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AMDR of Carbo (CHO)
45-65% of intake
10-35% of intake
Essential fatty acids
- Linoleic acid (Omega-6)
- Alpha Linolenic (Omega-3)
AMDR of Lipids
20-35% of total calories
Water Soluble Vitamins
- Pantothenic Acid
- Vitamin C
Fat Soluble vitamins
A, D, E, K
Chemicals found in plants that may affect body processes
Calcium, Iron, Phosphorus, Magnesium, Zinc, Floride, Iodine, Copper, Manganese, Selenium, Chromium, Molybdenum, Sodium, Potassium, Chloride
food is a basic need of humans
Foods provide energy (calories), nutrients, and other substances needed for growth and health.
Health problems related to nutrition originate within cells
Poor nutrition can result from both inadequated and excessive levels of nutrient intake
Humans have adaptive mechanisms for managing fluctuations in food intake
Malnutrition can result from poor diets and from disease states, genetic factors, or combinations of these causes
Some groups of people are at higher risk of becoming inadequately nourished than others
Poor nutrition can influence the development of certain chronic diseases
adequacy, variety, and balance are key characteristics of a healthy diet
there are no "good" or "bad" foods.
A nutritious eating pattern consists of
- Calorie Control
Enriched means that they:
added nutrients back in that they had taken out through processing (Thiamin, Riboflavin, Niacin, and Iron).
Dietary supplement labeling cannot ________
Claim to treat, cure or prevent disease
Life course approach
- Diet at one stage of life affects the next
- Disease prevention and health promotion
- There is no one best diet for everyone
Community level assessment consists of
- Existing vital stats data
- Food programs
Individual-level assessment consists of:
Continuous assessment of trends to initiate corrective measures
assessment of intermittent times to detect the changes in the dietary or nutritional status of a population
Largest food assistance program:
SNAP (food stamps)
Women Infants and Children (WIC)
- Food vouchers
- Based on Nut risk and need
- Health benefits
- Every dollar invested save $3.13 on health costs for infants in first 2 years
Healthy People 2010
- Increase adults at healthy weight from 42 to 60%
- Reduce obesity from 23 to 15%
- Reduce iron deficiency in Women from 4-11% to 1-7%
- Reduce spina bifida from 7 to 3 per 10,000 and birth defects from 1.7-1.2 per 1,000 live births
- Increase proportion of women who get preconceptional counseling
- Gonadotropin-releasing hormone (GnRH)
- Follicle-stimulating hormone (FSH)
- Luteinizing hormone (LH)
Chronic Under nutrition
Primary effect is the birth of small and frail infants who have a high likelihood of death int he first year
Associated with dramatic decline in fertility that recovers when food intake does
Which type of under nutrition is more harmful for fertility?
Estrogen and leptin levels ______ with high body fat
Estrogen and leptin __________ when body fat is High
What hormones are associated with lower fertility?
Leptin and Estrogen
What BMI's put you at risk for lower fertility?
20 < BMI < 30
What is the first line treatment for under weight women?
Is clomid effective in treating underweight women?
True or False: Underweight men have reduced fertility
What kind of diet makes you more likely to have irregular menstrual cycles?
Plant based, low-fat deits
Iron status effects preconception in what ways?
- Lower infertility if you have adequate iron
- Pre-pregnancy iron deficiency associated with preterm delivery and low iron in infant
- 50% of women enter pregnancy with low iron
- Easier to build up iron stores before pregnancy
Oral Contraceptive risks
- cholesterol changes
- risk of blood clots
- weight gain
- increased levels of LDL
- Decreased bone density
Nutrition recommendations for preconception
- 1. Consume 400 mcg folate/folic acid
- 2. limit intake of Vitamin A from supplements to 5000IU/day
- 3. Limit or omit alcohol-containing beverages
Obesity and fertility in men
hormone changes, decreased sperm count, sperm motility, oxidative stress.
Obesity and fertility in women
high estrogen and leptin, insulin resistance, oxidative stress, inflamation
If you have 3 out of 5 of the following you have Metabolic Syndrome
- Waist circ. >40" in men, >35" in women
- Blood triglycerides >/= 150
- HDL <40 in men, <50 in women
- Blood pressure >/= 130/85
- Fasting blood glucose >/=110
Fertility treatment for obese women
wt. loss of 7-22 pounds (if BMI is over 25)
Hypothalamic Amenorrhea affects who?
Usually in women engaged in intellectual professions of those expose to social stress
Fixes for hypothalamic amenorrhea
weight gains of 6-11 lbs are usually sufficient to restore fertility
What is hypothalamic amenorrhea
one of the most common causes of anovulation and loss of menstrual cycles. Related to an energy deficiency
Female athlete triad
- Disordered eating
Loss of menstrual cycle
Primary therapeutic goal for anorexia nervosa:
normalization of body weight
Primary therapeutic goal for bulimia nervosa:
normalization of eating behaviors
Nutrition recomendations for type 2 diabetes in Preconception
- Wt. loss of 7%
- 15-20% protein
- <30% fat
- 50% CHO (high fiber)
- <7% sat fat
- little/no trans fat
- Cholesterol <200mg
- 14 g fiber per 1000 kcal
- 1/2 grains whole
- low GI foods-rich in fiber
How much physical activity is needed if you have type 2 diabetes?
150 minutes per week or an average of 21 minutes per day.
Risk factors for PCOS
- central fat sores
Nutritional management of PCOS
- increase insulin sensitivity
- dietary modification, weight loss, and exercise
What amount of weight loss is necessary for PCOS symptoms to improve?
5-10% of initial weight
How long does a PKU person have to follow the diet before they should conceive?
Desirable weight in newborns
3500-4500 kg or 7lb 12 oz - 10lbs
Health objectives for the nation (pregnant women)
- Reduce anemia 29-20%
- Reduce infant mortality from 7.6 to no more than 5 per 1000
- reduce spina bifida 7 to 3 per 10,000
- reduce low birth weight from 7.3-5%
- Reduce preterm births from 9.1-7.6%
- Increase abstinence from alcohol for preger women from 79-95%
- Reduce the incidence of FAS
- Increase proportion of women who gain weigh appropriately
Critical Periods have irreversible effects and last how long?
Most intense during the first 2 months after conception.
Small for gestational age
disproportionately small for gestational age (ex. head circumference is disproportionate to body)
proportionately small for gestational age (ex. head is small for their age but is proportionate to body).
Large for gestational age
Fetal-origins hypothesis of later disease risk
theory that exposure to adverse nutritional and other conditions during critical/sensitive periods of growth permanently affect body (makes you more likely to be sickly)
Pregnancy weight status <18.5
Recommended weight gain in pregnancy for underweight
Recommended weight gain in pregnancy for normal weight
Recommended weight gain in pregnancy for Overweight
Recommended weight gain in pregnancy for Obese
Recommended weight gain in pregnancy for twin pregnancy
Prepregnancy weight status 18.5-24.9
Prepregnancy weight status 25-29.9
Prepregnancy weight status 30 or higher
Rate of pregnancy weight gain should be
- 3-5lbs in first timester
- Gradual and consistent gains thereafter
1/3 of the normal duration of pregnancy
Recommended weight gain: 1st Trimester (0-13 wks)
Recommended weight gain: 2nd Trimester (14-26 wks.)
1 lb per week
Recommended weight gain: 3rd Trimester (27-40 wks)
1 lb per week
When is the 1st trimester?
When is the 2nd trimester?
When is the 3rd trimester?
27-40 weeks (birth)
Average weight lost at delivery
When is postpartum weight loss the most difficult?
if the woman gained >45lbs or had low activity levels
On average how much heavier are women who gained the recommended weight 1 yr. postpartum?
Energy needs for second trimester
Energy needs for third trimester
Pregnant women need how many CHO a day?
How much protein do pregnant women need?
Essential fatty acid needs in pregnancy
- Linoleic acid
- Alpha linolenic acid
How much water does a pregnant woman need?
What medication can cause a vitamin A toxicity?
How much vitamin D does a pregnant woman need?
5 mcg or 200 UI
How much calcium does a preg woman need?
How much iron does a pregnant woman absorb if she started with adequate stores?
How much iron does a pregnant woman store if she started with low iron stores?
How much iron does a pregnant woman store if she started with iron deficiency anemia
Iodine is needed for what?
Thyroid function, energy production, fetal brain development.
Deficient Iodine can cause what?
Is sodium restriction recommended during pregnancy for controlling edema or blood pressure?
Obesity in pregnancy causes higher risk of what?
- Cesarean section delivery
Recommendations for obesity in pregnancy.
- physical activity
- appropriate weight gain
Pregnancy after bariatric surgery is recommended when?
postponed 1-2 years after surgery
Nutritional recommendations for hypertension problems
- Vitamin D
- Colorful veggies and fruits
- appropriate weight gain
Diabetes in pregnancy causes greater risk for what?
- higher rates of misscarriage
- neonatal death
- congenital anomalies
What proportion of women who develop GD in a previous pregnancy will develop GD in subsequent pregnancies?
Exercise recommendations for GD
Exercise at 50-50% VO2 max
Formula for VO2 max:
220 - age * VO2 max = heartbeats/minute
Weight gain with twins
- 0.5 lbs per week in 1st tri
- 1.5 lbs per week in 2-3 tri
Weight gain with triplets
total of 50 lbs (33-34 weeks of gaining 1.5 lbs)
Nutrient needs for multiple pregnancy are based on what?
Weight gain (about 450 kcal)
Pregnant women with HIV/AIDS are at higher risk for what?
- Malabsorption (diarrhea, inflammatory response)
- loss of calcium from bones
- reduced immunity (higher risk of food borne illness)
Fetal Alcohol Spectrum avoidance recommendation
avoid alcohol during pregnancy
How many women consume alcohol during pregnancy?
- 12% once a month
- 2% consume 5 or more drinks on at least one occasion
- Short nose
- flat nasal bridges
- thin upper lips
- mental retardation
Adolescent pregnancy risks
compete with fetus for nutrients and calories
Adolescent pregnancy recomendations
- Require extra calories
- 1300mg calcium