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.
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.
Folic acid: This form of B vitamin helps prevent neural tube defects, especially spina bifida and anencephaly. These defects can be devastating and fatal. Many foods are now fortified with folic acid. Most women get enough as part of their diet through foods such as leafy greens, a rich source of folic acid. However, some doctors recommend that women take a pregnancy supplement that includes folic acid, just to make sure they are getting the recommended 400 to 800 micrograms.
“Berries, and a lot of fruits, are an excellent source of antioxidants and water-soluble vitamins,” says Julia Hincman, MS, RD, LDN, a registered dietitian with Massachusetts General Hospital in Boston. “They are important for the prevention of cancer and to maintain your weight.” They may also lower your risk of coronary heart disease. One of the many studies done on the benefits of berries looked at blueberries, a known powerhouse. Researchers found that all their benefits remained even after cooking. The serving size is one-half cup of fresh berries (or one-quarter cup if they are dried).
Nutrition-sensitive approaches are difficult to link to women's nutritional status (5, 102). This is due to limited measurement of benefits to program beneficiaries, families, households, and communities, limited timeframes to evaluate long-term impact, logistical and political realities that make implementation difficult, and different priorities of different stakeholders in multisectoral programs (102). Many nutrition-sensitive approaches, as will be described, thus focus on more distal measures of impact (e.g., coverage, knowledge) and not more proximal measures of women's nutritional status (e.g., BMI, anemia status, etc.).
Nutrition education Health clinics ↑ knowledge, NC Hgb, ↑ intake of fruits and vegetables, ↓/NC intake of fats, sweets, and sugar-sweetened beverages ↑ knowledge, NC Hgb, ↑ intake of fruits and vegetables, ↓/NC intake of fats, sweets, and sugar-sweetened beverages ↑ knowledge, NC urinary iodine, ↑ intake of nutrient-rich foods, ↑ intake of protein, ↑ weight gain, ↑/NC weight loss postpartum (obese women) with diet and exercise
Iron: Iron, too, remains a critical nutrient. Adult women between the ages of 19 and 50 need 18 mg a day. Pregnant women should shoot for 27 mg a day. “The volume of blood almost doubles when women are pregnant, which dramatically increases the demand for iron,” Schwartz tells WebMD. After delivery, lactating women need far less iron, only about 9 mg, because they are no longer menstruating. But as soon as women stop breast-feeding, they should return to 18 mg a day.
The social view of health combined with the acknowledgement that gender is a social determinant of health inform women's health service delivery in countries around the world. Women's health services such as Leichhardt Women's Community Health Centre which was established in 1974 and was the first women's health centre established in Australia is an example of women's health approach to service delivery.
Adult women, and particularly women with children, were the primary targets for empowerment interventions. Empowerment interventions were predominantly delivered through community-based programs, including home visits, community groups, and community centers (5, 161, 163). There was some evidence that empowerment interventions that included delivery platforms such as radio and television, as a complement to the community- and home-based delivery platforms (5), could have some impact on reaching a wider audience. Adolescent girls were largely not the target of empowerment interventions, except for those relating to reproductive health (158), and could potentially benefit from them.
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.
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.