However, many fortification programs in low- and middle-income countries are regional or voluntary and, thus, might have a limited nutritional impact at the national level (76). Although many efficacy trials show benefits of fortification interventions, scaling up fortification is limited by inadequate coverage and resources (13, 77, 78). Evidence for impact is also affected by suboptimal programming, low-bioavailability fortificants (e.g., reduced iron powder), poor consumption rates, weak enforcement mechanisms, and inadequate monitoring (76, 79, 80). More research is needed to evaluate the long-term impact of fortification and biofortification programs (75). In addition, there is also growing concern about fortifying and promoting food vehicles that have adverse health consequences when consumed in excess, such as salt and sugar, given the rising prevalence of overweight, obesity, and noncommunicable disease (81–83).
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.
SOURCES: Elaine Turner, PhD, RD, associate professor, department of Food Science and Human Nutrition, University of Florida, Gainesville. Sharon B. Spalding, MEd, CSCS, professor, physical education and health; and associate director, Virginia Women's Institute for Leadership, Mary Baldwin College Staunton, Va. American Dietetic Association web site. Institute of Medicine at the National Academies web site.
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.
According to researchers who recently reviewed the risks associated with coronary heart disease (CHD) in women, a poor diet was linked to 20 percent of all cases of heart disease. Factor in diet’s effect on other chronic diseases like diabetes and osteoporosis, and it’s obvious that good nutrition has huge women's health benefits. One way to immediately turn your health situation around is through the foods you choose to eat. Here are nine foods that you'll want to make part of your daily diet.
Community health posts and home visits provided a platform to make health care services more accessible (109, 110, 124). Community-based platforms for the delivery of health services included community center and home visits from community health workers, mobile clinics, community support groups, mobile phones, and mass media campaigns (105, 110). Community-based services were effective in reducing maternal mortality and managing HIV (106). However, 1 review found that community-based interventions were only effective in reducing maternal morbidity and not mortality (107, 110). In high-income settings, community-based services were associated with hypertension and diabetes management, and cervical and breast cancer screening (106). We found no references for the use of community-based integrated care to address women's nutrition in low- and middle-income settings. It could be an effective way to reach older women and women of reproductive age who do not regularly engage with health centers. For children, community-based services were effective in improving health outcomes, particularly among the poorest wealth quintiles (13, 110). More research is needed on the potential of community-based services to reduce inequities in delivery of care to women in different settings and across different socioeconomic statuses.
WASH interventions, such as toilet facilities, access to improved and safe water supply, and hand washing are associated with improved nutrition and health of entire communities (13, 14, 125–128). For women and adolescent girls, WASH interventions were associated with improved menstrual hygiene (126), reduced diarrhea and intestinal worm infections (128–131), and reduced maternal mortality (132). Women and young girls are also more affected by the physical and time burdens of collecting water (126), and harassment and violence associated with inadequate and unsafe toilet facilities (133, 134). Closer water points and sanitation facilities eased these gendered burdens (126, 135). WASH interventions and perceived water availability were associated with less time spent on water-related chores, and improved school attendance, women's empowerment, and self-esteem (126, 135, 136).
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.
Our review found that protein-energy supplementation was largely targeted to pregnant and lactating women (19, 86–88, 90, 91); however, there were some studies that evaluated the delivery of protein-energy supplementation to households (92, 93) and adolescents (46). The only studies we found that evaluated the impact of protein-energy supplementation in older, healthy women were hospital-based studies in high-income countries (96). Delivery platforms varied depending on the target audience. The majority of studies targeted pregnant women through antenatal care or through antenatal care–associated community-based programs. National programs targeting low-income families had broader reach, although they targeted households and not women specifically (92). Additional research is needed for how women might best be reached (94). For programs that provided provisions for women to take home, there was also limited information about how much was shared with other members of the household. School-based programs targeting adolescents could be an important venue to target interventions to adolescents in the future. However, children and adolescents not in school would be missed. Despite limited evidence of impacts of energy and protein supplementation on the health of women, supplementation might be an important complement to other interventions (e.g., nutrition education and counseling) to ensure that women have the resources needed to implement other interventions successfully. Indeed, many large-scale programs for protein-energy supplementation are often complemented with nutrition education and counseling (33).
“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.”
Native to East Asia, soybeans have been a major source of protein for people in Asia for more than 5,000 years. Soybeans are high in protein (more than any other legume) and fiber, low in carbohydrates and are nutrient-dense. Soybeans contain substances called phytoestrogens, which can significantly lower your "bad" LDL cholesterol and raise your "good" HDL cholesterol.
Before and during pregnancy. You need more of certain nutrients than usual to support your health and your baby’s development. These nutrients include protein, calcium, iron, and folic acid. Many doctors recommend prenatal vitamins or a folic acid supplement during this time. Many health insurance plans also cover folic acid supplements prescribed by your doctor during pregnancy. You also need to avoid some foods, such as certain kinds of fish. Learn more about healthy eating during pregnancy in our Pregnancy section.
Vickers, M. R; MacLennan, A. H; Lawton, B.; Ford, D.; Martin, J.; Meredith, S. K; DeStavola, B. L; Rose, S.; Dowell, A.; Wilkes, H. C; Darbyshire, J. H; Meade, T. W (4 August 2007). "Main morbidities recorded in the women's international study of long duration oestrogen after menopause (WISDOM): a randomised controlled trial of hormone replacement therapy in postmenopausal women". BMJ. 335 (7613): 239. doi:10.1136/bmj.39266.425069.AD. PMC 1939792. PMID 17626056.
Popular belief says if you really want to make a big change, focus on one new healthy habit at a time. But Stanford University School of Medicine researchers say working on your diet and fitness simultaneously may put the odds of reaching both goals more in your favor. They followed four groups of people: The first zoned in on their diets before adding exercise months later, the second did the opposite, the third focused on both at once, and the last made no changes. Those who doubled up were most likely to work out 150 minutes a week and get up to nine servings of fruits and veggies daily while keeping their calories from saturated fat at 10 percent or less of their total intake.
Many nutrition-sensitive approaches were delivered in broader community-based settings and more equitably reached women across the life course. Non-facilities-based settings more equitably delivered nutrition interventions to women who were not pregnant or lactating, and who were less engaged with health clinics and schools. For instance, food fortification, which was often delivered through markets, home visits, and community centers, seemed to be more effective at reaching women of reproductive age than health center–based delivery platforms. Community-level interventions are often reported as more equitable than platforms that require access to “fixed and well-equipped health facilities” (212). This aligns with our findings, where we found that community-based platforms such as home visits, community centers, homes of community leaders, work, mass media, mobile phones, and commercial settings were effective at reaching women across the life course (Table 1). Other delivery platforms such as marketplaces, water points, tailoring shops, and agricultural points for seeds or inputs were also effective. These locations need to be context-specific in order to capture where women spend their time. For instance, in countries where many adolescent girls do not attend school, school-based delivery platforms might be less effective. Delivery platforms also need to be sensitive to the sociodemographic differences that influence where women spend their time, such as differences for women in rural and urban areas, and of different socioeconomic statuses. Additional research needs to identify and report where women and adolescent girls are, and how best to reach them.
Iodine is needed for normal mental development of the baby, but it can be difficult to get enough from food. Ways of increasing iodine intake include using iodised salt, eating fish and seafood weekly (see your health professional for advice about safe types and amounts of fish), or using a multivitamin supplement that contains iodine and is safe for pregnancy.
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.
You know it's easier to fall off the healthy-eating wagon when the person across the table from you is going whole-hog on mozzarella sticks, but science still felt the need to study this. And evidence presented at the 2013 Agricultural and Applied Economic Associations annual meeting backs you up: In the study, people made similar dining choices as their companions did, possibly because we simply want to fit in. Not all eating partners make a bad influence, though. The report further speculates that if you're eating with a health-conscious person, you may be more likely to order something more nutritious as well.
If you usually head to the gym after work, take heed: Mental exhaustion can make you feel physically exhausted, even when you have plenty of energy, reports a Medicine & Science in Sports & Exercise study. When people played a brain-draining computer game before exercising, they reported a subsequent workout as being harder, yet their muscles showed the same activity as they did doing the same workout after an easy mental game. So if you think you can’t eke out those last 10 minutes on the rowing machine, remember: You can! [Tweet this motivation!]
During adolescence and early adulthood, women need to consume foods rich in calcium to build peak (maximum) bone mass. This will reduce the risk of developing osteoporosis, a progressive condition where there is a loss of bone that leaves those affected more susceptible to fractures. Women also need an adequate iron intake because they lose iron through menstruation. Women also need an adequate intake of calories to support energy and nutritional needs in order for the body to function properly. The amount of calories that an individual needs varies for each person and is based on age, gender and activity level. As a general recommendation, women between 23 and 50 years of age generally need between 1,700 and 2,200 calories per day to maintain their current energy needs and body weight. Older women generally require fewer calories to support and sustain energy needs. Consuming fewer than 1,500 calories per day, even in attempts to lose weight, can put women at nutritional risk and can result in malnutrition and poor health. For more information on how to calculate one’s nutritional needs, go to www.choosemyplate.gov and insert your personal information. The 2005 Dietary Guidelines for Americans is another reference or guide to assist you in learning to eat a balanced and nutritious diet for good health.
The authors’ contributions were as follows—ELF and CD: were involved in the acquisition of the data; ELF, CD, SMD, and JF: were responsible for the interpretation of the data; ELF: wrote the paper and had primary responsibility for the content; CD, SMD, WS, and JF: were involved in providing detailed comments and revising the manuscript for important intellectual content; and all authors: were involved in the conception of this review and read and approved the final manuscript.
Fats contain both saturated and unsaturated (monounsaturated and polyunsaturated) fatty acids. Saturated fat raises blood cholesterol more than unsaturated fat, which may even help lower harmful cholesterol. Reducing saturated fat (most comes from meat, dairy and bakery products) to less than seven percent of total daily calories may help you reduce your cholesterol level. Whenever possible, replace saturated fat with monounsaturated and polyunsaturated fats.
Sugar is a source of calories, not nutrients. Consuming too much sugar can lead to weight gain and tooth decay. Contrary to what many people think, there is no evidence linking high-sugar diets to hyperactivity or diabetes. However, high-fructose corn syrup, found in most processed foods, is linked with obesity, and obesity increases your risk for developing diabetes and other conditions.