Adolescent, maternal and Women's Health 2

Question 1

How does diet and how we eat (mindful eating) affect metabolism, gut microbiome, gut brain axis and immunity

Answer 1

Metabolism
- Food broken down to useable
compounds (LMAP1)
- Hormone regulation

Gut microbiome
- Interacts with:
CNS & ENS
- Immune system
- Vitamin and metabolite production
- Plays a role in appetite

Gut-brain axis
- Bi-directional communication
between CNS and ENS.
- Stress-mediated responses in gut
physiology, epithelial function and
motility (via vagus nerve and
cytokines in the blood stream)
- Mood and mental state also alters
the above. 

Intestinal permeability
- Increases with poor diet and stress LPS’s into blood stream

Question 2

How does gut microbiome change in diversity across life course

Answer 2

Gut microbiome rapidly changing in early years

Gut microbiome relatively
stable though affected by
external factors.
If chronic insult /
repeated can cause
harm.
external factors: breastfed, hospitalisation, care home, mode of birth delivery, diet, geography, drugs such as antibiotics, lack of sleep, physical activity 

Microbiome
becomes
less diverse
and more
unstable with
age

Question 3

lifestyle prescription for eating in pregnancy

Answer 3

Eat - eg. recommend to make time for meal and stop skipping meals (mindful eating) - packed lunches

• advise against too much caffeine in pregnancy
• health start vouchers for pregnant woman - milk, frozen fresh fruit and veg and vitamins, meal planning, increases water consumption with good water bottle, balanced meal an healthy snacks, eat dinner without devices

Question 4

Key points

Answer 4

a. Health impacts of the gut microbiome, gut-brain axis and intestinal permeability
highlight the role of diet beyond meeting nutritional requirements across the life
course.
b. Information from a patient’s typical day can offer key insights into lifestyle behaviours
that can be addressed during a consultation to improve maternal and child health
outcomes.
c. The symptom web aims to capture key biological, social and lifestyle determinants of
a patient’s health.
d. Applying the ‘How, What, When?’ principle to the four pillars can help to tailor the
prescription to an individual’s lifestyle.

Question 5

lifestyle prescription for movement in pregnancy

Answer 5

Move - yoga, cutting morning routine, walk more, CMO guidelines for physical activity, strength. exercises, talk test, incremental increases

Question 6

lifestyle prescription for relax in pregnancy

Answer 6

night, connect with social networks, mindful eating, time for hobbies, social community classes