Equally challenging for women are the physiological and emotional changes associated with the cessation of menses (menopause or climacteric). While typically occurring gradually towards the end of the fifth decade in life marked by irregular bleeding the cessation of ovulation and menstruation is accompanied by marked changes in hormonal activity, both by the ovary itself (oestrogen and progesterone) and the pituitary gland (follicle stimulating hormone or FSH and luteinizing hormone or LH). These hormonal changes may be associated with both systemic sensations such as hot flashes and local changes to the reproductive tract such as reduced vaginal secretions and lubrication. While menopause may bring relief from symptoms of menstruation and fear of pregnancy it may also be accompanied by emotional and psychological changes associated with the symbolism of the loss of fertility and a reminder of aging and possible loss of desirability. While menopause generally occurs naturally as a physiological process it may occur earlier (premature menopause) as a result of disease or from medical or surgical intervention. When menopause occurs prematurely the adverse consequences may be more severe.[114][115]

  Home visits  ↓ anemia, ↑ Hgb, ↑ food consumption, ↑ weight gain (underweight adolescents), NC mortality, ↓ fatigue  ↓ anemia, ↑ serum folate, ↑ serum B-12, NC mortality, NC depression  ↓ anemia, ↑ MN status (Hgb, ferritin, folate, B-12, zinc, riboflavin), ↑/NC serum retinol, ↓/NC night blindness, ↑ weight gain, NC maternal mortality, NC depression   
Calcium: “Getting enough calcium is important for all ages, but it's particularly important during adolescence and early adulthood, when bones are absorbing calcium,” says Heather Schwartz, MS, RD, a medical nutrition therapist at Stanford University Hospital and Clinics. Calcium and vitamin D are often paired in fortified foods such as milk. The reason: The body needs D in order to absorb calcium.
Cervical cancer is associated with human papillomavirus (HPV), which has also been implicated in cancers of the vulva, vagina, anus, and oropharynx. Almost 300 million women worldwide have been infected with HPV, one of the commoner sexually transmitted infections, and 5% of the 13 million new cases of cancer in the world have been attributed to HPV.[124][75] In developed countries, screening for cervical cancer using the Pap test has identified pre-cancerous changes in the cervix, at least in those women with access to health care. Also an HPV vaccine programme is available in 45 countries. Screening and prevention programmes have limited availability in developing countries although inexpensive low technology programmes are being developed,[125] but access to treatment is also limited.[123] If applied globally, HPV vaccination at 70% coverage could save the lives of 4 million women from cervical cancer, since most cases occur in developing countries.[6]

Wood, Susan F.; Dor, Avi; Gee, Rebekah E.; Harms, Alison; Mauery, D. Richard; Rosenbaum, Sara J.; Tan, Ellen (15 June 2009). Women's health and health care reform: the economic burden of disease in women'. D. Richard. Washington DC: George Washington University, School of Public Health and Health Services, Jacobs Institute of Women's Health. Retrieved 17 July 2016.
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.
All of the identified studies focused on LNSs for pregnant and lactating women through antenatal care–based and –affiliated delivery platforms (97–101). These studies relied on antenatal care to recruit mothers but delivered the intervention through home visits. There was no evidence evaluating use of LNSs for women who were not pregnant or lactating. The majority of studies evaluating LNS interventions involved children with severe or moderate acute malnutrition. Although LNS supplementation could be an intervention to provide essential nutrients to women and girls, it is expensive. Filling energy gaps using local foods or other commodities can often be done at a lower cost (97). LNS supplementation should be limited to contexts in which cheaper, more sustainable solutions are not available.
Women often received micronutrient supplements during antenatal and postnatal care (13, 35–42, 51, 60), and, as such, supplementation was often targeted to pregnant and lactating women. The delivery of micronutrient supplementation commonly occurred in health care settings for at-home consumption. Community-based antenatal care that involved home visits by community health workers was also a common delivery platform for supplementation delivery. There were some studies that reported micronutrient supplementation to adolescents, women of reproductive age, pregnant women, and women with young children outside of the antenatal care setting. These included primary health care clinics, home visits, community centers, pharmacies, and workplaces (32, 38–43, 45, 52, 53). Adolescent girls were also reached by community- and school-based programs (26, 41, 46). School-based programs were more efficacious in reducing rates of anemia among adolescent girls, compared with the community-based interventions (26, 46). However, many of the reported studies to date involved small samples of adolescents in controlled settings, and additional research is needed on the effectiveness of these programs (59, 62).

  Schools (“condition” and delivery platform)  ↑ food expenditures, ↑/NC food share, ↑ HH food consumption, ↑ dietary diversity, ↑ HH intake of fruits, vegetables, and ASF, ↑/NC intake of fats and sweets  ↑ knowledge about health and nutrition, ↑ food expenditures, ↑/NC food share, ↑ HH food consumption, ↑ dietary diversity, ↑ HH intake of fruits, vegetables, and ASF, ↑/NC intake of fats and sweets, ↑ participation in social networks, ↑ self-confidence, ↑ control HH resources  ↑ knowledge about health and nutrition, ↑ HH food security, ↑ food expenditures, ↑/NC food share, ↑ HH food consumption, ↑ dietary diversity, ↑ HH intake of fruits, vegetables, and ASF, ↑/NC intake of fats and sweets, ↑ participation in social networks, ↑ self-confidence, ↑ control over resources  ↑ knowledge about health, NC hypertension, ↓ missed meals, ↑ health care utilization 
Although women in industrialised countries have narrowed the gender gap in life expectancy and now live longer than men, in many areas of health they experience earlier and more severe disease with poorer outcomes. Gender remains an important social determinant of health, since women's health is influenced not just by their biology but also by conditions such as poverty, employment, and family responsibilities. Women have long been disadvantaged in many respects such as social and economic power which restricts their access to the necessities of life including health care, and the greater the level of disadvantage, such as in developing countries, the greater adverse impact on health.
Integrated health care, which integrates curative and preventive interventions, can improve nutrition outcomes for women across the life course through improved access to counseling, vaccinations, and screening and treatment of illnesses (103–107). Access to primary health care positively contributed to the prevention, diagnosis, and management of both communicable and noncommunicable disease (108). Distribution of insecticide-treated bed nets, condoms, screening and testing for disease, and delivery of medical treatments were often associated with integrated health initiatives and improved health and nutrition outcomes (13, 109). Access to health care was associated with the delivery of nutrition-specific interventions to manage pregnancy-induced hypertension, diabetes, pre-eclampsia, and hemorrhage (106, 107, 110). However, some studies showed that integrated services increased knowledge, but did not result in changes in health or nutrition outcomes (103). In addition, in many settings, quality of care was inadequate (107) and incorrect diagnoses and treatments were common (111).
Gahagan, Jacqueline (15 August 2016). "Commentary on the new sex and gender editorial policy of the Canadian Journal of Public Health". Canadian Journal of Public Health. 107 (2): e140–1. doi:10.17269/cjph.107.5584. PMID 27526209. Lay summary – Jon Tattrie. Canadian Journal of Public Health tells researchers to address sex, gender in trials: Research 'excluding 50 per cent of the population' isn't best return for taxpayers, says Jacqueline Gahagan. Canadian Broadcasting Corporation News: Nova Scotia (7 December 2016).
Omega-3s: These essential fatty acids, EPA and DHA, play many roles in the body, including building healthy brain and nerve cells. Some studies show that omega-3s, especially DHA, can help prevent preterm births. Even women who don't plan to have children should be sure to get plenty of omega-3s. These healthy oils have been shown to reduce the risk of heart disease, the number one killer of women.
  Community centers (e.g., women's groups, community kitchens)    ↓ anemia, ↑ nutrition knowledge, ↑ HH food security, ↑ HH food consumption, ↑ dietary diversity, ↑ intake of Fe-rich foods, ↑ intake of ASF, ↑ income, ↑ control over resources, ↑ decision-making  ↑ nutrition knowledge, ↓/NC anemia, ↑ food expenditures, ↑ HH food security, ↑ HH food consumption, ↑/NC dietary diversity, ↑ intake of vitamin A–rich foods, ↑/NC intake of vegetables and meat, ↑ intake of fruits and ASF, NC BMI, ↓ underweight, ↑ income, ↑ control over resources, ↑ decision-making  ↑ HH food security, ↑ dietary diversity 
For a strong backside that will turn heads wherever you go, Marta Montenegro, a Miami-based exercise physiologist and strength and conditioning coach, recommends completing 100 kettlebell swings nonstop with a moderate weight at the end of a legs workout. [Tweet this tip!] If you can’t access a kettlebell, do deadlifts and hip-thrusters instead. “Women tend to overemphasize the quadriceps even when they think they are working the butt. With these two exercises, you'll have no problem engaging the glutes and posterior muscles of the legs,” Montenegro says.
Nutrition education, including communication and counseling to raise awareness and promote nutrition-related knowledge and behaviors aligned with public health goals, was found to increase women's knowledge and improve women's dietary diversity and protein intake (15–21). It also reduced energy intake of overweight women over a 9-mo period (22). However, evidence for the effectiveness of nutrition education interventions showed mixed impact on biological and anthropometric markers of women's nutritional status (14–16, 18, 23–29). This could be due to lack of statistical power given the small sample sizes of the reviewed studies. For adolescent girls, nutrition education was found to reduce odds of overweight, and improve knowledge, dietary intake, physical activity, and sedentary behavior (27, 29, 30). This was particularly true for nutrition education that lasted longer than 12 mo (29). Nutrition education was also more strongly associated with changes in health outcomes in studies evaluating childhood obesity treatment, rather than childhood obesity prevention (29).
In the United States, infertility affects 1.5 million couples.[86][87] Many couples seek assisted reproductive technology (ART) for infertility.[88] In the United States in 2010, 147,260 in vitro fertilization (IVF) procedures were carried out, with 47,090 live births resulting.[89] In 2013 these numbers had increased to 160,521 and 53,252.[90] However, about a half of IVF pregnancies result in multiple-birth deliveries, which in turn are associated with an increase in both morbidity and mortality of the mother and the infant. Causes for this include increased maternal blood pressure, premature birth and low birth weight. In addition, more women are waiting longer to conceive and seeking ART.[90]
While the rates of the leading causes of death, cardiovascular disease, cancer and lung disease, are similar in women and men, women have different experiences. Lung cancer has overtaken all other types of cancer as the leading cause of cancer death in women, followed by breast cancer, colorectal, ovarian, uterine and cervical cancers. While smoking is the major cause of lung cancer, amongst nonsmoking women the risk of developing cancer is three times greater than amongst nonsmoking men. Despite this, breast cancer remains the commonest cancer in women in developed countries, and is one of the more important chronic diseases of women, while cervical cancer remains one of the commonest cancers in developing countries, associated with human papilloma virus (HPV), an important sexually transmitted disease. HPV vaccine together with screening offers the promise of controlling these diseases. Other important health issues for women include cardiovascular disease, depression, dementia, osteoporosis and anemia. A major impediment to advancing women's health has been their underrepresentation in research studies, an inequity being addressed in the United States and other western nations by the establishment of centers of excellence in women's health research and large scale clinical trials such as the Women's Health Initiative.
Calcium: “Getting enough calcium is important for all ages, but it's particularly important during adolescence and early adulthood, when bones are absorbing calcium,” says Heather Schwartz, MS, RD, a medical nutrition therapist at Stanford University Hospital and Clinics. Calcium and vitamin D are often paired in fortified foods such as milk. The reason: The body needs D in order to absorb calcium.
Weighing yourself too often can cause you to obsess over every pound. Penner recommends stepping on the scale or putting on a pair of well-fitting (i.e. not a size too small) pants once a week. “Both can be used as an early warning system for preventing weight gain, and the pants may be a better way to gauge if those workouts are helping you tone up and slim down.” [Tweet this tip!]
While what works best for one woman may not always be the best choice for another, the important thing is to build your dietary choices around your vital nutritional needs. Whether you’re looking to improve your energy and mood, combat stress or PMS, boost fertility, enjoy a healthy pregnancy, or ease the symptoms of menopause, these nutrition tips can help you to stay healthy and vibrant throughout your ever-changing life.
While women tend to need fewer calories than men, our requirements for certain vitamins and minerals are much higher. Hormonal changes associated with menstruation, child-bearing, and menopause mean that women have a higher risk of anemia, weakened bones, and osteoporosis, requiring a higher intake of nutrients such as iron, calcium, magnesium, vitamin D, and vitamin B9 (folate).
If you do decide to diet, you still need to maintain good nutrition. You want to cut back on calories, not nutrients. And while you want to reduce fat, don't eliminate it entirely. Some studies suggest that older women who maintain a higher body-fat percentage are less likely to suffer from osteoporosis and other conditions associated with menopause. Fat cells also retain estrogen, which helps maintain the calcium in your bones. Younger women should be careful, too: a low body fat percentage can lead to infertility; below 17 percent may lead to missed periods, also known as amenorrhea.
If you thought texting changed your love life, imagine what it could do for your waistline. When people received motivational text messages promoting exercise and healthy behaviors twice a week (i.e., “Keep in the fridge a Ziploc with washed and precut vegetables 4 quick snack. Add 1 string cheese 4 proteins”), they lost an average of about 3 percent of their body weight in 12 weeks. Participants in the Virginia Commonwealth University study also showed an improvement in eating behaviors, exercise, and nutrition self-efficacy, and reported that the texts helped them adopt these new habits. Find health-minded friends and message each other reminders, or program your phone to send yourself healthy eating tips.
Folate is most important for women of childbearing age. If you plan to have children some day, think of folate now. Folate is a B vitamin needed both before and during pregnancy and can help reduce risk of certain serious common neural tube birth defects (which affect the brain and spinal chord). Women ages 15-45 should include folate in their diet to reduce the risk for birth defects if one becomes pregnant, even if one is not planning a pregnancy.
Breast cancer is the second most common cancer in the world and the most common among women. It is also among the ten most common chronic diseases of women, and a substantial contributor to loss of quality of life (Gronowski and Schindler, Table IV).[6] Globally, it accounts for 25% of all cancers. In 2016, breast cancer is the most common cancer diagnosed among women in both developed and developing countries, accounting for nearly 30% of all cases, and worldwide accounts for one and a half million cases and over half a million deaths, being the fifth most common cause of cancer death overall and the second in developed regions. Geographic variation in incidence is the opposite of that of cervical cancer, being highest in Northern America and lowest in Eastern and Middle Africa, but mortality rates are relatively constant, resulting in a wide variance in case mortality, ranging from 25% in developed regions to 37% in developing regions, and with 62% of deaths occurring in developing countries.[17][122]
Don't take dramatic steps alone. You need to work closely with an experienced health care professional to lose weight, particularly if you have other medical problems, plan to lose more than 15 to 20 pounds or take medication on a regular basis. An initial checkup can identify conditions that might be affected by dieting and weight loss. Make sure you find out how much experience your health care professional has dealing with nutrition. It's not always well covered in medical schools. You may want to talk to a registered dietitian before embarking on a diet.
After menopause. Lower levels of estrogen  after menopause raise your risk for chronic diseases such as heart disease, stroke, and diabetes, and osteoporosis, a condition that causes your bones to become weak and break easily. What you eat also affects these chronic diseases. Talk to your doctor about healthy eating plans and whether you need more calcium and vitamin D to protect your bones. Read more about how very low estrogen levels affect your health in our Menopause section. Most women also need fewer calories as they age, because of less muscle and less physical activity. Find out how many calories you need based on your level of activity.
In addition to death occurring in pregnancy and childbirth, pregnancy can result in many non-fatal health problems including obstetrical fistulae, ectopic pregnancy, preterm labor, gestational diabetes, hyperemesis gravidarum, hypertensive states including preeclampsia, and anemia.[34] Globally, complications of pregnancy vastly outway maternal deaths, with an estimated 9.5 million cases of pregnancy-related illness and 1.4 million near-misses (survival from severe life-threatening complications). Complications of pregnancy may be physical, mental, economic and social. It is estimated that 10–20 million women will develop physical or mental disability every year, resulting from complications of pregnancy or inadequate care.[39] Consequently, international agencies have developed standards for obstetric care.[52]

  Community centers (e.g., women's groups, community kitchens)    ↓ anemia, ↑ nutrition knowledge, ↑ HH food security, ↑ HH food consumption, ↑ dietary diversity, ↑ intake of Fe-rich foods, ↑ intake of ASF, ↑ income, ↑ control over resources, ↑ decision-making  ↑ nutrition knowledge, ↓/NC anemia, ↑ food expenditures, ↑ HH food security, ↑ HH food consumption, ↑/NC dietary diversity, ↑ intake of vitamin A–rich foods, ↑/NC intake of vegetables and meat, ↑ intake of fruits and ASF, NC BMI, ↓ underweight, ↑ income, ↑ control over resources, ↑ decision-making  ↑ HH food security, ↑ dietary diversity 
It's a cliché, to be sure, but a balanced diet is the key to good nutrition and good health. Following that diet, however, isn't always that easy. One challenge is that women often feel too busy to eat healthfully, and it's often easier to pick up fast food than to prepare a healthy meal at home. But fast food is usually high in fat and calories and low in other nutrients, which can seriously affect your health. At the other extreme, a multimillion dollar industry is focused on telling women that being fit means being thin and that dieting is part of good nutrition.

You can get calcium from dairy products like milk, yogurt and cheese, canned fish with soft bones (sardines, anchovies and salmon; bones must be consumed to get the benefit of calcium), dark-green leafy vegetables (such as kale, mustard greens and turnip greens) and even tofu (if it's processed with calcium sulfate). Some foods are calcium-fortified; that is, they contain additional calcium. Examples include orange juice, certain cereals, soy milk and other breakfast foods. Talk to your health care professional about whether you should take calcium supplements if you don't think you're getting enough calcium from food sources.


Adopting a plant-based diet could help tip the scales in your favor. A five-year study of 71,751 adults published in the Journal of the Academy of Nutrition and Dietetics found that vegetarians tend to be slimmer than meat-eaters even though both groups eat about the same number of calories daily. Researchers say it may be because carnivores consume more fatty acids and fewer weight-loss promoting nutrients, like fiber, than herbivores do. Go green to find out if it works for you.
A workout partner not only keeps you accountable, she also may help you clock more time at the gym and torch more fat. A British survey of 1,000 women found that those who exercise with others tend to train six minutes longer and burn an extra 41 calories per session compared to solo fitness fanatics. [Tweet this fact!] Women with Bikram buddies and CrossFit comrades said they push themselves harder and are more motivated than when they hit the gym alone.
  Microcredit institution  NC HH food security, NC individual food security, NC food expenditures, NC food consumption, ↑ social status, ↑ self-confidence  ↑ health knowledge, NC health status, NC HH food security, NC individual food security, ↑/NC food expenditures, NC food consumption, NC school enrollment, ↑/NC empowerment, ↑ self-confidence, ↑/NC decision-making, ↑ social status, ↑/NC health care utilization  ↑ health knowledge, NC health status, ↑/NC food expenditures, NC school enrollment, ↑/NC empowerment, ↑/NC decision-making power, ↑ self-confidence, ↑/NC health care utilization  NC health status, ↑/NC food expenditures, ↑/NC empowerment, ↑/NC decision-making power, ↑ self-confidence, NC health care utilization 
Popular belief says if you really want to make a big change, focus on one new healthy habit at a time. But Stanford University School of Medicine researchers say working on your diet and fitness simultaneously may put the odds of reaching both goals more in your favor. They followed four groups of people: The first zoned in on their diets before adding exercise months later, the second did the opposite, the third focused on both at once, and the last made no changes. Those who doubled up were most likely to work out 150 minutes a week and get up to nine servings of fruits and veggies daily while keeping their calories from saturated fat at 10 percent or less of their total intake. 
Omega-3 fatty acids are essential for the neurological and early visual development of your baby and for making breast milk after birth. Aim for two weekly servings of cold water fish such as salmon, tuna, sardines, herring, or anchovies. Sardines are widely considered the safest and most sustainable fish to eat, while seaweed is a rich vegetarian source of Omega-3s.
  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 
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