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Nutrition through life > Requirements during pregnancy > Flashcards

Requirements during pregnancy Flashcards

1
Q

why energy requirement increase during pregnancy

A
  • An increase in BMR is one of the major components to the increase in energy requirement during pregnancy.
  • The increase in BMR is due to (1) the metabolic contributions of the uterus and fetus, and (2) the increase in work of the lungs and heart.
  • Fat-free mass (FFM) is the strongest predictor of BMR, as fat mass is not metabolically active.
  • In pregnancy, the FFM is comprised of:

o An increase in blood volume (low energy-requiring)

o Skeletal muscle mass (moderate energy-requiring)

o Fetal and uterine tissues (high energy-requiring, which is the major reason causing the raise in BMR)

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2
Q

how much energy is used by the fetus of energy added to the diet during late pregnancy

A

half of increment in energy expenditure

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3
Q

how much kcal fetus uses per kg of body weight per day

A

56 kcal/kg

a 3 kg burns 168 kcal per day

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4
Q

The additional energy requirements of pregnancy include

A
  • (1) the energy required to provide for the growth of tissues, and (2) the energy required for the maintenance of new tissue.
  • The new tissue includes the products of conception (fetus, placenta, amniotic fluid), and the increased maternal tissues (uterus, breasts, blood).
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5
Q

the energy cost of new tissue deposition may be calcualted from

A
  • from the amount of protein and fat deposited throughout the pregnancy.
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6
Q

what is recommended PAL

A
  • 1.6 – 1.7
  • Active
  • 60 min/d moderate intensity (walking 4 mph)
  • Converted to PA coefficient for EER calculation
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7
Q

what is low energy, moderate and high energy -requiring tissues expenditure in fetus

A
  • FFM in pregnancy is comprised of
  • ↑ Blood volume -> Low energy-requiring
  • Skeletal muscle mass -> Moderate energy-requiring
  • Fetal and uterine tissues -> High energy-requiring
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8
Q

how much energy is needed to gain 1 g of protein and 1 g of fat

A

5.6 kcal/g for pro and 9.5 kcal/g for fat

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9
Q

how much kcal is deposited every day during pregnancy and was it similar to theoreical value calculation

A

180 kcal/day,

  • The estimated energy deposition from this study was similar to the theoretical energy cost of tissue deposition analyzed previously.
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10
Q

What happens to PAL during pregnancy

A
  • There is a steady decrease in PAL as pregnancy advances.
    • PAL = TEE/BMR

During pregnancy, there is an increase in BMR, causing a decrease in PAL

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11
Q

median increase of TEE throughout pregnancy is

A

8 kcal/per gest.week

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12
Q

EER during pregnancy is the sum of

A

The EER during pregnancy is the sum of the (1) TEE of the woman in a non-pregnant state, (2) the median change in TEE of 8 kilocalories/week, and (3) the energy deposition of 180 kilocalories/day

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13
Q

when enrgy should be added in food durign pregnancy

A
  • During the first trimester, there is little weight gain and variation in TEE.
    • The additional energy required is solely acknowledged as of the second trimester.
  • The first trimester occurs from weeks 1 to 12, the second trimester from weeks 13 to 27, and the third trimester from week 28 to birth.
  • 8 kilocalories per week is multiplied by the midpoint week during the second trimester (week 20), and the midpoint week for the third trimester (week 34) to avoid over- and underestimations.
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14
Q

why pregnant women need more protein

A
  • The additional protein requirements for pregnancy are based on (1) the support in growth of maternal and fetal tissues, and (2) for the maintenance of additional protein stores.
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15
Q

when protein requirements for pregnant women increase

A
  • Protein requirements vary with each trimester due to differences in protein needs for growth, and maintenance of the additional total protein accretion that has accumulated by the end of each trimester.
    • The estimate of protein requirements is based on the growth and body composition at the end of each trimester, which assures an adequate protein intake to support growth throughout gestation.
  • As the total weight gain by the end of each trimester increases with the duration of pregnancy, the additional protein intake required to maintain the increased body weight increases as well.
    • There is low deposition of tissue during the first trimester, and, thus, there is NO increase in protein requirement during the first trimester.
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16
Q

what is the requirement for protein in women

A
  • The protein needed for new tissue to growth and the protein needed for the maintenance of new tissue during pregnancy is additional to non-pregnant protein requirements.
    • The additional pregnancy protein requirement during the second and third trimesters are averaged to devise the EAR for protein during pregnancy.
  • The average total additional protein requirement (EAR) is 21 grams of protein per day, assuming the average additional body weight gain over 40 weeks of gestation is 16.0 kg.
    • The RDA for pregnant women is 25 grams of protein per day of additional protein.
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17
Q

what mothers have decreased risk of low borth weight infants (what products)

A
  • A protein and/or energy poor diet prior to, or during pregnancy, is associated with an increased risk of low-birth weight.
  • Mothers that eat more servings of dairy products, meat, and fish are at a decreased risk of low-birth weight infants.
  • The pre-pregnancy period is key to prepare for the demands of pregnancy.
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18
Q

how much in advance women should prepare for pregnancy

A
  • Provision of protein and energy supplements for 5 to 7 months, instead of 2 months before conception, provide higher birth weight and greater birth length.
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19
Q

why omega 6 are important in pregnant women and what is requirement

A
  • Omega-6 fatty acids are incorporated into placental tissue and fetus and must be obtained from the maternal tissues or through dietary intake.
  • The AI is based on median linoleic acid intake of pregnant women, in which there is a lack of evidence for deficiency. There is a lack of information to determine an EAR.
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20
Q

Omega-3 FAs during pregnancy

A
  • The demand for omega-3 fatty acids must be obtained from the maternal tissues or through dietary intake.
  • The AI is used to determine the requirement for omega-3 fatty acids.
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21
Q

Principal EFA in Blood of Low-Birth Weight and Normal Birth Weight Infants

A
  • A study measured essential fatty acid content in maternal blood and fetal cord blood indicated that there are higher levels of ETA (omega-9 fatty acid), and lower levels of arachidonic acid (omega-6 fatty acid) and DHA (omega-3 fatty acid) in low-birth weight infants.
  • High levels of ETA indicate an essential fatty acid deficiency.
    • If there is a lack of both omega-6 and omega-3 fatty acids, desaturase enzymes produce omega-9 fatty acids, such as ETA, from oleic acid.
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22
Q

why vegetarians have higher risk of infants with cognitive developement problemes

A
  • Vegetarian diets provide an excessive omega-6 to omega-3 ratio due to high linoleic acid intake (e.g. 15:1, 20:1).
  • Adequate ratio of omega-6 to omega-3 range from 4:1 to 10:1.

Vegetarians have higher quantities of AA (arachidonic acid) and lower amounts of DHA, which could pose risk for brain development

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23
Q

why there is an increased metabolic rate in pregnancy

A
  • Pregnancy induces an increase in metabolic rate due to an increased fuel requirement.
  1. The establishment of the placental-fetal unit
  2. An increase in the energy supply for the growth and development of the fetus
  3. An increased maternal storage of fat EARLY in pregnancy
  4. Energy to sustain the growth of the fetus during the last trimester
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24
Q

what adaptations happen during pregnancy in regards to CHO requirement

A
  1. ↓ Fasting maternal blood [glucose]
  2. Development of insulin resistance
  3. Tendency to developing ketosis
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25
Q

What hormones contribute to insulin resistance

A

Placental lactogen, estrogen, and progesterone

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26
Q

What is the role of Placental lactogen, estrogen, and progesterone in insulin resistance

A
  • Blunting of the action of insulin increases catabolism of maternal fat, glycogen, and protein to increase nutrient uptake by the fetus.
  • After consuming a meal, the blood sugar of the mother becomes particularly high, increasing the uptake of glucose by the placenta.

During the second half of pregnancy, there is an upregulation of glucose transporters on the fetal portion of the placenta, increasing the uptake of glucose

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27
Q

RQ during pregnancy is ____ for both BMR and 24-hour energy expenditure

A

increased

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28
Q

what does it mean increase in glucose utilization by the maternal-fetal unit

A
  • Glucose oxidation may solely account for 70% of the estimated fetal brain’s fuel requirement, which indicates that the fetal brain can clearly use keto acids. Conversely, there is commonly an increase in keto acids in pregnant women.
  • The glucose requirement in late gestation is 33 grams per day. Conversely, the amount of glucose that is transferred from the mother to the fetus is lower (17 to 26 grams per day) in late gestation.
  • If non-glucose sources supply 30% of the fuel requirement of the fetal brain, then the fetal brain glucose utilization rate is 23 grams per day.
  • These findings exhibit that the fetal brain utilizes essentially all the glucose derived from the mother
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29
Q

CHO requirement furing pregnancy is based on

A
  • The carbohydrate requirement during pregnancy is based on the transfer of an adequate supply of glucose to the fetal brain (33 grams per day) that is independent of the utilization of keto acids.
    • The EAR for carbohydrates is equal to the EAR for non-pregnant women (100 grams/day) with the rounded additional amount required during the last trimester (35 grams/day), which is equal to 135 grams/day.
    • CV=15%-> RDA=175 grams/day
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30
Q

Should CHO be consumed from some particular source?

A

•No evidence to indicate that a certain portion be consumed as starch or sugar

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31
Q

For heart health for normal individuals what is recommendation for fiber

A

•For heart health: 14 g Dietary Fiber/1,000 kcal, particularly from cereals = Fiber AI

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32
Q

what is the difference between functional fiber and dietary fiber

A
  • Functional fiber may be found in the diet, but it is either isolated and extracted from food, or synthesized in a laboratory setting. Functional fiber is specifically made to exert a physiological effect.
  • In comparison to functional fiber, dietary fiber also comes with other nutrients and phytochemicals, which may also exert beneficial effects.
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33
Q

Is there a change in requirement for pregnant women in terms of fiber

A
  • There is no evidence that the beneficial effect of fiber for pregnant women is different than for non-pregnant women.
  • The AI remains 14 grams of dietary fiber per 1000 kilocalories. Given that the reference intake of a pregnant women is 2000 kilocalories, the AI for pregnant women is 28 grams/day of fiber.
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34
Q

Is thirst a good marker for water intake

A
  • Thirst is not correlated with fluid needs, as by the time a sensation of thirst is detected, the body has already been significantly stressed by a loss of fluid or change in sodium status. Behaviour dictates fluid intake.
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35
Q

what is the requirement for water in pregant women

A

In adults it is 2.7,when in pregnancy 3 L/day , AI

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36
Q

How energy components change during pregnancy summary

A

Component of Energy Requirements

Increase, Decrease, or No Change

BMR

­

TEE

increased for both TEE and BMR

­

PAL

decreased

EER

  • No change during the first trimester
  • ­ increased during the second and third trimesters
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37
Q

Is there an increase in Ca requirement during pregnancy?

A

No

  • The lack of correlation between the number of pregnancies and bone mineral density, as well as that additional calcium does not provide benefit during pregnancy indicates that there is no additional requirement for calcium during pregnancy, particularly as it is known that calcium absorption increases during pregnancy.
38
Q

When the most Ca is needed for fetus and how it is achieved if the requirements are not higher

A
  • Around 25 to 30 grams of calcium are transferred to the fetus throughout the duration of the pregnancy. The majority of the transfer occurs during the third trimester, which corresponds to the maximal period of skeletal growth.
  • The major physiological adaptation to meet the increased need for calcium is an increase in efficiency in intestinal absorption.
39
Q

how vitamin D influences Ca status during pregnancy

A
  • Blood [1,25 (OH)2D], which is active vitamin D (calcitriol), increases during pregnancy. That being said, the role of calcitriol is unclear.
    • Vitamin D increases calcium absorption by decreasing urinary calcium excretion, increasing calcium resorption from bone, and increasing absorption from the intestine.
    • However, during pregnancy, the change in calcium absorption is NOT due to vitamin D but may be due to changes in calciotropic hormones.
40
Q

Does the woman suffer from not enough Ca intake?

A
41
Q

Do pregnant women need to consume more P and does anythign happen to its metabolism

A
  • There is no additional phosphorus requirement during pregnancy.
  • There is an increase of 10% in intestinal absorption of phosphorus during pregnancy, which may possibly cover increased phosphorus requirements during pregnancy.
42
Q

Mg requirement __ during pregnancy

Serum Mg ____, which may be due to ____. It parallels with __

A
  • The requirement for magnesium increases during pregnancy.
  • Serum magnesium decreases during pregnancy, which may be due to hemodilution.

This parallels the decrease observed in serum potassium

43
Q

Why requirement for Mg is increased during pregnancy

A
  • There is no data that indicates that magnesium is conserved during pregnancy or that intestinal absorption is increased. Thus, the increase in magnesium requirement for pregnant women is associated with their weight gain, as it is assumed that weight gain results in an increased requirement for magnesium.
44
Q

Requirement for iron ___ during pregnancy

A

increases

45
Q

How does iron req increase ( components)

A
  • The requirement for absorbed iron in pregnancy includes (1) basal losses, (2) iron deposited in the fetus and related tissues, and (3) iron from the expansion of hemoglobin mass.
  • The total usage of iron throughout pregnancy is equal to 1,070 mg:
    • 250 mg (basal losses)
    • 320 mg (fetal and placental deposition)
    • 500 mg (increase in hemoglobin mass)
46
Q

when requirements for iron increase

A
  • The requirement for iron are increased during the second and third trimesters, but the absorption also increases during the second and third trimesters.
  • The requirement for iron during the first trimester is lower than in non-pregnant women, but the requirement for iron during the second and third trimesters are increased.
47
Q

How anemia can influence pregnancy

A
  • Severe anemia (hemoglobin below 40 g/L) is associated with perinatal maternal mortality.
  • Moderate anemia (hemoglobin below 80 g/L) is associated with twice the risk of maternal death due to heart failure, hemorrhage, and infection.

Large epidemiological studies demonstrate that maternal anemia is associated with premature delivery, low-birth weight infants, and an increased perinatal infant mortality

  • Iron deficiency (1) limits the expansion of maternal red blood cell mass, and (2) decreases hemoglobin synthesis, which increases the workload of the maternal heart to supply the fetus with oxygen.
48
Q

Can there be high hemoglobin, what are the consequences and causes

A
  • High hemoglobin at the time of delivery is associated with adverse pregnancy outcomes (e.g. SGA).

High hemoglobin may reflect a decreased plasma volume associated with maternal hypertension and pre-eclampsia, which are associated with an increased risk of poor fetal outcome.

49
Q

why iron is important for fetus

A
50
Q

Do pregnant women need supplements for iron

A
  • The habitual Canadian diet cannot meet the iron RDA, which means that pregnant women are recommended to ingest iron supplements.
  • Supplementation assumes inadequate pre-pregnant iron stores.
    • If a woman possesses normal iron stores prior the supplement, a supplement during pregnancy may be unnecessary, as storage iron can be used. However, iron levels prior to pregnancy are rarely verified, in which case women in general are recommended to ingest iron supplements.
51
Q

As needs decrease during first semester for iorn, do requirement for iron are different

A

EAR and RDA established using estimates for the 3rd trimester to build iron stores during 1st trimester

for all 27 mg/day

52
Q

What is happening to K requirement during pregnancy

A

There is no additional potassium requirement during pregnancy. The AI for potassium during pregnancy is the same as for non-pregnant women

DRI considers a recommended intake level for a nutrient to reduce the risk of chronic disease, the chronic disease risk reduction intake (CDRR) . However, the committee found the evidence to be insufficient to derive a CDRR for potassium. AI based on the highest median potassium intakes in pregnant adults

decreased frim 4.7 g to 2.6 g/day for healthy women

53
Q

why there is an increase in sodium requirements in pregnancy, does it mean that there is increase in AI for Na

A
  • Pregnancy requires an extra 2.1 to 2.3 grams of sodium to (1) maintain the increase in plasma volume, (2) provide for the products of conception.
    • The accumulation occurs over the course of the pregnancy.
  • The additional sodium required is 0.07 grams/day, which is so minimal that sodium requirements during pregnancy do not differ from that of non-pregnant women., AI=1.5 g/day
  • No evidence to change UL for pregnant women
54
Q

Do lower Na intake than recommended will help during pregnancy

A

-Na reduction has no apparent benefit in lowering BP or preventing pregnancy-induced HTN or its complications

55
Q

why thiamine requriements increase during pregnancy

A
  • During pregnancy, the requirement for thiamin increases by 30% due to (1) an increase in growth of maternal and fetal compartments (20%), and (2) a small increase in energy utilization (10%).
56
Q

What happens to riboflavin requirements during pregnancy and why

A
  • The requirement for riboflavin increases during pregnancy.
  • During pregnancy, there is an additional riboflavin requirement of 0.3 mg/day due to (1) an increase in growth of maternal and fetal compartments, and (2) a small increase in energy utilization.
57
Q

whay happens to riboflavin excreion in late pregnancy and what can happen in deficiences

A
  • There is a decreased urinary excretion of riboflavin during the progression of pregnancy, and an increased frequency of appearance of clinical signs of ariboflavinosis (sores on the mouth) in pregnant women at low intakes (< 0.8 mg/day).
    • If a pregnant woman and a non-pregnant woman both ingest 0.8 mg/day of riboflavin, the clinical signs (ariboflavinosis) appear more frequently in pregnant women than in non-pregnant women.
58
Q

is the an increase in requirement for niacin

A
  • The requirement for niacin increases during pregnancy.
  • There is no direct evidence to suggest a change in niacin requirement during pregnancy.
  • The EAR is estimated that the need for niacin increases by 3 mg/day of niacin equivalents to account for the increase in energy utilization and growth.
59
Q

what happens to vitamin B 6 requirement?

A

Increase

60
Q

Why vitamin B6 requirement increase?

A
  • There is a significant fetal uptake of vitamin B6.
  • The fetus and placenta accumulate 25 mg of vitamin B6 during the duration of pregnancy (0.1 mg/day).
  • There is an increase in metabolic needs and weight of the mother, and a 75% bioavailability of vitamin B6 in food, which produces an additional average pregnancy requirement of 0.25 mg
61
Q

when need for vitamin B6 is the highest

A
  • The increased need is concentrated in the second half of gestation.
    • Vitamin B6 is not stored in the body to any substantial extent, and it is unlikely that a surplus in early gestation would satisfy the increased need later in gestation.
    • An extra 0.6 mg/day of vitamin B6 is required to meet the need in the third trimester.
62
Q

what happens to th biomarker of vitamin B6 in the body during pregnancy

A

The maintenance of plasma [pyridoxal phosphate] at non-pregnant values requires 2 mg/day of supplemental vitamin B6 during the first trimester, and 4 to 10 mg/day during the third trimester

63
Q

why folate requirements increase during pregnancy

A

During pregnancy, folate requirements increase substantially due to (1) single-carbon transfer reactions, and (2) nucleotide synthesis (cell division) for uterine enlargement, placental development, expansion of maternal erythrocyte number, and fetal growth

64
Q

how do we know that folate is actively trnasported to the fetus

A
  • Umbilical cord blood has a higher plasma folate concentration than the maternal blood, which indicates that folate is actively transferred to the fetus.
65
Q

inadequate folate results in

A
  • in a decrease in maternal serum and erythrocyte folate, developing megaloblastic marrow changes, and subsequent megaloblastic anemia if inadequate intake continues.
66
Q
  • The primary indicator of adequacy of folate is
A

the maintenance of erythrocyte folate, which reflects tissue stores.

67
Q

EAR for pregnant women is derived from

A

The EAR is derived by adding the quantity of DFEs (200 μg/day), the EAR for non-pregnant women (320 μg/day), forming an EAR of 520 μg/day of DFEs, RDA 600

To decrease the risk of developing an infant with a NTD, women that are capable of becoming pregnant must consume 400 μg/day of folic acid from fortified foods, supplements, or both, and must consume food folate from a varied diet

68
Q

How requirement for cobalbumin changes during pregnancy

A

The requirement for vitamin B12 increases during pregnancy

69
Q

How extra vitamin B12 is provided in pregnant women and what happens ti B12 concentrations in blood

A
  • The absorption of vitamin B12 may increase during pregnancy, in which there is an increase of intrinsic factor-B12 receptors.
  • The serum total vitamin B12 concentration decreases during the first trimester by a significant factor, which indicates that it is not caused by hemodilution, as hemodilution is sparse during the first trimester.
  • By the sixth month of pregnancy, the levels of vitamin B12 decrease to half the concentration found in non-pregnant women, which is partially due to hemodilution.
70
Q

what vitamin B12 is taken by the fetus, does the mothere suffer

A
  • Only the newly absorbed vitamin B12 is readily transported across the placenta. Thus, the maternal liver stores are a less important source of the vitamin for the fetus.
    • The current maternal intake and absorption of vitamin B12 during pregnancy are more important components of vitamin B12 status in infants than maternal vitamin B12 stores.
71
Q

What happens to infants if mothers were strictly vegetarian 3 years before

A
  • Vitamin B12 deficiency in infants aged 4 to 6 months is associated with mothers following a strict vegetarian diet for only 3 years.
72
Q

By how much EAR for B12 is increased

A
  • There is a fetal deposition of 0.1 to 0.2 μg/day of vitamin B12, as the maternal absorption of the vitamin becomes more efficient, causing an increase in the EAR by 0.2 μg/day.
73
Q

what happens to metabolism and requirement for vit b7

A
  • There is no additional biotin requirement during pregnancy.
  • Recent studies concerning biotin are conflicting, demonstrating either a lower or higher plasma concentration of biotin during pregnancy.
  • There is an increase in a biotin metabolite (3-hydroxyisovaleric acid) in over half of the healthy pregnant women by the third trimester.
    • There is a decrease in the urinary excretion of biotin in 50% of women.
74
Q

what can b7 requirement affect during pregnancy

A
  • The consumption of a raw egg (avidin) white increases biotin requirement.
  • Biotinidase deficiency decreases the function of the enzyme, which separates biotin from proteins and enzymes within food components, aiding in the recycling of the biotin. Thus, biotinidase deficiency increases biotin requirement.
  • Anticonvulsants induce biotin catabolism, increasing biotin requirement.
  • Pregnancy
75
Q

why it is thought that maybe ther eis insufficient vitamin B7 intake in pregnant women

A
  • The ratio of biotin metabolites to the amount of biotin excreted in the urine is increased during pregnancy.
  • Normal changes or indicative of low biotin intake vs need?
76
Q

Why choline requirement increase

A
  • The requirement for choline increases during pregnancy.
  • There is a substantial quantity of choline delivered to the fetus through the placenta, which may deplete the maternal stores of choline.
77
Q

Choline function during pregnancy

A
  • Choline may be associated with an important role during embryogenesis and perinatal development.
    • A study demonstrated that mice fed extra dietary choline demonstrate a long-lasting enhancement of spatial memory.
  • Choline deficiency in pregnancy may lead to increased concentrations of homocysteine, and potentially birth defects.
    • However, 90% of Americans are not ingesting sufficient quantities of choline.
78
Q

Increase in digested choline can be doen with

A

Increased eggs consumption

79
Q

how B6,b12 and folate are related

A
  • The endogenous pathway for the de novo biosynthesis of choline is derived from phosphatidylethanolamine.
    • Betaine, derived from choline, is used as a methyl donor to convert homocysteine to methionine.
    • If there is a deficiency in vitamin B12 or folate, the system utilizes betaine, derived from choline, to detoxify homocysteine into methionine. Thus, a sub-optimal level of vitamin B12 and folate may negatively influence choline levels.
80
Q

Increased choline intake study showed

A
  • is (1) an increased fetal demand for phosphatidylcholine during pregnancy, (2) an increase in maternal choline intake during the last trimester, and (3) a decrease in the baby’s circulating cortisol by altering the methylation state and the expression pattern of genes that regulate cortisol production in the placenta.
81
Q

Do pregnant women need mroe vit B5

A
  • There is no additional pantothenic acid requirement during pregnancy.
  • There is no information showing that usual intakes are inadequate for pregnancy.
  • The rounded AI is utilized to determine the requirement for pantothenic acid in pregnant women, which is higher than in non-pregnant women but NOT because of an increased need, but simply due to the fact that the AI happens to be higher in pregnant women.
  • The AI for pantothenic acid is higher in pregnant women, but this just represents the USUAL intake of pregnant women. It is not due to an increased requirement.
82
Q

why vitamin C requirements increase during pregnancy

A
  • The requirement for vitamin C increases during pregnancy.
  • The quantity of vitamin C within the plasma decreases with the progression of pregnancy due to hemodilution and the active transfer to the fetus, which increases vitamin C requirement during pregnancy.
83
Q

based on what info vitamin C requirement wasa set for pregnant women and what should happen so the requirement is increased

A
  • The quantity of additional vitamin C required is based on the knowledge that 7 mg/day of vitamin C is required to prevent young infants from developing scurvy.
    • The EAR for pregnancy is estimated to increase by 10 mg/day, producing an RDA of 85 mg/day.
  • The requirement for vitamin C is increased in certain subpopulations, such as women who frequently consume street drugs, cigarettes, heavy alcohol, and aspirin.
  • Smoking over 20 cigarettes per day doubles the requirement for vitamin C.
84
Q

why requirement of vitamin A increases during pregnancy

A

The EAR is based on (1) the required accumulation of vitamin A in the fetal liver during gestation, and (2) the assumption that the liver contains half of the body’s vitamin A when liver stores are low, such as in newborns.

85
Q

when most of vitamin A is stored and what is absortption efficiency

A
  • The efficiency of maternal vitamin A absorption is 70%.
  • Vitamin A accumulates mostly during the last three months of pregnancy.
  • The requirement for vitamin A increases by 50 μg/day during the last trimester
86
Q

CV for vitamin A is

A

20%

87
Q

Ul for vitmain A is based on

A
  • In non-pregnant women, the UL for vitamin A is based on liver abnormalities, and in pregnant women, the UL for vitamin A is based on teratogenicity.

An increased intake of beta-carotene has not been shown to be associated with vitamin A toxicity

88
Q

is there an additonal requirement for vit D,E, K during pregnancy?

A

No

89
Q

is vitamin D transferred to the fetus?

A
  • There are only small quantities of active vitamin D that are transferred to the fetus, which do not affect overall vitamin D status of a pregnant woman.

An intake of 400 IU/day, supplied by pre-natal vitamin supplements, would not be excessive.

90
Q

Vitamin E deficiency may occur in what infants

A

premature newborns, which is termed hemolytic anemia, as vitamin E prevents oxidants from destroying red blood cells.

91
Q

Can increased intake help with deficiency symptoms of vit E in infants

A

There are no reports of deficiency during pregnancy, and there is no evidence that maternal supplementation would prevent deficiency symptoms in premature offspring, which indicates that vitamin E supplementation for pregnancy is not necessary

Nutrition through life (7 decks)

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