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.
For example, these magazines may want to look at one of their likely advertisers, Athleta. The clothing line that specializes in stretchy yoga wear came under fire last year when it had decidedly non-plus-size models display the line’s plus-size clothing. Athleta followed up an apologetic statement by adding some non-“straight-size” non-supermodels to its latest clothing line, and receiving accolades from catalogue readers on Twitter.
Vitamin D: Over the past decade, dozens of studies have revealed many important roles for vitamin D, the nutrient that skin cells produce when they are exposed to sunlight. The recommended daily intake of Vitamin D is 600 IU per day, although recommended levels are under review. If you avoid the sun or live in the northern half of the U.S., ask your doctor whether your vitamin D level should be tested.
Granted, our brief magazine survey here is far from inclusive. 2016 saw the debut of magazine FabUplus, specifically geared to the plus-size woman. Women’s Running featured regular-sized women on its August 2015 and April 2016 covers. But even as Shape promotes the body-positivity movement with interviews with people like Willcox, who now runs a plus-size modeling agency, it’s still pushing posts like the below. How are these body types different exactly?
Oaks BM, Young RR, Adu-Afarwuah S, Ashorn U, Jackson KH, Lartey A, Maleta K, Okronipa H, Sadalaki J, Baldiviez LM et al. Effects of a lipid-based nutrient supplement during pregnancy and lactation on maternal plasma fatty acid status and lipid profile: results of two randomized controlled trials. Prostaglandins Leukot Essent Fatty Acids 2017;117:28–35.
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.
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.
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.
Something else to remember: an estimated 90 to 95 percent of dieters who lose weight regain all or part of it within five years, and the consequences can be even worse than simply being overweight. Those who exercise regularly as part of a weight loss diet and maintenance program are more likely to keep the weight off. Also note that an overly restrictive diet can lead to more overeating, a natural reaction to food deprivation.
Actually, more people suffer from food intolerances, which don't involve the immune system. However, food intolerance symptoms—such as intestinal distress—may mimic those of a food allergy. If you have a food intolerance, talk to a nutritionist about diagnosis and treatment; if you have food allergies, you need to see an allergist. Whether you have food allergies or intolerance, you will need to develop a diet that fits your needs and avoids foods that trigger a reaction.
Omega-3 fatty acids are essential for the neurological and early visual development of your baby and for making breast milk after birth. Aim for two weekly servings of cold water fish such as salmon, tuna, sardines, herring, or anchovies. Sardines are widely considered the safest and most sustainable fish to eat, while seaweed is a rich vegetarian source of Omega-3s.
Women who have very low levels of sunlight exposure or have naturally very dark skin are at risk of vitamin D deficiency. Those affected may include women who cover most of their body when outdoors, shift workers, those who are unable to regularly get out of their house or women in residential care. Women who have certain medical conditions or are on some medications may also be affected.
Katz DL, O'Connell M, Yeh MC, Nawaz H, Njike V, Anderson LM, Cory S, Dietz W; Task Force on Community Preventive Services. Public health strategies for preventing and controlling overweight and obesity in school and worksite settings: a report on recommendations of the Task Force on Community Preventive Services. MMWR Recomm Rep 2005;54(RR-10):1–12.
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
Our review highlighted how a focus on delivery platforms could indicate who is missed by different nutrition interventions, by evaluating where there is overlap or divergence in where interventions are delivered (as represented in the Venn diagram in Figure 1). Our findings showed that a large proportion of nutrition-specific interventions were delivered at clinic-based settings or community-based health posts. Health centers are important delivery platforms, particularly for pregnant and lactating women (113, 210). However, only half of women worldwide even attend the appropriate number of antenatal care visits (with nearly 86% of women attending 1 visit) and only 59% receive appropriate postnatal care (211). Other delivery platforms, such as schools and universities, were more effective at reaching some adolescents and women of reproductive age. However, interventions delivered at “facilities” (schools, health clinics, health posts) require participation with those facilities, and participation is often limited because of time, costs, distance, and other responsibilities, including work and childcare (116). Facilities-based care is also more likely to miss certain groups, including older women.
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).
Calcium: “Getting enough calcium is important for all ages, but it's particularly important during adolescence and early adulthood, when bones are absorbing calcium,” says Heather Schwartz, MS, RD, a medical nutrition therapist at Stanford University Hospital and Clinics. Calcium and vitamin D are often paired in fortified foods such as milk. The reason: The body needs D in order to absorb calcium.
Choline: Some studies link low choline levels to increased risk of neural tube defects. Recommended levels have been established for this nutrient, but it's easy to get enough in your diet. Eggs are an excellent source of choline, for example. “Eating a few eggs a week should give you all you need,” Frechman says. “Most people can eat the equivalent of an egg a day without worrying about cholesterol.” Other choline-rich food sources include milks, liver, and peanuts.
The extent to which interventions target women more generally, as opposed to just mothers, is not well documented. It requires reflecting on “Who is the woman in women's nutrition?” to identify which women are actually targeted in nutrition interventions, which are not, how they are reached, and gaps in policies and interventions to reach women who are missed. To address this, in this comprehensive narrative review, we 1) summarize existing knowledge about interventions targeting women's health and nutrition in low- and middle-income countries, 2) identify gaps in current delivery platforms that are intended to reach women and address their health and nutrition, and 3) determine strategies to reshape policies and programs to reach all women, at all stages of their lives, with a particular focus on women in low- and middle-income countries.