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).
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).
Pregnancy Unintended pregnancy Gravidity and parity Obstetrics Antenatal care Adolescent pregnancy Complications of pregnancy Hyperemesis gravidarum Ectopic pregnancy Miscarriage Obstetrical bleeding Gestational diabetes Hypertension Preeclampsia Eclampsia Childbirth Midwifery Preterm birth Multiple births Oxytocin Obstructed labor Cesarian section Retained placenta Obstetrical fistulae Vesicovaginal fistula Rectovaginal fistula Episiotomy husband stitch Postpartum care Maternal deaths Perinatal mortality Stillbirths Abortion Mother-to-child transmission Sterilization Compulsory sterilization
Published ten times per year, Women's Health magazine is a premier publication focused on the health, fitness, nutrition, and lifestyles of women. With a circulation of 1.5 million readers, you'll be in good company with a subscription to this successful magazine published by Rodale. From cover to cover, each issue will provide you with tips on improving every aspect of your life.
Folate or vitamin B9 (also known as folic acid when used in fortified foods or taken as a supplement) is another nutrient that many women don’t get enough of in their diets. Folate can greatly reduce the chance of neurological birth defects when taken before conception and during the first few weeks of pregnancy. Folate can also lower a woman’s risk for heart disease and certain types of cancer, so even if you’re not planning on getting pregnant (and many pregnancies are unplanned), it’s an essential nutrient for every woman of childbearing age. In later life, folate can help your body manufacture estrogen during menopause.
Trying to balance the demands of family and work or school—and coping with media pressure to look and eat a certain way—can make it difficult for any woman to maintain a healthy diet. But the right food can not only support your mood, boost your energy, and help you maintain a healthy weight, it can also be a huge support through the different stages in a woman’s life. Healthy food can help reduce PMS, boost fertility, make pregnancy and nursing easier, ease symptoms of menopause, and keep your bones strong. Whatever your age or situation, committing to a healthy, nutritious diet will help you look and feel your best and get the most out of life.
 Integrated health care  Health clinics  ↑ knowledge about FP, NC use of FP  ↑ knowledge about diabetes, ↓ incidence of diabetes, ↑ glycemic control, ↑ hypertension screening and Tx, ↓ hypertension, NC mortality (from coronary artery disease), ↓ depression, ↑/NC health care utilization, ↑ knowledge about FP, ↑/NC use of FP, ↑/NC STI screening, NC STI incidence, ↑ cervical cancer screening, ↑ mammography  ↓/NC anemia, ↑ Hgb, ↑ glycemic control, ↑ hypertension screening and Tx, ↓ hypertension, ↓ pre-eclampsia, ↓ maternal mortality, ↓/NC placental malaria, ↓ parasitemia, ↓/NC depression, NC health care utilization, ↑/NC hospital deliveries, NC cesarean delivery, ↑/↓ knowledge about FP, ↑/NC use of FP, ↑ STI screening, ↓ STI incidence, ↑ cervical cancer screening, ↑ mammography  ↑ knowledge about diabetes, ↓ diabetes, ↑ glycemic control, ↑ hypertension screening and Tx, ↓ hypertension, NC mortality (from coronary artery disease), ↑ health care utilization, ↓ depression, ↑ mammography, ↑ cervical cancer screening 
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.
The best training tool you're not using: a jump rope. “It may seem a little juvenile until you think of all the hot-bodied boxing pros who jump rope every single day,” says Landon LaRue, a CrossFit level-one trainer at Reebok CrossFit LAB in L.A. Not only is it inexpensive, portable, and easy to use almost anywhere, you’ll burn about 200 calories in 20 minutes and boost your cardiovascular health while toning, he adds.
  Community centers  NC HH or individual food security, NC food expenditures, NC food consumption, ↑ social status, ↑ self-confidence  ↑ health and knowledge, ↓ anemia, ↑/NC HH food security, NC individual food security, NC food expenditures, ↑/NC food consumption, ↑/NC dietary diversity, ↑ MN-rich foods (Fe, vitamin A, vitamin C, calcium), ↑/NC intake of protein, ↑ ASF intake, ↑/NC BMI, ↑ weight gain, ↑ social status, ↑ self-confidence, ↑/NC decision-making  ↑ health and nutrition knowledge, ↓/NC anemia, ↑/NC HH food security, ↑/NC food expenditures, ↑/NC HH food consumption, ↑/NC dietary diversity, ↑ nutrient-rich foods (Fe, vitamin A), NC intake of protein, ↑/NC intake of vegetables and ASF, ↑/NC BMI, ↓ underweight, ↑ weight gain, NC diarrheal morbidity, ↑ self-confidence, ↑/NC decision-making, ↑ control HH resources  ↑ health knowledge, ↑/NC HH food security, ↑/NC HH food consumption, ↑ dietary diversity, ↑ self-confidence, ↑/NC decision-making 
“It was a privilege to have taken the course with you. Already, I have used the cueing methods on 2 clients. I have also taken the initiative to ask one of my post-natal client today about her birthing journey and she was so open and excited to share with me. It struck me that usually nobody asks them about it as more attention is focused on the baby.”

Anaemia is a major global health problem for women.[132] 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).[133] 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.[6]
The World Health Organization (WHO) estimates that 35% of women in the world have experienced physical or sexual violence over their lifetime and that the commonest situation is intimate partner violence. 30% of women in relationships report such experience, and 38% of murders of women are due to intimate partners. These figures may be as high as 70% in some regions.[138] Risk factors include low educational achievement, a parental experience of violence, childhood abuse, gender inequality and cultural attitudes that allow violence to be considered more acceptable.[139]
What you eat is even more important as you enter your 40s. Women need protein (meat, fish, dairy, beans, and nuts), carbohydrates (whole grains), fats (healthy oils), vitamins, minerals, and water. These foods have been linked to some disease prevention, such as osteoporosis, high blood pressure, heart disease, diabetes, and certain cancers. The American Academy of Family Physicians supports the development of healthy food supply chains in supplemental nutrition programs so as to broaden the availability of healthy food.
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).
A related issue is the inclusion of pregnant women in clinical studies. Since other illnesses can exist concurrently with pregnancy, information is needed on the response to and efficacy of interventions during pregnancy, but ethical issues relative to the fetus, make this more complex. This gender bias is partly offset by the iniation of large scale epidemiology studies of women, such as the Nurses' Health Study (1976),[162] Women's Health Initiative[163] and Black Women's Health Study.[164][6]
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Dairy. Women should get 3 cups of dairy each day, but most women get only half that amount.6 If you can’t drink milk, try to eat low-fat plain yogurt or low-fat cheese. Dairy products are among the best food sources of the mineral calcium, but some vegetables such as kale and broccoli also have calcium, as do some fortified foods such as fortified soymilk, fortified cereals, and many fruit juices. Most girls ages 9 to 18 and women older than 50 need more calcium for good bone health.
Low-fat diets also can help you lose weight.16 But the amount of weight lost is usually small. You can lose weight and lower your risk for heart disease and stroke if you follow an overall healthy pattern of eating that includes more fruits, vegetables, whole grains and beans that are high in fiber, nuts, low-fat dairy and fish, in addition to staying away from trans fat and saturated fat.
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]
These challenges are included in the goals of the Office of Research on Women's Health, in the United States, as is the goal of facilitating women's access to careers in biomedicine. The ORWH believes that one of the best ways to advance research in women's health is to increase the proportion of women involved in healthcare and health research, as well as assuming leadership in government, centres of higher learning, and in the private sector.[155] This goal acknowledges the glass ceiling that women face in careers in science and in obtaining resources from grant funding to salaries and laboratory space.[178] The National Science Foundation in the United States states that women only gain half of the doctorates awarded in science and engineering, fill only 21% of full-time professor positions in science and 5% of those in engineering, while earning only 82% of the remuneration their male colleagues make. These figures are even lower in Europe.[178]
The implications of direct nutrition interventions on women's nutrition, birth outcome and stunting rates in children in South Asia are indisputable and well documented. In the last decade, a number of studies present evidence of the role of non-nutritional factors impacting on women's nutrition, birth outcome, caring practices and nutritional status of children. The implications of various dimensions of women's empowerment and gender inequality on child stunting is being increasingly recognised. Evidence reveals the crucial role of early age of marriage and conception, poor secondary education, domestic violence, inadequate decision-making power, poor control over resources, strenuous agriculture activities, and increasing employment of women and of interventions such as cash transfer scheme and microfinance programme on undernutrition in children. Analysis of the nutrition situation of women and children in South Asia and programme findings emphasise the significance of reaching women during adolescence, pre-conception and pregnancy stage. Ensuring women enter pregnancy with adequate height and weight and free from being anemic is crucial. Combining nutrition-specific interventions with measures for empowerment of women is essential. Improvement in dietary intake and health services of women, prevention of early age marriage and conception, completion of secondary education, enhancement in purchasing power of women, reduction of work drudgery and elimination of domestic violence deserve special attention. A range of programme platforms dealing with health, education and empowerment of women could be strategically used for effectively reaching women prior to and during pregnancy to accelerate reduction in stunting rates in children in South Asia.
All youth need calcium to build peak (maximum) bone mass during their early years of life. Low calcium intake is one important factor in the development of osteoporosis, a disease in which bone density decreases and leads to weak bones and future fractures. Women have a greater risk than men of developing osteoporosis. During adolescence and early adulthood, women should include good food sources of calcium in their diets This is when bone growth is occurring and calcium is being deposited into the bone. This occurs in women until they are 30 to 35 years of age. Women 25 to 50 years of age should have 1,000 mg of calcium each day, while women near or past menopause should have 1,200 mg of calcium daily if they are taking estrogen replacement therapy; otherwise, 1,500 mg per day is recommended. Women older than 65 years of age should have 1,500 mg per day.
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.
Nutrition is particularly important during pregnancy to ensure your health and the health of the baby. It's normal to gain weight during pregnancy—not just because of the growing fetus, but because you'll need stored fat for breast-feeding. The Institute of Medicine (IOM) recommends a gain of 25 to 35 pounds in women of normal weight when they get pregnant; 28 to 40 pounds in underweight women; and at least 15 pounds in women who are overweight when they get pregnant. The IOM has not given a recommendation for an upper limit for obese women, but some experts cap it as low as 13 pounds. If you fit into this category, discuss how much weight you should gain with your health care professional.
Globally, women's access to health care remains a challenge, both in developing and developed countries. In the United States, before the Affordable Health Care Act came into effect, 25% of women of child-bearing age lacked health insurance.[176] In the absence of adequate insurance, women are likely to avoid important steps to self care such as routine physical examination, screening and prevention testing, and prenatal care. The situation is aggravated by the fact that women living below the poverty line are at greater risk of unplanned pregnancy, unplanned delivery and elective abortion. Added to the financial burden in this group are poor educational achievement, lack of transportation, inflexible work schedules and difficulty obtaining child care, all of which function to create barriers to accessing health care. These problems are much worse in developing countries. Under 50% of childbirths in these countries are assisted by healthcare providers (e.g. midwives, nurses, doctors) which accounts for higher rates of maternal death, up to 1:1,000 live births. This is despite the WHO setting standards, such as a minimum of four antenatal visits.[177] A lack of healthcare providers, facilities, and resources such as formularies all contribute to high levels of morbidity amongst women from avoidable conditions such as obstetrical fistulae, sexually transmitted diseases and cervical cancer.[6]
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