study guide ch.14

What can affect likelihood of conception?

Nutritional status of mother and father-to-be can affect likelihood of conception.

What nutrients and factors are linked to fertility?

Link between body fat and fertility, roles of certain dietary fats, carbohydrates, antioxidant nutrients, B vitamins, zinc, iron, and overall dietary patterns.

What is the role of folate?

Role in DNA synthesis and metabolism of homocysteine

Why is folate important for reproduction?

Important for the sperm and egg which transmit genetic information

What is folate?

Folate is natural form found in foods such as green leafy vegetables, strawberries, and orange juice

What is folic acid?

Folic acid is synthetic form found in supplements and fortified foods

What can oxidation do?

Oxidation can damage DNA and cell membranes, including egg and sperm

How are antioxidants related to fertility?

Diets rich in antioxidants are linked to improved fertility in men and women

What nutrients are antioxidants?

Vitamins E and C; Selenium and zinc; Beta-carotene and some other plant pigments

What may improve fertility?

Routine intake of a daily multivitamin and mineral supplement may improve fertility.

What is the role of zinc in male fertility?

Important for male fertility; Helps protect sperm from oxidative damage; Required for normal sexual maturation, sperm, and hormone production

What are iron and zinc important for in females?

Important for female fertility; Required for normal ovulation; Higher intake of nonheme iron related to improved fertility

What are dietary fat recommendations when trying to conceive?

Limit saturated and trans fat when trying to conceive

What are high fat intakes linked to?

High intakes linked to poor sperm quality; Promote insulin resistance and impair ovulation in women

What is PCOS?

Polycystic ovary syndrome (PCOS) is characterized by many tiny cysts that surround the ovaries.

What is the leading cause of female infertility?

PCOS is the leading cause of female infertility.

What are symptoms of PCOS?

Increased testosterone leading to excess hair growth on face, acne, and abdominal fat deposition; Insulin resistance and higher risk for diabetes, cardiovascular disease, and high blood pressure; Irregular or absent periods; Difficulty conceiving; Higher-than-average rates of spontaneous abortion

What helps improve PCOS?

Weight loss is important to improve metabolic and fertility issues in women with PCOS.

How much weight loss improves conception chances?

Lose 5–10% body weight to improve chances of conception.

What improves insulin sensitivity?

Daily physical activity can improve insulin sensitivity.

How can diet help PCOS?

Controlling carbohydrate intake can help control PCOS and improve fertility

What carbohydrate intake is recommended for PCOS?

Lower range of carbohydrate intake (45% of total kcal)

What foods are recommended for PCOS?

Whole grains and whole fruits and vegetables

What should be limited for PCOS?

Limit sugar-sweetened beverages

How long does pregnancy last?

Pregnancy lasts 38–42 weeks.

How is pregnancy divided?

Pregnancy divided into three trimesters.

What happens in the first 8 weeks after conception?

embryo develops from fertilized ovum into fetus.

How does the fetus receive nourishment?

Fetus receives nourishment via placenta.

What is a fertilized ovum called initially?

Fertilized ovum known as zygote until it divides.

What happens within 30 hours?

Within 30 hours: zygote divides into two cells.

What happens within 4 days?

128 cells.

What happens at 14 days?

embryo.

What happens within 35 days?

heart beating, eyes and limb buds visible.

What happens at 8 weeks?

embryo becomes fetus.

What happens at 13 weeks?

organs formed; fetus can move.

What happens to mother’s breasts during pregnancy?

Mother’s breast weight increases during pregnancy due to fat deposition for breastfeeding.

What risks do infants of obese women have?

Infants born to women who are obese have increased risk of: Birth defects; Death in first few weeks after birth; Childhood obesity

What risks do obese pregnant women have?

Pregnant women who are obese have increased pregnancy complications.

What risks are increased with excessive maternal body weight?

Excessive maternal body weight increases risks of: Diabetes; Hypertension; Blood clots; Spontaneous abortions

What fetal complications are linked to excessive maternal body weight?

Birth defects; Fetal macrosomia

What increases risk for birth defects?

Obesity, high blood pressure, and uncontrolled diabetes increase risk for birth defects.

How does diabetes affect birth defects risk?

Women with diabetes are two to three times more likely to give birth to a baby with birth defects.

What is WIC?

Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

What does WIC offer?

Offers health assessments, education, and EBT cards to purchase foods.

Who is eligible for WIC?

Available for pregnant women, infants, and children up to 5 years of age from eligible populations.

What nutrients does WIC emphasize?

High-quality protein; Calcium; Iron; Vitamin A; Vitamin C

How many participate in WIC?

More than 8 million women, infants, and children participate.

What defines a successful pregnancy?

Protection of mother’s physical and emotional health so she can return to prepregnancy health; Gestation period longer than 37 weeks; Birth weight greater than 5.5 lb.

How many extra calories are needed in pregnancy?

Average pregnancy requires approximately 350–450 kcal more per day during last two trimesters.

How do micronutrient and calorie needs change?

Micronutrient needs increase up to 50%, calorie needs increase about 20%.

What are calorie needs in first trimester?

First trimester approximately 2200 kcal/day for active 24-year-old woman.

What are calorie needs in second and third trimester?

Second and third trimesters approximately 2600 kcal/day for active 24-year-old woman.

What about calorie needs with multiple fetuses?

Women pregnant with multiple fetuses may need more than an extra 450 kcal/day.

What are protein needs in pregnancy?

Additional 25 g/day; 1.1 g/kg/day

What are carbohydrate needs in pregnancy?

RDA increases to 175 g/day to avoid ketosis

What are fat needs in pregnancy?

20–35% of total calories; Saturated fat less than 10% total kcal; Avoid trans fat; Linoleic acid: 13 g/day; Alpha-linolenic acid: 1.4 g/day

What are weight gain recommendations based on BMI?

Low BMI

What is weight gain by trimester?

First trimester: 2–4 lb.;

Second and third trimester: 0.8–1 lb/week.

How can neural tube defects be prevented?

Meeting folate needs helps prevent neural tube defects.

What are neural tube defects?

Neural tube defects include: Spina bifida; Anencephaly

How does folic acid supplementation help?

Supplementation with folic acid in periconceptional period reduces risk of neural tube defects.

What is recommended folic acid intake?

Women of childbearing age should take 400 mcg folic acid daily.

What if previous child had neural tube defect?

Women who previously had child with neural tube defect advised to consume 4000 mcg/day folic acid.

What nutrient has toxicity risk in pregnancy?

Vitamin A

What level of vitamin A is teratogenic?

Doses as low as 3000 mcg RAE/day are teratogenic

What defects are caused by vitamin A toxicity?

Primary defects include facial and cardiac defects

Where does vitamin A toxicity usually come from?

Toxicity usually from fortified foods or megadose supplements

How can heartburn be alleviated?

Avoid lying down after eating; Decrease dietary fat intake; Avoid spicy foods; Consume liquids between meals

How can constipation and hemorrhoids be alleviated?

Exercise regularly; Increase water to 10 cups/day; Consume adequate dietary fiber (28 g/day); Reevaluate iron supplement amount

How can nausea and vomiting be alleviated?

Avoid fried, greasy, acidic foods; Cook with good ventilation; Eat soda crackers or dry cereal before getting out of bed; Avoid large fluid intakes early morning; Eat smaller, frequent meals; Iron supplements may trigger symptoms

How do nutrient needs change in breastfeeding?

Nutrient needs similar to second and third trimester except: Increased calorie needs; Increased vitamins A, E, C, riboflavin; Increased minerals copper, chromium, iodine, manganese, selenium, zinc; Decreased folate; Decreased iron

How many calories are needed for milk production?

Milk production may require 500 kcal/day or more.

What is recommended energy intake for breastfeeding?

Recommended energy intake: extra 330–400 kcal/day.

How much fluid is needed in breastfeeding?

Breastfeeding requires 13 cups fluid/day.

What is minimum calorie intake during breastfeeding?

At least 1800 kcal/day recommended.

What foods should be included during breastfeeding?

Include dairy products, fruits, vegetables, and whole grains.

Why should infant nurse 10–20 minutes?

Infant should nurse at least 10–20 minutes because milk composition changes during feeding.

What is fore milk?

Fore milk: less fat.

What is hind milk?

Hind milk: more fat.

What is colostrum?

Produced for a few days after birth; Yellowish and thick; Contains antibodies and immune and growth factors; Infant absorbs unaltered; Rich in human milk oligosaccharides that help establish healthy gut microbiota.

What is a teratogen?

Environmental influences such as exposure to teratogens can cause birth defects.

What substances act as teratogens?

Harmful substances pose great risk to developing fetus; Toxic chemicals, alcohol, nicotine, illicit drugs, some medications, and environmental hazards may act as teratogens.