For this comprehensive narrative review, we evaluated both nutrition-specific and nutrition-sensitive interventions. Nutrition-specific approaches are those that address the immediate determinants of nutrition (e.g., food and nutrient intake, diet-related practices and behaviors, disease, etc.), whereas nutrition-sensitive approaches are those that address the underlying determinants of nutrition (e.g., food security, access to resources, safe and hygienic environments, adequate health services, etc.) (5, 12). We evaluated the following nutrition-specific interventions described by Bhutta et al. (13, 14): nutrition counseling and education, micronutrient supplementation and fortification, protein and energy supplementation, and lipid-based supplementation. We also included the following nutrition-sensitive approaches described by Ruel and Alderman (5) and Bhutta et al. (14): health care; family planning; water, sanitation, and hygiene (WASH); empowerment; income-generation; education; and social protection. For each intervention, we 1) described the scale and coverage of the intervention, when available; 2) summarized the evidence of effectiveness for women's health and nutrition outcomes; and 3) described and evaluated the target population and delivery platforms, as described in the published articles and as summarized in Table 1. The delivery of interventions included the physical platforms, as well as the adherence and the implementation challenges of the different interventions.
Another major difference between the January covers we picked up: the scantily clad women versus coverboy Mark Wahlberg, who got to keep all of his clothes on. Shields (“Fitter Than Ever At 52!”) and Menounos (“Huge career. New fiancé. Then a brain tumor” right next to the shot of her in a teeny red bikini.) were not so fortunate. Maybe it’s on purpose: Menounos appears happy to show off her huge engagement rock as well as her impossibly flat abs, while Shields has been modeling since she was 11 months old, although hardly in such an unappealing posture as this one.
Micronutrient supplementation programs for vitamin A, iron and folic acid, calcium, zinc, and multiple micronutrients effectively impacted the micronutrient status of pregnant and lactating women, as well as women of reproductive age and adolescent girls (13, 14, 33, 35–48). Interventions making use of multiple micronutrients were more effective at changing plasma micronutrient concentrations than interventions focused solely on 1 nutrient alone (38, 42). In countries with comprehensive programs for iron supplementation during pregnancy, anemia prevalence dropped (1, 49). Positive health impacts of supplementation were most notable among pregnant women who were deficient and at risk of low intake (43, 50). However, there were some studies that showed inconsistent or limited evidence for the effectiveness of supplementation on other maternal health outcomes (31, 51–58).
Many nutrition-sensitive approaches were delivered in broader community-based settings and more equitably reached women across the life course. Non-facilities-based settings more equitably delivered nutrition interventions to women who were not pregnant or lactating, and who were less engaged with health clinics and schools. For instance, food fortification, which was often delivered through markets, home visits, and community centers, seemed to be more effective at reaching women of reproductive age than health center–based delivery platforms. Community-level interventions are often reported as more equitable than platforms that require access to “fixed and well-equipped health facilities” (212). This aligns with our findings, where we found that community-based platforms such as home visits, community centers, homes of community leaders, work, mass media, mobile phones, and commercial settings were effective at reaching women across the life course (Table 1). Other delivery platforms such as marketplaces, water points, tailoring shops, and agricultural points for seeds or inputs were also effective. These locations need to be context-specific in order to capture where women spend their time. For instance, in countries where many adolescent girls do not attend school, school-based delivery platforms might be less effective. Delivery platforms also need to be sensitive to the sociodemographic differences that influence where women spend their time, such as differences for women in rural and urban areas, and of different socioeconomic statuses. Additional research needs to identify and report where women and adolescent girls are, and how best to reach them.
Popular belief says if you really want to make a big change, focus on one new healthy habit at a time. But Stanford University School of Medicine researchers say working on your diet and fitness simultaneously may put the odds of reaching both goals more in your favor. They followed four groups of people: The first zoned in on their diets before adding exercise months later, the second did the opposite, the third focused on both at once, and the last made no changes. Those who doubled up were most likely to work out 150 minutes a week and get up to nine servings of fruits and veggies daily while keeping their calories from saturated fat at 10 percent or less of their total intake.
I subscribed to this magazine thinking it would be about health, fitness, and above all, working out. The headlines on the cover seemed to suggest that was true, with the biggest fonts advertising things like "flat abs now" and "maximize your workout". In reality, the content of the magazine is mostly beauty (how that counts as "health" is beyond me) and weight-loss. Oh, the endless, endless articles about "burn more fat!" "three new foods that will help you burn fat!" "drop pounds with this easy exercise!" I don't need to lose weight and I found that these articles just played into my growing impression, as issue after issue dropped on my doormat, that the magazine views women as vapid, stereotypical beings whose only desire is to look good, whether through exercise (almost inevitably restricted to cardio and yoga), the "right" work-out clothes (really?) or knowing what dress is in fashion or what color make-up to buy. If you enjoy that sort of thing, that's fine- it is essentially one step above Cosmopolitan on the seriousness scale. If you're looking for actual information about working out and building muscle, know that Women's Health magazine is barely aware that these things exist, and when it does, it will come wrapped in the form of "ten minutes a day to tone your bum like a super-model!" or something equally cringe-inducing.
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.
In the past, women have often tried to make up deficits in their diet though the use of vitamins and supplements. However, while supplements can be a useful safeguard against occasional nutrient shortfalls, they can’t compensate for an unbalanced or unhealthy diet. To ensure you get all the nutrients you need from the food you eat, try to aim for a diet rich in fruit, vegetables, quality protein, healthy fats, and low in processed, fried, and sugary foods.
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.
The total fat in your daily diet should average no more than 30 percent of your total calories consumed. And saturated fat should be no more than 10 percent of those 30 percent of calories. The amount of fat and saturated fat you eat depends on the foods you select and consume that have fat in them. Consider consulting with a nutrition professional to learn more about how to calculate your fat needs and to not exceed what are healthy amounts. There are many tools available to help you determine how much fat you should consume each day based on your current energy and nutrition needs. Reading food labels is one way to begin to identify where and how much fat is in particular food items.
Omega-3s: These essential fatty acids, EPA and DHA, play many roles in the body, including building healthy brain and nerve cells. Some studies show that omega-3s, especially DHA, can help prevent preterm births. Even women who don't plan to have children should be sure to get plenty of omega-3s. These healthy oils have been shown to reduce the risk of heart disease, the number one killer of women.
The social view of health combined with the acknowledgement that gender is a social determinant of health inform women's health service delivery in countries around the world. Women's health services such as Leichhardt Women's Community Health Centre which was established in 1974 and was the first women's health centre established in Australia is an example of women's health approach to service delivery.
Calories. Most times, women need fewer calories. That’s because women naturally have less muscle, more body fat, and are usually smaller. On average, adult women need between 1,600 and 2,400 calories a day. Women who are more physically active may need more calories. Find out how many calories you need each day, based on your age, height, weight, and activity level.
For a strong backside that will turn heads wherever you go, Marta Montenegro, a Miami-based exercise physiologist and strength and conditioning coach, recommends completing 100 kettlebell swings nonstop with a moderate weight at the end of a legs workout. [Tweet this tip!] If you can’t access a kettlebell, do deadlifts and hip-thrusters instead. “Women tend to overemphasize the quadriceps even when they think they are working the butt. With these two exercises, you'll have no problem engaging the glutes and posterior muscles of the legs,” Montenegro says.
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.
Calcium may even be harmful for men, at least in large amounts. The worry is prostate cancer, and two Harvard studies have raised the alarm. In 1998, the Health Professionals Follow-up Study found that a high consumption of calcium from food or supplements was linked to an increased risk of advanced prostate cancer. The risk was greatest in men who got more than 2,000 mg a day. More recently, the U.S. Physicians' Health Study reported that a high consumption of calcium from dairy products appeared to increase a man's risk of prostate cancer by up to 37%. A study from the Fred Hutchinson Cancer Research Center in Seattle also found a link between calcium and advanced prostate cancer.
Here, too, body size is the main difference between the needs of males and females. Despite all the hype about high-protein diets, our protein requirements are really quite modest — only about a third of a gram per pound of body weight. For a 125-pound woman, that amounts to about 42 grams, for a 175-pound man, 58 grams. That's a tiny difference, just about half an ounce a day.
World Health Organization. Salt reduction and iodine fortification strategies in public health: report of a joint technical meeting convened by the World Health Organization and The George Institute for Global Health in collaboration with the International Council for the Control of Iodine Deficiency Disorders Global Network, Sydney, Australia, March 2013 . Geneva: World Health Organization; 2014.
Community health posts and home visits provided a platform to make health care services more accessible (109, 110, 124). Community-based platforms for the delivery of health services included community center and home visits from community health workers, mobile clinics, community support groups, mobile phones, and mass media campaigns (105, 110). Community-based services were effective in reducing maternal mortality and managing HIV (106). However, 1 review found that community-based interventions were only effective in reducing maternal morbidity and not mortality (107, 110). In high-income settings, community-based services were associated with hypertension and diabetes management, and cervical and breast cancer screening (106). We found no references for the use of community-based integrated care to address women's nutrition in low- and middle-income settings. It could be an effective way to reach older women and women of reproductive age who do not regularly engage with health centers. For children, community-based services were effective in improving health outcomes, particularly among the poorest wealth quintiles (13, 110). More research is needed on the potential of community-based services to reduce inequities in delivery of care to women in different settings and across different socioeconomic statuses.
Schools (“condition” and delivery platform) ↑ food expenditures, ↑/NC food share, ↑ HH food consumption, ↑ dietary diversity, ↑ HH intake of fruits, vegetables, and ASF, ↑/NC intake of fats and sweets ↑ knowledge about health and nutrition, ↑ food expenditures, ↑/NC food share, ↑ HH food consumption, ↑ dietary diversity, ↑ HH intake of fruits, vegetables, and ASF, ↑/NC intake of fats and sweets, ↑ participation in social networks, ↑ self-confidence, ↑ control HH resources ↑ knowledge about health and nutrition, ↑ HH food security, ↑ food expenditures, ↑/NC food share, ↑ HH food consumption, ↑ dietary diversity, ↑ HH intake of fruits, vegetables, and ASF, ↑/NC intake of fats and sweets, ↑ participation in social networks, ↑ self-confidence, ↑ control over resources ↑ knowledge about health, NC hypertension, ↓ missed meals, ↑ health care utilization
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.”
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.
Although canola oil appears to be good for the cardiovascular system, two Harvard studies have raised concerns that ALA might be bad for the prostate. In 1993, the Health Professionals Follow-up Study of 47,781 men published a major evaluation of dietary fat and prostate cancer. It found that saturated fat from animal sources such as red meat and whole-fat dairy products was linked to a 2.6-fold increase in prostate cancer. But the study also provided some disquieting news about ALA: Men who consumed the most ALA were 3.4 times more likely to be diagnosed with prostate cancer than those who had the lowest dietary intake.
I realize that none of the above foods have 100% DV of calcium, and while we all should be getting a variety of these foods through the week to help increase the amount of calcium from whole foods, you can also boost it with a supplement- especially if you fall into any of the above categories. I’ve really been liking the New Chapter’s Every Woman’s One Daily Multivitamin which has calcium and is rich in vitamin D3. Read more on that in the next question!
Women, as we age, are also more susceptible to the breakdown of our bones, which may result in osteoporosis over time. Genetically, women have a particularly high risk of osteoporosis compared to men, so it’s recommended that women monitor their calcium intake to be sure they’re getting enough. Weight training is another great way (and my favorite!) to build bone density, which is another great reason you should hit the weights!
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.
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.
The trick to biking uphill is to look ahead and anticipate. “Try to plan for what's coming,” says Georgia Gould, a LUNA pro athlete and 2012 Olympic bronze medalist in women's mountain biking. “Start shifting down one gear at a time for a smooth, energy-saving transition. Ideally your cadence should stay the same as you transition from harder to easier gears.”
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).