Nutrition And Pregnancy (PDF)

Nutrition And Pregnancy OBJECTIVES To review the nutrients required for growth, development and maintenance of a healthy body To describe fetal development from conception to birth and explain how maternal malnutrition can affect critical periods. To compare the prenatal and pregnancy requirements f...

Nutrition And Pregnancy OBJECTIVES To review the nutrients required for growth, development and maintenance of a healthy body To describe fetal development from conception to birth and explain how maternal malnutrition can affect critical periods. To compare the prenatal and pregnancy requirements for kilocalories, proteins, vitamins, and minerals. To identify the Food Groups – the source of nutrients To compare meal plans of normal and pregnant woman To use supertracker (myplate) to assess a meal plan Explain how both underweight and overweight can interfere with a healthy pregnancy and how weight gain To discuss the common health problems associated with pregnancy. To identify foods and behaviors that are associated with harmful consequences. PREGNANCY From Conception to Birth The nutrients from food eaten by the mother is used to makes bones, muscles, blood cells, skin and all the tissues required to give birth to an infant. Usually a prenatal supplement is recommended to prevent deficiencies Vitamin-mineral megadoses can be toxic, especially vitamin A. e.g codliver oil Text Book References Understanding Nutrition by Whitney & Rolfes Planning a Healthy Diet: Chapter 2 Pregnancy Chapter 15 © 2009 Cengage - Wadsworth Websites www.supertracker.usda.gov https://www.youtube.com/watch?v=MukLDO5kGh8 https://www.youtube.com/watch?v=vZ67QXVJKBg https://www.youtube.com/watch?v=j6OWmgqrcbY Nutrients Macronutrient Carbohydrates Fats/Lipids Micronutrients Vitamins (water and fat soluble) Minerals (major and trace) Water Proteins Energy Requirements Compared with the non pregnant state the changes recommended are: Energy 1st Trimester: no increase in energy intake required 2nd Trimester: An additional 340 Kcal per day 3rd Trimester: An additional 450 Kcal per day Components of Weight Gain During Pregnancy Water and Fiber Requirements Carbohydrate: Ideally 175 g (No less than 135 g) per day Fat: Additional essential fatty acids (linoleic and linolenic acid) Protein: An additional 25 grams per day Water: From 8 (8 oz) glasses to 10 per day Fiber: Slight increase from 28 to 30 g per day. The Nutrients Energy Yielding Vitamins Minerals Carbohydrates Fats/Lipids Protein A D E K Riboflavin Niacin Biotin Pantothenic acid B6 Folate B12 C Calcium Phosphosus Magnesium Iron Zinc Iodine Selenium Fluoride Increase Significant increase Same amount Critical Periods of Development Growth and Development during Pregnancy Critical periods are finite periods of intense development and rapid cell division. Neural Tube Defects The critical period is 17-30 days gestation. Anencephaly affects brain development. Spina bifida can lead to paralysis or meningitis. Chronic Diseases Chronic disease in later life for the infant Blood pressure, glucose tolerance, and immune functions © 2009 Cengage - Wadsworth ZINC Roles in the Body Zinc is important in a multitude of chemical reactions in the body, which includes making parts of DNA, RNA Synthesis of heme for hemoglobin Sperm development and Fetal development The best sources of dietary zinc are protein-rich foods. Phytates and fiber can bind zinc, therefore limiting absorption. Zinc deficiency symptoms include growth retardation and sexual immaturity. © 2009 Cengage - Wadsworth IRON Roles in the Body Include The release of energy in cell metabolism the synthesis of hemoglobin – the protein which carries oxygen in the blood the synthesis of myoglobin - the protein in the muscles which makes oxygen available for muscle contractions A deficiency of iron results in iron deficiency anemia which is common in children, women, and can have serious consequences in pregnant women. The best sources of dietary iron are protein-rich foods e.g. meat, fish and poultry. Plant sources including whole and enriched grains, legumes and dark green leafy vegetables e.g. Broccoli, spinach, callaloo also contribute some iron © 2009 Cengage - Wadsworth FOLATE and VITAMIN B12 Both these vitamins are involved in the synthesis of DNA and the formation of new cells. Vitamin B12 is involved in maintaining nerve cells, and reforming folate. Folate Food Sources Legumes e.g. lentils an pinto beans Fruits e.g. Tomato, oranges Vegetables e.g Broccoli, Asparagus Vitamin B12 Food Sources (only from animal products) Meat, fish, poultry, and shellfish Milk, cheese and eggs Fortified cereals © 2009 Cengage - Wadsworth FOLATE Folate and Neural Tube Defects Neural tube defects include spina bifida and anencephaly. Women of childbearing age should eat folate-rich foods and folate-fortified foods and take folate supplements containing 0.4 mg (400 microgram) of folate daily. Pregnant women should take folate supplements. © 2009 Cengage - Wadsworth GUIDELINES 1 Adequacy (dietary)—providing sufficient energy and essential nutrients for healthy people 2. Balance (dietary)—consuming the right proportion of foods. (Enough but not too much especially of the minerals) 3. kcalorie (energy) control—balancing the amount of foods and energy to sustain physical activities and metabolic needs GUIDELINES 4. Nutrient density—measuring the nutrient content of a food relative to its energy content Empty-kcalorie foods denote foods that contribute nutrients. energy but lack 5. Moderation (dietary)—providing enough but not too much of a food or nutrient. 6. Variety (dietary)—eating a wide selection of foods within and among the major food groups Food Groups 1. 2. 3. 4. 5. Fruits [cups] Vegetables [cups] Grains [oz.] Protein Foods (Meat, Poultry, Fish, Legumes, Eggs, and Nuts) [oz.] Milk & Milk Products (Milk, Yogurt and Cheese) [cups] Food group plans sort foods into groups based on nutrient content. A Good plan will include a variety of fruits, vegetables, milk and milk products, and whole grains. Figure 2-2a p42 Figure 2-2b p42 Figure 2-2c p42 Figure 2-2d p43 Figure 2-2e p43 Figure 2-2f p43 Notable Nutrients per Food Group Fruits: and Fiber Folate, Vitamin A, Vitamin C, Potassium Vegetables: Folate, Vitamin A, Vitamin C, Vitamin K, Vitamin E, magnesium, potassium, and Fiber Grains: Contribute, Folate, Niacin, Riboflavin, Thiamin, iron, magnesium, selenium, and Fiber Notable Nutrients per Food Group Protein: Meat Fish Poultry Eggs: Protein, Niacin, Thiamin, Vitamin B6 and B12, A, iron, magnesium, potassium, zinc Legumes and nuts: Protein, Folate, Thiamin, Vitamin E, iron, magnesium, potassium, zinc and fiber Milk: Protein, Riboflavin, Vitamin B12, Calcium, Magnesium, Potassium and when fortified vitamin A and D. [Oils: Contribute, , Vitamin E and essential fatty acids. ] Table 2-6 p48 Recommended Daily Amounts Per Food Group Food Groups Non- Pregnant (2000 Kcal) Pregnant: 2nd & 3rd Trimester (2500 kcal) Fruits 2 cups 2 cups Vegetables 2½ cups 3 cups Grains 6 ozs 8 ozs Meat & Legumes 5½ ozs 6½ ozs Milk 3 cups 3 cups Table 2-3 p44 © 2009 Cengage - Wadsworth Maternal Weight Weight Prior to Conception Underweight Tend to have lower birth weight babies Higher rates of preterm (premature 42 weeks) Tend to be greater than 9 pounds at birth (macrosomia) More difficult labor and delivery, birth trauma, and cesarean sections Higher risk for neural tube defects, heart defects and other abnormalities Weight loss should be postponed until after delivery. © 2009 Cengage - Wadsworth Vegetarian Diets during Pregnancy Vegetarian diets can be adhered to during pregnancy provided they: Provide adequate energy. include milk and milk products contain a variety of legumes, cereals, fruits, and vegetables Plant-only diets may cause problems during pregnancy. Supplements of iron, vitamin B12, calcium, and vitamin D may be required. © 2009 Cengage - Wadsworth Problems during Pregnancy Nausea Constipation and Hemorrhoids Heartburn Food Cravings and Aversions Nonfood Cravings – Pica (Often associated with irondeficiency) gestational diabetes and hypertension © 2009 Cengage - Wadsworth Problems during Pregnancy Common Nutrition-Related Concerns of Pregnancy Food Cravings and Aversions Common Do not reflect real physiological needs Hormone-induced changes in sensitivity to taste and smell Nonfood Cravings Pica Often associated with iron-deficiency © 2009 Cengage - Wadsworth Gestational Diabetes Gestational Diabetes Risk factors Age 25 or older BMI >25 or excessive weight gain Complications in previous pregnancies Symptoms of diabetes Family history of diabetes Hispanic, African American, Native American, South or East Asian, Pacific Islander or indigenous Australian © 2009 Cengage - Wadsworth Pregnancy in Adolescents & Older women Adolescents, are usually still growing and do not usually consume a healthy diet. Pregnancy in this group is associated with Complications include iron-deficiency anemia and prolonged labor. Higher rates of stillbirths, preterm births, and low-birthweight infants Major public health problem and costly Pregnancy in Older Women is associated with Hypertension and diabetes High rate of birth defects – Down syndrome © 2009 Cengage - Wadsworth Be Careful With Caffeine consumption – Tea, coffee, caffeinated sodas since moderate to heavy use may cause spontaneous abortion. Its wise to limit consumption Weight-loss dieting is hazardous and not recommended during pregnancy. Sugar substitutes are acceptable, but follow FDA guidelines. Fish known to be high in mercury FISH Fish relatively high in omega-3 fatty acids and low in mercury include: (12 ozs per week) anchovies mackerel smelt bonito trout sardines eel pollack tilapia herring salmon Fish with high levels of mercury should be avoided these include: shark snapper swordfish tilefish © 2009 Cengage - Wadsworth king mackerel golden