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Biochemistry > Nutrition Through The Life Cycle > Flashcards

Nutrition Through The Life Cycle Flashcards

1
Q

Nutrition role in epigenetics

A

. Fetal origins hypothesis: retain genes in fetus may or may not be activated depending on environment exposed to in utero

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2
Q

Main goals of nutrition-related care

A

. 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

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3
Q

What maternal factors decrease fetal birth weight?

A 
. 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
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4
Q

Milieu

A

. Causes complex series of adjustments in carbs, protein, and fat metabolism during gestation so fetus gets continuous fuel supply

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5
Q

Main fuel for fetus

A

. 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

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6
Q

Fluctuations in glucose and hormone levels during pregnancy

A

. 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

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7
Q

Gestational diabetes

A

. 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

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8
Q

What determines Energy requirements during pregnancy

A

. 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

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9
Q

Additional calorie recommendations for pregnancy from institute of medicine

A

. No extra in 1st trimester
. 340 extra per day in second
. 450 extra per day in 3rd

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10
Q

Protein requirement during pregnancy

A

. 15% total energy intake should be from protein

. Higher in 2nd and 3rd trimester

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11
Q

Lipid requirement in pregnancy

A

20-35% total calories

. Adequate amounts of omega-3s

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12
Q

Carb requirement during pregnancy

A

. Pre-pregnancy requirement

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13
Q

Micronutrient requirement during pregnancy

A

. Inc. in quantity

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14
Q

Vit. A in pregnancy

A

. Cross placenta and fetal storage account for recommendation of extra 1000 IU of it daily
. Can cause toxicity in mega doses

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15
Q

Iron during pregnancy

A

. 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

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16
Q

Ca in pregnancy

A

. 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

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17
Q

zinc in pregnancy

A

. Active constituent in enzymes or cofactor

. Supplementation found to improve maternal reproductive outcome

18
Q

Mg deficiency in pregnancy

A

. Assoc. w/ inc. risk of miscarriage, fetal growth retardation and preterm delivery

19
Q

Tissue effects from fetal malnourishment

A

. Reduced size and number of cells in placenta
. Reduces number brain cells and head size
. Proportional reduction in size of other organs
. Alterations in normal cell constituents
. In protein malnutrition the rapidly dividing cells suffer the most

20
Q

Influencing factors on fetus with maternal malnutrition

A

. Fetal consequences of malnutrition depend on timing, severity, and duration of maternal dietary restriction
. Consequences can be reversible if restriction primarily affects growth in cell size

21
Q

Fetal alcohol syndrome

A

. Most severe form of fetal alcohol spectrum disorder
. Leading cause of non-genetic based intellectual disabilities
. Facial abnormalities, growth deficiency, and CNS dysfunction
. High rate of prenatal mortality, but those that survive are irritable and hyperactive after birth
. Total brain weight positively correlated w/ peak alcohol blood concentration
. High alcohol conc. Reduces or displaces transfer of nutrients through placenta
. Significant if alcohol use is in 1st trimester

22
Q

Infant physical growth

A

. From rite to 1 y/o infants triple their weight and inc. length by 50%
. Birth weight determined by mother’s pre-pregnancy weight and her weight gain during pregnancy
. Weight loss occurs at first due to loss off fluid and some catabolism of tissue (ang. 6% but can exceed 10%) but returns to birth weight by 10th day

23
Q

Factors contributing to inc. needs to daily requirements in infants

A

. High resting metabolic rate
. Growth and development
. Inefficient absorption

24
Q

Nutrient requirements in infants

A

. Carbs and fats necessary
. Protein greater than adults bc AAs needed
. Fe from prenatal reserves and food sources

25
Q

Renal solute load

A

. For each g of protein ingested, 4 mOsm of solute are produced in form of urea
. Makes infants vulnerable to water imbalance

26
Q

Advantages of breast feeding

A

. Easily digested
. Allows for maternal weight loss
. Fewer infections

27
Q

Major non-immune components of breast milk

A

. Carbs: lactose is 40% calories bc giestion and absorption is less efficient than other sugars but is important for generation of acid environment in distal bowel
. Human milk oligosaccharides: indigestible but is prebiotic, aids in GI bifidobacteria growth, prevents infections by mimicking glycine receptors
. Fat: 50% calories, difficult to digest so less is absorbed than consumed
. 0.2% DHA
. Proteins: 10% calories, casein and whey

28
Q

Transient lactose intolerance in infants is seen in ___

A

. Premature infants (50% lactase activity)

. Infants following acute viral or bacterial gastroenteritis

29
Q

Whey contents in breast milk

A

. Igs
. Enzyme (alpha-amylase, lipase) hormones
. Nucleotides and other N-containing compounds
. AAs like taurine and essential AA binding proteins
. Alpha-lactalbumin used in lactose synthesis
. Lactoferrin that binds to Fe inhibiting bacterial multiplication

30
Q

Macrophages in breast milk

A

. Produce lysozyme

. Breakdown bacterial cell wall and destroy it

31
Q

T/F infants don’t make Igs for weeks or months after birth

A

T

32
Q

Maternal IgA

A

. Antibody that is protected from digestion in guts of infants
. Specific for the antigens in her environment and work on specific pathogens
. Useful so gut bacteria can grow while preventing harmful bacteria from taking over
. Doe sno cause inflammatory response

33
Q

Bifidus factor

A

. Stimulates growth of bifidus bacteria

. Antagonizes The survival of enterobacteria

34
Q

Infant formula

A

. Made from cow’s milk by removing butter fat, adding veggie oil, carbs, and dec. protein
. Can’t reproduce immunological properties, digestibility, and tropic effects of human milk

35
Q

Disadvantages of cow’s milk

A

. Poorly digested fat
. Low con. Vit. C
. Excessive Na and PO4 that can result in high renal solute load inc. risk of dehydration w/ vomiting, diarrhea, or heat exposure
. GI bleeding
. Risk of milk protein allergy
. No recommended before 6-12 months of age

36
Q

Solid foods for infants

A

. Have extrusion reflex that prevents solid food intake before 4-5 months old
. Solid food starts 4-6 months after the learn oral and gross motor skills

37
Q

Ca, Fe, and Zn in adolescents

A

. Ca: 45% skeletal mass is formed during adolescence
. Women usually don’t achieve genetically determined bone mass
. Fe: losses w/ periods
. Zn: important for growth and sexual maturation

38
Q

Body composition changes when aging

A

. Dec. in lean body mass and inc. in total body fat
. Energy requirements dec. over lifespan due to decline in physical activity and metabolic activity of lean body mass (recommended energy intake reduction each year after 30)

39
Q

Sarcopenia

A

. Loss of muscle mass and strength
. Assoc. w/ functional impairment
. More commonly seen in men than in women

40
Q

Nutrient requirements with aging

A

. Protein needs do not decline, may need more if frail or chronically ill to maintain nitrogen balance
. Vit. D: inc. from 400 to 600 IU/day due to dec. GFR
.Vit. B6 needs inc. w/ age
. Dec. Fe requirement in women w/ age as period stops

Biochemistry (64 decks)

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