as aerobic and muscle-strengthening activities. Pregnant and postpartum women should do at least 150 minutes of moderate-intensity aerobic activity a week. Adults with chronic condition




Your heart hates air pollution; portable filters could help



Microscopic particles floating in the air we breathe come from sources such as fossil fuel combustion, fires, cigarettes and vehicles. Known as fine particulate matter, this form of air pollution increases the risk of cardiovascular and other serious health problems.
"Despite improvements in air quality across the U.S. during the past few decades, more than 88,000 deaths per year occur in the U.S. due to fine particulate matter air pollution exposure," says Robert Brook, M.D., a cardiovascular medicine specialist at the University of Michigan's Frankel Cardiovascular Center.
Now, researchers have found that an inexpensive portable air purifier used inside a home is powerful enough to round up a good portion of those miniscule particles and get them out of the indoor air -- a simple move that may protect the heart.
A recent study published in JAMA Internal Medicine found three days of using a low-cost air purifier at home significantly lowered urban seniors' fine particulate matter exposure. It also significantly lowered their blood pressure, which is the leading cause of morbidity and mortality worldwide.
"The results show that a simple practical intervention using inexpensive indoor air filtration units can help protect at-risk individuals from the adverse health effects of fine particulate matter air pollution," says Brook, the study's senior author.
He conducted the research with colleagues from the University of Michigan and Michigan State University, including first author Masako Morishita, Ph.D., of MSU.
Improving indoor air
Because the nation's population spends nearly 90 percent of its time indoors, researchers focused on exposure to pollutants while people are inside their own homes.
So instead of heading to a highway or factory, or even a park, Brook and his colleagues took their air pollution fight to living rooms and bedrooms in low-income senior housing in Detroit.
Forty seniors participated in this randomized, double-blind study between fall 2014 and fall 2016. Ninety-five percent of the participants were black; all were nonsmokers.
Each person experienced three different three-day scenarios: a sham air filter (an air filtration system without a filter), a low-efficiency air purifier system and a high-efficiency air purifier system.
Participants went about their normal business during the study period and were allowed to open windows and go outside as often as they wished. Blood pressure was measured each day, and participants wore personal air monitors to determine their personal air pollution exposure.
The researchers focused on reduced air pollutant exposure and lowered blood pressure over a three-day period as an indication of the portable air filters' potential to be cardioprotective.
As a result, Brook says fine particulate matter exposure was reduced by 40 percent, and systolic blood pressure was reduced by an average of 3.4 mm Hg (normal systolic blood pressure is considered less than 120 mm Hg; stage 1 hypertension begins at 130 and stage 2 at 140).
"The benefits were even more marked in obese individuals who had 6 to 10 mm Hg reduction in systolic blood pressure," says Brook, also a professor of internal medicine at the U-M Medical School.
And even a small investment could reap big benefits: High-efficiency air purifiers reduced pollutant exposure to a greater degree, but they didn't lower people's blood pressure more significantly than low-efficiency air purifiers, which are widely available for less than $70 apiece.
A relatable model
Existing research has investigated air pollution's cardiovascular and metabolomic effects in heavily polluted areas, also reporting some improvements after deploying air filters.
However, Brook says his team's report adds an important new consideration: It was conducted in a much cleaner environment that already met existing air quality standards for fine particulate matter yet still showed the potential to reduce exposure.
"During the time of the study in Detroit, outdoor fine particulate matter levels averaged 9 micrograms per cubic meter, which is within the National Ambient Air Quality Standards," Brook adds. "This strongly supports that even further improvements in air quality can be yet more protective to public health."
The JAMA Internal Medicine paper further differs from previous studies through its focus on an elderly and low-income population.
Researchers, Brook says, wanted to explore preventive strategies in everyday situations where aging adults are already dealing with other health conditions and may be on medications.
Nearly half of participants in the small study met the criteria for obesity -- and their mean blood pressure would be classified as hypertensive, according to the 2017 American Heart Association/American College of Cardiology guideline.
It's also the first known pollution and heart health study to focus on a three-part combination of low-income seniors, an urban environment in the U.S. and personal exposures to fine particulate matter.
Clearing the air
Despite the findings in the small study, more research is needed.
"It's premature to recommend that our patients purchase indoor air filters to prevent heart diseases," Brook says.
His team plans to test the approach in more diverse populations to learn whether personal reductions in fine particulate matter exposure will lead to fewer heart attacks and other negative outcomes associated with high blood pressure.
Brook says future research must also study long-term effects of the intervention to see if the reduced blood pressure will stay lower over longer time periods and result in fewer cardiovascular events.
Currently available epidemiologic calculations predict an approximate 16 percent decrease in cardiovascular events if a 3.2 mm Hg reduction in systolic blood pressure is maintained for a period of months to years, the study's authors note.
"In the meantime, clinicians and medical societies should play an active role in supporting clean air regulations in the effort to improve the health of their patients and families," Brook says.

Diet fluctuations lead to a rollercoaster of risk for heart disease and diabetes


During the holiday season, it can be difficult for even the most determined of us to stick to a healthy diet. A piece of Halloween candy here, a pumpkin spice latte there, and suddenly we're left feeling like we forgot what vegetables taste like.

Our weight isn't the only aspect of our health that can fluctuate during times like these. According to a new article in the journal Nutrients, risk factors for cardiovascular disease closely track with changes in eating patterns, even only after a month or so.
"If you're inconsistent about what kinds of foods you eat, your risk factors for developing these diseases are going to fluctuate," said Wayne Campbell, a professor of nutrition science at Purdue University. "Even in the short term, your food choices influence whether you're going to have a successful or unsuccessful visit with your doctor."
Diet failure isn't an anomaly, it's the norm, and there are a variety of reasons for that. This can lead to repetitive attempts of adopting, but not maintaining, healthy eating patterns.
To assess how these diet fluctuations affect risk factors for diabetes and cardiovascular disease, such as blood pressure and cholesterol, Campbell's team looked to two previous studies (also led by Campbell at Purdue). The research study participants adopted either a DASH-style eating pattern (Dietary Approaches to Stop Hypertension) or a Mediterranean-style eating pattern.
"Our DASH-style eating pattern focused on controlling sodium intake, while our Mediterranean-style focused on increasing healthy fats," said Lauren O'Connor, the lead author of the paper. "Both eating patterns were rich in fruits, vegetables and whole grains."
Participants adopted a healthy eating pattern for five or six weeks and then had their risk factors measured. The study participants then returned to their normal eating patterns for four weeks and came back for a checkup. After adopting a healthy eating pattern again for another five or six weeks, participants had their risk factors assessed one last time.
The results look almost exactly as you'd expect: like a cardiovascular rollercoaster. How fast the participants' health started to improve after adopting a healthier diet is impressive, though. It only takes a few weeks of healthy eating to generate lower blood pressure and cholesterol.
"These findings should encourage people to try again if they fail at their first attempt to adopt a healthy eating pattern," Campbell said. "It seems that your body isn't going to become resistant to the health-promoting effects of this diet pattern just because you tried it and weren't successful the first time. The best option is to keep the healthy pattern going, but if you slip up, try again."
The long-term effects of adopting and abandoning healthy eating patterns on cardiovascular disease are unknown. Research on weight cycling suggests that when people who are overweight repeatedly attempt to lose weight, quit, and try again, that may be more damaging to their long-term health than if they maintained a steady weight. To know if long-term health effects of cycling between eating patterns raise similar concerns, further studies are needed.
 


 

Monday, November 12, 2018

How vitamin D and fish oil affect risk of heart attack, stroke and cancer



For years, it's remained an open question: What effects do dietary supplements such as high doses of vitamin D or omega-3 fatty acids derived from fish oil have on the risk of diseases such as heart attack, stroke and cancer? While there have been hints along the way, until now, no randomized clinical trial of a general population, especially a racially diverse population, has been large enough to adequately address these questions. Brigham and Women's Hospital investigators leading the VITamin D and OmegA-3 TriaL (VITAL) conducted a rigorous placebo-controlled trial over the course of 5.3 years, gleaning a treasure trove of information on the effects of both supplements. The team found that omega-3 fish oil reduced heart attack rates but did not affect risk of stroke or cancer. In addition, vitamin D did not significantly affect heart attack, stroke or cancer incidence but was associated with a decrease in cancer deaths that started one to two years after participants began treatment. Results from VITAL were presented by JoAnn Manson, MD, DrPH, chief of the Division of Preventive Medicine at the Brigham, at the American Heart Association Scientific Sessions 2018, and published simultaneously in the New England Journal of Medicine.

The VITAL study population was racially and ethnically diverse, and 20 percent of the participants were African American. The team found that the reduction of heart attack risk among those taking omega-3s was especially pronounced among African American participants, with a 77 percent reduction observed.

"VITAL is one of only a few randomized trials that has had a diverse study population, and African Americans have not been well studied in previous trials of omega-3 supplements. We found that omega-3 supplements were associated with a dramatic reduction in risk of heart attacks among African Americans in our study. If this finding is confirmed and replicated, it may point to a very promising approach to reducing coronary risk among African Americans," said Manson. "We found that omega-3s were associated with a reduction in risk of heart attacks across our study population, especially among participants who had lower than average fish intake (less than 1 1/2 servings per week). In addition, VITAL results showed that with time, vitamin D supplements may lower risk of cancer death. We plan to follow these participants for the next several years to see if this signal becomes stronger."

VITAL, a randomized, double-blind, placebo-controlled trial, enrolled 25,871 men and women age 50 and older from across the U.S., including 5,106 African Americans. Eligible participants had no history of cancer, heart attack, stroke, or other forms of cardiovascular disease at the time of enrollment.

While earlier trials have examined whether fish oil or other supplements may prevent heart attack or stroke in patients with a history of heart disease or at very high risk of such disease, VITAL is the first large trial of omega-3 fatty acids for primary prevention - that is, preventing the first occurrence - of heart disease in a general population.

VITAL was designed to test the independent effects of vitamin D and omega-3 supplements, as well as to test for synergy between the two. Participants were divided into four groups: vitamin D (2000 IU/day of vitamin D? [cholecalciferol]) plus omega-3s (1g/day of Omacor [known as Lovaza in the U.S.]); vitamin D plus placebo omega-3s; omega-3s plus placebo vitamin D; and placebos for both.
Researchers compared those who received active omega-3s with those who received placebo. After a median of five years of treatment, 805 participants had suffered a major adverse cardiovascular event, such as a heart attack or stroke (386 in the omega-3 group and 419 in the placebo group). While these rates did not statistically differ, VITAL found a significant 28 percent reduction in risk of heart attack among participants taking the omega-3 fatty acid supplements (145 cases in the omega-3 group and 200 in the placebo group). This effect was greater among people who had lower fish intake (a 40 percent reduction). No significant differences were seen for cancer outcomes.

The research team also examined the effect of vitamin D on cancer rates. A total of 1,617 participants were diagnosed with cancer by the end of the study; 793 had been taking vitamin D and 824 had been taking the placebo - a non-significant difference. Rates of specific forms of cancer - including breast, prostate and colorectal cancer - did not differ significantly between groups. However, when the team examined rates after participants had been taking supplements for at least two years, they found that cancer deaths were significantly reduced by 25 percent among those taking vitamin D. No differences were seen for cardiovascular outcomes with vitamin D.

No serious side effects, such as bleeding, high blood calcium levels, or gastrointestinal symptoms were found with either supplement. The two supplements did not appear to interact with each other or have synergistic effects. In addition to cardiovascular disease and cancer outcomes, VITAL will report on the effects of vitamin D and omega-3s on rates of diabetes, cognitive function, autoimmune disease, respiratory infections, depression and more in the months ahead.

"Over the next six months, we will have even more results to share that may help clinicians and patients understand the benefits and risks of taking omega-3 and vitamin D supplements," said Manson. "Medical and public health authorities may look at the study results and decide if clinical guidelines should be updated. In the meantime, if you're already taking one or both of these supplements, there's no clear reason to stop. If you want to consider starting, our recommendation is to talk with your health care provider, but this does not need to be done on an urgent basis." 


New concussion recommendations for kids



The American Academy of Pediatrics (AAP) has updated its concussion recommendations to support children and teens engaging in light physical activity and returning to school as they recover. The report, revised for the first time in eight years, also advises against complete removal of electronic devices, such as television, computers and smartphones, following a concussion.

Previously, the academy had recommended that kids recovering from concussions not be active or use electronics, due to concerns that either were too simulating and might hinder the brain from recovering.

The new recommendations are included in a new clinical report published online Nov. 12 in Pediatrics, the journal of the AAP.

"We've learned that keeping kids in dark rooms and eliminating all cognitive and physical activity actually worsened a lot of kids' symptoms rather than improving them," said Mark Halstead, MD, an associate professor of pediatrics and of orthopedic surgery and lead author of the AAP report offering updated recommendations on sports-related concussions in children and adolescents.

The basis for the AAP's original recommendations stems from the notion that the brain needed time to recuperate after a concussion. However, researchers found that recovering children who were prohibited from activities and electronics can develop feelings of social isolation, anxiety or depression.

"Shutting down an active child entirely doesn't make them feel good and, frankly, can make them feel like they are being punished for getting hurt," said Halstead, director of the St Louis Children's Hospital Young Athlete Center Sports Concussion Program. "Kids can develop anxiety by missing school, and the fear of getting behind can overwhelm them."

Young athletes should stop playing immediately after a concussion is suspected, Halstead said. But light physical activity, such as brisk walking, can be incorporated as they are recovering. Similarly, academic workloads may need to be lessened after brain injury; however, such students shouldn't need to miss prolonged periods of school or disengage in learning.

"A cookie-cutter treatment approach does not work, because no two concussions are alike," Halstead said. "Although we have these recommendations, physicians and families need to evaluate each child or teen with a concussion on an individual basis."

For boys, the report attributed most concussions to playing ice hockey, football and lacrosse. For girls, head injuries most often resulted from playing soccer, lacrosse and field hockey.
The AAP estimates 1.1 million to 1.9 million children and teens are treated for a recreational or sports-related concussion each year.

However, Halstead said concussions are still likely underreported, partly because of an overall lack of awareness about head injuries among families and coaches, and because of the belief by some young athletes that they need to tough out an injury for fear they won't be able to play their sport again.
"More research is needed on sports-related concussions, especially among athletes in elementary and middle school," Halstead said. "Much of the focus has been on high school athletes."

Additionally, the report concluded that each concussion is unique, with symptoms varying in type and severity; most child and teen athletes will recover from a sports-related concussion within the first four weeks after injury; and the long-term effects of one or more concussions have not been determined.

Friday, November 9, 2018

Rushing kids to specialize in one sport may not be best path to success


It may be tempting for parents or coaches to urge young children to specialize in one sport early on to help maximize their chance at making it to the big leagues, but that might not be the best path to success.

In a study that looked at the sports histories of professional and collegiate ice hockey players, Penn State College of Medicine researchers found that on average, the athletes played multiple sports as kids and waited until around age 14 to focus solely on ice hockey.

Matthew Silvis, professor of family and community medicine and orthopaedics and rehabilitation, said the results help dispel a belief that kids have to specialize in a sport at an early age in order to succeed.

As the Hershey Bears team physician, Silvis said he has seen many young children begin specializing in ice hockey as early as age six, which he says comes with mental and physical health risks.

"In many sports, there's a belief among many parents and coaches that in order for your child to make the team or have the best chance for a collegiate scholarship, you have to pick a sport really early in life and only focus on that one sport," Silvis said. "That actually runs counter to what we think in terms of sports medicine and sports performance, and this study supported our line of thinking."
The researchers said that in addition to the risk of children becoming burned out after playing only one sport from a young age, there are also physical risks to early specializing.

"If a child participates in one sport, they're only working certain muscle groups," Silvis said. "You are consistently placing your body through the same movement patterns and demands. It puts you at risk of an overuse injury."

The researchers gave 91 professional, NCAA Division I and NCAA Division III ice hockey players a survey about their personal histories in sports participation. The participants noted when they started participating in sports, which sports they played, and when and why they decided to specialize in ice hockey.

After analyzing the data, the researchers found that the mean age of beginning any sport was 4.5 years, and the mean age of specializing in ice hockey was 14.3 years. Only 12 percent of the athletes specialized in their sport before 12 years of age. Most of the athletes played two to four sports as children, with soccer and baseball being the most popular in addition to hockey.

The mean age of specializing in ice hockey -- around 14 -- was consistent across professional, NCAA Division I and NCAA Division III players.

Silvis said he was surprised by some of the additional findings, which were recently published in the journal Sports Health: A Multidisciplinary Approach.

"It was interesting and a little surprising to us that the most commonly played secondary sport among ice hockey players was soccer," Silvis said. "But anecdotally, before Hershey Bears games, I often see players warming up in a big circle in the hallway kicking around a soccer ball."

Silvis hopes that the study will not only send the message that it is OK for children to play multiple sports when they're young, but that it can actually be an asset, as well.

"If you only play one sport, you also miss out on sports diversification, which is the idea that being a really good soccer or tennis player may help you be a really good ice hockey player," Silvis said. "We've seen a lot of professional athletes coming out in support of this, saying that by playing a lot of sports you'll learn many skills and work different muscle groups that will help you if you specialize in one sport later on."

Additionally, Silvis said that if parents are encouraging their kids to specialize in a sport in the hopes that they will go on to receive a collegiate sports scholarship, there are other avenues they could consider.

"I like to say to parents, if you want your child to get a scholarship for college, send them to math or science camp not sports camp," Silvis said. "While some kids will go on to become professional athletes, the majority will support themselves someday by using other skills, and academic scholarships are much more plentiful to help lessen the cost of a college education."

Sarah Black, Kevin Black, Aman Dhawan, Cayce Onks and Peter Seidenberg, all from Penn State Sports Medicine, also participated in this research.

Soy formula feeding during infancy associated with severe menstrual pain in adulthood



Research found that African-American infant girls that were fed soy formula were more likely to experience severe menstrual pain as young adults.
Research found that African-American infant girls that were fed soy formula were more likely to experience severe menstrual pain as young adults. NIEHS
New research suggests that infant girls fed soy formula are more likely to develop severe menstrual pain as young adults. The finding adds to the growing body of literature that suggests exposure to soy formula during early life may have detrimental effects on the reproductive system. The study appears online in the journal Human Reproduction.
Scientists at the National Institute of Environmental Health Sciences (NIEHS), part of the National Institutes of Health, along with collaborators from Vanderbilt University Medical Center in Nashville, Tennessee, and the Henry Ford Health System in Detroit, examined data from 1,553 African-American women, aged 23-35, participating in the NIEHS Study of Environment, Lifestyle, and Fibroids (SELF). (link is external)
The researchers found that women who had ever been fed soy formula as babies were 50 percent more likely to have experienced moderate or severe menstrual discomfort between the ages of 18 and 22, and 40 percent more likely to have used hormonal contraception to help alleviate menstrual pain.
NIEHS postdoctoral researcher and lead author Kristen Upson, Ph.D., offered a potential explanation for the association between soy formula and severe menstrual pain. She said that data from previous laboratory animal studies suggest that early-life exposure to genistein, a naturally occurring component in soy formula, interferes with the development of the reproductive system, including factors involved in menstrual pain. She said these studies have also shown that developmental changes can continue into adulthood.
However, severe menstrual pain is not the only adverse reproductive health condition that Upson has linked to infant soy formula. She and her collaborators at the Fred Hutchinson Cancer Research Center in Seattle previously linked soy formula feeding to endometriosis, a condition where tissue that normally lines the inside of the uterus grows outside. Using SELF data, Upson and NIEHS senior scientist Donna Baird, Ph.D., have also linked infant soy formula to larger fibroids among woman with fibroids and to heavy menstrual bleeding.
Other studies by NIEHS scientists found that girl infants fed soy formula had changes in the cells of the vagina, including differences in how specific genes are turned on and off.
The only other research that evaluated soy formula in relation to menstrual pain was published in 2001 by scientists at the University of Pennsylvania, Philadelphia, and the University of Iowa, Iowa City. The study, which primarily included white young adults who participated in feeding studies when they were infants, also found an association between soy formula feeding and severe menstrual pain in the women.
"The results of both studies indicate that the findings may apply to all women, but further research is warranted before any changes are made to soy formula feeding recommendations," said Baird.
The American Academy of Pediatrics (AAP) promotes human milk as the ideal source of nutrition for infants. It does not recommend soy formula for babies born prematurely. For full term infants, the AAP recommends soy formula in rare cases where the child’s body cannot break down the sugars in milk or if the family prefers a vegetarian diet.
Upson said some estimates put the prevalence of menstrual pain in women of reproductive age at 60 percent. She added that menstrual pain can have a substantial impact on the quality of life, affecting school performance, work productivity, and relationships.
"Given how common menstrual pain is and the impact it can have on women’s lives, the next steps in research should examine exposures, even those that occur earlier in life that may increase a women’s risk of experiencing menstrual pain," said Upson.