Interventions resulting in public infrastructure changes were found to be less effective than household-based interventions; however, both are important aspects of improved health outcomes for women (128, 130). Public water infrastructure requires regular maintenance and periodic replacement and water from these sources is often contaminated (130). However, even public water points that provide good-quality water have had minimal impacts on health outcomes (136). One review estimated that water-source interventions were associated with a 27% reduction in diarrhea risk at all ages, whereas household-based interventions were associated with a 43% reduction (128). This could be associated with bias and confounding, as measuring WASH outcomes is not a blinded process (128). The differential impact could also be related to practice. As compared with public water sources, home water connections were associated with greater odds of handwashing and fecal waste disposal (136). As a significant portion of diarrheal disease is a result of person-to-person transmission and poor hygiene, interventions that improve domestic hygiene behaviors can have a significant impact (136). Behavior change communication and resource provision, e.g., soap and point-of-use water treatment resources, were also important and sustainable aspects of WASH interventions (131, 137).
CCTs have been more thoroughly evaluated for nutrition outcomes, particularly in Latin American countries. They were associated with improvements in women's knowledge of health and nutrition, as well as their self-esteem, participation in social networks, control over resources, and decision-making power (5, 202). Although intrahousehold allocation for women is not clear, CCTs increased household food expenditure and were associated with improved household dietary diversity, including increased household consumption of animal protein, fruits, and vegetables, and reduced consumption of staples and grains (14, 192, 202). There was also some evidence that household expenditure on fats and sweets also increased significantly (202). However, these findings were not consistent and some evaluations showed no significant increase (14, 202, 203). Despite this, in Mexico, there was evidence that in-kind and cash transfer programs resulted in excess weight gain in women who were not underweight (5, 93). This warrants future research given the burden of overweight and obesity among women.
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.
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.
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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).
SOURCES: Elaine Turner, PhD, RD, associate professor, department of Food Science and Human Nutrition, University of Florida, Gainesville. Sharon B. Spalding, MEd, CSCS, professor, physical education and health; and associate director, Virginia Women's Institute for Leadership, Mary Baldwin College Staunton, Va. American Dietetic Association web site. Institute of Medicine at the National Academies web site.

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.
So we can applaud some of the efforts of Women’s Health. As editor Amy Keller Laird announced in that Jan/Feb issue, the magazine “will no longer be using fitness models in our monthly ‘15-Minute Workout.’ We’ll feature readers of various body types and sizes,” like the refreshingly normal-sized Morgan Gibson Kanner, hurling a weight plate around in stretchy workout clothes. As progressive as the layout is, Laird points out that “it’s logistically difficult to book nonmodels who have day jobs”; sounds like she should hook up with Willcox’s modeling service.
“Whole grains help with digestion and are excellent for your heart, regularity [because of the fiber content], and maintaining a steady level of blood sugar,” says Hincman. “They are also a great source of energy to power you throughout the day.” Whole grains, such as oats, also help improve cholesterol levels. While food manufacturers are adding fiber to all sorts of products, whole grains, like whole wheat, rye, and bran, need to be the first ingredient on the food label of packaged foods, she stresses. Watch your serving sizes, however. Current guidelines are for six one-ounce equivalent servings per day (five if you’re over 50). One ounce of whole-wheat pasta (weighed before cooking) is only one-half cup cooked.
Second, the scope of nutrition-specific and nutrition-sensitive approaches was largely focused on undernutrition. There were major research and programming gaps in studies targeting overweight, obesity, and noncommunicable disease. In our review, the interventions addressing overweight, obesity, and noncommunicable disease were limited to nutrition education and integrated healthcare. However, overweight and obesity were identified as potential concerns for interventions targeting undernutrition, including food supplementation, and in-kind and cash transfers. This might be a result of the types of interventions that were evaluated, but also speaks to the need to broaden the scope of nutrition interventions that are commonly assessed (5, 13, 14) to explicitly address overweight, obesity, and noncommunicable disease as nutrition outcomes, and not just as unintended consequences. Globally, there is limited evidence of large-scale interventions that effectively prevent, treat, or correctly classify adiposity-related noncommunicable diseases, and this is a growing area of concern around the world (208). Future evaluations of nutrition interventions might also include interventions that influence women's time and physical environment, and that encourage physical activity or change in access to and affordability of certain foods, as these might also influence overweight, obesity, and noncommunicable disease outcomes for women.
After menopause. Lower levels of estrogen  after menopause raise your risk for chronic diseases such as heart disease, stroke, and diabetes, and osteoporosis, a condition that causes your bones to become weak and break easily. What you eat also affects these chronic diseases. Talk to your doctor about healthy eating plans and whether you need more calcium and vitamin D to protect your bones. Read more about how very low estrogen levels affect your health in our Menopause section. Most women also need fewer calories as they age, because of less muscle and less physical activity. Find out how many calories you need based on your level of activity.
Of the few studies evaluating nutrition education interventions for women and adolescent girls who were overweight and obese, many were “facility-based” and involved delivery platforms such as health clinics (13, 22), worksites (30), and schools (26, 27, 29). Delivery platforms targeting women and adolescents who were undernourished similarly involved facility-based settings (13), but also included community outreach (16, 28), home visits, community kitchens (15, 28), and text messaging platforms (32). Such community-based platforms could provide additional opportunities for the delivery of nutrition education interventions addressing overweight, obesity, and associated noncommunicable disease in the future.
Protein should provide about 15% of a healthy person's daily calories. As a rule of thumb, people of both sexes and any size will do fine with about 60 grams of protein a day. Athletes who have large muscles and work out hard may need 20% more. But even that's not very much; 8 ounces of chicken or 6 ounces of canned tuna, for example, will fit the bill.

Evaluations of protein-energy supplementation were limited to specific situations and contexts, and few studies evaluated national-scale programs (14, 33). National-level protein-energy supplementation programs for women and adolescent girls are expensive and challenging to implement compared with other efficacious interventions (33). Procuring, preparing, and distributing food and appropriately targeting women most in need (e.g., women below the poverty line, women who have or are at high risk of malnutrition, etc.) present challenges to protein-energy supplementation interventions (33).
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).
When women reach childbearing age, they need to eat enough folate (or folic acid) to help decrease the risk of birth defects. The requirement for women who are not pregnant is 400 micrograms (mcg) per day. Including adequate amounts of foods that naturally contain folate, such as citrus fruits, leafy greens, beans and peas will help increase your intake of this B vitamin. There also are many foods that are fortified with folic acid, such as breakfast cereals, some rices and breads.  Eating a variety of foods is recommended to help meet nutrient needs, but a dietary supplement with folic acid also may be necessary. This is especially true for women who are pregnant or breast-feeding, since their daily need for folate is higher, 600 mcg and 500 mcg per day, respectively. Be sure to check with your physician or a registered dietitian nutritionist before taking any supplements., .

Fiber is an important part of an overall healthy eating plan. Good sources of fiber include fortified cereal, many whole-grain breads, beans, fruits (especially berries), dark green leafy vegetables, all types of squash, and nuts. Look on the Nutrition Facts label for fiber content in processed foods like cereals and breads. Use the search tool on this USDA page to find the amount of fiber in whole foods like fruits and vegetables.
Most traditional fitness plans happen in predictable patterns that usually involve moving in two planes of motion—up and down or forward and backward—ignoring the third plane of motion, lateral. “Move your body in all directions to create the most fit, functional, and athletic physique,” Stokes says. If you're a runner, cyclist, or walker, remember to include movements such as jumping jacks, side shuffles, side lunges, and carioca (the grapevine-like move) in your warm-up or cool-down, she suggests.
Educational interventions most often targeted school-age children and adolescent girls, and there were few examples of programs targeting women of reproductive age (174). The majority of education interventions were delivered in formal school-based settings (174). However, this is a “selective” delivery platform given that not all adolescents attend schools (193). School fees and distance to school are major barriers to school enrollment (174, 194). Educational interventions need to be sensitive to the reasons why girls are not in school, e.g., work, and to the hours and locations that might make education interventions more accessible (193). Nonformal education, alternative education, mobile schools, and literacy programs can target women and girls not in school, although these approaches were less common and not as well evaluated (174). Interventions that target girls who are no longer in school provide valuable examples about how such interventions could be delivered to hard-to-reach groups (182).
Women need more of this mineral because they lose an average of 15 to 20 milligrams of iron each month during menstruation. Without enough iron, iron deficiency anemia can develop and cause symptoms that include fatigue and headaches. After menopause, body iron generally increases. Therefore, iron deficiency in women older than 50 years of age may indicate blood loss from another source and should be checked by a physician.
“Whole grains help with digestion and are excellent for your heart, regularity [because of the fiber content], and maintaining a steady level of blood sugar,” says Hincman. “They are also a great source of energy to power you throughout the day.” Whole grains, such as oats, also help improve cholesterol levels. While food manufacturers are adding fiber to all sorts of products, whole grains, like whole wheat, rye, and bran, need to be the first ingredient on the food label of packaged foods, she stresses. Watch your serving sizes, however. Current guidelines are for six one-ounce equivalent servings per day (five if you’re over 50). One ounce of whole-wheat pasta (weighed before cooking) is only one-half cup cooked.
Obviously, the best treatment plan for poor nutrition is to change your diet. Most Americans eat too little of what they need and too much of that they don't. For many women, decreasing fat and sugar consumption and increasing fruit, vegetables and grains in your diet can make a big difference. Many women also need to boost consumption of foods containing fiber, calcium and folic acid. Compare your diet to that suggested by the food pyramid and compare your nutrient intake to the suggested daily levels. Adjust accordingly, and you may be able to dramatically improve your health.
The implications of direct nutrition interventions on women's nutrition, birth outcome and stunting rates in children in South Asia are indisputable and well documented. In the last decade, a number of studies present evidence of the role of non-nutritional factors impacting on women's nutrition, birth outcome, caring practices and nutritional status of children. The implications of various dimensions of women's empowerment and gender inequality on child stunting is being increasingly recognised. Evidence reveals the crucial role of early age of marriage and conception, poor secondary education, domestic violence, inadequate decision-making power, poor control over resources, strenuous agriculture activities, and increasing employment of women and of interventions such as cash transfer scheme and microfinance programme on undernutrition in children. Analysis of the nutrition situation of women and children in South Asia and programme findings emphasise the significance of reaching women during adolescence, pre-conception and pregnancy stage. Ensuring women enter pregnancy with adequate height and weight and free from being anemic is crucial. Combining nutrition-specific interventions with measures for empowerment of women is essential. Improvement in dietary intake and health services of women, prevention of early age marriage and conception, completion of secondary education, enhancement in purchasing power of women, reduction of work drudgery and elimination of domestic violence deserve special attention. A range of programme platforms dealing with health, education and empowerment of women could be strategically used for effectively reaching women prior to and during pregnancy to accelerate reduction in stunting rates in children in South Asia.
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