Nutritional Considerations During Pregnancy

Study Notes

Nutritional Considerations (Lifecycle)

Nutritional needs change based on life stage (age, physiological condition, etc.)
Pregnancy nutritional care starts before conception
Healthy eating during pregnancy reduces risk of diseases in the child
Eating patterns (undernourished or unhealthy patterns) increase risk of chronic diseases
Pregnancy complications (childbirth, C-section, BP, gestational diabetes)
Fertility and nutrition (male and female)
Key supplement needed during pregnancy and before conception- FOLATE (folic acid supplements – 400ug daily)
Meeting needs for lactating mothers post-pregnancy
Maternal changes during pregnancy: blood volume increases by 50%, placenta develops (transfer nutrients), fat increases for energy, uterus enlarges, breasts develop (lactation)
Normal pregnancy weight gain is 11-16 kg (25-35 lbs)
2-4lbs in 1st trimester, 1lb/week in 2nd and 3rd trimester
75% of pregnancy weight gain is from tissues, fluids, and stores
Eating for two: Pregnant women don't need to eat twice as much
Health Canada recommends 2-3 servings per day
1st trimester: Energy needs similar to non-pregnant levels (Calories)
2nd and 3rd trimesters need 2-3 more servings of food
Protein: increase by 25g (increase from 0.8/kg/d to 1.1g/kg/day)
Fibre: additional 3-5g per day
Fats: include essential fatty acids and long-chain PUFAs (linoleic acid, alpha linolenic acid, DHA, and arachidonic acid) – from fish, nuts, seeds, olive oil, eggs
Additional Micronutrient needs: Folate & Vitamin B12 for proper spinal cord development and preventing anemia
Folic acid supplements should provide 400ug daily; Vegans need B12 supplements
Calcium & Vitamin D absorption doubles during pregnancy: increase servings of dairy ( 3-4 servings per day). Lactase intolerant women need specific guidance
Iron requirements increase by 50% (27mg/day)
Zinc requirements are high and absorption inhibited by high intake of Fe
Well-planned diet is important for vegetarians and vegans
Moderate activity (30 minutes/day) during pregnancy benefits digestion, mood, stress reduction and preventing excess weight gain; speeding recovery from child birth
If inactive before pregnancy, start slowly after childbirth
Common issues in pregnancy include weight gain, hyperemesis gravidarum (morning sickness), dehydration/electrolyte imbalance, weight loss, adolescent pregnancy nutrient needs, socio economic issues, gestational diabetes, risks of bigger babies, risks of childhood obesity
Low BW (< 2.5 kg or 5.5 lbs) has birth complications or is associated with diseases and death
Normal BW (3-4 kg or 6.5-9 lbs).
High BW (>4 kg or 9 lbs) associated with difficult birth, mom and child complications, or Cesarean section
Exclusive breastfeeding for 6 months (may be exceptions)
All breastfed infants-Vit. D supplement of 400IU.
Continue breastfeeding as long as it continues
A baby's birth weight doubles by four months and triples by one year, and energy needs for the first year is 100kcal/kg/day (6 months basal rate is high and then decreased by 7-12 months as activity increases)
Height, weight, and head circumference as standard guidelines
Mom's nutritional requirements breastfeeding include milk production 750-1L/day, water intake increasing at least 1L more than pre-pregnancy, energy expenditure increasing 700-800 kcal/day, recommended pre-pregnancy intake + 500kcal, weight loss is 200kcal/day deficit

Geriatric Nutrition

Diet & exercise to maintain muscle mass (fat mass ↑ as age ↑), healthy, active, healthy life expectancy
Low Body mass (LBM) and Basal Metabolic Rate (BMR) and activity decrease with age
Energy needs generally decrease with age (50+)
Micronutrient needs may remain the same or increase
Vitamins such as Vit. D, B12, folate, Ca and Iron are important as well as adequate fiber
Fluid needs remain constant (risk of dehydration)
Increased risk of malnutrition (undernutrition, sarcopenic obesity) based on physiological changes in the body.
Physiological changes could be decline in muscle size and strength, frailty, mobility, endurance, risks of falls
Acute & chronic/acute illnesses (kidney disease, BP, heart disease)
Decreased nutrient intake, impaired immune function, increased illness and increased use and access to medication can cause malnutrition in later adulthood.
Physical changes, difficulty accessing/preparing food, loneliness, low income, confusion/depression, poor appetite, alcohol use/abuse, and institutionalization complicate nutrition needs in the elderly
Keeping active, involved in community, maintaining muscle mass, function and mental health, individualized care and respecting dignity in the elderly is important for quality of life