I L: Lifespan, athletics, BDS Flashcards
weight gain guidelines for pregnancy: underweight***
(BMI <18.5) 28-40#
weight gain guidelines for pregnancy: normal weight***
(BMI 18.5-24.9) 25-35#
weight gain guidelines for pregnancy: overweight***
(BMI 25-29.9) 15-25#
weight gain guidelines for pregnancy: obese***
(BMI >= 30) 11-20#
target for weight gain during pregnancy***
at least achieve the lower limit
who should strive to achieve upper end of weight gain during pregnancy to reduce risk?
black and very young women
calories during pregnancy –>
+ 340 = 2nd trimester
+ 452 = 3rd trimester
calories during lactation –>
\+330 = 1st 6 months \+400 = 6-12 months
protein needs during pregnancy and lactation –>
71g during second half of pregnancy and lactation
minimum recommended levels of hemoglobin and hematocrit –>
- hgb = 11 g/dL
- hct = 33%
weight gain timeframe***
1#/month for the first three months; 1#/week thereafter
who is at risk during pregnancy?*** (3)
1) failure to gain 4 lbs (1.8kg)/month in last half of pregnancy
2) <16 or >= 35 y/o
3) <12 months between pregnancy
who is most at risk during pregnancy?***
YOUNG teenager
a pregnant adolescent is high risk and needs…?
extra Fe, Ca, Zn
alcohol during pregnancy? is wine OK?***
NO –> NO ALCOHOL
supplements for pregnancy
- ferrous sulfate: 30 mg during 2nd & 3rd trimester
- folic acid: 400 mcg (added to 200 from foods = 6000
when should a ferrous sulfate supplement be taken?
between meals, not with milk, tea, or coffee
AI calcium for pregnancy and lactation
- <=18 y/o: 1300 mg
- >18 yo: 1000 mg
what is progesterone?**
hormone that develops placenta after implantation
what role does linolenic acid play in pregnancy?***
needed for DEVELOPMENT OF FETAL NERVOUS SYSTEM
normal birth weight is?***
2500-4000 g
numbers for:
- low birth weight (LBW)
- very low birth weight (VLBW)
- extremely low birth weight (ELBW)
- low birth weight (LBW) = <2500 g
- very low birth weight (VLBW) = <1500 g
- extremely low birth weight (ELBW) = <1000 g
SGA vs. AGA vs. LGA
(small, appropriate, large: for gestational age)
SGA = <10th percentile
AGA = 10th - 90th percentile
LGA = >90th percentile
what is a neonate?
birth to one month
what type of protein can a neonate absorb?
whole, intact protein
calorie, protein, water, fat, height, length, weight parameters and guidelines –>
see p. I N 15 (probably DNK)
human milk has how many calories per ounce?***
20 kcal/ounce
role of prolactin? oxytocin?
- prolactin = stimulates milk production
- oxytocin = moves milk through ducts
colostrum
yellowish transparent fluid secreted from the breast during first few days
nutritional value of colostrum vs. mature milk**
- MORE protein, LESS fat and CHO
- HAS antibodies
how long is exclusive breast-feeding recommended for? then supplemented by weaning foods for how long?***
- exclusive breast feeding = 4-6 months
- weaning foods = at least up to 12 months
human milk vs. cow’s milk nutrition
- human milk = less protein, more CHO and FAT
- cow’s milk = more protein, less CHO and FAT
BREASTFED infants need what supplemental micronutrients?
- vitamin D
- fluoride after 6 months (IF WATER CONTAINS INADEQUATE FLUORIDE)
how do you know if milk supply is adequate?***
1) if infant gains WEIGHT & LENGTH
2) frequent stools
3) 6-8 WET DIAPERS/DAY
what is the Baby Friendly Hospital Initiative?***
global effort to increase INCIDENCE and DURATION of breast-feeding
infant formula has how many calories per ounce? how much is needed?**
- 20 kcal/ounce (same as human milk)
- 2.5 ounces/lb/day
nutritional value of infant formula vs. human milk
- infant formula = MORE protein + iron, but NO antibodies
supplemental/additional micronutrients for INFANT FORMULA fed babies
- vitamin D = MET if receiving 1 quart vit.D-fortified/day
- fluoride after 6 months if water supply is inadequate
what type of formula is recommended for all infants on formula?***
iron-fortified
unmodified cow’s milk in formula is…?
tough hard curd and inappropriate; hard to digest, increased renal solute load
casein hydrolysate (does/does NOT) have lactose***
DOES NOT
what is hyperbilirubinemia?
unconjugated bilirubin levels elevated within first week of life as a result of increased breakdown of RBCs or decreased intestinal mobility
treatment for hyperbilirubinemia***
9-12 feedings per day of human milk or formula to PROMOTE HYDRATION AND INTESTINAL MOTILITY
what happens to fetal iron stores at 3-4 months? what should be done?
decrease –> need additional iron, from formula or supplemental foods
when should solids be added?*******
4-6 MONTHS; WHEN SITTING POSTURE CAN BE SUSTAINED (HEAD & NECK UP) + EXTRUSION REFLEX DIMINISHES
extrusion reflex***
tongue pulling back
palmar grasp vs. pincer grasp***
- palmar = whole hand (ex: cookies)
- pincer = thumb and forefinger (ex: Cheerios)
when should large finger foods be added? when should small finger foods be added?
- large/palmar grasp = 6-8 months
- small/pincer grasp = 9-12 months
whole cow’s milk- when should it be given?***
AFTER FIRST YEAR OF LIFE- NO COW’S WHOLE MILK DURING FIRST YEAR OF MILK
what types of milk are inappropriate during the first 2 years of life?***
low fat and non-fat milks
for those who can not tolerate cow’s milk-based or soy products, what formula should be used?***
formula from a casein hydrolysate (Pregestimil –> remember, casein hydrolysate does not have lacose)
growth rates:
1-3 y/o
4-6 y/o
7-10 y/o
- growth slows = 1-3 & 7-10
- growth spurts = 4-6
limit fruit juice to _____ up to age ____***
4 ounces per day up to age 6
at least ______ of physical activity each day for children***
60 minutes/day
calcium for males and females ages 9-13
1300 mg AI
weight for length/stature is used for?***
SHORT-TERM WEIGHT (identifies stunting, wasting, over-nutrition, WNL nutrition)
stature/length for age is used for?***
LONG-TERM nutritional status; DETERMINES STUNTING, shortness/tallness
when should length be measured? stature or height?***
- length: 0-36 months
- stature/height: 2-20 years old
weight-for age is used for?***
NOT VERY USEFUL- does not include height, short-term marker of growth, not used for under/overweight
BMI-for-age starts at age?***
2 y/o
BMI-for-age percentiles***
- OBESE = >=95th
others but Jean says you don’t need to know: underweight <5th, normal 5th to 84th, overweight 85th to 94th
measure head circumference (occipital frontal circumference) until what age?***
3 years old
how long should you measure supine length (laying down)?***
until age 2
growth does not deviate by more than _____ from the established pattern of growth***
25 percentile points (within 25th percentile is OK, check again if more)
major reasons for large discrepancies in growth patterns is?***
human error in measurement
newborn inital 6% loss of birth weight should be regained by?
10-14 days
normal gestation is approximately?
40 weeks
adjusted age
chronologic age - correction factor of (40 weeks-number of weeks born at)
American Academy of Pediatrics - growth charts for Down syndrome***
growth charts to assess children with Down syndrome no longer reflect the population and SHOULD NOT BE USED
growth charts for other special needs are based on?***
SMALL populations
what are typical causes of failure to thrive (FTT)?***
- ILLNESS, DIET, poor appetite
- **LACK OF FIBER leading to CHRONIC CONSTIPATION, DIMINISHED INTAKE
lead poisoning symptoms***
irritability, lethargy, anorexia, vomiting, diarrhea, anemia
RDA for protein:
- > = 19 y/o males
- females
- M >= 19: 56g
- F: 46g
AMDRs
45-65% CHO, 20-35% FAT, 10-35% PRO
AI for fiber <50 y/o: M & F
M = 38g, F = 25g
AI for fiber >50: M & F
M = 30g, F = 21g
fluid needs for adults***
35 mL/kg or 1 mL/kcal ingested
AI for fluids**
M = 3.7 L/day
F (older than 19) = 2.7 L/day
sodium AI for men and women 19-50
1.5g /day
AI for linolenic acid and linoleic acid
linolenic acid = 1.6 M, 1.1 F
linoleic acid = 17 M, 12 F
ages for:
- young old
- aged
- oldest old
- young old = 65-74
- aged = 75-84
- oldest old = 85 and older
kcal and protein needs for elderly
kcal decreases, protein remains the same
elderly often lack what micronutrients?***** (5)
Ca & Fe (decreased absorption due to decreased HCl); B6, B12, folate
why is constipation usually a problem for elderly?
less gastric motility, less HCl secretion in stomach
athletes water needs during PA***
16 ounces water for every 1# body weight lost
hydration recommendations before activity
LIMITED research = 10 mL/kg of a high sodium containing beverage prior to activity 1-4 hours long
refueling recommendations for during and after continuous physical activity (1-4 hours)**
need FLUID, CARBS, SODIUM
compared to during the activity, how much sodium is needed to restore hydration after exercise in athletes?***
MORE sodium than during
carbohydrate loading
store 2-3 times normal amount of muscle glycogen
adverse effects of CHO loading
weakness, bloating, dizziness, soreness
at rest and during normal activities, what are the primary energy sources?***
FATS
during low to moderate intensity aerobic activity (long duration, steady pace…i.e. endurance training), what is a significant energy source?
fat
what is needed as a fuel source for exercise above 60-65% maximal oxygen uptake?
CHO
during PROLONGED exercise, reliance on what nutrient? why?**
CHO –> to provide PYRUVATE for continued lipid oxidation
how long is it before muscle glycogen is depleted?
2-3 hours of continuous exercise at 60-80%
creatine supplements**
DO NOT enhance endurance (NOT helpful for marathon runner, soccer player)
herbals, botanicals, and supplements are regulated by>
DSHEA: Dietary Supplement Health and Education Act
botanicals - claims on the label
physiological effect can be noted, but no claims about prevention or cure of specific conditions can be made
BDS that have blood clotting as a potential issue**
- black cohosh (menopause)
- garlic (decrease cholesterol, BP)
- ginger (antiemetic)
- ginkgo biloba (vasodilation)
- ginseng (immunity, endurance)
- St. John’s Wort (antidepressive)
patients & supplement usage
ask about their supplement usage, make sure they do not combine drugs and herbs with similar actions or exceed recommended dosages
BDS and use —>
see chart p. I N 20 (may not need to know)
