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This 11 page Study Guide was uploaded by Ian Spath on Monday January 19, 2015. The Study Guide belongs to NHM 201 at a university taught by Karin Pennington in Fall. Since its upload, it has received 210 views.
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Date Created: 01/19/15
Chapter 2 Infertility Involuntary absence of production of children lnfecundity Biological inability to bear children after one year of unprotected intercourse Fertility actual production of children The word best applies to specific vital statistic rates but it is commonly taken to mean the ability to bear children Fecundity Biological ability to bear children Miscarriage Generally defined as the loss of a conceptus in the first 20 weeks of pregnancy also called spontaneous abortion Endocrine a system of ductless glands such as the thyroid adrenal glands ovaries and testes that produces secretions that affect body functions Immunological having to do with the immune system and its functions in protecting the body from bacterial viral fungal or other infections and from foreign proteins ie those proteins that differ from proteins normally found in the body Subfertility reduced level of fertility characterized by unusually long time to conception over 12 months or repeated early pregnancy losses Puberty the period in life during which humans become biologically capable of reproduction Ova eggs of the female produced and stored within the ovaries singular is ovum Menopause Cessation of the menstrual cycle and reproductive capacity in females Menstrual Cycle an approximately 4week interval in which hormones direct a build up of blood and nutrient stores within the wall of the uterus and ovum maturation and release If the ovum is fertilized by a sperm the stored blood and nutrients are used to support the growth of the fertilized ovum lf fertilization does not occur they are released from the uterine wall over a period of 3 to 7 days The period of blood flow is called the menses or the menstrual period Pituitary Gland a peasized gland located at the base of the brain It is connected to the hypothalamus and produces and secretes growth hormone prolactin oxytocin follicle stimulating hormone luteinizing hormone and other hormones in response to signals from the hypothalamus Corpus Luteum corpus body luteum yellow a tissue about 12 mm in diameter formed from the follicle that contained the ovum prior to its release It produces estrogen and progesterone the yellow body derivation comes from the accumulation of lipid precursors of these hormones in the corpus luteum Prostaglandins a group of physiologically active substances derived from the essential fatty acids They are present in many tissues and perform such functions as the constriction or dilation of blood vessels and stimulation of smooth muscles and the uterus Testes Male reproductive glands located in the scrotum also called testicles Androgens types of steroid hormones produced in the testes ovaries and adrenal cortex from cholesterol Some androgens testosterone dihydrotestosterone stimulate development and functioning of male sex organs Epididymis tissues on top of the testes that store sperm Semen the penile ejaculate containing a mixture of sperm and secretions from the testes prostate and other glands It is rich in zinc fructose and other nutrients also called seminal fluid Pelvic Inflammatory Disease PID a general term applied to infections of the cervix uterus fallopian tubes or ovaries Occurs predominantly in young women and is generally caused by infection with a sexually transmitted disease such as gonorrhea or Chlamydia Endometriosis a disease characterized by the presence of endometrial tissue in abnormal locations such as deep within the uterine wall in the ovary or in other sites within the body The condition is quite painful and is associated with abnormal menstrual cycles and infertility in 30 40 percent of affected women Did You Know More than half of all pregnancies are unplanned Children born to women over 35 are more likely to have disorders related to chromosomal defects Sperm numbers and viability decrease after age 35 but sperm is still produced 50 of conceptions fail 20 of pregnancies result in miscarriage 85 of women in the US have given birth by the age of 44 Healthy People 2020 Objectives related to preconception Increase the number of women who were at a healthy weight prior to pregnancy 485 to 534 Increase the percent of women who took a MVIfolic acid supplement prior to pregnancy 301 to 331 Increase the proportion of women of childbearing potential with intakes of at least 400 mcg of folic acid from fortified foods and supplements 238 to 262 Reduce iron deficiency among females of childbearing age 104 to 94 Increase the proportion of women who receive preconception counseling Sources of Disrupted Fertility Contraceptive use Severe stress Tubal damage Chromosomal abnormalities STDs Endometriosis Leading cause hormone irregularities Unknown causes about 50 of cases Factors related to impaired fertility in women and men Weight ossgt 1015 of usual weight Inadequate or excessive body fat Negative energy balance Extreme levels of exercise High alcohol intake Inadequate antioxidant status Endocrine disorders hypothyroidism Celiac Disease Diabetes Factors related to impaired fertility in women Recent oral contraceptive use Eating disorders High caffeine intake Alcohol But makes sense to abstain Vegetarian Diets Metabolic Syndrome Age gt35 PCOS Poor iron stores Factors related to impaired fertility in men 0 Inadequate zinc 0 Alcohol Intake 0 Heavy metal exposure lead mercury cadmium manganese 0 Halogen pesticides and glycol anti freeze de icers 0 Steroid Abuse 0 High intake of soy foods Undernutrition 0 Chronic Small effect Results in small frail infants with high death rate during rst year of life 0 Acute from famine or deliberate Clear and dramatic effect Affects both men and women Body Fat Weight and Fertility Excessive and inadequate body fat related to declines in fertility in men and women Excessive body fat Obese women have higher levels of estrogen androgens and leptin than nonobese women Menstrual irregularity in 3047 of overweight and obese women Inadequate body fat Healthy Weight Reduces Risks High blood pressure Gestational Diabetes Induced labor longer labor Cesarean section Large Baby A child with a low Apgar Score Preterm labor and delivery Stillbirth Weight Loss and Exercise and Fertility 0 Women Weight loss that exceeds 10 15 of usual weight weight related amenorrhea High levels of physical activity delay menarche or interrupt menstrual cycles 0 Men Weight loss that exceeds 10 15 of usual weight reduces sperm Viability and motility Leptin a protein secreted by fat cells that by binding to speci c receptor sites in the hypothalamus decreases appetite increases energy expenditure and stimulates gonadotropin secretion Leptin levels are elevated by high and reduced by low levels of body fat Body Mass Index BMI Weight in kgheight in m2 BMIs lt185 are considered underweight 185 249 normal weight 25 299 overweight and BMIs of 30 and higher obesity Anovulatory Cycles Menstrual cycles in which ovulation does not occur Amenorrhea absence of menstrual cycle Antioxidants Chemical substances that prevent or repair damage to molecules and cells caused by oxidizing agents Vitamins C see Illustration 23 and E selenium and certain components of plants function as antioxidants Free radicals Chemical substances often oxygen based that are missing electrons the absence of electrons makes the chemical substance reactive and prone to oxidizing nearby molecules by stealing electrons from them Free radicals can damage lipids cell membranes DNA and tissues by altering their chemical structure and functions they also form as a normal part of metabolism Over time oxidative stress causes damage to lipids cell membranes DNA cells and tissues Nutritionrelated side effects of Contraceptives Oral THDL Triglycerides LDL Trisk of blood clots blood copper levels lblood levels of 812 and B6 Injections Weight Gain TLDL and Insulin lHDL bone density Implants ie Norplant Implanon Weight Gain Early Pregnancy Nutrition Exposures Nutrient Status Insufficient folate Excessive vitamin A retinol retinoic acid High maternal blood levels of lead Iodine deficiency Iron deficiency Alcohol Limit or omit alcohol Fetal Alcohol Syndrome Embryo the developing organism from conception through 8 weeks Periconceptional period the time period around conception variously measured in weeks or months depending on the pregnancy outcomes of interest DNA methylation the modification of a replicated strand of DNA by addition of a methyl group Ch3 to specific regions of the strand Methylation can suppress the activity of certain genes in ways that affect metabolic processes and disease risk It is a normal part of development and is needed for cellular differentiation and organ development but can also be influenced by nutritional and other environmental exposures Fetus the developing organism from 8 weeks after conception to the moment of birth Neural Tube Defects NTDs a group of birth defects that are caused by incomplete development of the brain spinal cord or their protective coverings Spina bifida is one of the most common types of neural tube defects Gene variant an alteration in the normal sequence of a gene The different forms of the same genes are considered alleles Allele a different version of the same gene alleles have a different arrangement of bases than the usual version of the gene NutritionRelated Concerns before conception and during the periconceptional period Premenstrual Syndrome PMS or PMDD premenstrual dysphoric disorder Dysmenorrhea painful menstruation Obesity and Fertility Eating Disorders and Fertility Diabetes Mellitus Prior to Pregnancy Polycystic Ovary Syndrome PCOS Phenylketonuria PKU Celiac Disease PMS Thought to be related to abnormal serotonin activity following ovulation Treatments include l Caffeine 1 Stress meditation yoga T Exercise TMagnesium 200 mg TCalcium 1200 mg Vitamin B6 in doses of 50100 mg may reduce severity of symptoms Males Obesity and Fertility Males 0 Reduced SHBG levels sex hormone binding globulin levels 0 Reduced sperm count Females 0 Highly irregular anovulatory or no menstrual cycles 0 Reduced SHBG levels 0 Increased estrogen blood glucose insulin levels 0 Intervention Weight Loss Eating Disorders and Fertility 0 Anorexia nervosa and Bulimia nervosa related to menstrual irregularities and infertility 0 Intervention for Anorexia Normalize body weight therapy required 0 Intervention for Bulimia Normalize eating behaviors therapy required Diabetes Mellitus Increases risk of maternal and fetal complications High blood glucose in first 2 months of pregnancy is teratogenic Prediabetes Interventions for Type 2 Diabetes T Insulin Sensitivity Weight loss regular physical activity smoking cessation diet Interventions forType1 Diabetes Exercise and diet Diabetes Diet 50 of total kcalories from carbohydrate 1520 total kcalories from protein lt30 o total kcalories from fat T Complex carbohydrates T fiber 14g1000 kcals Whole grains 12 of all grain intake 1 Simple sugars high glycemic index foods T Monounsaturated fats T Antioxidant vegetables 3 regular meals and snacks daily Frequently monitor blood glucose levels Polycystic Ovary Syndrome PCOS Signssymptoms High levels of intraabdominal fat hirtuism alopecia acne high levels of blood insulin triglycerides low levels of HDL Includes menstrual dysfunction insulin resistance high blood insulin levels obesity Obesity does not cause PCOS but it makes fertility and metabolic problems worse Goal is to increase insulin sensitivity Intervention is dietary modification weight loss amp physical activity Secondary treatment is metformin or other insulinsensitizing drugs Phenylketonuria PKU 0 Inherited error in phenylalanine metabolism 0 If not controlled high levels of phenylalanine can accumulate in the embryo and fetus Impair central nervous system development Treatment LOW phenylalanine diet 0 Girl With PKU can t eat protein Celiac Disease 0 Sensitive to gliadin protein found in gluten in Wheat rye and barley Causes fat malabsorption Associated With infertility in males and females Diagnosis often delayed 0 Intervention Gluten Free Diet 0 Normal reproduction returns once celiac disease has been stabilized With gluten free dietFoods that Contain Gluten Ingredient Labels to Identify Wheat Example 1 Ingredients Semolina wheat niacin reduced iron thiamin mononitrate riboflavin folic acid Example 2 Ingredients Semolina niacin reduced iron thiamin mononitrate riboflavin folic acid Contains Wheat Chapter 3 Periconceptional period the time period around conception variously measured in weeks or months depending on the pregnancy outcomes of interest Premenstrual Syndrome premenstrual 5 the period of time preceding menstrual bleeding syndrome 5 a constellation of symptoms a condition occurring among women of reproductive age that includes a group of physical and psychological symptoms with onset in the luteal phase and subsiding with menstrual bleeding Premenstrual dysphoric disorder PMDD is a severe form of pMS Luteal phase the second half of the menstrual cycle usually days 14 to 28 that occurs after ovulation Serotonin a neurotransmitter derived from the amino acid tryptophan that affects nerve cell activities that excite or inhibit various behaviors and body functions It plays a role in mood appetite regulation food intake respiration pain transmission blood vessel constriction sleep and other body functions Insulin resistance a condition in which cell membranes have reduced sensitivity to insulin so that more insulin than normal is required to transport a given amount of glucose into cells Metabolic syndrome a constellation of metabolic abnormalities that increase the risk of heart disease hypertension type 2 diabetes and other disorders Metabolic syndrome is characterized by insulin resistance abdominal obesity high blood pressure and triglycerides levels low levels of hDL cholesterol and impaired glucose tolerance It is also called syndrome X and insulin resistance syndrome Anovulation the absence of ovulation Chronic inflammation Low grade inflammation that lasts weeks months or years Inflammation is the first response of the body s immune system to infectious agents toxins or irritants lt triggers the release of biologically active substances that promote oxidation and other reactions to counteract the infection toxin or irritant a side effect of chronic inflammation is that it also damages lipids cells and tissues Polycystic ovary syndrome PCOS polycysts 5 many cysts ie abnormal sacs with membranous linings a condition in females generally characterized by insulin resistance high blood insulin levels obesity polycystic ovaries menstrual dysfunction amenorrhea infertility hirsutism excess body hair and acne Luteinizing hormone LH a hormone produced by the pituitary gland that stimulates ovulation the development of the corpus luteum which secretes progesterone and the production of testosterone in males Follicle stimulating hormone FSH a hormone produced by the pituitary gland that stimulates ovarian follicle growth and maturation estrogen secretion and endometrial changes characteristic of the first portion of the menstrual cycle in females lt stimulates sperm production in males Amenorrhea absence of menstrual cycles Sex hormone binding globulin SHBG a protein that binds with the sex hormones testosterone and estrogen these hormones are inactive when bound to ShBG but are available for use when needed Low levels of ShBG are related to increased availability of testosterone and estrogen in the body Gonadotropin releasing hormone GnRH a hormone produced in the hypothalamus that is responsible for the release of follicle stimulating hormone and luteinizing hormone by the pituitary Hypothalamic amenorrhea a condition characterized by cessation of menstruation due to changes in hypothalamic signals that maintain ovulation Changes in hypothalamic function appear to be triggered by an energy deficit also called functional hypothalamic amenorrhea and weightrelated amenorrhea Female athlete triad a condition marked by the simultaneous presence of an eating disorder menstrual dysfunction and osteoporosis in otherwise healthy female athletes It is characterized by the interrelated factors of energy deficit menstrual dysfunction and loss of bone mineral density Anorexia nervosa an eating disorder characterized by extreme weight loss poor body image and irrational fears of weight gain and obesity Bulimia nervosa an eating disorder characterized by recurrent episodes of rapid uncontrolled eating of large amounts of food in a short period of time Episodes of binge eating are followed by compensatory behaviors such as such as selfinduced vomiting dieting excessive exercise or misuse of laxatives to prevent weight gain Teratogenic exposures that produce malformations in embryos or fetuses Congenital abnormality a structural functional or metabolic abnormality present at birth also called congenital anomalies these may be caused by environmental or genetic factors or by a combination of the two Structural abnormalities are generally referred to as congenital malformations and metabolic abnormalities as inborn errors of metabolism Type 1 diabetes a disease characterized by high blood glucose levels resulting from destruction of the insulinproducing cells of the pancreas This type of diabetes was called juvenileonset diabetes and insulindependent diabetes in the past and its official name is type 1 diabetes mellitus Type 2 diabetes a disease characterized by high blood glucose levels due to the body s inability to use insulin normally or to produce enough insulin this type of diabetes was called adultonset diabetes and noninsulindependent diabetes in the past and its official name is type 2 diabetes mellitus Glycemic index GI a measure of the extent to which blood glucose levels are raised by consumption of an amount of food that contains 50 grams of carbohydrate compared to 50 grams of glucose a portion of white bread containing 50 grams of carbohydrate is sometimes used for comparison instead of 50 grams of glucose Autoimmune disease Diseases that result from a failure of an organism to recognize its own constituent parts as self the organism attempts to defend itself from the perceived foreign substance through actions of its immune system these actions can damage molecules cells tissues and organs type 1 diabetes lupus and rheumatoid arthritis are examples of autoimmune disease Rotavirus a virus that is the most common cause of severe diarrhea among children Diarrhea caused by rotavirus generally lasts 2 days and recovery is full in otherwise healthy children The rotavirus is generally spread from an infected person s stools to food
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