Give your body a little more credit: It tells you when you’re hungry—you may not be listening, though. Before chowing down because there’s only one slice of pie left or because the last guest arrived at the brunch, stop and check in with your stomach. “If you’re not hungry, make yourself a small plate and sip on some tea or coffee while everyone else digs in,” recommends Elle Penner, M.P.H., R.D., a MyFitnessPal expert. When your belly starts to finally grumble, food will be there.

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).


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.
Foods that contain natural folic acid include orange juice, green leafy vegetables, peas, peanuts and beans. (One cup of cooked kidney beans contains 230 mcg of folic acid.) Fortified foods, such as ready-to-eat breakfast cereals, also contain a synthetic form of folic acid, which is more easily absorbed by your body than the natural form. Folic acid is now added to all enriched grain products (thiamin, riboflavin, niacin, and iron have been added to enriched grains for many years).

Notice that alcohol isn't included in a food group. If you drink alcohol, do so in moderation, up to one drink per day for women and two drinks per day for men. Alcohol offers little nutritional value, and when used in excess, can cause short-term health damage, such as distorted vision, judgment, hearing and coordination; emotional changes; bad breath; and hangovers. Long-term effects may include liver and stomach damage, vitamin deficiencies, impotence, heart and central nervous system damage and memory loss. Abuse can lead to alcohol poisoning, coma and death. Pregnant women should not drink at all because alcohol can harm the developing fetus and infant. According to the March of Dimes, more than 40,000 babies are born each year with alcohol-related damage. Even light and moderate drinking during pregnancy can hurt your baby. If you are breastfeeding, discuss drinking alcohol with your health care professional. After clearing it with your doctor, you may be able to have an occasional celebratory single, small alcoholic drink, but you should abstain from breastfeeding for two hours after that drink.
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).

So we can applaud some of the efforts of Women’s Health. As editor Amy Keller Laird announced in that Jan/Feb issue, the magazine “will no longer be using fitness models in our monthly ‘15-Minute Workout.’ We’ll feature readers of various body types and sizes,” like the refreshingly normal-sized Morgan Gibson Kanner, hurling a weight plate around in stretchy workout clothes. As progressive as the layout is, Laird points out that “it’s logistically difficult to book nonmodels who have day jobs”; sounds like she should hook up with Willcox’s modeling service.


Focus on the long term. Diets fail when people fall back into poor eating habits; maintaining weight loss over the long term is exceedingly difficult. Most people regain the weight they've lost. In fact, some studies indicate that 90 to 95 percent of all dieters regain some or all of the weight originally lost within five years. Your program should include plans for ongoing weight maintenance, involving diet, exercise and a behavioral component. While there are some physical reasons for obesity, there are also behavioral reasons for excessive eating. For example, many women use food as a source of comfort (perhaps to deal with stress). For these women, a weight loss program with a behavioral component will offer alternatives to replace food in this role.

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


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.

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).
  Home visits  ↓/NC anemia, ↑/NC Hgb, ↑ serum ferritin, ↑/NC serum retinol, ↓ vitamin A deficiency  ↓/NC anemia and Fe-deficiency anemia, ↑/NC Hgb, ↑/NC serum ferritin, ↑ serum folate, ↑ serum zinc, NC serum retinol  ↓ anemia, ↑ Hgb, ↑ serum ferritin, ↑/NC serum retinol, ↑ erythrocyte thiamine diphosphate concentrations, ↓ night blindness, ↑/NC weight gain  ↓ anemia, ↑/NC Hgb, ↑ serum ferritin, NC serum retinol, ↑ serum calcium, ↑ 25(OH)D concentrations, ↓ PTH, ↓ bone turnover 
Manson, JoAnn E.; Chlebowski, Rowan T.; Stefanick, Marcia L.; Aragaki, Aaron K.; Rossouw, Jacques E.; Prentice, Ross L.; Anderson, Garnet; Howard, Barbara V.; Thomson, Cynthia A.; LaCroix, Andrea Z.; Wactawski-Wende, Jean; Jackson, Rebecca D.; Limacher, Marian; Margolis, Karen L.; Wassertheil-Smoller, Sylvia; Beresford, Shirley A.; Cauley, Jane A.; Eaton, Charles B.; Gass, Margery; Hsia, Judith; Johnson, Karen C.; Kooperberg, Charles; Kuller, Lewis H.; Lewis, Cora E.; Liu, Simin; Martin, Lisa W.; Ockene, Judith K.; O'sullivan, Mary Jo; Powell, Lynda H.; Simon, Michael S.; Van Horn, Linda; Vitolins, Mara Z.; Wallace, Robert B. (2 October 2013). "Menopausal Hormone Therapy and Health Outcomes During the Intervention and Extended Poststopping Phases of the Women's Health Initiative Randomized Trials". JAMA. 310 (13): 1353–1368. doi:10.1001/jama.2013.278040. PMC 3963523. PMID 24084921.
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.
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!
Focus on the long term. Diets fail when people fall back into poor eating habits; maintaining weight loss over the long term is exceedingly difficult. Most people regain the weight they've lost. In fact, some studies indicate that 90 to 95 percent of all dieters regain some or all of the weight originally lost within five years. Your program should include plans for ongoing weight maintenance, involving diet, exercise and a behavioral component. While there are some physical reasons for obesity, there are also behavioral reasons for excessive eating. For example, many women use food as a source of comfort (perhaps to deal with stress). For these women, a weight loss program with a behavioral component will offer alternatives to replace food in this role.
There are a number of cultural factors that reinforce this practice. These include the child's financial future, her dowry, social ties and social status, prevention of premarital sex, extramarital pregnancy and STIs. The arguments against it include interruption of education and loss of employment prospects, and hence economic status, as well as loss of normal childhood and its emotional maturation and social isolation. Child marriage places the girl in a relationship where she is in a major imbalance of power and perpetuates the gender inequality that contributed to the practice in the first place.[93][94] Also in the case of minors, there are the issues of human rights, non-consensual sexual activity and forced marriage and a 2016 joint report of the WHO and Inter-Parliamentary Union places the two concepts together as Child, Early and Forced Marriage (CEFM), as did the 2014 Girl Summit (see below).[95] In addition the likely pregnancies at a young age are associated with higher medical risks for both mother and child, multiple pregnancies and less access to care[96][11][93] with pregnancy being amongst the leading causes of death amongst girls aged 15–19. Girls married under age are also more likely to be the victims of domestic violence.[92]

Many women and teenage girls don't get enough calcium. Calcium-rich foods are critical to healthy bones and can help you avoid osteoporosis, a bone-weakening disease. Additionally, recent studies suggest that consuming calcium-rich foods as part of a healthy diet may aid weight loss in obese women while minimizing bone turnover. The National Institute of Medicine recommends the following calcium intake, for different ages:
 Income-generation activities  Home visits    ↑ health knowledge, ↑ health care utilization, ↓ poverty  ↑ nutrition and knowledge, ↓ anemia, ↓/NC night blindness, ↑ intake of vitamin A–rich foods, ↑/NC intake of vegetables, ↑ intake of ASF, ↓ underweight, ↑ health care utilization, ↓ poverty  ↑ health knowledge, ↑ health care utilization, ↓ poverty 
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.[151][152] 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.[6][153]
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