NUTR 53-06 Final Study Guide

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Morning sickness (definition, causes, all the related information)

"Morning sickness," or nausea related to pregnancy, is so common that some health care professionals consider it an initial sign of pregnancy. In spite of its name, "morning" sickness can occur at any time of the day. It usually begins during the first trimester and often ends by the 20th week of pregnancy, although about 10 percent of women experience it longer. The causes of morning sickness are unknown, but lower blood glucose during early pregnancy or fluctuating hormone levels, particularly increased estrogen, may play a role. Though there are no known dietary deficiencies that cause morning sickness or dietary changes that can prevent it, some women find relief in eating frequent, small meals that are high in carbohydrates such as pasta, rice, and crackers and avoiding an empty stomach. Salty foods such as potato chips combined with sour and tart beverages such as lemonade have been shown to help. Vitamin B6 (100 milligrams or less daily) may also reduce the nausea and vomiting. Because there is an upper limit for safe vitamin B6 intake, pregnant women should consult their health care provider before increasing it. Ginger consumption has also been shown to help ease morning sickness. However, ginger root may inhibit a specific enzyme in the body, causing potentially adverse effects, including interfering with blood clotting. As with vitamin B6, pregnant women should not consume ginger supplements or extracts without first consulting their health care provider.Though morning sickness is uncomfortable, it usually does not harm the health of the woman or her fetus. However, in rare cases (less than 1 percent of pregnancies) some women experience a more severe form of morning sickness called hyperemesis gravidarum (hyper=overstimulated, esis=vomiting, gravida=pregnant), which can cause serious complications including dehydration, electrolyte imbalances, and weight loss. Women with hyperemesis gravidarum often have to be hospitalized for treatment. The loss of appetite that often accompanies nausea can be harmful if it causes the mother to reduce her intake of nutritious foods. Whereas avoiding coffee, tea, and fried or spicy foods (common aversions for pregnant women) is fine, limiting consumption of fruits, vegetables, and whole grains, along with an inability to tolerate prenatal supplements, may result in certain nutrient deficiencies. When the fetus does not receive adequate amounts of an array of nutrients during pregnancy, fetal development may be irreversibly harmed.

Pregnancy in teenagers

An adolescent's body is still growing; thus, pregnant teens have higher nutrient needs than pregnant adults. At the same time, adolescents are more likely to eat on the run, skip meals, eat nutrient-poor snacks, and consume inadequate amounts of whole grains, fruits, vegetables, and dairy products. A pregnant teen's inadequate diet can mean not only a low-birthweight or SGA baby, but her own diminished health status. Teenage mothers are also more likely to develop pregnancy-induced hypertension and iron-deficiency anemia and to give birth prematurely, putting both baby and mother at risk for health problems.In addition, adolescents are less likely to receive adequate prenatal care than their older counterparts. If she receives prenatal care, pays close attention to her nutrition, and avoids unhealthy habits, a teenage mother can experience a normal, healthy pregnancy.

Alcohol and pregnancy (all the information related)

Because alcohol can affect embryonic development before a woman is even aware that she is pregnant, the U.S. Surgeon General recommends that all women who may become pregnant abstain from alcohol. Drinking alcohol during pregnancy can lead to fetal alcohol spectrum disorders (FASDs) in the baby. Children exposed to even low levels of alcohol during pregnancy can be born with learning and behavioral disabilities that last a lifetime. Because there is no known safe level of alcohol consumption, pregnant women should abstain completely to eliminate the chance of having a baby with these disorders.

Recommendations for breast feeding (i.e. At least up to 6 months of age

Breastfeeding helps reduce the risk for type 2 diabetes, certain cancers, and postpartum depression and may help mothers return to their pre-pregnancy weight. Breastfeeding is the least expensive and most convenient way to nourish an infant and helps the mother and baby bond. Human milk is rich in nutrients, antibodies, and other compounds that protect the infant against infections, allergies, and chronic diseases and may enhance the child's cognitive development. Women are advised to breastfeed exclusively for the first 6 months of their baby's life, and then breastfeed to supplement solid food for the remainder of the first year, or longer if desired. A mother must increase her fluid and nutrient intake to help her body produce breast milk.

Cigarette smoking and risks in pregnancy

Cigarette smoking increases the risk of infertility in women, possibly making conception more difficult. Prenatal exposure to cigarette smoke may stunt the fetus' growth and development, affect a child's future intellect and behavior, and increase the risk of birth defects, stillbirth, premature birth, and sudden infant death syndrome (SIDS). Nicotine and carbon monoxide are particularly dangerous because they reduce the amount of oxygen that reaches the baby, thus intensifying adverse effects. In addition, pregnant smokers may weigh less and gain less weight during pregnancy than nonsmokers, which can contribute to a low-birthweight baby. Even secondhand smoke can affect the health of a mom-to-be and her infant. Exposure to passive smoke in utero is associated with stillbirth, preterm birth, low birthweight, congenital anomalies, neonatal and infant mortality, asthma, and respiratory infections.

Pregnancy and causes of constipation

Constipation is common near the end of pregnancy. The slower movement of food through the GI tract, the iron in prenatal supplements, and a tendency for less physical activity are contributing factors. Regular physical activity and a fiber-rich diet that features whole grains, fruits, and legumes and other vegetables, along with plenty of fluids, can help prevent or alleviate constipation.

What type of foods should be avoided by pregnant women?

Excessive amounts of preformed vitamin A (retinol) can increase the risk of birth defects, especially when taken during the first trimester Women who take dietary supplements should consume no more than 5,000 IU of preformed vitamin A daily and should avoid other vitamin and mineral supplements with more than 100 percent of the DRI. Raw and undercooked animal products are more likely to carry pathogens and should be avoided during pregnancy. Pregnant women should also avoid unpasteurized milk, cheese, and juices and raw sprouts. Sugar substitutes such as aspartame (Equal), sucralose (Splenda), acesulfame-K (Sunett), and saccharin (Sweet 'N Low) have been deemed safe to consume within the FDA's level of acceptable daily intake. Whereas consumption of sugar substitutes in pregnancy may not pose a direct health risk, it is recommended that women use them sparingly so as not to displace the nutrients that are essential to a healthy pregnancy. Women with PKU, however, should avoid using aspartame.

Folic acid and it's importance in pregnancy

Folic acid, the synthetic form of folate or vitamin B9, is needed to create new cells and help a fetus grow and develop properly in utero. Consuming the DRI of folic acid (400 μg per day) beginning at least 1 month prior to conception, and preferably earlier, helps reduce the risk of giving birth to a newborn with a neural tube defect (NTD) such as anencephaly or spina bifida. NTDs occur when the embryonic neural tube fails to fold properly. This improper folding results in incomplete brain and skull development (anencephaly) or a herniation and exposure of the spinal cord (spina bifida). Foods rich in the naturally occurring form of this B vitamin—folate—are also helpful for meeting the DRI. These include lentils, beets, broccoli, and most leafy green vegetables.

Allergies in children and common allergens

Food allergies are caused by proteins called allergens, which are interpreted by the body as foreign and trigger an immune response that ranges in severity from uncomfortable to life-threatening. The reason for the increased prevalence is not known, but may be due to delayed introduction of allergenic foods. Most food allergies are caused by eggs, cow's milk, peanuts, soy, wheat, tree nuts, fish, and shellfish.

Weight gain (amounts) during pregnancy based on BMI (for example: recommended weight gain for a pregnant woman with pre-pregnancy weight that represents BMI within acceptable normal range ---> BMI 18.5-24.9)

For example, women having a single baby who conceive at a healthy weight (with a BMI between 18.5 and 24.9) should gain 25-35 pounds, whereas underweight or overweight women have different weight gain goals .The pattern of weight gain—that is, the rate of weight gained per week of pregnancy after the first trimester—as well as total weight gain influence the outcome of the pregnancy, especially for twin and triplet pregnancies, which tend to be shorter than singleton pregnancies. Figure 17.6 shows healthy patterns of weight gain during a singleton pregnancy.

Antioxidants in plants and decrease risks of Alzheimer's in older adults

Healthy diet, physical activity, social engagement may help reduce risk

Infant should not have whole milk and honey, up to age one (Reasoning behind it)

Honey has been known to carry spores of Clostridium botulinum, which can develop in an infant's GI tract and secrete a toxin that causes infant botulism. Untreated infant botulism may cause paralysis of the arms, legs, trunk, and respiratory muscles, causing a potentially fatal respiratory failure. Older children (1 year and older) and adults can consume honey without these concerns because the mature GI tract can destroy the spores.

Infant diet and the type of nutrients need to be added to their diet

Infants up to 6 months of age should consume 60 grams of carbohydrate per day and 95 grams per day at 7-12 months. Infants need about 9 grams of protein per day during the first 6 months of life and 11 grams daily in the second 6 months. There's no need to limit fat in the first year of life, and doing so could negatively impact physical and mental growth and development. Three nutrients should be added to an infant's diet: vitamin K, vitamin D, and iron. All newborns should receive an injection of vitamin K, which participates in the synthesis of clotting proteins. It is recommended that an infant receive this bolus of vitamin K after initiation of breastfeeding. The amount of vitamin D in breast milk is inadequate to prevent rickets, so infants should also receive 400 IU of vitamin D drops daily beginning during the first 2 months of life. Infants exclusively fed adequate amounts of vitamin D-fortified formula do not require additional vitamin D. Once they reach age 1, children can drink vitamin D-fortified milk instead of infant formula or breast milk; however, if they don't get enough vitamin D through foods, including fortified milk, they may still need supplementation. Exposure of the infant's skin to sunlight to obtain vitamin D is not recommended because it can cause sunburns and increases the risk of skin cancer. Iron-rich foods, such as enriched cereals, should be introduced at around 6 months, as the infant's stores of iron are depleted by this time. Premature infants, who have lower iron stores because they were born early, may need iron supplementation before age 6 months. Because vitamin B12 is naturally found only in animal foods, supplementation may be recommended if the infant is being breast-fed by a strictly vegan mother. If the child's water supply is non-fluoridated, or if bottled water is used for mixing formula, a fluoride supplement may also be necessary. Beverages such as apple juice are a popular component of infant diets; however, the AAP suggests avoiding the introduction of juice until the child is a toddler. Juice should not be given to an infant until at least 6-9 months of age and should be limited to 4-6 ounces per day. Though juice provides nutrients, it often displaces more nutrient-dense foods. Only 100 percent juice, not juice drinks, should be used.

Activities and exercises in pregnancy; what is not safe?

Low-impact activities such as walking, swimming, and stationary cycling are best because they pose less risk of injury for both mother and baby. In contrast, high-impact activities, such as tennis and basketball, could injure the baby and cause joint injuries for the mother.

Concentrate on older adults nutrition and risks of chronic diseases .

Older adults need fewer calories, not less nutrition Metabolic rate declines with age, reducing calorie needs Continued intake of nutrients required to build cells, repair tissues, reduce risk of chronic disease Older adults need to get adequate fiber and fluids Fiber reduces risk of diverticulosis, heart disease, other chronic illnesses Fiber and fluids help prevent constipation Declining thirst mechanism increases risk of dehydration

What is pica and cravings of non-food items

Pica is the abnormal, compulsive intake of nonedible items such as laundry starch, burnt matches, cornstarch, clay, dirt, paint chips, or baking soda. Pica has been associated with low blood levels of iron, which has led to the theory that pregnant women seeking out nonfood substances have an iron deficiency. However, other research suggests that pica causes the iron deficiency in these women. Consuming nonfood substances can lead to the ingestion of toxic compounds, such as lead, that could lead to lead poisoning and other ill effects in both the mother and the baby.

Risks of osteoporosis and consuming preformed vitamin A

Preformed vitamin A: overconsumption may increase risk of osteoporosis and fractures

Eclampsia

Seizures or coma in a woman with preeclampsia.

Vegan pregnant women and risks of deficiencies for zinc, iron and B12 (learn about it)

She needs more iron to make additional red blood cells, which increase her oxygen-carrying capacity and help replace possible significant iron losses from bleeding during birth. Iron is essential for fetal growth and development and for the growth of the placenta. A woman also needs extra iron to prevent iron-deficiency anemia, a condition associated with premature birth and an increased risk of death for both mother and baby. Choline, found in high amounts in animal foods, is important during pregnancy and breastfeeding. Choline is needed for healthy cells to divide and grow, especially in the brain. Vegans who don't consume any animal products need to make sure that they are getting adequate amounts of vitamin B12 from reliable sources, such as dietary supplements and fortified foods. Women should not take iron supplements with foods that have components that inhibit its absorption, including milk products (calcium), high-fiber foods (phytate), and coffee and tea (polyphenolic compounds). Because iron can interfere with the absorption of other minerals, a woman taking more than 30 milligrams of iron daily should also take 15 milligrams of zinc and 2 milligrams of copper to prevent a deficiency of these minerals. Zinc is needed in protein metabolism and in the synthesis of DNA so that cells can replicate and differentiate. Copper, as part of enzymes, is needed in the production of energy, the synthesis of connective tissues, and the transport and use of iron.

What is placenta and its role

The placenta is the site of common tissue between the mother and the embryo where nutrients, oxygen, and waste products are exchanged through the umbilical cord. The maternal blood vessels exchange nutrients and oxygen with the fetal vessels, and the fetal vessels deliver waste products for the maternal blood to carry away for excretion. Because the placenta has distinct maternal and fetal tissue layers, maternal and fetal blood do not mix; instead, substances diffuse between the two circulatory systems. Although this dual lining prevents the passage of red blood cells, bacteria, and many large proteins from mother to fetus, potentially harmful substances, such as alcohol, illicit drugs, and common prescription and over-the-counter medications, can cross the placenta into fetal blood vessels. The placenta also releases hormones required to support the physiological changes of pregnancy, including the hormones that trigger labor and birth.

Risks that gestational diabetes can cause for fetus and infant

Though the cause of gestational diabetes is still unknown, the hormones from the placenta may cause insulin resistance in the mother, which in turn causes hyperglycemia. Extra blood glucose crosses the placenta, stimulating the baby's pancreas to make more insulin, which leads to the storage of excess glucose as fat and can result in macrosomia or a large baby. A larger than normal baby may be at risk of injury to its shoulders during vaginal birth or may require cesarean birth. Because the fetus is producing extra insulin during its gestation, the newborn may have elevated insulin levels, causing a rapid drop in blood glucose levels, which can cause hypoglycemia. Gestational diabetes also increases the risk of jaundice and breathing problems in newborns and birth defects. In addition, women with gestational diabetes and the babies they carry are at higher risk of developing type 2 diabetes, as well as hypertension and being overweight, later on in life.

The reasons for requirements of vitamin D and B12 in older adults .

Vitamin D: ability to convert from sunlight (and to absorb and convert to active form in intestines and kidneys) declines with age Daily need increases from 600 IU/day to 800 IU/day for those aged 70 and older Vitamin B12: Many over age 50 can't absorb natural form because stomach produces less HCl Synthetic form in fortified foods and supplements should be added to diet

Cancer in older adults and how the risk decreases (for example: increase in weight, eating red/processed meat, high salt food can increase the risks)

You can reduce your risk for cancer with a healthy diet Phytonutrients (lycopene) Antioxidants (carotenoids, selenium) Retinoids (vitamin A), vitamin D, folate Omega-3 fatty acids (in fish, some oils) Fiber Helps dilute, shed waste products in intestinal tract Feeds healthy bacteria in colon, creating by-product that may help fight cancer Avoid foods and beverages that may increase your risk for cancer Diet high in red and/or processed meats Nitrites in processed meats can react with amino acids to form cancer-promoting compounds (nitrosamines, nitroamides) Alcohol, consumed in excess High salt consumption Excess body weight Contributes to as many as 1 in 5 cancer-related deaths

Definition of Macrosomia

a large newborn, weighing more than 8 pounds, 13 ounces.

Foods that have anti-inflammatory effect for rheumatoid arthritis in older adults

omega-3 fats in seafood may help


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