Globally, women's access to health care remains a challenge, both in developing and developed countries. In the United States, before the Affordable Health Care Act came into effect, 25% of women of child-bearing age lacked health insurance.[176] In the absence of adequate insurance, women are likely to avoid important steps to self care such as routine physical examination, screening and prevention testing, and prenatal care. The situation is aggravated by the fact that women living below the poverty line are at greater risk of unplanned pregnancy, unplanned delivery and elective abortion. Added to the financial burden in this group are poor educational achievement, lack of transportation, inflexible work schedules and difficulty obtaining child care, all of which function to create barriers to accessing health care. These problems are much worse in developing countries. Under 50% of childbirths in these countries are assisted by healthcare providers (e.g. midwives, nurses, doctors) which accounts for higher rates of maternal death, up to 1:1,000 live births. This is despite the WHO setting standards, such as a minimum of four antenatal visits.[177] A lack of healthcare providers, facilities, and resources such as formularies all contribute to high levels of morbidity amongst women from avoidable conditions such as obstetrical fistulae, sexually transmitted diseases and cervical cancer.[6]
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]
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]
Women's empowerment relates to women's ability to make life choices (158). Higher levels of empowerment were associated with increased income, household decision-making, control over resources, and utilization of health resources (5, 158–160). For nutrition outcomes, empowerment was associated with increased income allocated to food expenditures and improved household food security (160, 161). It was also associated with increased dietary diversity, but had no impact on women's BMI (5, 161, 162). For example, mothers’ participation in empowerment activities through Helen Keller International's Enhanced Homestead Food Production (EHFP) program in Burkina Faso was associated with increased fruit intake (difference-in-differences = 15.8 percentage points, P = 0.02) and nearly statistically significant increases in meat intake and dietary diversity (163). Participation was also associated with decreased prevalence of underweight (difference-in-differences = −8.7 percentage points, P < 0.01) but not overall mean BMI (163). In addition, the EHFP program in Bangladesh and Nepal was associated with decreasing trends in maternal anemia (anemia prevalence decreased by a magnitude of 12%, P = 0.075 in Bangladesh, and 26%, P = 0.009 in Nepal) (160). However, this was not consistent with findings from Cambodia (160).

Published ten times per year, Women's Health magazine is a premier publication focused on the health, fitness, nutrition, and lifestyles of women. With a circulation of 1.5 million readers, you'll be in good company with a subscription to this successful magazine published by Rodale. From cover to cover, each issue will provide you with tips on improving every aspect of your life.
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).

The U.S. Department of Agriculture's (USDA) food pyramid system (www.mypyramid.gov) provides a good start by recommending that the bulk of your diet come from the grain group—this includes bread, cereal, rice and pasta— the vegetable group; and the fruit group. Select smaller amounts of foods from the milk group and the meat and beans group. Eat few—if any—foods that are high in fat and sugars and low in nutrients. The amount of food you should consume depends on your sex, age and level of activity.
Nutrition is particularly important during pregnancy to ensure your health and the health of the baby. It's normal to gain weight during pregnancy—not just because of the growing fetus, but because you'll need stored fat for breast-feeding. The Institute of Medicine (IOM) recommends a gain of 25 to 35 pounds in women of normal weight when they get pregnant; 28 to 40 pounds in underweight women; and at least 15 pounds in women who are overweight when they get pregnant. The IOM has not given a recommendation for an upper limit for obese women, but some experts cap it as low as 13 pounds. If you fit into this category, discuss how much weight you should gain with your health care professional.
Nutrition education, including communication and counseling to raise awareness and promote nutrition-related knowledge and behaviors aligned with public health goals, was found to increase women's knowledge and improve women's dietary diversity and protein intake (15–21). It also reduced energy intake of overweight women over a 9-mo period (22). However, evidence for the effectiveness of nutrition education interventions showed mixed impact on biological and anthropometric markers of women's nutritional status (14–16, 18, 23–29). This could be due to lack of statistical power given the small sample sizes of the reviewed studies. For adolescent girls, nutrition education was found to reduce odds of overweight, and improve knowledge, dietary intake, physical activity, and sedentary behavior (27, 29, 30). This was particularly true for nutrition education that lasted longer than 12 mo (29). Nutrition education was also more strongly associated with changes in health outcomes in studies evaluating childhood obesity treatment, rather than childhood obesity prevention (29).
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.

Globally, there were 87 million unwanted pregnancies in 2005, of those 46 million resorted to abortion, of which 18 million were considered unsafe, resulting in 68,000 deaths. The majority of these deaths occurred in the developing world. The United Nations considers these avoidable with access to safe abortion and post-abortion care. While abortion rates have fallen in developed countries, but not in developing countries. Between 2010–2014 there were 35 abortions per 1000 women aged 15–44, a total of 56 million abortions per year.[41] The United nations has prepared recommendations for health care workers to provide more accessible and safe abortion and post-abortion care. An inherent part of post-abortion care involves provision of adequate contraception.[73]
Also limit the amount of cholesterol you consume. Cholesterol is a fat-like substance found in every cell of the body. It helps digest some fats, strengthen cell membranes and make hormones. But too much cholesterol can be dangerous: When blood cholesterol reaches high levels, it can build up on artery walls, increasing the risk of blood clots, heart attack and stroke. Although dietary cholesterol can contribute to heart disease, the greater risk comes from a diet high in saturated and trans fats.
For some simple suggestions about eating a healthy, balanced diet, check out the "New American Plate Concept" from the American Institute for Cancer Research. This concept suggests you fill your plate with two-thirds or more of vegetables, fruits, whole grains or beans and only one-third or less of animal protein. This simple principle can guide you toward healthier eating. For more details, visit http://www.aicr.org/site/PageServer?pagename=reduce_diet_new_american_plate.
Before you start a juice cleanse diet, know that drastically restricting your caloric intake to drop pounds may backfire: In a 2010 study, women placed on a 1,200-calorie diet for three weeks had elevated levels of cortisol, our primary stress hormone. [Tweet this fact!] Chronic stress has been associated with an increased risk of weight gain as well as coronary heart disease, hypertension, diabetes, cancer, and impaired immune functioning. 
For a strong backside that will turn heads wherever you go, Marta Montenegro, a Miami-based exercise physiologist and strength and conditioning coach, recommends completing 100 kettlebell swings nonstop with a moderate weight at the end of a legs workout. [Tweet this tip!] If you can’t access a kettlebell, do deadlifts and hip-thrusters instead. “Women tend to overemphasize the quadriceps even when they think they are working the butt. With these two exercises, you'll have no problem engaging the glutes and posterior muscles of the legs,” Montenegro says.

Although growing bodies need plenty of energy in the form of calories, many children and teenagers consume way too many, says Ruth Frechman, RD, a spokesperson for the American Dietetic Association. The latest findings from federal surveys show that 18% of adolescents and teenagers are fatter than they should be. Kids who are obese are 16 times more likely than healthy weight children to become obese as adults, other findings show.
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
The authors’ contributions were as follows—ELF and CD: were involved in the acquisition of the data; ELF, CD, SMD, and JF: were responsible for the interpretation of the data; ELF: wrote the paper and had primary responsibility for the content; CD, SMD, WS, and JF: were involved in providing detailed comments and revising the manuscript for important intellectual content; and all authors: were involved in the conception of this review and read and approved the final manuscript.
Internationally, many United Nations agencies such as the World Health Organization (WHO), United Nations Population Fund (UNFPA)[171] and UNICEF[172] maintain specific programs on women's health, or maternal, sexual and reproductive health.[1][173] In addition the United Nations global goals address many issues related to women's health, both directly and indirectly. These include the 2000 Millennium Development Goals (MDG)[142][43] and their successor, the Sustainable Development Goals adopted in September 2015,[47] following the report on progress towards the MDGs (The Millennium Development Goals Report 2015).[174][37] For instance the eight MDG goals, eradicating extreme poverty and hunger, achieving universal primary education, promoting gender equality and empowering women, reducing child mortality rates, improving maternal health, combating HIV/AIDS malaria and other diseases, ensuring environmental sustainability, and developing a global partnership for development, all impact on women's health,[43][11] as do all seventeen SDG goals,[47] in addition to the specific SDG5: Achieve gender equality and empower all women and girls.[109][175]

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.
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.
Improvements in maternal health, in addition to professional assistance at delivery, will require routine antenatal care, basic emergency obstetric care, including the availability of antibiotics, oxytocics, anticonvulsants, the ability to manually remove a retained placenta, perform instrumented deliveries, and postpartum care.[11] Research has shown the most effective programmes are those focussing on patient and community education, prenatal care, emergency obstetrics (including access to cesarean sections) and transportation.[41] As with women's health in general, solutions to maternal health require a broad view encompassing many of the other MDG goals, such as poverty and status, and given that most deaths occur in the immediate intrapartum period, it has been recommended that intrapartum care (delivery) be a core strategy.[39] New guidelines on antenatal care were issued by WHO in November 2016.[51]
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.
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.
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.
Fluids: Fluid needs increase as women age. The reason: Kidneys become less efficient at removing toxins. “Drinking more fluids helps kidneys do their job,” Schwartz says. “Unfortunately, thirst signals often become impaired with age, so people are less likely to drink enough water and other fluids.” Rather than fret about how many glasses to drink, Frechman says, check the color of your urine. "It should be clear or very pale colored. If it becomes darker, you need more fluid.”
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 often received micronutrient supplements during antenatal and postnatal care (13, 35–42, 51, 60), and, as such, supplementation was often targeted to pregnant and lactating women. The delivery of micronutrient supplementation commonly occurred in health care settings for at-home consumption. Community-based antenatal care that involved home visits by community health workers was also a common delivery platform for supplementation delivery. There were some studies that reported micronutrient supplementation to adolescents, women of reproductive age, pregnant women, and women with young children outside of the antenatal care setting. These included primary health care clinics, home visits, community centers, pharmacies, and workplaces (32, 38–43, 45, 52, 53). Adolescent girls were also reached by community- and school-based programs (26, 41, 46). School-based programs were more efficacious in reducing rates of anemia among adolescent girls, compared with the community-based interventions (26, 46). However, many of the reported studies to date involved small samples of adolescents in controlled settings, and additional research is needed on the effectiveness of these programs (59, 62).
Anemia can deplete your energy, leaving you feeling weak, exhausted, and out of breath after even minimal physical activity. Iron deficiency can also impact your mood, causing depression-like symptoms such as irritability and difficulty concentrating. While a simple blood test can tell your doctor if you have an iron deficiency, if you’re feeling tired and cranky all the time, it’s a good idea to examine the amount of iron in your diet.
The U.S. Public Health Service recommends that all women of childbearing age consume 400 mcg of folic acid (a B vitamin) daily to reduce their risk of having a pregnancy affected with spina bifida or other neural-tube defects. Women who are actively trying to get pregnant should consume 600 mcg, and lactating women should consumer 500 mcg. Women of childbearing age should also take care to meet the daily requirements for calcium, fiber, iron, protein and vitamin D. Discuss supplements with a health care professional, however. Iron and vitamin D in particular can be dangerous in high amounts.
“The reason most people don't see changes isn't because they don't work hard—it's because they don't make their workouts harder,” says Adam Bornstein, founder of Born Fitness. His suggestion: Create a challenge every time you exercise. “Use a little more weight, rest five to 10 seconds less between sets, add a few more reps, or do another set. Incorporating these small variations into your routine is a recipe for change,” he says.
There were also supplementation programs that targeted nonpregnant women. National supplementation programs that provided food baskets to low-income families increased maternal BMI and improved household food insecurity (92, 93). However, there were some unintended consequences. In Mexico, food transfer programs disproportionately increased weight gain in overweight women compared with underweight women (93), and 1 study in Bangladesh found that food transfers had larger impacts on men's intake than women's intake, except with less preferred foods (94). Adolescents who received protein-energy supplementation at school showed an increase in weight gain during supplementation, as well as improvements in school attendance and mathematics scores (46, 95). However, the impact of supplementation on micronutrient deficiencies and, specifically, hemoglobin concentration, was limited (46).

WHO (1948). "WHO definition of Health". Archived from the original (Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19–22 June 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948.) on 7 July 2016. Retrieved 6 July 2016., in WHO (2016)


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).

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.
The U.S. Department of Agriculture's (USDA) food pyramid system (www.mypyramid.gov) provides a good start by recommending that the bulk of your diet come from the grain group—this includes bread, cereal, rice and pasta— the vegetable group; and the fruit group. Select smaller amounts of foods from the milk group and the meat and beans group. Eat few—if any—foods that are high in fat and sugars and low in nutrients. The amount of food you should consume depends on your sex, age and level of activity.

  Community centers  ↑ MN provision, ↑ health care utilization, ↑ knowledge about FP, ↑/NC use of FP  ↑ MN provision, ↑ health care utilization, ↑ knowledge about FP, ↑/NC use of FP  ↑ knowledge about nutritional needs, ↑ MN provision, ↓/NC maternal mortality, ↓ parasitemia, ↑ health care utilization, ↑ hospital deliveries, ↑ knowledge about FP, ↑/NC use of FP, ↑ STI testing   


According to the American Heart Association, it's better to eat more complex carbohydrates (vegetables, fruits and whole grains) than simple carbohydrates found in sugars. Complex carbohydrates add more fiber, vitamins and minerals to the diet than foods high in refined sugars and flour. Foods high in complex carbohydrates are usually low in calories, saturated fat and cholesterol.
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.
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