Pregnancy 2 Flashcards
Describe recommendations for carbohydrate intake during pregnancy compared to the non-pregnant adult. Provide overall commonsense recommendations regarding appropriate food choices. How does the DRI for fiber differ from that of the intake of average Americans?
- 45-65% of calorie, needed for energy
- DRI during pregnancy: 175 g/day
- Choose whole grains, legumes, fruits, vegetables
- Avoid processed white flour, white rice, baked goods (can affect maternal blood sugar & fetal fat deposition)
- DRI fiber: 28g/day
Describe recommendations for protein intake during pregnancy (describe the 3 ways of estimating). What is the average protein intake of the US pregnant woman?
How much protein is in a cup of milk, an ounce of cheese, an egg, an ounce of meat, a cup of beans, and a slice of bread?
- 1.1 g/kg body weight
- Average intake is about 82 g/d
- Sources like milk (8 g), cheese (7 g), tortilla/bread (3 g), eggs (7 g), meat (7 g), chicken, fish, beans (13 g)
List 6 potential problem nutrients for vegetarians/vegans based on what food groups are eliminated from the diet. Provide advice for the vegetarian and vegan.
1) Vitamin B12 - fortified foods
2) Vitamin D - fortified foods
3) Calcium - fortified foods
4) Iron - supplements, beans
5) Zinc - supplements, beans
6) Omega 3 fats - supplements, fortified eggs, milk
What is the AI for EFA for pregnant, non-pregnant, and lactating women?
ALA
- Non Preg: 1.1 g
- Preg: 1.4 g
- Lact: 1.3 g
LA
- Non preg: 12 g
- Preg: 13 g
- Lact: 13 g
List the essential fatty acids (in each group) and provide a detailed list of food sources.
Omega 3:
- ALA: flaxseed oil, canola oil, soybean oil, chia seeds, walnuts, greens
-EPA: fish, supplements
- DHA: fish, supplements, fortified eggs, human milk
Omega 6: most women consume enough
- LA: vegetable oils, wheat germ
- AA: synthesized in body, meats
How might intake of omega 3 fats in the diet affect physiology (give examples)? Include in your answer the definition of eicosanoids. In general, what are roles of eicosanoids derived from fatty acids? What percentage of the brain’s phosphoglycerides are made of DHA?
- DHA makes up 30% of phospholipids of gray matter in the brain
- Omega 3 fats In diet can lessen the effects of eicosanoids which Is a Inflammatory response hormone
What are the specific functions of DHA and EFA in pregnancy? What percentage of ALA is converted to DHA? Can a pregnant woman meet her needs for omega 3 fats from ALA alone?
- DHA & EPA cross placenta during 3rd trimester which affects:
1) fetal development of brain, retina, neural tissue
2) length of gestation (prevents preterm labor)
3) risk for perinatal depression
4) risk for preeclampsia - Only 9% of ALA can convert to DHA
- pregnant women probably can not meet omega 3 needs just from ALA
State the FDA 2017 advice “What Pregnant Women and Parents should know about eating fish” in detail. Include all specific recommendations for women and children, including portions, what to do about fish advisories, and what specific fishes to avoid or limit.
- 2-3 servings of fish per week from best choice list or 1 serving from good choice list, eat a variety
- Best: catfish, cod, crab, crawfish, lobster, shrimp, scallop
- Avoid: king mackerel, marlin, orange roughy, shark, swordfish, tilefish, bigeye tuna
- Limit: white tuna
- check fish advisories for local fishing areas, limit to one serving and no other fish that week
Vitamin A. What are the functions of vitamin A with respect to pregnancy? What are the effects of supplementation with medications similar to retinoids? What is retinoic acid syndrome? What are the 2 primary concerns about vitamin A and influence on pregnancy in the US? What is the DRI for pregnancy?
- normal cellular functions, differentiation, reproduction & development
- Deficiency is the #1 cause of blindness in the world
- High Vit A medications and supplements can be teratogenic
- RAS: high forehead, ear malformation, flat nasal bridge, heart defect, brain malformation
- Do not take supplements with retinol when pregnant, east many orange & green plants
Vitamin D. Indicate the functions of vitamin D during pregnancy. What are deficiency statistics? What are potential outcomes of pregnancy associated with low intake of vitamin D? What is the DRI? Provide practical recommendations to obtain adequate amounts. Include good food sources in your answer. What issues can affect vitamin D status?
- functions: absorption and metabolism of calcium and phosphorus (bone and tooth), immune function, cell division
- 50-65% of pregnant women are deficient
- Negative outcomes mom: osteomalacia, infectious disease, CVD, preeclampsia
- Negative outcomes infant: LBW, rickets, poor bone mineralization
- Foods: egg yolk, salmon, tuna fish, cod, liver oil, fortified milk, fortified cereals, orange juice
- things that affect Vit D: low intake (ex: vegan diet), obesity, limited sun exposure
Calcium. What are functions of calcium? Does the AI for calcium increase during pregnancy? Explain. Compare the AI for ages 14-18 and > 19. What are 3 ways in which low intake affect pregnancy outcome? What are good sources, including plant and dairy sources? What are risks associated with low intake?
- Functions: teeth, bones, blood clotting, muscles, nerves, heart to function
- Fetal skeleton required 30 g, mostly accumulated In 3rd trimester
- Calcium needs do not increase during pregnancy because calcium absorption significantly increases
- Low intake: pregnancy induced hypertension, preeclampsia, increased risk of lead poisoning
- Sources: yogurt, sardines, cheddar cheese, milk, tofu, kale cooked, fortified cereal, cottage cheese, bok chow, broccoli raw
Zinc. What are the functions of zinc, food sources, and problems with assessment. What is the DRI for pregnancy? Non-pregnant? What are potential risks associated with low intake?
- Functions: cofactor for many enzymes, growth
- sources: meats
- vegetarian diet/taking iron supplements/ low intake at risk
- no good markers for zinc status, thought deficiency may be associated with preterm delivery and infections
Sodium. How may low sodium intake affect pregnancy? What is advised for sodium intake for pregnant women?
- should not be restricted, needed for plasma and fluid balance
- dietary Na doesn’t increase hypertension risk during pregnancy
- Inadequate Intake can complicate the course and outcome of pregnancy
- Advice: salt to taste
