Infrastructure  ↓ water point distance, ↑ time savings, ↑/NC women's hygiene, ↑/NC water quality, ↓/NC diarrheal morbidity, ↓ intestinal parasite prevalence, ↑ school attendance, NC wage employment  ↓ water point distance, ↑ time savings, ↑/NC women's hygiene, ↑/NC water quality, ↓/NC diarrheal morbidity, ↓ intestinal parasite prevalence, NC wage employment, ↑ participation in income-generating activities  ↓ maternal mortality, ↓ water point distance, ↑ time savings, ↑/NC women's hygiene, ↑/NC water quality, ↓/NC diarrheal morbidity, ↓ intestinal parasite prevalence, NC wage employment, ↑ participation in income-generating activities  ↓ water point distance, ↑ time savings, ↑/NC women's hygiene, ↑/NC water quality, ↓/NC diarrheal morbidity, ↓ intestinal parasite prevalence, NC wage employment, ↑ participation in income-generating activities 
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

You don't want to be judged, gawked at, or hassled when working out at a fitness center. Everyone has different goals when they begin their fitness journey. What brings us together as a family is our common bond — we ALL want great results! Helping you look and feel great is our passion. If you think Bella Women's Fitness is just like any other fitness center, you'll need to stop in for a reality check! We would be glad to show you how the Bella Fitness experience can change your life.
Our women’s fitness programs are designed for women from the ground up. We teach from the female anatomy and physiology, the feminine psyche and include all the subtle bodies – the emotional, mental and spiritual that have an impact on the physical. We understand the different needs of the woman as she exercises through pregnancy, postnatal, menopause and the later years of her life and how these changes affect her women’s fitness needs and goals.

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]
A workout partner not only keeps you accountable, she also may help you clock more time at the gym and torch more fat. A British survey of 1,000 women found that those who exercise with others tend to train six minutes longer and burn an extra 41 calories per session compared to solo fitness fanatics. [Tweet this fact!] Women with Bikram buddies and CrossFit comrades said they push themselves harder and are more motivated than when they hit the gym alone.
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.
A 55-year-old woman who gets less than 30 minutes of daily physical activity should eat five ounces of grains; two cups of vegetables; one and a half cups of fruit; three cups of milk; five ounces of meat and beans; five teaspoons of oils, and no more than 130 calories of additional fat and sugar. If she got 30 to 60 minutes of daily exercise, she could increase her intake to six ounces of grains; two and a half cups of vegetables; and up to 265 additional calories of fat and sugar.
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.
Diseases such as chlamydia and gonorrhoea are also important causes of pelvic inflammatory disease (PID) and subsequent infertility in women. Another important consequence of some STIs such as genital herpes and syphilis increase the risk of acquiring HIV by three-fold, and can also influence its transmission progression.[75] Worldwide, women and girls are at greater risk of HIV/AIDS. STIs are in turn associated with unsafe sexual activity that is often unconsensual.[74]
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.

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.
While what works best for one woman may not always be the best choice for another, the important thing is to build your dietary choices around your vital nutritional needs. Whether you’re looking to improve your energy and mood, combat stress or PMS, boost fertility, enjoy a healthy pregnancy, or ease the symptoms of menopause, these nutrition tips can help you to stay healthy and vibrant throughout your ever-changing life.
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.

Women's health is positioned within a wider body of knowledge cited by, amongst others, the World Health Organization, which places importance on gender as a social determinant of health.[22] While women's health is affected by their biology, it is also affected by their social conditions, such as poverty, employment, and family responsibilities, and these aspects should not be overshadowed.[23][24]


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.
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.
Women who are socially marginalized are more likely to die at younger ages than women who are not.[21] Women who have substance abuse disorders, who are homeless, who are sex workers, and/or who are imprisoned have significantly shorter lives than other women.[21] At any given age, women in these overlapping, stigmatized groups are approximately 10 to 13 times more likely to die than typical women of the same age.[21]
I joined WFOB two years ago after my gym closed down without any notice. I wasn't used to working out at an all woman's gym but I have to tell you this place is great. I look forward to going everyday. It's a no judgment zone. Everyone is there for the same reason. The woman all work hard and are very supportive of one another. The classes are diverse enough to find something you can do. And if you can't there are free weights and machines to do your own thing. Julie is always switching things up to make it interesting. She always has new ideas and is a very wise business person.
  Community centers  NC HH or individual food security, NC food expenditures, NC food consumption, ↑ social status, ↑ self-confidence  ↑ health and knowledge, ↓ anemia, ↑/NC HH food security, NC individual food security, NC food expenditures, ↑/NC food consumption, ↑/NC dietary diversity, ↑ MN-rich foods (Fe, vitamin A, vitamin C, calcium), ↑/NC intake of protein, ↑ ASF intake, ↑/NC BMI, ↑ weight gain, ↑ social status, ↑ self-confidence, ↑/NC decision-making  ↑ health and nutrition knowledge, ↓/NC anemia, ↑/NC HH food security, ↑/NC food expenditures, ↑/NC HH food consumption, ↑/NC dietary diversity, ↑ nutrient-rich foods (Fe, vitamin A), NC intake of protein, ↑/NC intake of vegetables and ASF, ↑/NC BMI, ↓ underweight, ↑ weight gain, NC diarrheal morbidity, ↑ self-confidence, ↑/NC decision-making, ↑ control HH resources  ↑ health knowledge, ↑/NC HH food security, ↑/NC HH food consumption, ↑ dietary diversity, ↑ self-confidence, ↑/NC decision-making 
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.
Dairy. Women should get 3 cups of dairy each day, but most women get only half that amount.6 If you can’t drink milk, try to eat low-fat plain yogurt or low-fat cheese. Dairy products are among the best food sources of the mineral calcium, but some vegetables such as kale and broccoli also have calcium, as do some fortified foods such as fortified soymilk, fortified cereals, and many fruit juices. Most girls ages 9 to 18 and women older than 50 need more calcium for good bone health.
Native to East Asia, soybeans have been a major source of protein for people in Asia for more than 5,000 years. Soybeans are high in protein (more than any other legume) and fiber, low in carbohydrates and are nutrient-dense. Soybeans contain substances called phytoestrogens, which can significantly lower your "bad" LDL cholesterol and raise your "good" HDL cholesterol.

Poor nutrition can manifest itself in many ways. The more obvious symptoms of a nutritional deficiency include dull, dry or shedding hair; red, dry, pale or dull eyes; spoon-shaped, brittle or ridged nails; bleeding gums; swollen, red, cracked lips; flaky skin that doesn't heal quickly; swelling in your legs and feet; wasted, weak muscles; memory loss; and fatigue.


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:

Our review highlighted how a focus on delivery platforms could indicate who is missed by different nutrition interventions, by evaluating where there is overlap or divergence in where interventions are delivered (as represented in the Venn diagram in Figure 1). Our findings showed that a large proportion of nutrition-specific interventions were delivered at clinic-based settings or community-based health posts. Health centers are important delivery platforms, particularly for pregnant and lactating women (113, 210). However, only half of women worldwide even attend the appropriate number of antenatal care visits (with nearly 86% of women attending 1 visit) and only 59% receive appropriate postnatal care (211). Other delivery platforms, such as schools and universities, were more effective at reaching some adolescents and women of reproductive age. However, interventions delivered at “facilities” (schools, health clinics, health posts) require participation with those facilities, and participation is often limited because of time, costs, distance, and other responsibilities, including work and childcare (116). Facilities-based care is also more likely to miss certain groups, including older women.
However, many fortification programs in low- and middle-income countries are regional or voluntary and, thus, might have a limited nutritional impact at the national level (76). Although many efficacy trials show benefits of fortification interventions, scaling up fortification is limited by inadequate coverage and resources (13, 77, 78). Evidence for impact is also affected by suboptimal programming, low-bioavailability fortificants (e.g., reduced iron powder), poor consumption rates, weak enforcement mechanisms, and inadequate monitoring (76, 79, 80). More research is needed to evaluate the long-term impact of fortification and biofortification programs (75). In addition, there is also growing concern about fortifying and promoting food vehicles that have adverse health consequences when consumed in excess, such as salt and sugar, given the rising prevalence of overweight, obesity, and noncommunicable disease (81–83).
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.
Recent research by the Centers for Disease Control and Prevention showed that ART babies are two to four times more likely to have certain kinds of birth defects. These may include heart and digestive system problems, and cleft (divided into two pieces) lips or palate. Researchers don't know why this happens. The birth defects may not be due to the technology. Other factors, like the age of the parents, may be involved. More research is needed. The risk is relatively low, but parents should consider this when making the decision to use ART.
The Center’s Pelvic Floor 6 hour course is a prerequisite for all of the courses in our curriculum. We base our courses on the movement of the pelvis and how it affects the rest of the female body. We will also look at the pelvic floor from a healthy stand- point rather than a problematic one. This course will offer an in depth look at the anatomy and function of the pelvic floor, its application to movement and the breath and will discuss the reasons for dysfunction and how many of these problems can be prevented. Our approach contains both the scientific evidenced based research and the more holistic viewpoint of this most intimate part of the female body.
 Nutrition education  Health clinics  ↑ knowledge, NC Hgb, ↑ intake of fruits and vegetables, ↓/NC intake of fats, sweets, and sugar-sweetened beverages  ↑ knowledge, NC Hgb, ↑ intake of fruits and vegetables, ↓/NC intake of fats, sweets, and sugar-sweetened beverages  ↑ knowledge, NC urinary iodine, ↑ intake of nutrient-rich foods, ↑ intake of protein, ↑ weight gain, ↑/NC weight loss postpartum (obese women) with diet and exercise   
First off, if you suspect you have a vitamin deficiency or you fall into one of those groups, you should definitely chat with your doctor or dietitian to determine which are lacking in your diet. And like I stated earlier, if you want to be sure you getting the recommended levels of vitamins and nutrients, I recommend a multivitamin like New Chapter’s Every Woman’s One Daily Multivitamin. It’s expertly formulated for active women with nutrients for energy, stress, immune, heart and bone support*. My favorite thing about them is that they’re made with superfood herbal blends that include ginger, organic turmeric, chamomile and European elderberry. The cool thing about New Chapter’s supplements is that they’re fermented with probiotics and whole foods, so they’re gentle enough to take on an empty stomach.** They’re also Non-GMO Project Verified, gluten-free, and vegetarian, which is great for so many lifestyles.

 	Home visits 	↑/NC knowledge about hygiene and sanitation, ↑ hand-washing, ↑ water quality, ↓/NC diarrheal morbidity, ↓ intestinal parasite prevalence 	↑/NC knowledge about hygiene and sanitation, ↑ hand-washing, ↑ water quality, ↓/NC diarrheal morbidity, ↓ intestinal parasite prevalence 	↓ maternal mortality, ↑/NC knowledge about hygiene and sanitation, ↑/NC hand-washing, ↑ water quality, NC waste disposal, ↓/NC diarrheal morbidity, ↓ intestinal parasite prevalence 	↑/NC knowledge about hygiene and sanitation, ↑ hand-washing, ↑ water quality, ↓/NC diarrheal morbidity, ↓ intestinal parasite prevalence 

Foods that contain natural folic acid include orange juice, green leafy vegetables, peas, peanuts and beans. (One cup of cooked kidney beans contains 230 mcg of folic acid.) Fortified foods, such as ready-to-eat breakfast cereals, also contain a synthetic form of folic acid, which is more easily absorbed by your body than the natural form. Folic acid is now added to all enriched grain products (thiamin, riboflavin, niacin, and iron have been added to enriched grains for many years).
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).

Vickers, M. R; MacLennan, A. H; Lawton, B.; Ford, D.; Martin, J.; Meredith, S. K; DeStavola, B. L; Rose, S.; Dowell, A.; Wilkes, H. C; Darbyshire, J. H; Meade, T. W (4 August 2007). "Main morbidities recorded in the women's international study of long duration oestrogen after menopause (WISDOM): a randomised controlled trial of hormone replacement therapy in postmenopausal women". BMJ. 335 (7613): 239. doi:10.1136/bmj.39266.425069.AD. PMC 1939792. PMID 17626056.


To optimise women's control over pregnancy, it is essential that culturally appropriate contraceptive advice and means are widely, easily, and affordably available to anyone that is sexually active, including adolescents. In many parts of the world access to contraception and family planning services is very difficult or non existent and even in developed counties cultural and religious traditions can create barriers to access. Reported usage of adequate contraception by women has risen only slightly between 1990 and 2014, with considerable regional variability. Although global usage is around 55%, it may be as low as 25% in Africa. Worldwide 222 million women have no or limited access to contraception. Some caution is needed in interpreting available data, since contraceptive prevalence is often defined as "the percentage of women currently using any method of contraception among all women of reproductive age (i.e., those aged 15 to 49 years, unless otherwise stated) who are married or in a union. The “in-union” group includes women living with their partner in the same household and who are not married according to the marriage laws or customs of a country."[62] This definition is more suited to the more restrictive concept of family planning, but omits the contraceptive needs of all other women and girls who are or are likely to be sexually active, are at risk of pregnancy and are not married or "in-union".[37][63][58][59]


Women's Fitness of Boston is conveniently located, fairly priced and a delight to be a member of. The owner, Julie, works so hard to make sure that her clients enjoy the gym. She is also a great personal trainer, and is willing to work closely with clients to push them to their potential. She's just that right balance of energetic and serious, making sure that her clients get what they need.
You should consume only 25 percent to 35 percent of your total calories per day from fat, with a significant portion from good fats like omega-3 and omega-6 fatty acids. According to the American Heart Association, women should get at least five to 10 percent of their total daily calories from omega-6 fatty acids (equal to 12 to 20 grams), and anywhere from 0.5 to 3 grams of omega-3 fatty acids, depending on individual risk for heart disease.
Women who are socially marginalized are more likely to die at younger ages than women who are not.[21] Women who have substance abuse disorders, who are homeless, who are sex workers, and/or who are imprisoned have significantly shorter lives than other women.[21] At any given age, women in these overlapping, stigmatized groups are approximately 10 to 13 times more likely to die than typical women of the same age.[21]
Adult women, and particularly women with children, were the primary targets for empowerment interventions. Empowerment interventions were predominantly delivered through community-based programs, including home visits, community groups, and community centers (5, 161, 163). There was some evidence that empowerment interventions that included delivery platforms such as radio and television, as a complement to the community- and home-based delivery platforms (5), could have some impact on reaching a wider audience. Adolescent girls were largely not the target of empowerment interventions, except for those relating to reproductive health (158), and could potentially benefit from them.
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.
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]
It’s been a while since I’ve picked up any of these, but when I did, the messages weren’t nearly as body-positive. In fact, a quick perusal of other Shape magazine covers from the 1980s (I was probably still reading Seventeen then, but still) shows a bunch of celebrity cover models who would like you to get off the couch immediately, with demands like “Get Strong!” and “Push For Fitness!” Also suspect: “How To Think And Eat Like A Thin Person” and “Is Food Your Lover? How To End The Affair.”
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.
Manson, JoAnn E.; Chlebowski, Rowan T.; Stefanick, Marcia L.; Aragaki, Aaron K.; Rossouw, Jacques E.; Prentice, Ross L.; Anderson, Garnet; Howard, Barbara V.; Thomson, Cynthia A.; LaCroix, Andrea Z.; Wactawski-Wende, Jean; Jackson, Rebecca D.; Limacher, Marian; Margolis, Karen L.; Wassertheil-Smoller, Sylvia; Beresford, Shirley A.; Cauley, Jane A.; Eaton, Charles B.; Gass, Margery; Hsia, Judith; Johnson, Karen C.; Kooperberg, Charles; Kuller, Lewis H.; Lewis, Cora E.; Liu, Simin; Martin, Lisa W.; Ockene, Judith K.; O'sullivan, Mary Jo; Powell, Lynda H.; Simon, Michael S.; Van Horn, Linda; Vitolins, Mara Z.; Wallace, Robert B. (2 October 2013). "Menopausal Hormone Therapy and Health Outcomes During the Intervention and Extended Poststopping Phases of the Women's Health Initiative Randomized Trials". JAMA. 310 (13): 1353–1368. doi:10.1001/jama.2013.278040. PMC 3963523. PMID 24084921.
Focus on the long term. Diets fail when people fall back into poor eating habits; maintaining weight loss over the long term is exceedingly difficult. Most people regain the weight they've lost. In fact, some studies indicate that 90 to 95 percent of all dieters regain some or all of the weight originally lost within five years. Your program should include plans for ongoing weight maintenance, involving diet, exercise and a behavioral component. While there are some physical reasons for obesity, there are also behavioral reasons for excessive eating. For example, many women use food as a source of comfort (perhaps to deal with stress). For these women, a weight loss program with a behavioral component will offer alternatives to replace food in this role.
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