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 often received micronutrient supplements during antenatal and postnatal care (13, 35–42, 51, 60), and, as such, supplementation was often targeted to pregnant and lactating women. The delivery of micronutrient supplementation commonly occurred in health care settings for at-home consumption. Community-based antenatal care that involved home visits by community health workers was also a common delivery platform for supplementation delivery. There were some studies that reported micronutrient supplementation to adolescents, women of reproductive age, pregnant women, and women with young children outside of the antenatal care setting. These included primary health care clinics, home visits, community centers, pharmacies, and workplaces (32, 38–43, 45, 52, 53). Adolescent girls were also reached by community- and school-based programs (26, 41, 46). School-based programs were more efficacious in reducing rates of anemia among adolescent girls, compared with the community-based interventions (26, 46). However, many of the reported studies to date involved small samples of adolescents in controlled settings, and additional research is needed on the effectiveness of these programs (59, 62).
Systematically report and evaluate women's nutrition outcomes in research and program evaluation documents in low- and middle-income countries, including outcomes for adolescents, older women, and mothers (as opposed to reporting on women's nutrition as child nutrition outcomes alone). When possible, report and evaluate differences by setting (e.g., rural compared with urban) and socioeconomic status.
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.
Granted, our brief magazine survey here is far from inclusive. 2016 saw the debut of magazine FabUplus, specifically geared to the plus-size woman. Women’s Running featured regular-sized women on its August 2015 and April 2016 covers. But even as Shape promotes the body-positivity movement with interviews with people like Willcox, who now runs a plus-size modeling agency, it’s still pushing posts like the below. How are these body types different exactly?
Carbohydrates should provide 45%–65% of your daily calories. Most of those calories should come from the complex carbohydrates in high-fiber and unrefined foods, such as bran cereal and other whole-grain products, brown rice, beans and other legumes, and many fruits and vegetables. These carbohydrates are digested and absorbed slowly, so they raise the blood sugar gradually and don't trigger a large release of insulin. People who eat lots of these foods have higher HDL ("good") cholesterol levels and a lower risk of obesity, diabetes, and heart disease. A good amount of soluble fiber in the diet lowers LDL ("bad") cholesterol, and high-fiber diets reduce the risk of intestinal disorders ranging from constipation and diverticulosis to hemorrhoids. Some studies have shown that fiber may help reduce the risk of colon cancer. Men need more fiber than women: 38 vs. 25 grams a day before the age of 50 and 30 vs. 21 grams a day thereafter.
So we can applaud some of the efforts of Women’s Health. As editor Amy Keller Laird announced in that Jan/Feb issue, the magazine “will no longer be using fitness models in our monthly ‘15-Minute Workout.’ We’ll feature readers of various body types and sizes,” like the refreshingly normal-sized Morgan Gibson Kanner, hurling a weight plate around in stretchy workout clothes. As progressive as the layout is, Laird points out that “it’s logistically difficult to book nonmodels who have day jobs”; sounds like she should hook up with Willcox’s modeling service.
Although canola oil appears to be good for the cardiovascular system, two Harvard studies have raised concerns that ALA might be bad for the prostate. In 1993, the Health Professionals Follow-up Study of 47,781 men published a major evaluation of dietary fat and prostate cancer. It found that saturated fat from animal sources such as red meat and whole-fat dairy products was linked to a 2.6-fold increase in prostate cancer. But the study also provided some disquieting news about ALA: Men who consumed the most ALA were 3.4 times more likely to be diagnosed with prostate cancer than those who had the lowest dietary intake.
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.).