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).
Nutrition-sensitive approaches are difficult to link to women's nutritional status (5, 102). This is due to limited measurement of benefits to program beneficiaries, families, households, and communities, limited timeframes to evaluate long-term impact, logistical and political realities that make implementation difficult, and different priorities of different stakeholders in multisectoral programs (102). Many nutrition-sensitive approaches, as will be described, thus focus on more distal measures of impact (e.g., coverage, knowledge) and not more proximal measures of women's nutritional status (e.g., BMI, anemia status, etc.).

Maintaining a healthy weight is important piece of the puzzle to achieve good health. A healthy weight can be determined using the body mass index charts (see web source below). If you find you are overweight or obese, weight loss may be beneficial for you. Before you begin any weight loss efforts, consult with your medical provider and/or consult a registered dietitian to create a weight loss plan. If you are underweight, consult a medical provider to assess your weight status.
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.
Also limit the amount of cholesterol you consume. Cholesterol is a fat-like substance found in every cell of the body. It helps digest some fats, strengthen cell membranes and make hormones. But too much cholesterol can be dangerous: When blood cholesterol reaches high levels, it can build up on artery walls, increasing the risk of blood clots, heart attack and stroke. Although dietary cholesterol can contribute to heart disease, the greater risk comes from a diet high in saturated and trans fats.

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.


  Home visits  ↑/NC knowledge about hygiene and sanitation, ↑ hand-washing, ↑ water quality, ↓/NC diarrheal morbidity, ↓ intestinal parasite prevalence  ↑/NC knowledge about hygiene and sanitation, ↑ hand-washing, ↑ water quality, ↓/NC diarrheal morbidity, ↓ intestinal parasite prevalence  ↓ maternal mortality, ↑/NC knowledge about hygiene and sanitation, ↑/NC hand-washing, ↑ water quality, NC waste disposal, ↓/NC diarrheal morbidity, ↓ intestinal parasite prevalence  ↑/NC knowledge about hygiene and sanitation, ↑ hand-washing, ↑ water quality, ↓/NC diarrheal morbidity, ↓ intestinal parasite prevalence 

Most vegetarians eat milk products and eggs, and as a group, these lacto-ovo-vegetarians enjoy good health. A healthful vegetarian diet falls within the food pyramid guidelines offered by the USDA. However, meat, fish and poultry are major sources of iron, zinc and B vitamins, so pay special attention to these nutrients. Vegans (those who eat only plant-based food) should consult a health care professional about adding vitamin and mineral supplements; make sure you consume sufficient quantities of protein, vitamin B12, vitamin D and calcium.
In the past, women have often tried to make up deficits in their diet though the use of vitamins and supplements. However, while supplements can be a useful safeguard against occasional nutrient shortfalls, they can’t compensate for an unbalanced or unhealthy diet. To ensure you get all the nutrients you need from the food you eat, try to aim for a diet rich in fruit, vegetables, quality protein, healthy fats, and low in processed, fried, and sugary foods.
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