Changes in the way research ethics was visualised in the wake of the Nuremberg Trials (1946), led to an atmosphere of protectionism of groups deemed to be vulnerable that was often legislated or regulated. This resulted in the relative underrepresentation of women in clinical trials. The position of women in research was further compromised in 1977, when in response to the tragedies resulting from thalidomide and diethylstilbestrol (DES), the United States Food and Drug Administration (FDA) prohibited women of child-bearing years from participation in early stage clinical trials. In practice this ban was often applied very widely to exclude all women. Women, at least those in the child-bearing years, were also deemed unsuitable research subjects due to their fluctuating hormonal levels during the menstrual cycle. However, research has demonstrated significant biological differences between the sexes in rates of susceptibility, symptoms and response to treatment in many major areas of health, including heart disease and some cancers. These exclusions pose a threat to the application of evidence-based medicine to women, and compromise to care offered to both women and men.
Oaks BM, Young RR, Adu-Afarwuah S, Ashorn U, Jackson KH, Lartey A, Maleta K, Okronipa H, Sadalaki J, Baldiviez LM et al. Effects of a lipid-based nutrient supplement during pregnancy and lactation on maternal plasma fatty acid status and lipid profile: results of two randomized controlled trials. Prostaglandins Leukot Essent Fatty Acids 2017;117:28–35.
Research is a priority in terms of improving women's health. Research needs include diseases unique to women, more serious in women and those that differ in risk factors between women and men. The balance of gender in research studies needs to be balanced appropriately to allow analysis that will detect interactions between gender and other factors. Gronowski and Schindler suggest that scientific journals make documentation of gender a requirement when reporting the results of animal studies, and that funding agencies require justification from investigators for any gender inequity in their grant proposals, giving preference to those that are inclusive. They also suggest it is the role of health organisations to encourage women to enroll in clinical research. However, there has been progress in terms of large scale studies such as the WHI, and in 2006 the Society for Women's Health Research founded the Organization for the Study of Sex Differences (OSSD) and the journal Biology of Sex Differences to further the study of sex differences.
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.
Energy and protein supplementation was most often associated with weight gain of women, and often targeted pregnant women with suboptimal weight. For pregnant women, energy and protein supplementation modestly increased maternal weight (86–90). Other maternal outcomes were not frequently reported, and were often secondary objectives of protein-energy supplementation interventions (33, 88). Many studies reported on infant health outcomes, including reductions in low birth weight and preterm births (19, 89–91). Adequate energy and protein intake was also relevant for interventions targeting the prevention of excessive gestational weight gain of overweight and obese pregnant women. These interventions restricted dietary energy intake of overweight women during pregnancy and resulted in reduced excess weight gain during pregnancy but had no impact on pregnancy-related hypertension and pre-eclampsia (19, 88).
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.
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.
Most Americans get far more protein than they really need. In theory, that may not be wise. Like carbohydrates, protein provides 4 calories per gram, and excess calories from any source will be stored as body fat. Excess dietary protein increases calcium loss in the urine, perhaps raising the risk for osteoporosis ("thin bones," more a worry for women) and kidney stones (a particular worry for men).
A related issue is the inclusion of pregnant women in clinical studies. Since other illnesses can exist concurrently with pregnancy, information is needed on the response to and efficacy of interventions during pregnancy, but ethical issues relative to the fetus, make this more complex. This gender bias is partly offset by the iniation of large scale epidemiology studies of women, such as the Nurses' Health Study (1976), Women's Health Initiative and Black Women's Health Study.
It has affected more than 200 million women and girls who are alive today. The practice is concentrated in some 30 countries in Africa, the Middle East and Asia. FGC affects many religious faiths, nationalities, and socioeconomic classes and is highly controversial. The main arguments advanced to justify FGC are hygiene, fertility, the preservation of chastity, an important rite of passage, marriageability and enhanced sexual pleasure of male partners. The amount of tissue removed varies considerably, leading the WHO and other bodies to classify FGC into four types. These range from the partial or total removal of the clitoris with or without the prepuce (clitoridectomy) in Type I, to the additional removal of the labia minora, with or without excision of the labia majora (Type II) to narrowing of the vaginal orifice (introitus) with the creation of a covering seal by suturing the remaining labial tissue over the urethra and introitus, with or without excision of the clitoris (infibulation). In this type a small opening is created to allow urine and menstrual blood to be discharged. Type 4 involves all other procedures, usually relatively minor alterations such as piercing.
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
Sleeping seven to nine hours a night for five days straight may stave off bags under your eyes as well as saddlebags on your thighs. When women get enough sleep, they don’t take in extra, unnecessary calories to stay awake, according to a study published in the Proceedings of the National Academy of Sciences. Read: Adequate beauty rest can help you pass up pick-me-up snacks and head off added pounds.
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.
Pregnancy Unintended pregnancy Gravidity and parity Obstetrics Antenatal care Adolescent pregnancy Complications of pregnancy Hyperemesis gravidarum Ectopic pregnancy Miscarriage Obstetrical bleeding Gestational diabetes Hypertension Preeclampsia Eclampsia Childbirth Midwifery Preterm birth Multiple births Oxytocin Obstructed labor Cesarian section Retained placenta Obstetrical fistulae Vesicovaginal fistula Rectovaginal fistula Episiotomy husband stitch Postpartum care Maternal deaths Perinatal mortality Stillbirths Abortion Mother-to-child transmission Sterilization Compulsory sterilization
Published ten times per year, Women's Health magazine is a premier publication focused on the health, fitness, nutrition, and lifestyles of women. With a circulation of 1.5 million readers, you'll be in good company with a subscription to this successful magazine published by Rodale. From cover to cover, each issue will provide you with tips on improving every aspect of your life.
Consult your health care professional. Women of childbearing age may want to consider taking folic acid supplements to reduce the risk of having a pregnancy affected with neural tube defects. Many women and teenage girls don't get enough calcium or vitamin D, both of which are critical to healthy bones and avoiding osteoporosis. Some people with diabetes appear to benefit from chromium. Vegetarians, especially vegans, may want to consider supplements to obtain nutrients they aren't getting from animal products.
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.
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 tiny gender differences in minerals other than calcium and iron depend on body size. But while the dietary requirements for selenium fit this rule, men may benefit from supplements of about 200 micrograms a day, a level about four times above the RDA. That's because both a clinical trial and an observational study suggest that selenium may reduce the risk of prostate cancer. It's far from proven, but it's something for men to consider.
Gahagan, Jacqueline (15 August 2016). "Commentary on the new sex and gender editorial policy of the Canadian Journal of Public Health". Canadian Journal of Public Health. 107 (2): e140–1. doi:10.17269/cjph.107.5584. PMID 27526209. Lay summary – Jon Tattrie. Canadian Journal of Public Health tells researchers to address sex, gender in trials: Research 'excluding 50 per cent of the population' isn't best return for taxpayers, says Jacqueline Gahagan. Canadian Broadcasting Corporation News: Nova Scotia (7 December 2016).
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.
Iron helps to create the hemoglobin that carries oxygen in your blood. It’s also important to maintaining healthy skin, hair, and nails. Due to the amount of blood lost during menstruation, women of childbearing age need more than twice the amount of iron that men do—even more during pregnancy and breastfeeding. However, many of us aren’t getting nearly enough iron in our diets, making iron deficiency anemia the most common deficiency in women.
After 40, your hormone levels (estrogen) drop. This causes your insulin (hormone that helps your body use sugar) rise. Your thyroid levels go down. This combination makes you hungrier. You end up eating more and burning fewer calories. Much of the weight gain occurs around your belly. Eat more foods with fiber (berries, whole grains, nuts) to fill you up and help you eat less. Aim for 25 grams of fiber each day after the age of 40. Other ways to increase your metabolism include:
After menopause. Lower levels of estrogen after menopause raise your risk for chronic diseases such as heart disease, stroke, and diabetes, and osteoporosis, a condition that causes your bones to become weak and break easily. What you eat also affects these chronic diseases. Talk to your doctor about healthy eating plans and whether you need more calcium and vitamin D to protect your bones. Read more about how very low estrogen levels affect your health in our Menopause section. Most women also need fewer calories as they age, because of less muscle and less physical activity. Find out how many calories you need based on your level of activity.
Nutrition is particularly important when you are pregnant. Weight gain during pregnancy is normal—and it's not just because of the growing fetus; your body is storing fat for lactation. The National Academy of Sciences/Institute of Medicine (NAS/IOM) has determined that a gain of 25 to 35 pounds is desirable. However, underweight women should gain about 28 to 40 pounds, and overweight women should gain at least 15 pounds. The IOM has not given a recommendation for an upper limit for obese women, but some experts cap it as low as 13 pounds. If you fit into this category, discuss how much weight you should gain with your health care professional. Remember that pregnancy isn't the time to diet. Caloric restriction during pregnancy has been associated with reduced birth weight, which can be dangerous to the baby.
Eat healthy fats. According to the American Heart Association, women should get at least five to 10 percent of total daily calories from omega-6 fatty acids (equal to 12 to 20 grams), and between 0.5 and 3 grams of omega-3 fatty acids, depending on individual risk for heart disease. Good sources of omega-6 fatty acids include sunflower, safflower, corn, cottonseed and soybean oils. And good sources of omega-3 fatty acids include fatty fish, tofu and other forms of soybeans, canola, walnuts, flaxseed, and their oils. Talk with your health care professional about how much of these beneficial oils you should be getting, how you can best incorporate them into your diet and whether or not you should be taking them in supplement form.
In addition to diet, exercise and other lifestyle factors can also play an important role in bone health. Smoking and drinking too much alcohol can increase your chances of developing osteoporosis, while weight-bearing exercise (such as walking, dancing, yoga, or lifting weights) can lower your risk. Strength or resistance training—using machines, free weights, elastic bands, or your own body weight—can be especially effective in helping to prevent loss of bone mass as you age.