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).
After 40, your hormone levels (estrogen) drop. This causes your insulin (hormone that helps your body use sugar) rise. Your thyroid levels go down. This combination makes you hungrier. You end up eating more and burning fewer calories. Much of the weight gain occurs around your belly. Eat more foods with fiber (berries, whole grains, nuts) to fill you up and help you eat less. Aim for 25 grams of fiber each day after the age of 40. Other ways to increase your metabolism include:
Dairy. Women should get 3 cups of dairy each day, but most women get only half that amount.6 If you can’t drink milk, try to eat low-fat plain yogurt or low-fat cheese. Dairy products are among the best food sources of the mineral calcium, but some vegetables such as kale and broccoli also have calcium, as do some fortified foods such as fortified soymilk, fortified cereals, and many fruit juices. Most girls ages 9 to 18 and women older than 50 need more calcium for good bone health.
Micronutrient supplementation Health clinics ↓ anemia and Fe-deficiency anemia, ↑ Hgb, ↓ soil-transmitted helminth infection, ↑ cognitive function ↓ anemia and Fe-deficiency anemia, ↑ Hgb, ↑ serum ferritin, ↓ soil-transmitted helminth infection ↓/NC anemia, ↑/NC MN status (Hgb, folate, zinc, retinol), ↑ MN status [ferritin, B-12, 25(OH)D], ↓/NC gestational hypertension and pre-eclampsia, NC gestational diabetes, ↓/NC hyperthyroidism, ↓/NC night blindness, ↓ bone mineral content, ↑ weight gain (among underweight women), ↓ maternal mortality, ↓/NC placental malaria, NC parasitemia, NC maternal infection, ↓/NC depression and perceived stress
Don't take dramatic steps alone. You need to work closely with an experienced health care professional to lose weight, particularly if you have other medical problems, plan to lose more than 15 to 20 pounds or take medication on a regular basis. An initial checkup can identify conditions that might be affected by dieting and weight loss. Make sure you find out how much experience your health care professional has dealing with nutrition. It's not always well covered in medical schools. You may want to talk to a registered dietitian before embarking on a diet.
Weighing yourself too often can cause you to obsess over every pound. Penner recommends stepping on the scale or putting on a pair of well-fitting (i.e. not a size too small) pants once a week. “Both can be used as an early warning system for preventing weight gain, and the pants may be a better way to gauge if those workouts are helping you tone up and slim down.” [Tweet this tip!]
Social protection interventions are intended to support vulnerable households by providing them with in-kind (e.g., food) or cash transfers. The impact of social protection on women's nutrition was nuanced, as such interventions were associated with protecting against adverse nutrition outcomes, but were also associated with excess weight gain in some settings. In-kind transfers, including food baskets, fortified foods, and school lunches, improved women's and adolescent girls’ energy and micronutrient intakes, as described in the preceding sections. Both CCTs and unconditional cash transfers were common around the world and were associated with improvements in health care utilization and increased food expenditures (5, 14, 195, 196). CCTs were dependent on “conditions” such as school attendance and health care utilization. For children in Burkina Faso, CCTs were associated with greater numbers of preventative health visits compared with unconditional cash transfers (197), and this could be relevant to adult women's health care utilization as well. Unconditional cash transfers, such as old-age pensions, were also common, including in low- and middle-income countries (5, 198). Older women who received pensions had fewer missed meals (199), although evidence was mixed (200). In South Africa, granddaughters who cohabitated with women who received pensions had improved anthropometric measures and fewer missed meals, indicating spillover effects of pension transfers (199, 201).
Income-generation interventions largely target adult women (women of reproductive age, women with young children, and older women). Many microfinance and loan programs are targeted to women because of their likelihood to pay back the loans, although women with lower education levels and smaller businesses do not benefit to the same degree as women who are educated or who have bigger businesses (165). There was limited evidence of such interventions targeting adolescent girls (169). In order to understand the potential impact of income-generating activities on adolescents, more information is needed about the pathways by which adolescents contribute to their own food security, the degree to which they rely on their caregivers to meet their nutritional needs, and how those dynamics change with the age of adolescents (169). Training, workshops, and extension activities were often delivered through community centers, community groups, and financial institutions (165). Other affiliated interventions, such as agricultural extension and nutrition education, were provided at the community level and at home visits (160, 173). These delivery platforms were effective at reaching women, including low-income women, particularly when they engaged with existing community groups (e.g., self-help, farmers’, and women's groups) (160, 161, 167, 169, 172, 173).
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).
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.
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.
Calcium is extremely important after menopause when your osteoporosis risk increases. But it’s actually vital to women’s health at every age, particularly while the body is still making bone. For optimal bone health, you need three daily servings of dairy products (for example, eight ounces of milk or yogurt, or one and a half ounces of cheese per serving), which also provide other nutrients, like protein, potassium, magnesium, and zinc. “If you can tolerate dairy, low-fat sources are extremely important,” says Hincman. Besides low-fat or skim milk, try calcium-rich Greek-style yogurt, which supplies twice the protein with less or none of the sugar of traditional yogurt varieties, she says.
The guidelines also establish ranges (called acceptable macronutrient distribution ranges or AMDR) for fat, carbohydrates and protein, instead of exact percentages of calories or numbers of grams. The report maintains that since all three categories serve as sources of energy, they can, to some extent, substitute for one another in providing calories.