Delivery platforms for women across the life course. This Venn diagram represents the delivery platforms for different interventions by target population. The overlapping regions indicate delivery platforms that are shared by the target groups: adolescent girls, women of reproductive age, pregnant and lactating women, mothers of young children, and older women.
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.
Important sexual health issues for women include Sexually transmitted infections (STIs) and female genital cutting (FGC). STIs are a global health priority because they have serious consequences for women and infants. Mother-to-child transmission of STIs can lead to stillbirths, neonatal death, low-birth-weight and prematurity, sepsis, pneumonia, neonatal conjunctivitis, and congenital deformities. Syphilis in pregnancy results in over 300,000 fetal and neonatal deaths per year, and 215,000 infants with an increased risk of death from prematurity, low-birth-weight or congenital disease.[74]
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.
Third, of the interventions that were evaluated, many interventions targeted women who were pregnant, lactating, or with young children <5 y of age. We do not refute the important focus on mothers and their children as a group deserving of special attention, given women's increased nutrient needs during pregnancy and lactation and the intergenerational consequences during this period. However, even the interventions that focused on maternal nutrition often only reported on birth and nutrition outcomes of the child, and not those of the mother. In addition, although there were interventions that targeted adolescent girls and women of reproductive age, they were fewer and less well evaluated than interventions that targeted women as mothers. This aligns with findings from other research which illustrated a higher proportion of programs targeting pregnant and lactating women and women with young children (209). We also found major gaps in the targeting of interventions for older women. With growing rates of overweight, obesity, and noncommunicable diseases, in addition to undernutrition and micronutrient deficiencies, it is essential to think outside of the maternal-focused paradigm to reach women at all life stages.
Not surprisingly, many integrated health services were delivered in health clinics and facilities. Many women faced barriers to health facility–based care for nutrition, such as distance, time, quality of care, stocking of supplies, and the capacity and nutrition knowledge of healthcare professionals (105, 119). These barriers need to be taken into consideration to enhance the coverage of integrated health care services. Universal health care mitigated cost barriers to seeking health care, but did not address all of the barriers noted here (105, 109, 114, 120–123).
 Integrated health care  Health clinics  ↑ knowledge about FP, NC use of FP  ↑ knowledge about diabetes, ↓ incidence of diabetes, ↑ glycemic control, ↑ hypertension screening and Tx, ↓ hypertension, NC mortality (from coronary artery disease), ↓ depression, ↑/NC health care utilization, ↑ knowledge about FP, ↑/NC use of FP, ↑/NC STI screening, NC STI incidence, ↑ cervical cancer screening, ↑ mammography  ↓/NC anemia, ↑ Hgb, ↑ glycemic control, ↑ hypertension screening and Tx, ↓ hypertension, ↓ pre-eclampsia, ↓ maternal mortality, ↓/NC placental malaria, ↓ parasitemia, ↓/NC depression, NC health care utilization, ↑/NC hospital deliveries, NC cesarean delivery, ↑/↓ knowledge about FP, ↑/NC use of FP, ↑ STI screening, ↓ STI incidence, ↑ cervical cancer screening, ↑ mammography  ↑ knowledge about diabetes, ↓ diabetes, ↑ glycemic control, ↑ hypertension screening and Tx, ↓ hypertension, NC mortality (from coronary artery disease), ↑ health care utilization, ↓ depression, ↑ mammography, ↑ cervical cancer screening 
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.).
During adolescence and early adulthood, women need to consume foods rich in calcium to build peak (maximum) bone mass. This will reduce the risk of developing osteoporosis, a progressive condition where there is a loss of bone that leaves those affected more susceptible to fractures. Women also need an adequate iron intake because they lose iron through menstruation. Women also need an adequate intake of calories to support energy and nutritional needs in order for the body to function properly. The amount of calories that an individual needs varies for each person and is based on age, gender and activity level. As a general recommendation, women between 23 and 50 years of age generally need between 1,700 and 2,200 calories per day to maintain their current energy needs and body weight. Older women generally require fewer calories to support and sustain energy needs. Consuming fewer than 1,500 calories per day, even in attempts to lose weight, can put women at nutritional risk and can result in malnutrition and poor health. For more information on how to calculate one’s nutritional needs, go to www.choosemyplate.gov and insert your personal information. The 2005 Dietary Guidelines for Americans is another reference or guide to assist you in learning to eat a balanced and nutritious diet for good health.
What you eat is even more important as you enter your 40s. Women need protein (meat, fish, dairy, beans, and nuts), carbohydrates (whole grains), fats (healthy oils), vitamins, minerals, and water. These foods have been linked to some disease prevention, such as osteoporosis, high blood pressure, heart disease, diabetes, and certain cancers. The American Academy of Family Physicians supports the development of healthy food supply chains in supplemental nutrition programs so as to broaden the availability of healthy food.
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.[151][152] 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.[6][153]
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:
Among other things, you need calcium to build healthy bones and teeth, keep them strong as you age, regulate the heart’s rhythm, and ensure your nervous system functions properly. Calcium deficiency can lead to, or exacerbate, mood problems such as irritability, anxiety, depression, and sleep difficulties. If you don’t get enough calcium in your diet, your body will take calcium from your bones to ensure normal cell function, which can lead to weakened bones or osteoporosis. Women are at a greater risk than men of developing osteoporosis, so it’s important to get plenty of calcium, in combination with magnesium and vitamin D, to support your bone health.
In addition to death occurring in pregnancy and childbirth, pregnancy can result in many non-fatal health problems including obstetrical fistulae, ectopic pregnancy, preterm labor, gestational diabetes, hyperemesis gravidarum, hypertensive states including preeclampsia, and anemia.[34] Globally, complications of pregnancy vastly outway maternal deaths, with an estimated 9.5 million cases of pregnancy-related illness and 1.4 million near-misses (survival from severe life-threatening complications). Complications of pregnancy may be physical, mental, economic and social. It is estimated that 10–20 million women will develop physical or mental disability every year, resulting from complications of pregnancy or inadequate care.[39] Consequently, international agencies have developed standards for obstetric care.[52]
For girls and adult women, educational interventions are considered a powerful means of improving their health and nutritional status throughout their lives. Education level is often associated with maternal caregiving practices and the nutritional outcomes of their children (174, 175). Few studies, however, evaluated the impact of education as an intervention on women's nutrition outcomes. Instead, many studies used survey data and reported on associations between education and nutrition. For instance, in low- and middle-income countries, higher levels of education were associated with lower prevalence of underweight and higher prevalence of overweight among women (176, 177). However, this depended on the type of employment in which women participated (178, 179). In addition, in many high-income settings, the converse was true (177). Level of literacy was also associated with improved anthropometric measures. In southern Ethiopia, literate mothers were 25% less likely to be undernourished than were illiterate women (180). One econometric analysis suggested that doubling primary school attendance in settings with low school attendance was associated with a 20–25% decrease in food insecurity (181). Overall, though, these associations were limited in their ability to draw conclusions about causality and the effect of education interventions on nutrition outcomes.
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.
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Women's Fitness is a funky gym in a basement in Downtown Crossing. There's a spinning room, a weights room, and a cardio room that also doubles as a studio for classes, so if you're on a treadmill there might be a class happening in front of you. I took Strength in Motion with Kate and thought it was a really fun class. I burned about 350 calories in the 45 minute class. They have lockers with keys, and showers, but you have to bring your own towel and toiletries if you don't have towel service.
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.
Still, it seems like women’s magazines have made some progress in the images that women see reflected back at them. 2017 did see the rise of plus-size models like Graham and Huffine on the cover of Vogue and Elle, respectively, but these are plus-size supermodels. There is still room for improvement in the worlds of fitness and fashion. And fitness fashion.
Women's menstrual cycles, the approximately monthly cycle of changes in the reproductive system, can pose significant challenges for women in their reproductive years (the early teens to about 50 years of age). These include the physiological changes that can effect physical and mental health, symptoms of ovulation and the regular shedding of the inner lining of the uterus (endometrium) accompanied by vaginal bleeding (menses or menstruation). The onset of menstruation (menarche) may be alarming to unprepared girls and mistaken for illness. Menstruation can place undue burdens on women in terms of their ability to participate in activities, and access to menstrual aids such as tampons and "sanitary pads". This is particularly acute amongst poorer socioeconomic groups where they may represent a financial burden and in developing countries where menstruation can be an impediment to a girl's education.[113]
Animal products, such as meat, fish and poultry are good and important sources of iron. Iron from plant sources are found in peas and beans, spinach and other green leafy vegetables, potatoes, and whole-grain and iron-fortified cereal products. The addition of even relatively small amounts of meat or foods containing vitamin C substantially increases the total amount of iron absorbed from the entire meal.
Folic acid: This form of B vitamin helps prevent neural tube defects, especially spina bifida and anencephaly. These defects can be devastating and fatal. Many foods are now fortified with folic acid. Most women get enough as part of their diet through foods such as leafy greens, a rich source of folic acid. However, some doctors recommend that women take a pregnancy supplement that includes folic acid, just to make sure they are getting the recommended 400 to 800 micrograms.
Progress has been made but girls 14 and younger represent 44 million of those who have been cut, and in some regions 50% of all girls aged 11 and younger have been cut.[84] Ending FGC has been considered one of the necessary goals in achieving the targets of the Millennium Development Goals,[83] while the United Nations has declared ending FGC a target of the Sustainable Development Goals, and for February 6 to known as the International Day of Zero Tolerance for Female Genital Mutilation, concentrating on 17 African countries and the 5 million girls between the ages of 15 and 19 that would otherwise be cut by 2030.[84][85]
Iron: Essential for healthy blood cells, iron becomes especially important when girls begin to menstruate. With each period, a woman loses small amounts of iron. “About 10% of American women are iron deficient,” says Dorothy Klimis-Zacas, PhD, a professor of nutrition at the University of Maine and co-editor of Nutritional Concerns of Women (CRC Press, 2003). “About 5% have iron deficiency anemia.” Symptoms of low iron include fatigue, impaired immunity, and poor performance at school or work.
The delivery of nutrition education reached women across all life stages and through many platforms. Many nutrition education studies that targeted pregnant and lactating mothers reported on women's outcomes, but the primary focus of many of these studies was child health outcomes (13, 14, 19, 21, 24, 28); few studies focused on dietary outcomes and behaviors of pregnant and lactating women themselves (17, 20, 23). There were some studies evaluating the impact of nutrition education on the practices and outcomes of school-age children and adolescent girls (15, 18, 27, 29, 34), as well as older women (16, 22, 25, 30). Many of the nutrition education interventions were clinic-based (17–20, 23, 24). However, nutrition education was also delivered through community-based programs, including home visits (16, 21), community centers (15, 16, 20, 21), worksites (25), and schools (25, 27, 30, 34).
But then, class instructors started leaving, cockroach bodies started appearing, the bath stalls didn't appear to be cleaned (I swear I saw the same goop of body wash on the wall for weeks), the morning crew started being late most mornings (one day I waited for about an hour and no one showed), the overnight lockers are more child sized cubbies (to be fair, I can't speak to the sizes of lockers elsewhere), bath towels smell like chemicals, some towels were scrunched up (like what cheap towels tend to do after a while they start to shrink up) which is fine but they should be replaced! A handful of times they don't care about music, either there's no music on at all or it's the same song on loop. I've seen staff members argue with each other in front of customers making it awkward for everyone.

The U.S. Department of Health and Human Services declared last week National Women’s Health Week (May 14-20th), but in reality we should be taking care of ourselves and have this awareness all year round, right? To kick this month off inspired by women’s health, let’s talk about health, nutrition, and of course answer your questions from Instagram, Twitter, and email from over this year!


These challenges are included in the goals of the Office of Research on Women's Health, in the United States, as is the goal of facilitating women's access to careers in biomedicine. The ORWH believes that one of the best ways to advance research in women's health is to increase the proportion of women involved in healthcare and health research, as well as assuming leadership in government, centres of higher learning, and in the private sector.[155] This goal acknowledges the glass ceiling that women face in careers in science and in obtaining resources from grant funding to salaries and laboratory space.[178] The National Science Foundation in the United States states that women only gain half of the doctorates awarded in science and engineering, fill only 21% of full-time professor positions in science and 5% of those in engineering, while earning only 82% of the remuneration their male colleagues make. These figures are even lower in Europe.[178]

Sugar is a source of calories, not nutrients. Consuming too much sugar can lead to weight gain and tooth decay. Contrary to what many people think, there is no evidence linking high-sugar diets to hyperactivity or diabetes. However, high-fructose corn syrup, found in most processed foods, is linked with obesity, and obesity increases your risk for developing diabetes and other conditions.
Poor nutrition may be one of the easiest conditions to self-diagnose. Look at the food pyramid and the suggested servings. Look at your diet. Are you getting the recommended daily amounts of fruits and vegetables? Enough calcium? Read the labels and compare what you eat to what you need. You may discover that even if your weight is ideal, you are not getting enough nutrition.
Almost 25% of women will experience mental health issues over their lifetime.[126] Women are at higher risk than men from anxiety, depression, and psychosomatic complaints.[17] 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.[119] Women also metabolise drugs used to treat depression differently to men.[119][127] Suicide rates are less in women than men (<1% vs. 2.4%),[27][28] but are a leading cause of death for women under the age of 60.[17]
Among other things, you need calcium to build healthy bones and teeth, keep them strong as you age, regulate the heart’s rhythm, and ensure your nervous system functions properly. Calcium deficiency can lead to, or exacerbate, mood problems such as irritability, anxiety, depression, and sleep difficulties. If you don’t get enough calcium in your diet, your body will take calcium from your bones to ensure normal cell function, which can lead to weakened bones or osteoporosis. Women are at a greater risk than men of developing osteoporosis, so it’s important to get plenty of calcium, in combination with magnesium and vitamin D, to support your bone health.
Give your body a little more credit: It tells you when you’re hungry—you may not be listening, though. Before chowing down because there’s only one slice of pie left or because the last guest arrived at the brunch, stop and check in with your stomach. “If you’re not hungry, make yourself a small plate and sip on some tea or coffee while everyone else digs in,” recommends Elle Penner, M.P.H., R.D., a MyFitnessPal expert. When your belly starts to finally grumble, food will be there.
Delivery platforms for women across the life course. This Venn diagram represents the delivery platforms for different interventions by target population. The overlapping regions indicate delivery platforms that are shared by the target groups: adolescent girls, women of reproductive age, pregnant and lactating women, mothers of young children, and older women.
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).
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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.

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.


Grains, vegetables and fruits are essential to getting the vitamins, minerals, complex carbohydrates (starch and dietary fiber) and other nutrients you need to sustain good health. Some of these nutrients may even reduce your risk of certain kinds of cancer. But experts say we rarely eat enough of these foods. To make matters worse, we also eat too much of unhealthy types of food, including fat (and cholesterol), sugar and salt.
What you eat is even more important as you enter your 40s. Women need protein (meat, fish, dairy, beans, and nuts), carbohydrates (whole grains), fats (healthy oils), vitamins, minerals, and water. These foods have been linked to some disease prevention, such as osteoporosis, high blood pressure, heart disease, diabetes, and certain cancers. The American Academy of Family Physicians supports the development of healthy food supply chains in supplemental nutrition programs so as to broaden the availability of healthy food.
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