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
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.
Our review found that protein-energy supplementation was largely targeted to pregnant and lactating women (19, 86–88, 90, 91); however, there were some studies that evaluated the delivery of protein-energy supplementation to households (92, 93) and adolescents (46). The only studies we found that evaluated the impact of protein-energy supplementation in older, healthy women were hospital-based studies in high-income countries (96). Delivery platforms varied depending on the target audience. The majority of studies targeted pregnant women through antenatal care or through antenatal care–associated community-based programs. National programs targeting low-income families had broader reach, although they targeted households and not women specifically (92). Additional research is needed for how women might best be reached (94). For programs that provided provisions for women to take home, there was also limited information about how much was shared with other members of the household. School-based programs targeting adolescents could be an important venue to target interventions to adolescents in the future. However, children and adolescents not in school would be missed. Despite limited evidence of impacts of energy and protein supplementation on the health of women, supplementation might be an important complement to other interventions (e.g., nutrition education and counseling) to ensure that women have the resources needed to implement other interventions successfully. Indeed, many large-scale programs for protein-energy supplementation are often complemented with nutrition education and counseling (33).
^ Jump up to: a b c Aldridge, Robert W.; Story, Alistair; Hwang, Stephen W.; Nordentoft, Merete; Luchenski, Serena A.; Hartwell, Greg; Tweed, Emily J.; Lewer, Dan; Vittal Katikireddi, Srinivasa (2017-11-10). "Morbidity and mortality in homeless individuals, prisoners, sex workers, and individuals with substance use disorders in high-income countries: a systematic review and meta-analysis". Lancet. 391 (10117): 241–250. doi:10.1016/S0140-6736(17)31869-X. ISSN 1474-547X. PMC 5803132. PMID 29137869. All-cause standardised mortality ratios were significantly increased in 91 (99%) of 92 extracted datapoints and were 11·86 (95% CI 10·42–13·30; I2=94·1%) in female individuals
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.
If you do decide to diet, you still need to maintain good nutrition. You want to cut back on calories, not nutrients. And while you want to reduce fat, don't eliminate it entirely. Some studies suggest that older women who maintain a higher body-fat percentage are less likely to suffer from osteoporosis and other conditions associated with menopause. Fat cells also retain estrogen, which helps maintain the calcium in your bones. Younger women should be careful, too: a low body fat percentage can lead to infertility; below 17 percent may lead to missed periods, also known as amenorrhea.
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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