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Kin 232 > Module 10 and 11 > Flashcards

Module 10 and 11 Flashcards

1
Q

What kind of changes do we see in the body during pregnancy?

A
  1. Cardiovascular
  2. electrolyte and fluids
  3. endocrine
  4. fetus
  5. GI
  6. hematological change
  7. immune system
  8. metabolism
  9. renal system
  10. respiratory
  11. skin and CT
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2
Q

How does pregnancy affect cardiovascular and respiratory changes?

A

cardiovascular: increased cardiac output, blood volume and blood flow to uterus
respiratory: thoracic cage and diaphgram shift, sweating at lower temp

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3
Q

how does pregnancy affect metabolism changes

A

metabolic shift: increased gluconeogenesis and insulin secretion, rising insulin resistance and lypolysis
metabolism: max amount of sugar pulled from blood for fetus, insulin resistance increases since all the glucose is going to baby

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4
Q

how does pregnancy affect the renal and immune system

A

renal: increased renal blood flow, and sodium+water retention
immune: extra protection against infections

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5
Q

how does pregnancy affect endocrine and hematological changes

A

endocrine: elevated levels of hCG, progesterone, estrogen, thyroid function
hematological: increased BV, haemodilution, clotting

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6
Q

how does pregnancy affect GI, skin and fluid balance

A

GI: slower motility and improved nutrient absorption
Skin: loosens for birth
electrolyte: altered management

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7
Q

What are some benefits to physical activity during pregnancy

A
  1. increased cardiopulmonary reserve (how much it can pump)
  2. glucose regulation
  3. improved well being
  4. regulated weight gain
  5. fetal and placental adaptations
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8
Q

what are some suggestions for physical activity for pregnant women

A
  1. all woman should exercise (unless there are complications), at least 150 minutes a week, 3 times a week, both aerobic and resistance
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9
Q

What pre pregnancy factors influence pregnancy energy requirements

A
  1. BMI
  2. body weight change
  3. level of PA
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10
Q

What can excessive weight gain during pregnancy lead to

A
  1. gestational hypertension
  2. gestational diabetes
  3. C section
  4. birth defects
  5. child obesity
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11
Q

What is healthy weight gain for certain BMI classes?

A

underweight = 12-18kg
normal = 11-16kg
overweight = 7-11kg
obese = 5-9 kg

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12
Q

explain the distribution of weight in a pregnant woman

A

total weight gain = 25-35 pounds
breast = 1-2 pounds
baby = 6-8 pounds
placenta = 1-2 pounds
uterus = 1-2 pounds
amniotic fluid = 2-3 pounds

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13
Q

what are the energy needs for each trimester

A

1 trimester = no additional calories required
2nd trimester = +350kcal/day, since metabolic rate increased by 15%
3rd trimester = +450kcal/day

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14
Q

what are the macronutrient needs for pregnant woman

A

same as normal, but increase protein by 25 grams in second half of pregnancy

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15
Q

What micronutrient needs increase in pregnancy

A
  • vitamind B
  • folate +600mcg/day
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16
Q

how does folate deficiency affect pregnancy

A

deficiency leads to birth defecs in brain and spinal cord

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17
Q

How does vitamin D deficiency affect pregnancy

A
  • low birth weight
  • rickets
  • asthma
  • type 1 diabetes
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18
Q

What are calcium needs during pregnancy

A

1000mg/day??

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19
Q

what changes do we see in calcium demands/absorption during pregnancy

A
  • more demand placed on calcium stores
  • intestinal absorption increases
  • breast milk is high in calcium
  • gut becomes more sensitive to it
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20
Q

What changes in iron needs do we see in pregnancy

A
  • RDA increases to 27mg
  • supplementation recommended
  • increased requirements due to increased blood volume
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21
Q

Why is omega 3 important in pregnancy

A
  • positively associated with lower risk of preterm birth
  • DHA essential for visual and neurological development
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22
Q

What is the RDA for omega 3 during pregnancy

A

200-300mg/day. supplementation can be considered with health care team

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23
Q

what are some dietary considerations for pregnant woman>

A
  1. pica: wierd cravings
  2. caffeine - limit to 200-300 mgs/day
  3. avoid certain foods
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24
Q

what foods should be avoided by pregnant women

A
  • undercooked eggs or meat
  • cured meat
  • raw fish
  • soft cheese
  • pate
  • mercury rich foods
  • unwashed produce (ecoli)
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25
What is gestational diabetes
a form of diabetes that occurs during pregnancy, roughly 3-20% of them
26
how can gestational diabetes form
hormonal changes in pregnancy lead to insulin resistance
27
how can we diagnose gestational diabetes
1. glucose challenge test - drink 50g of glucose in 5 minutes, then in one hour draw blood (<7.8mmol) 2. oral glucose tolerance test - after GCT, drink 75 g glucose and 2 blood draws
28
what are the risks of gestational diabetes
1. maternal short term = increased BP and preeclampsi 2. maternal long term = risk of type 2 diabetes later in life 3. fetal macrosomnia= larger than normal baby 4. fetan neonatal hypoglycaemia= baby may have low blood sugar after birth 5. fetal obesity/diabetes= increased risk
29
how can we manage gestational diabetes
- dietary changes - exercise - monitor blood glucose
30
why is veganism/vegetarianism good in pregnancy
- high fibre and healthy microbiome - healthy weight gain
31
why is veganism/vegetarianims bad in pregnancy
- if inexperienced, means their body is not well adjusted, and can be deficient in protein, iron, calcium, DHA, zinc and B12
32
why is intake of sufficient calories important?
its important for growth, development and maturation
33
why is hydration really important in adolescents?
they have a higher surface area to body mass ratio, so more of their body is exposed to heat. they sweat less (fewer glands and less mature thermoregulatory system) they're really bad at hydrating
34
why is physical activity important in seniors?
1. reduces loss of cardio function, muscle strength and bone density 2. improves lipid profile 3. supports change in body mass and cognition 4. reduces insulin resistance
35
where is creatine synthesized
in the liver and kidney. synthezied from arginine, glycine and methionine (2-3g per day)
36
What are some foods high in creatine
meat, fish and poultry. 1g/day in omnivorous diet
37
what is special about creatine
it can cross the blood brain barrier and improves strength
38
where is most of the creatine in our body
in the muscle - 95%
39
define food allergy
a consistent adverse immune response to the proteins in a food =
40
what are the types of food allergies
1. IgE reaction 2. non-IgE reaction
41
what is an IgE reaction
Immunoglobulin E reaction: B cells make special antibodies for a food protein. it is life threatening and intense
42
what is a non-IgE reaction
- other parts of the body react, but it does not involve antibodies (believed to be T cell mediated), and is very specific
43
what are examples of non-IgE reaction
enterocolitis syndrom eosinophilic esophagitis disorder
44
what are the major allergens
peanut, tree nut, dairy, egg
45
why are allergens on the rise?
hygiene hypothesis: cleaner environments means a shift away from fighting germs and towards allergies
46
how many canadians have allergies
7.5% - 3-4% in adults - 6% in children
47
what are some risk factors for developing a food allergy
age: young children more common family history another food allergy related medical conditions: asthma, eczema or hay fever
48
how do we diagnose allergies?
1. Oral food challenge (gold standard): positive double blind, placebo 2. blood: food specific IgE test 3. skin prick test
49
what are the two responses to IgE tests?
class 1 and 2: low level allergy, low clinical reaction class 3-5: IgE reaction, higher degree of sensitivity
50
how do we treat allergies?
1. avoidance and epi pen 2. oral immunotherapy (exposure therapy) 3. sublingual immunotherapy = small amounts of food under the tongue, 2mg initially. high risk in older kids
51
describe the process behind oral immunotherapy as a treatment for allergies
-1-4 weeks = give a small amount of allergic food - 6+months = up dosing phase every two weeks - about 80% reach a maintenance dose and are "desensitized" - 1 year = able to tolerate much higher doses
52
what is food intolerance
It is a limited ability to digest certain foods. symptoms appear within hours to days, and it is much harder to identify since it involves the digestive system
53
what are some symptoms of food intolerance
nausea, bloating, abdominal pain, gas and diarrhea
54
how can we test for food intolerance
- go see naturopath, homeopaths etc. - requires detection of IgC antibodies
55
why are there concerns of at home tests for allergies/food intolerances?
1. lack of scientific support 2. expensive $350-450 3. poor counselling can lead to fear and avoidance of foods
56
how do we treat food intolerances?
1. history: eliminate true food allergy 2. eliminate common triggers: onion, coffee, gum etc 3. work on eating behaviours: pace, chewing, hydration 4. Low FODMAP diet
57
what are FODMAPs?
a collection of short chain carbs that aren't absorbed properly in the gut and can trigger symptoms in those with intolerance
58
what does FODMAP stand for
Fermentable Oligosaccharide Disaccharide Monosaccharide Polyol
59
what foods are suitable and not suitable for fodmap
low fodmap: banana, blueberries, carrot, celery, grains, lactose free milk high fodmap: milk, yoghurt, apple, mango, broccoli, onion, garlic, legumes
60
What are the differences between allergy and intolerance
Allergy: Immune system activated, exposure for symptom really small, symptoms within 1-2 hours, treatment of medicine or avoidance intolerance: no immune system activation, normal serving size for symptoms, symptoms in hours to days, treatment of limitation, avoidance
61
what are the type of sweeteners
natural: honey, stevia etc artificial: - nutritive: polyols - non-nutritive: no energy value
62
what are the 5 tastes
1. sweet 2. umami 3. bitter 4. salty 5. sour
63
What are some of the high intensity sugars?
acesulfame-k: 200x table sugar aspartame: 200x saccharin: 200-700x stevia: 200-400x sucralose: 600x
64
how are sweeteners regulated?
within acceptable intake, between 5-15mg/kg/bw/day, it does not cause cancer and is pretty safe
65
How much sweetener should we consume per day
>50mg/kg/bw/day
66
do non nutritive sweeteners affect appetite?
no impact yet shown?
67
do non nutritive sweeteners affect energy intake?
idk. question asked are do they result in lower calorie intake or is the lack of calories compesnated for?
68
Non nutritive can or can't help with weight loss
they can! its about reducing calories
69
do NNS sweeteners affect glucose homeostasis?
so far, no
70
What sweeteners have correlations with cancer
aspartame - no association sucralose - weak evidence acesulfame-K - weak saccharin - link in rats but not humans

Kin 232 (6 decks)

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