Maternal Nutrition, Energy Balance, and Weight Management PDF

Maternal Nutrition, Energy Balance and Weight Management Alex Kojo Anderson, PhD, MPH, CPH Professor and Graduate Coordinator Department of Nutritional Sciences University of Georgia Presentation Outline ❖ Overview of Maternal Nutrition ❖ Energy Bal...

Maternal Nutrition, Energy Balance and Weight Management Alex Kojo Anderson, PhD, MPH, CPH Professor and Graduate Coordinator Department of Nutritional Sciences University of Georgia Presentation Outline ❖ Overview of Maternal Nutrition ❖ Energy Balance ❖ Weight Gain Recommendations ❖ Managing Weight During Pregnancy ❖ Potential Risk of Poor Nutrition and Weight Management ❖ Key Nutrients in Pregnancy ❖ Summary Ice Breaker The 9 months of pregnancy represent the most intense period of growth and development humans ever experience. Nutrition status stands out as one of the factors affecting fetal growth and development that are within our control to change. In what ways does nutrition status impact fetal growth, development, and long-term health? The Status of Pregnancy Outcomes Overview of Maternal Nutrition The nutritional requirements of women are distinct throughout their lives. before, during pregnancy & while breastfeeding risk of nutritional inadequacy is greatest during these times Adequate maternal nutrition is essential for optimal health and well-being of mothers and their babies. Overview of Maternal Nutrition Optimal maternal nutrition before pregnancy helps build nutrient reserves and prepares the body for the increased demands of energy and essential nutrients during pregnancy. This reduces the risk of pregnancy complications and contributes to healthier pregnancy outcomes. Adequate maternal nutrition during pregnancy is critical for the health and well-being of the mother and the developing baby. It promotes safe delivery and long-term health benefits for the mother and baby. Adequate nutrition for lactating mothers is also vital for supporting breast milk production. Physiology of Pregnancy Conception triggers thousands of complex and sequenced biological changes The rapidity of metabolic and functional changes occurring within the mother and fetus places high demands on maternal nutrient reserves How well the process proceeds has short- and long- term effects on health, growth, development, and disease risk throughout life Physiology of Pregnancy Pregnancy begins at conception Average pregnancy is 38 weeks Pregnancy duration of 40 weeks is more commonly used with the assessment date of the onset of last menstrual period Maternal circulating nutrients Support plasma volume expansion Physiological processes that follow Physiology of Pregnancy: Normal Changes During Pregnancy There are numerous physiological changes that normally occur during pregnancy Body water changes Increases from 7 to 10 liters: intracellular and extracellular High gains in body water are associated with edema Birthweight is strongly related to plasma volume Physiology of Pregnancy: Normal Changes During Pregnancy Maternal nutrient metabolism Changes can be seen within the first weeks after conception Ensures that nutrients will be available to the fetus when needed Physiology of Pregnancy: Normal Changes During Pregnancy Carbohydrate metabolism Glucose is the preferred fuel for the fetus Early pregnancy: high estrogen and progesterone stimulate insulin, which increases glucose conversion to glycogen and fat Late pregnancy: human chorionic somatotropin (hSC) and prolactin inhibit conversion of glucose to glycogen and fat Diabetogenic effect of pregnancy: results from maternal insulin resistance Physiology of Pregnancy: Normal Changes During Pregnancy Accelerated fasting metabolism Allows pregnant women to primarily use store fat for energy Spares glucose and amino acids for fetal use Protein metabolism Increased protein and nitrogen needs during pregnancy Nitrogen and amino acids are conserved during pregnancy Maternal and fetal protein needs must be met by maternal dietary intake Physiology of Pregnancy: Normal Changes During Pregnancy Fat metabolism Fat stores accumulated in first half of pregnancy Enhanced fat mobilization in last half of pregnancy Blood lipid levels increase Increased cholesterol is used for steroid hormone synthesis and by the fetus for nerve and cell membrane formation Physiology of Pregnancy: Normal Changes During Pregnancy Mineral metabolism Impressive changes occur to support plasma volume expansion and transfer of minerals to the growing fetus Calcium: needed for bone formation Increased maternal absorption and calcium mobilization Sodium: accumulation in mother, placenta, and fetus Restriction of sodium is potentially harmful and may lead to functional and growth impairments Physiology of Pregnancy: Normal Changes During Pregnancy The placenta: functions Hormone and enzyme production Nutrient and gas exchange Removal of waste products The placenta: structure Double lining of cells separating maternal and fetal blood Physiology of Pregnancy: Normal Changes During Pregnancy The fetus is not a parasite Nutrients are first used for maternal needs, then for the placenta, and last for fetal needs The fetus is generally harmed more by poor maternal nutritional status than the mother is Factors Affecting Maternal Nutrition Many factors can influence the dietary choices of women. geographical location determines which foods are accessible to women poverty can impact the ability to afford healthy foods like fruits and vegetables social and cultural norms can constrain women’s ability to make decisions about their dietary choices These factors can contribute to inadequate nutrient intake, which can affect the nutritional status of women. Source: www.unicef.org/nutrition/maternal nutrition  Maternal Nutrition and Child Mortality in Ghana In Ghana, maternal nutrition is a significant public health concern due to its direct impact on the health and development of children. Poor nutrition among pregnant women is a major cause of child mortality. Ghana has made gains over the past years in reducing child mortality rates however, the rates are still high when compared to some African countries. Ghana Maternal Health Survey, GSS, 2018. Adu & Owusu, Int. Journal of Health Planning and Management, 2023. ENERGY BALANCE Pregnancy Weight Gain Recommendations Related to the weight and health status of the newborn Pre-pregnancy weight status Recommended weight gain body mass index Underweight,