The delivery of nutrition education reached women across all life stages and through many platforms. Many nutrition education studies that targeted pregnant and lactating mothers reported on women's outcomes, but the primary focus of many of these studies was child health outcomes (13, 14, 19, 21, 24, 28); few studies focused on dietary outcomes and behaviors of pregnant and lactating women themselves (17, 20, 23). There were some studies evaluating the impact of nutrition education on the practices and outcomes of school-age children and adolescent girls (15, 18, 27, 29, 34), as well as older women (16, 22, 25, 30). Many of the nutrition education interventions were clinic-based (17–20, 23, 24). However, nutrition education was also delivered through community-based programs, including home visits (16, 21), community centers (15, 16, 20, 21), worksites (25), and schools (25, 27, 30, 34).
Nutrition is particularly important when you are pregnant. Weight gain during pregnancy is normal—and it's not just because of the growing fetus; your body is storing fat for lactation. The National Academy of Sciences/Institute of Medicine (NAS/IOM) has determined that a gain of 25 to 35 pounds is desirable. However, underweight women should gain about 28 to 40 pounds, and overweight women should gain at least 15 pounds. The IOM has not given a recommendation for an upper limit for obese women, but some experts cap it as low as 13 pounds. If you fit into this category, discuss how much weight you should gain with your health care professional. Remember that pregnancy isn't the time to diet. Caloric restriction during pregnancy has been associated with reduced birth weight, which can be dangerous to the baby.
Studies link high sodium intake to higher blood pressure, and evidence suggests that many people at risk for high blood pressure can reduce their risk by consuming less salt or sodium, as well as following a healthy diet. Most Americans consume more sodium than they need. The recommended amount is less than 2,300 mg per day for children and adults to age 50. The limit drops to 1,500 mg per day for those 51 and older or those of any age who are African American or have hypertension, diabetes or chronic kidney disease. You get 2,300 mg in just one teaspoon of salt. One good way to reduce your sodium intake is to eat fewer prepared and packaged foods.
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.
Nutrition interventions that target mothers alone inadequately address women's needs across their lives: during adolescence, preconception, and in later years of life. They also fail to capture nulliparous women. The extent to which nutrition interventions effectively reach women throughout the life course is not well documented. In this comprehensive narrative review, we summarized the impact and delivery platforms of nutrition-specific and nutrition-sensitive interventions targeting adolescent girls, women of reproductive age (nonpregnant, nonlactating), pregnant and lactating women, women with young children <5 y, and older women, with a focus on nutrition interventions delivered in low- and middle-income countries. We found that although there were many effective interventions that targeted women's nutrition, they largely targeted women who were pregnant and lactating or with young children. There were major gaps in the targeting of interventions to older women. For the delivery platforms, community-based settings, compared with facility-based settings, more equitably reached women across the life course, including adolescents, women of reproductive age, and older women. Nutrition-sensitive approaches were more often delivered in community-based settings; however, the evidence of their impact on women's nutritional outcomes was less clear. We also found major research and programming gaps relative to targeting overweight, obesity, and noncommunicable disease. We conclude that focused efforts on women during pregnancy and in the first couple of years postpartum fail to address the interrelation and compounding nature of nutritional disadvantages that are perpetuated across many women's lives. In order for policies and interventions to more effectively address inequities faced by women, and not only women as mothers, it is essential that they reflect on how, when, and where to engage with women across the life course.
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Calcium: Although some bone loss is inevitable with age, women can slow the process by getting enough calcium and vitamin D. Women between the ages of 50 and 70 need 1200 mg of calcium and 600 IU of Vitamin D a day. Women older than 70 require 1200 mg of calcium and 800 IU of Vitamin D a day. Because the skin becomes less efficient at converting sunlight to vitamin D as we age, older women may need more vitamin D in the form of supplements. Talk to your doctor.
SOURCES: Elaine Turner, PhD, RD, associate professor, department of Food Science and Human Nutrition, University of Florida, Gainesville. Sharon B. Spalding, MEd, CSCS, professor, physical education and health; and associate director, Virginia Women's Institute for Leadership, Mary Baldwin College Staunton, Va. American Dietetic Association web site. Institute of Medicine at the National Academies web site.
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.
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.
Folate or vitamin B9 (also known as folic acid when used in fortified foods or taken as a supplement) is another nutrient that many women don’t get enough of in their diets. Folate can greatly reduce the chance of neurological birth defects when taken before conception and during the first few weeks of pregnancy. Folate can also lower a woman’s risk for heart disease and certain types of cancer, so even if you’re not planning on getting pregnant (and many pregnancies are unplanned), it’s an essential nutrient for every woman of childbearing age. In later life, folate can help your body manufacture estrogen during menopause.
What you eat and drink is influenced by where you live, the types of foods available in your community and in your budget, your culture and background, and your personal preferences. Often, healthy eating is affected by things that are not directly under your control, like how close the grocery store is to your house or job. Focusing on the choices you can control will help you make small changes in your daily life to eat healthier.
The new guidelines encourage eating more nutrient-dense food and beverages. Many of us consume too many calories from solid fats, added sugar and refined grains. The guidelines promote a diet that emphasizes vegetables, fruits, whole grains, fat-free or low-fat dairy products, seafood, lean meat and poultry, eggs, beans and peas, and nuts and seeds.