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HSS4102 > Module 5 part 2 - Diet and pregnancy > Flashcards

Module 5 part 2 - Diet and pregnancy Flashcards

1
Q

What is neuralation?

A

process where the neural plate bends upwards and later fuses to form the hollow tube that eventually becomes the brain and spinal cord of CNS

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2
Q

What is a neural tube defect?

A

when the neural tube does not close properly
develop early during pregnancy

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3
Q

What are the 2 most common types of NTDs?

A
  1. spinal bifida (spinal cord defect)
  2. anencephaly (brain defect)
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4
Q

What are 6 risk factors for NTDs?

A
  1. already have a baby with a NTD
  2. family history of NTD
  3. have type 1 diabetes
  4. obese
  5. taken medications (sodium valproate)
  6. low circulating folic acid levels
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5
Q

What is the enzyme called that reduces the monoglutamate form to THf and converts it to either methyl or formyl forms of folate?

A

dihydrofolate reductase

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6
Q

What is the main form of folate in plasma?

A

5-methyl-THF

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7
Q

What is the bacteria called that is significant in the human gut microbiota for regulating folate production?

A

bifidobacterium

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8
Q

Can folate be syntehsized by another microbiota in the human body? if so, which one?

A

YES –> colonic microbiota (can be absorbed across the colon)

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9
Q

What are the 4 functions of folic acid?

A
  1. synthesis of purine and thymidine –> needed for DNA replication an repair
  2. methyl donor –> key to DNA methylation as an epigenetic regulation mechanism
  3. converts homocysteine to methioine in synthesis of SAM –> important for metabolic functions
  4. important to rapidly dividing cells in any tissues especially in pregnancy
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10
Q

See slide 13 for one carbon metabolism

A
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11
Q

What 2 things have low levels of folic acid been associated with?

A
  1. elevated homocysteine –> increased risk for heart disease and stroke
  2. birth defects –> NTDs especially
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12
Q

How can NTDs be prevented in pregnancy?

A

increasing folate (folic acid) intake at least a month before pregnancy and during the first 3 months of pregnancy

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13
Q

When it is critical to keep folate levels good in pregnancy>

A

3rd and 4th week of pregnancy

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14
Q

How is folic acid helpful in pregnancy besides preventing NTDs?

A
  • helps with placental development
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15
Q

What are the 3 receptors that have been associated with folate transport across the placenta during pregnancy?

A
  1. folate receptor - alpha (FOLR1) and beta (FOLR2)
  2. reduced folate carrier (RFC)
  3. proton coupled folate transporter (PCFT)
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16
Q

which folate transport receptor showed the greatest expression in placentas from pregnancies complicated with birth defects? WHY

A

proton couple folate transporter (PCFT)

probably an adaptive response to increase the folate flux at the maternal fetal interface

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17
Q

What are some things (hormones, substances, conditions, etc..) that could affect the transport of folate in the placenta? does it increase or decrease uptake?

A
  1. having gestational diabetes –> decrease uptake
  2. high levels of leptin –> decrease uptake
  3. Intrauterine Growth Restriction (IGUR) –> decreases uptake especially at RfC protein expression
  4. alcohol –> decrease uptake
  5. increased FOLR1 methylation –> ??
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18
Q

When the mother was deficient in folate, what two things can be inhibited in terms of the placenta and signalling?

A
  1. mTORC1
  2. mTORC2
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19
Q

What does mTORC do?

A

involved in the function and growth of the placenta during pregnancy. The mTOR pathway responds to nutrient availability and growth factors that regulate protein expression and cell growth

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20
Q

Can folic acid decrease the risk of preclampsia? if so how (x2)?

A

YES
1. reduces plasma homocysteine
2. improves the function of endothelial cells

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21
Q

What is placental abruption? can this occur with folic acid deficency?

A

placenta separates from the wall of the uterus before birth
YES

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22
Q

Is paternal folate deficiency in mice show effects? if so what?

A

YES
1. infertility and subfertility
2. reduced sperm number
3. increased sperm DNA damage
4. embryo defects
5. increased birth defects
6. differential methyaltion sperm genes implicated in development
7. chronic diseases developments

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23
Q

Does a paternal folate deficiency have more of an impact of fetal weight or placental weight?

A

Placental weight –> showed a significant reduction!

It is essential in regulating placental folate metabolism

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24
Q

Why is folate important for the males? (4 take aways)

A
  • male reproductive health
  • reduces germ-line mutation frequency and chromatin instability
  • embryo development is dependent on paternal folate status (placental growth, protection from developmental delay and congenital anomalies)
  • mechanism is likely through changes in sperm DNA –> METHYLATION
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25
Q

What has hyperhomocysteinemia in pregnant women been associated with?

A
  • venous thrombosis
  • recurrent miscarriage
    -abruption placentae
  • preeclampsia
  • neural tube defects
  • fetal growth restriction.
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26
Q

Does folate help convert homocysteine into methionine?

A

YES

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27
Q

What can homocysteine cause?

A
  1. heart attack
  2. some birth defects
  3. depression
  4. AD
  5. osteoporosis
  6. stroke
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28
Q

As you get older you need more folic acid. Even a little more if you are pregnant or breast feeding. True or false

A

true

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29
Q

What foods are rich in folate?

A

beans
peas
lentils
oranges and orange juice
asparagus
broccoli
dark leafy green vegetables such as spinach and mustard greens

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30
Q

What is more bioavailable folate or folic acid?

A

folic acid

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31
Q

what can hinder the activity of folates (x2)?

A
  1. catechins and polyphenols (tea, cocoa, wine, other plant foods)
  2. alcohol
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32
Q

Can there be an increased risk of cancer in you have chronically elevated levles on unmetabolized folic acid?

A

YES –> but there are more pros to folic acid than cons so the benefits outweigh the risks

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33
Q

What are other micronutrients that are important to fetal growth and development (8)? –> look at sldie 47-48 for function

A
  1. Choline
  2. Vitamin B12
  3. Vitamin B6
  4. Omega 3 fatty acids
  5. DHA
  6. iodine
  7. Vitamin A
  8. Iron
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34
Q

Is it recommended to lose weight/be underweight while you are pregnant? why or why not?

A

NO!
associated with…
- LBW
- difficulty breast freeding
- increased risk for developmental delays and illness
- poor offspring growth development
- various pregnancy complications (if underweight pre-pregnancy)

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35
Q

Is it normal to lose weight (few pounds) in the first trimester of your pregnancy?

A

YES- b/c of morning sickness

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36
Q

during the rest of pregnancy, gaining weight becomes more important for baby’s healthy development. true or false

A

true

37
Q

what is the key thing to do if you are losing weight in prergnancy>

A

get your key nutrients!! –> high quality prenatal vitamin is helpful

38
Q

Gaining more than the recommended weight during pregnancy does not put you at risk for maternal obesity. true or false

A

false –> it does

39
Q

What are 6 things that maternal overweight and obesity associated with?

A
  1. maternal morbidity
  2. preterm birth
  3. infant mortality
  4. hypertension
  5. preclampsia
  6. gestational diabetes
40
Q

what 3 things account for about 35% of total pregnancy weight gain?

A
  1. placenta
  2. fetus
  3. amniotic fluid
41
Q

What is the goal with weight during pregnancy?

A

balance getting enough nutrients to support the growth of your fetus and maintaining a healthy
weight

42
Q

What 4 things should you look for when choosing a good prenatal vitamin?

A

if it has…
1. vitamin D
2. Vitamin C
3. niacin
4. Vitamin E

43
Q

What 2 things do you need more of nutrient wise when you are pregnant and why?

A
  1. folic acid –> prevents NTDs
  2. iron –> supports development of placenta and fetus
44
Q

When should you start taking prenatal vitamins?

A

before conception or when you are of reproductive age regularly

45
Q

What is vitamin A good for?

A
  • sperm production
  • normal reproductive cycles in females
46
Q

What are the 2 forms of vitamin A and where it is found or used?

A
  1. preformed vitamin A –> used directly by the body, found in animal products
  2. provitamin A carotenoids –> must be converted into retinol
47
Q

How is vitamin A helpful during pregnancy (x6)?

A
  1. embryonic growth (development of heart, eyes, lungs, kidneys, and bones, CNS, respiratory and circ system)
  2. helps with postpartum tissue repair
  3. maintains normal vision
  4. fights infection
  5. supports immune system
  6. fat metabolism
48
Q

Can vitamin A in excess teratogenic to embryonic development?

A

Yes@

49
Q

If you’re pregnant or thinking of having a baby: avoid taking supplements containing vitamin A, including fish liver oil, unless advised to by your GP.
Avoid liver or liver products, such as pâté, as these are very high in vitamin A. True or false

A

True

50
Q

What is vitamin D3 also known as and where is it generated?

A

cholecalciferol

skin of animals when light energy is absorbed by a precursor molecule 7- dehydrocholesterol.

51
Q

the two step process of Vitamin D3 metabolized within the body to the hormonally-active form (1,25-dihydroxycholecalciferol). true or false

A
  1. true
52
Q

What does the active form of vitamin D bind to?

A

intracellular receptors that then function as transcription factors to modulate gene expression

53
Q

What is vitamin D known for?

A
  1. mineral metabolism
  2. bone growth
  3. facilitate intestinal absorption of calcium
  4. stimulates absorption of phosphate and magnesium
54
Q

What is the 2 common outcomes of low vitamin D in pregnancy and fetal development (look at slide23 when in doubt)

A
  • musculoskeletal problems (rickets, osteomalacia)
  • development of autoimmune diseases and susceptibility to disease (ex: asthma, allergies)
55
Q

What is vitamin B12 known for (x4)?

A
  1. RBC formation
  2. cell metabolism
  3. nerve function
  4. production of DNA
56
Q

What food sources contain vitamin B12?

A
  • poultry
  • meat
  • fish
  • dairy products
57
Q

Why is vitamin B12 important for fetal development?

A
  • brain development
  • produces healthy RBCs
58
Q

How does the fetus get vitamin B12 (x2)?

A
  1. placenta
  2. breast milk
59
Q

What are 2 essential fatty acids called that must be obtained from our diet (hint one is an omega 3 and the other is an omega 6?

A
  1. ALA (omega 3)
  2. linoleic acid (omega 6)
60
Q

What 2 things is ALA converted into that can only be consumed in food or dietary supplements to increase their levels in the body?

A
  1. EPA
  2. DHA
61
Q

Where is ALA found in foods?

A

plant oils (flaxseed, soybean, canola oils)

62
Q

Where is DHA and EPA found in foods?

A
  • fish
  • fish oils
  • krill oils
63
Q

What role does Omega-3s and Omega 6s play in the body?

A
  • provides energy for the body
  • form eicosanoids
64
Q

Where in the body is DHA found in high concentrations (x3)?

A
  • retina
  • brain
    -sperm
65
Q

What are eicosanoids?

A
  • signaling molecules
  • wide- ranging functions in the body’s cardiovascular, pulmonary, immune, and endocrine systems
66
Q

If eicosanoids are made from omega 6s, what are they mediators of?

A
  • inflammation
  • vasoconstriction
67
Q

If eicosanoids are made from omega 3s, what are they mediators of?

A

platelet aggregation

68
Q

What is the ratio of omega 3 to omega 6 we should have>\?

A

2-4:1 or 15-20:1

69
Q

How are omega 3 fatty acids helpful in fetal development?

A
  • DHA –> nervous system development
  • maintain balanced production of prostaglandins –> function for blood clotting!
  • make breast milk
70
Q

higher consumption of omega-3s may reduce
the risk of allergies in infants. true or false

A

true

71
Q

How are omega 3s good for pregnant women?

A
  • EPA and DHA intake prevents….
    1. preterm labour
    2. preclampsia
72
Q

What can risk is increased when consuming omega-3’s during pregnancy?

A

development of depression –> explain why postpartum mood disorders may become worse and begin earlier with subsequent pregnancies

73
Q

What are the risks of women at reproductive age who have anemia (low iron)?

A
  • increased risk of poor birth outcomes (LBW, PTB, still birth, death)
  • adverse maternal outcomes (death, postpartum hemorrhage, preeclampsia)
74
Q

How is iron helpful in fetal development?

A

-formation of placenta
- role in organ development (brain especially!)

75
Q

What hormones in the brain are affected by iron?

A
  • dopamine
  • noradrenalin
  • adrenaline
  • 5-hydroxytrytamine
76
Q

What is zinc known for in the body?

A
  • protein synthesis
  • cellular division
  • nucleic acid metabolism
77
Q

Severe zinc deficiency is not rare in humans. True or false

A

false -> it is rare

78
Q

What is zinc known for in fetal development during pregnancy?

A
  • helps slightly reduce preterm births
  • sperm formation
79
Q

Where is 75% of iodine stored in the body?

A

thyroid gland –> makes hormones necessary for physiological processes

80
Q

Having an iodine deficiency impacts fetal development how?

A
  • most damaging in the first few years of child life
  • LBW
  • decreased child survival
  • long-term impacts of fetal neurocognition –> reduced intellectual and motor performance, impaired speech development, learn, reading, and behaviour disorders
81
Q

Why are the thyroid hormones that iodine makes possible important to us?

A

ALL FOR NORMAL BRAIN DEVELOPMENT
- neurogenesis
- neuronal and glial cell differentiation and
migration,
- synaptogenesis
- myelination

82
Q

Where can you get an iodine deficiency by eating this in our diets?

A
  • cruciferous vegetables –> high in goitrogens that can cause an iodine deficency
  • women of child bearing age following a paleo diet
  • vegan
83
Q

What is the only form of Vitamin E that is used by the human body?

A

alpha-tocopherol

84
Q

What are some roles of vitamin E?

A
  • anti-oxidant
  • improve immune system
  • expand blood vessels
  • prevent blood clots
  • help produce prostaglandins
85
Q

Where is vitamin E found in foods?

A
  • vegetable oils
  • nuts
  • cereals
  • some leafy green vegetables
86
Q

What are you at risk of if you are vitamin E deficient in pregnancy?

A
  • pre-eclampsia
  • LBW
87
Q

How can vitamin E help the fetus?

A
  • neuro and brain development
  • decrease risk of preterm birth
88
Q

Is there such thing as consuming too much Vitamin E in pregnancy? if so, what can occur?

A

YES
- increase chance of birth defects
- increase your risk of bleeding

HSS4102 (7 decks)

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