Trans fatty acids, also known as trans fats, are solid fats produced artificially by heating liquid vegetable oils in the presence of metal catalysts and hydrogen. They also pose a health risk, increasing LDL or "bad" cholesterol and increasing your risk of coronary heart disease. They are often found in cookies, crackers, icing and stick margarine, and in small amounts in meats and dairy products. Beginning in January 2006, all food manufacturers had to list the amount of trans fatty acids in foods, resulting in a significant reduction in the amount of these fats used in prepared foods. In its guidelines, the American Heart Association notes that trans fats increase risk of heart disease by raising "bad" LDL cholesterol and should be avoided as much as possible. In addition, research has shown that trans fats can also decrease "good" HDL cholesterol, increase inflammation, disrupt normal endothelial cell function and possibly interfere with the metabolism of other important fats—even more evidence that they are very bad for overall health.
What you eat is even more important as you enter your 40s. Women need protein (meat, fish, dairy, beans, and nuts), carbohydrates (whole grains), fats (healthy oils), vitamins, minerals, and water. These foods have been linked to some disease prevention, such as osteoporosis, high blood pressure, heart disease, diabetes, and certain cancers. The American Academy of Family Physicians supports the development of healthy food supply chains in supplemental nutrition programs so as to broaden the availability of healthy food.
The daily calcium recommendations are 1,000 milligrams a day for women under 50, and 1,500 milligrams a day for women 51 and older. Oddly enough, these are the same requirements for men, who are much less prone to osteoporosis than women. But the recommendation takes into account the fact that women are smaller than men. Thus the amount of daily calcium is greater for women on a proportional basis.
Cardiovascular disease is the leading cause of death (30%) amongst women in the United States, and the leading cause of chronic disease amongst them, affecting nearly 40% (Gronowski and Schindler, Tables I and IV). The onset occurs at a later age in women than in men. For instance the incidence of stroke in women under the age of 80 is less than that in men, but higher in those aged over 80. Overall the lifetime risk of stroke in women exceeds that in men. The risk of cardiovascular disease amongst those with diabetes and amongst smokers is also higher in women than in men. Many aspects of cardiovascular disease vary between women and men, including risk factors, prevalence, physiology, symptoms, response to intervention and outcome.
The major differences in life expectancy for women between developed and developing countries lie in the childbearing years. If a woman survives this period, the differences between the two regions become less marked, since in later life non-communicable diseases (NCDs) become the major causes of death in women throughout the world, with cardiovascular deaths accounting for 45% of deaths in older women, followed by cancer (15%) and lung disease (10%). These create additional burdens on the resources of developing countries. Changing lifestyles, including diet, physical activity and cultural factors that favour larger body size in women, are contributing to an increasing problem with obesity and diabetes amongst women in these countries and increasing the risks of cardiovascular disease and other NCDs.
The average woman should get 10 to 35 percent of her daily calories from protein. Protein helps prevent muscle tissue from breaking down and repairs body tissues. Sources of animal proteins include meat, fish, poultry, eggs, milk and cheese. Vegetable proteins include dried beans and peas, peanut butter, nuts, bread and cereal. (A three-ounce serving of cooked chicken contains about 21 grams of protein.)
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. 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. 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. The UNFPA has made prevention of OF a priority and is the lead agency in the Campaign to End Fistula, which issues annual reports and the United Nations observes May 23 as the International Day to End Obstetric Fistula every year. Prevention includes discouraging teenage pregnancy and child marriage, adeaquate nutrition, and access to skilled care, including caesarian section.
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.
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.
We conducted a comprehensive narrative review to synthesize the existing literature on interventions targeting women's nutrition (11). We searched the PubMed database and Google Scholar from 1990 to December 2017 for peer-reviewed articles, systematic reviews, and grey literature that reported on a set of nutrition-specific and nutrition-sensitive interventions, outlined in what follows. We also reviewed the cited sources of key articles. When available, we used existing reviews to identify studies. Some of the review articles that emerged from our search included both high-income countries and low- and middle-income countries. When possible, we specified the delivery platforms for low- and middle-income countries. For review articles that did not explicitly describe the intervention delivery platforms, we reviewed the cited primary sources to identify the delivery platform for the discussed interventions.
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.).