Fundamentals of Nutrition: Chapter 13

Why is it important for pregnant women to focus on a nutrient-dense diet as caloric needs increase?

As caloric needs increase, nutrient requirements rise even more, making a nutrient-dense diet essential to ensure the body gets the necessary vitamins and minerals.

During the first few weeks of fetal development, what provides nutrients to the developing fetus?

the cells of the uterine lining.

When does the placenta gradually take over the role of feeding the embryo?

Between the 4th and 12th weeks

When does the embryo start to be called a fetus?

beginning in the 9th week of pregnancy

What does the placenta form from?

it forms from tissue deriving from both the fetus and the mother

What does the placenta provide to the fetus?

nutrients and respiration

handles waste from the fetus

produces hormones important to maintaining the pregnancy

Which trimester is a key period for the formation of embryonic and fetal organs?

the first trimester

The effects of malnutrition during critical periods are (irreversible/reversible)

irreversible

What is a healthy BMI for healthy women before pregnancy?

18.5 to 24.9

What is the most potent single indicator of an infant’s future health?

infant birthweight

What weight is considered a low birthweight?

less than 5 pounds, 8 ounces (2500 gram)

What is a major factor causing low birthweight

poor nutrition of the mother

What deficiency gives women a greater-than-normal risks of delivering low-birthweight or preterm infants.

iron deficiency anemia

What are other factors of low birthweight?

heredity, disease conditions, smoking, drug use, and alcohol use

What weight is considered a high birthweight

a weight of more than 8 pounds 13 ounces at birth.

High birthweight is often associated with…

maternal obesity or too much weight gain during pregnancy

In the first trimester, does a pregnant women need additional energy?

No, additional energy is not needed during the first trimester.

In the second trimester, how much additional energy does a pregnant woman need?

an additional ~340 calories per day.

In the third trimester, how much additional energy does a pregnant woman need?

an additional ~450 calories per day.

What is the RDA for CHO for non pregnant women and how does that differ from pregnant women

130 grams per day (non-pregnant women), while pregnant women require about 175 grams per day to support fetal development.

Why is an increase in CHO necessary?

to fuel the brain and spare the protein needed for fetal growth

How much the RDA for protein increase per day more than nonpregnant women, depending on the trimester?

The RDA for protein increases by ~25 grams per day during pregnancy compared to non-pregnant women, with higher needs in the second and third trimesters.

What is the normal body weight for protein which is the same during the 1st trimester?

0.8 g per kg per day, which is the same as for non-pregnant women.

What is the body weight for protein during the 2nd and 3rd trimester?

The RDA for protein during the 2nd and 3rd trimesters increases to 1.1 g per kg per day.

Is there an RDA for fat during pregnancy?

no, there is not

What percent of fat should make up the daily caloric intake?

25-35 percent

What role do fats play in the diet of pregnant women? give examples of fatty acids

providing energy, essential fatty acids (like linoleic and alpha-linolenic acids), and aiding in the absorption of fat-soluble vitamins.

Why are omega-3 fatty acids DHA and EPA important during pregnancy and lactation?

they are essential for the brain and eye development of the fetus and infant.

How many ounces of seafood does the dietary guidelines for Americans recommend that pregnant women consume each week, in part ot provide omega-3 fatty acids?

8-12 ounces of seafood each week

Why are folate and vitamin B12 important during pregnancy?

Folate and vitamin B12 are essential for cell replication and are needed in large amounts during pregnancy. Folate also plays a key role in preventing neural tube defects.

What is the neural tube?

The embryotic tissue that later forms the brain and spinal cord

What are neural tube defects?

Severe birth defects of the brain (anencephaly) and/or spinal cord (spina bifida) caused by interruption of the normal development of the neural tube

When does the embryo's neural tube typically close during pregnancy?

by the time a woman suspects she is pregnant, usually around the sixth week of pregnancy.

How can women reduce the risk of neural tube defects during pregnancy?

Women who can become pregnant are advised to obtain 400 micrograms of folic acid daily from supplements, fortified foods, or both, in addition to eating folate-rich foods, to reduce the risk of neural tube defects.

During pregnancy, how much does the folic acid recommendation increase?

it increases from 400 to 600 micrograms a day

What foods can people eat to recieve all the vitamin B12 they need, even for pregnancy?

meat, eggs, or dairy products

Why is choline important during pregnancy, and how much is recommended?

Choline is often grouped with B vitamins. The recommended daily intake (DRI) for choline during pregnancy is 450 milligrams, which is slightly higher than for nonpregnant women.

How can pregnant women ensure they get enough choline?

Since prenatal supplements usually don't contain choline, pregnant women are advised to consume choline-rich foods such as eggs, dairy products, legumes, meats, and seafood.

Why does a pregnant woman need iron?

to help increase her blood volume and support the placental and fetal needs.

How does a developing fetus use the mother's iron during pregnancy?

to accumulate enough iron for the first 4 to 6 months after birth.

How can women ensure adequate iron stores before and during pregnancy?

Women capable of becoming pregnant are advised to choose foods rich in heme iron, like meat, fish, and poultry, as they are most readily absorbed. They should also include additional iron sources, such as eggs, veggies, and legumes, and pair iron-rich foods with vitamin C-rich fruits and vegetables to enhance absorption.

in some situations, an iron supplement may be necessary

Why is iodine an essential nutrient for a developing fetus?

it is essential for healthy brain development in the fetus

How does the recommended daily intake (RDA) of iodine change for pregnant and lactating women?

The RDA of iodine for non-pregnant, non-lactating women is 150 mcg/day, which increases to 220 mcg/day for pregnant women and 290 mcg/day for lactating women.

What do the American Thyroid Association and the American Academy of Pediatrics recommend regarding iodine supplementation for women during pregnancy and breastfeeding?

to take a daily supplement containing 150 mcg of iodine as potassium iodide.

How can pregnant women ensure they get adequate iodine during pregnancy?

by focusing on healthy foods, cooking with iodized salt, and taking a prenatal micronutrient supplement. It's important to check that the prenatal supplement contains iodine.

Why does the American Academy of Pediatrics recommend that pregnant women avoid processed meats?

because the dietary nitrates in these meats can impact the body's ability to absorb iodine.

What does prenatal mean?

before birth; during or relating to preganncy

What is the ovum?

the egg

What is a zygote?

the product of the union of ovum and sperm; the product of conception

What are the two periods of prenatal development that occur after conception?

the embryonic period and the fetal period.

What is the embryonic period?

The stage of development that extends from conception through the eighth week of gestation; subdivided into pre-embryotic and embryotic phases

what is the fetal period?

Period of prenatal development, which starts at the beginning of the ninth week of gestation and continues until birth

What is the pre-embryonic phase?

the early phase of the embryonic period that begins with fertilization and continues through implantation?

What is a blastocyst?

Dense cellular sphere that develops in the early period of gestational development that lasts approximately 8 to 13 days after conception

What happens around 2 weeks after conception during prenatal development?

the blastocyst implants itself into the endometrium, the innermost lining of the uterus. The cell mass of the blastocyst then begins to differentiate, giving rise to specific tissues and organs.

What is the embryonic phase in prenatal development?

the final stage of the embryonic period, during which the formation of organs and organ systems begins.

How long does the embryonic phase last?

The embryonic phase spans from the start of the third week to the end of the eighth week after fertilization.

How large is the embryo by the end of the embryonic phase?

the embryo grows to about the size of a kidney bean.

What major development occurs by the end of the embryonic period?

the basic structures of all major body organs are formed.

What happens by the end of the embryonic period?

all major structures and organs are formed, and the embryo is now referred to as a fetus.

How can inadequate weight gain and poor nutritional health during the embryonic period affect the pregnancy?

Inadequate weight gain and poor nutritional health during this period can dramatically affect fetal growth

What are critical periods in a pregnancy?

periods in development when cells and tissues rapidly grow and differentiate to form body structures (i.e., heart, brain, lung development)

When does the heart and brain of the fetus develop in a pregnancy?

within ~14 weeks

when does the lung develop in a fetus during a pregnancy?

within ~24 weeks

What is the impact of malnutrition during critical periods of growth and development?

The effects of malnutrition during critical periods of growth and development are irreversible.

When are critical period most likely to occur?

during the early stages of pregnancy, but they can also occur at later stages

what are congenital disorders?

conditions present at birth that may result in physical, functional, and/or intellectual impairment; birth defect

Why do congenital disorders occur?

genetics, environmental, lifestyle, or combination of there factors

What percent of congenital disorders have no known cause?

50%

What are teratogens?

a term used to describe a broad group of environmental agents that negatively affect the normal course of cell growth and development in an unborn child

What percent of all congenital disorders are caused by teratogens?

4-5%

what are examples of teratogens?

alcohol

viral infections (chickenpox, rubella)

high intakes of certain nutrients (preformed vitamin A; retinol)

cigarette smoke

What happens wheb the blastocyst implants itself in the lining of the uterus?

embryonic and maternal tissues begin to form the placenta

What is the placenta?

An organ, consisting of fetal and maternal tissues, that supplies nutrients and oxygen to the fetus, and aids in the removal of metabolic waste products from the fetal circulation

What does the placenta transfer from the maternal blood to the fetus?

nutrients, hormones, oxygen, and other substances

Why is weight gain during pregnancy closely monitored?

because it is an important determinant of fetal growth and development.

How are the weight-gain guidelines for pregnant women determined?

The weight-gain guidelines for pregnant women, developed by the National Academy of Medicine, are based on the mother's pre-pregnancy body mass index (BMI).

Why might some pregnant women need to plan their diets more carefully?

Some pregnant women may need to plan their diets more carefully due to dietary restrictions, ensuring that all their nutritional needs are met.

Why is it especially important for vegan pregnant women to plan their diets carefully?

Vegan pregnant women must be particularly mindful of their diet because they do not consume foods of animal origin, making it harder to get adequate amounts of essential nutrients like vitamin B12, vitamin B6, iron, and calcium.

What foods can help vegan pregnant women meet their nutritional needs?

Vegan pregnant women can include additional servings of whole grains, legumes, nuts, and calcium-fortified foods like tofu and soy milk. Foods that provide vitamin B12, such as nutritional yeast and B12-fortified cereals, are also recommended.

What percent of women develop gestational diabetes?

10%

At how many week of the pregnancy does gestational diabetes occur?

usually around 28 weeks or later

What is gestational diabetes?

Abnormal glucose tolerance appearing during pregnancy; the exact cause is unknown

When does testing for gestational diabetes occur?

between weeks 24 and 28

What are risk factors for gestational diabetes?

women who have had gestational diabetes in the past

women with obesity

women with a family history of diabetes or prediabetes

Once diagnosed, what can keep blood glucose levels under control?

a healthy diet and exercise (similar to T2DM)

may require insulin injections

What is another name for pregnancy-induved hypertension

preeclampsia

What percent of pregnancies does pregnancy-induced hypertension affect?

about 6.5% of pregnancies

What is pregnancy-induced hypertension characterized by?

sudden increase in blood pressure

swelling (edema) typically around the face

rapid weight gain due to fluid retention

protein in the urine

When does pregnancy-induced hypertension typically occur, and how long does it last?

Pregnancy-induced hypertension usually occurs during a woman's first pregnancy, typically after 20 weeks of gestation, and usually starts to disappear within a few days after delivery.

What does the World Health Organization recommend for pregnant women at high risk of pregnancy-induced hypertension?

The World Health Organization recommends calcium supplementation for pregnant women at high risk of pregnancy-induced hypertension or those with low calcium intakes to help prevent the condition.

What is a certified lactation consultant (international board-certified lactation consultant, IBCLC)?

A healthcare provider, often a registered nurse or a registered dietitian nutritionists, with specialized training and certification in breast and infant anatomy and physiology who teaches the mechanics of breastfeeding to new mothers

What is essential for successful lactation and the nourishment of most healthy infants during the first 6 months of life?

Adequate nutrition is essential for successful lactation, and human breast milk is the only food needed by most healthy infants for the first 6 months of life.

What are the recommended foods for infants during the first 4 to 6 months of life?

The only foods recommended for infants during the first 4 to 6 months of life are breast milk and/or formula.

How is the decision to breastfeed, formula-feed, or combine both feeding methods made?

The choice to exclusively breastfeed, exclusively formula-feed, or to combine both is a complex and individual decision.

What do the Academy of Nutrition and Dietetics and the American Academy of Pediatrics recommend regarding infant feeding for the first 6 months of life?

The Academy of Nutrition and Dietetics and the American Academy of Pediatrics recommend that infants be exclusively breastfed, receiving only breast milk with no formula or other foods, for about the first 6 months of life.

What do experts recommend for infant feeding after 6 months of age?

After 6 months, a combination of breastfeeding, formula, and other food sources may continue for up to 1-2 years.

What were the breastfeeding statistics in the US for babies born in 2017?

In 2017, 84% of babies born in the US were breastfed at birth, but only 58% were still breastfeeding at 6 months, and just 26% were exclusively breastfed through 6 months.

What does breast milk contain that is beneficial for the baby?

immunoglobulins

beneficial bacteria

lactoferrin