Nutrition Through The Life Cycle Flashcards
Nutrition role in epigenetics
. Fetal origins hypothesis: retain genes in fetus may or may not be activated depending on environment exposed to in utero
Main goals of nutrition-related care
. Identify women who are at nutritional risk
. Provide appropriate nutritional management
. Attention should be paid to patient’s weight status, dietary practices, and use of harmful substances
What maternal factors decrease fetal birth weight?
. Under 5 yrs since 1st period . Under 90% standard weight . Excessive work or exercise . 50% decrease in calories while pregnant . Over 20 cigarettes/day . Chronic cocaine use . Social alcohol use
Milieu
. Causes complex series of adjustments in carbs, protein, and fat metabolism during gestation so fetus gets continuous fuel supply
Main fuel for fetus
. Glucose
. Has low glycogen stores and low rate of gluconeogenesis so it depends on mom’s glucose
. Early pregnancy the carb intake matches fetal requirement
. As pregnancy progresses the glucose need inc. and maternal sensitivty to insulin dec. to high glucose in blood can go to fetus
. Late pregnancy mom uses alternative fuels so fetus can have glucose
Fluctuations in glucose and hormone levels during pregnancy
. After meal women enters starved state rapidly from inc. fuel use for fetus
. Causes rapid decline in insulin and rise in counter regulatory hormones to inc. lipolysis
. Maternal hyperglycemia inc. glucose transfer to fetus since glucose transporters don’t require insulin
Gestational diabetes
. Occurs in women w/ no prior history of DM
. Resolves after pregnancy
. Inc. risk of preeclampsia and future risk of DM
. Universal screening accords btw 24 and 28 weeks gestation
. Treatment: involves diet regulation, adequate distribution of calories btw carbs, at and protein and sometimes insulin
What determines Energy requirements during pregnancy
. Change in mother’s usual physical activity
. Inc. in her BMR to support the work required for growth of fetus and accessory tissues
. Total energy needed: 40,000-70,000 calorie
Additional calorie recommendations for pregnancy from institute of medicine
. No extra in 1st trimester
. 340 extra per day in second
. 450 extra per day in 3rd
Protein requirement during pregnancy
. 15% total energy intake should be from protein
. Higher in 2nd and 3rd trimester
Lipid requirement in pregnancy
20-35% total calories
. Adequate amounts of omega-3s
Carb requirement during pregnancy
. Pre-pregnancy requirement
Micronutrient requirement during pregnancy
. Inc. in quantity
Vit. A in pregnancy
. Cross placenta and fetal storage account for recommendation of extra 1000 IU of it daily
. Can cause toxicity in mega doses
Iron during pregnancy
. Placenta has transferrin receptors
. Needed to manufacture Hb in both maternal and fetal RBCs
. Fetus accumulates most of its iron (80%) in the last trimester
. Most common cause of iron deficiency anemia in infant is prematurity due to lack of time to acquire sufficient iron
Ca in pregnancy
. Fetus acquires most of Ca in last trimester when skeletal growth is maximal and teeth are formed
. Hormonal factors are responsible for extensive adjustments in Ca metabolism that takes place in pregnant woman