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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
Q

What is gestational diabetes

A

a form of diabetes that occurs during pregnancy, roughly 3-20% of them

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26
Q

how can gestational diabetes form

A

hormonal changes in pregnancy lead to insulin resistance

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27
Q

how can we diagnose gestational diabetes

A
  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
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28
Q

what are the risks of gestational diabetes

A
  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
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29
Q

how can we manage gestational diabetes

A
  • dietary changes
  • exercise
  • monitor blood glucose
30
Q

why is veganism/vegetarianism good in pregnancy

A
  • high fibre and healthy microbiome
  • healthy weight gain
31
Q

why is veganism/vegetarianims bad in pregnancy

A
  • if inexperienced, means their body is not well adjusted, and can be deficient in protein, iron, calcium, DHA, zinc and B12
32
Q

why is intake of sufficient calories important?

A

its important for growth, development and maturation

33
Q

why is hydration really important in adolescents?

A

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
Q

why is physical activity important in seniors?

A
  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
Q

where is creatine synthesized

A

in the liver and kidney. synthezied from arginine, glycine and methionine (2-3g per day)

36
Q

What are some foods high in creatine

A

meat, fish and poultry. 1g/day in omnivorous diet

37
Q

what is special about creatine

A

it can cross the blood brain barrier and improves strength

38
Q

where is most of the creatine in our body

A

in the muscle - 95%

39
Q

define food allergy

A

a consistent adverse immune response to the proteins in a food

40
Q

what are the types of food allergies

A
  1. IgE reaction
  2. non-IgE reaction
41
Q

what is an IgE reaction

A

Immunoglobulin E reaction: B cells make special antibodies for a food protein. it is life threatening and intense

42
Q

what is a non-IgE reaction

A
  • other parts of the body react, but it does not involve antibodies (believed to be T cell mediated), and is very specific
43
Q

what are examples of non-IgE reaction

A

enterocolitis syndrom
eosinophilic esophagitis disorder

44
Q

what are the major allergens

A

peanut, tree nut, dairy, egg

45
Q

why are allergens on the rise?

A

hygiene hypothesis: cleaner environments means a shift away from fighting germs and towards allergies

46
Q

how many canadians have allergies

A

7.5%
- 3-4% in adults
- 6% in children

47
Q

what are some risk factors for developing a food allergy

A

age: young children more common
family history
another food allergy
related medical conditions: asthma, eczema or hay fever

48
Q

how do we diagnose allergies?

A
  1. Oral food challenge (gold standard): positive double blind, placebo
  2. blood: food specific IgE test
  3. skin prick test
49
Q

what are the two responses to IgE tests?

A

class 1 and 2: low level allergy, low clinical reaction
class 3-5: IgE reaction, higher degree of sensitivity

50
Q

how do we treat allergies?

A
  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
Q

describe the process behind oral immunotherapy as a treatment for allergies

A

-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
Q

what is food intolerance

A

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
Q

what are some symptoms of food intolerance

A

nausea, bloating, abdominal pain, gas and diarrhea

54
Q

how can we test for food intolerance

A
  • go see naturopath, homeopaths etc.
  • requires detection of IgC antibodies
55
Q

why are there concerns of at home tests for allergies/food intolerances?

A
  1. lack of scientific support
  2. expensive $350-450
  3. poor counselling can lead to fear and avoidance of foods
56
Q

how do we treat food intolerances?

A
  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
Q

what are FODMAPs?

A

a collection of short chain carbs that aren’t absorbed properly in the gut and can trigger symptoms in those with intolerance

58
Q

what does FODMAP stand for

A

Fermentable
Oligosaccharide
Disaccharide
Monosaccharide
Polyol

59
Q

what foods are suitable and not suitable for fodmap

A

low fodmap: banana, blueberries, carrot, celery, grains, lactose free milk
high fodmap: milk, yoghurt, apple, mango, broccoli, onion, garlic, legumes

60
Q

What are the differences between allergy and intolerance

A

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
Q

what are the type of sweeteners

A

natural: honey, stevia etc
artificial:
- nutritive: polyols
- non-nutritive: no energy value

62
Q

what are the 5 tastes

A
  1. sweet
  2. umami
  3. bitter
  4. salty
  5. sour
63
Q

What are some of the high intensity sugars?

A

acesulfame-k: 200x table sugar
aspartame: 200x
saccharin: 200-700x
stevia: 200-400x
sucralose: 600x

64
Q

how are sweeteners regulated?

A

within acceptable intake, between 5-15mg/kg/bw/day, it does not cause cancer and is pretty safe

65
Q

How much sweetener should we consume per day

A

> 50mg/kg/bw/day

66
Q

do non nutritive sweeteners affect appetite?

A

no impact yet shown?

67
Q

do non nutritive sweeteners affect energy intake?

A

idk. question asked are do they result in lower calorie intake or is the lack of calories compesnated for?

68
Q

Non nutritive can or can’t help with weight loss

A

they can! its about reducing calories

69
Q

do NNS sweeteners affect glucose homeostasis?

A

so far, no

70
Q

What sweeteners have correlations with cancer

A

aspartame - no association
sucralose - weak evidence
acesulfame-K - weak
saccharin - link in rats but not humans

Kin 232 (6 decks)

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