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).
Foods that contain natural folic acid include orange juice, green leafy vegetables, peas, peanuts and beans. (One cup of cooked kidney beans contains 230 mcg of folic acid.) Fortified foods, such as ready-to-eat breakfast cereals, also contain a synthetic form of folic acid, which is more easily absorbed by your body than the natural form. Folic acid is now added to all enriched grain products (thiamin, riboflavin, niacin, and iron have been added to enriched grains for many years).
Ovulation problems are often caused by polycystic ovarian syndrome (PCOS). PCOS is a hormone imbalance problem which can interfere with normal ovulation. PCOS is the most common cause of female infertility. Primary ovarian insufficiency (POI) is another cause of ovulation problems. POI occurs when a woman's ovaries stop working normally before she is 40. POI is not the same as early menopause.
Calcium: For adult women aged 19-50, the USDA recommended daily allowance is 1,000 mg/day. For women over 50, the recommended daily allowance is 1,200 mg/day. Good sources of calcium include dairy products, leafy green vegetables, certain fish, grains, tofu, cabbage, and summer squash. Your body cannot take in more than 500 mg at any one time and there’s no benefit to exceeding the recommended daily amount.
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.
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.
As the table above shows, some of the best sources of calcium are dairy products. However, dairy products such as whole milk, cheese, and yogurt also tend to contain high levels of saturated fat. The USDA recommends limiting your saturated fat intake to no more than 10% of your daily calories, meaning you can enjoy whole milk dairy in moderation and opt for no- or low-fat dairy products when possible. Just be aware that reduced fat dairy products often contain lots of added sugar, which can have negative effects on both your health and waistline.
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.