EXAM 4

Pregnancy

1. Definitions:

   • Conception: The fertilization of an egg by a sperm, resulting in the formation of a zygote.

   • Gestation: The period of time between conception and birth, typically lasting about 40 weeks in humans.

   • Placenta: An organ that develops during pregnancy, providing nutrients and oxygen to the fetus and removing waste products.

   • Zygote: A fertilized egg cell formed after sperm fertilizes an egg, marking the beginning of pregnancy.

   • Embryo: The developing organism from the second week to the eighth week after conception.

   • Fetus: The developing organism from the ninth week of pregnancy until birth.

   • Infant: A child in the first year of life, typically after birth until they turn one.

   • Teratogens: Substances or environmental factors that cause birth defects or developmental abnormalities in a fetus.

   • Umbilical Cord: A tube-like structure connecting the fetus to the placenta, through which nutrients and waste products are exchanged.

   • Neonate: A newborn baby, typically the first 28 days of life.

   • Hunger: A physiological signal or drive indicating the need for food.

2. Weight Gain in Pregnancy:

   • First trimester: 1-4 pounds.

   • Second trimester: 1 pound per week.

   • Third trimester: 1 pound per week.

   • The total weight gain for someone with a normal BMI should be 25-35 pounds. These amounts depend on the mother's BMI before pregnancy, as well as factors like metabolic rate, fetal health, and the amount of amniotic fluid and placenta.

3. Substance Affecting Male Fertility:

   • Environmental toxins (e.g., pesticides, lead), smoking, excessive alcohol, and stress can affect male fertility by reducing sperm count and motility or causing sperm DNA damage.

4. Critical Period for Neural Tube Development:

   • The first 4-6 weeks of pregnancy are critical for neural tube development. Folic acid (a form of folate) is crucial for preventing neural tube defects.

5. Pica:

   • Pica is the craving and consumption of non-food items like dirt, chalk, or clay. It might indicate nutritional deficiencies, such as iron or zinc, or psychological conditions.

6. Macronutrient Consumption:

   • Pregnant women should consume about 45-65% carbs, 20-35% fats, and 10-35% proteins to support the pregnancy.

7. Vitamin and Mineral Requirements:

   • Folate, iron, calcium, and vitamin D are especially important. Supplementing with folic acid greatly reduces the incidence of neural tube defects.

8. Importance of Folate, Iron, B12, and Vitamin C:

   • Folate helps with cell growth and development.

   • Iron supports the increased blood volume and prevents anemia.

   • Vitamin B12 helps in the formation of red blood cells and neurological function.

   • Vitamin C aids in iron absorption and boosts immune function.

9. Concerns with Alcohol Consumption:

   • Alcohol consumption during pregnancy can lead to Fetal Alcohol Spectrum Disorders (FASD), which can cause developmental delays, physical abnormalities, and cognitive issues. No safe amount of alcohol during pregnancy is recommended.

10. Foodborne Illnesses:

• Pregnant women are more susceptible to foodborne illnesses, such as listeriosis (can lead to miscarriage or preterm labor), salmonella, and toxoplasmosis.

11. Physical Activity:

• Moderate physical activity is generally safe during pregnancy, but activities that involve a risk of falling or trauma to the abdomen should be avoided.

12. Role of Exercise:

• Exercise helps maintain weight gain within healthy ranges, improves circulation, reduces stress, and helps with labor. Do’s include walking and swimming; don’ts include contact sports or exercises that involve lying flat on the back.

13. Common Health Problems During Pregnancy:

• Includes morning sickness, gestational diabetes, hypertension, anemia, and preeclampsia.

14. Listeriosis:

• Listeriosis is a foodborne illness caused by Listeria bacteria, which can harm the fetus, causing miscarriage, preterm birth, or stillbirth. Pregnant women are more susceptible.

15. Gestational Diabetes:

• This occurs during pregnancy and increases the risk for type 2 diabetes later in life for the mother. The baby may also be at risk for excessive birth weight and future metabolic issues.

16. Preeclampsia and Eclampsia:

• Preeclampsia involves high blood pressure and damage to organs, typically developing after 20 weeks. Eclampsiais a more severe form that can lead to seizures and is life-threatening.

17. High-Risk Pregnancy:

• A pregnancy is considered high-risk if it involves factors like teen pregnancies, maternal age over 35, preexisting medical conditions, or complications from previous pregnancies.

Infancy

18. Macronutrient and Micronutrient Needs:

• Infants need high amounts of protein for growth, carbohydrates for energy, and fat for brain development. Vitamins A, D, and C, and iron are also important.

19. Lactation and Its Benefits:

• Lactation is the process of producing and secreting milk. It’s beneficial because it provides ideal nutrition for infants and boosts immune protection. Colostrum is the first milk, rich in antibodies, while transitional milkfollows and provides more nutrients.

20. Where Is Milk Produced in the Breast?

• Milk is produced in the alveoli within the mammary glands.

20a. Prolactin vs. Oxytocin:

• Prolactin stimulates milk production, while oxytocin causes milk to be ejected from the breast.

21. Limitations to Breastfeeding:

• Some limitations include insufficient milk supply, inverted nipples, sore nipples, or maternal health issues. Some mothers may also need to return to work.

22. Breast Milk Composition:

• Foremilk is watery and quenches thirst, while hindmilk is richer in fat and provides more calories.

23. Breastfeeding vs. Formula Feeding:

• Breastfeeding provides natural antibodies and nutrients, but formula feeding is a viable option when breastfeeding isn’t possible.

23a. Age of Infant:

• An infant is defined as a child from birth to 1 year.

24. Energy Needs in Infants:

• Infants need more energy per body weight because they have rapid growth and higher metabolic rates.

25. Diet for the First 6 Months:

• Exclusive breast milk or formula is recommended. Cow's milk is not appropriate because it doesn’t provide the right balance of nutrients.

26. Complementary Foods:

• Foods like pureed fruits, vegetables, rice cereal, and soft foods can be introduced around 6 months.

27. Preterm Infant Needs:

• Preterm infants may require specialized nutrition like higher calorie formulas or breast milk fortified with extra nutrients.

28. Infant Health Issues:

• Common issues include jaundice, allergies, and the introduction of potentially allergenic foods.

29. Peanuts as Complementary Food:

• Introducing peanuts early may reduce the risk of peanut allergies in infants.

30. Common Food Allergies in the US:

• The most common allergies include milk, eggs, peanuts, tree nuts, soy, wheat, fish, and shellfish.

31. % of Children with Allergies in the US:

• Approximately 8% of children in the U.S. have a food allergy.

32. When to Introduce Complementary Foods:

• Complementary foods should be introduced around 6 months of age, when infants can sit up and have lost the tongue-thrust reflex.

Toddler Years

33. Definition of Toddler:

• A toddler is a child between the ages of 1 and 3 years.

34. Macronutrient Needs:

• Toddlers need adequate fat for brain development, protein for growth, and carbohydrates for energy.

35. Obesity in Toddlers:

• Obesity in toddlers can be prevented through healthy eating habits, portion control, and regular physical activity.

36. Iron Deficiency Anemia:

• Iron deficiency can be mitigated with iron-rich foods like meat, beans, and fortified cereals. Vitamin C helps increase iron absorption.

37. WIC (Women, Infants, and Children):

• WIC provides nutrition assistance to low-income pregnant women, new mothers, and children up to age 5.

38. Nonfood Items Consumed by Children with Pica:

• Common nonfood items include dirt, clay, or paint chips. Pica may indicate nutritional deficiencies or developmental concerns.

Ch. 14 – Childhood and Adolescence

38. Age and Classification of Adolescence and Childhood:

• Childhood typically refers to ages 2-12 years.

• Adolescence is generally classified as ages 13-18 years, though it can extend into the early 20s depending on cultural and developmental factors. It’s often broken down into early adolescence (ages 10-14), middle adolescence (ages 15-17), and late adolescence (ages 18-21).

39. Physical Activity for Preschool Age, School Age, Youth:

• Preschool (3-5 years): Encourage at least 3 hours of physical activity throughout the day, with activities that promote coordination, balance, and motor skills (e.g., running, jumping).

• School Age (6-12 years): Aim for 1 hour of moderate to vigorous physical activity daily, including sports, active play, and recreational activities.

• Youth (13-18 years): At least 1 hour of physical activity daily, which may include structured sports, walking, running, or other forms of exercise. Physical activity helps with growth, bone development, and mental health.

40. Macronutrient Requirements:

• Carbohydrates: Provide 45-65% of total daily calories to support growth, energy needs, and cognitive development.

• Proteins: Essential for growth and tissue repair, comprising about 10-30% of total daily calories.

• Fats: Should make up 25-35% of total daily calories, with a focus on healthy fats (e.g., omega-3s for brain development).

41. Micronutrients Needed – The Most Significant Ones:

• Vitamin A (vision, immune function)

• Vitamin D (bone health)

• Iron (growth and development, especially for girls and during adolescence)

• Calcium (bone growth)

• Vitamin C (immune health, tissue repair)

• Folate (cell growth, especially during adolescence)

42. Food Insecurity – Definitions:

• Malnutrition: A condition resulting from an unbalanced intake of nutrients, either too much or too little.

• Hunger: The physical sensation of needing food due to insufficient food intake.

• Food Security: Having consistent access to enough nutritious food for an active and healthy life.

• Food Insecurity: The lack of consistent access to adequate food, often due to financial or social constraints.

43. Macro and Micronutrient Deficiency:

• Macro deficiency: Insufficient intake of carbohydrates, proteins, or fats, leading to inadequate energy or growth issues.

• Micronutrient deficiency: A lack of essential vitamins or minerals (e.g., iron deficiency leading to anemia, vitamin D deficiency leading to bone problems).

44. Government Programs – SNAP, School Lunches, School Breakfast, Summer Feeding Program, WIC:

• SNAP (Supplemental Nutrition Assistance Program): Provides food assistance to low-income families.

• School Lunch and School Breakfast Programs: Provide free or low-cost meals to children in schools.

• Summer Feeding Program: Helps provide nutritious meals to children when school is not in session.

• WIC (Women, Infants, and Children): Offers nutrition education, healthy food, and health services to low-income pregnant women, new mothers, and children up to 5 years.

45. Toxicity – Lead and Its Role:

• Lead toxicity can impair cognitive development in children, causing learning disabilities, behavioral problems, and lower IQ. It’s mainly found in lead-based paints, contaminated water, or soil.

46. Stages of Puberty and What Happens in Each:

• Early Puberty (9-12 years): Beginning of hormonal changes, growth spurts, breast development in girls, and testicular enlargement in boys.

• Mid Puberty (12-15 years): Rapid physical growth, development of secondary sexual characteristics (e.g., voice deepening in boys, menstruation in girls).

• Late Puberty (15-18 years): Completion of physical development, maturation of reproductive organs, and stabilization of growth.

47. Micronutrient Needs During Puberty – Most Significant Ones:

• Iron (especially for girls due to menstruation).

• Calcium (critical for bone growth and development).

• Vitamin D (bone and immune health).

• Zinc (important for growth and immune function).

48. Energy Needs During Puberty – Boys vs. Girls:

• Boys typically have higher energy needs due to greater muscle mass and higher activity levels during puberty. Energy needs can range from 2,200 to 3,000 calories/day for boys, and 1,800 to 2,400 calories/day for girls depending on their activity levels and stage of development.

49. Eating Disorders – Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder:

• Anorexia nervosa: A psychological disorder marked by self-imposed starvation and excessive weight loss.

• Bulimia nervosa: Characterized by binge eating followed by purging (vomiting, over-exercising).

• Binge eating disorder: Compulsive overeating without purging, leading to weight gain and psychological distress.

50. Childhood Obesity – Measures to Be Taken:

• Encourage physical activity, limit screen time, promote healthy eating (e.g., fruits, vegetables, whole grains), and create supportive family environments.

Ch. 15 – Adulthood

51. Define Adulthood – Stages:

• Young Adulthood (ages 20-40): Establishing independence, career, and possibly family.

• Middle Adulthood (ages 40-65): Stability in career and relationships, possible health challenges.

• Late Adulthood (65+): Retirement, coping with health issues, and life reflection.

52. Energy and Macronutrient Needs:

• In adulthood, energy needs decrease with age due to slower metabolism.

• Macronutrients: About 45-65% of daily calories from carbohydrates, 20-35% from fats, and 10-35% from proteins.

• Protein intake is critical for maintaining muscle mass and function as one ages.

53. What Are SoFAAS and How Do They Impact Health?

• SoFAAS stands for Solid Fats, Added Sugars, which are often found in processed foods. High intake of SoFAAS contributes to weight gain, chronic diseases (like heart disease, type 2 diabetes), and poor nutritional quality.

54. Micronutrient Needs – Males and Females, B6 Deficiency and High Homocysteine Levels:

• B6 is important for metabolism and red blood cell production. B6 deficiency can lead to nerve damage and increased levels of homocysteine, which is associated with a higher risk for cardiovascular diseases and stroke.

55. Changes During Middle Age, Energy Requirements:

• Energy needs decrease due to a decline in basal metabolic rate and reduced physical activity. Weight gain is common in middle age due to muscle loss and changes in metabolism.

56. Do Seniors Need More or Less Protein Intake? Why?

• Seniors need more protein to help preserve muscle mass, support immune function, and prevent sarcopenia (muscle wasting). As muscle mass decreases with age, protein helps maintain strength and mobility.

57. Micronutrient Needs – Know the Major Ones:

• Calcium and Vitamin D for bone health.

• Vitamin B12 (as absorption decreases with age) for nerve health.

• Folate, Vitamin A, and Magnesium for overall health maintenance.

58. Menopause:

• Menopause typically occurs between ages 45-55 and involves the cessation of menstruation and a decline in estrogen levels. This can lead to symptoms like hot flashes, mood swings, and increased risk of osteoporosis and cardiovascular disease.

53. Golden Years and Homeostatic Imbalances – Dementia, Alzheimer’s, Dysphagia, Obesity, Anorexia of Aging:

• Dementia and Alzheimer’s: Cognitive decline that affects memory and functioning.

• Dysphagia: Difficulty swallowing, often linked with aging or neurological disorders.

• Obesity and Anorexia of Aging: Weight-related issues can be due to changes in metabolism or loss of appetite.

• Homeostatic imbalances: Imbalances in the body's ability to regulate processes like fluid balance, temperature, and metabolism.

54. Do Seniors Need More or Less Protein in Their Diet and Why?

• As mentioned, seniors need more protein to counteract muscle loss, prevent malnutrition, and support overall health.

55. Cardiovascular Disease, Hypertension, Diabetes, Cancer:

• Cardiovascular disease: The leading cause of death in adults, exacerbated by poor diet, lack of exercise, and smoking.

• Hypertension: High blood pressure, which can lead to stroke or heart disease.

• Diabetes (Type 1, Type 2, Gestational): Type 2 diabetes is the most common, associated with obesity and poor diet. Type 1 is an autoimmune condition.

• Cancer: Risk factors include genetics, environmental exposures, and lifestyle choices.

56. Modifiable vs. Unmodifiable Risk Factors:

• Modifiable risk factors can be changed (e.g., diet, physical activity, smoking).

• Unmodifiable risk factors cannot be changed (e.g., age, genetics, gender).