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.
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.
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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.
Picture your perfect self with your flat abs, firmer butt, and slim thighs every day. Seeing really is believing: “You become consciously and acutely aware of everything that can help you achieve the visualized outcome that you desire when you impress an idea into the subconscious part of you,” says celebrity yoga coach Gwen Lawrence. “It eventually becomes ‘fixed,’ and you automatically move toward that which you desire.”
A year later, a second Harvard study added to the concern. The Physicians' Health Study of 20,885 men did not evaluate diet per se, but it did measure the blood levels of ALA in 120 men who developed prostate cancer and compared them with the levels in 120 men who remained free of the disease. Men with moderately high ALA blood levels were 3.4 times more likely to develop prostate cancer than men with the lowest levels; curiously, though, men with the very highest levels were only 2 times more likely to get the disease.
You can get calcium from dairy products like milk, yogurt and cheese, canned fish with soft bones (sardines, anchovies and salmon; bones must be consumed to get the benefit of calcium), dark-green leafy vegetables (such as kale, mustard greens and turnip greens) and even tofu (if it's processed with calcium sulfate). Some foods are calcium-fortified; that is, they contain additional calcium. Examples include orange juice, certain cereals, soy milk and other breakfast foods. Talk to your health care professional about whether you should take calcium supplements if you don't think you're getting enough calcium from food sources.
Poor nutrition may be one of the easiest conditions to self-diagnose. Look at the food pyramid and the suggested servings. Look at your diet. Are you getting the recommended daily amounts of fruits and vegetables? Enough calcium? Read the labels and compare what you eat to what you need. You may discover that even if your weight is ideal, you are not getting enough nutrition.
The U.S. Public Health Service recommends that all women of childbearing age consume 400 mcg of folic acid (a B vitamin) daily to reduce their risk of having a pregnancy affected with spina bifida or other neural-tube defects. Women who are actively trying to get pregnant should consume 600 mcg, and lactating women should consumer 500 mcg. Women of childbearing age should also take care to meet the daily requirements for calcium, fiber, iron, protein and vitamin D. Discuss supplements with a health care professional, however. Iron and vitamin D in particular can be dangerous in high amounts.
Many nutrition-sensitive approaches were delivered in broader community-based settings and more equitably reached women across the life course. Non-facilities-based settings more equitably delivered nutrition interventions to women who were not pregnant or lactating, and who were less engaged with health clinics and schools. For instance, food fortification, which was often delivered through markets, home visits, and community centers, seemed to be more effective at reaching women of reproductive age than health center–based delivery platforms. Community-level interventions are often reported as more equitable than platforms that require access to “fixed and well-equipped health facilities” (212). This aligns with our findings, where we found that community-based platforms such as home visits, community centers, homes of community leaders, work, mass media, mobile phones, and commercial settings were effective at reaching women across the life course (Table 1). Other delivery platforms such as marketplaces, water points, tailoring shops, and agricultural points for seeds or inputs were also effective. These locations need to be context-specific in order to capture where women spend their time. For instance, in countries where many adolescent girls do not attend school, school-based delivery platforms might be less effective. Delivery platforms also need to be sensitive to the sociodemographic differences that influence where women spend their time, such as differences for women in rural and urban areas, and of different socioeconomic statuses. Additional research needs to identify and report where women and adolescent girls are, and how best to reach them.
If you thought texting changed your love life, imagine what it could do for your waistline. When people received motivational text messages promoting exercise and healthy behaviors twice a week (i.e., “Keep in the fridge a Ziploc with washed and precut vegetables 4 quick snack. Add 1 string cheese 4 proteins”), they lost an average of about 3 percent of their body weight in 12 weeks. Participants in the Virginia Commonwealth University study also showed an improvement in eating behaviors, exercise, and nutrition self-efficacy, and reported that the texts helped them adopt these new habits. Find health-minded friends and message each other reminders, or program your phone to send yourself healthy eating tips.