Nutrition 2020 Study Guide Exam 1
Nutrition 2020 Study Guide Exam 1 NFS 2020
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This 11 page Study Guide was uploaded by Camille Muir on Monday September 26, 2016. The Study Guide belongs to NFS 2020 at Southern Utah University taught by Matthew Schmidt in Fall 2016. Since its upload, it has received 52 views.
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Date Created: 09/26/16
Study Guide Preconception Nutrition Antioxidants: Vitamin C (Ascorbic Acid) Zinc Vitamin E (Tocopherol) Selenium Carotenoids (Vitamin A) Nutrients we are suboptimal in: Fiber (Nature’s broom; can lower risk of cancer, improve quality of life) Iron: Space pregnancies 18 months to 2 years because of iron levels. Vitamin D Calcium Folic Acid (is supplemental and found in foods we fortify; it is superior to folate. Folate is found in leafy greens, oranges, legumes and other natural sources.) This is a B vitamin. B9. (Could remember by saying you are pregnant for 9 months or nine letters in folic acid) Zinc Potassium Magnesium Others Cereal Study: Cereal is fortified with the vitamins and minerals you need. Cereal gives you higher intakes of folate, iron, zinc, calcium, fiber, and Vitamins A, C, D, and E Supplements and Pregnancy: Doctors suggest prenatal multivitamin supplements 3 months before conception Miscarriage The biggest cause of miscarriage is genetic defects with the baby. Critical periods: Periods where you need the building blocks (the right vitamins and minerals). If you don't have it, the body will continue without it, but you cannot fix it. Defects can occur without the right nutrients during critical periods. Calories are so important during pregnancy; Lots of women in the US under consume during pregnancy. The nutrient and clorie hierarchy: The mother* the placenta*the baby. Calories going to the baby start with the brain, heart, traveling down. Liver failure and other defects in the baby is possible when the mother underconsumes. Folic acid is the most crucial in the first 1528 days. (Not enough Folate during pregnancy=possible spina bifida) BMI BMI Chart levels. 18.524.9 is healthy Infertility General Knowledge: Sperm and eggs need antioxidants (plant foods) to take care of the free radicals Caffeine has a negative effect on fertility Heavy metals (mercury) could be a factor in infertility Causes of Infertility: Damage the sperm or eggs or Alter the hormones Ovulatory Infertility (Female Infertility) Reduces the risk of infertility: Folic Acid: mainly from multivitamin supplements reduces the risk of ovulatory infertility. Getting enough Iron (supplemental) Increases the risk of infertility: Carbohydrates: excess simple sugars are related to infertility. (High glycemic index food gets into your blood sugar fast (fruits, candy, juice, etc.)) (Low glycemic index foods include vegetables, legumes, complex carbs) Caffeine: Intakes of caffeinated drinks is associated with ovulatory infertility (data gathered in retrospective studies and animal studies, human studies are weak) Alcohol/Smoking causes free radicals that attack polyunsaturated fats (sperm and eggs made of polyunsaturated fats. Prenatal alcohol exposure can lead to o Absence of menstrual cycle o Failure to ovulate Trans fat (causes inflammation and free radicals that attack PUFAs (sperm and egg) Excessive exercise: Can produce abnormal menstrual cycles or amenorrhea Undernutrition o Cut calories by 50%, starvation; possible loss of menstruation o Weight loss of 1015% decreases estrogen levels o Primary effect the body finds a way. Birth of small and frail infants as a result (body finds a way) High body fat o alters hormones: Estrogen Leptin (hormone made by fat cells that effects quality of your eggs; obese people have too much) (Leptin makes you feel full) Insulin (increases androgen hormones) (In females, when you have high levels, it creates more testosterone) o Inflammation (body’s way of protecting broken down tissue) o Oxidative stress (Not enough antioxidants to “take care” of free radicals (Long term)) (Linked to cardiovascular disease, diabetes, stroke, cancer, Alzheimer’s, Parkinson’s) o Irregular menstrual cycles o The incidence of metabolic syndrome (Series of symptoms: (1 step away from type 2 diabetes) high insulin levels, excess fat in the waistline, high blood pressure) Infertility Risk Factors in Males Oxidative Stress Antioxidant status Metabolic syndrome Age (> 40 years) o Effects semen and increased free radical production Excess weight Vitamin D status Heavy metal exposure (lead, mercury, (from China)) Smoking o Effects of semen o Childhood cancers are higher in children born to parents who smoke Isoflavones o Animal studies show high intakes (soy) linked to infertility Undernutrition o Weight loss decreases fertility o Weight loss over 25% of normal weight stops sperm production Polycystic Ovary Syndrome (PCOS) Genetics does play a factor in this disease. Common symptoms: irregular period, high insulin levels, excessive abdominal fat, high testosterone, infertility, low HDLs, high triglycerides, hirsutism, acne, polycystic ovaries, etc. Treatment: increase insulin sensitivity through o Medication (hormone balance) o Exercise (brings hormone levels down for a period of time) o Weight loss (if needed) o Omega 3 fatty acid (chemical messengers (local communicators), inflammation (could have same effect as ibuprofen) 3 types: ALA (found in plants (walnuts, chia, flax seed), EPA, DHA (EPA and DHA are more inflammation: important for the brain (found in marine life (clams, shrimp, tuna, trout, salmon)) o Whole grains, fruits, and veggies (regulates blood sugar better Fiber, antioxidants, phytochemicals Low glycemic index foods Overcompensating is bad. Extra sugar in the blood stream bonds to cells, disrupting the messages. Diabetes Diabetes a leading cause of kidney failure, amputation, heart failure High blood glucose levels in the first 2 months of pregnancy are teratogenic (harmful to the fetus), and are associated with abnormalities in newborn. Type 2 is related to abdomen obesity Type 1 is genetic (beta cells (pancreas) don’t have the marker so white blood cells attack (autoimmune disease) and destroy it) Type 2 insulin binds to the receptor, door is opened glucose gets in o Type 2 theories: (in either of these the real problem is that the insulin lingers in the blood stream, causing problems) Insulin receptors are damaged Less protein doors are opened on the cell membrane that allow glucose in When glucose lingers in the blood stream, the pancreas releases more insulin, long term, causes problems. o Soluble fiber helps regulate blood glucose (insulin resistance) Treatment helping Type 1, Type 2, Pregnant Diabetes, Metabolic Syndrome, Insulin resistance, excess insulin, PCOS o Weight loss o Percent of total calories from energy nutrients: 1520% protein Less than 30% fat About 50% carbohydrates o Probiotics – takes fiber and makes a byproduct (short change fatty acids) that can alter how glucose is regulated Living bacteria A lot of them (millions and billions) Healthy bacteria (with health benefit) o Lower Fat Less than 7% saturated Low as possible trans fat 200 mg of cholesterol or lower o Carbohydrates: High fiber (especially (apples, oatmeal, fruits have more, artichokes) Whole grains Carb meal breakdown Take the total calories Divide in half (for half calories need to be carbs) Divide that number by 4 (4 calories to every gram to find grams) That number is how many grams of carbs they need. Snacks: 15 g if they are burning a low number of calories. (sedentary), 30 g if they are burning a high number of calories. (active) Divide the rest by three (three meals) Fertilization 2 Nutrients and 1 substance critical for peri conception Folate, B12, and Choline (good sources of choline are eggs, legumes and meat). Epigenetics (methyl and histones on DNA marks the way your DNA is read) When your DNA is not marked properly and read properly, leads to diseases at a young age like cancer, diabetes, CVD, and Schizophrenia Pregnancy Terms/Vocabulary • Gravida is a pregnant woman or the number of pregnancies a woman has experienced. • Parity: The number of previous deliveries experienced by a woman. – Nulli: none before – Primi: one previous – Multi: more than one previous • Postpartum: after childbirth • Prenatal: before birth • Neonatal: first four weeks after birth • Postnatal: occurring after first four weeks after birth 1 tri zygote (needs no extra calories) 2 tri embryo (needs an extra 300 calories) rd 3 tri fetus (needs an extra 500 calories) Embryo # of cells doubles every 24 hours 8 weeks: central nervous system, embryonic tail disappears Placenta Purposes: o Hormone production o Nutrient and oxygen exchange o Removal of waste o Placenta is so important because it protects the baby from the mother’s immune system. Placenta uses 3040% of glucose from mother’s diet. If mom doesn’t get enough, placenta isn’t as strong. Changes of Pregnancy Weight gain Blood volume and composition (volume increases by 40%) Cardiovascular function (heart is bigger, pumping more blood) Gastrointestinal function Renal function Metabolism Immune function Nutritional requirement Weight Gain During Pregnancy Healthy BMI weight gain needs to be between 2535 lbs. Most of the weight gained during pregnancy is gone directly after and in the weeks after pregnancy. Of the 30 lbs. gained, about 7 lbs. is fat, and the biggest purpose for it is preparing your body for lactation. Water Pregnant women need water to increase blood volume and fluid volume. The thirst mechanism is not a good mechanism to rely on because thirst is often mistaken for hunger. Water delivers calories and nutrients. Blood Volume and Edema In a person, the heart pumps blood and the cells take in nutrients and water, but the water is attracted back to the proteins in your blood. When that person becomes pregnant, the blood volume increases, but the protein count does not. Therefore, the water stays between the cells, causing edema. Very common, but not a concern. Cravings Cravings occur because of changes hormone, and senses. Often women won’t want to eat meat because of the smell, their sense of smell is heightened. Increased appetite because of increased metabolism. One concern with this is that women reach for comfort foods high in fat. Mercury and foods to avoid Avoid eating larger fish with larger amounts of mercury like o Shark o swordfish o tilefish o king mackerel o tuna sushi/ Bluefin tuna/canned tuna o orange rough o pike o limit walleye and bass. (this is the recommendation for pregnancy, lactation, elderly. Tuna is right on the line; canned tuna is supposed to be safe. We need Omega 3 and tuna is a good source, so we have a dilemma. If looking for a supplement for Omega 3, look for Krill Oil because of the low amounts of mercury. Avoid raw oysters, raw meat, raw eggs, unpasteurized cheese/ milk (soft, blueveined, brie, feta, camembert, goat cheese), cold meat spreads, lunch meats (unless handled well), processed meats (unless served steaming hot, well cooked and handled) Toxoplasmosis: Be cautious of how food is handled, mother’s immune system is down during pregnancy and food borne illnesses are easy to catch. Avoid undercooked/raw anything Avoid unpasteurized anything Wash all raw fruits/vegetables, especially homegrown (water or store bought citric acid) Wash your hands Cats o Don’t change the cat litter. Make someone else do it or where gloves o Keep cat indoors and don’t give them undercooked meat because they pick up bacteria o Wear gloves when gardening Gastrointestinal Function Gastrointestinal track slows down (GI motility), giving the baby more nutrients, but results in nausea, heartburn, constipation, morning sickness, vomiting, etc. o Constipation Solutions: Fiber(insoluble) and water, probiotics, prune juice (sugar alcohol is not recognized by the body as glucose so it is not absorbed, but rather attracts water in the colon causing loose stool), exercise speeds up the GI tract, and supposedly magnesium supplements. o Heartburn Solution: Smaller more frequent meals, because of stomach volume (large meals press against the esophagus and heartburn occurs). Also, avoid excess fat (slows down the tract), acidic foods and spicy foods. Don’t lie down after a meal (gravity slows down the process) o “Morning Sickness” Solutions: Separate liquid and solid food intake, avoid odors and foods that trigger nausea, start your prenatal supplement earlier (allow body to get used to higher levels of iron and zinc), change prenatal/take a different time of day, select easy foods (crackers, potato chips, popcorn, yogurt, hardboiled eggs), B6 Vitamin Supplements (?), ginger (1 gram a day for 4 days) PICA Ingestion of nonfood items o Clay/dirt o Laundry detergent o Paint chips o Ice o Buttons, paper, hair, etc. Problem o Intestinal obstruction o Weight gain o Ingestion of toxins and parasites o Reduce nutrient absorption Causes o Deficiencies of zinc and iron may be correlated, but this is for the most part untested and unproven. Nutrients that increase during pregnancy Most nutrients increase during pregnancy, specifically: o Fiber o Omega3 o Vitamin D o Folate o B12 o Choline o Calcium (Ca) o Potassium (K) o Magnesium (Mg) o Iron (Fe) o Zinc (Zn) Carbohydrates Needed Need 175+ grams/day to meet fetal needs. This amount will prevent ketosis (body using fat stores for energy instead of carbs) Iron This is a big deficiency because it is hard to absorb. Maternal iron deficiency associated with increased risk of low birth weight baby. Good birthweight is an indicator of baby’s health Women are at a greater risk because of the menstrual cycle Toxicity is possible with supplements oxidative damage (free radical damage shuts down your organs in extreme cases), and reduces zinc absorption (children need less). Zinc and Iron compete for similar transporters and so if you have too much of one, the other doesn’t get absorbed as well. Two forms of Iron o Heme (ferrous) best source of iron, found in meat o Nonheme found in plants Things that increase/decrease the laying down of iron Vitamin C increases absorption Calcium decreases absorption (compete for transporter, don’t take excess amounts of calcium with iron, especially nonheme). If you eat heme and nonheme iron at the same time, the nonheme is absorbed better than usual, because the heme is present. Bioavailability: o Red meat 54% absorption o Nonheme sources 2.8 percent absorption Zinc Best source is shellfish, then red meat, then legumes, whole grain, etc. Zinc deficiency can impact baby’s health: o Growth retardation o Oxidative stress o Fetal Death Calcium Increased need for calcium in the last trimester of pregnancy. 1200 mg a day takes care of most people’s calcium needs. Bones Calcium lowers high blood pressure Lead Lead is bad. Lead problem is coming from China. Manufacturing with heavy metals. Competes with Calcium. Those who don’t get enough calcium usually have an increase of lead in the blood. Know the sources of potential lead Sodium Be careful of restricting sodium too much because you need iodine. Iodine Deficiency could cause a goiter (and/or thyroid issues) Cretinism the highest cause of mental retardation Iodine deficiency could cause learning disability Salt 15% from iodized table salt, but the best source is cow milk Vitamin D Big deficiency The best source is the sun Atlanta, Georgia and above, we do not make Vitamin D from the sun OctoberJanuary (solar noon (the sun directly above you) is the best time to make Vitamin D from the sun) Food sources: fatty fish is the best source, mushrooms also have it, fortified milk. Not many things are fortified because it is the biggest toxicity. Sunblock will stop the production of Vitamin D. You can get a toxicity from supplements and the tanning bed. Vitamin D plays a role in bones. Vitamin D deficiency is correlated to depression. Vitamin D deficiency during pregnancy: o Miscarriage o Preterm birth o Maternal infection o Type 2 diabetes in infant Risk factors for vitamin D inadequacy during pregnancy o Vegan diet o Low intake of dairy o Limited exposure to sunlight o Sunblock o Dark skin (need more) o Obesity (need more)
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