However, many fortification programs in low- and middle-income countries are regional or voluntary and, thus, might have a limited nutritional impact at the national level (76). Although many efficacy trials show benefits of fortification interventions, scaling up fortification is limited by inadequate coverage and resources (13, 77, 78). Evidence for impact is also affected by suboptimal programming, low-bioavailability fortificants (e.g., reduced iron powder), poor consumption rates, weak enforcement mechanisms, and inadequate monitoring (76, 79, 80). More research is needed to evaluate the long-term impact of fortification and biofortification programs (75). In addition, there is also growing concern about fortifying and promoting food vehicles that have adverse health consequences when consumed in excess, such as salt and sugar, given the rising prevalence of overweight, obesity, and noncommunicable disease (81–83).
The ability to determine if and when to become pregnant, is vital to a woman's autonomy and well being, and contraception can protect girls and young women from the risks of early pregnancy and older women from the increased risks of unintended pregnancy. Adequate access to contraception can limit multiple pregnancies, reduce the need for potentially unsafe abortion and reduce maternal and infant mortality and morbidity. Some barrier forms of contraception such as condoms, also reduce the risk of STIs and HIV infection. Access to contraception allows women to make informed choices about their reproductive and sexual health, increases empowerment, and enhances choices in education, careers and participation in public life. At the societal level, access to contraception is a key factor in controlling population growth, with resultant impact on the economy, the environment and regional development. Consequently, the United Nations considers access to contraception a human right that is central to gender equality and women's empowerment that saves lives and reduces poverty, and birth control has been considered amongst the 10 great public health achievements of the 20th century.
Eat healthy fats. According to the American Heart Association, women should get at least five to 10 percent of total daily calories from omega-6 fatty acids (equal to 12 to 20 grams), and between 0.5 and 3 grams of omega-3 fatty acids, depending on individual risk for heart disease. Good sources of omega-6 fatty acids include sunflower, safflower, corn, cottonseed and soybean oils. And good sources of omega-3 fatty acids include fatty fish, tofu and other forms of soybeans, canola, walnuts, flaxseed, and their oils. Talk with your health care professional about how much of these beneficial oils you should be getting, how you can best incorporate them into your diet and whether or not you should be taking them in supplement form.
Trans fatty acids, also known as trans fats, are solid fats produced artificially by heating liquid vegetable oils in the presence of metal catalysts and hydrogen. They also pose a health risk, increasing LDL or "bad" cholesterol and increasing your risk of coronary heart disease. They are often found in cookies, crackers, icing and stick margarine, and in small amounts in meats and dairy products. Beginning in January 2006, all food manufacturers had to list the amount of trans fatty acids in foods, resulting in a significant reduction in the amount of these fats used in prepared foods. In its guidelines, the American Heart Association notes that trans fats increase risk of heart disease by raising "bad" LDL cholesterol and should be avoided as much as possible. In addition, research has shown that trans fats can also decrease "good" HDL cholesterol, increase inflammation, disrupt normal endothelial cell function and possibly interfere with the metabolism of other important fats—even more evidence that they are very bad for overall health.
A number of implementation challenges exist for micronutrient supplementation. Access to care is often associated with socioeconomic status and may influence women's access to and use of supplementation programs. For instance, in one study, the highest wealth quintile of pregnant women had the highest use of iron and folic acid supplementation during antenatal care (33). However, even for women who have access to micronutrient supplements, the coverage and quality of micronutrient supplementation programs were limited (39). Incorrect doses, inadequate supplies, and incomplete adherence were major limitations (33), and poorly performing programs had limited impact on nutrition outcomes (59). Integration of supplementation programs with behavior change interventions improved knowledge, adherence, and coverage of supplementation interventions (32, 33, 60). The use of local micronutrient-rich foods can also help overcome limitations associated with supplement provision. In Nepal, improvements in the dark adaptation of night-blind pregnant women did not differ significantly between food and synthetic sources of vitamin A (61). When available, consumption of micronutrient-rich foods can be as effective as micronutrient supplements.
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Internationally, many United Nations agencies such as the World Health Organization (WHO), United Nations Population Fund (UNFPA) and UNICEF maintain specific programs on women's health, or maternal, sexual and reproductive health. In addition the United Nations global goals address many issues related to women's health, both directly and indirectly. These include the 2000 Millennium Development Goals (MDG) and their successor, the Sustainable Development Goals adopted in September 2015, following the report on progress towards the MDGs (The Millennium Development Goals Report 2015). For instance the eight MDG goals, eradicating extreme poverty and hunger, achieving universal primary education, promoting gender equality and empowering women, reducing child mortality rates, improving maternal health, combating HIV/AIDS malaria and other diseases, ensuring environmental sustainability, and developing a global partnership for development, all impact on women's health, as do all seventeen SDG goals, in addition to the specific SDG5: Achieve gender equality and empower all women and girls.
Fourth and finally, there was a general lack of focus on the relevant delivery platforms for nutrition interventions. Many studies were not explicit about how and where interventions were delivered, and we had to cross-reference multiple sources to identify the delivery platform for many interventions. Delivery platforms are important and relevant information in terms of replicability, but also for identifying who is effectively reached and missed. Information about delivery platforms is also instrumental in understanding gaps in implementation. A greater emphasis on delivery platforms could enhance the reach of nutrition interventions and could also strengthen the capacity to mobilize resources more effectively. For instance, organizing and grouping interventions by delivery platform (e.g., antenatal care, community centers, schools, clinics) or by the relevant stakeholders required for delivery (e.g., ministries, health care providers, teachers, administrators, transporters, etc.) could have the potential to more efficiently deliver nutrition interventions.
Nutrition education, including communication and counseling to raise awareness and promote nutrition-related knowledge and behaviors aligned with public health goals, was found to increase women's knowledge and improve women's dietary diversity and protein intake (15–21). It also reduced energy intake of overweight women over a 9-mo period (22). However, evidence for the effectiveness of nutrition education interventions showed mixed impact on biological and anthropometric markers of women's nutritional status (14–16, 18, 23–29). This could be due to lack of statistical power given the small sample sizes of the reviewed studies. For adolescent girls, nutrition education was found to reduce odds of overweight, and improve knowledge, dietary intake, physical activity, and sedentary behavior (27, 29, 30). This was particularly true for nutrition education that lasted longer than 12 mo (29). Nutrition education was also more strongly associated with changes in health outcomes in studies evaluating childhood obesity treatment, rather than childhood obesity prevention (29).
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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.
Also limit the amount of cholesterol you consume. Cholesterol is a fat-like substance found in every cell of the body. It helps digest some fats, strengthen cell membranes and make hormones. But too much cholesterol can be dangerous: When blood cholesterol reaches high levels, it can build up on artery walls, increasing the risk of blood clots, heart attack and stroke. Although dietary cholesterol can contribute to heart disease, the greater risk comes from a diet high in saturated and trans fats.
When you’re at the bar or a party and starving, your options aren’t always the best. But if it’s bruschetta, chips and salsa, or wings, go for the chicken (though nuts would be even better). Protein fills you up faster than carbs do, making it less likely that you’ll overeat, says Christopher Ochner, Ph.D., a research associate at New York Obesity Nutrition Research Center at St. Luke's Roosevelt Hospital Center. And since it’ll keep you satiated longer, you won’t be as tempted when your friend orders a brownie sundae or brings out a tray of blondies.
Behavioral differences also play a role, in which women display lower risk taking including consume less tobacco, alcohol, and drugs, reducing their risk of mortality from associated diseases, including lung cancer, tuberculosis and cirrhosis. Other risk factors that are lower for women include motor vehicle accidents. Occupational differences have exposed women to less industrial injuries, although this is likely to change, as is risk of injury or death in war. Overall such injuries contributed to 3.5% of deaths in women compared to 6.2% in the United States in 2009. Suicide rates are also less in women.
Calories. Most times, women need fewer calories. That’s because women naturally have less muscle, more body fat, and are usually smaller. On average, adult women need between 1,600 and 2,400 calories a day. Women who are more physically active may need more calories. Find out how many calories you need each day, based on your age, height, weight, and activity level.
Many WASH interventions targeted mothers and their caregiving behaviors for children. However, these interventions were applied to entire households and not individual household members. Larger community-based hygiene and sanitation initiatives broadly reached more people in the community (131). However, certain populations such as the elderly and young children might have limited access to public infrastructure, such as public latrines, particularly if there are physical and economic barriers to accessing them (136).
Evaluations of protein-energy supplementation were limited to specific situations and contexts, and few studies evaluated national-scale programs (14, 33). National-level protein-energy supplementation programs for women and adolescent girls are expensive and challenging to implement compared with other efficacious interventions (33). Procuring, preparing, and distributing food and appropriately targeting women most in need (e.g., women below the poverty line, women who have or are at high risk of malnutrition, etc.) present challenges to protein-energy supplementation interventions (33).
The trick to biking uphill is to look ahead and anticipate. “Try to plan for what's coming,” says Georgia Gould, a LUNA pro athlete and 2012 Olympic bronze medalist in women's mountain biking. “Start shifting down one gear at a time for a smooth, energy-saving transition. Ideally your cadence should stay the same as you transition from harder to easier gears.”
“The reason most people don't see changes isn't because they don't work hard—it's because they don't make their workouts harder,” says Adam Bornstein, founder of Born Fitness. His suggestion: Create a challenge every time you exercise. “Use a little more weight, rest five to 10 seconds less between sets, add a few more reps, or do another set. Incorporating these small variations into your routine is a recipe for change,” he says.
The increasing focus on Women's Rights in the United States during the 1980s focused attention on the fact that many drugs being prescribed for women had never actually been tested in women of child-bearing potential, and that there was a relative paucity of basic research into women's health. In response to this the National Institutes of Health (NIH) created the Office of Research on Women's Health (ORWH) in 1990 to address these inequities. In 1993 the National Institutes of Health Revitalisation Act officially reversed US policy by requiring NIH funded phase III clinical trials to include women. This resulted in an increase in women recruited into research studies. The next phase was the specific funding of large scale epidemiology studies and clinical trials focussing on women's health such as the Women's Health Initiative (1991), the largest disease prevention study conducted in the US. Its role was to study the major causes of death, disability and frailty in older women. Despite this apparent progress, women remain underepresented. In 2006 women accounted for less than 25% of clinical trials published in 2004, A follow up study by the same authors five years later found little evidence of improvement. Another study found between 10–47% of women in heart disease clinical trials, despite the prevalence of heart disease in women. Lung cancer is the leading cause of cancer death amongst women, but while the number of women enrolled in lung cancer studies is increasing, they are still far less likely to be enrolled than men.
Animal products, such as meat, fish and poultry are good and important sources of iron. Iron from plant sources are found in peas and beans, spinach and other green leafy vegetables, potatoes, and whole-grain and iron-fortified cereal products. The addition of even relatively small amounts of meat or foods containing vitamin C substantially increases the total amount of iron absorbed from the entire meal.
For healthy bones and teeth, women need to eat a variety of calcium-rich foods every day. Calcium keeps bones strong and helps to reduce the risk for osteoporosis, a bone disease in which the bones become weak and break easily. Some calcium-rich foods include low-fat or fat-free milk, yogurt and cheese, sardines, tofu (if made with calcium sulfate) and calcium-fortified foods including juices and cereals. Adequate amounts of vitamin D also are important, and the need for both calcium and vitamin D increases as women get older. Good sources of vitamin D include fatty fish, such as salmon, eggs and fortified foods and beverages, such as some yogurts and juices.
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“The more colorful the vegetables — and fruits — the more nutrients you’re going to get in your diet,” says Hincman. And green leafy veggies, like turnip, collard and mustard greens, kale, Chinese cabbage, and spinach, all rich sources of vitamins and minerals, are a great place to start. Many are also a good source of iron, important for women’s health, especially after menopause. One serving of cooked leafy greens — a half a cup — is not a lot, considering that just around two and one half cups of veggies, or five servings in total, is all you need each day.
Of the few studies evaluating nutrition education interventions for women and adolescent girls who were overweight and obese, many were “facility-based” and involved delivery platforms such as health clinics (13, 22), worksites (30), and schools (26, 27, 29). Delivery platforms targeting women and adolescents who were undernourished similarly involved facility-based settings (13), but also included community outreach (16, 28), home visits, community kitchens (15, 28), and text messaging platforms (32). Such community-based platforms could provide additional opportunities for the delivery of nutrition education interventions addressing overweight, obesity, and associated noncommunicable disease in the future.
Home visits ↓/NC anemia, ↑/NC Hgb, ↑ serum ferritin, ↑/NC serum retinol, ↓ vitamin A deficiency ↓/NC anemia and Fe-deficiency anemia, ↑/NC Hgb, ↑/NC serum ferritin, ↑ serum folate, ↑ serum zinc, NC serum retinol ↓ anemia, ↑ Hgb, ↑ serum ferritin, ↑/NC serum retinol, ↑ erythrocyte thiamine diphosphate concentrations, ↓ night blindness, ↑/NC weight gain ↓ anemia, ↑/NC Hgb, ↑ serum ferritin, NC serum retinol, ↑ serum calcium, ↑ 25(OH)D concentrations, ↓ PTH, ↓ bone turnover
Home visits ↓ anemia, ↑ Hgb, ↑ food consumption, ↑ weight gain (underweight adolescents), NC mortality, ↓ fatigue ↓ anemia, ↑ serum folate, ↑ serum B-12, NC mortality, NC depression ↓ anemia, ↑ MN status (Hgb, ferritin, folate, B-12, zinc, riboflavin), ↑/NC serum retinol, ↓/NC night blindness, ↑ weight gain, NC maternal mortality, NC depression
Anaemia is a major global health problem for women. Women are affected more than men, in which up to 30% of women being found to be anaemic and 42% of pregnant women. Anaemia is linked to a number of adverse health outcomes including a poor pregnancy outcome and impaired cognitive function (decreased concentration and attention). The main cause of anaemia is iron deficiency. In United States women iron deficiency anaemia (IDA) affects 37% of pregnant women, but globally the prevalence is as high as 80%. IDA starts in adolescence, from excess menstrual blood loss, compounded by the increased demand for iron in growth and suboptimal dietary intake. In the adult woman, pregnancy leads to further iron depletion.
Young adults. Teen girls and young women usually need more calories than when they were younger, to support their growing and developing bodies. After about age 25, a woman’s resting metabolism (the number of calories her body needs to sustain itself at rest) goes down. To maintain a healthy weight after age 25, women need to gradually reduce their calories and increase their physical activity.
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Community centers (including banks, town halls, post offices) ↑ knowledge about health and nutrition, ↑ food expenditures, ↑/NC food share, ↑ HH food consumption, ↑ dietary diversity, ↑ intake of MN (except for heme-Fe), ↑ HH intake of fruits, vegetables, and ASF, ↑/NC intake of fats and sweets, ↑ weight gain (greater among high BMI), ↑ participation in social networks, ↑ self-confidence, ↑ control over resources ↑ knowledge about health and nutrition, ↑ HH food security, ↑ food expenditures, ↑/NC food share, ↑ HH food consumption, ↑ dietary diversity, ↑ HH intake of fruits, vegetables, and ASF, ↑/NC intake of fats and sweets, ↑ participation in social networks, ↑ self-confidence, ↑ control over resources, ↑ ANC coverage ↑ knowledge about health, NC hypertension, ↓/NC missed meals, NC food sufficiency, ↑ health care utilization
Globally, cervical cancer is the fourth commonest cancer amongst women, particularly those of lower socioeconomic status. Women in this group have reduced access to health care, high rates of child and forced marriage, parity, polygamy and exposure to STIs from multiple sexual contacts of male partners. All of these factors place them at higher risk. In developing countries, cervical cancer accounts for 12% of cancer cases amongst women and is the second leading cause of death, where about 85% of the global burden of over 500,000 cases and 250,000 deaths from this disease occurred in 2012. The highest incidence occurs in Eastern Africa, where with Middle Africa, cervical cancer is the commonest cancer in women. The case fatality rate of 52% is also higher in developing countries than in developed countries (43%), and the mortality rate varies by 18-fold between regions of the world.
After menopause. Lower levels of estrogen after menopause raise your risk for chronic diseases such as heart disease, stroke, and diabetes, and osteoporosis, a condition that causes your bones to become weak and break easily. What you eat also affects these chronic diseases. Talk to your doctor about healthy eating plans and whether you need more calcium and vitamin D to protect your bones. Read more about how very low estrogen levels affect your health in our Menopause section. Most women also need fewer calories as they age, because of less muscle and less physical activity. Find out how many calories you need based on your level of activity.
Some fat is an important part of your diet; fat is part of every cell. It maintains skin and hair; stores and transports fat-soluble vitamins A, D, E and K; keeps you warm; and protects your internal organs. It even helps your mental processes—not surprising given that fat comprises about 60 percent of your brain. But many women consume too much fat. The American Heart Association (AHA) recommends that you keep your total fat intake between 25 and 35 percent of your total calories.