Filed under: Women's health
The month of October is Military Health System’s Women’s Health Month. There are more than 350,000 female members of the military (16% of the total military force). While it’s important for all military members to consume nutritious diets, women have special nutrient needs: iron, folic acid, and calcium.
Iron. Iron deficiency is the most common nutritional deficiency among women. Poor dietary intake of iron combined with intense physical activity can lead to fatigue, weakness, and pale skin—all signs of iron-deficiency anemia (IDA). Iron-rich foods include meat, poultry, fish, spinach, beans, and fortified cereals. Consume these foods with vitamin C–rich foods such as strawberries and oranges for better iron absorption. HPRC discusses other reasons for IDA in this article on “Iron deficiency.”
Folic acid. Women of childbearing age need enough folic acid to reduce the risk of birth defects. But even if you’re not pregnant, folic acid helps make blood cells that boost your immune system. Folic acid can be found in leafy green vegetables, beans, peas, and fortified cereals and bread.
Calcium. Compared to men, women are at greater risk for osteoporosis, in which bones become weak and are more likely to break. Women need to start getting more calcium at an early age to keep bones strong. Calcium-rich foods include low-fat dairy products, tofu, kale, and fortified cereals and juices. Vitamin D is also important to help the absorption of calcium. Read more about vitamin D in HPRC’s Vitamin D, the sunshine vitamin.”
All of these nutrients can be found in supplement form, but as with any dietary supplement, consult your doctor first to determine if they are necessary and safe. For more information on supplements, read HPRC’s “Women's health and dietary supplements.” Remember, most people can achieve adequate intake of these nutrients with a balanced diet. Poor nutrition puts you at risk for injuries and makes it harder for you to perform at your best.
If you’d like to know more about women’s health, visit the Military Health System's web page.
The Air Force recently launched a new website to support pregnant Airmen: Pregnancy A to Z. It provides information from real parents and physicians through videos that provide tips for the first trimester all the way through to delivery and post-partum. Check out the exercise library too—keeping fit while you’re pregnant is essential for a healthy pregnancy and an easy recovery. And the site isn’t just for moms. Dads-to-be will find helpful information as well.
There are more than 200,000 women in the military today—almost 15% of active duty members. Not surprisingly then, pregnancy in the military has become a hot health topic as more and more women choose to serve. Even though most women should exercise during pregnancy, pregnant women still engage in less physical activity than their non-pregnant counterparts. Being active during pregnancy has a lot of health benefits, including maintaining a healthy weight and reducing risk of gestational diabetes and preeclampsia, stress, operative or assisted deliveries, and labor time. Remember this very important message – Don’t ignore pain or fatigue; listen to your body and consult your healthcare provider if you have concerns!
The U.S. Department of Health and Human Services (HHS) recommends that healthy pregnant women engage in moderate-intensity aerobic exercise at least 150 minutes a week, which comes out to around 20-30 minutes a day. Women who already engage in vigorous-intensity exercise can continue physical activity at this level as long as they remain healthy and check with their healthcare provider about when to adjust activity levels (and what limits they should keep in mind). A healthy fetus is not adversely affected even by vigorous exercise, but be careful that you don’t overdo it. Remember that your body is changing with pregnancy—it may take more effort to do the same exercises you did before you were pregnant, and you may not realize when you’re pushing yourself too hard. Monitor your heart rate and use tools such as the talk test to gauge intensity. The American College of Sports Medicine (ACSM) has adopted the age-based heart rate ranges for pregnant women from the Society of Obstetricians and Gynecologists of Canada.
After giving birth, you may find that the “baby weight” gained during pregnancy is stubbornly hanging around. Excess weight carries a whole host of adverse health risks, so keep moving—even walking for 45 minutes three to four times per week at low to moderate intensity can reduce risk of chronic disease. As with any exercise program, resuming activity after giving birth should be a gradual process (after consulting with your Doctor).
Certain general precautions should be taken with exercise during pregnancy. Avoid contact sports and exercises that increase the risk of falling. Avoid exercises that require stomach-down (supine) positions, with the exception of swimming during pregnancy, which doesn’t place stress on your joints like other forms of exercise do. Regular exercise before you get pregnant can help you prepare for the physical changes that occur during pregnancy and keep you ready and resilient for your family and your military service.
If you’re pregnant, keep in mind there isn’t any consensus about exercising at altitude, so it’s even more important to know the symptoms of acute mountain sickness (AMS). Take time to acclimatize if you travel to altitudes above 2500 meters and allow two or three days before exercising moderately. Wait for complete acclimatization before engaging in heavy exercise.
First and foremost, however, if you become pregnant, consult with your healthcare provider before starting or continuing any exercise routine. Also, each service branch has its own policies regarding pre- and post-natal exercise ().
Military servicewomen are exempt from physical fitness tests for a minimum of six months after giving birth. For many, though, this may not be enough time to get back to pre-pregnancy fitness levels. To date, studies have found that after pregnancy many active-duty women had slower run times, were not able to do as many push-ups, and had lower overall fitness scores compared to their pre-pregnancy fitness tests. One Air Force study found that sit-ups were the only component of the fitness test that didn’t change after pregnancy, despite increases in abdominal circumference. While exercise is generally recommended for women during pregnancy, there are many reasons why a lot of women stop, decrease, or are unable to do physical training during this time—having a baby is exhausting! Lack of sleep and sleep disturbances, quality and quantity of family support systems, breastfeeding needs, hormonal changes, and the physical stress of childbirth all impact recovery and performance. Getting back into an exercise routine takes time and patience. Discuss any possible restrictions with your doctor before starting. Begin slowly and at lower intensities until you feel stronger. Brisk walking, especially with your baby, is good exercise and good bonding time.
About half of all military personnel use some dietary supplements, and military women most commonly use weight-loss supplements. But is there a place for dietary supplements in enhancing women’s health? Dietary supplements, by definition, are intended to “supplement the diet” and can contain a dietary ingredient such as a vitamin, mineral, herb or other botanical, amino acid, or combinations of these and/or other substances or constituents intended to be consumed by mouth.
Active women may require more nutrients, but vitamin and mineral needs normally can be met by eating a variety of nutrient-rich foods. The Dietary Guidelines for Americans focus largely on the recommendation that nutrient-dense foods and beverages—such as fruits, vegetables, whole grains, low-fat dairy products, lean meats and poultry, eggs, nuts and seeds—can provide all the nutrients needed by most everyone. These recommendations are based on research that shows a varied, healthy diet lowers the risk of most diseases.
Some dietary supplements have been found to be beneficial for women’s health, such as folic acid, iron, and calcium. Folic acid, a B vitamin involved in the production of new cells in the body, has been shown to help prevent birth defects. Women who are thinking of becoming pregnant or are pregnant should take a supplement that includes 400 micrograms of folic acid per day. Fortified foods such as green, leafy vegetables, enriched whole grain breads, flour, pasta, rice, and most ready-to-eat cereals also contain folic acid. Adolescent girls, women of childbearing age, and especially pregnant women also need more iron, which is a mineral involved in the transport of oxygen in the body. Women in these groups should choose iron-rich foods, particularly red meat, fish, and poultry, as well as iron-fortified foods. When iron levels are low, symptoms may include feeling extra tired and weak, along with a decrease in immune function. A healthcare provider or dietitian can determine the need for supplementation if diet alone cannot maintain iron levels or for those who have iron-deficiency anemia. Calcium is an important mineral that helps maintain strong bones, healthy teeth, and proper functioning of the heart, muscles, and nerves. All women should strive to get their calcium from foods such as low-fat milk, yogurt, cheese, dark-green, leafy vegetables, and foods such as orange juice and soy milk that have been calcium-fortified. Those who may need more should discuss calcium supplement options with a dietitian, since there are many forms available and it is important to determine how much and which kind is suitable for your particular needs.
Some dietary supplement products marketed for weight loss are targeted toward women. Do they work? According to the Food and Drug Administration (FDA), some weight-loss supplements contain hidden prescription drug ingredients. For additional information, see Operation Supplement Safety’s (OPSS) “Are there any safe supplements to help me lose weight?” Furthermore, women looking to enhance their performance may turn to dietary supplement products. OPSS has additional resources for competitive athletes to search for particular products that are certified, as well as helpful red flags on what to avoid.
Some women’s nutrient needs differ from those of men, and they can vary over the course of a lifetime. From adolescent girls, to women of childbearing age, to women over 50, these needs change based on the demands of the physiological changes that occur in the body. One thing is certain: A variety of nutritious food is really the spice of life and should be the basis for fueling all of life’s stages.