Home visits ↓/NC anemia, ↑/NC Hgb, ↑ serum ferritin, ↑/NC serum retinol, ↓ vitamin A deficiency ↓/NC anemia and Fe-deficiency anemia, ↑/NC Hgb, ↑/NC serum ferritin, ↑ serum folate, ↑ serum zinc, NC serum retinol ↓ anemia, ↑ Hgb, ↑ serum ferritin, ↑/NC serum retinol, ↑ erythrocyte thiamine diphosphate concentrations, ↓ night blindness, ↑/NC weight gain ↓ anemia, ↑/NC Hgb, ↑ serum ferritin, NC serum retinol, ↑ serum calcium, ↑ 25(OH)D concentrations, ↓ PTH, ↓ bone turnover
Breast cancer is the second most common cancer in the world and the most common among women. It is also among the ten most common chronic diseases of women, and a substantial contributor to loss of quality of life (Gronowski and Schindler, Table IV). Globally, it accounts for 25% of all cancers. In 2016, breast cancer is the most common cancer diagnosed among women in both developed and developing countries, accounting for nearly 30% of all cases, and worldwide accounts for one and a half million cases and over half a million deaths, being the fifth most common cause of cancer death overall and the second in developed regions. Geographic variation in incidence is the opposite of that of cervical cancer, being highest in Northern America and lowest in Eastern and Middle Africa, but mortality rates are relatively constant, resulting in a wide variance in case mortality, ranging from 25% in developed regions to 37% in developing regions, and with 62% of deaths occurring in developing countries.
Poor nutrition can manifest itself in many ways. The more obvious symptoms of a nutritional deficiency include dull, dry or shedding hair; red, dry, pale or dull eyes; spoon-shaped, brittle or ridged nails; bleeding gums; swollen, red, cracked lips; flaky skin that doesn't heal quickly; swelling in your legs and feet; wasted, weak muscles; memory loss; and fatigue.
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.
Nutrition interventions that target mothers alone inadequately address women's needs across their lives: during adolescence, preconception, and in later years of life. They also fail to capture nulliparous women. The extent to which nutrition interventions effectively reach women throughout the life course is not well documented. In this comprehensive narrative review, we summarized the impact and delivery platforms of nutrition-specific and nutrition-sensitive interventions targeting adolescent girls, women of reproductive age (nonpregnant, nonlactating), pregnant and lactating women, women with young children <5 y, and older women, with a focus on nutrition interventions delivered in low- and middle-income countries. We found that although there were many effective interventions that targeted women's nutrition, they largely targeted women who were pregnant and lactating or with young children. There were major gaps in the targeting of interventions to older women. For the delivery platforms, community-based settings, compared with facility-based settings, more equitably reached women across the life course, including adolescents, women of reproductive age, and older women. Nutrition-sensitive approaches were more often delivered in community-based settings; however, the evidence of their impact on women's nutritional outcomes was less clear. We also found major research and programming gaps relative to targeting overweight, obesity, and noncommunicable disease. We conclude that focused efforts on women during pregnancy and in the first couple of years postpartum fail to address the interrelation and compounding nature of nutritional disadvantages that are perpetuated across many women's lives. In order for policies and interventions to more effectively address inequities faced by women, and not only women as mothers, it is essential that they reflect on how, when, and where to engage with women across the life course.
In our review, we found that fortification interventions that provided fortified foods reached women of all life stages through home visits, community distribution centers, local markets, and retail stores. Delivery of fortified foods in school-based programs, at work, and in maternal–child health centers were also used to target school-age children, women of reproductive age, and pregnant and lactating women that were engaged with those facilities (37, 72–74, 84). There was mixed evidence that consumption of fortified foods reached all socioeconomic groups. Some studies showed differences in consumption between nonpoor and extremely poor, and between urban and rural stakeholders (33, 64, 85). Women who have restricted access to markets, depend largely on locally grown foods, are in areas with underdeveloped distribution channels, or have limited purchasing power, might have limited access to fortified foods (64). Additional research is needed to address implementation gaps and to determine the best platforms for reaching high-risk populations.
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).
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.
In 2000, the United Nations created Millennium Development Goal (MDG) 5 to improve maternal health. Target 5A sought to reduce maternal mortality by three quarters from 1990 to 2015, using two indicators, 5.1 the MMR and 5.2 the proportion of deliveries attended by skilled health personnel (physician, nurse or midwife). Early reports indicated MDG 5 had made the least progress of all MDGs. By the target date of 2015 the MMR had only declined by 45%, from 380 to 210, most of which occurred after 2000. However this improvement occurred across all regions, but the highest MMRs were still in Africa and Asia, although South Asia witnessed the largest fall, from 530 to 190 (64%). The smallest decline was seen in the developed countries, from 26 to 16 (37%). In terms of assisted births, this proportion had risen globally from 59 to 71%. Although the numbers were similar for both developed and developing regions, there were wide variations in the latter from 52% in South Asia to 100% in East Asia. The risks of dying in pregnancy in developing countries remains fourteen times higher than in developed countries, but in Sub-Saharan Africa, where the MMR is highest, the risk is 175 times higher. In setting the MDG targets, skilled assisted birth was considered a key strategy, but also an indicator of access to care and closely reflect mortality rates. There are also marked differences within regions with a 31% lower rate in rural areas of developing countries (56 vs. 87%), yet there is no difference in East Asia but a 52% difference in Central Africa (32 vs. 84%). With the completion of the MDG campaign in 2015, new targets are being set for 2030 under the Sustainable Development Goals campaign. Maternal health is placed under Goal 3, Health, with the target being to reduce the global maternal mortality ratio to less than 70. Amongst tools being developed to meet these targets is the WHO Safe Childbirth Checklist.
The mission of Student Health and Counseling Services is to enhance the physical and mental health of students in order to help them achieve academic success, personal development and lifelong wellness by providing an integrated program of quality, accessible, cost sensitive and confidential healthcare services, tailored to their unique and diverse needs and to assist the University community, through consultation and education, to develop a healthy campus environment consistent with UC Davis "Principles of Community".
Loss of taste. Some medicines alter your sense of taste making you lose your appetite. Ask your health care professional if there are alternatives to the medicine you're taking. You might also experiment with spices to make foods tastier. Also, rotating tastes of each food on your plate, rather than eating one food at once, can help you taste various flavors better. Foods with strong scents also taste better, since taste and smell are linked.
You know strength training is the best way to trim down, tone up, and get into “I love my body” shape. But always reaching for the 10-pound dumbbells isn’t going to help you. “Add two or three compound barbell lifts (such as a squat, deadlift, or press) to your weekly training schedule and run a linear progression, increasing the weight used on each lift by two to five pounds a week,” says Noah Abbott, a coach at CrossFit South Brooklyn. Perform three to five sets of three to five reps, and you’ll boost strength, not bulk. “The short, intense training will not place your muscles under long periods of muscle fiber stimulation, which corresponds with muscle growth,” Abbott explains.
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.
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).