Interventions resulting in public infrastructure changes were found to be less effective than household-based interventions; however, both are important aspects of improved health outcomes for women (128, 130). Public water infrastructure requires regular maintenance and periodic replacement and water from these sources is often contaminated (130). However, even public water points that provide good-quality water have had minimal impacts on health outcomes (136). One review estimated that water-source interventions were associated with a 27% reduction in diarrhea risk at all ages, whereas household-based interventions were associated with a 43% reduction (128). This could be associated with bias and confounding, as measuring WASH outcomes is not a blinded process (128). The differential impact could also be related to practice. As compared with public water sources, home water connections were associated with greater odds of handwashing and fecal waste disposal (136). As a significant portion of diarrheal disease is a result of person-to-person transmission and poor hygiene, interventions that improve domestic hygiene behaviors can have a significant impact (136). Behavior change communication and resource provision, e.g., soap and point-of-use water treatment resources, were also important and sustainable aspects of WASH interventions (131, 137).
What is a healthy weight? The answer is different for everyone. But it’s important to know what a healthy weight is for you. Check out our top questions and answers on weight, weight gain, and weight loss. And talk to your doctor or nurse about your weight goals. Women often gain and lose weight differently, so the steps you need to take to lose weight may be different from the steps someone else needs to take.
You can get calcium from dairy products like milk, yogurt and cheese, canned fish with soft bones (sardines, anchovies and salmon; bones must be consumed to get the benefit of calcium), dark-green leafy vegetables (such as kale, mustard greens and turnip greens) and even tofu (if it's processed with calcium sulfate). Some foods are calcium-fortified; that is, they contain additional calcium. Examples include orange juice, certain cereals, soy milk and other breakfast foods. Talk to your health care professional about whether you should take calcium supplements if you don't think you're getting enough calcium from food sources.
Poor nutrition can manifest itself in many ways. The more obvious symptoms of a nutritional deficiency include dull, dry or shedding hair; red, dry, pale or dull eyes; spoon-shaped, brittle or ridged nails; bleeding gums; swollen, red, cracked lips; flaky skin that doesn't heal quickly; swelling in your legs and feet; wasted, weak muscles; memory loss; and fatigue.
Our review highlighted how a focus on delivery platforms could indicate who is missed by different nutrition interventions, by evaluating where there is overlap or divergence in where interventions are delivered (as represented in the Venn diagram in Figure 1). Our findings showed that a large proportion of nutrition-specific interventions were delivered at clinic-based settings or community-based health posts. Health centers are important delivery platforms, particularly for pregnant and lactating women (113, 210). However, only half of women worldwide even attend the appropriate number of antenatal care visits (with nearly 86% of women attending 1 visit) and only 59% receive appropriate postnatal care (211). Other delivery platforms, such as schools and universities, were more effective at reaching some adolescents and women of reproductive age. However, interventions delivered at “facilities” (schools, health clinics, health posts) require participation with those facilities, and participation is often limited because of time, costs, distance, and other responsibilities, including work and childcare (116). Facilities-based care is also more likely to miss certain groups, including older women.
Women's menstrual cycles, the approximately monthly cycle of changes in the reproductive system, can pose significant challenges for women in their reproductive years (the early teens to about 50 years of age). These include the physiological changes that can effect physical and mental health, symptoms of ovulation and the regular shedding of the inner lining of the uterus (endometrium) accompanied by vaginal bleeding (menses or menstruation). The onset of menstruation (menarche) may be alarming to unprepared girls and mistaken for illness. Menstruation can place undue burdens on women in terms of their ability to participate in activities, and access to menstrual aids such as tampons and "sanitary pads". This is particularly acute amongst poorer socioeconomic groups where they may represent a financial burden and in developing countries where menstruation can be an impediment to a girl's education.
WASH interventions, such as toilet facilities, access to improved and safe water supply, and hand washing are associated with improved nutrition and health of entire communities (13, 14, 125–128). For women and adolescent girls, WASH interventions were associated with improved menstrual hygiene (126), reduced diarrhea and intestinal worm infections (128–131), and reduced maternal mortality (132). Women and young girls are also more affected by the physical and time burdens of collecting water (126), and harassment and violence associated with inadequate and unsafe toilet facilities (133, 134). Closer water points and sanitation facilities eased these gendered burdens (126, 135). WASH interventions and perceived water availability were associated with less time spent on water-related chores, and improved school attendance, women's empowerment, and self-esteem (126, 135, 136).
Nutrition interventions that target mothers alone inadequately address women's needs across their lives: during adolescence, preconception, and in later years of life. They also fail to capture nulliparous women. The extent to which nutrition interventions effectively reach women throughout the life course is not well documented. In this comprehensive narrative review, we summarized the impact and delivery platforms of nutrition-specific and nutrition-sensitive interventions targeting adolescent girls, women of reproductive age (nonpregnant, nonlactating), pregnant and lactating women, women with young children <5 y, and older women, with a focus on nutrition interventions delivered in low- and middle-income countries. We found that although there were many effective interventions that targeted women's nutrition, they largely targeted women who were pregnant and lactating or with young children. There were major gaps in the targeting of interventions to older women. For the delivery platforms, community-based settings, compared with facility-based settings, more equitably reached women across the life course, including adolescents, women of reproductive age, and older women. Nutrition-sensitive approaches were more often delivered in community-based settings; however, the evidence of their impact on women's nutritional outcomes was less clear. We also found major research and programming gaps relative to targeting overweight, obesity, and noncommunicable disease. We conclude that focused efforts on women during pregnancy and in the first couple of years postpartum fail to address the interrelation and compounding nature of nutritional disadvantages that are perpetuated across many women's lives. In order for policies and interventions to more effectively address inequities faced by women, and not only women as mothers, it is essential that they reflect on how, when, and where to engage with women across the life course.
Energy and protein supplementation was most often associated with weight gain of women, and often targeted pregnant women with suboptimal weight. For pregnant women, energy and protein supplementation modestly increased maternal weight (86–90). Other maternal outcomes were not frequently reported, and were often secondary objectives of protein-energy supplementation interventions (33, 88). Many studies reported on infant health outcomes, including reductions in low birth weight and preterm births (19, 89–91). Adequate energy and protein intake was also relevant for interventions targeting the prevention of excessive gestational weight gain of overweight and obese pregnant women. These interventions restricted dietary energy intake of overweight women during pregnancy and resulted in reduced excess weight gain during pregnancy but had no impact on pregnancy-related hypertension and pre-eclampsia (19, 88).
Everyone seems to have food allergies these days, but in fact, such allergies are rare. According to the National Institute of Allergy and Infectious Diseases, while one in three adults think they have a food allergy or modify their family's diet, only about four percent do. A food allergy is an abnormal immune-system response to certain foods (most commonly, fish, shellfish, peanuts, other nuts and eggs). Symptoms can include hives, rashes, nasal congestion, nausea, diarrhea and gas. However, symptoms of food intolerance—such as intestinal distress—may mimic those of a food allergy. You may want to talk to an allergist about diagnosis and treatment. Whether you have food allergies or intolerance, you will need to develop a diet that fits your needs and avoids foods that trigger a reaction.