The U.S. Department of Health and Human Services declared last week National Women’s Health Week (May 14-20th), but in reality we should be taking care of ourselves and have this awareness all year round, right? To kick this month off inspired by women’s health, let’s talk about health, nutrition, and of course answer your questions from Instagram, Twitter, and email from over this year!
Calcium: “Getting enough calcium is important for all ages, but it's particularly important during adolescence and early adulthood, when bones are absorbing calcium,” says Heather Schwartz, MS, RD, a medical nutrition therapist at Stanford University Hospital and Clinics. Calcium and vitamin D are often paired in fortified foods such as milk. The reason: The body needs D in order to absorb calcium.
To optimise women's control over pregnancy, it is essential that culturally appropriate contraceptive advice and means are widely, easily, and affordably available to anyone that is sexually active, including adolescents. In many parts of the world access to contraception and family planning services is very difficult or non existent and even in developed counties cultural and religious traditions can create barriers to access. Reported usage of adequate contraception by women has risen only slightly between 1990 and 2014, with considerable regional variability. Although global usage is around 55%, it may be as low as 25% in Africa. Worldwide 222 million women have no or limited access to contraception. Some caution is needed in interpreting available data, since contraceptive prevalence is often defined as "the percentage of women currently using any method of contraception among all women of reproductive age (i.e., those aged 15 to 49 years, unless otherwise stated) who are married or in a union. The “in-union” group includes women living with their partner in the same household and who are not married according to the marriage laws or customs of a country."[62] This definition is more suited to the more restrictive concept of family planning, but omits the contraceptive needs of all other women and girls who are or are likely to be sexually active, are at risk of pregnancy and are not married or "in-union".[37][63][58][59]

Women's health has been described as "a patchwork quilt with gaps".[4] Although many of the issues around women's health relate to their reproductive health, including maternal and child health, genital health and breast health, and endocrine (hormonal) health, including menstruation, birth control and menopause, a broader understanding of women's health to include all aspects of the health of women has been urged, replacing "Women's Health" with "The Health of Women".[5] The WHO considers that an undue emphasis on reproductive health has been a major barrier to ensuring access to good quality health care for all women.[1] Conditions that affect both men and women, such as cardiovascular disease, osteoporosis, also manifest differently in women.[6] Women's health issues also include medical situations in which women face problems not directly related to their biology, such as gender-differentiated access to medical treatment and other socioeconomic factors.[6] Women's health is of particular concern due to widespread discrimination against women in the world, leaving them disadvantaged.[1]
Micronutrient supplementation programs for vitamin A, iron and folic acid, calcium, zinc, and multiple micronutrients effectively impacted the micronutrient status of pregnant and lactating women, as well as women of reproductive age and adolescent girls (13, 14, 33, 35–48). Interventions making use of multiple micronutrients were more effective at changing plasma micronutrient concentrations than interventions focused solely on 1 nutrient alone (38, 42). In countries with comprehensive programs for iron supplementation during pregnancy, anemia prevalence dropped (1, 49). Positive health impacts of supplementation were most notable among pregnant women who were deficient and at risk of low intake (43, 50). However, there were some studies that showed inconsistent or limited evidence for the effectiveness of supplementation on other maternal health outcomes (31, 51–58).
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).
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.
Family planning and birth spacing can influence the nutrition of adolescent girls, women of reproductive age, and women with young children by reducing the number of adverse outcomes associated with pregnancy and abortion. For adolescent girls, in particular, pregnancy is associated with increased risk of birth complications, anemia, hindered linear growth, and loss of educational attainment (8, 107). Delaying early child marriages and providing access to family planning, particularly for young wives, allow girls to achieve their maximum growth potential (8, 142). However, for women with young children, there was scarce evidence from observational studies to suggest that greater birth spacing had any impact on anthropometric status (BMI, weight), micronutrient status (anemia, as well as serum zinc, copper, magnesium, and folate), and maternal mortality outcomes (13, 107, 143–147). Findings were mixed, which was attributed to sample size and other confounding factors such as maternal age, breastfeeding status, and supplementation status (146, 147). The strongest evidence of the impact of birth spacing on women's nutrition was related to increased risk of preterm delivery and maternal anemia in interpregnancy intervals <6 mo (14, 146, 147) and increased risk of pre-eclampsia in intervals >5 y (107).
Child marriage (including union or cohabitation)[91] is defined as marriage under the age of eighteen and is an ancient custom. In 2010 it was estimated that 67 million women, then, in their twenties had been married before they turned eighteen, and that 150 million would be in the next decade, equivalent to 15 million per year. This number had increased to 70 million by 2012. In developing countries one third of girls are married under age, and 1:9 before 15.[92] The practice is commonest in South Asia (48% of women), Africa (42%) and Latin America and the Caribbean (29%). The highest prevalence is in Western and Sub-Saharan Africa. The percentage of girls married before the age of eighteen is as high as 75% in countries such as Niger (Nour, Table I).[11][92] Most child marriage involves girls. For instance in Mali the ratio of girls to boys is 72:1, while in countries such as the United States the ratio is 8:1. Marriage may occur as early as birth, with the girl being sent to her husbands home as early as age seven.[11]

In addition to diet, exercise and other lifestyle factors can also play an important role in bone health. Smoking and drinking too much alcohol can increase your chances of developing osteoporosis, while weight-bearing exercise (such as walking, dancing, yoga, or lifting weights) can lower your risk. Strength or resistance training—using machines, free weights, elastic bands, or your own body weight—can be especially effective in helping to prevent loss of bone mass as you age.


Women's nutrition is often eclipsed by maternal nutrition. There are important linkages between maternal nutrition and the health, cognitive development, and earning potential of future generations (1). However, with reduced childbearing and longer life spans, women's experiences extend beyond motherhood (2). Interventions and policies that target women solely as mothers fail to account for women before they conceive, after they no longer engage with programs targeting maternal–child health, as well as those who never have children (3, 4). A woman's nutrition should matter not (only) because of her reproductive potential, but because it is fundamental to her rights as a person and to her well-being and ability to thrive (5–7). With increasing attention to the nutritional needs of adolescent girls (8, 9), in addition to the rising prevalence of overweight, obesity, and noncommunicable disease affecting women later in life (10), it is becoming more imperative that interventions reach women at all life stages.
Research findings can take some time before becoming routinely implemented into clinical practice. Clinical medicine needs to incorporate the information already available from research studies as to the different ways in which diseases affect women and men. Many "normal" laboratory values have not been properly established for the female population separately, and similarly the "normal" criteria for growth and development. Drug dosing needs to take gender differences in drug metabolism into account.[6]
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.
Not being able to do a pull-up doesn’t mean you shouldn’t step up to the bar. Simply hanging on for as long as possible can improve your upper-body strength, Montenegro says. Concentrate on keeping your body as still as possible, and you’ll naturally recruit your abs, hips, and lower back in addition to your arms, she explains, or slowly move your legs in circles or up and down to further engage your abs. 
If you lose weight suddenly or for unknown reasons, talk to your health care professional immediately. Unexplained weight loss may indicate a serious health condition. And even if it doesn't, simply being underweight is linked to menstrual irregularity, menstrual cessation (and sometimes, as a result, dental problems, such as erosion of the enamel and osteoporosis) and a higher risk of early death.
As the science of nutrition continually evolves, researchers recognize that nutrients needed to maintain a healthy lifestyle must be tailored to the individual for maximum effectiveness. Recognizing that people are not all alike and that one size does not fit all when it comes to planning and achieving a healthful diet, the Institute of Medicine's dietary guidelines, titled "Dietary Reference Intakes for Macronutrients," stress the importance of balancing diet with exercise and recommends total calories based on an individual's height, weight and gender for each of four different levels of physical activity.

While women tend to need fewer calories than men, our requirements for certain vitamins and minerals are much higher. Hormonal changes associated with menstruation, child-bearing, and menopause mean that women have a higher risk of anemia, weakened bones, and osteoporosis, requiring a higher intake of nutrients such as iron, calcium, magnesium, vitamin D, and vitamin B9 (folate).

By contrast, ovarian cancer, the leading cause of reproductive organ cancer deaths, and the fifth commonest cause of cancer deaths in women in the United States, lacks an effective screening programme, and is predominantly a disease of women in industrialised countries. Because it is largely asymptomatic in its earliest stages, more than 50% of women have stage III or higher cancer (spread beyond the ovaries) by the time they are diagnosed, with a consequent poor prognosis.[121][6]

Consult your health care professional. Women of childbearing age may want to consider taking folic acid supplements to reduce the risk of having a pregnancy affected with neural tube defects. Many women and teenage girls don't get enough calcium or vitamin D, both of which are critical to healthy bones and avoiding osteoporosis. Some people with diabetes appear to benefit from chromium. Vegetarians, especially vegans, may want to consider supplements to obtain nutrients they aren't getting from animal products.
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.

There has been an international effort to reduce this practice, and in many countries eighteen is the legal age of marriage. Organizations with campaigns to end child marriage include the United Nations[97] and its agencies, such as the Office of the High Commissioner for Human Rights,[98] UNFPA,[99] UNICEF[91][93] and WHO.[95] Like many global issues affecting women's health, poverty and gender inequality are root causes, and any campaign to change cultural attitudes has to address these.[100] Child marriage is the subject of international conventions and agreements such as The Convention on the Elimination of All Forms of Discrimination against Women (CEDAW, 1979) (article 16)[101] and the Universal Declaration of Human Rights[102] and in 2014 a summit conference (Girl Summit) co-hosted by UNICEF and the UK was held in London (see illustration) to address this issue together with FGM/C.[103][104] Later that same year the General Assembly of the United Nations passed a resolution, which inter alia[105]
Long-term goals are imperative, but they can make you feel overwhelmed or discouraged at times. Instead of thinking about how many dress sizes smaller you want to be in four months, focus on small everyday victories, suggests Michael Snader, BodyAware specialist and nutritionist at The BodyHoliday, a health and wellness resort in St. Lucia. “For example, today you are going to eat breakfast, fit in a workout, and drink more water,” he says. Stay focused on the present, and your future will be successful. 
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.

Anemia can deplete your energy, leaving you feeling weak, exhausted, and out of breath after even minimal physical activity. Iron deficiency can also impact your mood, causing depression-like symptoms such as irritability and difficulty concentrating. While a simple blood test can tell your doctor if you have an iron deficiency, if you’re feeling tired and cranky all the time, it’s a good idea to examine the amount of iron in your diet.
Not being able to do a pull-up doesn’t mean you shouldn’t step up to the bar. Simply hanging on for as long as possible can improve your upper-body strength, Montenegro says. Concentrate on keeping your body as still as possible, and you’ll naturally recruit your abs, hips, and lower back in addition to your arms, she explains, or slowly move your legs in circles or up and down to further engage your abs. 
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