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." 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".
A number of health and medical research advocates, such as the Society for Women's Health Research in the United States, support this broader definition, rather than merely issues specific to human female anatomy to include areas where biological sex differences between women and men exist. Women also need health care more and access the health care system more than do men. While part of this is due to their reproductive and sexual health needs, they also have more chronic non-reproductive health issues such as cardiovascular disease, cancer, mental illness, diabetes and osteoporosis. Another important perspective is realising that events across the entire life cycle (or life-course), from in utero to aging effect the growth, development and health of women. The life-course perspective is one of the key strategies of the World Health Organization.
In our review, we found that fortification interventions that provided fortified foods reached women of all life stages through home visits, community distribution centers, local markets, and retail stores. Delivery of fortified foods in school-based programs, at work, and in maternal–child health centers were also used to target school-age children, women of reproductive age, and pregnant and lactating women that were engaged with those facilities (37, 72–74, 84). There was mixed evidence that consumption of fortified foods reached all socioeconomic groups. Some studies showed differences in consumption between nonpoor and extremely poor, and between urban and rural stakeholders (33, 64, 85). Women who have restricted access to markets, depend largely on locally grown foods, are in areas with underdeveloped distribution channels, or have limited purchasing power, might have limited access to fortified foods (64). Additional research is needed to address implementation gaps and to determine the best platforms for reaching high-risk populations.
In low- and middle-income countries, health care services often respond to acute health needs and many focus on maternal–child health (105, 106, 110, 112). The use of preventative care is limited, and there are concerns about the capacity of health systems to address noncommunicable diseases, such as diabetes, in low- and middle-income settings (108, 112). This has implications for the reach of integrated health care interventions across the life course. Maternal and reproductive health care is often sought by women when they are pregnant and in the early years of their children's lives (3, 113). Even so, many women visit health facilities late in their pregnancy or not at all (114–116). For adolescents and adult women, care is often not sought until they are sick (3, 117, 118). This is problematic for older women, in particular, as screening and treatment for age-related health issues, such as diabetes, cancer, and hypertension, require access to preventative health care services (3).
Changes in the way research ethics was visualised in the wake of the Nuremberg Trials (1946), led to an atmosphere of protectionism of groups deemed to be vulnerable that was often legislated or regulated. This resulted in the relative underrepresentation of women in clinical trials. The position of women in research was further compromised in 1977, when in response to the tragedies resulting from thalidomide and diethylstilbestrol (DES), the United States Food and Drug Administration (FDA) prohibited women of child-bearing years from participation in early stage clinical trials. In practice this ban was often applied very widely to exclude all women. Women, at least those in the child-bearing years, were also deemed unsuitable research subjects due to their fluctuating hormonal levels during the menstrual cycle. However, research has demonstrated significant biological differences between the sexes in rates of susceptibility, symptoms and response to treatment in many major areas of health, including heart disease and some cancers. These exclusions pose a threat to the application of evidence-based medicine to women, and compromise to care offered to both women and men.
Calcium: For adult women aged 19-50, the USDA recommended daily allowance is 1,000 mg/day. For women over 50, the recommended daily allowance is 1,200 mg/day. Good sources of calcium include dairy products, leafy green vegetables, certain fish, grains, tofu, cabbage, and summer squash. Your body cannot take in more than 500 mg at any one time and there’s no benefit to exceeding the recommended daily amount.
While what works best for one woman may not always be the best choice for another, the important thing is to build your dietary choices around your vital nutritional needs. Whether you’re looking to improve your energy and mood, combat stress or PMS, boost fertility, enjoy a healthy pregnancy, or ease the symptoms of menopause, these nutrition tips can help you to stay healthy and vibrant throughout your ever-changing life.
Our findings identified gaps and limitations in the evaluation, scope, targeting, and delivery platforms of nutrition interventions in low- and middle-income countries. First, the monitoring and evaluation of nutrition programs that reported on women's nutrition outcomes was generally inadequate. Many of the studies we identified included small-scale efficacy trials. Although there were many large-scale programs that targeted women and adolescent girls with nutrition-specific and nutrition-sensitive approaches, they lacked rigorous evaluation. Whether the evidence about women's outcomes was limited because they are not systematically measured or because they are not well reported is not clear. Negative results are often not published, and many evaluations of nutrition interventions that are conducted by the same groups responsible for implementing them are typically presented positively. This may have also skewed our findings. More intentional research-quality program evaluation, including of large-scale programs, would provide a stronger evidence base. Of the studies identified in this review, many reported on short-term findings such as changes in knowledge, dietary behaviors, and program coverage. They were limited in their ability to report clinical and anthropometric outcomes for women, the duration of those outcomes, and the feasibility of scaling up programs. There is also a need for systematic, long-term evaluations of interventions whose effects on nutrition outcomes are more distal (e.g., nutrition education compared with micronutrient supplementation). The effects of multisectoral interventions are even more complex to measure. However, frameworks exist to evaluate complex interventions (102) and could be utilized to evaluate the impact of interventions across the life course.
Schools (and universities) ↓/NC anemia, ↓ Fe-deficiency anemia, ↑/NC MN status [Hgb (↑ if anemic), ferritin, zinc, retinol], ↑ MN status [folate, riboflavin, 25(OH)D, iodine], ↓ PTH, ↓ goiter prevalence, ↓ MN deficiency (vitamin A, B-12, C), ↑ bone mineral accretion, ↑/NC weight gain/BMI, ↑ MUAC, ↑ gut inflammation, ↓/NC respiratory symptoms and diarrheal morbidity, ↑ fitness (for Fe-deficient subjects), ↑/NC short-term cognitive function ↑ Hgb (↑ if anemic), ↑ serum ferritin, ↑ total body Fe, ↑ urinary iodine concentration, ↑ serum zinc, ↑ aerobic power, NC net energetic efficiency
Important sexual health issues for women include Sexually transmitted infections (STIs) and female genital cutting (FGC). STIs are a global health priority because they have serious consequences for women and infants. Mother-to-child transmission of STIs can lead to stillbirths, neonatal death, low-birth-weight and prematurity, sepsis, pneumonia, neonatal conjunctivitis, and congenital deformities. Syphilis in pregnancy results in over 300,000 fetal and neonatal deaths per year, and 215,000 infants with an increased risk of death from prematurity, low-birth-weight or congenital disease.
Choline: Some studies link low choline levels to increased risk of neural tube defects. Recommended levels have been established for this nutrient, but it's easy to get enough in your diet. Eggs are an excellent source of choline, for example. “Eating a few eggs a week should give you all you need,” Frechman says. “Most people can eat the equivalent of an egg a day without worrying about cholesterol.” Other choline-rich food sources include milks, liver, and peanuts.
Community centers (e.g., women's groups, community kitchens) ↓ anemia, ↑ nutrition knowledge, ↑ HH food security, ↑ HH food consumption, ↑ dietary diversity, ↑ intake of Fe-rich foods, ↑ intake of ASF, ↑ income, ↑ control over resources, ↑ decision-making ↑ nutrition knowledge, ↓/NC anemia, ↑ food expenditures, ↑ HH food security, ↑ HH food consumption, ↑/NC dietary diversity, ↑ intake of vitamin A–rich foods, ↑/NC intake of vegetables and meat, ↑ intake of fruits and ASF, NC BMI, ↓ underweight, ↑ income, ↑ control over resources, ↑ decision-making ↑ HH food security, ↑ dietary diversity
There were also supplementation programs that targeted nonpregnant women. National supplementation programs that provided food baskets to low-income families increased maternal BMI and improved household food insecurity (92, 93). However, there were some unintended consequences. In Mexico, food transfer programs disproportionately increased weight gain in overweight women compared with underweight women (93), and 1 study in Bangladesh found that food transfers had larger impacts on men's intake than women's intake, except with less preferred foods (94). Adolescents who received protein-energy supplementation at school showed an increase in weight gain during supplementation, as well as improvements in school attendance and mathematics scores (46, 95). However, the impact of supplementation on micronutrient deficiencies and, specifically, hemoglobin concentration, was limited (46).
Women also understand the relationship between working out and how it can affect everything they do in life. Most major health issues affecting women can be treated or improved by a simple workout plan. Weight loss and cardiovascular exercise help everything from stress and heart disease to diabetes. And don't forget the small, but important "fringe" benefits of fitness such as just feeling better about yourself, having more energy for your family and loved ones and living a life that begins every day by feeling good about getting up and getting moving.
Second, the scope of nutrition-specific and nutrition-sensitive approaches was largely focused on undernutrition. There were major research and programming gaps in studies targeting overweight, obesity, and noncommunicable disease. In our review, the interventions addressing overweight, obesity, and noncommunicable disease were limited to nutrition education and integrated healthcare. However, overweight and obesity were identified as potential concerns for interventions targeting undernutrition, including food supplementation, and in-kind and cash transfers. This might be a result of the types of interventions that were evaluated, but also speaks to the need to broaden the scope of nutrition interventions that are commonly assessed (5, 13, 14) to explicitly address overweight, obesity, and noncommunicable disease as nutrition outcomes, and not just as unintended consequences. Globally, there is limited evidence of large-scale interventions that effectively prevent, treat, or correctly classify adiposity-related noncommunicable diseases, and this is a growing area of concern around the world (208). Future evaluations of nutrition interventions might also include interventions that influence women's time and physical environment, and that encourage physical activity or change in access to and affordability of certain foods, as these might also influence overweight, obesity, and noncommunicable disease outcomes for women.
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.
Focus on the long term. Diets fail when people fall back into poor eating habits; maintaining weight loss over the long term is exceedingly difficult. Most people regain the weight they've lost. In fact, some studies indicate that 90 to 95 percent of all dieters regain some or all of the weight originally lost within five years. Your program should include plans for ongoing weight maintenance, involving diet, exercise and a behavioral component. While there are some physical reasons for obesity, there are also behavioral reasons for excessive eating. For example, many women use food as a source of comfort (perhaps to deal with stress). For these women, a weight loss program with a behavioral component will offer alternatives to replace food in this role.
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).
When you do high-intensity interval training (and if you’re not, you should be!), follow a 2:1 work-to-rest ratio, such as sprinting one minute followed by 30 seconds of recovery. [Tweet this secret!] According to several studies, the most recent out of Bowling Green State University, this formula maximizes your workout results. The BGSU researchers also say to trust your body: Participants in the study set their pace for both running and recovery according to how they felt, and by doing so women worked at a higher percentage of their maximum heart rate and maximum oxygen consumption than the men did.
It doesn't matter how many pushups you can do in a minute if you're not doing a single one correctly. “There is no point in performing any exercise without proper form,” says Stokes, who recommends thinking in terms of progression: Perfect your technique, then later add weight and/or speed. This is especially important if your workout calls for performing “as many reps as possible” during a set amount of time. Choose quality over quantity, and you can stay injury-free.
Women, as we age, are also more susceptible to the breakdown of our bones, which may result in osteoporosis over time. Genetically, women have a particularly high risk of osteoporosis compared to men, so it’s recommended that women monitor their calcium intake to be sure they’re getting enough. Weight training is another great way (and my favorite!) to build bone density, which is another great reason you should hit the weights!
Female genital mutilation (also referred to as female genital cutting) is defined by the World Health Organization (WHO) as "all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons". It has sometimes been referred to as female circumcision, although this term is misleading because it implies it is analogous to the circumcision of the foreskin from the male penis. Consequently, the term mutilation was adopted to emphasise the gravity of the act and its place as a violation of human rights. Subsequently, the term cutting was advanced to avoid offending cultural sensibility that would interfere with dialogue for change. To recognise these points of view some agencies use the composite female genital mutilation/cutting (FMG/C).
Don't take dramatic steps alone. You need to work closely with an experienced health care professional to lose weight, particularly if you have other medical problems, plan to lose more than 15 to 20 pounds or take medication on a regular basis. An initial checkup can identify conditions that might be affected by dieting and weight loss. Make sure you find out how much experience your health care professional has dealing with nutrition. It's not always well covered in medical schools. You may want to talk to a registered dietitian before embarking on a diet.
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Obviously, the best treatment plan for poor nutrition is to change your diet. Most Americans eat too little of what they need and too much of that they don't. For many women, decreasing fat and sugar consumption and increasing fruit, vegetables and grains in your diet can make a big difference. Many women also need to boost consumption of foods containing fiber, calcium and folic acid. Compare your diet to that suggested by the food pyramid and compare your nutrient intake to the suggested daily levels. Adjust accordingly, and you may be able to dramatically improve your health.
Our women’s fitness programs are designed for women from the ground up. We teach from the female anatomy and physiology, the feminine psyche and include all the subtle bodies – the emotional, mental and spiritual that have an impact on the physical. We understand the different needs of the woman as she exercises through pregnancy, postnatal, menopause and the later years of her life and how these changes affect her women’s fitness needs and goals.
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.
Trimming some fat may eliminate some guilt, but be warned: Buying foods labeled “low-fat,” “non-fat,” or “fat-free” may encourage you to eat up to 50 percent more calories, according to three studies by Cornell University’s Food and Brand Lab. Fat’s not the issue when it comes your weight since most of these foods only have about 15 percent fewer calories than their regular counterparts. Go for the full-fat version and eat less—you probably will naturally since they taste better.
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).
Diseases such as chlamydia and gonorrhoea are also important causes of pelvic inflammatory disease (PID) and subsequent infertility in women. Another important consequence of some STIs such as genital herpes and syphilis increase the risk of acquiring HIV by three-fold, and can also influence its transmission progression. Worldwide, women and girls are at greater risk of HIV/AIDS. STIs are in turn associated with unsafe sexual activity that is often unconsensual.
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Not surprisingly, many integrated health services were delivered in health clinics and facilities. Many women faced barriers to health facility–based care for nutrition, such as distance, time, quality of care, stocking of supplies, and the capacity and nutrition knowledge of healthcare professionals (105, 119). These barriers need to be taken into consideration to enhance the coverage of integrated health care services. Universal health care mitigated cost barriers to seeking health care, but did not address all of the barriers noted here (105, 109, 114, 120–123).