nutrition highlights in health and disease Flashcards
Nutrition in pregnancy - protein
10 g/ day extra, 40-55 g/day
At risk- veggies, dieters
deficiency–> increased risk of preeclampsia, long term risk to adult chronic diseases (fetal programming)
-> alters mechanisms that modulate BP, cholesterol metabolism, insulin response to glucose and other processes
Low Birth weight is a biomarker of porr nutriotional intrauterine environment
Low birth weight–> adult HTN, Insulin resistance type 2 DM, hyperlipidemia, MS
Placenta 11B HDSD2 inactivates cortisol, a low amount of the enzyme–> low birthweight
High placenta also gives rise to HTN
Nutrition in pregnancy and infancy Lipids
synapses are increased in density over time–> adulthood
Last months of development super important for rain
Brain is full of fat, largest membrane surface areas
mostly long chain polyunsaturated fatty acid DHA 22 6 omega 3, arachidonic acid (also sperm and retina)
DHA is required for brain development: neurogenesis (including effects on length and branching), migration and differentiation, synaptogenesis, neurotransmission (effects on membrane fluididty
Low plasma and RBC DHA associated with poor visual development in infants, poorer cognitive development in infants
Low brain DHA–low visual acuity and impaired attention–slower brain maturation
Most accumulation of DHA in the brain is during the last trimester and the 1st year of life, DHA in high concentration in synaptic membrane, myelin and retina
Premies miss the large fat transfer from the mom, gibe a bunch of DHA to the baby
Alpha linolenic acid
Today- omega 6 more than omega 3 (precursor to DHA!)
We cant make omega 3, and we cant convert omega 3 (linoleic acid from plants) to DHA (fish fat),
Lipids pregnancy and infancy
Omega 3 Fats and Dietary Recommendations
Pregnant women/ breastfeeding women: 8-12 oz of a variety of low mercury seafood
High mercury seafood: tilefish, shark, sworfish, king mackerels, marlin, bigeye Ahi tuna, orange roughy, Albacore tuna
Folate and pregnancy
Pregnancy and neural tube Defects
Folic acid zips up the neural tube
Spina bfida is a slightly unzipped neural tube
Brain and spinal cord is formed in the 1st month of pregancny, significantly reduces incidence of NTD offspring
most women dont know they are pregnant until 6-8 weeks
MTHFR gene folate pathway, mutation, woment with TT–> folate status can decrease
B12 deficiency in pregnancy and infants
vegan low B12, high methyl malonic acid indicates a low B 12,
Nutrition Breast milk
solid foods introduced at 4-6 months
Growth, breast fed infants grow longer and leaner than formula fed
lower risk of illness and obesisty and GI maturation
Immune factors, mother- infant dyad, contains immunoglobulins- IgA, IgG, IgD, IgE, when exposed to an infectious agent, immunoglobulins are produced against the organisms and given to infant
Secretory IgA- most abundant- resistant to protein digestion
binds with harmful bacteria, preventing their entry into the infants blood stream
when infants become infected, IgA helps decrease diarrhea that accompanies it
Lymphocytes, and lysozymes- bacterial cell walls, LActoferrin (iron binding- bacteria need free iron to survive and proliferate)
Human milk oligosaccharides (HMOs)- solid component of human breast milks, increase growth of B infantis (longum), non digested- allows microbiota growth, B infantis inhibits binding of the pathogenic bacteria, anti infalmmatory, decreases intestinal permeability via tight junctions, (decreased asthma, allergic sensitization, rihnitis,)
formula fed vs breast fed
Hospitilsation of Lower RTI, GI inf, ets otisi, necrotizing, asthma, atopic dermatits, childhood cancer, type 2 diabetes, obestiy
Infancy GERD vs normal phsyiologic reflux
healthy normal infants- many spit up on a daily basis, self resolving by a year ish
Infant stomach is smaller- ,, shaped differently, empties slower, LES is weaker, disorganize dperistalsis
PPIs are being used frequently. true GERD over 2 years, PPIS dont help infact hurt
Gaastric acid is an important defense mechanism,
nutrition needs in infancy
infants need more (double) puond for pound
vitamin D and iron
skin pigmentation is a UV light competitor
Pregnant women need vitamin D (premies)
Vitamin D up regulates innate immunity , seasonal peaks of infections influenza,
Expression of vitD receptors, expression of 1 a hydroxylase, Macrophage conversion of 25 OHD to 125oh2D, activation of the VDR and downstream cathelicidin and defensin activation and enhaced macrophage killing
RSV- in winter
supplement vit d
Iron an dpregnancy
Pregnancy is needed for Iron
moms RBC production
C section loses a lot of blood
Delayed cod clamping
Contiinue prenatal vitamins thry lactation and w/ c section
most common deficiency, watch for excess milk intake
Cows milk has low iron, and crowds out need, infants cant recycle iron (Hb, ETC in mirochondria), decreased motivation, attention span, intelligence, disruptive in kids its irreversible attention span, cognitive
Carbohydrates Anatomy of grains
Grains- husk-inedible, bran- fiber resistant starch, endosperm- starch and protein
Germ- nutirnt rich oils, vitamin E
Whole grain food- just husk removedm more slowly absorbed
White flour only endosperm
how to classify carbs
Chemical and structural properties, Gastrointestinal fate (Degree of digestion by human enzymes, rate of digestion and absorption, Digestion and fermentation by gut bacteria, profile of fermentation products, Where in the GIt is it digested/ fermented
Fruits have lots of simple carbs but the biber slows it digestability, small amounts
Regular sugars
Amylose and amylopectins- in processed breads
Starches in healthy foods are resistant starches
intestinal fate of carbs
the small intestines eat the small sugars–> blood, gives calories
colon starches go to fiber and resistant starches
want butyrare
Most fructose goes to liver and gets metabolized (low Km)
–> Lipids, give Vitamine E to prevent NASH
