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A 55-year-old woman who gets less than 30 minutes of daily physical activity should eat five ounces of grains; two cups of vegetables; one and a half cups of fruit; three cups of milk; five ounces of meat and beans; five teaspoons of oils, and no more than 130 calories of additional fat and sugar. If she got 30 to 60 minutes of daily exercise, she could increase her intake to six ounces of grains; two and a half cups of vegetables; and up to 265 additional calories of fat and sugar.
 Income-generation activities  Home visits    ↑ health knowledge, ↑ health care utilization, ↓ poverty  ↑ nutrition and knowledge, ↓ anemia, ↓/NC night blindness, ↑ intake of vitamin A–rich foods, ↑/NC intake of vegetables, ↑ intake of ASF, ↓ underweight, ↑ health care utilization, ↓ poverty  ↑ health knowledge, ↑ health care utilization, ↓ poverty 
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]
The U.S. Department of Agriculture's (USDA) food pyramid system (www.mypyramid.gov) provides a good start by recommending that the bulk of your diet come from the grain group—this includes bread, cereal, rice and pasta— the vegetable group; and the fruit group. Select smaller amounts of foods from the milk group and the meat and beans group. Eat few—if any—foods that are high in fat and sugars and low in nutrients. The amount of food you should consume depends on your sex, age and level of activity.
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.
Recent research by the Centers for Disease Control and Prevention showed that ART babies are two to four times more likely to have certain kinds of birth defects. These may include heart and digestive system problems, and cleft (divided into two pieces) lips or palate. Researchers don't know why this happens. The birth defects may not be due to the technology. Other factors, like the age of the parents, may be involved. More research is needed. The risk is relatively low, but parents should consider this when making the decision to use ART. 

Women have traditionally been disadvantaged in terms of economic and social status and power, which in turn reduces their access to the necessities of life including health care. Despite recent improvements in western nations, women remain disadvantaged with respect to men.[6] The gender gap in health is even more acute in developing countries where women are relatively more disadvantaged. In addition to gender inequity, there remain specific disease processes uniquely associated with being a woman which create specific challenges in both prevention and health care.[18]

If you count calories, count fat calories, too. Food labels indicate how many calories come from fat, both in actual grams and in percentages. This helps you assess the percentage of fat in your diet. If the total number of fat calories is 30 percent or more of the total calories you consume in a day, you probably need to cut back. But don't be misled by terms like "lower fat." Ask yourself "lower than what?" and look at the overall percentage of fat calories in the food.
“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).
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]
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.
Of near miss events, obstetrical fistulae (OF), including vesicovaginal and rectovaginal fistulae, remain one of the most serious and tragic. Although corrective surgery is possible it is often not available and OF is considered completely preventable. If repaired, subsequent pregnancies will require cesarian section.[53] While unusual in developed countries, it is estimated that up to 100,000 cases occur every year in the world, and that about 2 million women are currently living with this condition, with the highest incidence occurring in Africa and parts of Asia.[39][53][54] OF results from prolonged obstructed labor without intervention, when continued pressure from the fetus in the birth canal restricts blood supply to the surrounding tissues, with eventual fetal death, necrosis and expulsion. The damaged pelvic organs then develop a connection (fistula) allowing urine or feces, or both, to be discharged through the vagina with associated urinary and fecal incontinence, vaginal stenosis, nerve damage and infertility. Severe social and mental consequences are also likely to follow, with shunning of the women. Aprt from lack of access to care, causes include young age, and malnourishment.[11][55][53] The UNFPA has made prevention of OF a priority and is the lead agency in the Campaign to End Fistula, which issues annual reports[56] and the United Nations observes May 23 as the International Day to End Obstetric Fistula every year.[57] Prevention includes discouraging teenage pregnancy and child marriage, adeaquate nutrition, and access to skilled care, including caesarian section.[11]
Getting enough water also is important. Many experts recommend at least eight 8-ounce glasses of water daily—more if you exercise frequently or are exposed to extremes of heat and cold. The 2010 Dietary Guidelines for Americans emphasize drinking more water and other calorie-free beverages, along with fat-free or low-fat milk and 100 percent fruit juices, instead of calorie-packed regular sodas.
B12: Like folic acid, B12 is essential for healthy nervous system development and function. Pregnant women who are vegans or vegetarians may fall short on B12, since it is present in animal protein and to a lesser extent in dairy. Teenage and adult women need 2.4 mcg. Recommended levels rise to 2.6 mcg for pregnant women and 2.8 mcg for lactating women.
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.
Some fat is an important part of your diet; fat is part of every cell. It maintains skin and hair; stores and transports fat-soluble vitamins A, D, E and K; keeps you warm; and protects your internal organs. It even helps your mental processes—not surprising given that fat comprises about 60 percent of your brain. But many women consume too much fat. The American Heart Association (AHA) recommends that you keep your total fat intake between 25 and 35 percent of your total calories.
You should eat a healthful, well-balanced diet during pregnancy. However, you should avoid certain foods, including raw or undercooked fish, poultry and meat; raw or partially cooked eggs or foods containing raw eggs; unpasteurized juices; raw sprouts; unpasteurized milk products; and some soft cheeses (cream cheese is OK). Avoid deli meats and frankfurters unless they have been reheated to steaming hot before eating. To prevent food-borne illnesses, take the following precautions:
A workout partner not only keeps you accountable, she also may help you clock more time at the gym and torch more fat. A British survey of 1,000 women found that those who exercise with others tend to train six minutes longer and burn an extra 41 calories per session compared to solo fitness fanatics. [Tweet this fact!] Women with Bikram buddies and CrossFit comrades said they push themselves harder and are more motivated than when they hit the gym alone.
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.
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]
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.
Research from Tufts University nutrition scientists shows that Americans are drinking so much soda and sweet drinks that they provide more daily calories than any other food. Obesity rates are higher for people consuming sweet drinks. Also watch for hidden sugar in the foods you eat. Sugar may appear as corn syrup, dextrose, fructose, fruit juice concentrate or malt syrup, among other forms, on package labels.
 	Community centers 	↑/NC knowledge about hygiene and sanitation, ↑ water quality, ↓ diarrheal morbidity 	↑/NC knowledge about hygiene and sanitation, ↑ water quality, ↓ diarrheal morbidity 	↑/NC knowledge about hygiene and sanitation, ↑/NC hand-washing, ↑ water quality, NC waste disposal, ↓ diarrheal morbidity 	↑/NC knowledge about hygiene and sanitation, ↑ water quality, ↓ diarrheal morbidity 

Vinyasa and power may not be the only forms of yoga that will get you closer to that long, lean, limber look. Research presented at the 73rd Scientific Sessions of the American Diabetes Association found that restorative yoga—which focuses more on relaxing and stress-reducing movements rather than a challenging flow or balancing poses—burns more subcutaneous fat (the kind directly under your skin) than stretching does. By the end of the yearlong study, yogis who practiced at least once a month lost an average of about three pounds, nearly double the amount lost by those who only stretched. So if you don’t feel up for a more athletic yoga class, ease your way into a practice with a gentle one.
For some simple suggestions about eating a healthy, balanced diet, check out the "New American Plate Concept" from the American Institute for Cancer Research. This concept suggests you fill your plate with two-thirds or more of vegetables, fruits, whole grains or beans and only one-third or less of animal protein. This simple principle can guide you toward healthier eating. For more details, visit http://www.aicr.org/site/PageServer?pagename=reduce_diet_new_american_plate.
The Center for Young Women’s Health (CYWH) is a collaboration between the Division of Adolescent and Young Adult Medicine and the Division of Gynecology at Boston Children’s Hospital. The Center is an educational entity that exists to provide teen girls and young women with carefully researched health information, health education programs, and conferences.

Hysterosalpingography (HIS-tur-oh-sal-ping-GOGH-ru-fee): This is an x-ray of the uterus and fallopian tubes. Doctors inject a special dye into the uterus through the vagina. This dye shows up in the x-ray. Doctors can then watch to see if the dye moves freely through the uterus and fallopian tubes. This can help them find physical blocks that may be causing infertility. Blocks in the system can keep the egg from moving from the fallopian tube to the uterus. A block could also keep the sperm from reaching the egg.
Before you start a juice cleanse diet, know that drastically restricting your caloric intake to drop pounds may backfire: In a 2010 study, women placed on a 1,200-calorie diet for three weeks had elevated levels of cortisol, our primary stress hormone. [Tweet this fact!] Chronic stress has been associated with an increased risk of weight gain as well as coronary heart disease, hypertension, diabetes, cancer, and impaired immune functioning. 
You can customize your cookie preferences by using the settings next to "Analytical Cookies" and "Marketing Cookies." Click the "Save Preferences" button to save your customized settings. You can access and change your cookie preferences at any time by clicking "Data Protection Settings" icon in the lower left corner of our website. For more detailed information on the cookies we use, please visit the Academy's Privacy Policy.
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]

Postmenopausal bleeding is caused by endometrial cancer only 9% of the time, but 91% of women with endometrial cancer have postmenopausal bleeding. For this reason, it’s always important that women have any unusual or postmenopausal bleeding checked by a doctor to rule out endometrial cancer. An ultrasound and biopsy are typically recommended to determine what is causing the bleeding. (Locked) More »


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.
There are a number of cultural factors that reinforce this practice. These include the child's financial future, her dowry, social ties and social status, prevention of premarital sex, extramarital pregnancy and STIs. The arguments against it include interruption of education and loss of employment prospects, and hence economic status, as well as loss of normal childhood and its emotional maturation and social isolation. Child marriage places the girl in a relationship where she is in a major imbalance of power and perpetuates the gender inequality that contributed to the practice in the first place.[93][94] Also in the case of minors, there are the issues of human rights, non-consensual sexual activity and forced marriage and a 2016 joint report of the WHO and Inter-Parliamentary Union places the two concepts together as Child, Early and Forced Marriage (CEFM), as did the 2014 Girl Summit (see below).[95] In addition the likely pregnancies at a young age are associated with higher medical risks for both mother and child, multiple pregnancies and less access to care[96][11][93] with pregnancy being amongst the leading causes of death amongst girls aged 15–19. Girls married under age are also more likely to be the victims of domestic violence.[92]
Stress can wreak serious havoc on our bodies, but we actually need stress to a certain extent. For example, if we were running from a bear, we would need our stress response to kick in full force. We would start breathing faster, sending more oxygen to muscles to fuel movement, then our bodies would release stress hormones from our adrenal glands (cortisol) to heighten our focus by tapping into energy reserves for fuel so we could flee the danger. Cortisol isn’t always the bad guy, but when this response is high and chronic it tells your body to eat more than it “needs” because it’s thinking much more about survival, not stress over a work deadline or relationship woe. Cortisol is needed, but high levels of cortisol over time will contribute to those mentioned health impacts, especially abdominal weight gain! The problem is when we’re actually not in danger and our bodies are living in this state chronically. THIS is the magic piece of the puzzle – learning how we can turn off that heightened stress response when it’s not needed.
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.
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]
Food fortification is one of the most cost-effective strategies to improve micronutrient status through a variety of food vehicles, including staples, condiments, and processed foods (63, 64). Common fortifiable micronutrients include iron, folic acid, vitamin A, vitamin D, vitamin E, and iodine, although B vitamins and vitamin C are also used as fortificants (33, 64). Food fortification reduced anemia and iron deficiency anemia, and improved vitamin A, folate, niacin, thiamin, vitamin B-6, vitamin B-12, zinc, and iodine status of women of reproductive age and adolescents (13, 46, 61, 63–74). Vitamin D and calcium fortification were found to reduce the risk of osteoporosis among older women, especially for those exposed to inadequate sunlight (63, 64). Biofortification efforts, including those that involved breeding or genetic modification of plants to improve micronutrient content, have also shown improvements in the vitamin A and iron status of women (64, 75). Similar to micronutrient supplementation, women and girls with low micronutrient status were most likely to benefit.

Salt, caffeine and alcohol intake may interfere with the balance of calcium in the body by affecting the absorption of calcium and increasing the amount lost in the urine. Moderate alcohol intake (one to two standard drinks per day) and moderate tea, coffee and caffeine-containing drinks (no more than six cups per day) are recommended. Avoid adding salt at the table and in cooking
When trying to adopt new healthy habits, it's important to work around other long-standing practices that could sabotage your efforts if overlooked. For example, if you are a morning person, working out in the a.m. is likely best, but if you’re a night person, exercise after work, says Tara Stiles, owner of Strala Yoga in New York City. [Tweet at Tara!]“Don't try to become one or the other if it's not natural to you. You're more likely to stick to it if you like the time of day and the whole experience.”

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.[76] 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).[76]

Always be sure you get regular servings of dairy products, calcium-rich tofu and greens, and calcium-fortified orange juice. Also, eat lean meat and/or high-quality protein combinations such as pinto beans and rice. Avoid fiber supplements as these bind calcium and other minerals in the intestinal tract. When this happens the absorption of essential nutrients decreases.
There are many well-documented challenges in disentangling empowerment interventions from other interventions with which they are delivered. Empowerment interventions are often integrated into income-generating activities and agricultural extension, and many empowerment approaches are retroactively classified as “nutrition-sensitive” despite a lack of nutrition components in the original intervention designs (5). In addition, many studies are limited in scope and their evaluation of nutrition outcomes (159), and it is difficult to evaluate which dimensions of women's empowerment matter most for nutrition (162). Notably, indicators to quantify women's empowerment are also not used consistently and vary widely between individual studies (158).

At Women's Fitness Company, we strive everyday to support and empower women to change their lives through fitness and education. We do this by focusing on relationships with you, our member and by providing the highest quality of service and the most knowledgeable staff in the valley. You do not have to feel alone in reaching your fitness goals because everything we do starts and ends with you!


Recent research by the Centers for Disease Control and Prevention showed that ART babies are two to four times more likely to have certain kinds of birth defects. These may include heart and digestive system problems, and cleft (divided into two pieces) lips or palate. Researchers don't know why this happens. The birth defects may not be due to the technology. Other factors, like the age of the parents, may be involved. More research is needed. The risk is relatively low, but parents should consider this when making the decision to use ART.
I realize that none of the above foods have 100% DV of calcium, and while we all should be getting a variety of these foods through the week to help increase the amount of calcium from whole foods, you can also boost it with a supplement- especially if you fall into any of the above categories. I’ve really been liking the New Chapter’s Every Woman’s One Daily Multivitamin which has calcium and is rich in vitamin D3. Read more on that in the next question!
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.
Research from Tufts University nutrition scientists shows that Americans are drinking so much soda and sweet drinks that they provide more daily calories than any other food. Obesity rates are higher for people consuming sweet drinks. Also watch for hidden sugar in the foods you eat. Sugar may appear as corn syrup, dextrose, fructose, fruit juice concentrate or malt syrup, among other forms, on package labels.
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.
Iron is one of the keys to good health and energy levels in women prior to menopause. Foods that provide iron include red meat, chicken, turkey, pork, fish, kale, spinach, beans, lentils and some fortified ready-to-eat cereals. Plant-based sources of iron are more easily absorbed by your body when eaten with vitamin C-rich foods. So eat fortified cereal with strawberries on top, spinach salad with mandarin orange slices or add tomatoes to lentil soup.
Women and men differ in their chromosomal makeup, protein gene products, genomic imprinting, gene expression, signaling pathways, and hormonal environment. All of these necessitate caution in extrapolating information derived from biomarkers from one sex to the other.[6] Women are particularly vulnerable at the two extremes of life. Young women and adolescents are at risk from STIs, pregnancy and unsafe abortion, while older women often have few resources and are disadvantaged with respect to men, and also are at risk of dementia and abuse, and generally poor health.[17]
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.
It has not been scientifically established that large amounts of vitamins and minerals or dietary supplements help prevent or treat health problems or slow the aging process. Daily multivitamin tablets can be beneficial to some people who do not consume a balanced diet or a variety of foods. Generally, eating a well-balanced diet with a variety of foods provides the necessary nutrients your body needs. Eating whole foods is preferable to supplements because foods provide dietary fiber and other nutritional benefits that supplements do not. If you choose to take vitamin and mineral supplements, it is recommended to choose a multi-vitamin that does not exceed 100 percent of the Recommended Dietary Intake (RDI).

The delivery platforms of birth spacing and family planning interventions were often associated with health clinics and community health posts (148–150). Many interventions targeted lactating women during the follow-up with their young children (148, 151–153). Home visits by community health workers and service provision at community health posts and mobile clinics were also used to target women and adolescents who were married, and were found to be effective at increasing use of contraception (150, 154). School-based programs were also effective at reaching adolescent girls and increased their knowledge about contraceptives and sexually transmitted infections, use of contraception, and treatment of sexually transmitted infections (155). In high-income settings, school-based interventions were most effective at reducing pregnancies and repeated pregnancies among adolescents when contraception was also available on-site (107). This might have implications for their effectiveness in low- and middle-income countries, as well. In addition, formative work of 2 ongoing studies suggested that mass media, mobile devices, texting, and community mobilization could also be used as platforms to reach adolescent girls and women of reproductive age (156, 157). Community-based programs that target men, families, and communities, beyond those that reach married and postpartum women alone, have potential to change cultural norms and enhance women's health outcomes; however, these are not well captured in the literature.
Globally, cervical cancer is the fourth commonest cancer amongst women, particularly those of lower socioeconomic status. Women in this group have reduced access to health care, high rates of child and forced marriage, parity, polygamy and exposure to STIs from multiple sexual contacts of male partners. All of these factors place them at higher risk.[11] In developing countries, cervical cancer accounts for 12% of cancer cases amongst women and is the second leading cause of death, where about 85% of the global burden of over 500,000 cases and 250,000 deaths from this disease occurred in 2012. The highest incidence occurs in Eastern Africa, where with Middle Africa, cervical cancer is the commonest cancer in women. The case fatality rate of 52% is also higher in developing countries than in developed countries (43%), and the mortality rate varies by 18-fold between regions of the world.[123][17][122]
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.
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