Chapter 3: Preconception Nutrition II

Question 1

Preconceptional Period

Answer 1

The time period around conception, variously measured in weeks or months depending on the pregnancy outcomes of interest.

Question 2

Premenstrual Syndrome

Answer 2

A condition occurring among women of reproductive age that includes a group of physical and psychological symptoms with onset in the luteal phase and subsiding with menstrual bleeding. Incidence about 15-25% of women. Dx: when a woman displays 1-5 of the common PMS sx during the luteal phase of her cycle for two consecutive cycles. A standardized questionnaire is used to determine the dx.

Question 3

Luteal Phase

Answer 3

The second half of the menstrual cycle that occurs after ovulation.

Question 4

Serotonin

Answer 4

A neurotransmitter derived from the amino acid tryptophan that affects nerve cell activities that excite or inhibit various behaviors and body functions. It plays a role in mood, appetite regulation, food intake, respiration, pain transmission, blood vessel constriction, sleep and other body functions.

Question 5

Insuline Resistance

Answer 5

A condition in which cell membranes have reduced sensitivity to insulin so that more insulin than normal is required to transport a given amount of glucose into cells.

Question 6

Metabolic Syndrome

Answer 6

A constellation of metabolic abnormalities that increase the risk of heart disease, hypertension, type 2 diabetes, and other disorders. Metabolic syndrome is characterized by insulin resistance, abdominal obesity, high blood pressure and triglycerides levels, low levels of HDL cholesterol, and impaired glucose tolerance.

Question 7

Anovulation

Answer 7

The absence of ovulation.

Question 8

Chronic Inflammation

Answer 8

Low-grade inflammation that lasts weeks, months, or years. Inflammation is the first response of the body’s immune system to infections agents, toxins, or irritant. It triggers the release of biologically active substances that promote oxidation and other reactions to counteract the infection, toxin, or irritant. A side effect of chronic inflammation is that is also damages lipids, cells, and tissues.

Question 9

Polycystic Ovary Syndrome

Answer 9

A condition in females generally characterized by insulin resistance, high blood insulin levels, obesity, polycystic ovaries, menstrual dysfunction, amenorrhea, infertility, hirsutism, and acne.

Question 10

Luteinizing Hormone (LH)

Answer 10

A hormone produced by the pituitary gland that stimulates ovulation, the development of the corpus luteum (which secretes progesterone), and the production of testosterone in males.

Question 11

Follicle Stimulating Hormone (FSH)

Answer 11

A hormone produced by the pituitary gland that stimulates ovarian follicle growth and maturation, estrogen secretion, and endometrial changes characteristic of the first portion of the menstrual cycle in females. It stimulates sperm production in males.

Question 12

Amenorrhea

Answer 12

Absence of menstrual cycles.

Question 13

Sex Hormone Binding Globulin (SHBG)

Answer 13

A protein that binds with the sex hormones testosterone and estrogen. These hormones are inactive when bound to SHBG, but are available for use when needed. Low levels of SHBG are related to increased availability of testosterone and estrogen in the body.

Question 14

Gonadotropin Releasing Hormone (GnRH)

Answer 14

A hormone produced in the hypothalamus that is responsible for the release of FSH and LH by the pituitary.

Question 15

Hypothalamic Amenorrhea

Answer 15

A condition characterized by cessation of menstruation due to changes in hypothalamic signals that maintain ovulation. Changes in hypothalamic function appear to be triggered by an energy deficit. Reduced GnRH secretion which causes lower FSH and LH and reduced estrogen secretion.

Question 16

Female Athlete Triad

Answer 16

A condition marked by the simultaneous presence of an eating disorder, menstrual dysfunction, and osteoporosis in otherwise healthy female athletes. It is characterized by the interrelated factors of energy deficit, menstrual dysfunction, and loss of bone mineral density.

Question 17

Anorexia Nervosa

Answer 17

An eating disorder characterized by extreme weight loss, poor body image, and irrational fears of weight gain and obesity. Causes amenorrhea related to change in GnRH release and low estrogen levels. Conception is rare and it can take a long time after successful intervention for regular cycles to return

Question 18

Bulimia Nervosa

Answer 18

An eating disorder characterized by recurrent episodes of rapid, uncontrolled eating or large amounts of food in a short period of time. Episodes of binge eating are followed by compensatory behaviors such as self-induced vomiting, dieting, excessive exercise, or misuse of laxatives, to prevent weight gain. Causes oligomenorrhea, amenorrhea, irregular cycles, and infertility.

Question 19

Teratogenic

Answer 19

Exposures that produce malformations in embryos or fetuses.

Question 20

Congenital Abnormality

Answer 20

A structural, functional, or metabolic abnormality present at birth. Also called congenital anomalies. These may be caused by environmental or genetic factors, or by a combination of the two. Structural abnormalities are generally referred to as congenital malformations, and metabolic abnormalities as inborn errors of metabolism.

Question 21

Type 1 Diabetes

Answer 21

A disease characterized by high blood glucose levels resulting from destruction of the insulin-producing cells of the pancreas.

Question 22

Type 2 Diabetes

Answer 22

A disease characterized by high blood glucose levels due to the body’s inability to use insulin normally, or to produce enough insulin.

Question 23

Glycemic Index (GI)

Answer 23

A measure of the extent to which blood glucose levels are raised by consumption of an amount of food that contains 50 grams of CHO compared to 50 grams of glucose.

Question 24

Autoimmune Disease

Answer 24

Diseases that result from a failure of an organism to recognize its own constituent parts as “self”. The organism attempts to defend itself from the perceived foreign substance through actions of its immune system. These actions can damage molecules, cells, tissues, and organs.

Question 25

Phenylketonuria (PKU)

Answer 25

An inherited error in phenylalanine metabolism most commonly caused by a deficiency of phenylalanine hydroxylase, which converts the essential amino acid phenylalanine to the nonessential amino acid tyrosine.

Question 26

Premenstrual Dysphoric DIsorder (PMDD)

Answer 26

A severe form of PMS that occurs in about 5% of women. Most have greater than 5 sx and experience them intensely with accompanying anxiety, depression, or dramatic mood changes.

Question 27

PMS Treatment

Answer 27

Decreased caffeine which is known to cause increased severity. Exercise can decrease symptoms. Ca supplements of 1200 mg qd can cause improvement if taken for more than 3 cycles. Vit B6 may decrease depression.

Question 28

Obesity Effects in Men

Answer 28

Decreased testosterone, LH, FSH levels.
Higher estrogen levels.
Decreased sperm count/motility and negative changes in morphology.
Increased susceptibility to inflammation and oxidative stress which can cause impaired sperm function/motility.

Question 29

Obesity Effects in Women

Answer 29

High testosterone levels.
Decreased sex Hormone Binding Globulin levels.
Increases risk of metabolic syndrome and insulin resistance.
Irregular or anovulatory cycles.
Central obesity is positively correlated with reduced fertility.
Oxidative stress and inflammation.

Question 30

Nutritional Goals for Eating Disorders

Answer 30

Multidisciplinary care yielding healthful eating patterns and attitudes and stable weight at a reasonable level.

Question 31

Type 1 Diabetes Intervention Goals

Answer 31

Careful family planning and an individualized nutrition plan. Achieve tight BG control 3-6 months before attempting conception because high BG levels in the first two months of pregnancy are teratogenic and creates a higher risk of pelvis, heart, CNS abnormalities and miscarriage.

Question 32

Type 2 Diabetes Intervention Goals

Answer 32

Blood sugar control
Weight loss if appropriate
Establish regular physical activity
Change diet to promote BG homeostasis and heart health
Encourage whole grains, low GI foods, low-fat meat and dairy, fish, dried beans, nuts, and seeds

Question 33

PCOS and Nutrition

Answer 33

Primary goal is to increase insulin sensitivity. Weight loss if appropriate through diet and daily exercise. Individualized diet that often includes: nonfat dairy and other lean protein, low GI foods, high in fiber and antioxidants, regular mealtimes are encouraged, adequate vitamin D, and 5-10% weight loss yields improvement.

Question 34

Nutrition Intervention for PKU

Answer 34

A diet low in phe is CRITICAL prior to, and during pregnancy. Elevated maternal phe can cause MR and microcephaly in the baby. Elevated levels in the first 8 weeks increased the risk of heart defects. Goal is to achieve maternal levels between 120-360. Supplemental 200mg DHA daily.