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.
Salt, caffeine and alcohol intake may interfere with the balance of calcium in the body by affecting the absorption of calcium and increasing the amount lost in the urine. Moderate alcohol intake (one to two standard drinks per day) and moderate tea, coffee and caffeine-containing drinks (no more than six cups per day) are recommended. Avoid adding salt at the table and in cooking
Lipid-based nutrient supplement (LNS) programs are intended to enrich diets with micronutrients and essential fatty acids (97), and are often used in emergency settings to meet nutritional needs of pregnant and lactating women (98). Of the studies that report on women's health outcomes, LNSs provided to pregnant and lactating women increased body weight and midupper arm circumference, particularly of multiparous women and women >25 y of age (99). They were associated with increased plasma α-linoleic acid, although not plasma lipids and other fatty acids (100). LNSs did not affect women's immune responses, particularly pregnant women's anti-malarial antibody responses (101). There was limited evidence connecting LNS supplementation to unhealthy weight gain and retention, and this is being explored in ongoing studies in Ghana (97).
You know it's easier to fall off the healthy-eating wagon when the person across the table from you is going whole-hog on mozzarella sticks, but science still felt the need to study this. And evidence presented at the 2013 Agricultural and Applied Economic Associations annual meeting backs you up: In the study, people made similar dining choices as their companions did, possibly because we simply want to fit in. Not all eating partners make a bad influence, though. The report further speculates that if you're eating with a health-conscious person, you may be more likely to order something more nutritious as well.
Pregnancy Unintended pregnancy Gravidity and parity Obstetrics Antenatal care Adolescent pregnancy Complications of pregnancy Hyperemesis gravidarum Ectopic pregnancy Miscarriage Obstetrical bleeding Gestational diabetes Hypertension Preeclampsia Eclampsia Childbirth Midwifery Preterm birth Multiple births Oxytocin Obstructed labor Cesarian section Retained placenta Obstetrical fistulae Vesicovaginal fistula Rectovaginal fistula Episiotomy husband stitch Postpartum care Maternal deaths Perinatal mortality Stillbirths Abortion Mother-to-child transmission Sterilization Compulsory sterilization
However, many fortification programs in low- and middle-income countries are regional or voluntary and, thus, might have a limited nutritional impact at the national level (76). Although many efficacy trials show benefits of fortification interventions, scaling up fortification is limited by inadequate coverage and resources (13, 77, 78). Evidence for impact is also affected by suboptimal programming, low-bioavailability fortificants (e.g., reduced iron powder), poor consumption rates, weak enforcement mechanisms, and inadequate monitoring (76, 79, 80). More research is needed to evaluate the long-term impact of fortification and biofortification programs (75). In addition, there is also growing concern about fortifying and promoting food vehicles that have adverse health consequences when consumed in excess, such as salt and sugar, given the rising prevalence of overweight, obesity, and noncommunicable disease (81–83).
Our findings identified gaps and limitations in the evaluation, scope, targeting, and delivery platforms of nutrition interventions in low- and middle-income countries. First, the monitoring and evaluation of nutrition programs that reported on women's nutrition outcomes was generally inadequate. Many of the studies we identified included small-scale efficacy trials. Although there were many large-scale programs that targeted women and adolescent girls with nutrition-specific and nutrition-sensitive approaches, they lacked rigorous evaluation. Whether the evidence about women's outcomes was limited because they are not systematically measured or because they are not well reported is not clear. Negative results are often not published, and many evaluations of nutrition interventions that are conducted by the same groups responsible for implementing them are typically presented positively. This may have also skewed our findings. More intentional research-quality program evaluation, including of large-scale programs, would provide a stronger evidence base. Of the studies identified in this review, many reported on short-term findings such as changes in knowledge, dietary behaviors, and program coverage. They were limited in their ability to report clinical and anthropometric outcomes for women, the duration of those outcomes, and the feasibility of scaling up programs. There is also a need for systematic, long-term evaluations of interventions whose effects on nutrition outcomes are more distal (e.g., nutrition education compared with micronutrient supplementation). The effects of multisectoral interventions are even more complex to measure. However, frameworks exist to evaluate complex interventions (102) and could be utilized to evaluate the impact of interventions across the life course.