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. 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.
Manson, JoAnn E.; Chlebowski, Rowan T.; Stefanick, Marcia L.; Aragaki, Aaron K.; Rossouw, Jacques E.; Prentice, Ross L.; Anderson, Garnet; Howard, Barbara V.; Thomson, Cynthia A.; LaCroix, Andrea Z.; Wactawski-Wende, Jean; Jackson, Rebecca D.; Limacher, Marian; Margolis, Karen L.; Wassertheil-Smoller, Sylvia; Beresford, Shirley A.; Cauley, Jane A.; Eaton, Charles B.; Gass, Margery; Hsia, Judith; Johnson, Karen C.; Kooperberg, Charles; Kuller, Lewis H.; Lewis, Cora E.; Liu, Simin; Martin, Lisa W.; Ockene, Judith K.; O'sullivan, Mary Jo; Powell, Lynda H.; Simon, Michael S.; Van Horn, Linda; Vitolins, Mara Z.; Wallace, Robert B. (2 October 2013). "Menopausal Hormone Therapy and Health Outcomes During the Intervention and Extended Poststopping Phases of the Women's Health Initiative Randomized Trials". JAMA. 310 (13): 1353–1368. doi:10.1001/jama.2013.278040. PMC 3963523. PMID 24084921.
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.
It takes a lot of discipline to turn down a cupcake or roll out of your warm bed for a cold morning run. To make staying on track easier, it's important to make a real connection with your motivation, says Tara Gidus, R.D., co-host of Emotional Mojo. So think less about fitting into your skinny jeans or spring break bikini and more about emotional ties to the people you love. “Your relationships will grow stronger when you are physically healthy and taking care of yourself,” she says.
Even if you are the most independent exerciser around, give a group fitness class a shot at least once a week—you may find that you enjoy it more than sweating solo. “Happiness and health are shared through social connectedness and closeness,” says Greg Chertok, director of sport psychology at the Physical Medicine and Rehabilitation Center in New Jersey. “Geography and proximity are predictors of how contagious emotions can be, and this may translate into an athletic environment too.” Sign up for Bikram, CrossFit, spin, or Zumba, and you could find yourself—gasp!—smiling at the gym thanks to your classmates.
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.
Equally challenging for women are the physiological and emotional changes associated with the cessation of menses (menopause or climacteric). While typically occurring gradually towards the end of the fifth decade in life marked by irregular bleeding the cessation of ovulation and menstruation is accompanied by marked changes in hormonal activity, both by the ovary itself (oestrogen and progesterone) and the pituitary gland (follicle stimulating hormone or FSH and luteinizing hormone or LH). These hormonal changes may be associated with both systemic sensations such as hot flashes and local changes to the reproductive tract such as reduced vaginal secretions and lubrication. While menopause may bring relief from symptoms of menstruation and fear of pregnancy it may also be accompanied by emotional and psychological changes associated with the symbolism of the loss of fertility and a reminder of aging and possible loss of desirability. While menopause generally occurs naturally as a physiological process it may occur earlier (premature menopause) as a result of disease or from medical or surgical intervention. When menopause occurs prematurely the adverse consequences may be more severe.
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. 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.
Something else to remember: an estimated 90 to 95 percent of dieters who lose weight regain all or part of it within five years, and the consequences can be even worse than simply being overweight. Those who exercise regularly as part of a weight loss diet and maintenance program are more likely to keep the weight off. Also note that an overly restrictive diet can lead to more overeating, a natural reaction to food deprivation.
Maintaining a healthy weight is important piece of the puzzle to achieve good health. A healthy weight can be determined using the body mass index charts (see web source below). If you find you are overweight or obese, weight loss may be beneficial for you. Before you begin any weight loss efforts, consult with your medical provider and/or consult a registered dietitian to create a weight loss plan. If you are underweight, consult a medical provider to assess your weight status.
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.
The U.S. Public Health Service recommends that all women of childbearing age consume 400 mcg of folic acid (a B vitamin) daily to reduce their risk of having a pregnancy affected with spina bifida or other neural-tube defects. Women who are actively trying to get pregnant should consume 600 mcg, and lactating women should consumer 500 mcg. Women of childbearing age should also take care to meet the daily requirements for calcium, fiber, iron, protein and vitamin D. Discuss supplements with a health care professional, however. Iron and vitamin D in particular can be dangerous in high amounts.
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.
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.
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.
“Nuts are a great source of protein and monounsaturated fatty acids,” says Hincman, as well as much needed vitamin E. Examples of great choices include walnuts, almonds, and hazelnuts. Nuts are also very calorie-dense, however, so you need only a palmful for good nutrition and to feel satisfied — just one-half ounce of nuts is considered equivalent to one ounce of a typical protein choices, like chicken or beef. Hincman suggests extending the volume in a serving of nuts by adding in raisins or dried cranberries.
To help you learn how to eat healthfully, start with the U.S. Department of Agriculture's (USDA) dietary guidelines system, which you can find at http://www.mypyramid.gov. The MyPyramid system, which looks somewhat like the familiar food pyramid of old, offers guidance based on individual needs and replaces "serving" recommendations with actual amounts of food. It also emphasizes the importance of balancing nutritious (and tasty!) food choices from all food groups every day with daily physical 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.
We only included studies that reported on women's health and nutrition outcomes, and excluded studies that were targeted to women but that reported only on health and nutrition outcomes of children (including birth outcomes). We included outcomes for adolescent girls ages 10–19 y, pregnant and lactating women, nonpregnant and nonlactating women of reproductive age (>19 y), and older women. Studies that described interventions targeting a wider age range of adolescent girls (e.g., ages 8–24 y) were also included but adolescent girls aged >19 y were reported in this review as nonpregnant and nonlactating women of reproductive age. Although many adolescents in low- and middle-income countries are married and bearing children, adolescents (10–19 y) as reported in this review reflect girls who are nonpregnant and nonlactating. The few interventions in low- and middle-income countries that target pregnant and lactating adolescents are reported under pregnant and lactating women. A description of the articles included in this review can be found in Supplemental Table 1.
In 2013 about 289,000 women (800 per day) in the world died due to pregnancy-related causes, with large differences between developed and developing countries. Maternal mortality in western nations had been steadily falling, and forms the subject of annual reports and reviews. Yet, between 1987 and 2011, maternal mortality in the United States rose from 7.2 to 17.8 deaths per 100,000 live births, this is reflected in the Maternal Mortality Ratio (MMR). By contrast rates as high as 1,000 per birth are reported in the rest of the world, with the highest rates in Sub-Saharan Africa and South Asia, which account for 86% of such deaths. These deaths are rarely investigated, yet the World Health Organization considers that 99% of these deaths, the majority of which occur within 24 hours of childbirth, are preventable if the appropriate infrastructure, training, and facilities were in place. In these resource-poor countries, maternal health is further eroded by poverty and adverse economic factors which impact the roads, health care facilities, equipment and supplies in addition to limited skilled personnel. Other problems include cultural attitudes towards sexuality, contraception, child marriage, home birth and the ability to recognise medical emergencies. The direct causes of these maternal deaths are hemorrhage, eclampsia, obstructed labor, sepsis and unskilled abortion. In addition malaria and AIDS complicate pregnancy. In the period 2003–2009 hemorrhage was the leading cause of death, accounting for 27% of deaths in developing countries and 16% in developed countries.
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.
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.
It sounds counterintuitive, but fatty fish are actually good for you because they deliver omega-3 polyunsaturated fatty acids (PUFAs), fats with cardiovascular and anti-inflammatory benefits. While fish oil capsules will help you meet your PUFA needs, studies have found that fish itself offers even more nutritional benefits, including vitamin D, selenium, and antioxidants. Among the best choices are salmon, albacore tuna, herring, and trout. Recommendations are for 1 gram of PUFAs daily for people with coronary heart disease and at least 250 to 500 mg daily for those who want to prevent it.