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.
The extent to which interventions target women more generally, as opposed to just mothers, is not well documented. It requires reflecting on “Who is the woman in women's nutrition?” to identify which women are actually targeted in nutrition interventions, which are not, how they are reached, and gaps in policies and interventions to reach women who are missed. To address this, in this comprehensive narrative review, we 1) summarize existing knowledge about interventions targeting women's health and nutrition in low- and middle-income countries, 2) identify gaps in current delivery platforms that are intended to reach women and address their health and nutrition, and 3) determine strategies to reshape policies and programs to reach all women, at all stages of their lives, with a particular focus on women in low- and middle-income countries.
We live in a modern world with amazing advancements in technology, yet our soil lacks minerals that it once contained causing whatever grows out of it (i.e. fruits, vegetables, and whole foods) to be significantly lower in minerals than it once was. Not only is our soil different, but our food takes a long time to get to us! Unless we’re growing our own whole food in our gardens, picking it out with our bare hands, and washing it off before eating, most likely our produce has been picked weeks before it reaches your grocery store and is purchased by you. This entire process can take weeks and cause nutrients to be depleted from the whole food (2).
Third, of the interventions that were evaluated, many interventions targeted women who were pregnant, lactating, or with young children <5 y of age. We do not refute the important focus on mothers and their children as a group deserving of special attention, given women's increased nutrient needs during pregnancy and lactation and the intergenerational consequences during this period. However, even the interventions that focused on maternal nutrition often only reported on birth and nutrition outcomes of the child, and not those of the mother. In addition, although there were interventions that targeted adolescent girls and women of reproductive age, they were fewer and less well evaluated than interventions that targeted women as mothers. This aligns with findings from other research which illustrated a higher proportion of programs targeting pregnant and lactating women and women with young children (209). We also found major gaps in the targeting of interventions for older women. With growing rates of overweight, obesity, and noncommunicable diseases, in addition to undernutrition and micronutrient deficiencies, it is essential to think outside of the maternal-focused paradigm to reach women at all life stages.
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.
Aggressive and early treatment of constipation can prevent painful complications from the condition, including hemorrhoids, anal fissures, ulcerations of the colon, bowel obstruction, and rectal prolapse. Start with lifestyle changes—such as adding more fiber to the diet, drinking enough water, and regular exercise. Used wisely, medications also can be very helpful. (Locked) More »
Nutritionists recommend choosing a rainbow of fruits and vegetables because each one provides a unique blend of nutrients. Within the color spectrum, yellow or orange veggies are great sources of vitamin A for skin and eye health and better immunity against infection. At the top of the list are carrots, sweet potatoes, pumpkin, and the many types of squash. While it takes just one whole carrot or six baby carrots to make one serving (one-half cup), you’ll need only half a starchy sweet potato.
It has not been scientifically established that large amounts of vitamins and minerals or dietary supplements help prevent or treat health problems or slow the aging process. Daily multivitamin tablets can be beneficial to some people who do not consume a balanced diet or a variety of foods. Generally, eating a well-balanced diet with a variety of foods provides the necessary nutrients your body needs. Eating whole foods is preferable to supplements because foods provide dietary fiber and other nutritional benefits that supplements do not. If you choose to take vitamin and mineral supplements, it is recommended to choose a multi-vitamin that does not exceed 100 percent of the Recommended Dietary Intake (RDI).
For once we're not talking about breakfast but rather the recovery meal after your workout. “So many women skip post-exercise nutrition because they don’t want to 'undo the calories they just burned,'” says Amanda Carlson-Phillips, vice president of nutrition and research for Athletes’ Performance and Core Performance. “But getting a combination of 10 to 15 grams of protein and 20 to 30 grams of carbohydrates within 30 minutes of your workout will help to refuel your body, promote muscle recovery, amp up your energy, and build a leaner physique.”
The U.S. Department of Agriculture's (USDA) food pyramid system (www.mypyramid.gov) provides a good start by recommending that the bulk of your diet come from the grain group—this includes bread, cereal, rice and pasta— the vegetable group; and the fruit group. Select smaller amounts of foods from the milk group and the meat and beans group. Eat few—if any—foods that are high in fat and sugars and low in nutrients. The amount of food you should consume depends on your sex, age and level of activity.
Pregnancy presents substantial health risks, even in developed countries, and despite advances in obstetrical science and practice. Maternal mortality remains a major problem in global health and is considered a sentinel event in judging the quality of health care systems. Adolescent pregnancy represents a particular problem, whether intended or unintended, and whether within marriage or a union or not. Pregnancy results in major changes in a girl's life, physically, emotionally, socially and economically and jeopardises her transition into adulthood. Adolescent pregnancy, more often than not, stems from a girl's lack of choices. or abuse. Child marriage (see below) is a major contributor worldwide, since 90% of births to girls aged 15–19 occur within marriage.
In addition to addressing gender inequity in research, a number of countries have made women's health the subject of national initiatives. For instance in 1991 in the United States, the Department of Health and Human Services established an Office on Women's Health (OWH) with the goal of improving the health of women in America, through coordinating the women's health agenda throughout the Department, and other agencies. In the twenty first century the Office has focussed on underserviced women. Also, in 1994 the Centers for Disease Control and Prevention (CDC) established its own Office of Women's Health (OWH), which was formally authorised by the 2010 Affordable Health Care Act (ACA).
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.
Forman, David; de Martel, Catherine; Lacey, Charles J.; Soerjomataram, Isabelle; Lortet-Tieulent, Joannie; Bruni, Laia; Vignat, Jerome; Ferlay, Jacques; Bray, Freddie; Plummer, Martyn; Franceschi, Silvia (November 2012). "Global Burden of Human Papillomavirus and Related Diseases". Vaccine. 30: F12–F23. doi:10.1016/j.vaccine.2012.07.055. PMID 23199955.
Income-generation interventions largely target adult women (women of reproductive age, women with young children, and older women). Many microfinance and loan programs are targeted to women because of their likelihood to pay back the loans, although women with lower education levels and smaller businesses do not benefit to the same degree as women who are educated or who have bigger businesses (165). There was limited evidence of such interventions targeting adolescent girls (169). In order to understand the potential impact of income-generating activities on adolescents, more information is needed about the pathways by which adolescents contribute to their own food security, the degree to which they rely on their caregivers to meet their nutritional needs, and how those dynamics change with the age of adolescents (169). Training, workshops, and extension activities were often delivered through community centers, community groups, and financial institutions (165). Other affiliated interventions, such as agricultural extension and nutrition education, were provided at the community level and at home visits (160, 173). These delivery platforms were effective at reaching women, including low-income women, particularly when they engaged with existing community groups (e.g., self-help, farmers’, and women's groups) (160, 161, 167, 169, 172, 173).
Social protection interventions are intended to support vulnerable households by providing them with in-kind (e.g., food) or cash transfers. The impact of social protection on women's nutrition was nuanced, as such interventions were associated with protecting against adverse nutrition outcomes, but were also associated with excess weight gain in some settings. In-kind transfers, including food baskets, fortified foods, and school lunches, improved women's and adolescent girls’ energy and micronutrient intakes, as described in the preceding sections. Both CCTs and unconditional cash transfers were common around the world and were associated with improvements in health care utilization and increased food expenditures (5, 14, 195, 196). CCTs were dependent on “conditions” such as school attendance and health care utilization. For children in Burkina Faso, CCTs were associated with greater numbers of preventative health visits compared with unconditional cash transfers (197), and this could be relevant to adult women's health care utilization as well. Unconditional cash transfers, such as old-age pensions, were also common, including in low- and middle-income countries (5, 198). Older women who received pensions had fewer missed meals (199), although evidence was mixed (200). In South Africa, granddaughters who cohabitated with women who received pensions had improved anthropometric measures and fewer missed meals, indicating spillover effects of pension transfers (199, 201).
Schools (“condition” and delivery platform) ↑ food expenditures, ↑/NC food share, ↑ HH food consumption, ↑ dietary diversity, ↑ HH intake of fruits, vegetables, and ASF, ↑/NC intake of fats and sweets ↑ knowledge about health and nutrition, ↑ 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 HH 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 ↑ knowledge about health, NC hypertension, ↓ missed meals, ↑ health care utilization
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.