KIN 2183: Basic Nutrition Lifecycle 1 PDF

KIN 2183: Basic Nutrition Topic 12: Lifecycle 1 Fall & Spring Semesters Presented by Riley Bailey  Nutrition Before Conception Some deficiency-related problems develop very early in pregnancy Neural tube defects o Related to inadequate level of folate o Affects the embryo...

KIN 2183: Basic Nutrition Topic 12: Lifecycle 1 Fall & Spring Semesters Presented by Riley Bailey  Nutrition Before Conception Some deficiency-related problems develop very early in pregnancy Neural tube defects o Related to inadequate level of folate o Affects the embryo in the first few weeks o Adequate folate (400 µg daily) before conception can reduce the risk 2  Nutrition Before Conception A healthful diet before conception includes o Avoiding teratogens: substances that cause birth defects  Includes avoiding alcohol and illegal drugs o Avoiding other possible hazards  Smoking, caffeine, medications, some herbs, and supplements o Body mass index (BMI) between 19.8 and 26.0 kg/m2 and appropriate level of physical activity 3  Nutrition Before Conception A healthful diet before conception reduces the risk of developing nutrition-related disorders during pregnancy, such as o Gestational diabetes o Hypertensive disorders 4  Nutrition During Pregnancy A full-term pregnancy lasts 38 to 42 weeks o First trimester: conception to week 13 o Second trimester: week 14 to week 27 o Third trimester: week 28 to week 40 Embryonic stage: approximately day 15 to week 8 After week 8, the developing baby is called a fetus 5  Nutrition During Pregnancy First trimester o Zygote (fertilized egg) travels through the fallopian tube and implants in the wall of the uterus o Development of organs, limb buds, facial features, and placenta o Embryos are extremely vulnerable to teratogens during this time 6  Nutrition During Pregnancy Second trimester o Weeks 14–27 o Continued development of organ systems o Growth from approximately 3 inches to over 1 foot long by the end of the second trimester 7  Nutrition During Pregnancy Third trimester o Weeks 28 to birth o Time of considerable growth o Fetus gains three-quarters of its weight in this time o Brain growth is also extensive o Lungs become fully mature o A balanced, adequate diet for the mother is essential during this time 8  Nutrition During Pregnancy An undernourished mother is more likely to give birth to a low-birth-weight baby o Low birth weight: describes any baby born weighing less than 5.5 pounds o Increased risk of infections, learning disabilities, impaired physical development, and death in the first year 9  Nutrition During Pregnancy Preterm babies are born before 38 weeks and may be low-birth-weight babies Small-for-gestational-age babies are born at term but weigh less than would be expected for their gestational age Nutrition plays a major role in these conditions 10  Nutrition During Pregnancy Weight gain during pregnancy o Women who do not gain enough weight are at risk of having a low-birth-weight baby o Too much weight gain is also risky o Women should not diet during pregnancy since this may deprive the fetus of critical nutrients 11  Nutrition During Pregnancy The requirement for nearly all nutrients increases during pregnancy Pregnant women must pay attention to their intake of: o Macronutrients o Micronutrients o Fluids 12  Macronutrients Energy o An additional 300 to 450 kcal/day may be required in the second and third trimesters o Nutrient-dense foods are essential in order to obtain sufficient nutrients Protein and carbohydrate o 1.1 g/day/kg body weight (~additional 25 g/day) of protein o At least 175 g/day of carbohydrates 13  Macronutrients Fat o The percentage of Calories obtained from fat should not change during pregnancy o Limit saturated fat; avoid trans fats o Consume rich sources of docosahexaenoic acid (DHA), an omega-3 polyunsaturated fatty acid 14  Micronutrients The micronutrients that are most critical during pregnancy include folate calcium vitamin B12 iron vitamin C zinc vitamin A sodium vitamin D iodine 15  Folate Required for cell division Critical in the first 28 days for development of the neural tube, which becomes the brain and spinal cord 400 µg/day for sexually active women 600 µg/day for pregnant women Deficiency is associated with anencephaly and spina bifida 16  Micronutrients Vitamin B12 Vitamin A o Regenerates the active form of o Needs increase by 10% in folate pregnancy o 2.6 µg/day during pregnancy  770 µg/day Vitamin C o Excess vitamin A can cause fetal abnormalities o Production of collagen (connective tissue) o Supplementation is not recommended due to toxicity o 85 mg/day during pregnancy risk o Deficiency results in elevated o Beta-carotene (provitamin A) risk of preterm births and is not associated with birth preeclampsia defects 17  Micronutrients Vitamin D Calcium o Adequate intake (AI) does not o 1,000 mg/day, same as for increase during pregnancy non-pregnant women o Excessive vitamin D can o Calcium absorption is more cause developmental efficient during pregnancy disabilities in newborns Zinc o If exposure to sunlight is o Critical for making proteins, limited or milk consumption DNA, and RNA is low, supplementation is advised o Need increases 38% during pregnancy o Prenatal vitamin supplements (11 mg/day) contain 10 µg/dose 18  Micronutrients (cont.) Iron Sodium o Increased need for red o 1,500 mg/day, same as for blood cells increases the non-pregnant women need for iron by 50–80% Iodine (27 mg/day) o Need for iodine increases o Fetal need for iron increases significantly in the third trimester o 220 µg/day can be obtained o Iron stores of mother are from iodized salt depleted to support needs of the fetus o Iron-deficiency anemia is common during pregnancy 19  Fluids During Pregnancy The amount of fluids needed increases to 3 liters per day o Increase in maternal blood volume o Body temperature regulation o Production of amniotic fluid to protect and cushion the fetus o Combat fluid retention and constipation o Reduce risk of urinary tract infections 20  Nutrition-Related Concerns Nutrition-related problems during pregnancy can include o Morning sickness o Food and nonfood cravings and aversions o Gastroesophageal reflux (GER)/heartburn o Constipation o Gestational diabetes o Preeclampsia (maternal blood pressure increase) 21  Morning Sickness Morning sickness: nausea and vomiting associated with pregnancy o Can occur at any time; often lasts all day o May begin after the first missed period and can last 12 to 16 weeks o Can be severe enough to require hospitalization o No cure, but symptoms can be reduced 22  Cravings and Aversions Most women crave a certain type of food (sweet, salty) rather than a specific food o Little evidence supports the idea that cravings indicate a deficiency o Due to hormonal fluctuations, physiologic changes, or familial or cultural roots o Pica: craving a nonfood item (ice, clay, laundry starch) o Food aversions are common but not universal among pregnant women 23  Gastroesophageal Reflux (GER) Gastroesophageal reflux (GER) is common during pregnancy Tips to help minimize it include o Avoid excessive weight gain o Chew food slowly o Wait for 1 hour after eating before lying down o Sleep with your head elevated 24  Constipation Pregnancy hormones that cause smooth muscles to relax also slow the movement of material through the large intestine Reduce constipation by consuming 25–35 g/day of fiber and plenty of fluids, and remaining physically active 25  Gestational Diabetes Gestational diabetes: insufficient insulin production or insulin resistance that increases blood glucose levels during pregnancy o Affects as many as 10% of U.S. pregnancies o Condition resolves after birth occurs o Risk of delivering a large baby o Gestational diabetes increases a woman’s risk of developing type 2 diabetes 26  Gestational Hypertension Preeclampsia: pregnancy-induced hypertension o Affects up to 10% of U.S. pregnancies o Can be fatal if left untreated o Deficiencies in vitamin C, vitamin E, and magnesium increase the risk o Treatment focuses on managing blood pressure and often includes bed rest o The only cure is childbirth 27  Foodborne Illness Pregnancy alters a woman’s immune system leaving them more vulnerable to infectious diseases including foodborne illnesses o Listeriosis: a serious and sometimes fatal illness caused my listeria monocytogenes o Third leading cause of death by foodborne illness o Severe infections of listeria can lead to premature birth or miscarriage 28  Food Safety Pregnant women should avoid consuming o Unpasteurized milk, raw or partially cooked eggs, raw or undercooked meat/fish/poultry, unpasteurized juices, and raw sprouts o Large fish such as shark, swordfish, and king mackerel, along with canned albacore tuna o Soft cheeses unless the label specifically states the product is made with pasteurized milk 29 Foodborne Illness 30  Nutrition-Related Concerns Adolescent pregnancy Vegetarianism Exercise Caffeine consumption Alcohol consumption Smoking Illegal drug use Food safety 31  Adolescent Pregnancy Nutritional needs of pregnant adolescents are higher than those of adult women Adolescent bodies are still growing and changing, adding to the nutritional needs of pregnancy 24 births for every 1,000 adolescents; currently the lowest adolescent pregnancy rate in 60 years 32  Vegetarianism A vegetarian consuming eggs and dairy products has the same nutritional concerns as a nonvegetarian A complete vegetarian (vegan) must carefully monitor the intake of vitamin D calcium vitamin B6 iron vitamin B12 zinc 33  Exercise During Pregnancy Reduces risk of gestational diabetes and preeclampsia Helps prevent excessive prenatal weight and body fat gain Improves mood, energy level, sleep patterns Enhances posture and balance Improves muscle tone, strength, and endurance Reduces lower back pain and shortens the duration of active labor Reduces risk of preterm birth and large-for- gestational age infants 34  Consumption of Caffeine Caffeine is a stimulant that crosses the placenta and reaches the fetus 200–300 mg of caffeine per day very likely will cause no harm Some studies have linked 100 mg per day intakes to an increased risk of miscarriage, stillbirth, preterm birth, and decreased birth weight 35  Consumption of Alcohol Alcohol is a known teratogen that crosses the placenta and is associated with various birth defects, delivery complications, sudden infant death syndrome, and increased risk of miscarriage Fetal alcohol syndrome (FAS): variety of characteristics associated with prenatal exposure to high quantities of alcohol o Malformations of face, limbs, heart, and nervous system o Many developmental disabilities 36  Smoking and Drug Use Maternal smoking exposes the fetus to toxins o Smoke contains lead, cadmium, cyanide, nicotine, and carbon monoxide o Fetal blood flow is reduced o Increased risk of miscarriage, stillbirth, placental abnormalities, preterm delivery, and low birth weight Most drugs pass through the placenta into fetal blood o Newborns suffer withdrawal symptoms 37  Breastfeeding Lactation: production of breast milk o Prolactin: hormone responsible for the synthesis of milk  Produced toward the end of pregnancy  Suppressed by estrogen and progesterone until childbirth Colostrum: first milk produced (from birth up to 3 days after); rich in proteins, antibodies, vitamins, and minerals o Oxytocin: hormone responsible for milk let-down 38  Breastfeeding Milk production requires 700–800 kcal/day Lactating women should consume 330 kcal/day above their prepregnancy needs the first 6 months, 400 kcal/day the second 6 months This allows a woman to gradually lose weight (1–4 pounds per month) 15–20 g of protein and 80 g of carbohydrate required per day above prepregnancy needs Fluid and many micronutrient needs are increased 39  The Benefits of Breastfeeding High-quality nutrition Protection from infections, allergies, and residues Assists the mother in weight loss Suppresses ovulation Provides an opportunity for bonding Convenience and cost efficient 40  Breastfeeding Nutritional quality of breast milk o The main protein, lactalbumin, is easily digested o Primary carbohydrate is lactose o Rich source of readily absorbed calcium and magnesium Composition of milk changes during a feeding o Foremilk is watery and low in fat o Hindmilk is very high in fat It is important to let infant suckle for at least 20 minutes 41  Challenges Associated with Breastfeeding Many harmful substances are passed into breast milk, including o Illegal drugs, caffeine, nicotine, and prescription and over-the-counter medications HIV is passed through breast milk Conflicts with mother’s employment Social concerns 42  Infant Nutrition Optimal nutrition is critical in the first year o High energy needs, 40–50 kcal/lb/day o 40–50% of energy should come from fat o Iron, vitamin D, zinc, fluoride, and iodide needs are a concern o The nervous system continues to develop o Infants typically grow 10 inches in length and triple their weight in the first year 43  Infant Nutrition Infants’ nutritional needs are unique o Their energy needs are high to support rapid growth o Their digestive tracts and kidneys are still immature o They are small in size 44  Infant Nutrient Needs 40–50 kcals per pound of Breast milk or formula should body weight per day be supplemented with solid o Approximately 600–650 kcals food beginning at 4 to 6 per day at around 6 months of months age 40–50% of energy needs o Breastmilk and commercial formulas are energy and should be consumed from fat nutrient dense to meet these during the first year of life demands No more than 20% of an infant’s daily energy needs should be consumed from protein 45  Supplements for Infants? Several micronutrients may need supplementation o Vitamin D because of limited exposure to sunlight o Iron - stores are depleted by the sixth month o Fluoride for tooth development o Vitamin B12 if the mother is a vegan o Water is generally not required unless loss is excessive (diarrhea, vomiting, fever, hot weather) Care must be taken to prevent oversupplementation 46  Formulas Very tightly regulated by federal government o Minimum and maximum standards for 29 nutrients o Protein source: casein or whey from cow’s milk o Carbohydrate source: lactose and sucrose o Fat source: vegetable oils or microbiologically produced lipids Specialized formulas are available: soy-based, predigested, others for certain medical conditions 47  When to Introduce Solid Food Introduce solid food at 6 months o Tongue movement allows swallowing o Muscle development allows infant to sit up o Digestive system and kidneys have matured o Less likely to develop food allergies o Iron-fortified cereals are well tolerated 48  Infant Nutrition Infants should not eat Nutrition-related o Foods they could choke concerns for infants on include o Corn syrup or honey o Allergies o Goat’s milk o Dehydration o Cow’s milk o Colic o Too much salt or sugar o Anemia o Nursing bottle syndrome o Lead poisoning 49  Infant Nutrition Allergies o Solid foods should be introduced one at a time for a week to watch for allergies o Cow’s milk, egg whites, peanuts, and wheat commonly trigger food allergies Dehydration o Extremely dangerous for infants o Caused by diarrhea, vomiting, and inadequate fluid intake o Pediatric electrolyte solution may be used 50  Infant Nutrition Colic o Uncontrollable crying that can last for hours o Precise cause is unknown Anemia o Infants are born with enough iron for only 6 months o Anemia can develop o Iron-fortified cereal/supplement may be needed 51  Nursing Bottle Syndrome Leaving an infant alone with a bottle can lead to cavities (dental caries) and tooth decay The high-carbohydrate fluid provides an optimal food source for bacteria that cause dental caries Rather than a bottle, begin using a cup by 8 months and no bottle after 18 months 52  Infant Nutrition Lead poisoning o Especially toxic to infants because the brain and nervous system are still developing o Results in reduced mental capacity, behavioral problems, and impaired growth o Remove old, lead-based paint o Allow tap water to run a minute before use to discard lead leached from pipes o Use only cold tap water because hot tap water is more likely to leach lead 53  In Depth: The Fetal Environment Increased evidence suggests that the fetal environment—including a mother’s nutritional status—can influence risks for obesity and chronic diseases later in life This relationship has been called “fetal origins theory” 54  In Depth: The Fetal Environment If exposed to famine in the first trimester, the child has increased risk of obesity, coronary heart disease, abnormal serum lipid profile, and metabolic syndrome Fetal adaptation: when a fetus is exposed to harmful elements, it goes into “survival mode”: hormones shift to promote energy storage, and enzymes can increase or decrease the size and function of various body organs 55  In Depth: The Fetal Environment Fetal stressors that influence adult health include nutrient deficiencies o Low maternal intake of calcium increases risk of hypertension in offspring o Poor maternal folate intake is linked to neural tube defects and early signs of atherosclerosis o Zinc deficiency has been linked to later-life disorders such as diabetes and atherosclerosis 56  In Depth: The Fetal Environment Strong evidence links maternal dietary excesses to health problems in adult offspring o Maternal obesity may account for changes in the “programming” of the fetal brain, resulting in lifelong health consequences o Maternal obesity increases rates of spina bifida, neural tube defects, infant heart defects, cleft lip and palate, and abnormal arms or legs o Maternal diabetes can increase risks of infant type 2 diabetes, overweight, and metabolic syndrome 57  In Depth: The Fetal Environment Other detrimental maternal impacts on a fetus include exposure to o Alcohol o Tobacco o Toxic agents, such as environmental pollutants 58 Questions, Cusswords, Comments? 59