Our review highlighted how a focus on delivery platforms could indicate who is missed by different nutrition interventions, by evaluating where there is overlap or divergence in where interventions are delivered (as represented in the Venn diagram in Figure 1). Our findings showed that a large proportion of nutrition-specific interventions were delivered at clinic-based settings or community-based health posts. Health centers are important delivery platforms, particularly for pregnant and lactating women (113, 210). However, only half of women worldwide even attend the appropriate number of antenatal care visits (with nearly 86% of women attending 1 visit) and only 59% receive appropriate postnatal care (211). Other delivery platforms, such as schools and universities, were more effective at reaching some adolescents and women of reproductive age. However, interventions delivered at “facilities” (schools, health clinics, health posts) require participation with those facilities, and participation is often limited because of time, costs, distance, and other responsibilities, including work and childcare (116). Facilities-based care is also more likely to miss certain groups, including older women.
Amongst non-governmental organizations (NGOs) working to end child marriage are Girls not Brides, Young Women's Christian Association (YWCA), the International Center for Research on Women (ICRW) and Human Rights Watch (HRW). Although not explicitly included in the original Millennium Development Goals, considerable pressure was applied to include ending child marriage in the successor Sustainable Development Goals adopted in September 2015, where ending this practice by 2030 is a target of SDG 5 Gender Equality (see above). While some progress is being made in reducing child marriage, particularly for girls under fifteen, the prospects are daunting. The indicator for this will be the percentage of women aged 20–24 who were married or in a union before the age of eighteen. Efforts to end child marriage include legislation and ensuring enforcement together with empowering women and girls. To raise awareness, the inaugural UN International Day of the Girl Child[a] in 2012 was dedicated to ending child marriage.
Female genital mutilation (also referred to as female genital cutting) is defined by the World Health Organization (WHO) as "all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons". It has sometimes been referred to as female circumcision, although this term is misleading because it implies it is analogous to the circumcision of the foreskin from the male penis. Consequently, the term mutilation was adopted to emphasise the gravity of the act and its place as a violation of human rights. Subsequently, the term cutting was advanced to avoid offending cultural sensibility that would interfere with dialogue for change. To recognise these points of view some agencies use the composite female genital mutilation/cutting (FMG/C).
Many women and teenage girls don't get enough calcium. Calcium-rich foods are critical to healthy bones and can help you avoid osteoporosis, a bone-weakening disease. Additionally, recent studies suggest that consuming calcium-rich foods as part of a healthy diet may aid weight loss in obese women while minimizing bone turnover. The National Institute of Medicine recommends the following calcium intake, for different ages:
To achieve these goals, cut down on saturated fat from animal products (meat and the skin of poultry, whole-fat dairy products, and certain vegetable foods — palm oil, palm kernel oil, cocoa butter, and coconut). And it's just as important to reduce your consumption of trans fatty acids, the partially hydrogenated vegetable oils found in stick margarine, fried foods, and many commercially baked goods and snack foods.
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It doesn't matter how many pushups you can do in a minute if you're not doing a single one correctly. “There is no point in performing any exercise without proper form,” says Stokes, who recommends thinking in terms of progression: Perfect your technique, then later add weight and/or speed. This is especially important if your workout calls for performing “as many reps as possible” during a set amount of time. Choose quality over quantity, and you can stay injury-free.
Hysterosalpingography (HIS-tur-oh-sal-ping-GOGH-ru-fee): This is an x-ray of the uterus and fallopian tubes. Doctors inject a special dye into the uterus through the vagina. This dye shows up in the x-ray. Doctors can then watch to see if the dye moves freely through the uterus and fallopian tubes. This can help them find physical blocks that may be causing infertility. Blocks in the system can keep the egg from moving from the fallopian tube to the uterus. A block could also keep the sperm from reaching the egg.
Women's reproductive and sexual health has a distinct difference compared to men's health. Even in developed countries pregnancy and childbirth are associated with substantial risks to women with maternal mortality accounting for more than a quarter of a million deaths per year, with large gaps between the developing and developed countries. Comorbidity from other non reproductive disease such as cardiovascular disease contribute to both the mortality and morbidity of pregnancy, including preeclampsia. Sexually transmitted infections have serious consequences for women and infants, with mother-to-child transmission leading to outcomes such as stillbirths and neonatal deaths, and pelvic inflammatory disease leading to infertility. In addition infertility from many other causes, birth control, unplanned pregnancy, unconsensual sexual activity and the struggle for access to abortion create other burdens for women.
Our findings identified gaps and limitations in the evaluation, scope, targeting, and delivery platforms of nutrition interventions in low- and middle-income countries. First, the monitoring and evaluation of nutrition programs that reported on women's nutrition outcomes was generally inadequate. Many of the studies we identified included small-scale efficacy trials. Although there were many large-scale programs that targeted women and adolescent girls with nutrition-specific and nutrition-sensitive approaches, they lacked rigorous evaluation. Whether the evidence about women's outcomes was limited because they are not systematically measured or because they are not well reported is not clear. Negative results are often not published, and many evaluations of nutrition interventions that are conducted by the same groups responsible for implementing them are typically presented positively. This may have also skewed our findings. More intentional research-quality program evaluation, including of large-scale programs, would provide a stronger evidence base. Of the studies identified in this review, many reported on short-term findings such as changes in knowledge, dietary behaviors, and program coverage. They were limited in their ability to report clinical and anthropometric outcomes for women, the duration of those outcomes, and the feasibility of scaling up programs. There is also a need for systematic, long-term evaluations of interventions whose effects on nutrition outcomes are more distal (e.g., nutrition education compared with micronutrient supplementation). The effects of multisectoral interventions are even more complex to measure. However, frameworks exist to evaluate complex interventions (102) and could be utilized to evaluate the impact of interventions across the life course.
Abortion is the intentional termination of pregnancy, as compared to spontaneous termination (miscarriage). Abortion is closely allied to contraception in terms of women's control and regulation of their reproduction, and is often subject to similar cultural, religious, legislative and economic constraints. Where access to contraception is limited, women turn to abortion. Consequently, abortion rates may be used to estimate unmet needs for contraception. However the available procedures have carried great risk for women throughout most of history, and still do in the developing world, or where legal restrictions force women to seek clandestine facilities. Access to safe legal abortion places undue burdens on lower socioeconomic groups and in jurisdictions that create significant barriers. These issues have frequently been the subject of political and feminist campaigns where differing viewpoints pit health against moral values.
Family planning and birth spacing can influence the nutrition of adolescent girls, women of reproductive age, and women with young children by reducing the number of adverse outcomes associated with pregnancy and abortion. For adolescent girls, in particular, pregnancy is associated with increased risk of birth complications, anemia, hindered linear growth, and loss of educational attainment (8, 107). Delaying early child marriages and providing access to family planning, particularly for young wives, allow girls to achieve their maximum growth potential (8, 142). However, for women with young children, there was scarce evidence from observational studies to suggest that greater birth spacing had any impact on anthropometric status (BMI, weight), micronutrient status (anemia, as well as serum zinc, copper, magnesium, and folate), and maternal mortality outcomes (13, 107, 143–147). Findings were mixed, which was attributed to sample size and other confounding factors such as maternal age, breastfeeding status, and supplementation status (146, 147). The strongest evidence of the impact of birth spacing on women's nutrition was related to increased risk of preterm delivery and maternal anemia in interpregnancy intervals <6 mo (14, 146, 147) and increased risk of pre-eclampsia in intervals >5 y (107).
Almost 25% of women will experience mental health issues over their lifetime. Women are at higher risk than men from anxiety, depression, and psychosomatic complaints. Globally, depression is the leading disease burden. In the United States, women have depression twice as often as men. The economic costs of depression in American women are estimated to be $20 billion every year. The risks of depression in women have been linked to changing hormonal environment that women experience, including puberty, menstruation, pregnancy, childbirth and the menopause. Women also metabolise drugs used to treat depression differently to men. Suicide rates are less in women than men (<1% vs. 2.4%), but are a leading cause of death for women under the age of 60.
Healthy eating is a way of eating that improves your health and helps prevent disease. It means choosing different types of healthy food from all of the food groups (fruits, vegetables, grains, dairy, and proteins), most of the time, in the correct amounts for you. Healthy eating also means not eating a lot of foods with added sugar, sodium (salt), and saturated and trans fats.
Not getting enough fiber can lead to constipation and can raise your risk for other health problems. Part of healthy eating is choosing fiber-rich foods, including beans, berries, and dark green leafy vegetables, every day. Fiber helps lower your risk for diseases that affect many women, such as heart disease, diabetes, irritable bowel syndrome, and colon cancer. Fiber also helps you feel full, so it can help you reach and maintain a healthy weight.
Although there is evidence that interventions can address widespread malnutrition among women, there is a lack of operational research and programs to tackle the issue. There is an imperative for the nutrition community to look beyond maternal nutrition and to address women's nutrition across their lives (3). How we reach women matters, and different delivery platforms are more appropriate for some women than others. Delivery platforms for reaching young mothers are different from those for adolescents and postmenopausal women. There is a need to intentionally consider strategies that appropriately target and deliver interventions to all women. This means that nutrition researchers and practitioners need to further adapt existing strategies and modes of delivery to adequately engage women who might not be in clinic settings (78). This also requires that researchers and practitioners explore how to deliver nutrition interventions to women and at different stages of life in order to reduce inequities in the delivery of nutrition services and to reach women missed by programs focusing on maternal nutrition alone.
One of the challenges in assessing progress in this area is the number of clinical studies that either do not report the gender of the subjects or lack the statistical power to detect gender differences. These were still issues in 2014, and further compounded by the fact that the majority of animal studies also exclude females or fail to account for differences in sex and gender. for instance despite the higher incidence of depression amongst women, less than half of the animal studies use female animals. Consequently, a number of funding agencies and scientific journals are asking researchers to explicitly address issues of sex and gender in their research.
The guidelines also establish ranges (called acceptable macronutrient distribution ranges or AMDR) for fat, carbohydrates and protein, instead of exact percentages of calories or numbers of grams. The report maintains that since all three categories serve as sources of energy, they can, to some extent, substitute for one another in providing calories.
The effect of education programs on nutrition outcomes is difficult to assess because programs often have poor baseline data or nutrition outcomes are not evaluated (174, 182). Studies that used longitudinal analyses and “natural” experiments (e.g., before and after a national education policy) found that education was associated with reduced fertility (183, 184), and delayed early marriages and pregnancies (184–187). The impact was more significant for higher levels of education (185). However, 1 study in Malawi identified negative associations between education and timing of first birth, although these findings were largely not statistically significant (188). Secondary education for adolescents and women of reproductive age also showed no impact on women's empowerment (184), although it did show an impact on improved literacy and leadership (174). Educational interventions that provided conditional cash transfers (CCTs) and school feeding, as well as other forms of social protection to families of enrolled girls, were associated with greater school enrollment and attendance (189–191), improved test scores (189, 190), reduced gender gaps (192), and reduced hunger (190, 191).
Fluids: Fluid needs increase as women age. The reason: Kidneys become less efficient at removing toxins. “Drinking more fluids helps kidneys do their job,” Schwartz says. “Unfortunately, thirst signals often become impaired with age, so people are less likely to drink enough water and other fluids.” Rather than fret about how many glasses to drink, Frechman says, check the color of your urine. "It should be clear or very pale colored. If it becomes darker, you need more fluid.”
Cervical cancer is associated with human papillomavirus (HPV), which has also been implicated in cancers of the vulva, vagina, anus, and oropharynx. Almost 300 million women worldwide have been infected with HPV, one of the commoner sexually transmitted infections, and 5% of the 13 million new cases of cancer in the world have been attributed to HPV. In developed countries, screening for cervical cancer using the Pap test has identified pre-cancerous changes in the cervix, at least in those women with access to health care. Also an HPV vaccine programme is available in 45 countries. Screening and prevention programmes have limited availability in developing countries although inexpensive low technology programmes are being developed, but access to treatment is also limited. If applied globally, HPV vaccination at 70% coverage could save the lives of 4 million women from cervical cancer, since most cases occur in developing countries.
Folate or vitamin B9 (also known as folic acid when used in fortified foods or taken as a supplement) is another nutrient that many women don’t get enough of in their diets. Folate can greatly reduce the chance of neurological birth defects when taken before conception and during the first few weeks of pregnancy. Folate can also lower a woman’s risk for heart disease and certain types of cancer, so even if you’re not planning on getting pregnant (and many pregnancies are unplanned), it’s an essential nutrient for every woman of childbearing age. In later life, folate can help your body manufacture estrogen during menopause.
Also known as “myofascial release,” foam rolling is an easy way to benefit your entire body. “While stretching addresses the length of muscle fiber, rolling improves the quality of the tissue,” says Rob Sulaver, CEO and founder of Bandana Training. This leads to tension- and pain-free muscles, which function better so you perform better. Be sure to roll for five minutes before your workout. Not sure what to do? Try these 10 ways to use a foam roller.