Something else to remember: an estimated 90 to 95 percent of dieters who lose weight regain all or part of it within five years, and the consequences can be even worse than simply being overweight. Those who exercise regularly as part of a weight loss diet and maintenance program are more likely to keep the weight off. Also note that an overly restrictive diet can lead to more overeating, a natural reaction to food deprivation.
It’s one thing to tell women that their curves are awesome; it’s another thing to depict women who actually have them, making Shape’s #LoveMyShape section the most inspiring part of its site, much more than that bit about those last five pounds. Showing always trumps telling. Ramping up the normal-sized body movement might actually help get women on the road to “Hot & Happy”—as they realize that the order of those two adjectives should be transposed.
For healthy bones and teeth, women need to eat a variety of calcium-rich foods every day. Calcium keeps bones strong and helps to reduce the risk for osteoporosis, a bone disease in which the bones become weak and break easily. Some calcium-rich foods include low-fat or fat-free milk, yogurt and cheese, sardines, tofu (if made with calcium sulfate) and calcium-fortified foods including juices and cereals. Adequate amounts of vitamin D also are important, and the need for both calcium and vitamin D increases as women get older. Good sources of vitamin D include fatty fish, such as salmon, eggs and fortified foods and beverages, such as some yogurts and juices.
Second, the scope of nutrition-specific and nutrition-sensitive approaches was largely focused on undernutrition. There were major research and programming gaps in studies targeting overweight, obesity, and noncommunicable disease. In our review, the interventions addressing overweight, obesity, and noncommunicable disease were limited to nutrition education and integrated healthcare. However, overweight and obesity were identified as potential concerns for interventions targeting undernutrition, including food supplementation, and in-kind and cash transfers. This might be a result of the types of interventions that were evaluated, but also speaks to the need to broaden the scope of nutrition interventions that are commonly assessed (5, 13, 14) to explicitly address overweight, obesity, and noncommunicable disease as nutrition outcomes, and not just as unintended consequences. Globally, there is limited evidence of large-scale interventions that effectively prevent, treat, or correctly classify adiposity-related noncommunicable diseases, and this is a growing area of concern around the world (208). Future evaluations of nutrition interventions might also include interventions that influence women's time and physical environment, and that encourage physical activity or change in access to and affordability of certain foods, as these might also influence overweight, obesity, and noncommunicable disease outcomes for women.
As women, many of us are prone to neglecting our own dietary needs. You may feel you’re too busy to eat right, used to putting the needs of your family first, or trying to adhere to an extreme diet that leaves you short on vital nutrients and feeling cranky, hungry, and low on energy. Women’s specific needs are often neglected by dietary research, too. Studies tend to rely on male subjects whose hormone levels are more stable and predictable, thus sometimes making the results irrelevant or even misleading to women’s needs. All this can add up to serious shortfalls in your daily nutrition.
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).
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.
Nutrition-sensitive approaches are difficult to link to women's nutritional status (5, 102). This is due to limited measurement of benefits to program beneficiaries, families, households, and communities, limited timeframes to evaluate long-term impact, logistical and political realities that make implementation difficult, and different priorities of different stakeholders in multisectoral programs (102). Many nutrition-sensitive approaches, as will be described, thus focus on more distal measures of impact (e.g., coverage, knowledge) and not more proximal measures of women's nutritional status (e.g., BMI, anemia status, etc.).