Pregnancy Flashcards
Which 5 things might affect food safety in pregnant women?
Vitamin A (retinol), Fish, Alcohol, Caffeine and foodborne illnesses may cause food safety issues in pregnant women
Identify possible food safety issues during pregnancy: VITAMIN A: Retinol
Possible food safety issues during pregnancy:
Vitamin A
- Retinol form can be harmful to foetus
- >8000-10000 micrograms is harmful, teratogenic
- Teratogenic = substance that can have a negative effect on embryo or foetus development causing abnormalities/ birth defects
- Teratogenesis includes: cleft lip, cleft palate, fluid on the brain, heart defects etc.
Study showed pregnant women who used products containing 12-cioretinoic acid had babies with cranio facial abnormalities, heart defects and CNS issues.
- Studies have shown effects of retinol in animals (rabbits, rats, mice) to be detrimental to offspring
- Studies show links to supplement use and birth defects
- Studies show liver intake can be detrimental due to high Vit a content
- Study showed liver intake increased circulating retinoids acid metabolites in women in greater amounts in comparison to supplementation
- Advised not to consume Vitamin A supplements or supplements that contain retinol
- Advised not to consume liver or pate during pregnancy
- Plant based sources of carotene can be consumed freely e.g carrots
Identify possible food safety issues during pregnancy: FISH
FISH
- Fish high in methylmercury can be harmful to foetus: tuna, swordfish, shark, marlin
- Methylmercury half life= 70 days
- Maternal exposure 1 year prior to pregnancy determines foetal exposure
- >3.3 micrograms (ug)/kg per week may be harmful. Equivalent to 280g of fresh tuna or 560g of canned tuna.
- Canned tuna has less methylmercury than fresh
- Bloomingdale et al. 2010 found that advice to limit fish to 2 portions per week led to avoidance of fish consumption in pregnant women due to fear of infant harm
- Unsaturated fat is important for baby development. LC omega 3 FA are needed for brain and visual development. Low fish consumption may affect intake of vital nutrient.
- However advice to limit oily fish due to presence of dioxins and polychlorinated biphenyl.
- Limit of 2 portions of oily fish per week
- Limit of 2 portions of fish with methylmercury per week
- NHS advice: no more than 2 portions of oily fish
- NHS advice: no more than 2 tuna steaks or 4 medium cans of tuna.
- NHS advice: tuna isn’t oily fish so can be consumed alongside oily fish.
Which foods should be avoided in pregnancy?
Foods to be avoided in pregnancy:
- Liver, pate or vitamin A containing supplements
- Raw, cured or game meats
- Mould ripened soft cheeses
- Unpasteurised milk or foods made from it
- Raw or partially cooked eggs if not British lion eggs.
- Alcohol
- Liquorice root
Consumption of which foods should be limited during pregnancy
Foods that should have limited intake during pregnancy:
- Fish that may be contaminated with methylmercury (no more than 2 portions per week)
- Oily fish (no more than 2 portions per week)
- Caffeine (no more than 200mg/day)
- Herbal tea ( no more than 4 cups per day)
Describe the physiological changes during pregnancy
Physiological changes during pregnancy:
-Placental development
-Uterus growth
-Breast enlargement for lactation
- Blood volume increase for placenta exchange leads to increased iron and folate requirements for increased RBCs.
-Changes to the respiratory system: Deeper breathing and improved maternal gaseous exchange
-Changes to the gut: gut slows down. Reduced motility and gastric acid secretion which may increase calcium and iron absorption to support the growth of the foetus and maternal tissue changes. The baby may press on the mother and make her breathless
- Changes to the urinary system: kidney function changes. Kidneys increase in size, the filtration rate also increases. Changes in fluid balance and waste excretion. The baby may press on the bladder.
- High fat depot breakdown during the last trimester
- 10-12kg of weight gained with the fat stores having the greatest increase
- Baby bones becomes ossified so mother’s calcium store is important
What are the nutrient and micronutrient recommendations for pregnant women?
Nutrient and micronutrient recommendations during pregnancy
- Extra 200kcal per day in 3rd trimester
- Vitamin C: 50 mg/ day (addition 10mg) to increase iron absorption
- Vitamin D: 10 micrograms/day. Deficiency increases infant rickets risk and lowers calcium absorption.
- 400 micrograms of folate during first 12 weeks to reduce chance of neural tube defects. Could also support formation of RBCs.
- Iron supplementation advised for women with anaemia history. Best for all pregnant women to eat iron rich sources.
- Requirements for most B Vitamins are increased by 10-50% in pregnancy
- South Asian, Black, Middle Eastern, obese women may benefit from Vitamin D supplements as are most at risk for deficiency.
- No changes to carbohydrates
- Protein changes not advised in UK due to excess consumption. But additional 6g per day in final trimester may be advised in some places.
What nutritional advice may be given in plant based pregnancy?
Plant based pregnancy nutritional advice:
- Take a Vit B12 supplement
- Protein complementary
- LCFA supplementation
- Iodine supplement
- Do things to increase mineral bioavailability
Describe diet-related conditions that may occur during pregnancy
Describe diet-related conditions that may occur during pregnancy
* Vitamin D deficiency
* Iron deficiency anaemia: may cause low birth weight, preterm delivert, neonatal death
* Gestational diabetes: increased insulin resistance during pregnancy to ensure theres adequate glucose supply for infant- increased rates of insulin secretion
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Appraise the impact of nutrition in pregnancy on birth weight and long-term health
- Gestational diabetes may lead to large baby/ heavy weight > 4.5kg > higher risk of overweight or obesity and developing type 2 diabetes in later life
- Gestational diabetes has permanent effect on foetal glycaemic control, increased T2D
- Obesity: greater risk of miscarriage, gestational diabetes, pre-eclampsia, birth defects, birth trauma
- Low maternal energy intake, poor maternal dietary quality, low maternal weight gain, low pre-pregnancy BMI <20kg/m2 associated with low birth weight
- Barker’s hypothesis: low birthweight associated with chronic disease in adult life: coronary heart disease, hypertension, high cholesterol and T2D
- Excessive dietary intake leading to weight gain
Explain the increased maternal demand for energy, protein and micronutrients during pregnancy
- Iron: for placenta development, increased blood volume, and blood losses during delivery. Increased intake not necessary due to adaptations.
- Calcium: Foetal skeletal growth in last trimester. Increased intake not necessary due to adaptations
- Iodine: deficiency associated with death and cretinism. Increased intake not necessary in UK.
- Vitamin D: for increased calcium mobilization
Evaluate the main physiological changes that take place during pregnancy and how these impact micronutrient needs
Evaluate the main physiological changes that take place during pregnancy and how these impact micronutrient needs
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