Guidance For The Pregnant Athlete Flashcards
Define infecundity and infertility
Infecundity: unable to get pregnant or carry child to term
Infertility: inability to get pregnant after 12 months of trying
What are benefits of exercise for pregnant athletes
Lower maternal weight
Decreased odds of cesarean delivery
Reduce odds of a large newborn, without altering risk of having a small newborn
What is vigorous intensity physical activity defined as
6.0 metabolic equivalents of training
60-84% of aerobic capacity reserve (or heart rate reserve)
Signs stress may be too high in the pregnant athlete
Low energy availability
Menstrual dysfunction
Low bone mineral density
Substantial loss of weight
BMI less than 18.5
Body fat <12%
Elevated blood pressure
List adverse reproductive outcomes for those experiencing prepartum obesity
Gestational diabetes
Hypertension
Preeclampsia
Miscarriage
Caesarian delivery
Preterm delivery
Postpartum weight retention
Fetal growth disorders
Even a reduced energy availability of less than 45 kcal/kg of FFM in female athletes can lead to
Menstrual irregularities
Decreased bones mass
Slow metabolic rate
Trigger hypoglycemia
Elevate blood cholesterol
What diet is associated with a reduced risk of impaired ovulation
Plant based diet
What nutrient is linked to supporting infertility and what blood values are associated with a successful fertility
Trans fat
Folate and vitamin B6
The use of what has been linked with a 73% lower incidence of infertility in women
Prenatal vitamin likely due to improving ovarian function
List benefits of folate for pregnancy
Enhance ovarian response to internal gonadotropin resulting in enhanced ovulation and fertility
Reduced risk of miscarriage
Reduce risk for neural defects such as spina bifida and anencephaly
Reduce risk of congenital heart disease and cleft lip and palate
Fetal benefits of a mother who eats healthy and exercises
Decreased fat mass
Improved stress tolerance
Advanced neurobehavioral maturation
List symptoms of pregnancy
Unusual fatigue
Abnormal eating habits
Dyspnea
Nausea
Bouts of dizziness
Heartburn
Constipation
During what trimester(s) is fatigue most likely to be present
First and third trimesters
Second trimester is usually accompanied by an increase in energy
What is severe nausea and vomiting called
Hyperemesis gravidarum
What negative effects can hyperemesis gravidarum lead to
Intrauterine growth retardation
Childhood insulin resistance
Psychological disorders in adulthood
Treatment protocols for morning sickness
Eat small, frequent meals to avoid an empty stomach or feelings of hunger
Eat dry, salty, and bland foods such as crackers
Incorporate protein rich foods at each feeding
Use an electrolyte enhanced effervescent in water, homemade oral rehydration solution, or sports drinks to aid in rehydration in cases of vomiting
Use vitamin B6 up to 200 mg/day
Use ginger products up to 1000 mg/day
Treatments for constipation during pregnancy
Increase fluid intake
Be physically active
Increase fiber intake
Supplement fiber with adding 4-6 tablespoons of bran or a daily dose of psyllium, methylcellulose, or polycarbophil
Use probiotics such as bifodobacterium lactis
Treatment of GERD symptoms during pregnancy
Avoid acidic and spicy food, caffeine, carbonated beverages, chocolate, and peppermint
Limit intake of animal fats, plant based diets can help
Eat smaller, more frequent meals not close to bedtime
Wear loose fitting clothes
Medications include histamine 2 receptor antagonists, proton pump inhibitor, and antacids
Treatment for frequent urination during pregnancy
Reduce fluid intake before bedtime
Don’t resist the need to urinate
Wear a sanitary pad
Perform kegel exercises
Treatment options for musculoskeletal dysfunction during pregnancy
Physical therapy
Bracing or external support
Passive stretching and deep tissue massage
Inconclusive evidence to support the use of magnesium, calcium, and vitamin C
What is the increase in BMR for healthy and overweight/obese women along with recommended energy intake during the first, second, and third trimester
First trimester
Healthy BMI: 5%
Elevated BMI: 7% increase
Energy needs: 45 kcal/kg prepregnancy fat mass + energy exhausted during physical activity
Second trimester:
Healthy BMI: 11%
Elevated BMI: 16%
Energy needs: 45 kcal/kg prepregnancy fat mass + energy exhausted during physical activity + 340 kcal
Third trimester:
Healthy BMI: 24%
Elevated BMI: 36%
Energy needs: 45 kcal/kg prepregnancy fat mass + energy exhausted during physical activity + 452 kcal
What is the estimated overall energy cost from conception through delivery
75000-85000 kcal
What food and beverage options are allowed in low risk women in the active phase of labor and why
Small amounts of clear liquids and foods:
Water
Fruit juice without pulp
Broth
Gelatin products
Carbonated beverages
Tea and black coffee
Sports drinks
Ice pops
Reduce likelihood of ketone production leading to ketoacidosis
What are contraindications for providing food during labor
Eclampsia
Preeclampsia
Obesity
Use of opioids to manage pain
Carbohydrate recommendations for sedentary and moderately physically active women prepregnancy and pregnancy
Sedentary
Prepregnancy: 130 g/day carbs
Pregnancy: 175 g/day carbs
Moderately physically active
Prepregnancy: 5-7 g/kg/day carbs
Pregnancy: 5-7 g/kg/day + 45 g carbs
Protein recommendations for sedentary and physically active pregnant women
Sedentary women:
First trimester: 0.8 g/kg/day
Second and third trimester: 1.1 g/kg/day of prepregnancy weight or an additional 25 G protein for single pregnancies and 1.4 g/kg/day of prepregnancy weight or an additional 50 G protein for twins
Physically active women:
- Typically consuming 1.2-2.0 g/kg/day already
- Recommend to add 25 g for single pregnancies and 50 g for twins
What are daily fat, omega 3, and omega 6 recommendations for pregnancy
Daily fat: 20-35%
Omega 3: 1.4 g/day
Omega 6: 13 g/day
Iron recommendations during pregnancy
Daily
Ferritin greater than 70 ug/L
Ferritin between 31-70 ug/L
Ferritin between 15-30 ug/L
Ferritin less than 15 ug/L
Daily: 27 mg/day
Ferritin greater than 70 ug/L: no iron supplements
Ferritin between 31-70 ug/L: 30-40 mg ferrous iron/day
Ferritin between 15-30 ug/L: 60-80 mg ferrous iron/day
Ferritin less than 15 ug/L: 100 mg ferrous iron/day
Folate needs prepregnancy and pregnancy
Prepregnancy: 200 mcg/d
Pregnancy: 600 mcg/d
Foods high in folate
Asparagus
Avocado
Dried beans
Fortified grains
Green leafy vegetables
Oranges
Peas
RDA for vitamin b12 during pregnancy and food sources
2.6 mcg/day
Eggs, cheese, milk products, meat, fish, shellfish, poultry, soy foods, fortified grains
RDA for zinc in prepregnancy and pregnancy and what 2 populations are at risk for deficiency
Prepregnancy: 8 mg/d
Pregnancy: 11 mg/d
At risk: plant based dieters and low income
RDA for vitamin d prepregnancy and pregnancy
Prepregnancy: 10 mcg or 400 IU
Pregnancy: 15 mcg or 600 IU
List most common micronutrients associated with pregnancy issues if deficient
Folate
Choline
Vitamin B12
Vitamin D
Iron
Iodine
Zinc
Fluid requirements during pregnancy
3 L/day
What food or beverage products are contraindicated for use during pregnancy
Raw fish and shellfish
Seafood with high mercury content
Undercooked meat and poultry
Raw or soft cooked eggs
Unpasteurized foods
Unwashed fruits and vegetables
Raw sprouts
Caffeine
Alcohol
Dietary supplements
List foods or food products containing raw or undercooked eggs
Eggnog
Custard
Cookie dough
Cake batter
Hollandaise
Mayonnaise
Caesar salad
List raw sprouts
Alfalfa
Clover
Radish
Mung beans
List unpasteurized soft cheeses
Queso
Camembert
Brie
Feta
Blue cheese
Recommendation for caffeine intake during pregnancy and hidden sources of caffeine
Less than 200 mg/day
Guarana
Yerba mate
Kola or kola nut
Cocoa
Citrus aurantium (bitter orange)
How does caffeine, alcohol, and certain dietary supplements reach the fetus
By crossing over the placenta
Singleton weight gain recommendations per IOM and American College of Obstetricians and Gynecologists
Underweight athlete
Healthy BMI
Overweight BMI
Obese BMI
Underweight athlete: 28-40 lbs
Healthy BMI: 25-40 lbs
Overweight BMI: 15-25 lbs
Obese BMI: 11-20 lbs
Twin pregnancy weight gain recommendations per IOM
Healthy BMI
Overweight BMI
Obese BMI
Healthy BMI: 37-54 lbs
Overweight BMI: 31-50 lbs
Obese BMI: 25-42 lbs
Rate of weight gain for pregnant women in second and third trimester
Healthy BMI
Singleton
Twins
Overweight
Obese
Healthy BMI
Singleton: 1 lb/week
Twins: 1.5 lb/week
Overweight: 0.6 lb/week
Obese: 0.5 lb/week
What is mean milk production and energy cost of it
Mean milk production: 749 g/day or 26 oz/day
Energy cost: 453 kcal/day or 17 kcal/oz
Daily energy recommendations for breastfeeding women
45 kcal/kg of FFM/day + 300-500 kcal/day + physical activity energy expenditure
Recommended weight loss postpartum should not exceed
4.5 lbs/month
