Exam 2

100% Juice

"100% juice" means no added sugar -Still has a lot of natural (intrinsic) sugar -Juice cuts out fiber -Eat your calories, don't drink them

Lipid Needs

-1st 20 weeks: Lipogenesis (increase maternal fat stores). A good thing. Needs to start storing fat. -2nd 20 weeks: Lipolysis and Cholesterol Synthesis. Breakdown of this fat storage to release the fat to the baby. Baby develops most during 2nd 20 weeks. -Needed for hormone production, cell structure, vitamin D production, -Increase of fat as energy source for mother, and carbs can go to energize the baby. -Increase in plasma lipoproteins, cholesterol, and triglycerides- atherogenic lipid profile (no harm and reverts post pregnancy) -Seen in 2nd and 3rd trimester. LDL levels go up. Looks like mother is at risk for cardiovascular disease, but it's normal.

Triglyceride Needs (pregnancy)

-2nd: 1.32 mmol/L -3rd: 2.58 mmol/L

Cholesterol Needs (pregnancy)

-2nd: 200mg/dL -3rd: 240 mg/dL -Body is releasing fat into bloodstream to be transferred to baby.

Dietary Guidelines for Americans

-Based on scientific research: systematic reviews -Written by experts in the fields of nutrition, medicine, etc. -Provides evidence based recommendations about the components of a healthy diet and nutritionally adequate diet. -Evidence is observational, association based. •Takes less time, resources, subjects, etc

Whole Grain Products

-Brown Rice -Buckwheat -Bulgur -Millet -Oatmeal -Popcorn -Quinoa -Rolled Oats -If it says "Whole" in front of grain -Wild Rice

Added Sugar

-Brown Sugar -Corn Syrup -High Fructose Corn Syrup -Fructose -Honey -Sucrose

Solid Fats

-Coconut oil -Palm Oil -Partially Hydrogenated -Butter -Palm Kernel

Weight Gain recommendations

-First trimester: 2-4 lbs weight gain at the maximum. Some women even lose weight due to morning sickness. -Second Trimester: +340 kcal/day, +25g protein/day -Third Trimester: +452 kcal/day, +25g protein/day Total Weight gain: -For a woman at a healthy body weight: 25-35 lbs by time baby is born. -If she is underweight: 28-40 lbs. -Overweight: 15-25 lbs -Obese: 11-20 lbs

Protein Needs

-Focus on complete, animal proteins. -No evidence of protein storage during pregnancy, so it's needed on a daily consistent basis. -Both fetal and maternal are obtained from diet -No increased protein needs during first trimester. -RDA: • 1st trimester: 46g/day min. 0.8g/kg of body weight. • 2nd and 3rd: 71g/day min. 1.1 g/kg of body weight -Complete and Complementary Protein Food Sources: • Peanut butter, milk, nuts -Vegetarians: consider not following diet during pregnancy.

Foundation of the Dietary Guidelines for Americans

-Focuses more on disease prevention than disease treatment -Emphasizes a focus on overall eating patterns (Get your nutrition from food, not dietary supplements unless you have to). -Healthy eating patterns have a level of adaptability based on individual preferences and budget constraints. This means that not everyone has access to the "best" diet. -Sometimes, the "better" or "okay" diet is acceptable also. -Diets can be adapted or modified given a person's situation.

Folic Acid and B12

-Folic Acid: the synthetic, man-made form of B vitamins. Found in fortified foods (cereal grains and prenatal vitamins) -Support fetal neural and cell development -Consume before and during pregnancy -RDA Before pregnancy: 400 mcg, after pregnancy: 600mcg -B12 is important to metabolize folic acid, and helps with red blood cell development.

Essential Fatty Acid Needs (Pregnancy)

-MUFAs and PUFAs. -Linoleic Acid: the father/the main Omega 6. Ex: Walnuts, Sunflower seeds, Sunflower oil, Corn oil, Soybean oil -Alpha-Linolenic Acid: the father/the main Omega 3. Ex: Flaxseed, vegetable plants, soybeans, soybean oil, flaxseed, walnuts. ONLY plants and plant products.

Top 8 Food Allergies

-Milk -Eggs -Soy -Wheat -Peanuts -Tree nuts -Shellfish -Fin fish

Purpose of the Dietary Guidelines

-Promote health -Prevent chronic disease -Help people reach and maintain a healthy weight

Sodium

-Salt -Can be added through vitamins

New Food Label

-Separates total sugar from added sugar values. -Adding percent daily value for Sugar -Updated daily values for sodium, dietary fiber, vitamin D -Requiring Potassium and Vitamin D, no longer requiring Vitamin A and C to be listed -Instead of just giving percent daily value, gives amounts as well for micronutrients -Focus on type of fat and remove "Calories from Fat" -Update serving sizes based on how people eat

Iron

-Supports a larger blood volume and needed for oxygen transport -Iron-deficiency anemia is common in women and infants -If woman has adequate iron during pregnancy, will help baby store iron in the liver, which is important during breast feeding. -Body will increase iron absorption during pregnancy -RDA: is 27 mg during and 18mg prior to pregnancy -UL is 45 mg/day -Iron rich foods and Vitamin C foods -Heme Iron: Well absorbed; meat, poultry and fish. -Non Heme Iron: Less absorbed; plants (fruits, vegetables) -Enhance iron absorption: Vitamin C -Inhibit iron absorption: Calcium -Iron supplementation is not recommended unless anemic. -Ferous Fumarate is the best form -Can lead to nausea and constipation

Dairy

1 serving = 1 cup. (300 mg of Calcium) 1 Serving equals: -2 oz of a processed cheese product (American cheese) -1.5 oz of a natural cheese product (Cheddar, Swiss, mozzarella Cheese, etc) -1 cup (8oz) of yogurt -1.5 cups of ice cream (bad cause sugar, sat fat, and calories) -1 cup of cow's milk -1 cup of calcium fortified soy milk

Grains

1 serving = 1 oz 1 Serving equals: -1 slice of whole grain bread -1 cup of cereal -½ cup of hot cereal (oatmeal) -½ cup cooked pasta -½ cup cooked rice -1 six inch tortilla -3 cups of popped popcorn -5 to 7 crackers

Protein

1 serving = 1 oz. 1 serving equals: -1 oz of chicken (really any meat products) -½ oz of nuts (2 TBSP or 1/8 of a cup) -1/4 cup of legumes (peanuts, beans) -1 egg (scrambled, hard boiled, etc) -1 TBSP of Nut Butter (Almond Butter, etc) -2 TBSP of Hummus

Fruits

1 serving = 1/2 cup 1 Serving equals: -1/4 cup (4 TBSPs) raisins -½ cup grapes -½ cup 100% grape juice

Vegetables

1 serving = 1/2 cup. 1 serving equals: -½ cup raw or cooked vegetable -½ cup vegetable juice (problem cause it's high in sodium) -1 cup leafy veggies (lettuce, spinach)

5 Recommendations

1) Americans should follow a healthy eating pattern across their lifespan. -Parents need to make sure children are getting healthy eating patterns. -Children are not as resistant to health problems as we think they are. Need nutrient dense foods. -Fruits, vegetables, dairy, grains, proteins. (Vegetable oils: MUFAs and PUFAs). -Limits: sat and trans fat, added sugar, sodium 2) Focus on variety, nutrient density, and the amount of food consumed. 3) Limit calories from added sugar and saturated fat, and reduce sodium intake. 4) Shift to healthier food/beverage choices. 5) Support healthy eating patterns for all. -Goes back to adaptability/resources. Need to adjust dietary recommendations.

Nutrient Use (Pregnancy)

1) Nutrients are used by the mother first. (Mother has to be healthy for baby to survive) -If the mother enters pregnancy malnourished, it'll only further malnourish her and the baby. 2) Then nutrients are used by the placenta -Blood supply between mother and baby. -Nutrients go from mother to baby by way of the placenta. -Placenta produces growth hormones and enzymes, facilitates nutrient and gas exchange, blocks some bacteria. -Viruses, alcohol, medications, and toxic micronutrient levels can all be passed onto baby. 3) Finally nutrients are used by the fetus. -Have to have a good support structure for baby to get what it needs.

6 Principles of a Healthy Diet

1) Nutritional Adequacy: getting the right amount of each nutrient. Look at the DRI's. (RDA or AI). 2) Balance: Don't want one nutrient exceeding another or replacing another. Don't emphasize one nutrient and forget to consume another vitamin. Making sure that you're getting the right amount without having excess in one and inadequacy in another. 3) Kcalorie Controlled: Making sure you're achieving your intake of calories based on your calorie expenditure. Intake = output. Individualized. 4) Nutrient Dense: selecting foods that give you a lot of nutrients for a small amount of calories. 5) Moderation: All foods fit in the diet. Some just have to be consumed in small, infrequent amounts. Don't over-consume any one food or food group. 6) Variety: eating different foods from each of the different food groups.

Organic Food

95-100% of ingredients have to meet criteria. 1) Has not been produced with the use of a synthetic pesticide/fertilizer. -Usually has been fertilized with manure instead 2) Has not been produced with GMO's -Includes cross breeding and cross pollination (natural). 3) No hormones or antibiotics were used in production 4) No irradiation (subjecting product to low level radiation for a short period of time to kill microorganisms) -People are afraid it makes food radioactive -Often used in fruits and vegetables

Anorexia of aging

A decline in apetite

100% Juice

A juice product will tell you the percent on the front of the label, or above the nutrition facts panel

Carbohydrate Needs

AMDR of Carbohydrates during pregnancy: 45-65% of calories. (same as before) -Consume at least 175g of carbohydrate per day during pregnancy -Nutrient Dense Food Sources: • Whole grains • Fruit • Starchy Vegetables • Milk and Yogurt • Legumes -Watch Added Sugar • Safe to consume non-nutritive sweeteners (Aspartame, etc) during pregnancy at normal levels. -Carbs are needed to energize our building/growing process, and we don't want to use fat or protein for energy.

<10% of daily kcals

Added Sugar Intake (Dietary Guidelines for Americans)

Decreased Foods

Added Sugar, Sat Fat, Sodium, and Alcohol

Adult Physical Activity

Adults: -For basic health benefits (help cardiovascular, respiratory function, muscles, bones etc): need to participate in 150 minutes per week of moderate intensity physical activity. An average of 30 min, 5 days per week. Or could do 75 minutes of vigorous activity. If adult is looking for additional health benefits (lose weight and maintain weight loss, control BP, control blood sugar): have to do 300 minutes per week of moderate intensity physical activity. Or 60 minutes 5 days per week. Or can have 150 min of high intensity activity. Adults and Children should participate in muscle strengthening activities at least 3 times a week.

Cow's Milk

Avoided by infants until after 1 year. o Don't have enzymes to digest casein o May lead to GI bleeding, impaired nutrient absorption, and low iron status

Children Physical Activity

Children need 60 minutes per day of moderate or vigor physical activity. (some say bare minimum is 3 times a week) Adults and Children should participate in muscle strengthening activities at least 3 times a week.

Nutrient Content Claims

Claim that has to do with the amount of a nutrient/calories in a food product. -Ex: Reduced Fat, Low Fat, Good Source of, etc -"No Fat"/"Fat Free"/"Sodium Free": doesn't mean completely 0. Often it's .5 g or mg or whatever or less. Can still be trace amounts. -"Reduced"/"Less": 25% less than the original product. -"High"/"Rich Source of"/"Excellent source of": 20% of more of daily serving. -"Good Source of": 10-19% of daily value

Changes in Serving Size

Did this because people don't do the math. -No more "1.5 servings". -Changes packaging and labeling of single serving products. -Changed based on how much people eat/drink in one sitting. -Re-designing label to emphasis calories, serving size, etc.

Update

Dietary Guidelines for Americans are updated every 5 years. -The most recent update was 2015

Increased Calorie Needs

During pregnancy, energy needs are increased. -Increase in Basal Metabolic Rate (BMR: someone's energy expenditure at rest). The amount of energy your body needs to keep heart pumping, brain working, etc. -Total Daily Energy Expenditure: combined BMR with physical activity -Body uses energy to digest food. Eating increases BMR -Metabolism increases during periods of growth and development. -Focus on nutrient dense foods -Occur mostly in 2nd and 3rd trimester, not really in the first.

Food Groups

Fruits, Grains, Vegetables, Protein, and Dairy

Increased Food Groups

Fruits, veggies, dairy, grains, proteins, and vegetable oils

Health Claims

Have to have substantial, scientific evidence behind them. -Telling you an association between an ingredient or a nutrient in the product and how it helps to reduce risk of some type of disease/prevent the occurrence -Ex: Calcium and Vitamin D intake reduce risk of osteoporosis

Weight Gain

Healthy body weight at point of conception reduces risk of preterm delivery, gestational diabetes, hypertension, etc. -Too little weight gain increases risk of pre term delivery and SGA Infants -Too much weight gain increases risk of post-partem with retention

Ingredient Order

Ingredients are listed in order from greatest amount to least amount (weight)

Prior to Conception

Male and Female Nutrition status prior to conception are equally important. -Female nutrition status becomes more important post conception (during development) -Has to be contribution of "healthy" sperm -Have to have a healthy diet to have healthy cells.

Sarcopenia

Muscle loss associated with the aging process. Decline in strength. Not consuming enough protein.

Micronutrients

Must be listed on a food label: -Vitamin D -Potassium -Calcium -Sodium -Iron

EPA and DHA

Nonessential Omega 3's, but are important. -EPA: Anti Inflammatory Eicosanoid Production. Chemical messengers. -DHA: Cell membranes CNS (Central Nervous System), accumulation in fetal brain tissue and cells. -Improved intelligence, vision, and CNS Functionality; decrease risk of pre-term delivery -Only come from fatty fish: salmon, tuna, etc. -During pregnancy, okay to consume 8-12 oz of fatty fish per week. o Limit white albacore tuna to <6oz per week. o Avoid swordfish, tilefish, shark, and king mackerel o Choose variety of low-mercury containing fatty fish

Caffeine

Not harmful during pregnancy. -No more than 200 mg a day (12-16 fl oz cups of coffee). -Could make fetus more hyperactive. -No evidence for birth/growth defects.

Infant Benefits

Of breastfeeding • Nutritionally complete food for first 6 months of life (except Vitamin D) • Iron stores in liver • Immune support • Helps with lymphocyte, antibody (immunogobins) production, Histocompatibility antigens, bifidus factors (introduces natural probiotics in GI Tract), nutrient carrier proteins (iron and B12), and enzymes • Reduction in infant mortality from SIDS • Reduced occurrence for infant acute illness • Reduced risk of allergies • Reduced risk of diabetes, gastrointestinal disorders, and cancer • Reduces risk of childhood obesity • Improved cognitive functionality. (DHA content in breast milk)

Mother Benefits

Of breastfeeding. • Helps with Oxytocin release (stimulates uterine contraction and reduced post partum blood loss) • Stimulates Prolactin Release which delays ovulation (helps with birth spacing) • Supports post partum weight loss • Reduce occurrence of breast cancer, ovarian cancer, and rheumatoid arthritis • Psychological Benefits: Reduces post partum depression and improves self confidence • Reduces food costs: Annual formula cost is $1500.

2 main goals

Of health promotion and disease prevention. o Maintaining health and functional independence.

Overweight

Overweight woman: Increases risk for preterm delivery, gestational diabetes, and hypertension. -If overweight, maintain same weight til after pregnancy. Dieting (limiting consumption) is never ok during pregnancy. -Baby's more susceptible to weight related diseases.

Allergen Labelling Law

Required labeling of a food with a top 8 food allergen -Allergen is bolded in ingredients list or in Allergen is listed separately by statement "Contains..."

Federal Agencies

Responsible for publishing the Dietary Guidelines for Americans. -Department of Health and Human Services -US Department of Agriculture

<10% of daily kcals

Saturated Fats intake (Dietary Guidelines for Americans)

Foods

Should be introduced one at a time to an infant to prevent allergy and to promptly identify the allergen if a reaction occurs.

<2,300 mg per day (1 tsp of salt)

Sodium Intake (Dietary Guidelines for Americans)

Alcohol Intake (Dietary Guidelines for Americans)

Suggests not to drink it at all. Women: 1 drink per day, no more than 7 in a week, no more than 4 within a 2 hour period Men: No more than 2 drinks per day, no more than 14 per day, and no more than 4 in a two hour period.

6 Key Lifestyle Behaviors

That have the greatest influence on adult health o Sleeping regularly and adequately o Eating well-balanced meals regularly o Engaging in physical activity regularly o Not smoking o Not using alcohol o Maintaining a healthy body weight

Structure Function Claim

The relationship between a nutrient and what it does in the body (what its function is). Doesn't relate function to disease, just states function. -Not regulated. People can put whatever they want on the label as long as there is some scientific truth to it. -Has to have a disclaimer statement so consumers understand the nutrient is not intended to diagnosis, treat, cure, or prevent any disease.

Non Dairy milk

These products have been fortified with calcium. They've actually added more than the calcium from dairy products so that it is more bioavailable to the body. -Also have been fortified with Vitamin D -Gives more MUFAs and PUFAs than dairy milk, and reduces Sat Fat content (except coconut milk) -Gives much less protein and potassium though

3 cups

Total Dairy Serving Requirement

2 Cups

Total Fruit Serving Requirement

6 oz

Total Grains Serving Requirement

5.5 oz

Total Protein Serving Requirement

2.5 cups

Total Vegetable Serving Requirement

Underweight

Underweight at point of conception causes risk to increase for preterm delivery. -If underweight, woman needs to gain weight -Baby could have low-birth weight or very low-birth weight, which increases baby's health consequences throughout life. -Baby's more susceptible to weight related diseases.

Calorie Needs

Used to develop energy expenditure equations (Total food group serving recommendations). 1) Age and Gender: -women need fewer calories than men -as we age, muscle mass declines, which means calorie needs decline 2) Height and Weight: -more weight means more energy needed to maintain that weight 3) Physical Activity: -more muscle a person has, the more calories they need -the more calories we burn, the more we can take in

Physical Activity Recommendations

Vigorous: burning more than 7 kcal per minute • Jogging, running, biking, etc. Moderate: burning about 3.5 to 7 kcalories per minute • Brisk walking, shooting hoops, yoga, walking a dog, etc

Energy Needs

metabolic rate decreases with aging, directly correlates with decrease in muscle mass. (the more muscle mass a person has, the higher the metabolic rate). Energy needs also decrease, don't need to eat as much.

Nutrient Intake

o Appropriate energy intake helps prevent obesity, diabetes, and cardiovascular diseases. o Fiber helps prevention of gastrointestinal diseases like diverticulitis and colon cancer

Juice Intake

o Can be offered beginning at 6 months of age, must be 100% juice. o If baby is still bottle fed or sippy cup fed, should not be fed juice (causes tooth decay) o Only pasteurized juice. o Should be complementary to breast/formula milk o No more than 4-6 oz of juice per day. o Weaning from breast/bottle to cup: 12-24 months.

Lactation

o Energy: A woman while breast-feeding (especially in the first 6 months) is going to use 500 calories per day in milk production. Calories come from nutrient stores (help her lose weight) and diet. If she eats 330 more calories per day, the other 170 calories come from her fat stores. She'll lose 2 lbs per month • Don't want her to lose weight too quickly or cut calories too fast, affects nutritional quality of breast milk • Some women may need to eat more or less than 330 calories a day • Should focus on nutrient -dense foods o Omega-3 DHA: Consume 200-300 mg/day o Micronutrients: Ensure intake of nutrient dense foods to support adequate macronutrient and micronutrient content of breast mik • Supplements should not be the sole source of a nutrient's intake o Fluid: normal fluid is required to remain hydrated

Formula

o Formulas are formulated to mimic human breast milk. Typically made of whey protein from milk. Contain added sugar to mimic the carbohydrate content (corn syrup, sucrose), water, vitamins, minerals, and vegetable oils. o Energy wise: human milk and infant formula are very similar. o Protein: whey is more easily digested for infants (they do not have digestive enzymes to digest casein, can't have cow's milk) • Human Milk: whey • Cow's milk: casein o Carb, Fat, Calcium content is all similar o Most formulas are iron fortified. However, breast milk has it in smaller amounts, more bioavailable. High doses of iron can impede and impair factors that help with the absorption capacity of iron. • Don't mix iron fortified with breast feeding o Vitamin C is around the same o Vitamin D is low in breast milk. Formula is fortified with Vitamin D. (baby needs 400 IU every day supplementation)

Choking Hazard

o Gum, hard candy, hot dog slices, large apple slices, marshmallows, nuts, peanut butter, popcorn, whole beans, whole grapes

Formula Preparation

o If a family is feeding their baby infant formula, have to remember it's food. o The can holding the formula can have bacteria growing in it o Formula needs to be prepared in a clean environment, bottles need to be sterilized/cleaned well o Breast milk needs to be refrigerated.

Breastfeeding

o Infants should be fed through breastfeeding for first 6 months of life o Introduce complementary foods by 6 months of life (can start introducing at 4 months) o By 6 months of age, infant should be gradually transitioned to complementary foods and decreased amount of breast feeding o Continue breast feeding until at least 12 months of life o Weaning from breast milk should be done by 12 months o Child can be introduced to cows milk at 12 months

Complementary Foods

o Introduce foods one at a time at intervals of 2-7 days between to assess for allergies and intolerances o Do not feed honey/corn syrup to an infant <12 months old (Botulism: causes paralysis) o Do not feed cow's milk until after 1 year (and then only whole milk) o Caution for choking hazard foods (hot dog). Cut things very very small. o Don't feed infants caffeinated, sugar-sweetened, herbal, low-calorie beverages o Water should be used sparingly. Mostly Breast milk or formula.

Solid Foods

o Rice cereal: 4-6 months. Least allergenic. Then wheat cereal. o 6-8 months: pureed vegetables, then pureed fruit o 8-12 months: strained and then chopped meat. Finger type foods/soft solids.

Old Age

o Variable. Pretty much over 60 o Retirement age is 65

Exercise

o While pregnant, a woman may exercise o If individual was very athletic prior to pregnancy, can continue to do what they did before with physician supervision o Reduces risk of GDM, preeclampsia, low back pain, excessive weight gain, blood clots o Not advised for poorly nourished or high risk pregnancies o Recommend: • Low impact workouts. Not a lot of pressure on the baby • Walking, cycling, swimming • 30 min, maximum 5 times a week

Infant Protein

• Birth to 6 months: 2.2g/kg body weight • 7 -12 months: 1.6g/kg body weight • Baby's need less protein than adults • Needs impacted by body composition: if infant is more muscular, need more protein to maintain that muscle mass • For formula-fed infants: make sure the baby is not under fed or over fed, and formula is made correctly (not diluted)

Mercury Contamination

• Can harm the developing brain and nervous system.

Constipation

• Cause: hormonal changes affecting muscle tone and crowding of internal organs. • Treatment: high-fiber diet, physical activity, and fluids

Infant Energy

• DRI 1st 6 months: 108 kcal/kg • DRI 2nd 6 months: 98 kcal/kg • Highest metabolic rate than any other point in life (rapid growth) • Inability to tolerate fasting because of very high kcal needs • Assessment of nutritional Adequacy based on their growth (head circumference: is baby actually obtaining adequate nutrition status) • Factors affecting energy needs of infants similar to those affecting energy needs of adults

Alcohol

• Easily passes through breast milk to infant • Can be consumed during breastfeeding, but cannot feed infant her breast milk if alcohol has not yet cleared her blood (2-3 hours per drink consumed. 3 drinks = 8 hours) • Cannot breast feed immediately after consuming alcohol • Based on body weight. • Can reduce breast milk releases • Can impact infant motor development, sleep patterns, and weight gain

Infant Lipid

• Fat is very important for babies • DHA needs to continue during the first year of life. Mom still needs to make sure she's getting DHA in her diet if she's breast feeding. • Fat is main source of a baby's energy needs. (building; mylin sheath of nerves, hormone production, etc) • Babies best absorb fat from human breast milk and vegetable oils. • Poor absorption of butter fat.

Infant Fluoride

• Function: healthy tooth enamel and prevention of cavities. • Fluoridated tap water is safe for lactating women and infants because breast milk is low in fluoride • Fluoride supplements may be needed for infants not in an area with fluoridated tap water • Too much: Fluorosis: spotty brittle teeth; also affects bones • If baby is eating a powder or concentrated formula, use low fluoride bottled water (distilled or purified) for preparation. Can result in baby getting too much fluoride.

GERD

• Gastroesophageal Reflux Disease • Avoid consuming: • Large, high fat meals • Carminatives (spearmint oils), caffeine, chocolate • Garlic and onions • Acidic and spicy foods • Avoid eating Food several hours (3-4) before bed • Stay upright and avoid vigorous activity after eating • Increase protein intake: raise LES pressure • Consume beverages between meals, not during meals • Lose weight if overweight • Avoid tightly fitted clothing • Reduce stress

Infant Iron

• If when women was pregnant had adequate iron (through food or supplement), the baby is going to store iron in its liver. • Storing iron in its liver to last the first 6 months of its life without supplementation • Breast milk is low in iron, but not a problem if baby had adequate iron stores while in the womb • Infant formulas have added iron

Infant Vitamin D

• Important for calcium absorption, bone mineralization, prevention of rickets • The one nutrient that breast milk is deficient in • Breast feeding is nutritionally adequate for first 6 months, with exception of Vitamin D (need supplement) • Formula Fed infants consuming less than 1 L per day need Vitamin D supplement • All Infants: 400 IU/per (need to know this) • Supplements: drop into baby's mouth

Pica

• Iron Deficiency • Eating disorder/nutrient deficiency • Commonly seen in: • African Americans • Those residing in the Southern US • Nutrient Deficient (Fe, Zn, or Ca) during pregnancy • Not a safe practice. • Can result in: • Geophagia: eat dirt • Pagophagia: eat metal, laundry detergent, or ice chips • Amylophagia: eating Laundry starch, chalk, baking powder, corn starch, baking soda, etc

Fetal Alcohol Syndrome

• Irreversible brain damage, growth retardation, mental retardation, facial abnormalities, vision abnormalities, and other health problems

Gestational Diabetes

• Pregnancy related form of diabetes. • Usually resolves after infant is born. • Advise against excessive weight gain during and after pregnancy • Increases risk for developing type 2 diabetes later on

Toxoplasmosis

• Raw and undercooked meat and seafood, Unwashed food and vegetables, Contaminated drinking water, cat liter boxes and feces. • Toxoplasmosis gondii

Infant Carbohydrate

• Remains body's primary metabolic fuel • Consumed as lactose (milk-based), sucrose, or corn syrup • AI for infants: • Birth to 6 months: 60g/day • 6 -12 months: 95g/day • Lack of adequate glucose will lead to body using more Amino Acids for glucose production results in decreased infant growth • Fiber: begin introduction with solid foot (~5g/day by 1 year)

Morning Sickness

• Typically begins around week 5 and ends at end of first trimester (week 15) • Results from hormonal changes or low blood sugar levels • Eating a snack at night or before getting up in the morning will help. • Associated with reduced risk of miscarriage • Women with high nutrient levels going into pregnancy tend to have less morning sickness • Severe and persistent: hyperemesis gravidarum • Therapeutic interventions: • Keep blood sugar stable (eating saltines) • Investigative use of Vitamin B6 and ginger • Eating raw honey at least 30 minutes before meals to soothe the stomach

Listeriosis

• Woman is at increased risk for food borne illness during pregnancy • Hot dogs and deli meats, refrigerated smoked seafood unless cooked to 165 degrees F. • Has to be cooked. No cold cuts, no sushi • Soft cheeses, Fresh fruit juice, and raw milk, unless pasteurized. • Listeria Monocytogenes: the bacteria that causes it. Likes cold temperatures

Caffeine

• hard for infants to metabolize. • Found in low levels in breast milk • Won't impair development, but will make baby hyperactive • <300 mg/day (~3, 8 fl oz cups of coffee)