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Clinical Nutrition > Epigenetics > Flashcards

Epigenetics Flashcards

1
Q

general facts about epigenetis

A

plays an important role in early environment
may predispose someone to future diseases
involved in cancer, metaboli syndrome, CVD and autoimmune disease
in utero diet reshapes the genome

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2
Q

epigenetics are controlled by

A

methylation of DNA
tissue-specific chromatin alternation
nucleosome positioning of DNA
non-coding RNA, including miRNA

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3
Q

dutch hunger winter effects made those who were in gestation during that time are more prone to..?

A 
more obesity
dyslipidemia
early onset CAD
higher BP
hypomethylation at IGF2 gene
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4
Q

maternal under or overnutrition programs makes infant predisposed to..?

A 
heart disease
stroke
diabetes
obesity
hypertension
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5
Q

prenatal stress increases the risk of..?

A 
preterm birth
reduced birth weight
adult obesity
ADHD
type 1 diabetes
schizophrenia
autism
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6
Q

stress epigenetics are transgenerational, what does this mean?

A

they are passed down for at least 2 generations before they fade

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7
Q

maternal anxiety, stress, diet, increased methylation of 11beta-HSD2 leads to what?

A

increased fetal cortisol

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8
Q

what does mother do that causes baby to have higher cortisol?

A 
calorie restriction
low protein
high fat
high sugar
low magnesium
low choline
low folate
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9
Q

things that cause unhealthy epigenetic alterations?

A 
excess oxidation and free radicals
tobacco
excess alcohol
physiological stress
shiftwork
chronic inflammation
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10
Q

things that cause healhty epigenetic alterations?

A

polyunsaturated fats
fruits and veggies
folate and vitamin b12
selenium

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11
Q

if a pregnant woman is having heartburn, what shoud you recommend?

A

eat smaller meals, limit caffeine and carbonated beverages

stay upright for >3hours after eating

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12
Q

if a pregnant woman is nauseous or vomiting, what should you recommend?

A

small, frequent carb-containing meals
possibly ginger
smelling lemons may block noxious odors

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13
Q

hypertension increases the risk of what?

A

increases risk of preeclampsia
modified DASH diet
possibly Ca and Mg suppleents

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14
Q

how can you help a pregnant woman with legs cramps and edema?

A

increase fluid intake
stretch with toes pointed toward body
possibly Mg supplements

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15
Q

if a woman is craving ice chips, what does that mean?

A

iron deficiency

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16
Q

should a woman restric a food if they’re not allergic?

A

no

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17
Q

what should you avoid during pregnancy to not get listeria?

A

avoid unpasteurized products (including soft cheeses)
do no eat salads from store
reheat meat to steam (avoid deli meat))

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18
Q

what kind of meat should you avoid during pregnancy?

A

shark, swordfish, tilefish and king mackerel

albacore limited to 6oz a day

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19
Q

what supplements should pregnant women take?

A

folic acid
iron
copper
iodine

20
Q

summary of nutrition care during pregnancy

A
  1. Include a variety of food, including nutrient dense choices
  2. Energy to allow appropriate weight gain
  3. Protein intake around 20% of energy
  4. DHA from fatty, low mercury fish, twice/week
  5. Micronutrient intake to meet RDA (folic acid and iron supplementation may be necessary)
  6. Sodium intake that is not excessive, but not <2300 mg/d
  7. Sufficient fluid to produce dilute urine
  8. Avoid alcohol
  9. Avoid toxins and nonnutritive substances in food, water & environment
21
Q

dairy during pregnancy

A

all types of cow’s milk contain the same levels of protein, calcium and vitamin D

22
Q

vegetarians during pregnancy

A

need good sources of protein, iron, calcium and B12

23
Q

nutrients that normalized after delivery

A

zinc, thiamin, vitamin A, B6, B12

24
Q

nutrients that are normalized 2-4 months postpartum

A

iron

25
Q

nutrients that are normalized >6months postpartum

A

folate

26
Q

do you have to eat the placenta to regain your iron?

A

no

27
Q

what is the recommended spacing between babies?

A

18-24 months

28
Q

what is the recommendations for breastfeeding?

A

breastfeed exclusively for first 6 months

breastfeed through first year and supplement with complementary foods

29
Q

what are the extra calorie requirements for breast feeding?

A

0-6months= +330 cal/d
>6months= +400 cal/d
this is if sedentary

30
Q

what are the protein requirements for breast feeding?

A

1.1 g/kg of current body weight

c sections might need more

31
Q

carb requirements for breast feeding

A

210g/day to prevent ketosis

fiber= 28g/day

32
Q

lipid requirements for breast feeding

A

non set
omega 6= 13 g/day
omega 3= 1.3 g/day

33
Q

vitamin D during breast feeding

A

limited amount in breastmilk

supplement infant with 400 IU drops from birth or supplement mother with >6000 IU/d

34
Q

iodine during breast feeding

A

may require supplementation of 150 mc/d as potassium iodide

35
Q

zinc during breast feeding

A

supplementation does not affect breast milk unless ditary intake is really low

36
Q

B12 during breast feeding

A

supplement infant if mother is vegan

37
Q

caffeine in breast feeding

A

small amounts are okay if breastfeeding a full-term infant

limit if a premie

38
Q

colostrum

A

0-5 days
rich in antibodies, fat-soluble vitamins, electrolytes
high protein (80:20 ratio of casein to whey)

39
Q

transition milk

A

5-14 days postpartum

protein drops in lactos and fat increase

40
Q

mature milk

A 
2 weeks+
55:45 ratio of casein to whey
40% of energy as lactose
fat level varies by maternal intake
vitamin content varies with stage of lactation and diet; mineral content is not influenced by diet
41
Q

what kind of antibody is secreted most in humans?

A

IgA

42
Q

foremilk

A

first milk secreted during feeding
high in water, carbs and water-soluble vitamins
low in fat
usually first 10-15 min of feeding

43
Q

hindmilk

A

high-fat milk secreted after foremilk
infant must nurse long enough of each breast to get hind milk- if not they get too many carbs (gas) and not enough fat (less satiety)

44
Q

milk production stimulants (foods)

A

oats, barley, beans, almonds

dark green leafy veggies, apricots, dates, figs

45
Q

milk production stimulants (herbals)

A

fenugreek, milk thistle
anise, caraway, dill, fennel
alfalfa, nettle, goats rue

46
Q

milk production stimulants (meds)

A

motilium

reglan

47
Q

productive diet for postpartum depression

A 
omega 3s
folate
riboflavin
B6
B12
D
calcium
iron
selenium

Clinical Nutrition (19 decks)

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