The connection in women between hormones, lifestyles and heart disease was the focus of a "lunch and learn" event held Tuesday in the Scotland County Health Department's education classroom. Tiffany Nunn, a UNC-Pembroke student intern at the health department, made the Power Point presentation before some 25 health department and DSS employees and community participants.

"Being 'heart smart' can save your life or the life of someone you know," Nunn said at the beginning of her presentation. "Don't make the mistake of downplaying your health problems."

According to Center for Disease Control statistics, heart disease is the number one killer of women on a national level with one out of every two deaths occurring from the ailment. In Scotland County, some 91 women died in 2008 of the disease.

A certified nursing assistant at Scotland Memorial Hospital, Nunn told the assembly that she had witnessed the deaths of several women from the affliction.

"I was shocked at how young some of them were, women in their forties with children four and five years old. Don't think this disease is only for older people."

Nunn outlined the leading risk factors for heart disease in women, with smoking, obesity, and a sedentary lifestyle among the leading causes.

"Is a cigarette really worth your life?" Nunn asked rhetorically.

On the connection between heart problems and obesity, Nunn told the group that while being more than 20 pounds overweight can increase the risk of heart disease, daily exercise can help prevent 80 percent of certain cancers.

"Eating right and exercising are the best ways to prevent obesity," Nunn said, "but it has to be done right."

Nunn recommended joining an exercise gym or participating in the "Working Women's Workout" program held three days a week at the county Parks and Recreation Center.

"The 'Working Women's Workout' is sponsored by the Scotland County Healthy Carolinians in collaboration with Parks and Recreation, the Scotland County Health Department, and Cooperative Extension," Scotland County Health Educator Kathie Cox said. "The program is set up for all women, working or not, who would prefer not to go to a gym. Classes meet on Mondays, Tuesdays, and Thursdays for six week sessions at Scotland Place on Turnpike Road, and

are very reasonably priced."

Contact Cox at 277-2440 for more information.

Nunn's presentation included an explanation of the role of estrogen and progesterone in protecting a woman from heart disease.

"These hormones are in a delicate balance, but are vital to a woman's health," Nunn said. "The two work together to provide a thin layer of protection from heart disease."

The onset of menopause causes changes in these hormones, Nunn said, leading to a lack of production in post-menopausal women.

"Protection from heart disease from these hormones is gone in post-menopausal women, exposing the woman to a two to three times' increased risk of developing the disease," Nunn said.

Nunn listed three "heart smart" tests that a doctor can order if he or she suspects one is at risk for the disease.

"A stress echocardiogram test will measure how well the heart works," Nunn said, "while a CT scan for coronary calcification will reveal how much plaque has accumulated around the heart. And screening for vascular ultrasound is one of the best ways to detect the symptoms of heart disease."

A question and answer session followed the presentation, with Nunn inviting comments from the audience. One respondent said that a female relative of hers had all the warning signs of developing heart disease: she was menopausal, a smoker in her forties, and was neglecting her health.

"Heart disease can be a problem that affects your mother, your aunt, a sister, or your best friend," Nunn said. "I urge you to stress to your loved ones the importance of being 'heart smart', through proper diet, exercise, and by not downplaying one's health problems."

Cox, the county Healthy Carolinians coordinator and also Nunn's supervisor, praised her intern for a meaningful presentation.

"We're always excited to get quality interns like Tiffany," Cox said. "She is very creative, and her input has been a big asset in developing programs that will be of value to the community. We will be taking her program 'on the road', so to speak, and will be presenting the information discussed today to other places in Scotland County."

To arrange for Nunn to speak at your church or community gathering, contact Cox at 277-2440.

Upcoming presentations by Nunn include a March program on nutrition followed by a presentation on child abuse prevention in April.

Nunn, who will graduate this spring with a bachelor's degree in health promotions and education, plans to pursue a master's degree in public health this fall.