Gender differences in susceptibility and symptoms of disease and response to treatment in many areas of health are particularly true when viewed from a global perspective. Much of the available information comes from developed countries, yet there are marked differences between developed and developing countries in terms of women's roles and health. The global viewpoint is defined as the "area for study, research and practice that places a priority on improving health and achieving health equity for all people worldwide". In 2015 the World Health Organization identified the top ten issues in women's health as being cancer, reproductive health, maternal health, human immunodeficiency virus (HIV), sexually transmitted infections, violence, mental health, non communicable diseases, youth and aging.
Three related targets of MDG5 were adolescent birth rate, contraceptive prevalence and unmet need for family planning (where prevalence+unmet need = total need), which were monitored by the Population Division of the UN Department of Economic and Social Affairs. Contraceptive use was part of Goal 5B (universal access to reproductive health), as Indicator 5.3. The evaluation of MDG5 in 2015 showed that amongst couples usage had increased worldwide from 55% to 64%. with one of the largest increases in Subsaharan Africa (13 to 28%). The corollary, unmet need, declined slightly worldwide (15 to 12%). In 2015 these targets became part of SDG5 (gender equality and empowerment) under Target 5.6: Ensure universal access to sexual and reproductive health and reproductive rights, where Indicator 5.6.1 is the proportion of women aged 15–49 years who make their own informed decisions regarding sexual relations, contraceptive use and reproductive health care (p. 31).
Improvements in maternal health, in addition to professional assistance at delivery, will require routine antenatal care, basic emergency obstetric care, including the availability of antibiotics, oxytocics, anticonvulsants, the ability to manually remove a retained placenta, perform instrumented deliveries, and postpartum care. Research has shown the most effective programmes are those focussing on patient and community education, prenatal care, emergency obstetrics (including access to cesarean sections) and transportation. As with women's health in general, solutions to maternal health require a broad view encompassing many of the other MDG goals, such as poverty and status, and given that most deaths occur in the immediate intrapartum period, it has been recommended that intrapartum care (delivery) be a core strategy. New guidelines on antenatal care were issued by WHO in November 2016.
Micronutrient supplementation programs for vitamin A, iron and folic acid, calcium, zinc, and multiple micronutrients effectively impacted the micronutrient status of pregnant and lactating women, as well as women of reproductive age and adolescent girls (13, 14, 33, 35–48). Interventions making use of multiple micronutrients were more effective at changing plasma micronutrient concentrations than interventions focused solely on 1 nutrient alone (38, 42). In countries with comprehensive programs for iron supplementation during pregnancy, anemia prevalence dropped (1, 49). Positive health impacts of supplementation were most notable among pregnant women who were deficient and at risk of low intake (43, 50). However, there were some studies that showed inconsistent or limited evidence for the effectiveness of supplementation on other maternal health outcomes (31, 51–58).
Women and men differ in their chromosomal makeup, protein gene products, genomic imprinting, gene expression, signaling pathways, and hormonal environment. All of these necessitate caution in extrapolating information derived from biomarkers from one sex to the other. Women are particularly vulnerable at the two extremes of life. Young women and adolescents are at risk from STIs, pregnancy and unsafe abortion, while older women often have few resources and are disadvantaged with respect to men, and also are at risk of dementia and abuse, and generally poor health.
Vickers, M. R; MacLennan, A. H; Lawton, B.; Ford, D.; Martin, J.; Meredith, S. K; DeStavola, B. L; Rose, S.; Dowell, A.; Wilkes, H. C; Darbyshire, J. H; Meade, T. W (4 August 2007). "Main morbidities recorded in the women's international study of long duration oestrogen after menopause (WISDOM): a randomised controlled trial of hormone replacement therapy in postmenopausal women". BMJ. 335 (7613): 239. doi:10.1136/bmj.39266.425069.AD. PMC 1939792. PMID 17626056.
For girls and adult women, educational interventions are considered a powerful means of improving their health and nutritional status throughout their lives. Education level is often associated with maternal caregiving practices and the nutritional outcomes of their children (174, 175). Few studies, however, evaluated the impact of education as an intervention on women's nutrition outcomes. Instead, many studies used survey data and reported on associations between education and nutrition. For instance, in low- and middle-income countries, higher levels of education were associated with lower prevalence of underweight and higher prevalence of overweight among women (176, 177). However, this depended on the type of employment in which women participated (178, 179). In addition, in many high-income settings, the converse was true (177). Level of literacy was also associated with improved anthropometric measures. In southern Ethiopia, literate mothers were 25% less likely to be undernourished than were illiterate women (180). One econometric analysis suggested that doubling primary school attendance in settings with low school attendance was associated with a 20–25% decrease in food insecurity (181). Overall, though, these associations were limited in their ability to draw conclusions about causality and the effect of education interventions on nutrition outcomes.
If you’re not lifting weights already… what are you waiting for? Let me start by answering a question I get all the time — no, lifting weights isn’t just for men, everyone can reap the benefits of muscle growth. Lifting weights stimulates your lean body mass (i.e. muscle) to strengthen you from within and helps maintain healthy bone density (as mentioned earlier). Having more lean body mass – versus more fat mass – provides us with the strength we need to carry out our daily tasks, supports our core and spine, supports hormonal and bone health, AND allows our bodies to burn more calories and burn fat even while sitting. Resistance training can help decrease risks for osteoporosis, heart disease, type 2 diabetes, depression, obesity, aches and pains, and lastly arthritis. It also helps us mentally since weight training and working out, in general, makes us feel good thanks to all those endorphins that are released when your workout. You also get the added benefit of helping our metabolism, getting stronger, building muscle, and decreasing body fat when paired with well-balanced nutrition!
It sounds counterintuitive, but fatty fish are actually good for you because they deliver omega-3 polyunsaturated fatty acids (PUFAs), fats with cardiovascular and anti-inflammatory benefits. While fish oil capsules will help you meet your PUFA needs, studies have found that fish itself offers even more nutritional benefits, including vitamin D, selenium, and antioxidants. Among the best choices are salmon, albacore tuna, herring, and trout. Recommendations are for 1 gram of PUFAs daily for people with coronary heart disease and at least 250 to 500 mg daily for those who want to prevent it.
Calories. Most times, women need fewer calories. That’s because women naturally have less muscle, more body fat, and are usually smaller. On average, adult women need between 1,600 and 2,400 calories a day. Women who are more physically active may need more calories. Find out how many calories you need each day, based on your age, height, weight, and activity level.
The best training tool you're not using: a jump rope. “It may seem a little juvenile until you think of all the hot-bodied boxing pros who jump rope every single day,” says Landon LaRue, a CrossFit level-one trainer at Reebok CrossFit LAB in L.A. Not only is it inexpensive, portable, and easy to use almost anywhere, you’ll burn about 200 calories in 20 minutes and boost your cardiovascular health while toning, he adds.
Folic acid: This form of B vitamin helps prevent neural tube defects, especially spina bifida and anencephaly. These defects can be devastating and fatal. Many foods are now fortified with folic acid. Most women get enough as part of their diet through foods such as leafy greens, a rich source of folic acid. However, some doctors recommend that women take a pregnancy supplement that includes folic acid, just to make sure they are getting the recommended 400 to 800 micrograms.
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.
Most experts recommend 1,300 mg of calcium a day for girls aged 9 through 19. Natural sources of calcium, such as low-fat dairy products, are the smartest choice, because they also contain vitamin D and protein, both required for calcium absorption. Milk, yogurt, and cheese contribute most of the calcium in our diets. Some vegetables are also good sources, including broccoli, kale, and Chinese cabbage. Many foods are supplemented with calcium, including some brands of orange juice and tofu. The daily intake for Vitamin D is 600 IU per day for most children and healthy adults.
Some fat is an important part of your diet; fat is part of every cell. It maintains skin and hair; stores and transports fat-soluble vitamins A, D, E and K; keeps you warm; and protects your internal organs. It even helps your mental processes—not surprising given that fat comprises about 60 percent of your brain. But many women consume too much fat. The American Heart Association (AHA) recommends that you keep your total fat intake between 25 and 35 percent of your total calories.
There has been an international effort to reduce this practice, and in many countries eighteen is the legal age of marriage. Organizations with campaigns to end child marriage include the United Nations and its agencies, such as the Office of the High Commissioner for Human Rights, UNFPA, UNICEF and WHO. Like many global issues affecting women's health, poverty and gender inequality are root causes, and any campaign to change cultural attitudes has to address these. Child marriage is the subject of international conventions and agreements such as The Convention on the Elimination of All Forms of Discrimination against Women (CEDAW, 1979) (article 16) and the Universal Declaration of Human Rights and in 2014 a summit conference (Girl Summit) co-hosted by UNICEF and the UK was held in London (see illustration) to address this issue together with FGM/C. Later that same year the General Assembly of the United Nations passed a resolution, which inter alia
If motivation is your hang-up, change your exercise routine every 14 days. A University of Florida study discovered that people who modified their workouts twice a month were more likely than to stick to their plans compared to those who changed their regimens whenever they wanted to. Boredom didn’t appear to be a factor; it seems people simply enjoyed the variety more.
You should consume only 25 percent to 35 percent of your total calories per day from fat, with a significant portion from good fats like omega-3 and omega-6 fatty acids. According to the American Heart Association, women should get at least five to 10 percent of their total daily calories from omega-6 fatty acids (equal to 12 to 20 grams), and anywhere from 0.5 to 3 grams of omega-3 fatty acids, depending on individual risk for heart disease.
Sleeping seven to nine hours a night for five days straight may stave off bags under your eyes as well as saddlebags on your thighs. When women get enough sleep, they don’t take in extra, unnecessary calories to stay awake, according to a study published in the Proceedings of the National Academy of Sciences. Read: Adequate beauty rest can help you pass up pick-me-up snacks and head off added pounds.
We live in a modern world with amazing advancements in technology, yet our soil lacks minerals that it once contained causing whatever grows out of it (i.e. fruits, vegetables, and whole foods) to be significantly lower in minerals than it once was. Not only is our soil different, but our food takes a long time to get to us! Unless we’re growing our own whole food in our gardens, picking it out with our bare hands, and washing it off before eating, most likely our produce has been picked weeks before it reaches your grocery store and is purchased by you. This entire process can take weeks and cause nutrients to be depleted from the whole food (2).
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.
In our review, we found that fortification interventions that provided fortified foods reached women of all life stages through home visits, community distribution centers, local markets, and retail stores. Delivery of fortified foods in school-based programs, at work, and in maternal–child health centers were also used to target school-age children, women of reproductive age, and pregnant and lactating women that were engaged with those facilities (37, 72–74, 84). There was mixed evidence that consumption of fortified foods reached all socioeconomic groups. Some studies showed differences in consumption between nonpoor and extremely poor, and between urban and rural stakeholders (33, 64, 85). Women who have restricted access to markets, depend largely on locally grown foods, are in areas with underdeveloped distribution channels, or have limited purchasing power, might have limited access to fortified foods (64). Additional research is needed to address implementation gaps and to determine the best platforms for reaching high-risk populations.
Long-term goals are imperative, but they can make you feel overwhelmed or discouraged at times. Instead of thinking about how many dress sizes smaller you want to be in four months, focus on small everyday victories, suggests Michael Snader, BodyAware specialist and nutritionist at The BodyHoliday, a health and wellness resort in St. Lucia. “For example, today you are going to eat breakfast, fit in a workout, and drink more water,” he says. Stay focused on the present, and your future will be successful.
In addition, more research is needed to evaluate the impact of targeting women alone compared with targeting women alongside other members of their families and communities (e.g., with groups of other women, men, husbands, children, parents, in-laws, other family members, other community members, etc.). Interventions that targeted women with their children during child health visits or alongside other members of their communities through community mobilization and mass media campaigns showed improvements in knowledge and some health and nutrition behaviors of women. The inclusion of boys and men, for instance, as well as the inclusion of other family and community members, could enhance the impact and delivery of nutrition interventions for women through support of certain practices, reminders, time-savings, and normalization of nutrition behaviors. However, more research is needed to identify effective targeting mechanisms (i.e., alone or alongside other members of households and communities) and we expect that these will likely need to be context- and content-specific.
Globally, there were 87 million unwanted pregnancies in 2005, of those 46 million resorted to abortion, of which 18 million were considered unsafe, resulting in 68,000 deaths. The majority of these deaths occurred in the developing world. The United Nations considers these avoidable with access to safe abortion and post-abortion care. While abortion rates have fallen in developed countries, but not in developing countries. Between 2010–2014 there were 35 abortions per 1000 women aged 15–44, a total of 56 million abortions per year. The United nations has prepared recommendations for health care workers to provide more accessible and safe abortion and post-abortion care. An inherent part of post-abortion care involves provision of adequate contraception.
Women, as we age, are also more susceptible to the breakdown of our bones, which may result in osteoporosis over time. Genetically, women have a particularly high risk of osteoporosis compared to men, so it’s recommended that women monitor their calcium intake to be sure they’re getting enough. Weight training is another great way (and my favorite!) to build bone density, which is another great reason you should hit the weights!
Of near miss events, obstetrical fistulae (OF), including vesicovaginal and rectovaginal fistulae, remain one of the most serious and tragic. Although corrective surgery is possible it is often not available and OF is considered completely preventable. If repaired, subsequent pregnancies will require cesarian section. While unusual in developed countries, it is estimated that up to 100,000 cases occur every year in the world, and that about 2 million women are currently living with this condition, with the highest incidence occurring in Africa and parts of Asia. OF results from prolonged obstructed labor without intervention, when continued pressure from the fetus in the birth canal restricts blood supply to the surrounding tissues, with eventual fetal death, necrosis and expulsion. The damaged pelvic organs then develop a connection (fistula) allowing urine or feces, or both, to be discharged through the vagina with associated urinary and fecal incontinence, vaginal stenosis, nerve damage and infertility. Severe social and mental consequences are also likely to follow, with shunning of the women. Aprt from lack of access to care, causes include young age, and malnourishment. The UNFPA has made prevention of OF a priority and is the lead agency in the Campaign to End Fistula, which issues annual reports and the United Nations observes May 23 as the International Day to End Obstetric Fistula every year. Prevention includes discouraging teenage pregnancy and child marriage, adeaquate nutrition, and access to skilled care, including caesarian section.
Low-fat dairy products are excellent sources of calcium. Other good sources of calcium include salmon, tofu (soybean curd), certain vegetables (broccoli), legumes (peas and beans), calcium-enriched grain products, lime-processed tortillas, seeds and nuts. If you do not regularly consume adequate food sources of calcium, a calcium supplement can be considered to reach the recommended amount. The current recommendations for women for calcium are for a minimum of 1,200 mg per day.
“The reason most people don't see changes isn't because they don't work hard—it's because they don't make their workouts harder,” says Adam Bornstein, founder of Born Fitness. His suggestion: Create a challenge every time you exercise. “Use a little more weight, rest five to 10 seconds less between sets, add a few more reps, or do another set. Incorporating these small variations into your routine is a recipe for change,” he says.
The effect of education programs on nutrition outcomes is difficult to assess because programs often have poor baseline data or nutrition outcomes are not evaluated (174, 182). Studies that used longitudinal analyses and “natural” experiments (e.g., before and after a national education policy) found that education was associated with reduced fertility (183, 184), and delayed early marriages and pregnancies (184–187). The impact was more significant for higher levels of education (185). However, 1 study in Malawi identified negative associations between education and timing of first birth, although these findings were largely not statistically significant (188). Secondary education for adolescents and women of reproductive age also showed no impact on women's empowerment (184), although it did show an impact on improved literacy and leadership (174). Educational interventions that provided conditional cash transfers (CCTs) and school feeding, as well as other forms of social protection to families of enrolled girls, were associated with greater school enrollment and attendance (189–191), improved test scores (189, 190), reduced gender gaps (192), and reduced hunger (190, 191).
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.
Women's health refers to the health of women, which differs from that of men in many unique ways. Women's health is an example of population health, where health is defined by the World Health Organization as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity". Often treated as simply women's reproductive health, many groups argue for a broader definition pertaining to the overall health of women, better expressed as "The health of women". These differences are further exacerbated in developing countries where women, whose health includes both their risks and experiences, are further disadvantaged.
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.
The U.S. Department of Agriculture's (USDA) food pyramid system (www.mypyramid.gov) provides a good start by recommending that the bulk of your diet come from the grain group—this includes bread, cereal, rice and pasta— the vegetable group; and the fruit group. Select smaller amounts of foods from the milk group and the meat and beans group. Eat few—if any—foods that are high in fat and sugars and low in nutrients. The amount of food you should consume depends on your sex, age and level of activity.
In low- and middle-income countries, health care services often respond to acute health needs and many focus on maternal–child health (105, 106, 110, 112). The use of preventative care is limited, and there are concerns about the capacity of health systems to address noncommunicable diseases, such as diabetes, in low- and middle-income settings (108, 112). This has implications for the reach of integrated health care interventions across the life course. Maternal and reproductive health care is often sought by women when they are pregnant and in the early years of their children's lives (3, 113). Even so, many women visit health facilities late in their pregnancy or not at all (114–116). For adolescents and adult women, care is often not sought until they are sick (3, 117, 118). This is problematic for older women, in particular, as screening and treatment for age-related health issues, such as diabetes, cancer, and hypertension, require access to preventative health care services (3).