nutrition FINAL part 1
Why might a woman's nutritional status prior to conception be an important factor which could influence pregnancy outcome?
*
How are minerals classified?
-----Major or macrominerals (required in amounts over 100 mg / day). Ex.calcium, phosphorus, potassium, sulfur, sodium, chloride and magnesium. -----Trace elements (required in amounts under 100 mg / day). Ex. iron, zinc,copper, iodine, selenium, etc.
Where is vitamin D activated in the body? Where does it have its influence on calcium absorption? What is calbindin? How does vitamin D influence calbindin production? What does calbindin do to increase calcium absorption? Where is each step taking place?
-vit D is activated in the kidneys, effects absorption in GI tract -Calbindin is a calcium-binding protein -vit D activates the gene to produce calbindin when blod cal is low -calbindin picks up calcium and shuttles it across the intestinal tract cell and into the blood -takes place in intestinal tract cells
What are some factors that influence bioavailability? Be familiar with the examples given for each factor identified
1) Solubility-Vitamins that are fat-soluble require fat in the diet for absorption 2) Bonding with other compounds-can increase or decrease absorption. -Increased absorption- Iron can exist in food in its elemental form in plants or (bound to) a heme compound in meats its more readily absorbed with the heme that without -Decreased absorption- fiber, Pytates and oxylates are examples of substances that dont get absorbed that can bind to other nutri and prevent absorption. the lack of absorption of calcium in spinach is largely due to the binding of the calcium with the oxylates 3)mineral Mineral interactions- minerals compete for absorption so if u have 2 much of 1 it can block absorb. of other minerals 4) Vita.- mineral interactions some vita can help certian mineral absorption ex. non heme iron can be absorbed better with vitamin C and vita D is important in calcium absorption 5) Body's need for the nutrient- For some nutri, as the bod's need increases (i.e. pregnancy),the amt absorbed increases. Conversely, if needs are low or there is plenty of the nutrient already in the body, the absorption may decline calcium is better absorbed when pregnant
What are the three compounds that regulate blood calcium? What are the three ways that the body responds to low blood calcium? High blood calcium?
1) Vitamin D(calcitriol), Calcitonin, Parathyroid hormone (PTH) 2) increase calcium in blood -Parathyroid hormone (PTH)(helps activate vita D) and vitamin D reduce calcium excretion via the kidneys -Vitamin D increases calcium absorption in GI tract -Vitamin D and parathyroid hormone stimulate osteoclasts to break down bone to move cal to blood 3) decrease calcium in blood -Calcitonin in kidneys will increase calcium excretion -Calcitonin will inhibit activation of vitamin D so less calcium is absorbed in GI tract -Calcitonin will inhibit osteoclasts so less calcium is pulled from bone
Identify the ten recommendations for cancer prevention that were part of the American Institute for Cancer Research Second Expert Report. http://www.dietandcancerreport.org/expert_report/recommendations/index.php.
1)keep healthy weight 2)physical activity 30 min 3)avoid high cal foods and sugary drinks 4)eat vegtables 5)limit red meat 6)don't drink alcohol 7)eat less salt avoid moldy grains and cereals 8)don't rely on supplements 9)breastfeed 10)follow recommendations
What is the unique role of iodine in health? What happens if an adult does not get enough iodine? What can happen to children born to women who were iodine deficient during their pregnancy? What are the sources of iodine in our diet? What is the UN doing in places like Ecuador and China to help alleviate iodine deficiency?
1)needed for synthesis of two thyroid hormones (thyroxine and triiodothyronine) which help in the regulation of BMR 2/3)-goiter (enlarged thyroid) -slugishness -weight gain Mental and physical retardation if mom's level is deficient (cretinism) and even a Mild form can mean a drop in IQ 4) Salt,fish and seawater plants grown in soil close to the sea, dough conditioner 5) they are fortifying the salt with iodine
What is the protein RDA for pregnant women (_____ grams per kilogram body weight)?
1.1 grams per kilogram body weigh
Categorize the following meals from most absorbable iron to least absorbable iron: 1) peanut butter sandwich 2) rib-eye steak with baked potatoes 3) chick pea and rice salad with diced apricots and tomatoes.
2 3 1
At approximately what age do individuals reach peak bone mass?
20's-30's occurs in early adulthood
When in the lifecycle do individuals lay down more bone than they lose? When do they lose more bone than they lay down? What cells are involved in bone building and bone breakdown and what do they do?
20-30= gain more 35-45 & after menopause= loss osteoblasts (cells that build up bone) and osteoclasts (cells that break down bone)
What is the normal weight gain during pregnancy for a woman at a normal pre-pregnancy weight? How is this weight gain distributed among the three trimesters? How does the weight gain recommendation differ for women who are underweight or overweight prior to conception? (You don't need to know exact numbers for overweight or underweight women.)
25-35 pounds total 2-4 pounds for the first trimester and 1 pound per week in the second and third trimester underweight ppl need more overweight need less
How are vitamins classified?
?*
Why do we classify vitamin D as a vitamin and a hormone?
?*
Which vitamins are fat soluble?
A, D, E and K
The need for calcium doesn't increase during pregnancy yet the fetus certainly needs calcium to build the skeleton. How does the woman's body respond to the infant's need for calcium?
ABSORPTION of calcium increases considerably
What are some non-dietary factors that increase the risk of hypertension?
Age Insulin Resistance Inactivity Atherosclerosis (clogged arteries) Ethnicity Family History (heredity)
What is a free radical? What is an antioxidant?
Antioxidants are compounds that neutralize free radicals Free radical is an atom or molecule with one or more unpaired electrons. they are unstable
Which micronutrients are required to extract the energy from glucose, fatty acids and amino acids?
B VITA Iron and Copper
How do these micronutrients influence energy metabolism?
B Vitamins serve as coenzymes (enzyme activators) in the reactions that release energy from the macronutrients play a role in the final stages of energy metabolism.
If a person eats no animal products, which of the following nutrients might be most likely to drop in the diet: iron, zinc, folate, thiamin, B-12, calcium, Vitamin E?
B12
What are the three most common individual elements in vitamins?
CH___?*
Why do health care professionals promote breast feeding as the "best" option?
Colostrum- produced the first few days - thin, yellowish - high in immune protection helps uterus contract may reduce risk of breast cancer suppresses ovulation can be less expensive Can use fat stores to meet some of the increased kcalorie needs helps moms weight get back to normal
Compare and contrast the two different types of bone.
Cortical bone (dense or compact bone) ◦ Dense bone ◦ Forms exterior shell of bone and shaft of long bone Trabecular bone (spongy bone) ◦ Weblike structure
Which vitamins can be made by the body? How? Which vitamin can be made by bacteria in the G.I tract and absorbed by the body?
D, K, Niacin and biotin. D-made by the skin with sunlight and 7-dehydrocholesterol niacin- made in body requires tryptophan gut bacteria make- vit. K and Biotin
Describe the diet in the DASH study. What were the findings of this study? Was this a well controlled study? Defend you answer.
Dietary Approaches to Stop Hypertension Research shows a reduction in blood pressure in individuals following this diet High in -Low fat dairy (2-3 servings minimum) -fruits (4-5 servings) -vegetables (4-5 servings) -mostly whole grains reduced red meat, sugary beverages, sweets
What is pre-eclampsia and eclampsia? What are some other names for this disorder? How is it detected? Is a sodium restriction warranted for a woman with eclampsia?
Eclampsia AKA (toxemia or pregnancy-induced hypertension (PIH) simply suggests the more severe state of the disorder. The condition is characterized by high blood pressure, edema (fluid retention) and protein in the urine. it should not be treated with sodium restriction
What are some sources of free radicals in the body (endogenous)? in the environment (exogenous)?
Endo --metabolism (free radicals are byproducts of the production of energy from the macronutrients.) --Immune system(white blood cells produce free radicals to oxidize or breakdown foreign intruders) Exo tobacco smoke pollutants, organic solvents ultraviolet light rays radioactive emissions
In general, how do fat soluble vitamins differ from water soluble vitamins?
Fat SV: absorbed in the lymph travel by lipoprotien or bound to transport proteins excess is stored in liver Water SV: absorbed into blood stream travel freely bound to blood proteins excess is peed out lower risk of toxicity in comparison
What is the role of folate in red blood cell health? What is the role of vitamin B-12? Describe what happens to the red blood cell when a person is deficient in folate or vitamin B-12. What is this condition called?
Folate is necessary for DNA replication & vitamin B-12 is needed to convert folate to the active form. since blood cells get replaced often its the first place you would notice a deficiency in deficancy of these substances red blood cells (like all our cells) cannot divide as often as they should. The cells get bigger than usual, since they cannot divide, and they stay in an immature form called macrocytic or megaloblastic anemia
What are the forms of Vitamin A in food and in the body? Which form is found in plants? Which form is found in animals? Which compounds represent the active forms and which is the precursor form that can be converted to Vitamin A in the body? Which form is more toxic when consumed in excess?
Forms in food: animal- retinol and retinyl esters plants- beta carotene (can be converted to vit A in bod) Forms in body: Retinol (from animal) Retinal (conversion of beta carotene) Retinoic acid (made in bod. from retinol or retinal) retinol is more toxic in excess
Describe the composition of bone. What are the major minerals in bone? What else is in bone?
Hydroxyapetite crystals of calcium and phosphorus Protein matrix (collagen) Blood Vessels Bone Cells
What are two sources of vitamin K? calcium?
K= Dark green leafy vegetables, bacteria in the gut cal=dairy some leafy greens supplements
What is a normal blood pressure? What constitutes pre-hypertension? hypertension?
Less than 120/80 mmHg = optimal 120-139/80-89 = prehypertension 140/90 or greater = hypertension
What is listeriosis? Why is a concern for pregnant women? How can you avoid it?
Listeriosis is a food borne illness that can lead to miscarriages in pregnant women. wash salad greens well, heat all deli meats until they are steaming before eating and avoid any unpasteurized cheese
How is blood pressure measured? (In other words, what does the top number and bottom number mean?
Measured as systolic over diastolic systolic: arterial pressure caused by the contraction of the left ventricle diastolic: arterial pressure when heart is between beats
Are minerals organic?
No
What are the four major components of blood?
Plasma (fluid portion of blood - ~55%) Erythrocytes (red blood cells - `45%) ◦ Platelets (cell fragments that help blood to clot) ◦ Leukocytes (white blood cells)
How are vitamins like minerals? How are vitamins different from minerals?
SIMILARITY: both are micronutrients, They do not provide energy but are required for health, vitamins and minerals regulate body functions and help drive cell processes DIFFERENCE: vitamins are organic where minerals are not. minerals are not compounds like vitamins. they are elements minerals have a stuctural role where vitamins dont some vita. can be made in the body unlike minerals
What is the physiology of breastfeeding? (What produces the milk and what causes it to be "released"?)
Suckling infant sends a signal to the hypothalamus This initiates a release of the hormones oxytocin and prolactin by the pituitary Prolactin: stimulates milk production Oxytocin: causes release of milk from storage Milk is supplied to the infant
Which vitamins are Water soluble?
Thiamin (B-1), Riboflavin (B-2), Niacin (B-3), B-6, B-12, Folate, Pantothenic Acid, Biotin
Which two micronutrients are important for blood clotting? What is their role in this process? Why would you not be likely to see a problem with blood clotting if dietary intake of the mineral involved in blood clotting dropped below normal?
Vitamin K and Calcium, There is a cascade of chemical reactions that occur to allow blood clots to form and Vitamin K and calcium are both necessary for this series of reactions to successfully take place because vitamin K is fat soluble so you probs have stores and your bones can provide calcium if needed
Have there been any negative repercussions from taking supplements of antioxidants?
a study hypothesized that there would be a lower incidence of lung cancer in the group receiving beta-carotene Unfortunately, the opposite occurred. The group receiving beta-carotene had a significantly higher incidence of lung cancer
How do the following things influence a person's risk of developing osteoporosis: age, body weight, ethnicity, gender, exercise, calcium intake, menopause, estrogen production or intake
age- bone loss over time body weight- low BMI ethnicity- Caucasian, Hispanic or Asian gender- female exercise- creates needed stress on bones so they get stronger calcium intake-low amt will make weak bones menopause- see a loss in bone estrogen- again female hormone there is a correlation
What are the ramifications of drinking alcohol during pregnancy? smoking during pregnancy?
alcohol crosses the placenta freely and is directly toxic- Can cause disruption of oxygen supply, slowed cell division, etc. leading to lifelong problems or premature death smoking- Parental smoking can kill an otherwise healthy fetus or newborn - Constituents of cigarette smoke, such as nicotine and cyanide, are toxic to a fetus - Smoking restricts the blood supply to the growing fetus and so limits the delivery of oxygen and nutrients removal of wastes - Should be avoided completely
What things should you avoid consuming during a pregnancy?
alcohol, limit caffeine, take precautions against listeria, large predator fish
What is the normal period of gestation? What is the normal birth weight for a baby?
average weight of a newborn is approximately 7 lbs
Why is it essential to be sure you get adequate folate early in a pregnancy
because its important in cell division
Why might a high consumption of one mineral cause you to develop a deficiency disease for another mineral?
because minerals often compete and can block absorption of other minerals if you get too much of one leading to deficiency and disease
Why does the need for iron increase so dramatically during pregnancy?
because the baby needs it for developing blood supply and because maternal blood increases and baby stores 3-6 months worth since breast milk lacks in iron
What are some general functions of minerals?
blood health (iron), bone health (calcium, phosphorus, magnesium), and fluid balance and nerve transmission (sodium and potassium) ect.
Bernard had a blood test and found out that he is deficient in Vitamin B-12? He cannot understand how this can be the case since he eats a lot of meat and other foods rich in Vitamin B-12. What do you tell him to explain this situation?
body needs to produce a compound called the intrinsic factor(produced by cells in the stomach) for it to be absorbed so that could be messing up and causing the issue or it could be related to not producing enough stomach acid (is needed so that the B-12 can be released from the proteins it is attached to in the food)
What are the two feeding options for the newborn infant?
breastfeeding and formula
Describe osteomalacia and rickets? A deficiency of which nutrient is usually the cause of these two disorders?
caused by lack of vit D. causes legs to be bent looking, flexible and deformed causes mussel weakness and pain result in loss of bone mineral but not protein matrix called osteomalacia in adults. Rickets in children
When in one's life is it most important to consume adequate calcium for maximizing bone density?
child hood to early adulthood (20-30)
What is the time frame for the first trimester, second trimester, third trimester?
conception to 12 weeks= first trimester weeks 13-24= second trimester weeks 25 to delivery= third trimester
What is cancer? (See Figure 4.25 and useful links).
disease caused by an uncontrolled division of abnormal cells in a part of the body
Minerals perform their role as antioxidants as part of what larger compounds?
enzymes
What is the role of iron in red blood cell health? Describe what happens to the red blood cell when a person is deficient in iron. What is this condition called? What are the symptoms?
essential part of the protein hemoglobin which is found in red blood cells when deficiant the cells of the bone marrow cannot make adequate hemoglobin and the resulting red blood cells are small and pale. This condition is called microcytic anemia symptoms fatigue, loss of stamina, shortness of breath, weakness, dizziness, and pallor
How is this weight that a woman gains during pregnancy distributed? In other words, what are the basic components of this weight gain? (you don't have to know specific weights, just the general components)
fetus amniotic fluid placenta uterus maternal blood breast tissue extracellular fluid maternal fat
In addition to macrocytic anemia, what are some other negative effects of a deficiency of folate? vitamin B-12?
folate: neural tube defect, increased risk of heart disease and colon cancer B-12: nerve damage
What does an antioxidant do?
gives up electrons to free radicals so they don't do damage
What steps can a person take to avoid or delay the development of osteoporosis?
have enough vitamin D, keep healthy BMI, build calcium when your still building it
How can you improve the absorption of non-heme (elemental) iron?
have vita C with it
What are some dietary factors that increase the risk of hypertension?
high sodium intakes low intakes of potassium, magnesium, calcium excess kcalorie intake leading to obesity high intakes of alcoho
Why should pregnant women consume nutrient dense foods?
increased need for vitamin A, C, and B6. These micronutrients increase approximately 50% above the normal woman whereas kcal intake increases approximately 30% so you need really nutri dense food
What is osteoporosis? How does it differ physiologically from osteomalacia? Compare and contrast osteoporosis and osteomalacia.
is A loss of both mineral and protein matrix over time. Causes fragile, porous, brittle bones that break or shatter easily Not a deficiency disease for any nutrient but nutrition does influence risk Unlike osteomalacia, in osteoporosis the bone is not soft but is brittle and fragile
What is hemochromatosis?
is a genetically inherited condition, ppl with this disorder are extremely efficient at absorbing dietary iron,causeing them to accumulate and store dangerously high levels in their liver and other tissues. This can eventually lead to irreversible organ damage and possibly death
What does it mean to say that vitamin A (or any other compound) regulates gene expression?
it means it can turn on or off a gene. in vit A--We are talking about immune system cells (white blood cells), epithelial cells (skin cells and mucous membranes) and goblet cells (mucous producing cells).
What are the kcaloric needs of the pregnant woman in comparison to the non-pregnant woman? (What is the percentage increase and how does this translate into additional kcalories?)
kcal needs only increase on average about 15% extra 150 kcal per day
Where do we find vitamin D in the diet? Where do we find calcium in the diet?
milk and fish. Calcium- dairy some leafy greens
Bioavailability is mostly an issue with which groups of nutrients?
minerals like iron, calcium and zinc
What should be monitored during a pregnancy?
monitor weight and blood pressure regularly
What are the roles of vitamin A in the body? How does vitamin A influence immunity? night blindness? overall health of the eye?
night vision regulates gene expression if you dont get enough- lack of immune system cells, lack of epithelial cells and goblet cells leading to eye tissue dammage and keratinization of the eye leading to Xerophthalmia aka blindness due to lack of vit A
Do vitamins or minerals contain energy?
no
Is morning sickness a sign that the fetus is not developing normally?
no
Does research show that taking antioxidants in supplement form is advantageous?
no its conflicting
What are the possible consequences of not getting enough Vitamin A? Getting too much active (preformed) vitamin A?
not enough- inability to fight infection and disease, night blindness, damage of eye tissues or Xerophthalmia, a woman might have probs. getting pregnant
What is a neural tube defect? How does spina bifida differ from anencephaly?
occurs when the tube fails to close properly Spina Bifida - the spinal cord and backbone do not develop normally Anencephaly - Top or "head" end of the neural tube fails to close properly - brain development fails - All such infants die shortly after birth
Is there a specific concern regarding the overconsumption of folate? If so, what is it?
once a cancer of any type forms, increased folate / folic acid may actually speed up the growth
What happens when there is a deficiency of zinc in the body? What factors led to the zinc deficiencies seen in the Middle East in the 1960's?
people were eating marginal amounts of zinc and a lot of unrefined grains with phytates and fiber. The phytates and fiber were binding the small amount of zinc people were consuming and preventing its absorption.
What nutrient should women be very careful not to overconsume during a pregnancy?
preformed vitamin A because it can be toxic and cause birth defects
What are the two types of low birth weight? What can cause low birth weight in infants? Why is low birth weight a concern?
premature-born early but correct weight for gestational age small for gestational age-A child that is a low weight/size for its gestational age
What is the difference between a primary deficiency and a secondary deficiency?
primary is caused by diet secondary is when the person is consuming it but the prob is inside the body and has to do with absorption
Where does the majority of the sodium in our diets come from? (hint: it's not the salt shaker in our house)
processed foods
Why might elderly individuals be at particular risk for vitamin D deficiency?
production decreases as we age and they might not go outside much
How does vitamin D influences calcium absorption.
reduces calcium excretion in the kidneys, increases calcium absorption in GI tract, stimulate osteoclasts to break down bone to move cal to blood
What are the general functions of vitamins?
regulate body functions and help drive cell processes
When is the most critical period in the pregnancy, when an "insult" is most likely to cause a miscarriage or catastrophic defect in the unborn child?
the first eight to twelve weeks of a pregnancy
Be able to explain the concept of "critical period" in embryonic development.
the first eight to twelve weeks of a pregnancy are considered the critical period because any "insult" (drinking smoking ect) there's a higher chance of misscarage durring this time and if a organ system does not develop properly during this time theirs no chance at recovery
Describe the events that take place from conception to 2 weeks post conception in the female body.
the zygote develop's
Why are we concerned about free radicals? (In other words, what kind of damage can they do and what is does this damage lead to?)
they can mess up the Cell membrane they can inactivate important body proteins like enzymes DNA damage causing altered gene function leading too heart disease, aging, cataracts & macular degeneration
What will happen if a person consumes a diet completely devoid of vitamin D?
they would be fine
What is the purpose of red blood cells?
transport oxygen to organs
Name and describe the deficiency disease for vitamin C, iodine?
vit c= scurvy iodine= goiter
What are some nutrients that have antioxidant functions in the body?
vita- C, E and beta carotene minerals(as part of enzymes)- zinc, copper and manganese selenium
What factors might influence how much vitamin D a person makes from the sun?
where they live, if they cover up a lot, sunscreen how much time they spend outside
Are vitamins organic?
yes CH
What happens if you don't eat enough of an essential vitamin or mineral? Be able to identify the stages of a nutrient deficiency.
you will develop a deficiency 1 Decreased nutrient consumption / absorption 2 Declining Nutrient Stores 3 Abnormal Functions Inside the Body 4 Physical (outward) signs and symptoms
Identify the terminology used for the newly forming life from fertilization to delivery.
zygote- conception through week 2 embryo-week 3- week 8 fetus- week 8- birth
