Nutrition Flashcards
Fetal growth factors
Genetic-
Maternal-
Uterine size/circulation and placental implantation
Nutrition (delayed effects)
Endocrine increased in GH, GH-peptides (placental lactogen)
Placental-
What effect does placental lactogen have on fetal growth?
Relative insulin-resistance–>
Increased glucose and lipid concentrations–>
Increased fetal insulin–>
Increased fetal growth, adiposity, decreased protein breakdown
Mediated by IGF
What components of fetal composition decrease with gestational age and BW?
Total body water
Extracellular water
Sodium
Chloride
What components of fetal composition increase with gestational age and BW?
Intracellular water Protein Fat Calcium Phosphorus Magnesium Iron
What is the daily calorie expenditure of a fetus?
35-55kcal/kg/d
Where does the fetus get the majority of its energy source?
Maternal glucose 2/3 of fetal energy Transferred by facilitated diffusion ---> Glycolysis ---> Carbon source ---> Glycogen storage
What are the sources of caloric energy for the fetus?
Maternal glucose (2/3) Placental lactate (1/4) Maternal amino acids (remaining- transferred by active transport)
Essential amino acids
Lysine Phenylalanine Threonine Tryptophan Methionine Histidine Valine Leucine Isoleucine
Essential fatty acids are
Linoleic
Linolenic
LCPUFA’s are absorbed by
Reesterification
Chylomicron formation
Lymphatic transport by lipoproteins
S/MCFA are absorbed by
Hydrolyzed to FFA
Absorption across mucosa
A _____:______ ratio of _____ suggests fatty acid deficiency
Triene: tetrene ratio
> 0.4
The predominant carbohydrate in breast milk and most formulas is
Lactose
Transport of water soluble vitamins across the placenta is by
Active transport
Transport the fat soluble vitamins across the placenta is by
Simple or facilitated diffusion
Megaloblastic macrocytic anemia with hypersigmented neutrophils is caused by ____ deficiency
Vitamin B12 and folic acid
Vitamin B12 deficiency with anemia is associated with
Methylmalonic acidia
Homocystinuria
Vitamin E deficiency presents with
Hemolysis Anemia and reticulocytosis Thrombocytosis Acanthocytosis Neurologic deficits
Photophobia, conjunctivitis, abnormal epithelial bone formation, abnormal tooth enamel, scaling, failure to thrive are associated with ______ deficiency
Vitamin A
Fatigue irritability constipation cardiac failure (beriberi syndrome) are associated with ______ deficiency
Vitamin B1
Food to thrive, photophobia, blurred vision, dermatitis, mucositis are associated with ______ deficiency
Vitamin B2
Metabolic disorders associated with vitamin B1 deficiency are
Pyruvate dehydrogenase complex deficiency
Maple syrup urine disease
Glutaric aciduria type 1 is associated with ______ deficiency
Vitamin B2
Hypochromic anemia, seizures, dermatitis, mucositis are associated with ______ deficiency
Vitamin b6
Homocysteinuria is associated with ___ deficiency
Vitamin b6
Alopecia, dermatitis, scaling, seborrhea are associated with ______ deficiency
Biotin
Biotin deficiency is associated with these four metabolic disorders
Biotinidase deficiency
Beta methylcrotonyl glycinuria
Propionic academia
Pyruvate dehydrogenase complex deficiency
Poor wound healing and bleeding gums is associated with ______ deficiency
Vitamin C
Transient tyrosinemia can be associated with _____ deficiency
Vitamin C
Chromium is related to
Insulin production
Copper is related to
RBC production
Iron is related to
Hemoglobin and myoglobin
Duodenum/jejunum absorption
Manganese is related to
Enzyme activation
Bone structure
A cofactor for glutamine peroxidase is
Selenium
A component of enzymes carbonic anhydrase and carboxypeptidase is
Zinc
Zinc deficiency or impaired transport can cause
FTT Alopecia Diarrhea Dermatitis Acrodermatitis enteropathica Acquired zinc deficiency
In pregnancy, milk production is inhibited by
Estrogen
Progesterone
Lactose augments GI production is
Lactobacilli
Immunoglobulin in breast milk is
IgA
The main enzyme in breast milk is
Lipase
Primary breast milk components are
Whey (protein)
Lactose (CHO)
Long chain unsaturated fatty acids
Fatty acids increased in breast milk
Palmitic acid
Arachnidonic acid
DHA
Cholesterol
Inositol is involved in
Membrane synthesis
Retinal injury prevention
Surfactant production
Choline is a component of _____ and ______, involved in ________
Acetylcholine
Phophatidylcholine
CNS development
Carbohydrate gives ____ kcal/g and should be ___% of total kcal
3.4kcal/g
50%
Fats are ____kcal/g and should be ____% of total kcal
9kcal/g
40%
Protein is ____ kcal/g and should be ___% of total kcal
4 kcal/g
10%
Calcium phosphorus ratio should be
1.3-1.7:1
Lipid calories calculation
TF x 2.2kcal/ml
Protein calories calculation
Protein g/kg/d x 4 kcal/g
Fat calories calculation
Fat g/kcal/d x 9 kcal/g
GIR calculation
(% dextrose. X. TF)/ 144