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.
Women's experience of health and disease differ from those of men, due to unique biological, social and behavioural conditions. Biological differences vary all the way from phenotype to the cellular, and manifest unique risks for the development of ill health.[1] The World Health Organization (WHO) defines health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity".[2] Women's health is an example of population health, the health of a specific defined population.[3]
Fiber is an important part of an overall healthy eating plan. Good sources of fiber include fortified cereal, many whole-grain breads, beans, fruits (especially berries), dark green leafy vegetables, all types of squash, and nuts. Look on the Nutrition Facts label for fiber content in processed foods like cereals and breads. Use the search tool on this USDA page to find the amount of fiber in whole foods like fruits and vegetables.
To achieve these goals, cut down on saturated fat from animal products (meat and the skin of poultry, whole-fat dairy products, and certain vegetable foods — palm oil, palm kernel oil, cocoa butter, and coconut). And it's just as important to reduce your consumption of trans fatty acids, the partially hydrogenated vegetable oils found in stick margarine, fried foods, and many commercially baked goods and snack foods.
Women's menstrual cycles, the approximately monthly cycle of changes in the reproductive system, can pose significant challenges for women in their reproductive years (the early teens to about 50 years of age). These include the physiological changes that can effect physical and mental health, symptoms of ovulation and the regular shedding of the inner lining of the uterus (endometrium) accompanied by vaginal bleeding (menses or menstruation). The onset of menstruation (menarche) may be alarming to unprepared girls and mistaken for illness. Menstruation can place undue burdens on women in terms of their ability to participate in activities, and access to menstrual aids such as tampons and "sanitary pads". This is particularly acute amongst poorer socioeconomic groups where they may represent a financial burden and in developing countries where menstruation can be an impediment to a girl's education.[113]
Research from Tufts University nutrition scientists shows that Americans are drinking so much soda and sweet drinks that they provide more daily calories than any other food. Obesity rates are higher for people consuming sweet drinks. Also watch for hidden sugar in the foods you eat. Sugar may appear as corn syrup, dextrose, fructose, fruit juice concentrate or malt syrup, among other forms, on package labels.

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[97] and its agencies, such as the Office of the High Commissioner for Human Rights,[98] UNFPA,[99] UNICEF[91][93] and WHO.[95] 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.[100] 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)[101] and the Universal Declaration of Human Rights[102] 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.[103][104] Later that same year the General Assembly of the United Nations passed a resolution, which inter alia[105]

Calcium may even be harmful for men, at least in large amounts. The worry is prostate cancer, and two Harvard studies have raised the alarm. In 1998, the Health Professionals Follow-up Study found that a high consumption of calcium from food or supplements was linked to an increased risk of advanced prostate cancer. The risk was greatest in men who got more than 2,000 mg a day. More recently, the U.S. Physicians' Health Study reported that a high consumption of calcium from dairy products appeared to increase a man's risk of prostate cancer by up to 37%. A study from the Fred Hutchinson Cancer Research Center in Seattle also found a link between calcium and advanced prostate cancer.
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).
Carbohydrates should provide 45%–65% of your daily calories. Most of those calories should come from the complex carbohydrates in high-fiber and unrefined foods, such as bran cereal and other whole-grain products, brown rice, beans and other legumes, and many fruits and vegetables. These carbohydrates are digested and absorbed slowly, so they raise the blood sugar gradually and don't trigger a large release of insulin. People who eat lots of these foods have higher HDL ("good") cholesterol levels and a lower risk of obesity, diabetes, and heart disease. A good amount of soluble fiber in the diet lowers LDL ("bad") cholesterol, and high-fiber diets reduce the risk of intestinal disorders ranging from constipation and diverticulosis to hemorrhoids. Some studies have shown that fiber may help reduce the risk of colon cancer. Men need more fiber than women: 38 vs. 25 grams a day before the age of 50 and 30 vs. 21 grams a day thereafter.
The major differences in life expectancy for women between developed and developing countries lie in the childbearing years. If a woman survives this period, the differences between the two regions become less marked, since in later life non-communicable diseases (NCDs) become the major causes of death in women throughout the world, with cardiovascular deaths accounting for 45% of deaths in older women, followed by cancer (15%) and lung disease (10%). These create additional burdens on the resources of developing countries. Changing lifestyles, including diet, physical activity and cultural factors that favour larger body size in women, are contributing to an increasing problem with obesity and diabetes amongst women in these countries and increasing the risks of cardiovascular disease and other NCDs.[11][20]
The prevalence of Alzheimer's Disease in the United States is estimated at 5.1 million, and of these two thirds are women. Furthermore, women are far more likely to be the primary caregivers of adult family members with depression, so that they bear both the risks and burdens of this disease. The lifetime risk for a woman of developing Alzeimer's is twice that of men. Part of this difference may be due to life expectancy, but changing hormonal status over their lifetime may also play a par as may differences in gene expression.[119] Deaths due to dementia are higher in women than men (4.5% of deaths vs. 2.0%).[6]
Sugar is a source of calories, not nutrients. Consuming too much sugar can lead to weight gain and tooth decay. Contrary to what many people think, there is no evidence linking high-sugar diets to hyperactivity or diabetes. However, high-fructose corn syrup, found in most processed foods, is linked with obesity, and obesity increases your risk for developing diabetes and other conditions.

Not surprisingly, many integrated health services were delivered in health clinics and facilities. Many women faced barriers to health facility–based care for nutrition, such as distance, time, quality of care, stocking of supplies, and the capacity and nutrition knowledge of healthcare professionals (105, 119). These barriers need to be taken into consideration to enhance the coverage of integrated health care services. Universal health care mitigated cost barriers to seeking health care, but did not address all of the barriers noted here (105, 109, 114, 120–123).


Even just that single-page layout in Women’s Health is a huge step in the right direction. Seeing more normal-size women on the pages of fashion magazines and catalogues may actually be more inspirational than urging readers to take “more ‘me time.’” It’s also another area where women’s health magazines are surpassing the men’s version: The only non-cut men in Men’s Health are seen in “before” pictures in fitness makeovers. This is despite the fact that 90 percent of men are “overfat,” as the magazine itself reported. Non-six-pack men aren’t missing from the magazine because they’re difficult to find, same as non-size- 2s on the women’s side.
“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.

Also known as “myofascial release,” foam rolling is an easy way to benefit your entire body. “While stretching addresses the length of muscle fiber, rolling improves the quality of the tissue,” says Rob Sulaver, CEO and founder of Bandana Training. This leads to tension- and pain-free muscles, which function better so you perform better. Be sure to roll for five minutes before your workout. Not sure what to do? Try these 10 ways to use a foam roller.
Behavioral differences also play a role, in which women display lower risk taking including consume less tobacco, alcohol, and drugs, reducing their risk of mortality from associated diseases, including lung cancer, tuberculosis and cirrhosis. Other risk factors that are lower for women include motor vehicle accidents. Occupational differences have exposed women to less industrial injuries, although this is likely to change, as is risk of injury or death in war. Overall such injuries contributed to 3.5% of deaths in women compared to 6.2% in the United States in 2009. Suicide rates are also less in women.[27][28]
In 2000, the United Nations created Millennium Development Goal (MDG) 5[43] to improve maternal health.[44] 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.[45][46] 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.[39] 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%).[37] With the completion of the MDG campaign in 2015, new targets are being set for 2030 under the Sustainable Development Goals campaign.[47][48] Maternal health is placed under Goal 3, Health, with the target being to reduce the global maternal mortality ratio to less than 70.[49] Amongst tools being developed to meet these targets is the WHO Safe Childbirth Checklist.[50]
A related issue is the inclusion of pregnant women in clinical studies. Since other illnesses can exist concurrently with pregnancy, information is needed on the response to and efficacy of interventions during pregnancy, but ethical issues relative to the fetus, make this more complex. This gender bias is partly offset by the iniation of large scale epidemiology studies of women, such as the Nurses' Health Study (1976),[162] Women's Health Initiative[163] and Black Women's Health Study.[164][6]
Although there is evidence that interventions can address widespread malnutrition among women, there is a lack of operational research and programs to tackle the issue. There is an imperative for the nutrition community to look beyond maternal nutrition and to address women's nutrition across their lives (3). How we reach women matters, and different delivery platforms are more appropriate for some women than others. Delivery platforms for reaching young mothers are different from those for adolescents and postmenopausal women. There is a need to intentionally consider strategies that appropriately target and deliver interventions to all women. This means that nutrition researchers and practitioners need to further adapt existing strategies and modes of delivery to adequately engage women who might not be in clinic settings (78). This also requires that researchers and practitioners explore how to deliver nutrition interventions to women and at different stages of life in order to reduce inequities in the delivery of nutrition services and to reach women missed by programs focusing on maternal nutrition alone.
Before and during pregnancy. You need more of certain nutrients than usual to support your health and your baby’s development. These nutrients include protein, calcium, iron, and folic acid. Many doctors recommend prenatal vitamins or a folic acid supplement during this time. Many health insurance plans also cover folic acid supplements prescribed by your doctor during pregnancy. You also need to avoid some foods, such as certain kinds of fish. Learn more about healthy eating during pregnancy in our Pregnancy section.
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