The effect of education programs on nutrition outcomes is difficult to assess because programs often have poor baseline data or nutrition outcomes are not evaluated (174, 182). Studies that used longitudinal analyses and “natural” experiments (e.g., before and after a national education policy) found that education was associated with reduced fertility (183, 184), and delayed early marriages and pregnancies (184–187). The impact was more significant for higher levels of education (185). However, 1 study in Malawi identified negative associations between education and timing of first birth, although these findings were largely not statistically significant (188). Secondary education for adolescents and women of reproductive age also showed no impact on women's empowerment (184), although it did show an impact on improved literacy and leadership (174). Educational interventions that provided conditional cash transfers (CCTs) and school feeding, as well as other forms of social protection to families of enrolled girls, were associated with greater school enrollment and attendance (189–191), improved test scores (189, 190), reduced gender gaps (192), and reduced hunger (190, 191).
One of the challenges in assessing progress in this area is the number of clinical studies that either do not report the gender of the subjects or lack the statistical power to detect gender differences. These were still issues in 2014, and further compounded by the fact that the majority of animal studies also exclude females or fail to account for differences in sex and gender. for instance despite the higher incidence of depression amongst women, less than half of the animal studies use female animals. Consequently, a number of funding agencies and scientific journals are asking researchers to explicitly address issues of sex and gender in their research.
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Folate or vitamin B9 (also known as folic acid when used in fortified foods or taken as a supplement) is another nutrient that many women don’t get enough of in their diets. Folate can greatly reduce the chance of neurological birth defects when taken before conception and during the first few weeks of pregnancy. Folate can also lower a woman’s risk for heart disease and certain types of cancer, so even if you’re not planning on getting pregnant (and many pregnancies are unplanned), it’s an essential nutrient for every woman of childbearing age. In later life, folate can help your body manufacture estrogen during menopause.
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.
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.
All youth need calcium to build peak (maximum) bone mass during their early years of life. Low calcium intake is one important factor in the development of osteoporosis, a disease in which bone density decreases and leads to weak bones and future fractures. Women have a greater risk than men of developing osteoporosis. During adolescence and early adulthood, women should include good food sources of calcium in their diets This is when bone growth is occurring and calcium is being deposited into the bone. This occurs in women until they are 30 to 35 years of age. Women 25 to 50 years of age should have 1,000 mg of calcium each day, while women near or past menopause should have 1,200 mg of calcium daily if they are taking estrogen replacement therapy; otherwise, 1,500 mg per day is recommended. Women older than 65 years of age should have 1,500 mg per day.
In addition to diet, exercise and other lifestyle factors can also play an important role in bone health. Smoking and drinking too much alcohol can increase your chances of developing osteoporosis, while weight-bearing exercise (such as walking, dancing, yoga, or lifting weights) can lower your risk. Strength or resistance training—using machines, free weights, elastic bands, or your own body weight—can be especially effective in helping to prevent loss of bone mass as you age.