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.
There are a number of cultural factors that reinforce this practice. These include the child's financial future, her dowry, social ties and social status, prevention of premarital sex, extramarital pregnancy and STIs. The arguments against it include interruption of education and loss of employment prospects, and hence economic status, as well as loss of normal childhood and its emotional maturation and social isolation. Child marriage places the girl in a relationship where she is in a major imbalance of power and perpetuates the gender inequality that contributed to the practice in the first place.[93][94] Also in the case of minors, there are the issues of human rights, non-consensual sexual activity and forced marriage and a 2016 joint report of the WHO and Inter-Parliamentary Union places the two concepts together as Child, Early and Forced Marriage (CEFM), as did the 2014 Girl Summit (see below).[95] In addition the likely pregnancies at a young age are associated with higher medical risks for both mother and child, multiple pregnancies and less access to care[96][11][93] with pregnancy being amongst the leading causes of death amongst girls aged 15–19. Girls married under age are also more likely to be the victims of domestic violence.[92]

The ability to determine if and when to become pregnant, is vital to a woman's autonomy and well being, and contraception can protect girls and young women from the risks of early pregnancy and older women from the increased risks of unintended pregnancy. Adequate access to contraception can limit multiple pregnancies, reduce the need for potentially unsafe abortion and reduce maternal and infant mortality and morbidity. Some barrier forms of contraception such as condoms, also reduce the risk of STIs and HIV infection. Access to contraception allows women to make informed choices about their reproductive and sexual health, increases empowerment, and enhances choices in education, careers and participation in public life. At the societal level, access to contraception is a key factor in controlling population growth, with resultant impact on the economy, the environment and regional development.[58][59] Consequently, the United Nations considers access to contraception a human right that is central to gender equality and women's empowerment that saves lives and reduces poverty,[60] and birth control has been considered amongst the 10 great public health achievements of the 20th century.[61]
It’s the fourth week in January, the time when many new year’s resolutions are faltering, if they haven’t fallen away altogether. If the diet/exercise/fitness menu was on your list for 2018, you’re not alone, as many people try to eat less in the beginning of the year to help combat their excesses from Halloween candy, Thanksgiving dinner, and end-of-year sweets.
No matter how busy you are, eat lunch before 3 p.m., a Spanish study suggests. Researchers placed a group of women on a diet for 20 weeks; half ate lunch before 3 and half consumed their midday meal after 3. Although both groups’ daily caloric intake, time spent exercising and sleeping, and appetite hormone levels were the same, those who lunched late lost about 25 percent less weight than earlier eaters. Being European, lunch was the biggest meal of the day for these women, constituting 40 percent of their calories for the day, so consider slimming down dinner in addition to watching the clock.
Most vegetarians eat milk products and eggs, and as a group, these lacto-ovo-vegetarians enjoy good health. A healthful vegetarian diet falls within the food pyramid guidelines offered by the USDA. However, meat, fish and poultry are major sources of iron, zinc and B vitamins, so pay special attention to these nutrients. Vegans (those who eat only plant-based food) should consult a health care professional about adding vitamin and mineral supplements; make sure you consume sufficient quantities of protein, vitamin B12, vitamin D and calcium.
There remain significant barriers to accessing contraception for many women in both developing and developed regions. These include legislative, administrative, cultural, religious and economic barriers in addition to those dealing with access to and quality of health services. Much of the attention has been focussd on preventing adolescent pregnancy. The Overseas Development Institute (ODI) has identified a number of key barriers, on both the supply and demand side, including internalising socio-cultural values, pressure from family members, and cognitive barriers (lack of knowledge), which need addressing.[67][68] Even in developed regions many women, particularly those who are disadvantaged, may face substantial difficulties in access that may be financial and geographic but may also face religious and political discrimination.[69] Women have also mounted campaigns against potentially dangerous forms of contraception such as defective intrauterine devices (IUD)s, particularly the Dalkon Shield.[70]
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.
Sweet chili peppers may not be a winter food, but continue eating them in your burritos, stir-fries, and soups, and you may burn more fat during your outdoor cold-weather runs. These not-hot veggies contain chemicals called capsinoids, which are similar to the capsaicin found in hot peppers. Combine capsinoids with 63-degree or cooler temps, and you increase the amount and activity of brown fat cells—those that burn energy—and give your metabolism an extra boost, according to a study published in the Journal of Clinical Investigation.
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.

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.
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.
Women have also been the subject of abuse in health care research, such as the situation revealed in the Cartwright Inquiry in New Zealand (1988), in which research by two feminist journalists[165] revealed that women with cervical abnormalities were not receiving treatment, as part of an experiment. The women were not told of the abnormalities and several later died.[166]
Complementing income-generating interventions with interventions that more directly target women's nutrition has potential to have greater impacts on women's nutritional status (171). Integrated interventions were associated with improvements in health knowledge and behaviors, as well as increased intake of nutrient-rich foods (5, 164, 169, 170, 172). In Bangladesh and Cambodia, the aforementioned EHFP program was associated with increased income, decision-making power in the household, food expenditure (including on oils, salts, spices, fish, rice, and meat), and consumption of fruits and vegetables from home gardens (160, 173). There was also limited, but mixed, evidence of income-generating interventions and behavior change communication causing improvements in maternal anemia and BMI (164, 168, 170).

In 2013 about 289,000 women (800 per day) in the world died due to pregnancy-related causes, with large differences between developed and developing countries.[11][37] Maternal mortality in western nations had been steadily falling, and forms the subject of annual reports and reviews.[38] Yet, between 1987 and 2011, maternal mortality in the United States rose from 7.2 to 17.8 deaths per 100,000 live births, this is reflected in the Maternal Mortality Ratio (MMR).[38] By contrast rates as high as 1,000 per birth are reported in the rest of the world,[11] with the highest rates in Sub-Saharan Africa and South Asia, which account for 86% of such deaths.[39][37] These deaths are rarely investigated, yet the World Health Organization considers that 99% of these deaths, the majority of which occur within 24 hours of childbirth, are preventable if the appropriate infrastructure, training, and facilities were in place.[40][37] In these resource-poor countries, maternal health is further eroded by poverty and adverse economic factors which impact the roads, health care facilities, equipment and supplies in addition to limited skilled personnel. Other problems include cultural attitudes towards sexuality, contraception, child marriage, home birth and the ability to recognise medical emergencies. The direct causes of these maternal deaths are hemorrhage, eclampsia, obstructed labor, sepsis and unskilled abortion. In addition malaria and AIDS complicate pregnancy. In the period 2003–2009 hemorrhage was the leading cause of death, accounting for 27% of deaths in developing countries and 16% in developed countries.[41][42]


We conducted a comprehensive narrative review to synthesize the existing literature on interventions targeting women's nutrition (11). We searched the PubMed database and Google Scholar from 1990 to December 2017 for peer-reviewed articles, systematic reviews, and grey literature that reported on a set of nutrition-specific and nutrition-sensitive interventions, outlined in what follows. We also reviewed the cited sources of key articles. When available, we used existing reviews to identify studies. Some of the review articles that emerged from our search included both high-income countries and low- and middle-income countries. When possible, we specified the delivery platforms for low- and middle-income countries. For review articles that did not explicitly describe the intervention delivery platforms, we reviewed the cited primary sources to identify the delivery platform for the discussed interventions.
Trans fatty acids, also known as trans fats, are solid fats produced artificially by heating liquid vegetable oils in the presence of metal catalysts and hydrogen. They also pose a health risk, increasing LDL or "bad" cholesterol and increasing your risk of coronary heart disease. They are often found in cookies, crackers, icing and stick margarine, and in small amounts in meats and dairy products. Beginning in January 2006, all food manufacturers had to list the amount of trans fatty acids in foods, resulting in a significant reduction in the amount of these fats used in prepared foods. In its guidelines, the American Heart Association notes that trans fats increase risk of heart disease by raising "bad" LDL cholesterol and should be avoided as much as possible. In addition, research has shown that trans fats can also decrease "good" HDL cholesterol, increase inflammation, disrupt normal endothelial cell function and possibly interfere with the metabolism of other important fats—even more evidence that they are very bad for overall health.

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.


In the United States, infertility affects 1.5 million couples.[86][87] Many couples seek assisted reproductive technology (ART) for infertility.[88] In the United States in 2010, 147,260 in vitro fertilization (IVF) procedures were carried out, with 47,090 live births resulting.[89] In 2013 these numbers had increased to 160,521 and 53,252.[90] However, about a half of IVF pregnancies result in multiple-birth deliveries, which in turn are associated with an increase in both morbidity and mortality of the mother and the infant. Causes for this include increased maternal blood pressure, premature birth and low birth weight. In addition, more women are waiting longer to conceive and seeking ART.[90]
The gym is in the basement with seemed like slow ceiling and dim lighting.  I tried to attend a zumba class -- the class was in the middle floor, cramped and crowded.  I couldn't see the instructor (in fact I didn't even know who the instructor and what was going on)  people looked lost in the class.  I kept bumped into one of the cycles.  After 10mins of frustration, I gave up on zumba and just hopped on a treadmill, only to find the treadmill was placed on unleveled with a hole on the floor!  My treadmill was flip-flopping with each step.  I then went to the stretching area hoping to may just suck it up for the next 30 minutes and call it a day.  I found the mat to be dirty and the corner for stretching was dark and tight.   There's not enough lockers to use.  The shower stalls look small and dirty.  I just didn't get an good feeling after this first class.  

A year later, a second Harvard study added to the concern. The Physicians' Health Study of 20,885 men did not evaluate diet per se, but it did measure the blood levels of ALA in 120 men who developed prostate cancer and compared them with the levels in 120 men who remained free of the disease. Men with moderately high ALA blood levels were 3.4 times more likely to develop prostate cancer than men with the lowest levels; curiously, though, men with the very highest levels were only 2 times more likely to get the disease.

Child marriage (including union or cohabitation)[91] is defined as marriage under the age of eighteen and is an ancient custom. In 2010 it was estimated that 67 million women, then, in their twenties had been married before they turned eighteen, and that 150 million would be in the next decade, equivalent to 15 million per year. This number had increased to 70 million by 2012. In developing countries one third of girls are married under age, and 1:9 before 15.[92] The practice is commonest in South Asia (48% of women), Africa (42%) and Latin America and the Caribbean (29%). The highest prevalence is in Western and Sub-Saharan Africa. The percentage of girls married before the age of eighteen is as high as 75% in countries such as Niger (Nour, Table I).[11][92] Most child marriage involves girls. For instance in Mali the ratio of girls to boys is 72:1, while in countries such as the United States the ratio is 8:1. Marriage may occur as early as birth, with the girl being sent to her husbands home as early as age seven.[11]
Salt, caffeine and alcohol intake may interfere with the balance of calcium in the body by affecting the absorption of calcium and increasing the amount lost in the urine. Moderate alcohol intake (one to two standard drinks per day) and moderate tea, coffee and caffeine-containing drinks (no more than six cups per day) are recommended. Avoid adding salt at the table and in cooking

In low- and middle-income countries, health care services often respond to acute health needs and many focus on maternal–child health (105, 106, 110, 112). The use of preventative care is limited, and there are concerns about the capacity of health systems to address noncommunicable diseases, such as diabetes, in low- and middle-income settings (108, 112). This has implications for the reach of integrated health care interventions across the life course. Maternal and reproductive health care is often sought by women when they are pregnant and in the early years of their children's lives (3, 113). Even so, many women visit health facilities late in their pregnancy or not at all (114–116). For adolescents and adult women, care is often not sought until they are sick (3, 117, 118). This is problematic for older women, in particular, as screening and treatment for age-related health issues, such as diabetes, cancer, and hypertension, require access to preventative health care services (3).
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),[162] Women's Health Initiative[163] and Black Women's Health Study.[164][6]

Women have many unique health concerns — menstrual cycles, pregnancy, birth control, menopause — and that's just the beginning. A number of health issues affect only women and others are more common in women. What's more, men and women may have the same condition, but different symptoms. Many diseases affect women differently and may even require distinct treatment.
Young adults. Teen girls and young women usually need more calories than when they were younger, to support their growing and developing bodies. After about age 25, a woman’s resting metabolism (the number of calories her body needs to sustain itself at rest) goes down. To maintain a healthy weight after age 25, women need to gradually reduce their calories and increase their physical activity.

The daily calcium recommendations are 1,000 milligrams a day for women under 50, and 1,500 milligrams a day for women 51 and older. Oddly enough, these are the same requirements for men, who are much less prone to osteoporosis than women. But the recommendation takes into account the fact that women are smaller than men. Thus the amount of daily calcium is greater for women on a proportional basis.


The new guidelines encourage eating more nutrient-dense food and beverages. Many of us consume too many calories from solid fats, added sugar and refined grains. The guidelines promote a diet that emphasizes vegetables, fruits, whole grains, fat-free or low-fat dairy products, seafood, lean meat and poultry, eggs, beans and peas, and nuts and seeds.
Katz DL, O'Connell M, Yeh MC, Nawaz H, Njike V, Anderson LM, Cory S, Dietz W; Task Force on Community Preventive Services. Public health strategies for preventing and controlling overweight and obesity in school and worksite settings: a report on recommendations of the Task Force on Community Preventive Services. MMWR Recomm Rep  2005;54(RR-10):1–12.
If you count calories, count fat calories, too. Food labels indicate how many calories come from fat, both in actual grams and in percentages. This helps you assess the percentage of fat in your diet. If the total number of fat calories is 30 percent or more of the total calories you consume in a day, you probably need to cut back. But don't be misled by terms like "lower fat." Ask yourself "lower than what?" and look at the overall percentage of fat calories in the food.
In 2013 about 289,000 women (800 per day) in the world died due to pregnancy-related causes, with large differences between developed and developing countries.[11][37] Maternal mortality in western nations had been steadily falling, and forms the subject of annual reports and reviews.[38] Yet, between 1987 and 2011, maternal mortality in the United States rose from 7.2 to 17.8 deaths per 100,000 live births, this is reflected in the Maternal Mortality Ratio (MMR).[38] By contrast rates as high as 1,000 per birth are reported in the rest of the world,[11] with the highest rates in Sub-Saharan Africa and South Asia, which account for 86% of such deaths.[39][37] These deaths are rarely investigated, yet the World Health Organization considers that 99% of these deaths, the majority of which occur within 24 hours of childbirth, are preventable if the appropriate infrastructure, training, and facilities were in place.[40][37] In these resource-poor countries, maternal health is further eroded by poverty and adverse economic factors which impact the roads, health care facilities, equipment and supplies in addition to limited skilled personnel. Other problems include cultural attitudes towards sexuality, contraception, child marriage, home birth and the ability to recognise medical emergencies. The direct causes of these maternal deaths are hemorrhage, eclampsia, obstructed labor, sepsis and unskilled abortion. In addition malaria and AIDS complicate pregnancy. In the period 2003–2009 hemorrhage was the leading cause of death, accounting for 27% of deaths in developing countries and 16% in developed countries.[41][42]
Social protection programs typically target the most marginalized members of communities and typically families with children (5, 196). Cash transfers are often targeted to women in these households because they more often invest the transfers in household and food expenditures than men do (192, 202, 204, 205). Cash transfer programs were also targeted to older adults through government-coordinated programs (196, 198, 206). The delivery of transfers involved community centers (town halls, post offices) and banks, as well as locations associated with other services, e.g., schools or health centers (192, 206, 207). These latter platforms were relevant not only for the distribution of social protection programs (i.e., the receipt of transfers), but also for enrollment in and “conditions” of those programs. Conditional transfers required that recipients had access to certain delivery platforms (e.g., schools and health centers) in order to meet the “conditions” of their transfer, and this was a limitation in very rural areas. Although social protection programs are intended for the most vulnerable populations, their delivery platforms can serve as barriers to individuals’ receipt of services, particularly if they require engagement with health care, school, or work-related systems.
When you’re at the bar or a party and starving, your options aren’t always the best. But if it’s bruschetta, chips and salsa, or wings, go for the chicken (though nuts would be even better). Protein fills you up faster than carbs do, making it less likely that you’ll overeat, says Christopher Ochner, Ph.D., a research associate at New York Obesity Nutrition Research Center at St. Luke's Roosevelt Hospital Center. And since it’ll keep you satiated longer, you won’t be as tempted when your friend orders a brownie sundae or brings out a tray of blondies.

The daily calcium recommendations are 1,000 milligrams a day for women under 50, and 1,500 milligrams a day for women 51 and older. Oddly enough, these are the same requirements for men, who are much less prone to osteoporosis than women. But the recommendation takes into account the fact that women are smaller than men. Thus the amount of daily calcium is greater for women on a proportional basis.
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.
WASH interventions, such as toilet facilities, access to improved and safe water supply, and hand washing are associated with improved nutrition and health of entire communities (13, 14, 125–128). For women and adolescent girls, WASH interventions were associated with improved menstrual hygiene (126), reduced diarrhea and intestinal worm infections (128–131), and reduced maternal mortality (132). Women and young girls are also more affected by the physical and time burdens of collecting water (126), and harassment and violence associated with inadequate and unsafe toilet facilities (133, 134). Closer water points and sanitation facilities eased these gendered burdens (126, 135). WASH interventions and perceived water availability were associated with less time spent on water-related chores, and improved school attendance, women's empowerment, and self-esteem (126, 135, 136).
Vitamin D: Over the past decade, dozens of studies have revealed many important roles for vitamin D, the nutrient that skin cells produce when they are exposed to sunlight. The recommended daily intake of Vitamin D is 600 IU per day, although recommended levels are under review. If you avoid the sun or live in the northern half of the U.S., ask your doctor whether your vitamin D level should be tested.
A 45-year-old woman who gets less than 30 minutes of daily physical activity in addition to her normal routine should consume six ounce of grains; two and a half cups of vegetables; one and a half cups of fruit; three cups of milk; five ounces of meat and/or beans; five teaspoons of oil; and just 195 calories of additional fat and sugar. With a higher level of daily activity (30 to 60 minutes), this woman would be able to consume a little more in certain food groups: her fruit intake could rise to two cups; meat and beans to five and a half ounces; oils to six teaspoons; and extra fat and sugar to 265 calories.
Getting enough water also is important. Many experts recommend at least eight 8-ounce glasses of water daily—more if you exercise frequently or are exposed to extremes of heat and cold. The 2010 Dietary Guidelines for Americans emphasize drinking more water and other calorie-free beverages, along with fat-free or low-fat milk and 100 percent fruit juices, instead of calorie-packed regular sodas.
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