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Clinical Nutrition > Test 1 Lactation > Flashcards

Test 1 Lactation Flashcards

1
Q

Infertility vs subfertility

A

Infertility: inability to conceive within 12 months of trying

Subfertility: women who have had 2-3 losses or ovulate infrequently or men with sperm abnormalities

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2
Q

Most important micronutrients in the preconception state?

A

Zinc
Folate
Iron
Vitamin A

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3
Q

Lifestyle for increasing fertility

A

Adequate weight
Don’t smoke
Limit alcohol

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4
Q

Female diet for increasing fertility

A 
Vitamin D
Multivitamin with Folic acid
Iron
Protein
More PUFAs
Less caffeine
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5
Q

Male diet for increasing fertility

A 
Vitamin D, C
Calcium
Zinc
Low GI index foods
Less caffeine, animal protein and soy
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6
Q

Most important nutrients for fetal brain development

A 
Iron
Zinc
Iodine
PUFA
Vitamin A
B12
Folate
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7
Q

Physiological changes in blood during pregnancy

A
  • Increased volume
  • Water soluble components decrease
  • blood lipids increase
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8
Q

Physiological changes in circulatory system during pregnancy

A
  • Increase HR/CO
  • low BP first half, high BP second
  • low mg/ca intake associate with higher BP
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9
Q

Physiological changes in GI during pregnancy

A

Heartburn
Nausea/vomiting
Increased transit time (constipation)

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10
Q

Physiological changes in kidneys during pregnancy

A
  • GFR increases 50%

- increased Na retention

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11
Q

Physiological changes in metabolism during pregnancy

A

-fetus prefers glucose energy (carb intake)
-increased protein synthesis
Decreased nitrogen excretion
-fat storage in first half, mobilization in second half
-increased Ca absorption and mobilization from bone
-increased metabolism (fasts 12+ longer increase many keytones)

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12
Q

Causes of IUGR (intrauterine growth restrictions)

A 
1. Small placenta: less SA for absorption
Infection
HTN
Preeclampsia
Malnutrition
Small maternal size
Young mother
Substance abuse
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13
Q

What increases risk of miscarriage

A
  1. Underweight mother
  2. Oxidative stress
  3. Vitamin E and D deficiency in 1st trimester
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14
Q

What nutrient decreases risk of preterm delivery**?

A

Folic acid

Supplementation is required at least a year before getting pregnant to have affect

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15
Q

Energy requirements during each trimester

A

1st: no change
2nd (13-26wks) : +340 cal/d
3rd (27-42wk): +452 cal/day

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16
Q

Carb requirement during pregnancy

A

175 g/d

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17
Q

Fiber requirement during pregnancy

A

28 g/d

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18
Q

Most important nutrients DURING pregnancy

A 
Folate
B6,12
Vitamin K
Iron
Ca
Iodine
Zn
Cu
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19
Q

What is choline needed for during pregnancy

A

Signaling and nerve transmission

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20
Q

What vitamins in supplement form if taken during pregnancy increase risk of preterm labor and decrease birth weight

A

Vitamin C and E

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21
Q

What vitamin is teratogenic at high doses during pregnancy

A

vitamin A

22
Q

What are vitamin D and K good for during pregnancy

A

Bone health

23
Q

Severe deficeiency of Iodine during pregnancy can cause what

A

Impaired fetal neurodevelopment

24
Q

Deficiency in iron during pregnancy increases risk of what?

A

Postpartum depression

25
Q

RDA of what nutrient doubles during pregnancy

A

Iron

26
Q

What is epigenetics

A

Stable changes to a gene structure without changing DNA sequence.

Changes how genes are expressed

27
Q

What vitamins may have influence on gene expression (epigentics) because they are capable of methylation

A

B12 and folate

28
Q

What is fetal programming?

A

Maternal under or overnutrion can program infant to be predisposed to:

Heart disease
Stroke
Diabetes
Obesity
Hypertension
29
Q

Maternal stress and fetal cortisol relationship

A

11B-HSD2 produced by placenta and inactivated cortisol.

Increased maternal stress causes decreased expression of 11B-HSD2 and causes increased fetal cortisol

30
Q

What maternal dietary factors may increase fetal stress and cortisol concentrations

A

Calorie restriction
Low protein
High fat and sugar
Low Mg, choline, folate

Silence 11B-HSD2
(Hydroxysteroid dehydrogenase)

31
Q

What dietary factors cause healthy epigenetic alterations?

A

Polyunsaturated fats
Fruits/veggies (polyphenols)
Folate/Vit B12
Selenium

32
Q

What is one of the main dietary compounds that influence epeigenetic gene expression

A

Glucose

Affects methylation patterns

33
Q

Epigenetic diet

A 
Vitamin C, A, B12
Folate
Polyphenols
Copper
Sulforaphane
Omega-3s
Zinc
34
Q

How much weight should a woman gain during pregnancy

A

Normal weight: 25-35lbs
Twins: 35-45
Overweight: 15-25

35
Q

What are some side effects of pregnancy and fix?

A

Constipation
Heartburn: smaller meals, less caffine, stay upright, carbonated beverages
Nausea/vomiting: carb containing meals, ginger, smelling lemons
Hypertension: Ca/Mg/K
Leg cramps/edema: Mg, stretch, increase fluids

36
Q

What foods should be limited in pregnancy?

A
  • unpasteurized food (soft cheeses)
  • no salads from store
  • reheat meat (no cold deli meat)
  • shark, swordfish, tilefish, mackerel
  • albacore/tuna: 6oz/wk
37
Q

What supplements should pregnant females take

A

Folic acid

Iron

38
Q

What nutrients take longest to normalize after pregnancy

A

2-4 months: Iron

6+ months: folate

39
Q

What does WHO consider the minimum time between weaning 1 in fact and conception of the next?

A

18-24 months

Risk decreases with folic acid supplementation

40
Q

How many extra calories are required during lactation

A

0-6months: 330 cal/day

6+ months: 400 cal/day

41
Q

How many carbs are required during lactation

A

210g/day

42
Q

What are most important nutrients during lactation

A 
Vitamin D
B12
Iron
Iodine
Zinc
43
Q

Stages of lactation

A

Colostrum: 0-5days
Transition milk: 5-14 days
Mature milk: 2+ weeks

44
Q

Colostrum

A 
-0-5 days
Many antibodies
Fat-soluble vitamins
Electrolytes
High in protein
45
Q

Transition milk

A

5-14 days
Protein drops
Lactose/fat increase

46
Q

Mature milk

A

2+ weeks
40% of energy as lactose
55:45 casein:whey

47
Q

Foremilk contents

A

First milk secreted
High in water, cards and water-soluble vitamins

Low fat

48
Q

Hindmilk contents

A

High-fat milk

49
Q

What are galactagogues

A

Milk production stimulants

50
Q

Examples of galactagogues (milk production stimulants)

A
  • Oats, barley, beans, almonds
  • Dark leafy veggies
  • fenugreek milk thistle
  • alfalfa
  • caraway

Meds: motilium, reglan

51
Q

What foods may prevent postpartum depression

A 
Omega3
Folate
Riboflavin: cows milk/grains
B6,12: meats
Vitamin D
Calcium
Iron
Selenium: Brazil nuts/anything from ground
52
Q

What is used to measure postpartum depression

A

Edinburgh postpartum depression scale

EPDS

Clinical Nutrition (5 decks)

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