8) Fat, Carbohydrate, Water, Mineral, Electrolyte, and Vitamin Requirements in Lactation Flashcards
1
Q
How does the recommendation for energy vary during lactation?
A
The EER increases
2
Q
How does the recommendation for protein vary during lactation?
A
The RDA increases
3
Q
How do the recommendations for omega-3 and omega-6 fatty acids vary during lactation?
A
The AIs increase
4
Q
How does the recommendation for carbohydrates vary during lactation?
A
The RDA increases
5
Q
How does the recommendation for fiber vary during lactation?
A
The AI does not change
6
Q
How does the recommendation for water vary during lactation?
A
The AI increases
7
Q
How does the recommendation for calcium vary during lactation?
A
The RDA does not change
8
Q
How does the recommendation for phosphorus vary during lactation?
A
The RDA does not change
9
Q
How does the recommendation for magnesium vary during lactation?
A
The RDA does not change
10
Q
How does the recommendation for iron vary during lactation?
A
The RDA decreases
11
Q
How does the recommendation for zinc vary during lactation?
A
The RDA increases
12
Q
How does the recommendation for iodine vary during lactation?
A
The RDA increases
13
Q
How does the recommendation for selenium vary during lactation?
A
The RDA increases
14
Q
How does the recommendation for copper vary during lactation?
A
The RDA increases
15
Q
How does the recommendation for manganese vary during lactation?
A
The AI increases
16
Q
How does the recommendation for fluoride vary during lactation?
A
The AI does not change
17
Q
How does the recommendation for chromium vary during lactation?
A
The AI increases
18
Q
How does the recommendation for molybdenum vary during lactation?
A
The RDA increases
19
Q
How does the recommendation for potassium vary during lactation?
A
The AI increases
20
Q
How does the recommendation for sodium vary during lactation?
A
The AI does not change
21
Q
How does the recommendation for chloride vary during lactation?
A
The AI does not change
22
Q
How does the recommendation for thiamine vary during lactation?
A
The RDA increases
23
Q
How does the recommendation for riboflavin vary during lactation?
A
The RDA increases
24
Q
How does the recommendation for niacin vary during lactation?
A
The RDA increases
25
How does the recommendation for pyridoxine vary during lactation?
The RDA increases
26
How does the recommendation for folate vary during lactation?
The RDA increases
27
How does the recommendation for vitamin B12 vary during lactation?
The RDA increases
28
How does the recommendation for biotin vary during lactation?
The AI does not change
29
How does the recommendation for choline vary during lactation?
The AI increases
30
How does the recommendation for pantothenic acid vary during lactation?
The AI increases
31
How does the recommendation for vitamin C vary during lactation?
The RDA increases
32
How does the recommendation for vitamin A vary during lactation?
The RDA increases
33
How does the recommendation for vitamin D vary during lactation?
The RDA does not change
34
How does the recommendation for vitamin E vary during lactation?
The RDA increases
35
How does the recommendation for vitamin K vary during lactation?
The AI does not change
36
How is the milk energy output calculated? (2)
1) Milk production on a daily basis by a lactating mother
| 2) The energy density of human milk
37
What occurs to milk production rates prior to six months of lactation? What occurs afterwards?
- Milk production rates increase during the first 6 months of lactation
- After, milk production rates are variable due to differences in the weaning period (generally decrease)
38
Theoretically, the energy cost of lactation could be met how? (2)
1) Decreasing the time spent in physical activity
| 2) Increasing the efficiency of performing routine tasks
39
In general, how does weight fluctuate during the first 6 months post-partum?
Most women experience a mild and gradual weight loss
40
How is the EER for lactating women calculated (0 to 6 months post-partum)?
EER + Milk Energy Output - Weight Loss
41
How is the EER for lactating women calculated (7 to 12 months post-partum)?
EER + Milk Energy Output
42
How does diet and body composition affect the concentration of protein in human milk?
Human milk is NOT affected by either
43
Does the lactation process alter the maintenance of protein requirement?
No
44
What is the most important quantitative non-protein nitrogen component in breast milk?
Urea
45
How is urea in breast milk produced?
- Diversion of urea loss from urine
| - Colonic fermentation to milk
46
What two factors are the basis of the additional protein requirements during lactation?
- Output of total protein in milk
| - Output of non-protein nitrogen in milk
47
What factor is the basis of the additional omega-6 fatty acid requirement during lactation?
- It is based on the AI
- There is no evidence that an increase in requirement has any effect on infant growth and development
- The AI is based on the median intake of the healthy population
48
How is the demand for the secretion of omega-3 fatty acids in breast milk met? (2)
1) Omega-3 fatty acids from maternal tissues
| 2) Dietary intake
49
Lactating women display (lower/higher) plasma and RBC levels of DHA in comparison to non-lactating women.
lower
50
What may the lower plasma level of DHA in lactating women reflect?
1) Declining DHA status due to inadequate omega-3 fatty acid intake
2) Normal physiological response to changes in endocrine status, lipid metabolism, and nutrient transfer
51
How may DHA be increased in the mother and infant?
Supplementation of fish oil during pregnancy
52
What factor is the basis of the additional omega-3 fatty acid requirement during lactation?
- It is based on the AI
- There is no evidence that an increase in requirement has any effect on infant growth and development
- The AI is based on the median intake of the healthy population
53
How does the respiratory quotient and the carbohydrate utilization rate vary during lactation?
- Higher respiratory quotient
| - Higher carbohydrate utilization rate
54
Which fuel source does the mammary gland preferentially use?
Glucose
55
What must be present in sufficient quantities allow for proper milk production, in terms of carbohydrate metabolism? (3)
1) Increase in precursors for lactose synthesis
2) Increase in glucose from ingested carbohydrates
3) Increase in amino acids from ingested foods to prevent utilization of endogenous proteins
56
What factor is the basis of the additional carbohydrate requirement during lactation?
The amount of carbohydrates necessary to replace the carbohydrates secreted in human milk
57
What factor is the basis of the additional water requirement during lactation?
- It is based on the AI
- There is no evidence that renal function and hydration status are different during lactation
- The AI is based on the median intake of the healthy population
58
How may water requirement during lactation be calculated? (2)
- AI (median intake of the healthy population)
- The sum of the non-pregnant water requirement alongside the water content of milk
- These two values are similar
59
What is the primary source of calcium for the secretion in human milk? Is it dependent or independent of calcium intake?
- Increase in maternal bone resorption
| - Independent of calcium intake
60
How is the bone loss that occurs during lactation regained?
- Upon the return of ovarian function
| - The changes in bone mass are related to the lack of estrogen
61
What are the four sources of calcium that are used for milk production? (4)
1) Dietary intake
2) Fractional intestinal absorption
3) Decrease in renal excretion
4) Stimulation of bone resorption
62
How do blood calcitriol levels differ between lactating and non-lactating women?
They do not differ
63
How may bone loss be minimized by dietary calcium intakes during lactation?
- Dietary calcium intake does NOT minimize bone loss during lactation
- There is no evidence that calcium intake in lactating women should be increased
64
How does the concentration of phosphorus vary as lactation progresses?
Concentration of phosphorus decreases
65
The blood phosphorus levels of lactating women are (low/high).
high
66
What are the three reasons that explain for a high blood phosphorus level during lactation? (3)
1) Increase in bone resorption
2) Decrease in blood PTH, increasing serum inorganic phosphate concentration
3) Decrease in urinary excretion
67
Which nutrient requirements may be increased in lactating adolescents and in mothers nursing multiple infants?
- Calcium
- Phosphorus
- Magnesium
68
What provides the necessary magnesium for lactating women? (2)
1) Decreased urinary excretion
| 2) Increased bone resorption
69
How do blood concentrations of magnesium differ between lactating and non-lactating women?
They are the same
70
Until menstruation resumes, what are iron requirements based on for lactating women?
1) Iron secretion in human milk
| 2) Basal iron losses
71
What are the additional factors that are taken into consideration to calculate iron requirements for adolescent lactating mothers? (2)
- Iron requirements for the expected growth of the mother
1) Iron deposition in tissues
2) Hemoglobin mass
72
What events result in a release of zinc during the first month post-partum? (2)
1) Post-partum involution of the uterus
| 2) Decrease in maternal blood volume
73
How does the fractional absorption of zinc of lactating women differ from non-lactating women?
Fractional absorption is higher in lactating women
74
What form of selenium is largely present in milk? Is the bioavailability high or low?
- Selenomethionine
| - Bioavailability is higher than 90%
75
What factor is the basis of the additional manganese requirements during lactation?
- It is based on the AI
- There is no evidence of manganese deficiency in North America
- The AI is based on the median intake of the healthy population
76
The requirements for which minerals are increased to replace their loss in human milk?
- Zinc
- Iodine
- Selenium
- Copper
- Chromium
- Molybdenum
77
Is fluoride contained in high or low concentrations in human milk?
- Low fluoride concentrations
| - Insensitive to differences in the fluoride concentration of drinking water
78
What is the absorption efficiency of chromium?
Very low (1%)
79
What is the efficiency of conversion of dietary potassium to milk?
Almost 100%
80
The requirement for which electrolyte is increased to replace its loss in human milk?
Potassium
81
The requirements for which vitamins are increased to cover the energy costs of milk production?
- Thiamine
- Riboflavin
- Niacin
82
Women that are breastfeeding more than one infant are likely to require greater quantities of which vitamins? Why?
- Thiamine, riboflavin, niacin
| - As they are producing greater quantities of breast milk
83
Which vitamin requirement is GREATLY increased to cover the amount secreted in breast milk?
- Pyridoxine
| - They must ingest five times the amount secreted in breast milk
84
The requirements for which vitamins are increased to replace their loss in human milk?
- Thiamine
- Riboflavin
- Niacin
- Pyridoxine
- Folate
- Vitamin B12
- Biotin
- Choline
- Pantothenic acid
- Vitamin C
- Vitamin A
- Vitamin E
85
What is the calculation used to obtain the additional folate requirement during lactation?
Milk Volume x [Folate in breast milk] x Bioavailability factor
86
How does the quantity of vitamin B12 secreted during the first six months compare to afterwards?
- 0 to 6 months: 0.33 ug/day
| - 7 to 12 months: 0.25 ug/day
87
A low vitamin B12 concentration in human milk occurs commonly in which scenarios? (2)
1) Strict vegetarian mothers
| 2) Developing countries where there is a lower consumption of animal products
88
What two factors are the basis of the additional choline requirements during lactation?
1) To cover the substantial amount secreted in human milk
| 2) The lack of identification of mechanisms acquired for the conservation of maternal choline status
89
Blood pantothenic acid levels are (lower/higher) at 6 weeks and 3 months post-partum in comparison to control women.
lower
90
What two factors are the basis of the additional pantothenic acid requirements during lactation?
1) The additional secretion in human milk
| 2) The decrease in maternal blood concentrations when intakes are around 5 to 6 mg/day
91
How does the vitamin C content in human milk decrease once you add solid foods?
Decreases, but the EAR does not decrease over length of lactation
92
What is the EAR for vitamin A based on during lactation?
To assure adequate body stores of vitamin A
93
What is the minimum vitamin D intake required to sustain serum calcitriol during lactation?
- It is unclear
| - There is no evidence that lactation increases the mother's RDA for vitamin D
94
Is the EAR for vitamin E lower or higher than the actual intake?
Reported to be higher than the actual intake
95
If the intake of vitamin E is lower than the RDA, why are vitamin E supplements determined to be unnecessary during lactation?
- The estimates of vitamin E are underreported
| - Vitamin E deficiency in breastfed infants are extremely rare
96
How is the phylloquinone content influenced by the administration of pharmacological doses of vitamin K? How is it influenced by the typical diet?
- Increased with pharmacological doses
| - The typical diet has little effect on phylloquinone content in maternal milk
