Life Cycle Flashcards
1
Q
Timing of intro of solid foods in infancy
A
Depends on neurologic development, food allergenicity and gastro tolerance. Solids not recommended before 9-12mos
2
Q
Major growth phases in children
A
0-2yrs infancy 2-10 yrs childhood 10-12 yrs puberty
3
Q
Nutritional impact of adolescent transitions
A
Start eating with peers susceptible to dietary fads that may exclude food groups Meal patterns become erratic Snacking is common Fitness pursuit can lead to weight cycling, focus on performance improvement Girls concerned with weight and body image and can lead to disordered behavior
4
Q
Adolescent conditions exacerrbated by poor nutrition
A
- High sucrose intake may contrib to periodontal disease 2. Growth spurt induced changing nutrition requirements and assoc peer pressures may promote obesity 3. Substance abuse may lead to malnutrition 4. Acne worsened by zinc defish 5. Osteoporosis may be mitigated by increase calcium intake and activity 6. Dietary influence on hyperlipidemia and hypertension are risk factors for later diease 7. Erratic eating impacts control of T1D
5
Q
Risk factors for nutrient deficiencies in adults
A
- inadequate / unbalanced food intake 2. food fadism 3. use of meds or drugs inc alcohol 4. malabsorptive disease states 5. enteral or parenteral nutrition support 6. Renal dialysis 7. Behavioral disorders 8. Protein-energy malnutrition
6
Q
Total energy cost of pregnancy (requirement?)
A
between 80k and 110k Kcals. 300-400 per day
7
Q
Total protein cost of pregnancy requirement?)
A
1500g or 6/g/day
8
Q
Energy requirement of lactation
A
6 months = 115,000 kcal or 650kcal / day
9
Q
Protein requirement of lactation
A
6 months = 2700g or 15g/day
10
Q
Common nutrient deficiencies in elderly
A
Calories, calcium, iron, mangesium, folate, thiamin, riboflavin, vitamin B6, vitamin B12, Vitamin C, and Vitamin D
11
Q
Common changes in body composition in elderly
A
Loss of lean body mass Loss of bone density Gain of adipose tissue (linked to atherosclerosis, hypertension, T2D, cancer, osteoporosis
12
Q
Determinants of nutritional status in elderly
A
Loss of spouse Retirement Social Isolation Disabilities that interfere with shopping and meal prep Economic status Medication induced nutritional defish Oral status (edentia, periodontitis, hypogeusia
13
Q
Focus of nutritional biochem in elderly
A
Hemoglobin and albumin. Low hemo and low hetamocrits (volume of red blood cells in blood) are common. (occur in assoc with reduced hematopoiesis, chronic inflammation, low serum folate concentration or iron defish anemia.
14
Q
Elderly protein requirements
A
May need a lower set point than younger adults DIetary protein usually ineffective in increasing serum albumin in elderly Serum albumin of <3.5g/dL is indicative of malnutrition
15
Q
How nutritional reqs for the elderly vary
A
- Requirements for riboflavin, Vitmin B6, Vit B12 and D should increase 2. Vitamin A may be set too high 3. Calcium reqs should increase
16
Q
Fetal origins of disease or Developmental Origins of Health and Disease
A
the quality of nourishment throughout gestation and then neonate, then adult as one explanation for disease that manifest in adulthood
17
Q
Fertility: women with BMI less than 20
A
Risk for anovulation (extremes either way and for men and women may effect fert)
18
Q
Fertility and Vit D deficiency
A
- Women: may be associated with insulin resistance in PCOS 2. Men: lower testosterone andlower sperm quality
19
Q
Male fertility and calcium
A
Important for spermatogenesis, motility, hyper activation and acrosome (digestive enzymes that break down outside of ovum)
20
Q
Healthier sperm counts assoc with these micros
A
zinc, folic acid, antioxidants , avoidance of tobacco and alcohol
21
Q
Recommendations for improved male fertility include
A
eating a higher fiber, lower glycemic index (including high-fat dairy products and monounsaturatedfats, but reducing trans fats) and lower animal protein diet, in addition to obtaining iron from plant sources, consuming a multivitamin daily, and being moderately physically active
22
Q
Nutrients important for Brain and Nervous sys development in preconception period:
A
Iron, zinc, iodine, LCPUFA, vitamins A, B6, B12, folic acid, copper, protein, selenium
23
Q
Nutrients important for Placental function and structure
A
Iron, LCPUFA, vitamins E, C, B12, zinc, selenium, copper, omega-3 PUFA, folate
24
Q
Nutrients important for Inflammation and immune function
A
Vitamins A, D, zinc, fatty acids
25
Nutrients important for oxicative stress
Vitamins C, E, B6, B12, folic acid
26
Nutrients important for embryogenesis
Vitamins A, B6, B12, folic acid, zinc
27
No increased risk of miscarriage has been seen with caffeine consumption less than :
200 mg/day
28
Rec DHA intake during pregnancy and lactation
200mg (low mercury seafood is pref to supps)
29
30
31
FETUS- Nutrients for Brain Development
Long-chain polyunsaturated fatty acids, primarily DHA and AA
Function:
Cell membrane formation, myelin, synaptosomes, intracellular communication, signal transduction
Negative effect of deficiency:
Neurodevelopment, visual development
32
**Nutrient:**
Protein
**Function in Brain Development:**
Neuronal and glial structural proteins, synaptic structures and numbers, neurotransmitter peptide production, especially in cerebellum, hippocampus,and cerebral cortex
**Effect of Deficiency**
Overall central nervous system growth, neurodevelopment
33
Fetal Brain Development
Nutrient: Zinc
Function in Brain Dev
Cofactor in enzymes mediating protein and nucleic biochemistry,
growth, gene expression, neurotransmitters, especially affecting cerebellum, limbic system, cerebral cortex, temporal lobe, frontal lobe
Effect of Defish:
Attention, motor development delays,short-term memory, brain growth
34
Fetal Brain Dev
Nutrient: Iron
**Function in Brain Dev**
Myelination, dendritogenesis, synaptogenesis, neurotransmission,
especially in the hippocampus, striatum, frontal cortex
Effect of Defish:
Global intelligence, general motor development, neurodevelopment, attention, memory, language, auditory recognition
35
Fetal Brain Dev
Nutrient: Choline
Function in Brain Dev:
Methylation, myelin, neurotransmitters, especially affecting hippocampus, septum, striatum, anterior neocortex, midposterior neocortex
Effect of Defish:
Visual spatial and auditory memory in rodents
(no information yet available for humans)
36
Fetal Brain Dev
Nutrient: Copper
Function in Brain Dev
Iron transport, antioxidant activity, neurotransmitter synthesis, neuronal and glial energy metabolism, especially affecting cerebellum
Effect of Defish:
Motor control, cognitive function
37
Fetal Brain Dev
Nutrient: Iodine
Function in Brain Dev:
Thyroid synthesis, neuronal synthesis, myelination
Effect of Defish:
Cognitive function
38
Fetal Brain Dev
Nutrient: Vit A
Function in Brain Dev
Structural development, antioxidant
Effect of Defish:
Visual Function
39
Fetal Brain Dev:
Nutrient: Folate
Function in Brain Dev
One-carbon metabolism
Effect of defish:
Neural tube development
40
Pregnancy
Metabolism increases by _____ in a singleton pregnancy
15%
41
Pregnancy
The DRI for energy increases by ______ during the second tri and _____ during the 3rd tri
340kcal and 452kcal
42
Pregnancy
Protein req's in the second half of preg increase to
1.1 gm/kg/day
43
Pregnancy
For a singleton pregnancy the protein requirement in the second half of preg is \_\_\_\_\_. For each additional fetus this increases by\_\_\_\_.
1.1 gm/kg/day and 25g/day per addt'l fetus
44
Pregnancy
Protein should be \_\_\_\_% of total calories during pregnancy
20% (WHO recs 23%) Higher amounts (30-35 can result in adverse outcomes)
45
Pregnancy
The RDA for carbohydrates _____ slightly, helping maintain
appropriate blood glucose and prevent ketosis
Increases
46
Pregnancy
The DRI for fiber during pregnancy is \_\_\_\_\_\_\_\_\_
and, if met, will help a great deal in managing the constipation
that often accompanies pregnancy.
14 g/day/1000 kcal
47
Pregnancy
Recommendations for omega-6 PUFA (linoleic acid) and omega-3
PUFA (alpha-linolenic acid) \_\_\_\_\_\_\_slightly. Although not a
DRI, the recommended intake of docosahexaenoic acid (DHA)
is \_\_\_\_\_\_\_and can be met by one to two portions of fish per
week
increase, 200 mg/day
48
Pregnancy
The RDA for dietary \_\_\_\_\_\_equivalents increases
to support maternal erythropoietin. (production of red blood cells)
Folate
49
Pregnancy
Low folate levels are associated with
miscarriages, LBW, and preterm birth.
Early maternal folate deficiency is associated with: congenital malformations, including NTDs (including spina bifida and anencephaly), and possibly orofacial clefts and congenital heart defects
50
Pregnancy
Folica acid in the amount of \_\_\_\_\_\_\_/day is recommended for all women of child bearing age in anticipation of pregnancy (neural tube closes by day 28)
400mcg/day
51
Pregnancy
For women with previous NTD affected pregnancies up to ______ of folate is recommended
4000 mcg/day
52
Pregnancy
\_\_\_\_\_ taken with folate may be beneficial to those with the \_\_\_\_\_\_\_SNP.
Riboflavin, MTHFR
Folate and riboflavin interact to lower plasma tHcy, possibly by maximizing the catalytic activity of MTHFR.
53
Pregnancy
Possible adverse effects of supplementing folate in high doses
masking of vitamin B12 deficiency, tumor promotion, epigenetic hypermethylation, interference with antifolate treatments, and an increase in miscarriages and multiple births.
54
Pregnancy
25mg of ________ may/may not be helpful for nausea but does not appear to be dangerous
B6- Pyridoxine
55
Pregnancy
Deficiencies in B12 and folate may effect
Infant cognitive and motor development
Growth
Risk of NTDs
56
Pregnancy
Choline and Folate support
Fetal brain development
lower risk of NTD
Lower risk of orofacial clefts
Choline also appears to be important in placental functioning
and may affect maternal and fetal responses to stress.
57
Preg
The DRI for Choline increases or decreases in pregnancy
Increases slightly
58
Preg
DRI for Vitamin C increases/decreases in preg...
increases during pregnancy
and may be even higher for those who smoke, abuse alcohol
or drugs, or regularly take aspirin.
59
Preg
Defish in Vit C in pregnancy are associated with
pre term labor
60
Preg
Supplementing Vit C is not advised because
However supplemental vitamin C is not recommended
for the prevention of premature rupture of membranes
(PROM). Supplementation with vitamin C (1000 mg) along
with vitamin E (400 IU) also is not recommended for prevention
of preeclampsia (ACOG, 2013e) and actually may increase
risk of gestational hypertension and PROM (Dror and Allen,
2012). Vitamin C is actively transported across the placenta, so
there is also potential for excessive levels in the fetus
61
Preg
Vitamin A is critical for
rapid
growth, important in cellular differentiation, ocular development,
immune function, and lung development and maturity, as
well as gene expression
62
Preg
Low levels of Vit A are associated with
IUGR and increased risk of maternal and
neonatal mortality.
63
Preg
Excess preformed Vitamin A is \_\_\_\_\_\_\_\_\_\_
Detrimental to fetal growth and formation.
The acne medication isotretinoin is a vitamin A analog, and
exposed infants are at extremely high risk for fetal anomalies
and miscarriages. Women should stop its use for at least
1 month before conception.
64
Preg
Vit D needs in pregnancy increase/decrease/stay the same
Stay the same, Intakes of 600IU per day are sufficient
dietary sources of vitamin D are salmon and other fatty
fish, as well as some fortified breakfast cereals and mushrooms
exposed to UV light.
65
Children
More than \_\_\_\_% of children go to bed hungry and over _______ (fraction) are obese
a. 20
b. 1/3
66
Adolescence
During growth spurts current recommended allowances increase for the follwing
calcium, zinc, magnesium
67
Adolescence
Psychosocial change results in nutritional challenges such as:
1. Snacking on fat, sugar, protein and sodium in excess
2. vulnerable to unproven nutrition strategies to lose weight, gain muscle
3. eating disorders and techniques resulting in depletion of iron, zinc, B6, Mg and Vitamin A
4. substance abuse resulting in nutrient depletion
68
Adolescence
Osteoporosis may be delayed later in life by
increased calcium intake and physical activity
69
Adults
Risk factors for nutrient defish in adults:
1 inadequate intake
2. food fasism
3. medications or drugs/ alcohol
4. disease states
5. enteral or parenteral support
6. renal dialysis
7. behavior disorders affecting intake
8. protein - energy maluntiriton
70
Pregnancy
energy cost of pregnancy
80k-110k kcal during total preg
about 300-400 kcal per day
71
Lactation
Energy cost of 6 months of lactation
650 kcal/day
72
Lactation
Protein cost for 6 months
15g/day
73
Elderly
At risk for deficiency in
calories
calcium
iron
mg
folate
thiamin
riobflavin
b6
b12
Vitamin C
Vitamin D
74
Elderly
changes in body composition
loss of lean body mass
loss of bone density
gain of adipose tissue
75
Elderly
biochem assessment focuses on:
hemoglobin and albumin
76
Elderly
Low plasma hemoglobin and low hematocrit occur alongside
reduction in hematopoiesis, chronic inflammation, lowe serum folate concentration or iron deficiency anemia
77
Elderly
Serum albumin concertration of \_\_\_\_\_\_is indiativ of malnutrition
3.5g
78
Elderly
Nutritional requirement values that are increased for the elderly
Riboflavin
B6
B12
D
calcium
79
Elderly
Nurtient requirements that should decrease
Vitamin A
80
Vegetarian Diet
An increase of ____ to \_\_\_\_\_in recommended daily protein is recommended for strict vegetarians
15%-25%
\*vegans may require an additional 1.6 g/kg
81
Vegetarian
Good sources of digestible protein
Legumes, nuts, seeds (1-2svgs per day of each)
diary (2-3 servings per day)
grains (6 servings per day)
82
vegetarian
Dairy products are great sources of
calcium, B12 and riboflavin
83
Vegetarian
Supplements needed may include
B12 and Vit D
Veg diets do not enhance absorb of dietary iron or zinc so intake of grains, nuts, fruits and legumes is required
84
Pregnancy
Vit D need does/does not increase during pregnancy
Does not. 600 IU/day are sufficient
85
Pregnancy
Vit D metabolism changes how?
A drastic increase in conversion of 25 (OH) D to 1,25 (OH)2D
86
Infants/Child
Up to \_\_\_\_\_\_% of infants in children with speacial heatlh needs are at nutritional risk
40%
87
Infants
Decreased calories needed for
Spina bifida
down syndrome
88
Infant
Energy needs for infants
AAP: 105-130 cal/kg
89
Infants
Protein Requirements
0-6 mos 1.52g per kg body weight
7-12 mos: 1.2g/kg
90
Infants
What percent of calories should fat be of an infants diet
45-55%
91
Infant
Preterm infants have higher _____ needs
Iron
92
INfants
How do you correct age in preterm infants
Subtract gestational age at birth from 40 weeks
93
Pregnancy
Miscarriage: loss of a conceptus in the first 20 weeks of pregnancy
–Causes include:
* Defects in fetus
* Maternal infection
* Structural abnormalities of uterus
* Endocrine or immunological disturbances
94
Pregconception
what percentage of couples struggles with infertility
–An estimated 18 percent of U.S. couples
95
precon
•Development of female and male reproductive systems
–Begins during first months after conception
–Continue to grow and develop through puberty
96
precon
•Hormonal effects during the menstrual cycle
–Gonadotropin-releasing hormone (GnRH)
•Stimulates pituitary to release FSH and LH
–Follicle-stimulating hormone (FSH)
•Stimulates growth of ova
–Luteinizing hormone (LH)
•Stimulates secretion of progesterone
97
precon
•Two phases of menstrual cycle
–Follicular phase
* First half of menstrual cycle
* Follicle growth and maturation
–Luteal phase
* Last half of menstrual cycle
* Begins after ovulation
* Formation of corpus luteum
98
precon
–Weight loss exceeding \_\_\_\_\_percent of weight decreases estrogen, LH, and FSH
10-15
99
precon
## Footnote
•Sperm viability and motility decrease with when weight reached ____ to\_\_\_\_ percent below normal
10 to 15
100
precon
•Sperm viability and motility cease with when loss exceeded \_\_\_\_-% of normal
25%
101
precon
deficiency in _____ can impair normal functions of fertility in men
zinc
102
precon
–Related to reduced sperm count in men and decreased fertility in women
Soy isoflavones
103
preecon
–One month before conception through three months after conception
–Critical period when nutritional and other exposures can impact conception, pregnancy maintenance, and the growth, development and health of the offspring
104
precon
–Critical period when nutritional and other exposures can impact conception, pregnancy maintenance, and the growth, development and health of the offspring
–Hispanic Americans
–Women who take the anti-seizure drug valproate without appropriate folic acid supplementation
–Women who have previously delivered an infant with a neural tube defect
105
precon
•Recommended dietary intake and healthy dietary patterns
–400 mcg of folic acid
–More than 10,000 IU of vitamin A
–Limit or omit alcohol-containing beverages
106
precon
## Footnote
•Prevention of gestational and type 2 diabetesv
–Pre-pregnancy weight loss, increased fiber intake, and exercise
107
precon
•Most frequently inherited disorder of amino-acid metabolism
PKU
–Preventable cause of intellectual disability
* Causes elevation in blood phenylalanine levels due to very low levels or lack of the enzyme phenylalanine hydroxylase
* Nutrition management for women with PKU
–Low-phenylalanine diet for life
108
precon
Vitamin and mineral deficiencies and other health consequences that may occur in people with untreated celiac disease
folate
B12
Vit A
Vit D
Vit E
Vit K
Lactose intolerance
wegith loss
anemia
osteoporosis
subfertility
gorwth failure
irritable bowel disease
Calcium
Iron
109
preg
magnesium needs increase/decrease during preg?
Increase
maternal defish may hinder fetal growth
110
preg
phosphorus increases/stays the same
Stays the same
However, low phosphorus levels, indicative
of “refeeding syndrome,” have been found in women
experiencing severe vomiting or other situations resulting in
starvation.
111
preg
selenium need increases/stays same
stays the same
Selenium functions as an antioxidant and is important
for reproduction. Low selenium status is associated
with recurrent miscarriages, preeclampsia, and IUGR. The DRI
increases slightly during pregnancy, but there are no evidencebased
recommendations for supplementation
112
preg
sodium needs increase/stay the same
stay the same
restricting salt below 2300 is not recommended. Niether are diuretics
113
preg
Zinc needs increase/stay the same
increase
It provides a structural function in many tissues, including
some proteins involved in gene expression. Deficiency is
highly teratogenic, leading to congenital malformations, including
anencephaly and possibly oral clefts. Even a mild zinc
deficiency may lead to impaired fetal growth and brain development,
as well as impaired immune function. Women with
untreated low zinc levels associated with acrodermatitis enteropathica
have increased risk of miscarriage, fetal growth
restriction, hypertension, preeclampsia, preterm delivery, and
intrapartum hemorrhage.
Zinc is widely available and
114
preg
pica is often a result of this deficiency
iron deficiency anemia
treatment
with very high iron foods often decreases the cravings.
115
preg
what nutrient can mercury toxicity
selenium but only up to a point. must be cautious of toxicity
116
preg
prenatal supplement should include
A balanced prenatal supplement should contain 400 to
800 mcg of folic acid and also should contain iron unless contraindicated.
Copper is recommended if the supplement also contains
zinc or iron (Uriu-Adams et al, 2010). It should contain 150 mcg of
iodine in the form of potassium iodide, not kelp or seaweed (Leung
et al, 2013). Although some contain DHA, at least as much benefit
can come from including high DHA fish regularly in the diet
117
lact
Women who are lactating should take dietary supplements regardless of their nutrition status (true/false)
False
Unless a vitamin-mineral deficiency is identified, or the mother
has a restricted diet, dietary supplements are not necessary. A diet
including a variety of foods, adequate in calories, should provide
the woman with all the nutrients she needs.
(but many drs rec continuing prenatals)
118
lact
excess hydration may result in greater milk production / True or falst
fasle
it may result in less milk production. The body excretes excess water to maintain electrolyte balance
119
lact
poor nutrition may effect the ______ but not the \_\_\_\_\_\_\_of breast milk
Quantity/ Quality
120
lact
Mom's diet may affect the content of the following nutrients, in breastmilk
the fatty acid composition of a mother’s milk reflects her dietary
intake. In addition, milk concentrations of selenium, iodine,
and some of the B vitamins reflect the maternal diet.
121
lact
DRI for lactation is \_\_\_\_\_kcals for the first 6 months and \_\_\_\_\_for the second 6 months
The DRI for energy during lactation is 330 kcal greater during
the first 6 months of lactation and 400 kcal greater during
the second 6 months of lactation over that for a nonpregnant
woman.
122
lact
DRI for protein during lactation
The DRI suggests an additional 25 g of protein a day for lactation,
or 71 g of protein a day, based on an RDA of 1.1 gm/kg/day of a
woman’s body weight.
123
lact
Breastmilk has a \_\_\_\_\_to \_\_\_\_\_ratio off ______ : ____ in early lactation
Breastmilk has a whey:casein ratio of 90:10 early in lactation,
which changes to 80:20 as an average, and to 60:40 as the baby
gets older. It is speculated that this ratio makes breastmilk more
digestible.
124
lact
Because of reports of clinical rickets, the AAP recommends
that all breastfed infants receive \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
as a daily supplement starting at birth,
400 IU (10 mcg) of vitamin D
125
lact
the ________ content
of breastmilk is not related to maternal intake
Calcium
126
lact
recommendations
from the American Academy of Pediatrics state that lactating
women should ensure a daily intake of 290 mcg of ,
which generally requires supplementation of 150 mcg/day. This is important for baby's neurological development.
iodide
127
lact
Iodine requirements during lactation are \_\_\_\_\_\_\_that of pregnancy
double
128
Lact
The requirements for zinc during lactation are
greater/the same than/as those during pregnancy
Greater
In the process
of normal lactation, the zinc content of breastmilk drops
dramatically during the first few months from 2 to 3 mg/day
to 1 mg/day by the third month after birth. Zinc supplementation
has not been found to affect concentrations in the breastmilk
of women in developed countries but may increase the
zinc content of the milk of women in developing countries
with suboptimal zinc status
129
Lact
For lactating mothers whofollow a strict vegan diet without any animal products, a \_\_\_\_\_\_\_\_\_\_supplement is recommended strongly.
vitamin
B12
130
Lact
Common galactagogues that help with lactation
Fenugreek
milk thistle
Cooking herbs: anise, blackseed, caraway, coriander, dill, fennel,
Non-Food herbs: .alfalfa, blessed thistle,
nettle, goats rue, red clover, shatavari
131
infant
Infants may lose approximately\_\_\_\_\_\_%of their body weight during
the first few days of life, but their birth weight usually is regained
by the seventh to tenth day. Weight loss of more than
\_\_\_\_\_\_\_in the newborn period indicates need for further assessment
regarding adequacy of feeding.
7%
10%
132
Adol
Rec iron when a girl starts menstruating
15mg
133
