The 1st Annual Ladies' Home Journal Health Breakthrough Awards

Dr. Frank E. Speizer and Dr. Walter C. Willett: Understanding Women's Health Over the Long Haul

This year marks the 30th anniversary of the most wide-ranging -- and one of the most important -- health research projects ever: the Nurses' Health Study, an ongoing look at the risk factors for major chronic diseases in women and the longest-running study of its kind to focus on women.

Even if you don't recognize the study's name, chances are you've benefited from its findings. Under the guidance of Frank E. Speizer, MD, and his co-researcher, Walter C. Willett, MD, hundreds of papers on women's health have been published in leading medical journals over the past three decades. When it began, "most research had been done on men," says Dr. Willett. "There was a void of information about women."

How do we know that smoking causes heart disease in women? Thank the Nurses' Health Study. Just how healthy is walking? The NHS found that regular walking can stave off heart disease and keep you mentally sharp as you age. It was even ahead of the curve in documenting the harmful effects of trans fatty acids -- now the amount a food contains must be listed on food labels. "Virtually every American is eating differently this year because of our studies," says Dr. Willett, coauthor with Mollie Katzen of Eat, Drink & Weigh Less.

"I don't think I realized how successful it would become," says Dr. Speizer. "But there are more and more health events occurring among these women as they get older. We have 30-plus years of data; the information becomes more valuable as time goes on."

There are actually two Nurses' Health Studies. The original project (NHS I, for short) was established in 1976 by Dr. Speizer, currently the Edward H. Kass Professor of Medicine at Harvard Medical School and senior physician at the Channing Laboratory at Brigham and Women's Hospital, in Boston. NHS I consists of 121,700 married nurses who were ages 30 to 55 when the study began. Its original purpose was to see whether taking oral contraceptives affected a woman's health. (NHS I was the study that found that the pill increases breast-cancer risk modestly, an effect that goes away once you stop taking it.)

In 1989 Dr. Willett, now professor of epidemiology and nutrition at the Harvard School of Public Health, started the Nurses' Health Study II (NHS II) to further study oral contraceptives in a younger group of women as well as to look at how their diet and lifestyle habits affected their risk for disease. He's following 116,686 married nurses, who were 25 to 42 when NHS II began.

Why nurses? "We knew they would be highly motivated and would provide high-quality information about issues such as diagnoses and medications," says Dr. Willett. They were right: Every two years the nurses receive a questionnaire with assorted health questions, and the return rate has remained steady at 90 percent. The nurses have also sent in toenail clippings, blood samples, and cheek cell swabs, enabling researchers to examine hormone and nutrient levels and genetic markers for disease.

"It is an amazing sisterhood," says Carol Fout-Zignani, 50. When she joined NHS II in 1989 -- since then "I've been married, divorced, and married again" -- she had no idea it would be going strong nearly two decades later. "You really feel you're giving back by providing accurate information," says Fout-Zignani, director of continuing medical education at Norton Healthcare, in Louisville, Kentucky.

Both men credit the legions of physicians, researchers, doctoral students, programmers, and research assistants who help oversee the studies, crunch the numbers, and process the findings. Not to mention the nurses: "They have been committed for a very long time and that's what makes the study go," says Dr. Speizer, who stays involved but has passed the baton of principal investigator of NHS I to a colleague.

NHS recently received enough government funding to keep it afloat for at least five more years. And though some 19,000 nurses from NHS I have died -- they are passing away at a rate of three to four a day -- the study continues to be a rich source of health information. As the women of NHS I grow older, watch for a flurry of reports on healthy aging, cognitive function, and Parkinson's disease. Dr. Willett, who studied the mothers of nurses in NHS II, is now studying their sons and daughters.

"NHS is a landmark study," says Vivian Pinn, MD, director of the Office of Research on Women's Health at the National Institutes of Health. "The researchers started it and got women involved many years before attention was paid to women's health beyond the reproductive system and before women's health became part of our national consciousness. It is unique and important."