W11: Life cycle nutrition Flashcards by Faith Yeo

Early life nutrition : Pregnancy and lactation

Before pregnancy, it is important to achieve and maintain a healthy body weight. What are the health complications for underweight [1] and overweight [2] women before pregnancy?

Underweight: amenorrhea (impaired ovulation)
Overweight : low fertility, higher risks of complications

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Early life nutrition : Pregnancy and lactation

Before pregnancy, under/overweight men also contribute to what problems?

Low testosterone, leading to low fertility

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Early life nutrition : Pregnancy and lactation

Other than achieving and maintaing normal body weight, what does the mother need to do to prepare for pregnancy? [5]

Adequate and balanced diet
Be physically active
Manage chronic conditions (long term illness)
Eat prenatal supplements
Avoid harmful substances (smoking, alcohol)

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Early life nutrition : Pregnancy and lactation

What should be the main goal during pregnancy?

maximse nutrient storage and minimise losses.

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Early life nutrition : Pregnancy and lactation

During pregnancy, energy requirements increase by ____ to ____%.

What kinds of foods can mothers eat to meet nutrient requirements?

15-20%, eat ample nutrient dense foods

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Early life nutrition : Pregnancy and lactation

What are the main macronutrient needs for mothers during pregnancy, and how much more should be consumed?

Carbohydrates
Lipids
Protein – additional 25g per day

No guidelines for carbs and lipids, ensure sufficient can already

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Early life nutrition : Pregnancy and lactation

Why is ample carbohydrates needed by pregnant mothers? [2]

Glucose is the primary source of energy for placenta an foetus
Insulin secretion during pregnancy increases (breakdown glucose for fetus), depleting glycogen stores in mother and posing a risk of hypoglycermia (ow blood glucose)
-which is why preg women crave sweet stuff bc glucose may have fallen to lower than baseline levels

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Early life nutrition : Pregnancy and lactation

Mothers utilise fat stores for their own energy in the ____ trimester

third

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Early life nutrition : Pregnancy and lactation

What fatty acids are needed for adequate foetal brain development?

Omega 3 and 6

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Early life nutrition : Pregnancy and lactation

How much additional protein is needed by pregnant mothers per day, and why is this extra protein needed? [2]

25g, for expansion of blood volume and growth of maternal tissues

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Early life nutrition : Pregnancy and lactation

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Early life nutrition : Pregnancy and lactation

Why is iron needed during pregnancy? [3]

To increase blood volume → support foetus → blood and RBC transports O2 and nutrients
Build up infant’s iron source
Build up of maternal source of blood for blood loss during childbirth

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Early life nutrition : Pregnancy and lactation

what are the 2 main purposes of folate, Vit B12 and zinc during pregnancy?

Needed for cell growth (support foetal growth and development)
Synthesis of new DNA

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Early life nutrition : Pregnancy and lactation

What is the main purpose of Vit B6 and iodine during pregnancy? What are the functions of Vit B6 and iodine separately?

Overall purpose : Brain development
- Vit B6 : Development of nervous system
- Iodine : proper thyroid hormone function which regulates development of brain and nervous system

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Early life nutrition : Pregnancy and lactation

What is the purpose of calcium and vitamin D during pregnancy?

Bone development of foetus

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Early life nutrition : Pregnancy and lactation

Calcium intake by pregnant women usually falls below recommendations, so the foetus bone development is affected. True or False?

False, fetus bone development unaffected. If not enough calcium is consumed then calcium is drawn from mother’s body (calcium bank in mother’s bones)

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Early life nutrition : Pregnancy and lactation

What are the 2 factors that determine the amount of optimal weight gain by mothers during pregnancy?

Number of foetuses (e.g. single birth vs twin birth)
Pre-pregnnancy BMI

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Early life nutrition : Pregnancy and lactation

How does pre-pregnancy weight of mother affect the health of mother/fetus/both?

(talk abt outcomes if mother is overweight and underweight)

pre-pregnancy weight affects fetal growth.

underweight : higher rates of premature birth and infant death
overweight : medical complications may occur during pregnancy

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Early life nutrition : Pregnancy and lactation

How weight of mother during pregnancy affect the health of mother/fetus/both?

Fetal growth
- Weight gain during preg correlates closely with infant weight at birth,and is a predictor of health and development of foetus

Gain too much : developing foetus → gain a lot of weight and is big sized, complications during childbirth (need c sect etc)
Gain too little : baby may not receive enough nutrients, underweight at childbirth (may

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Early life nutrition : Pregnancy and lactation

How weight of mother post pregnancy affect the health of mother/fetus/both?

Since mother will gain weight after giving birth and return to pre-pregnancy weight is not typical, there may be an increase in BMI. With increased BMI, increased risk in

Diabetes and hypertension
Chronic diseases in later life

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Early life nutrition : Pregnancy and lactation

After pregnancy, what are the 2 most importnt micronutrients does the mother need to replenish?

Iron, as it is lost during pregnancy and during childbirth
Calcium, baby draws on mother’s calcium bank for bone development since mother may not have been eating recommended levels of calcium ++ prep for lactation (breast milk)

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Early life nutrition : Pregnancy and lactation

Recommendations on nutrition after child birth are similar to what kind of diets?

Normal and healthy diet.

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Early life nutrition : Pregnancy and lactation

For lactating mothers, the nutrition recommendations are similar to what kinds of diets?

Diet of pregnant moms to support growth of infants, to produce breast milk (nned more calcium, Vitamins etcetc)

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Early life nutrition : Pregnancy and lactation

If the mother is malnourished, then the quality of breast milk produced is not as nutritious. True or False?

False. The body will draw from mother’s nutrient stores to maintain nutrients in breast milk so that its quality is not affected

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# **Early life nutrition : Pregnancy and lactation** About ____kcal is passed onto infants in the form of breast milk

500

# **Early life nutrition : Pregnancy and lactation** During lactation, which 2 hormones promote growth and branching of duct system and milk producing cells? What are their specific functions.

1. Prolactin → Induce milk production, where milk is stored in lobules 2. Oxytocin (happy hormone) → Cause mammary glands to **eject milk** for release

# **Early life nutrition : Pregnancy and lactation** What is the difference between lactation and breast feeding?

1. Lactation : A physiological process. An automatic process in which body automatically stores milk in lobules. 2. Breast feeding : a learned behaviour. Mothers need to learn on how to eject the milk for baby to drink.

# **Early life nutrition : Pregnancy and lactation** What 2 main factors affects fertility of mother?

1. Maternal weight pre-pregnancy 2. Good nutrition

# **Early life nutrition : Pregnancy and lactation** What 2 main factors impact the growth of foetus, especially in the first trimester? | Hint : both factors related to nutrition

1. Maternal nutrient stores 2. Daily nutrition

# **Early life nutrition : Pregnancy and lactation** The daily nutriton of the mother throughout pregnancy only affects the foetus throughout the pregnancy. True or False?

False, nutrtion throughout the whole pregnancy may impact the foetus into his/her adulthood.

# **Early life nutrition : Children** in comparison to adult diets, what is the composition of breast milk like in terms of macronutrients and why is it like this?

1. Protein : way lower than adults, to reduce load on immature kidneys of infant to excrete excess N 2. way higher fat content : makes breast milk more energy dense for infant s who require twice the amount of energy as adults 3. Carbohydrates : a bit lower

# **Early life nutrition : Children** Carbohydrates in breast milk is usually in what form?

Lactose

# **Early life nutrition : Children** Infants have differennt micronutrient demands from adults. Which 5 micronutrients do infants need more than adults ? ## Footnote hint: 4 vit 1 mineral

1. Vitamin A 2. Vitamin D (calcium absorption for bones) 3. Vitamin E 4. Vitamin C 5. Iodine -- for thyroids hormone function

# **Early life nutrition : Children** Infants have different micronutrient demands from adults. Which 2 micronutrients(minerals) do infants need less than adults ?

1. Iron 2. Sodium (to reduce load on kidneys)

# **Early life nutrition : Children** What is the difference in composition of whey and casein in cows milk and breast milk?

Cow's milk : 20% whey, 80% casein Breast milk : 60% whey, 40% casein

# **Early life nutrition : Children** Why is breast milk so low in caesin?

Casein can coagulate in acidic conditions, causing stomach discomfort and poor digestibility in infants

# **Early life nutrition : Children** What is the main type of whey protein that is easily digested by infants, and present in breast milk and cow's milk?

α - lactalbumin

# **Early life nutrition : Children** What is the other protein found in cows milk and breast milk which binds to iron? What are the 2 benefits of this protein binding to iron?

Lactoferrin Benefits: - makes iron unavailable for gut bacteria growth, esp pathogenic ones - Makes iron easier to absorb by infant

# **Early life nutrition : Children** What are the 2 types of carbohydrates in breast milk?

1. Lactose 2. Human Milk Oligosaccharides

# **Early life nutrition : Children** Lactose is the main sugar in breast milk which enhances ____ absorption

Calcium

# **Early life nutrition : Children** Human Milk Oligosaccharides are highlycomplex structures derived from ____ different monosaccharides, and there are over ____ specific unique HMOs in human breast milk

5,150

# **Early life nutrition : Children** The infant formula aims to replicate the composition of human breast milk as much as possible. For oligosaccharides, what is one recent oligosaccharide that has been added to high end infant forumla? ## Footnote Give the full name

2' - Fucosyllactose, 2'-FL

# **Early life nutrition : Children** Why can't infant formula and cow's milk capture the microbiome profile and oligosaccharide of mother's breast milk?

Microbiome and HMO profile of breast milk is dependent on : 1) Genetics -- each mother has a unique microbiome and HMO profile
2) Interactions of mother with the environment -- profile is dynamic since environment that the mother is exposed to is also always changing (e.g. if mother falls sick etc)

# **Early life nutrition : Children** Polyunsaturated fatty acid composition in breast milk is always the same in all mothers. True or False?

False, polyunsaturated fatty acid composition (ARA and DHA) in breast milk depends on mother's diet and environment

# **Early life nutrition : Children** What are the 2 polyunsaturated fatty acids that are always present in human breast milk, but amounts may vary depending on diet

1. Arachidonic acid (ARA) 2. Docosahexa**e**noic acid (DHA)

# **Early life nutrition : Children** What unique structure do triglycerides have in human breast milk, and what benefit does this confer?

In the triglyceride, the fatty acid in the middle isalways saturated, while the other 2 are unsaturated. - this may improve calcium absorption by infants

# **Early life nutrition : Children** Human breast milk is low in which vitamin ? Which vitamin is the one where its amount depends on diet, and is usually in insufficient amounts?

1. Vitamin K 2. Vitamin D -- amount of vitamin D depends on diet ## Footnote DK

# **Early life nutrition : Children** Since human breast milk s low in Vitamin K, infants will get Vit K deficiency. True or False?

False, the gut microbiome of infant will synthesise vit K for it

# **Early life nutrition : Children** Human breast milk is high in which mineral?

calcium (drawn from calcium banks of mother if insufficient)

# **Early life nutrition : Children** Human breast milk is low in which 2 minerals?

Sodium, fluoride

# **Early life nutrition : Children** Human breast milk has high **bioavailability** in which 2 minerals?

iron, zinc

# **Early life nutrition : Children** In infants (0-1 years old), can milk formula be used as a sole substitute for human breast milk?

Yes, since infants only drink milk and don't eat other food

# **Early life nutrition : Children** At what stage do toddlers start taking in solid foods?

4-6 months old

# **Early life nutrition : Children** After infancy, above 1 years old, can milk be used as a substitute and don't provide foodto toddlers?

No, milk formula is treated as a supplementation

# **Early life nutrition : Children** At what age can cow's milk be provided to children? At what age should transition of full cream to low cream milk begin, and why is there a need to transition into low cream milk?

- below 1 years old : cannot take cow's milk - Above 1 : can drink cow's milk - start with full cream milk (high fat, meet energy requirements) - Slowly transition to low cream milk between 2-5 years old to prevent childhood obesity

# **Early life nutrition : Children** Although infant formula is not nutritionally equivalent to breast milk, why is it a good enough replacement for infant?

It is a basic need for survival of the infant since it is the sole food source

# **Late life nutrition : Elderly** What are the 6 aspects of ageing that may affect an elderly's nutrition and health?

1. Body composition --fat accumulation + muscle loss 2. Body weight -- overweight 3. Immunity and inflammation 4. Intestinal function 5. Tooth loss 6. Sensory loss and other physical problems ## Footnote **BBIITS**

# **Late life nutrition : Elderly** How does tooth loss affect the nutrition and/or health of elderly?

Difficult and painful chewing (mostly liquidy foods like porridge), which results in: 1.** limited food selections** and **less** dietary **variety** 2. Lower intakes of fibre-- constipation

# **Late life nutrition : Elderly** How does sensory loss and physical problems affect the nutrition and/or health of elderly?

Vision, mobility, hearing, taste and smell changes affect food choices

# **Late life nutrition : Elderly** How does immunity and inflammation affect the nutrition and/or health of elderly? [2]

With weakening of immune system : 1. Increase in allergies 2. Compromised by nutrient deficiencies

# **Late life nutrition : Elderly** In elderly, intestinal function declines where intestinal walls lose strength and elasticity. How does this affect the nutrition and/or health of elderly? [3]

1. Constipation -- cannot push out feces from large intestine 2. Diminsihed appetite 3. Diifculty swallowing (dysphagia)

# **Late life nutrition : Elderly** What are the changes in body composition of elderly that may affect their health?

increased fat, muscle loss (sarcopenia)

# **Late life nutrition : Elderly** For body weight of elderly, being moderately overweight with BMI of ____ to ____ (for Asians) may not be harmful.

22,25

# **Late life nutrition : Elderly** What are 7 lifestyle goals that eldery should aim to achieve? [7]

1. **M**aintaining a healthy body weight (diet + exercise) 2. **A**bstinence or moderate use of alcohol 3. **D**isease management and prevention to slow ageing 4. **N**ot smoking 5. **E**ating well-balanced meals 6. **S**leeping regularly and adequately 7. **S**tress free ## Footnote **MADNESS**

# **Late life nutrition : Elderly** What 2 physical activity goals should elderly strive to acheive?

1. Muscle building through strength and resistance training 2. Maintain **cardiovascular health** through aerobic activities

# **Late life nutrition : Elderly** What kinds of food should elderly eat and why?

Nutrient dense foods which are **lower in energy** and **higher in nutrients** - as elderly do not require as much energy as adults, but have increased nutrient needs due to changes in metabolism and age-related loss of muscle and bone mass

# **Late life nutrition : Elderly** What are the 7 nutrients lacking in elderly's diet? (macro/micronutrients)

**1. Water** 2. Fibre 3. Proteins -- essential amino acids 4. Fats -- mono and polyunsaturated fats (healthy) 5. Vitamin D - not getting enough sun exposure 6. Calcium 7. Vitamin B12 -- decreased absorption bc less HCl secreted, chyme less acidic, poorer absorption

# **Late life nutrition : Elderly** Why do elderly lack water? What are the effects of lacking water? [3]

They may not feel as thirsty. Effects: **1. Dehydration 2. Poor kidney function** 3. Constipation

# **Late life nutrition : Elderly** Why do elderly need protein?

Ageing leads to a** loss of muscle mass/strength** and proteins are needed to **maintain muscle strength**

# **Late life nutrition : Elderly** Why do elderly lack essential amino acids (proteins)?

Change in long term dietary choices may lead to low or lacking essential amino acids levels (e.g. if elderly eats chinese vegetarian food, mock meat is all gluten based which may not have all essential amino acids [plant-based])

# **Late life nutrition : Elderly** How can elderly consume all the essential amino acids, assuming they follow a vegetarian diet? [2]

1. Can eat more variety of plant proteins like legumes/ beans → complementary a.acid 2. Specialised milk powder formula for elderly

# **Late life nutrition : Elderly** Why do elderly lack fibre intake, and what are the consequences of low fibre intake [3]?

they have difficulty chewing and swallowing (esp insoluble fibre)
Health consequences: 1. Constipation 2**. High cholesterol 3. Risk of diabetes**

# **Late life nutrition : Elderly** Why do elderly lack Vitamin D? [3]

1. Elderly lack exposure to sunlight → lack of outdoor activities / cultural habits 2. **Reduced ability for skin** to **synthesise** vitamin D 3. **Reduced ability for kidney** to convert Vitamin D into its **active form**

# **Late life nutrition : Elderly** Why do elderly lack calcium? [2]

1. Not enough milk or soy intake 2. Lack of vit D which decreases calcium absorption

# **Late life nutrition : Elderly** Why does vit B12 absorption decrease significantly in elderly?

Reduced HCl secretion in stomach (absorption rate of Vit B12 is dependent on pH)

# **Late life nutrition : Elderly** In elderly, vit b12 deficiency is difficult to spot, and may be misidentified for ____ deficiency. What may be overlooked?

Folate Neruological damage may be overlooked

# **Late life nutrition : Elderly** What is the main problem caused by nutrient deficiencies in elderly?

Brain decline, leading to diseases such as dementia and Alzhimer's

# **Late life nutrition : Elderly** As the brain ages, what happens in the brain? [2]

1. Loss of neurons 2. Decreased blood supply

# **Late life nutrition : Elderly** Nutrient deficiencies may affect which aspects of the brain? [2]

1. Memory and cognition 2. Neurological damage and disorders (vit B12)

# **Late life nutrition : Elderly** What are the 4 vitamins and 1 macronutrient that can slow down memory and cognition loss?

- Vit C – involved in neurotransmitter pathway
- Folate,** B6**, B12 (B vitamins) – slows brain atrophy (loss of neurons and the connections between neurons in the brain, affecting memory)
- DHA – reduces cognitive decline

# **Late life nutrition : Elderly** What happens in Alzhimer's disease?

Nerve cells die, brain shrinks and loses ability to think, plan, remeber and form new memories.