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nutrition 322 > Chapter 4 > Flashcards

Chapter 4 Flashcards

1
Q

when maternal nutrients fall below optimal who is receiving less nutrients- mom or baby

A

the baby,

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2
Q

when is the critical periode

A

first 2 months after conception

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3
Q

what is the critical periode

A

pre-programmed time periodes during embryonic and fetal development ehen specific cells organs and tissues are formed and intergrated

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4
Q

how many weeks is a pregnanacy

A

average of 38 weeks but usually given as 40 weeks because they mesure from the date of the first day of the last menstrual cycle ( 2 nonpregnant weeks)

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5
Q

how are physiological changes in pregnancies classifed

A

first half and last half

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6
Q

what are maternal anabolic changes

A

first half of pregnancy - build the capacity of the ,pthers body to deliver relatively large quantaties of blood, 0xygen and nutrients to the fetus baby growth 10%

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7
Q

what is maternal catabolic

A

2nd half of pregnancy- energy and nutrient stores and the heightened capacity to deliver stored energy and nutrient to the fetus predominates- baby growth : 90%

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8
Q

how does maternal body water change during preg

A

increaes 7 to 10 litters- due to amniotic fluid, plasma le, this is to increase blood flow and nutrients to the baby

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9
Q

why do women feel tiered during the first part of prego

A

surge in blood volume, this fades after 2-3 month

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10
Q

what ios the dilution effect

A

increase volume of water in the blood, blood levels of fat soluble vitamens increase. where there is a decrease in water soluble vitamins

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11
Q

what is the fetus prefered fuel

A

glucose

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12
Q

diabetogenic effect of pregnancy

A

maternal insulin resistance, for continued availabilty of glucose for the fetus- make the mom slightly carb intolerant in the third trimester

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13
Q

what happens in the first half of preg for carb conversions

A

estrogen and progesterone increses insulin production so that glucose is converted to glycogen and fat

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14
Q

what happens in the second half of preg to carbs

A

rising levels of hCS and prolactin inhibits the conversion of glucose to glycogen and fats. at the same time insulin resistance is building so that the baby will always have a supply

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15
Q

what is accelerated fating metabolism

A

the mom metabolism is converted to glucogenic amino acid utilization, fat oxidation,and ketone production

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16
Q

what is protein metabolism

A

the amino acids that go towards tissue building come from the food eaten during pregnancy

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17
Q

what happens in fat metabolism during pregnancy

A

accumulation of maternal fat store in the first half and enhance fat mobilization in second half- trigloyceride levels more than double then non-prego. the others also increase but not as much

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18
Q

why do maternal blood have more cholestrol

A

used by placenta to make hormones and to make for nerve and cell membrane formation

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19
Q

what are the function of the placenta

A

hormone and enzymme production, nutrient and gas exchange between the mother and fetus, removal of waste products from fetus

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20
Q

what factors determine what crosses the placenta

A

size and charge,lipid soluability, the []between mom and baby

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21
Q

what is easiest to cross the placenta

A

water and lipids-enzyme and insualin dontr cross at all

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22
Q

when and what is the critical periode

A

genetically progrmammed time periodes suring embryonic and fetal development when specific cells, organs, and tissues are formed and integrated - during first 2 months

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23
Q

what is the first organ that develops

A

the brain therefore if there is lacking nutrients it will take priority compared to muscles and liver

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24
Q

what is maturation

A

stabilization of cell number and size

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25
what is IGF-1
primary growth stimulator of the baby promotes uptake of nutrients and inhibits tissue breakdown
26
what is SGA
Small for Gestational age- the wt is less than 10th percentile for gestational age the 2 pattern of growth are dSGA anf pSGA
27
dSGA
disproportionately small for gestational age: the wt is less than 10th percentile, but lenght and head circumferance are normal are skinny poorly developed muscles , look wasted and wrinkly due to malnutrtion in 3rd trimester show good catch up growth
28
what is pSGA
wt, lenght and head circumferance are less than 10th percentile for gestational age- stay small for life and dont catch up inutero longterm malnutrition
29
which babies have fewer health problems at birth but their catch up growth is slower
pSGA
30
what causes LGA
preprego obesity, poorly controlled diabetes, excessive weight gain,
31
how many cases of pregos leading to misscarridges
over30%
32
if there is a lack of vit d and e in the first trimester what might happen
a misscarridge
33
what can influence a preterm delivery
genital tract infections, insufficient flood flow, bleeding in uterus, preprego underweight, low weight gain in prego, stress, short interpregnanacy
34
epigenetics
role in silencing genes dose not change DNA
35
Thrifty phenotype
increase suseptibility to insulin resistance and weight gain in (bad nutrition)in utero
36
when do body fat storeincrease the most
btw 10 and 20 weeks or beofre fetal energy requirements is highest
37
what percentage on the overall weight gain does the fetus take up
1/3
38
what is the minimum amount of carbs a prego should eat
175 grams
39
when is the most critical time to avoid alcohol
during 2nd half
40
how much protein do we need during prego
71 gram about 1/2 goes to the fetus the rest goes to building blood in mom and stuff
41
how much fat should a prego eat
33% of all fat
42
how much linoleic acid omega 6
13 grams
43
how much linolenic acid and others omega 3
1.4 g flax, walnuts, leafy greens, canola oil
44
what are ecosanoids
molecules synthsised from esential fatty acids (epa) and (dha) in prego only about 9% of linolenic gets converted
45
what is the critical periode
a specific periode of time in embryogenesis where a nutritional deficiency or toxic insult may lead to birth defects or spontaneous abortions each organ system has its own critical periode it is a time of intense development /differentiation and hyperplasia of that organ system ex. neural tube closure
46
chorion frondosum
the fetal tissue exchanges substances by diffusion with maternal blood around the villi- becomes more and more branched as the fetus grows
47
lacunae
mothers blood
48
what are the roles of the palcenta
1: respiratory system- gas exchange 2: kidney- removal of waste products- urea, uric acid, 3: GIT-dose either simple diffusion(fat soluble), facilitaed diffusion (fe), active transport (ca, zn), pinocytosis (immuno globulins 4: immune system: transfer immune factors 5: endocrine system: production of hormones- estro, progestro, HCG
49
barkers hypothesis
fetal enviro correlated to later desease risk diabetes, chd, stroke
50
in fetal programming, what is maternal nutrition, stress , toxins
will permenently alters gene expression in fetal tissue, permenent effects on structure and function- endocrine , liver,kidney, brain
51
in fetal programming, what is the connectoin to the twin epidemic of obesity and type 2 diabetes
if baby is malnurished to allow the grain to have the glucose the rest of the body becomes insulin resistant- sippose to be for the thrifty genotype but when baby is born in obesogenic environment - this is TRANSGENERATIONAL but not genetic- their genes have not changed it is a trait
52
what is bad about a fast catch up rate
increse risk of insulin resistance type 2 diabetes and hypertension
53
what is methylation
ch3 on the gene to silence it example the exact same dna is in each one of our cells but the ear does not make insulin- example of epigenetics
54
oncogene
this specific gene will cause cancer but if there is enough b12 and folate in diet it will provide the ch3 needed so that the body doesnt take from the methyl silencing the cancer gene
55
what can we do to ensure healthy pregnancies
that young womens( teens) have the best diet possible, support healthies prego changes, feed infants well, avoid rapid weight gain
56
what happens to volume and composition
blood volume increases by 50% | increases # of RBC by more production in marrow and less RBC destruction
57
what is hemoglobulin
Hb/100ml of blood
58
hematocrit
% RBC / total blood volume
59
hemodilution
normal size and colour so what would look like anemia in non prego is actuality normal
60
what changes in the cardiovascular system
hypertrophy of the heart from more blood volume and increases cardiac output by 20% but due to progesterone the blood pressure decreases in the first half of - relaces
61
how does the respiratory system change
maternal and fetal o2 requirements increase ( increased BMR- anabolism) but as the fetus grows it presses on the diaphragms causing it to rise- this increase tidal volume so that it is deeped and more efficient by 30-40%
62
how does the renal function change in preg
glomerular filtration and renal bllod flow increases- due to this greater concentration of nutrients it can overwhelm the system and cause it to loose glucose, aa and water soluble vitamin in urine
63
how does the git change
appetite increases, git motility slows down for increased nutrient absorption , heart burn due to progesterone relaxes sphincter, constipation- hemoroids - straining a stool altered sense of taste gas
64
hormonal changes in preg
hpl,hgh.glucagon, cortisone -all lead to increased blood glucose concentration - diabetogenic afffect of preg also estrogen and progesterone
65
progesterone
relaxes all muscles, increases fat stores, allows for Na loss in the body (thats why should never limit salt intake)
66
estrogen
help uterine contraction, water retention- edema
67
what are other metabolic shifts that occur in preg
increased BMR- CO2 IN 2nd trimester- due to progesterone start to store fat as prego proceeds metabolism shifts to using fat as main fuel - glucose s used for baby
68
what is ketosis
ketosis is when the body breaks down fat for energy it uses alpha ketoglycerate, ketones - this can cause abortions and impaire the CNS overnight the women can get mild ketosis for gluconeogenesis the body converts alanine to pyruvate then to glucose, but in prego the fetus is getting most of the alanine to build dna and tissue
69
how does iron requirements change in prego
increases by 50% 27mg - due to increased blood volume and and rbc why is most common around the world to have deficiency: dont have enough to start with because poverty, teen, low vit c to increase absorption
70
their is an increased risk of fe deficiency when
low weight gain, premature delivery, death (baby) | mother will be fatigued, cardio stree and increased infection
71
what are the stages of annemia
1: decreased serum feritin (if stores are good in liver then it will leak out in blood) 2: fe deficiency without anemia decreased % transferin saturation (2 fes/ protein) 3: Iron deficiency anemia: decreased Hb, hematocrit, pale and small RBC
72
how do folate requirements change during prego
600mcg/day used in DNA replication is low in folate can lead to megoloblastic anemia (bigger becasue want to divide but cant due to low B12) ALL child bearing age should have 400mcg of folic acid in addition to rich foods
73
how do calcium requirements change during prego
no change- still 1000mg/600iu we arent getting enough anyway (geographical, dont drink milk vegans, lacto, dieting fashion) need it for skeletal fetal development , breastmilk - dont take natural supplements could have Pb
74
how do essential fatty acids change during prego
a-linolenic (18-3n-3)- 5-7% will convert to EPA (for heart health) and DHA( for eyes and brain) should get a 1:10 ratio with.... linoleic (18-2n-6) some convert to arachidonic a concern because ppl are eating more premade foods and are over zeolous on low fat foods
75
what is considered low birth weight
3.3lbs to 5.4 lbs
76
what is normal weight
7.5-8.8lbs
77
what is high birth weight
over 9 lbs
78
what are the key determinants of birth weight
1: maternal nutrition prior and during nutrition 2: maternal body size- under or overweight 3: maternal weight gain
79
if underweight when entering preg
the baby will be LBW, increased risk of preterm delivery, perinatal mortality, low apgar scale . mom should take fe supplements, eat enough and strive for upper weight gain
80
if overweight when entering preg
the mother will have hypertension, gestational diabetes, difficult labour or c-section(microbiome) infant: post term delivery, higher birthweight, birth trauma from difficult labour should strive for lower end of wt gain
81
normal body weight - wt gained
1st tri: 1.5-4lbs | 2-3rd tri: less than 1lbs/week
82
underweight- wt gained
1st tri: 5lbs | 2-3rd tri: more than 1 lb a week
83
overweight- wt gained
1st tri: 2lb | 2-3rd tri: 2/3lbs a week
84
what can influence a risky preg
1: maternal nutrition 2: maternal weight- prior and durin 3: socioeconomic status-npoverty, lack of support, education, domestic violence, alcohol, could have many children 4: age-,young still growing, shame, poor diet, education, risky experimenting periode - gynecologic age- if less tahn 2 years increases old- after 35 increases catabolism, fetal death is twice as high, more miscaridges, birth defects, risk of down syndrome increases from 1/1000 to 1/100 5: parity (# of live births in obstetrical history)- 1st is the most risky 6:maternal health: diabetes, pre-eclampsia,diseases- heart, hiv(can be transfered through delivery, placenta,breastmilk) 7: lifestyle-
85
what lifestyle choices can alter preg
vegetarian (fe, zn, b12,ca,d,pro, kcals -caffeineless than 300 mg is ok- stimulant though herbal teas- fennel and wintergreen are toxic pica: non-food substances: clay, laundry starch, cigarette ashes- GIT complication- can be toxic and replace nutritious foods drugs/meds: weed can cause FASD symptoms, abortions, cocaine can be addictive and lbw tobaco: #1 cause of low birth weight, risk factors for SIDS, nicotine, CO, alcohol
86
nicotine
vasoconscrictor decreased o2 flow from placenta
87
CO
PREFERENTIALITY crosses placenta instead of o2: lbw, perinatal mortality, reduces apetite( low B6, 12, c,e,folate,b-carotene, se
88
alcohol
``` known teratogen immature liver to detox, lbw abruptio placentae- breakaway still born add fas fathers sperm is just weird so doesnt nakeit anyway ```

nutrition 322 (11 decks)

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