Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NUTR 2050 > Midterm > Flashcards

Midterm Flashcards

1
Q

Calorie

A

measure of the amount of energy transferred from food to body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Nutrients

A

chemical substances in food that are used by the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Carbohydrates

A

organic compounds consisting of carbon, hydrogen, oxygen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Protein

A

organic compounds consisting of AA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Fat (lipids)

A

organic compounds that consists of a glycerol and 3 FAs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Vitamins

A

group of organic compounds essential for proper nutrient and growth (required in limited amounts)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Minerals

A

group of inorganic compounds essential for proper nutrition and growth (limited amounts)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Water

A

essential component of our diet; transport nutrients to cells; aids in some reactions (hydrolysis); regulates body temp., rids body of waste

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Essential Nutrients

A

Obtain from diet

- carbs, certain AA, EFAs, vitamins/minerals, water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Cholesterol

A

precursors for steroid hormones and vitamin D; synthesized in liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Glucose

A

major source of cellular energy; can be synthesized in liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Malnutrition

A

under- or over-nutrition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

RDA

A

Recommended Dietary Allowance

  • levels of essential nutrients
  • adequate for most healthy people
  • decrease risk of certain chronic diseases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

AI

A

Adequate Intake

- tentative RDAs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

EARs

A

Estimated Average Requirements

- estimated values to meet requirement of half of the healthy individuals in population

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Tolerable Upper Limit

A

UL

  • upper limits of nutrients compatible with health
  • these should not be exceeded
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Factors that influence nutrient needs

A

age, body size, gender, genetic traits, growth, illness, lifestyle habits, medications, pregnancy/lactation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

WHO: Health?

A

state of complete physical, mental and social well being and not merely the absence of disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Fundamental conditions and resources for health are

A

peace, shelter, education, food, income, stable ecosystem, sustainable resources, social justice and equity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Primary

A

health promotion activities aimed at preventing a specific illness/disease

  • preceded disease
  • immunizations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Secondary

A

Activities focused on early identification of health problems

  • identify and treat individuals who have asymptomatic/preclinical disease
  • screening/breast exam
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Tertiary

A

Educating an individual with the disease with the goal of returning individual back to optimum levels of functioning
- educating a person with type 2 diabetes on how to identify and prevent complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Public Health Agency of Canada

A

health promotion, prevention and control of disease, disease surveillance, public health emergencies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Health Canada

A

health care, education, food guide, development of food regulations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Canadian Food Inspection Agency

A

enforcement of food regulations set by health Canada, inspection of facilities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Sodium Reduction Task Force

A

Interim goal = population mean intake of Na to 2300 mg/day
Long term goal = reduce Na intake to a population mean where 95% of the population have daily intake less than UL (2300 mg/day)
Individual goal = 1500 mg/day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Average Na intake among Canadians

A

3400 mg/day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Healthy Eating and Active Living (HEAL) Action Plan

A

Ontario’s effort to meet Pan- Canada’s Healthy Living Strategy Targets

  • access to healthy food for children
  • help Ontarians access dieticians
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Healthy Change Ontario’s Action Plan

A

improving clinical care, child obesity, doesn’t replace HEAL

  • keep Ontario healthy
  • faster access to stronger family health care
  • right care, right time, right place
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What do dieticians do?

A

preparation of kits, educational material, policy implementation and guidelines, public level screening, public level education, nutrition counselling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Biological impacts of social determinants of health

A

physical environment 10%
biology and genetics 15%
health care system 25%
social and economic development 50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Social determinants of health

A

values, assumptions, beliefs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Core determinants of health

A 
income and social status
social support networks
education
employment and working conditions
social environments
physical environments
biology and genetic environments
culture
health services
personal health practices and coping skills
healthy child development
gender
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Socio-ecological model

A

Individual - personal level factors (age, food preference)
Interpersonal - factors relating to influence of families, peers, partners, culture
Organizational/Institutional - practice and physical environment of an organization (school, workplace)
Community - cultural values or norms unique to urban, rural and remote settings (access to food)
Public Policy - broader guidelines at various levels of government (Canada’s food guide)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Food Security

A

all people, at all times, have physical and economic access to sufficient, safe and nutrition food

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Food Insecurity

A

inability to acquire nutritionally adequate foods in culturally acceptable ways

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Traditional Foods

A

plants and animals harvested from local environment - contribute toward nutritional health and well being

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Determinants of traditional food choice

A

no time to prepare, lack of knowledge, unhealthy (rural)

no land access, expensive, no availability (rural)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Food Sovereignty

A

People’s right to healthy and culturally appropriate food produced through ecologically sound and sustainable methods and their right to define their own food and agriculture system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

4 main factors that need to be fulfilled in order to achieve food sustainability?

A

food availability, food supply, food access, cultural acceptability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Use of models in Public Health

A

organize our thinking, guide the design of intervention, evaluate the effects of interventions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Determinants of malnutrition

A

agriculture, government, community, school, habits, beliefs, ethnic identities, physiology, nutrition, sanitation, stress, age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What percentage of people in US are obese

A

70%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Causes of death in children under 5

A

neonatal 37%
acute respiratory infections 17%
diarrhea 16%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Greatest benefits to improve child mortality

A

breast feeding counselling, vitamin A supplementation, zinc fortification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Deficiency in vitamin A leads to

A

blindness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

food rich in Vit A

A

sweet potato

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Who is most commonly deficient in iron

A

pre-school aged children and women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

foods rich in iron

A

red meat and spinach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What protects many countries against iodine deficiency?

A

ionized salt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Symptoms of iodine deficiency

A

swelling of the neck

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

foods rich in iodine

A

cranberries and seaweed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What is zinc useful for

A

management of chronic diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

foods rich in zinc

A

soy beans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Periods with greatest benefit from nutrition interventions

A

prenatal, first 2 years of life, pre-conception, adolescence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Emerging Adulthood

A

phase of lifespan between adolescence and adulthood ~18-25 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Markers of transition to adulthood

A

completed education, left parents home, full time work, life partner, start family

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

characteristics of emerging adulthood

A

don’t see themselves as adults, time of identity exploration, high level of transition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Largest brain structure

A

frontal lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What area is within the prefrontal cortex that is associated with set functions

A

Executive Suite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What is the executive suite responsible for?

A

calibration of risk and reward, problem solving, prioritizing, long term planning, self evaluation, regulation of emotion (Overall maturity)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Myelination

A

more extensive myelination of nerves - more efficient signal transmission

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Synaptic Pruning

A

nerve connections are pruned back - more efficient signal transmission among retaining nerves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What do myelination and synaptic pruning lead to

A

sophisticated learning and emotion regulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Changes by end of emerging adulthood

A

more complex thinking, appreciation of diverse views, emotional regulation, risk taking and decision making

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

“window of opportunity”

A

emerging adulthood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

When is fast food intake at its highest

A

emerging adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

common barriers to food prep

A

too busy, insufficient money, inadequate cooking skills

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Who is the main target for fast food industry

A

young men

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

meal between dinner and breakfast

A

fourth meal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

large increase in prevalence of obesity among?

A

18-29 year olds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

transition to university weight gain

A

first 3-4 months –> 2-7 pound increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Body Mass Index

A

weight relative to height, not a direct measure of body fat, estimate of body fatness and risk associated with body fat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

pounds to kg

A

divide by 2.2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

inches to cm

A

multiply by 2.54

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Underweight BMI

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Normal BMI

A

18.5-24.9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Overweight BMI

A

25-29.9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Obese Class I BMI

A

30-34.9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Obese Class II BMI

A

35-39.9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Obese Class III BMI

A

> 40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

BMI Limitations

A

does not take into account bone density, not to be used with pregnant/lactating women, does not capture risk with weight change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

BMI results less accurate for

A

emerging/young adults, muscular/lean individuals, certain population groups, older adults >65, dehydrated individuals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Puberty

A

period in which humans become biologically capable of reproduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Ova

A

female reproductive cells that are produced and stored within ovaries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Follicle

A

cellular structure in ovary where ovum matures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Sperm

A

male reproductive cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

How long does puberty occur

A

3-5 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

menstrual cycle length

A

~4 week cycle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

GnRH in menstrual cycle

A

released by hypothalamus

- stimulates pituitary gland to release FSH and LH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

FSH in menstrual cycle

A

stimulates maturation of ovum (and sperm in men) and stimulates production of estrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

LH in menstrual cycle

A

stimulates secretion of progesterone and surge in LH causes release of ovum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Estrogen in menstrual cycle

A

stimulates further growth and maturation of follicle, stimulates vascularity and storage of glycogen/other nutrients within uterus, decrease in estrogen at end of menstrual –> release of GnRH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

Progesterone in menstrual cycle

A

prepares uterus for fertilized ovum, increases vascularity of endometrium and stimulates cell division of fertilized ova

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

Two phases of menstrual cycle

A

Follicular and luteal phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

Follicular Phase

A

first half of menstrual

  • follicle growth and maturation
  • main hormones = GnRH, FSH, LH, estrogen, progesterone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

Luteal Phase

A

last half of menstrual

  • after ovulation, development of egg
  • if ovum is not fertilized, decreases in estrogen and progesterone stimulate menstrual flow
  • decrease in estrogen stimulates the release of GnRH and it starts again
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

Different between men and women cycles

A

men - ongoing

women - cyclic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

Which signal releases LH and FSH in men

A

GnRH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

What stimulates the production of testosterone in men?

A

FSH and LH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

Maturation of sperm

A

70-80 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

where is sperm stored

A

epididymis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

Decreased fertility associated with

A

number, motility, morphology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

Main fertility disruptions

A

adverse effects, contraceptive use, severe stress, infection, tubal damage/structural damage, chromosomal damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

Nutrition/Lifestyle factors affecting fertility

A

energy status and nutrient adequacy, obesity, weigh loss, under-nutrition, high intensity training, low intake of specific foods/food components

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

What hormones do fat cells produce

A

estrogen, testosterone, leptin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

changes in levels of estrogen, testosterone and leptin affect?

A

follicular development, ovulation, sperm production, sperm maturation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

Hormonal differences can result in

A

irregularity of the menstrual cycle, ovulatory failure and amenorrhea (ovulatory failure)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

lower levels of testosterone lead to

A

lower sperm production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

first line of defence in improving fertility

A

weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

Weight reduction strategy should:

A

focus on lifestyle changes, improve overall diet quality, decrease caloric intake, increase physical activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

Acute under-nutrition

A

associated with dramatic decline in food energy and nutrients that recovers with normal food intake or eating behaviour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

Primary effect of chronic under nutrition

A

birth of small/underweight infants (likelihood of death in first year)
reduced fertility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

Adverse effects of intense physical activity

A

delayed age at puberty, lack of regular menstrual cycle, reduced levels of estrogen, low levels of body fat, decreased bone mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

Female Athletic triad

A

amenorrhea, eating disorder, osteoporosis

  • when energy intake is substantially less than requirement
  • decreased LH/FSH levels and lack of estrogen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

Oxidative Stress

A

when the production of free radicals exceeds the body’s own antioxidant defenses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

Oxidative stress in men

A

decrease sperm mobility and reduces ability of sperm to reach egg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

oxidative stress in women

A

harm egg and follicle development, interferes with implantation of egg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

Key antioxidants

A

vitamin C, E, beta-carotene, selenium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

Zinc - prevents oxidative stress in men only

A

prevents oxidative damage, involved in sperm maturation involved in testosterone synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

low zinc status in men associated with

A

low sperm count, low sperm quality, abnormal morphology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
122
Q

High Plant based diets effect son fertility

A

high finer –> reduce estrogen and irregular periods

isoflavones (soy) –> influence levels of gonadotropins, estrogen and progesterone, reduced sperm count

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
123
Q

Low iron intake linked to

A

premature delivery and low iron status of infant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
124
Q

caffeines affect on fertility

A

chance of conception decreased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
125
Q

alcohols affect on fertility

A

may decrease estrogen and testosterone levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
126
Q

Heavy metals affect on fertility

A

decreased sperm production and abnormal motility and mobility
E.g. mercury/lead

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
127
Q

when is folate very important

A

peri-conceptual period (after conception but before pregnancy is diagnosed)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
128
Q

insufficient amounts of folate lead to

A

embryonic development (neural tube defects = spina bifida)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
129
Q

folate recommendation

A

40 ug/day

130
Q

pregnancies most vulnerable to folate deficiency

A

single women, unplanned pregnancies, low education

131
Q

Bioavailability

A

the efficiency of absorption, utilization and/or retention of the nutrients present in food

132
Q

Bioavailability can be affected by

A

nutrient content, food processing, physical state of the person, ability to digest and absorb nutrients, interactions among components, presence of anti-nutritional factors

133
Q

Improving Bioavailability

A

Fortification and enrichment

134
Q

Fortification

A

addition of nutrients not originally present in the particular food

135
Q

Enrichment

A

addition of nutrients that were lost during food processing

136
Q

Folate

A

natural form, 50% bioavailability, prone to damage, leafy greens/beets

137
Q

Folic acid

A

synthetic form, highly bioavailable, supp.

138
Q

The leading cause of female infertility

A

Polycystic Ovary Syndrome

139
Q

Clinical signs of PCOS

A

high levels intra-abdominal fat, obesity, menstrual irregularities, acne, high testosterone, insulin resistance

140
Q

PCOS affect on infertility

A

~70%

  • absence of ovulation
  • irregular menstruation
  • risk of spontaneous abortions/gestational diabetes
141
Q

Nutritional management of PCOS

A

primary goal = increase insulin sensitivity
- weight loss and exercise
insulin sensitizing drugs
long term health problems - need team-centred approach, tailor plan to individual
suggested diet
- veg/fruit, lean protein, whole grain, fibre, non-fat dairy, regular meals
-low glycemic index
- healthier fat sources
–> can’t cure but can manage long term complications and alleviate symptoms
- symptoms tend to improve substantially from 5-10% weight loss

142
Q

Glycemic Index

A

measure of the extent to which 50 grams of carbohydrate containing food raises 2-hour post meal blood glucose compared to a similar amount of glucose or white bread

143
Q

High glycemic index

A

glucose, potatoes, pretzels, rice krispies, gatorade

144
Q

Medium glycemic index

A

sweet potatoes, brown rice, raisins

145
Q

Low glycemic index

A

oatmeal, banana, honey, pasta

146
Q

Diabetes Mellitus

A

intolerance to carbohydrates with fasting glucose >126 mg/dL

147
Q

Type 1 diabetes

A

results from destruction of insulin producing cells (10%)

148
Q

Type 2 diabetes

A

body unable to use insulin normally, to produce enough insulin or both (90%)

149
Q

Gestational diabetes

A

onset during pregnancy (usually type 2)

  • poorly controlled blood glucose levels
  • miscarriage/ risk of mother or infant developing type 2 later in life
150
Q

Affect of high blood glucose levels during first two months of pregnancy

A

teratogenic

- associated with 2-3 fold increase in congenital abnormalities

151
Q

Prevention of GDM

A

weight loss, exercise, healthy dietary pattern, increase fiber, intake of low GI foods, increase veggie/fruit consumption

152
Q

Gestational Age

A

Assessed from date of conception (avg. pregnancy = 38 weeks)

153
Q

Menstrual Age

A

assessed from onset of last menstrual period (LMP) (avg. pregnancy is 40 weeks)

154
Q

Peri-conceptual

A

4 weeks before and after conception

155
Q

Very pre-term

A

before 34 weeks

156
Q

Pre-term

A

before 37 weeks

157
Q

At term

A

40 weeks

158
Q

Post-term

A

greater than 42 weeks

159
Q

embryo

A

conception to 8 weeks

160
Q

fetus

A

8 weeks to 40 weeks

161
Q

neonatal/newborn

A

40 weeks to 1 week past term

162
Q

post-neonatal

A

1 week post term to 12 weeks post term

163
Q

Miscarriage/spontaneous abortion

A

conception to 20 weeks

164
Q

Fetal death/still birth

A

20 to 40 weeks

165
Q

perinatal

A

20 weeks to term

166
Q

Two phases of pregnancy

A

Anabolic and catabolic

167
Q

Maternal Anabolic

A

week 1-20
building mother’s capacity
10% fetal growth
- blood volume expansion, increased cardiac output, buildup of fat, nutrients and liver glycogen stored, growth of some maternal organs, increased appetite, food intake, decreased exercise tolerance, increased levels of anabolic hormones

168
Q

Maternal Catabolic

A

week 20-40
stored energy and nutrients to fetus
90% fetal growth
- mobilization of fat and nutrient stores, increased production and blood levels of glucose, triglycerides and FAs, decreased glycogen stores, accelerated fasting metabolism, increased appetite and food intake decline somewhat near term, increased levels of catabolic hormones

169
Q

How much does body water increase during pregnancy

A

7-10L

  • results from increased plasma and extracellular volume and amniotic fluid
  • preparation for women’s body to facilitate transfer of nutrients
  • by 2nd/3rd trimester body learns to compensate
  • edema
170
Q

What is the preferred fuel for fetus

A

Glucose

171
Q

Anabolic hormones

A

promote increased insulin production

172
Q

Catabolic hormones

A

promote increased insulin resistance

173
Q

3 sources of energy for fetus

A

maternal dietary glucose (carb)
glycogen stores (storage form)
new glucose created through gluconeogenesis

174
Q

Diabetogenic

A

effect of pregnancy results from maternal insulin resistance

175
Q

How much protein is accumulated for new maternal/fetal tissue

A

925g (2lbs)

- less used for energy, more used for protein synthesis

176
Q

Affect of fat stores

A

anabolic - accumulation

catabolic - fat mobilization

177
Q

What does mother use fat for

A

energy

178
Q

What does fetus use fat for

A

steroid hormone synthesis (estrogen and progesterone)

179
Q

What does placenta use fat for

A

nerve and cell membrane production (cholesterol helps to keep membranes fluid)

180
Q

Placenta functions

A

hormone and enzyme production
nutrient and gas exchange
removal of waste from fetus

181
Q

Factors that affect transfer of nutrients

A

size/charge

- small molecules with little charge pass most easily

182
Q

What passes through most easily

A

lipids - hydrophobic

183
Q

Priority of nutrients

A

mother > placenta > fetus

184
Q

Tissue growth in first 2 weeks following conception

A

organs, spine, brain stem

185
Q

Tissue growth following week 5

A

rudimentary kidney, liver, circulatory, eyes, ears, moth, hands, arms, GI

186
Q

Hypertrophy

A

cells grow in size

187
Q

Hyperplasia

A

cells multiply

188
Q

What is the most critical time for development in fetus

A

during first 2 months post conception

189
Q

Perinatal mortality

A

combined mortality of stillbirths and live births with death occurring up to 6 days of age as a proportion of all births

190
Q

low birth weight

A
191
Q

Large for gestational age

A

> 4500 g (10lbs)

  • rapid weight gain of mother, untreated gestational diabetes
  • complications for mother
  • taller later in life
  • later life risks dependent on maternal gestational diabetes
192
Q

Disproportionately small for gestational age

A

asymmetrical

  • shorter term malnutrition (3rd trimester)
  • post birth complications (hypoglycemia, hyperthermia)
  • small organs, normal cell #
  • can catch up
  • poorer academic performance, risk of heart disease, high blood pressure, type 2 diabetes later on
193
Q

Proportionately small for gestational age

A

symmetrical

  • chronic malnutrition
  • fewer birth related complications to dSGA
  • small organs and small # cells
  • minimal catch up, breast feeding helps
  • risk of obesity, high blood pressure, type 2 diabetes later on
194
Q

what percent does preterm birth account for in perinatal mortality

A

75-85%

195
Q

Risk factors for preterm birth

A

Known
- poor uterine blood flow, incompetent cervix, pre-eclampsia, cigarette smoking, under nutrition, low weight gain during pregnancy, short interval between pregnancies, multi-fetal pregnancies
Potential
- stress, anxiety, depression

196
Q

Reasons for infant mortality

A

access to health care, access to healthy/affordable foods, resources present

197
Q

Desirable birth weight

A

3500-4500 g (7lb 12 oz to 10lb)

- less risk of heart/lung disease, diabetes, hypertension

198
Q

Recommended weight gain for BMI

A

28-40 lbs

199
Q

Recommended weight gain for BMI 18.5 - 24.9

A

25-35

200
Q

Recommended weight gain for BMI 25-29.9

A

15-25

201
Q

Recommended weight gain for BMI >30

A

11-20

202
Q

Where does the weight come from?

A

~ 30 lbs (upper limit)

  • baby = 7-8
  • maternal fat/nutrient stores = 6
  • maternal blood = 4
  • fluid in maternal tissue = 4
  • placenta = 1-2
  • amniotic fluid = 2
  • uterus = 2
  • maternal breast tissue = 2
203
Q

Risk with too little weight gain

A

preterm birth and poor fetal growth

204
Q

Risk with too much weight gain

A

preterm birth, LGA, caesarian section birth and weight retention in mom

205
Q

Energy Needs in 1st trimester

A

no increase

206
Q

Energy needs in 2nd trimester

A

increase by 340 kcal

207
Q

Energy needs in 3rd trimester

A

increase by 452 kcal (2-3 servings from EWCFG)

208
Q

Average consumption of fluid during pregnancy

A

~9 cups/day

209
Q

carbohydrate intake

A

50-65%

210
Q

protein intake

A

increase 25 g/day ~71g/day

- average woman consumed ~78g

211
Q

Folate roles

A

needed for organ/tissue growth, gene expression

212
Q

Inadequate folate leads to

A

birth defects, low birth weight, preterm delivery

213
Q

Folate recommendations

A

600 ug (400ug folic acid supp)

214
Q

Vitamin A role

A

cell differentiation

215
Q

Vitamin A deficiency

A

affect fetal lungs, urinary tract, heart

216
Q

Vitamin A toxicity

A

> 10,000 IU/day

  • facial malformations, brain and heart dysfunctions
  • only with pre-formed vitamin A (retinol)
217
Q

Vitamin A recommendation

A

770 ug/day (same as non-pregnant women)

218
Q

Vitamin C recommendation

A

85 mg/day (75 mg in non-pregnant)

219
Q

Vitamin D deficiency

A

poor fetal bone and tooth enamel formation, smaller than average

220
Q

Vitamin D recommendation

A

660 IU (same in non-pregnant)

221
Q

Risk factors for vitamin D inadequacy

A

vegan, lack of sun exposure, dark skin, obesity

222
Q

Iron recommendation

A

27 mg/day (18 mg for non-pregnant)

223
Q

additional iron required for

A

fetus and placenta
increased RBC
blood loss at delivery

224
Q

What is used to measure iron status

A

ferritin

225
Q

Two forms of iron

A

heme and non-heme

226
Q

Heme iron

A

meat, poultry, fish

- more readily absorbed

227
Q

Non-heme iron

A

eggs, plant based foods, whole grain

228
Q

main inhibitors of iron absorption

A
  1. polyphenols - tea/coffee
  2. phytate - legumes/veggies
  3. calcium at levels above 300 mg
229
Q

Optimizing iron absorption

A

Vitmain C, drink tea/coffee 1-2 hours after meals, avoid Ca supp. with meals

230
Q

Calcium requirement

A

1000 mg/day (same as non-pregnant)

- increase in 3rd trimester by 300 mg/day

231
Q

Caffeine allowance

A

300mg/day

  • 1-3 x 200ml cups coffee
  • 12x 200 ml cups weak tea
  • 12 oz dark chocolate
232
Q

Two primary omega 3’s

A

DHA and EPA

233
Q

Why is EPA important in mothers diet?

A

keeps blood viscous, decreases inflammation, dilates blood vessels

234
Q

Why is DHA important for fetus?

A

structural component for cell membranes in NS –> higher intelligence, better vision

235
Q

Omega 3 recommendation

A

AI = 300mg, UL = 2g

236
Q

Best source of omega 3s

A

fish (5oz/week)

237
Q

Fish to avoid (mercury poisoning)

A

shark, tuna, swordfish

238
Q

Fish to eat

A

salmon, canned light tuna, haddock

239
Q

Vegetarian possible supplementation

A

folate, vitamin D, rion, vit B12, DHA, calcium

240
Q

Benefits of physical activity during pregnancy

A

decrease risk of gestational diabetes
better placenta function and birth outcomes
helps prepare for birth (shorter labor)
prevents weight retention post-partum

241
Q

Why is gestational diabetes mellitus a problem

A

extra glucose to fetus –> increase in insulin in fetus –> stored as triglycerides –> increase in fat mass –> metabolic adaptions that carry through life
- increased risk of still birth

242
Q

Gestational Diabetes risk to mother

A

c-section delivery, pre-eclampsia, risk of type 2 diabetes, high blood pressure, obesity later on

243
Q

Gestational Diabete risk to fetus

A

stillbirth, miscarriage, congenital abnormalities, large baby, insulin resistance, type 2 diabetes, high blood pressure, obesity later

244
Q

Risk factors for GDM

A

obesity, weight gain between pregnancies, underweight, over 35, family history, chronic hypertension

245
Q

GDM Management

A
  • 3 meals/snacks - even carbs throughout day
  • no energy restriction
  • limit concentrated sugar
  • appropriate weight gain
  • regular exercise
  • diet plan (40-50% CHO, 30-40% fat, 20% protein)
  • low GI diet (increased fruits/veggies, increased fiber)
  • if nutrition therapy doesn’t work - insulin
246
Q

Goals of Canadian Prenatal Nutrition Program

CPNP

A
  • improve maternal/infant health
  • reduce incidence of preterm birth
  • promote and support breast feeding
  • build partnership with communities
  • strengthen community support for pregnant women
247
Q

What does CPNP do?

A
  • funds community programs to provide services, resources to vulnerable pregnant women
  • target women living in poverty, teens isolated, drug/alcohol abuse, immigrant
  • enhances access to services (food/vit. supp., nutrition counselling, support, education, referral)
248
Q

Fetal Alcohol Spectrum Disorder (FASD)

A

Describes range of disabilities that result from exposure to alcohol during pregnancy

249
Q

The Government of Canada’s FASD Initiative

A

Prevent and improve lives of those affected - led by PHAC and health canada

250
Q

Ontario Programs

A 
Best Start
- resources for service providers
- community hubs
Healthy Babies Healthy Children
- 0-6 years of age 
- provide visiting nurse, family home visitors, referral services
251
Q

What hormones prepare mammary glands for lactation

A

estrogen and progesteron

252
Q

Functional unit of mammary glands

A

alveoli

253
Q

Each alveolus is composed of ? with a duct in the center

A

secretory cells

254
Q

What contract during letdown causing milk ejection?

A

Myoepithelial cells

255
Q

Two key hormones in lactogenesis

A

prolactin and oxytocin

256
Q

Prolactin

A
  • stimulates milk production

- inhibits ovulation

257
Q

Oxytocin

A
  • stimulates milk ejection (“let down”)

- promotes uterine contractions

258
Q

Lactogenesis I

A

Begins during last trimester and lasts 2-5 days after birth

- milk formation begins (lactose and protein content increase)

259
Q

Major CHO in milk

A

lactose

260
Q

Lactogenesis II

A

Begins 2-5 days following birth

  • increase in blood flow to breast
  • milk “comes in”/onset of milk secretion
261
Q

Lactogenesis III

A

Begins about 10 days after birth

- milk composition is more stable (quantity/nutrients)

262
Q

What is the only requirement for children up to age 6 months

A

human milk

263
Q

Milk allows for?

A

transfer of energy, nutrients and antibodies (IgA)

264
Q

Colostrum

A

Lactogenesis II

  • very high in protein
  • IgA and lactoferrin
  • low in energy, lactose, fat
  • yellow colour –> beta carotene
265
Q

Foremilk

A

produced at beginning of feeding

- lower in fat/energy

266
Q

Hindmilk

A

Stored deeper in breast

  • more concentrated
  • higher in fat/energy
267
Q

Major component of milk

A

water

- isotonic with maternal plasma

268
Q

Energy provided by milk

A

~0.65 kcal/ml

- less calories in milk vs. milk substitutes

269
Q

Second largest component of milk

A

Lipid

  • provide 1/2 the calories
  • maternal diet affects individual FA content but not overall fat content
270
Q

Protein fractions in human milk

A

Casein and whey

271
Q

Casein

A

main protein in mature human milk

- facilitates calcium absorption, increases calcium bioavailability by creating soluble complex

272
Q

Whey

A
  • water soluble
  • some mineral-, hormone- and vitamin-binding proteins are part of whey
    Ex. lactoferrin
273
Q

Lactose

A
  • enhances Ca absorption

- stimulates growth of good bacteria and prevents growth of bad in infant gut

274
Q

Oligosaccharides

A

medium length CHO containing lactose at one end

  • can be bound to proteins (glycoproteins) or lipids (glycolipids)
  • prevent binding of pathogenic microorganisms to walls of infant gut, preventing infection and diarrhea
275
Q

What vitamin is given to all new borns

A

vitamin K

276
Q

What are vitamin E levels linked to

A

milks fat content

277
Q

Vitamin E roles

A

muscle development, prevention of RBC lysis

278
Q

Vitamin A roles

A

cell differentiation

- twice as much in colostrum

279
Q

Vitamin D roles

A

fetal growth, addition to bone, and tooth/enamel formation

- maternal sun exposure can increase levels in milk up to 10 fold

280
Q

Low B12 seen in women:

A
  • vegans/undernourished
  • gastric bypass surgery
  • have hyperthyroidism or pernicious anemia (an ability to absorb B12)
281
Q

Mineral content in milk

A

decrease after 4 months (except for magnesium)

282
Q

Zinc roles

A

growth, cognitive development and immune function

  • bound to protein for increase availability
  • rare defect in mammary gland uptake of zinc may cause deficiency –> diaper rash
283
Q

Trace minerals in human milk

A

Copper, selenium, chromium, manganese, molydenum, nickel, fluoride
- not altered by mothers diet, except fluoride

284
Q

Fluoride AI

A

0.01 mg/day for infants

285
Q

Fluoride importance

A

helps prevent cavities and tooth decay

286
Q

Breast milk benefits to baby

A
  • best form of nutrition
  • increased bioavailability
  • protection from GI, respiratory and ear infections
  • decreased infant mortality (SIDS, sanitation)
  • decreased risk of of allergy, asthma, eczema, inflammatory bowel disease
  • special benefits for preterm infants
287
Q

Breast feeding benefits to mother

A
  • reduced post partum bleeding
  • delayed return of ovulation/start of menstruation
  • decreased risk of breast/ovarian cancer and osteoporosis
  • return to pre-pregnancy weight
  • increased self confidence/bonding with infant
  • practical
288
Q

Breastfeeding duration

A

Exclusive for 6 months

289
Q

Breastfeeding process

A
  • position baby
  • position breast
  • present breast
  • proper infant latch
290
Q

Evidence of successful feeding

A

wet diapers, diluted urine, smooth bowel movements, feeds frequently, adequate growth

291
Q

Ellyn Satter’s Division of Responsibility

A

Parents responsible for? And infant responsible for?

292
Q

Parent responsible for:

A

breast milk & calm environment

293
Q

Infant responsible for:

A

timing, tempo, amount consumed

294
Q

Breastfeeding recommendations

A

watch for signs of hunger, feed when awake, calm, hungry, relax and be comfortable, know when baby is full, feeding on demand

295
Q

Maternal diet during lactation

A
  • Increase kcal 330-400 kcal
  • drink 16 cups fluids a day
  • increase CHO/protein
  • increase choline, vitamin C, A, E, potassium, zinc, iodine, selenium, copper, manganese, chromium
  • no increase in vitamins D, K, sodium, chloride, calcium, phosphorus, magnesium, fluoride
  • double iron intake (18mg)
296
Q

Weight loss during breastfeeding

A

1 kg/month

297
Q

Alcohol in breast milk

A
  • quickly passes to breast milk (30-60m without food, 60-90 m with food)
  • can take 2.5 h per drink to clear from plasma
298
Q

Impact of alcohol on lactation

A
  • disrupts oxytocin and let down
  • odor/flavor
  • decreases volume consumed
  • interferes with infant sleep pattern
299
Q

Nicotine in breast milk

A
  • levels 1.5-3 times higher in breast milk vs. plasma

- affect amount, colour and flavour

300
Q

Marijuana in breast milk

A
  • transfers to breast milk
  • may affect DNA/RNA and proteins needed for growth
  • may have affect on brain development
301
Q

Caffeine in breast milk

A
  • 1% of that in plasma
  • may accumulate in infants less than 3-4 months
  • may interfere with sleep or cause hyperactivity/fussiness
  • moderate intake (
302
Q

Environmental contaminants in breast milk

A
  • may accumulate

- benefits of breast milk out weigh risk of exposure to contaminants

303
Q

Neonatal Jaundice

A

yellow colour of skin
AKA hyperbilirubinemia
- 60-70% newborns
- most frequent cause for hospital re-admission
- long term elevated bilirubin can cause permanent brain damage
- appears in the eyes first

304
Q

Bilirubin

A

a pigment produced as heme from RBC breakdown

- usually processed by liver, but infant liver isn’t fully mature

305
Q

End result of very high, untreated levels of bilirubin

A

Bilirubin Encephalopathy

  • may cause brain damage
  • mortality rate = 50%
  • may cause cerebral palsy, hearing loss, intellectual impairments
  • signs: being listless, sick, fevered, high pitched crying, poor latching/feeding, backward arching of neck/body
306
Q

Two type of jaundice in infants

A

breastfeeding jaundice and breast milk jaundice syndrome

307
Q

Breastfeeding jaundice

A 
early onset = 2-5 days of age
Causes:
- not feeding early enough after birth, nursing irregularily/improperly, infant given water
- delayed passage of meconium
Treatment:
- increased/supplemental feedings
308
Q

Breast milk jaundice syndrome

A 
- more serious
Late onset = 5 days of age
Causes unknown
Treatment
- phototherapy
309
Q

Development of food allergies influences by many factors:

A

genetics, time of introduction of other foods, air pollution

Prevention - breast feed as long as possible, slow introduction of foods such as nuts if family history

310
Q

Breastfeeding Initiation Rate

A

proportion of women who report breastfeeding their child, regardless of timing

311
Q

Breastfeeding Duration

A

total length of time the infant was breastfed

312
Q

Weaning

A

complete cessation of breastfeeding

313
Q

Women who did not initiate breast feeding

A

younger, single, less education

314
Q

Women who did initiate breast feeding

A

married, over 30, higher education

315
Q

Common breastfeeding problems

A

letdown failure, hyperactive letdown/hyper-lactation, engorgement, plugged ducts/mastitis

316
Q

Factors influencing initiation

A

embarrassment, time/work constraints, lack of support, lack of milk supply, concerns about diet/health, fear of pain/discomfort

317
Q

Global Breastfeeding - IBFAN

A

UNICEF, WHO

“The CODE” = international code of marketing breast-milk consituents

318
Q

Breast feeding committee of Canada

A

Goal = establish breastfeeding as a cultural norm in Canda by promoting the WHO/UNICEF baby friendly hospital initiative
Does not accept:
- free/low cost breast milk substitutes
- feeding bottles
- implements ten steps to successful breastfeeding

319
Q

INFACT Canada - La LechE League

A

Nestle Free Week

320
Q

Mother risk - telephone support

A

provides answer to questions regarding medications, chemical exposures and diseases
- website

321
Q

Breastfeeding

A

normal and unequalled method of feeding infants

- nutrition, immunologic protection, growth and development of infants and toddlers

NUTR 2050 (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions