Food fortification is one of the most cost-effective strategies to improve micronutrient status through a variety of food vehicles, including staples, condiments, and processed foods (63, 64). Common fortifiable micronutrients include iron, folic acid, vitamin A, vitamin D, vitamin E, and iodine, although B vitamins and vitamin C are also used as fortificants (33, 64). Food fortification reduced anemia and iron deficiency anemia, and improved vitamin A, folate, niacin, thiamin, vitamin B-6, vitamin B-12, zinc, and iodine status of women of reproductive age and adolescents (13, 46, 61, 63–74). Vitamin D and calcium fortification were found to reduce the risk of osteoporosis among older women, especially for those exposed to inadequate sunlight (63, 64). Biofortification efforts, including those that involved breeding or genetic modification of plants to improve micronutrient content, have also shown improvements in the vitamin A and iron status of women (64, 75). Similar to micronutrient supplementation, women and girls with low micronutrient status were most likely to benefit.
A number of implementation challenges exist for micronutrient supplementation. Access to care is often associated with socioeconomic status and may influence women's access to and use of supplementation programs. For instance, in one study, the highest wealth quintile of pregnant women had the highest use of iron and folic acid supplementation during antenatal care (33). However, even for women who have access to micronutrient supplements, the coverage and quality of micronutrient supplementation programs were limited (39). Incorrect doses, inadequate supplies, and incomplete adherence were major limitations (33), and poorly performing programs had limited impact on nutrition outcomes (59). Integration of supplementation programs with behavior change interventions improved knowledge, adherence, and coverage of supplementation interventions (32, 33, 60). The use of local micronutrient-rich foods can also help overcome limitations associated with supplement provision. In Nepal, improvements in the dark adaptation of night-blind pregnant women did not differ significantly between food and synthetic sources of vitamin A (61). When available, consumption of micronutrient-rich foods can be as effective as micronutrient supplements.
We only included studies that reported on women's health and nutrition outcomes, and excluded studies that were targeted to women but that reported only on health and nutrition outcomes of children (including birth outcomes). We included outcomes for adolescent girls ages 10–19 y, pregnant and lactating women, nonpregnant and nonlactating women of reproductive age (>19 y), and older women. Studies that described interventions targeting a wider age range of adolescent girls (e.g., ages 8–24 y) were also included but adolescent girls aged >19 y were reported in this review as nonpregnant and nonlactating women of reproductive age. Although many adolescents in low- and middle-income countries are married and bearing children, adolescents (10–19 y) as reported in this review reflect girls who are nonpregnant and nonlactating. The few interventions in low- and middle-income countries that target pregnant and lactating adolescents are reported under pregnant and lactating women. A description of the articles included in this review can be found in Supplemental Table 1.
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).
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.
Community centers (including banks, town halls, post offices) ↑ knowledge about health and nutrition, ↑ food expenditures, ↑/NC food share, ↑ HH food consumption, ↑ dietary diversity, ↑ intake of MN (except for heme-Fe), ↑ HH intake of fruits, vegetables, and ASF, ↑/NC intake of fats and sweets, ↑ weight gain (greater among high BMI), ↑ participation in social networks, ↑ self-confidence, ↑ control over resources ↑ knowledge about health and nutrition, ↑ HH food security, ↑ food expenditures, ↑/NC food share, ↑ HH food consumption, ↑ dietary diversity, ↑ HH intake of fruits, vegetables, and ASF, ↑/NC intake of fats and sweets, ↑ participation in social networks, ↑ self-confidence, ↑ control over resources, ↑ ANC coverage ↑ knowledge about health, NC hypertension, ↓/NC missed meals, NC food sufficiency, ↑ health care utilization
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.
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.
Similarly, the interview with Brooks is great, highlighting the beauty of her latest Lane Bryant ad with Ashley Graham, Candice Huffine, and Denise Bidot. Which makes it even harder to get past the “How to finally lose those last 5 pounds” tip posted on the front page of the magazine’s website. Mixed messages, Shape. Is it “love your shape” or “keep striving for hard-to-obtain body goals”?
Where Women’s Health may encourage its readers to take time for themselves, Men’s Health encourages its followers to “10x Your Life: Get More Done, Waste Less Time,” which I guess is comparable. Instead of many long-form articles, Men’s Health doles out info in short column bits with lots of graphics—the better for men to process quickly at the gym/in the barber chair/on the train?
Women who seek out a women's only club are usually looking for something different. They want the privacy of an all-women environment. They also want the attention they get from women who understand the unique fitness needs of other women and are especially patient and understanding with those who haven't had much experience with fitness in their lives.
Also known as “myofascial release,” foam rolling is an easy way to benefit your entire body. “While stretching addresses the length of muscle fiber, rolling improves the quality of the tissue,” says Rob Sulaver, CEO and founder of Bandana Training. This leads to tension- and pain-free muscles, which function better so you perform better. Be sure to roll for five minutes before your workout. Not sure what to do? Try these 10 ways to use a foam roller.
Iron: Essential for healthy blood cells, iron becomes especially important when girls begin to menstruate. With each period, a woman loses small amounts of iron. “About 10% of American women are iron deficient,” says Dorothy Klimis-Zacas, PhD, a professor of nutrition at the University of Maine and co-editor of Nutritional Concerns of Women (CRC Press, 2003). “About 5% have iron deficiency anemia.” Symptoms of low iron include fatigue, impaired immunity, and poor performance at school or work.
Consult your health care professional. Women of childbearing age may want to consider taking folic acid supplements to reduce the risk of having a pregnancy affected with neural tube defects. Many women and teenage girls don't get enough calcium or vitamin D, both of which are critical to healthy bones and avoiding osteoporosis. Some people with diabetes appear to benefit from chromium. Vegetarians, especially vegans, may want to consider supplements to obtain nutrients they aren't getting from animal products.
The best evidence that ALA can protect the heart comes from the Lyon Diet Heart Study, a randomized clinical trial in Europe. It tested the effects of an ALA-enriched Mediterranean diet in 605 patients with coronary artery disease. Over a four-year period, the high-ALA diet produced a 72% reduction in heart attacks and cardiac deaths and a 56% lower risk of dying from any cause (including cancer). The Mediterranean diet differed from the standard Western diet in many respects, but because it contained a special canola oil margarine, the greatest difference was in its ALA content, which was nearly eight times higher in the protective diet.
Adopting a plant-based diet could help tip the scales in your favor. A five-year study of 71,751 adults published in the Journal of the Academy of Nutrition and Dietetics found that vegetarians tend to be slimmer than meat-eaters even though both groups eat about the same number of calories daily. Researchers say it may be because carnivores consume more fatty acids and fewer weight-loss promoting nutrients, like fiber, than herbivores do. Go green to find out if it works for you.
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).
The recommended daily intake for vitamin E is 15 mg. Don't take more than 1,000 mg of alpha-tocopherol per day. This amount is equivalent to approximately 1,500 IU of "d-alpha-tocopherol," sometimes labeled as "natural source" vitamin E, or 1,100 IU of "dl-alpha-tocopherol," a synthetic form of vitamin E. Consuming more than this could increase your risk of bleeding because vitamin E can act as an anticoagulant (blood thinner).