Women have also been the subject of abuse in health care research, such as the situation revealed in the Cartwright Inquiry in New Zealand (1988), in which research by two feminist journalists revealed that women with cervical abnormalities were not receiving treatment, as part of an experiment. The women were not told of the abnormalities and several later died.
Changes in the way research ethics was visualised in the wake of the Nuremberg Trials (1946), led to an atmosphere of protectionism of groups deemed to be vulnerable that was often legislated or regulated. This resulted in the relative underrepresentation of women in clinical trials. The position of women in research was further compromised in 1977, when in response to the tragedies resulting from thalidomide and diethylstilbestrol (DES), the United States Food and Drug Administration (FDA) prohibited women of child-bearing years from participation in early stage clinical trials. In practice this ban was often applied very widely to exclude all women. Women, at least those in the child-bearing years, were also deemed unsuitable research subjects due to their fluctuating hormonal levels during the menstrual cycle. However, research has demonstrated significant biological differences between the sexes in rates of susceptibility, symptoms and response to treatment in many major areas of health, including heart disease and some cancers. These exclusions pose a threat to the application of evidence-based medicine to women, and compromise to care offered to both women and men.
It’s been a while since I’ve picked up any of these, but when I did, the messages weren’t nearly as body-positive. In fact, a quick perusal of other Shape magazine covers from the 1980s (I was probably still reading Seventeen then, but still) shows a bunch of celebrity cover models who would like you to get off the couch immediately, with demands like “Get Strong!” and “Push For Fitness!” Also suspect: “How To Think And Eat Like A Thin Person” and “Is Food Your Lover? How To End The Affair.”
Goodman explains, “We feature all sorts of outfits on our covers, with some more revealing than others. Our goal is to show that women are beautiful—no matter what they wear… So, whether that’s in a bikini or a leather jacket and jeans, we want our readers to know that being sexy is about being confident and owning who you are, not about the clothes you wear.” Or don’t wear, as the case may be.
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.
Here, too, body size is the main difference between the needs of males and females. Despite all the hype about high-protein diets, our protein requirements are really quite modest — only about a third of a gram per pound of body weight. For a 125-pound woman, that amounts to about 42 grams, for a 175-pound man, 58 grams. That's a tiny difference, just about half an ounce a day.
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 2000, the United Nations created Millennium Development Goal (MDG) 5 to improve maternal health. Target 5A sought to reduce maternal mortality by three quarters from 1990 to 2015, using two indicators, 5.1 the MMR and 5.2 the proportion of deliveries attended by skilled health personnel (physician, nurse or midwife). Early reports indicated MDG 5 had made the least progress of all MDGs. By the target date of 2015 the MMR had only declined by 45%, from 380 to 210, most of which occurred after 2000. However this improvement occurred across all regions, but the highest MMRs were still in Africa and Asia, although South Asia witnessed the largest fall, from 530 to 190 (64%). The smallest decline was seen in the developed countries, from 26 to 16 (37%). In terms of assisted births, this proportion had risen globally from 59 to 71%. Although the numbers were similar for both developed and developing regions, there were wide variations in the latter from 52% in South Asia to 100% in East Asia. The risks of dying in pregnancy in developing countries remains fourteen times higher than in developed countries, but in Sub-Saharan Africa, where the MMR is highest, the risk is 175 times higher. In setting the MDG targets, skilled assisted birth was considered a key strategy, but also an indicator of access to care and closely reflect mortality rates. There are also marked differences within regions with a 31% lower rate in rural areas of developing countries (56 vs. 87%), yet there is no difference in East Asia but a 52% difference in Central Africa (32 vs. 84%). With the completion of the MDG campaign in 2015, new targets are being set for 2030 under the Sustainable Development Goals campaign. Maternal health is placed under Goal 3, Health, with the target being to reduce the global maternal mortality ratio to less than 70. Amongst tools being developed to meet these targets is the WHO Safe Childbirth Checklist.
Systematically report and evaluate women's nutrition outcomes in research and program evaluation documents in low- and middle-income countries, including outcomes for adolescents, older women, and mothers (as opposed to reporting on women's nutrition as child nutrition outcomes alone). When possible, report and evaluate differences by setting (e.g., rural compared with urban) and socioeconomic status.