Obesity has reached epidemic proportions in the USA and affects one in three adult women aged 20 years or older, 62 % of women are overweight or obese (BMI more than 25 kg/m2). Obesity will soon surpass tobacco and become the leading cause of preventable death in the USA Women may be at greater risk of obesity than men. The sex difference is possibly related to differences in dietary patterns as well as physiological and behavioural (for example, reduced physical activity) changes associated with ageing, higher levels of body fat and the ability to store more fat, fluctuations in sex hormone concentrations, dysregulation of serotonin and higher leptin levels.
Women may also experience a larger burden of obesity related disease, including CVD, hypertension, dyslipidaemia, respiratory dis¬turbances, type 2 diabetes and osteoarthritis.
There is a requirement for innovative nutrition intervention strategies based on the links between the characteristics and quality of habitual long-term eating behaviours and obesity-related out-comes, such as dietary patterns and diet quality indices.
This study by Wolongevicz et al prospectively examined the relationship between diet quality a sand the development of overweight or obesity in women over a broad age range, The authors evaluated whether a previously validated, global diet index, the Framingham nutritional risk score predicted the development of overweight or obesity over 16 years in healthy, normal-weight (BMI
They identified a link between diet quality, assessed using the Framingham nutritional risk score, and risk of becoming overweight or obese in women.
Focusing on food intake behaviour is essential. A nutritional risk score that is comprehensive and nutrient-based, like the Framingham nutritional risk score allows assessment of overall nutrient intake patterns of individuals to identify areas for translation to dietary changes in food patterns, rather than using a more uniform set of inter¬vention guidelines that are potentially irrelevant or more restrictive than appropriate to the individual.
Wolongevicz et al (2010) Diet quality and obesity in women: the Framingham Nutrition Studies Brit J Nutr vol 103 1223-1229

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