Nutrition

Question 1

fats

Answer 1

• 20-35% of total caloric intake

- focus on mono/polyunsaturated fats (liquid at room temp)

Question 2

protein

Answer 2

*71g/day

• structural basis for new cells and tissues in mother, fetus
• if deficient, body will use amino acids for energy instead of building new tissue

meat, fish, eggs, dairy, tofu/soy, legumes, nuts, seeds

Question 3

carbohydrates

Answer 3

*175g/day

• glucose to fuel fetal growth and development
• low carb NOT healthy in pregnancy; GDM should mildly restrict

some cereals, whole grains, starchy vegetables, legumes

Question 4

fiber

Answer 4

• 28g/day

Question 5

folate

Answer 5

*400-800mcg/day in 1st tri

• reduces risk of NTDs, oral cleft and CV defects
• low levels –> low placental, birth weight; inc pre-eclampsia

leafy greens, bananas, lentils, fortified cereals

Question 6

DHA and EPA

Answer 6

*200-300mg/day

• DHA: structure, growth, development of fetal CNS and retina; maintains neurotransmitter function; reduces risk of PTB
• ALA: converted to DHA and EPA

fish, seafood (12oz/wk)
*AVOID shark, swordfish, king mackerel, tilefish, marlin, orange rough

Question 7

iron

Answer 7

*27mg/day

• demand increases in 2nd trimester; peaks in 3rd
• supp if Hct<33% (1st, 3rd tri) or <32% (2nd tri)
• heme iron absorbed more readily than non-heme
• deficiency –> LBW, perinatal mortality, inc risk PTB

heme: meat, poultry, fish
non-heme: eggs, legumes, veg, fruits, grains, nuts, lentils, blackstrap molasses, fortified products

Question 8

What improves iron absorption?

Answer 8

Vit C

Question 9

What decreases/impairs iron absorption?

Answer 9

tannins

tea, wine, calcium, legumes, whole grains

Question 10

calcium

Answer 10

• 1300mg/day (14-18yo)
• 1000mg/day (19-50yo)
• fetal skeletal growth and development
• def –> inc bone loss during pregnancy

milk, yogurt, cheese (more fat = less Ca2+); green leafy veg, broccoli, cabbage, bok choy; fortified foods; tofu, soybeans, beans; figs, sunflower seeds, tahini, almonds

Question 11

Vitamin D

Answer 11

• 600IU/day
• 4000IU/day to achieve 40-60mg/mL
• helps body use Ca2+
• maximizes fetal bone growth
• reduces PTB, pre-eclampsia
• adequate levels important in northern climates

sunlight
eggs, salmon w/ bones, fortified milk/cereal

Question 12

1g fat = ?

Answer 12

9 calories

Question 13

1g protein = ?

Answer 13

4 cals

Question 14

1g carb = ?

Answer 14

4 cals

Question 15

BMI =

Answer 15

weight (kg) / height (m2)

Question 16

underweight

Answer 16

BMI < 18.5

total: 28-40lbs
1st tri: 5 lb
2nd, 3rd tri: 1-2lbs/wk

Question 17

normal weight

Answer 17

BMI 18.5-24.9

total: 25-35lbs
1st tri: 2-5lbs
2nd, 3rd tri: 1-2lbs/wk

Question 18

overweight

Answer 18

BMI 25-29.9

total: 15-25lbs
1st tri: 0-2lbs
2nd, 3rd tri: 1/2 - 2/3 lb/wk

Question 19

obese

Answer 19

BMI ≥ 30

total: 11-20
1st tri: 0-1lbs
2nd, 3rd tri: 1/2 lb/wk

Question 20

Where is weight gained in pregnancy?

Answer 20

• Baby: 6-8lb
• Placenta: 1.5lb
• Amniotic fluid: 2lb
• Uterus growth: 2lb
• Breast growth: 2lb
• Added body fluids: 8lb
• Added muscle and fat stores: 7lb

Question 21

What is the concern for lactose intolerant pts?

Answer 21

Ca2+ intake

Question 22

What is the concern for vegans, vegetarians?

Answer 22

Vit B12
Ca2+ (inc to 1200-1500mg/day)
Vit D
Fe
Protein
Long-chain fatty acids

Question 23

pica

Answer 23

compulsive and purposeful intake of non-nutritive substances for >1mo

Question 24

pagophagia

Answer 24

consumption of ice

Question 25

geophagia

Answer 25

consumption of dirt, clay

Question 26

amylophagia

Answer 26

consumption of corn starch

Question 27

How much caffeine may pts consume?

Answer 27

200mg = ~2c coffee

Question 28

Which artificial sweeteners should be avoided in pregnancy?

Answer 28

sacarine

aspartame for pts w/ PKU

Question 29

Vitamin B12

Answer 29

eggs, meat, poultry, shellfish, milk

Question 30

iodine

Answer 30

• prevents goiter and retinism

* sea salt does NOT contain iodine

Question 31

Vitamin B3 (niacin)

Answer 31

meat, fish, poultry, enriched adn whole-grain breads and cereals

Question 32

T or F: zinc absorption is enhanced in a vegetarian diet

Answer 32

false

Question 33

Vitamin B1

Answer 33

• energy metabolism

- occupies special site on nerve cell membranes

Question 34

Vitamin A

Answer 34

• add supplements ONLY if at risk for deficiency

carrots, vitamins, organ meats, sweet potatoes, pumpkins, green leafy vegetables, egg yolks