Chapter 2: Preconception Nutrition
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| How do you achieve fertility? | complicated processes that can be disrupted by a number of factors related to body composition and dietary intake
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| What are oral contraceptives and contraceptive implants capable of doing to nutritional status? | adversely affecting some aspects
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| What type of nutritional status before pregnancy enhances the likelihood of conception and helps insure a healthy newborn? | optimal
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| ___% of couples are infertile | 15%
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| ___% of couples diagnosed as "infertile" will conceive within ____ years without use of technology. | 40%;
3
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| Healthy couples have a ____-____% chance of conception within a given menstrual cycle. | 20-25%
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| miscarriage | loss of conceptus in 1st 20 weeks of pregnancy
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| What are some causes of miscarriage? | defect in fetus
maternal infection
structural abnormalities of uterus
endocrine or immunological disturbances
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| Subfertility | reduced level of fertility characterized by unusually long time for conception
NOT INFERTILITY
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| ___% of couples are infertile | 18%
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| What are some causes of SUBfertility | having multiple missacarriages
sperm abnormalities
infrequent ovulation
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| Puberty | period in which humans become biologically capable of reproduction
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| Ova | eggs females produce and store within the ovaries (they are born with all their possible eggs at birth)
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| Menstrual Cycle | 4 week interval in which hormones direct buildup of blood and nutrient stores within uterus; ovum matures and is relaeased
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| When does the development of the reproductive systems start? | during the first months after conception and continues to grow into puberty
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| When does our capacity for reproduction start? | established during puberty when hormal changes stimulate maturation of reproduction system
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| What drives our reproductive system? | hormones
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| Women are born with a life-time supply of ___ million immature ova. | 7
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| ~____ ova will mature and be released during the fertile years | 400-500
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| Chromosomes in the ova can be damaged by.... | oxidation
radioactive particle exposure
aging
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| Women over the age of ___ are mre likely to have children with ____ related to _____ than younger women. | 35;
chromosomal defects
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| For men, ____ production begins during ___. | sperm;
puberty
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| Sperm production ____ after age ____ with ____ continuing to ____. | decreases;
35;
old
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| Gonadotropin-releasing hormone (GnRH) | stimulates pituitary to release FSH and LH
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| Follicle-stimulating hormone (FSH) | stimulates maturation of ovum and sperm
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| Luteinizing hormone (LH) | stimulates secretion of estrogen, progesterone, and testosterone
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| Estrogen stimulates the release of what other hormone? | GnRH in follicular phase and follicle growth and maturation of follicle
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| Estrogen also stimulates what 2 things within the uterus? | vacularity and stoage of glycogen, along ith other nutrients
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| Progesterone | prepares uterus for fertilized ovum, increases vacularity of endometrium, and stimulates cell division of fertilized ova
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| Follicular Phase | first half of menstrual cycle
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| What happens during the Follicular Phase? | follicle growth and maturation
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| What are the main hormones involved with the Follicular Phase? | GnRH, FSH, estrogen, and proestrogen
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| Luteal Phase | last half of menstrual cycle
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| When does the Luteal Phase occur during the process of ovulation? | after ovulation
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| What is formed during the Luteal Phase? | corpus luteum
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| What 2 hormones are involved in the Luteal Phase and what happens to them/ what does it induce? | decrease in estrogen and progestrone stimulate menstrual flow
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| What is the source of cramps and in which phase is it present? | postglandins;
Luteal Phase
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| Estrogen and Progesterone work in what way together? | synergistically
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| Which 3 interacting reproductive organs are involved in the male reproductive system? | hypothalamus
pituitary gland
testes
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| Androgens | testosterone
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| Where is sperm stored? | epididymis
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| What is sperm released out of the penis as? | semen
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| The epididymis is attached to what other organ? | The testes
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| What are some sources of disruption in fertility? | adverse nutritional eposure
contraceptive use
severe stress
infection
tubal damage or other structural damage
chromosomal damage
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| What are some nutritional related disruptions in fertility? | undernutrition
weight loss
obesity
high exercise levels
intake of specific foods and food components
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| Chronic Undernutrition | caused by no regular access to food; primary effect is the birth of small frail infants wtih high likelihood of death in the first year of life
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| Acute Undernutrition | associated wtih a dramatic decline in fertility that recovers when food intake does
ex. the dutch famine bad to good and things were back to normal
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| When there's undernutrition, do people still get pregnant? | yes
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| Decreased fertility seen with ___ or ___ body fat due to alterations in ____ | lo;
high;
hormones
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| Estrogen and leptin increased with ___ body fat and decreased with ___ body fat. | high;
low
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| Which two extremes of body fat lowers fertility? | too much and too little
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| Infertility is lower with a BMI of what and what? | less than 20
greater than 30
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| What is the effect of weight loss on fertility? | losing greater than 10-15% of your usual weight decreases estrogen
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| Weight loss increases the likelihood of... | amenorrhea
anovulatory cycles
short or absent luteal phases
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| Treating ____ women with this fertility drug is not effective. | underweight;
Clomid
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| Fertility in males decreases with ____, which was shown in a study during WWII | starvation by 50%
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| When a man is _____, his sperm viability and motility decrease ____ to ____%. | starving;
10, 15%
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| What is the main concern of intense physical activity? | decreased bone density
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| Diet may impact ___. | hormones
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| What are the main dietary practices that affect fertility? (correlations, not causes) | vegetarian diets, low fat intake, high intake of fiber, soy, caffience, alcohol
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| Oxidative stress in men decreases and reduces what? | decreases sperm motility
reduces ability of sperm to fuse with nan egg
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| Oxidative stress in women harms and interferes with which two things? | harms eggs and follicular development
interfere with corpus luteum function
interfere with implantation of the egg
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| Antioxidants | vitamin e
vitamin c
beta-carotene
selenium
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| Where are antioxidants found? | veggies and fruits
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| What do antioxidants do to the reproductive system? | protect the cells, including egs and sperm
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| What role does zinc play in men? | it reduces oxidative stress
sperm maturation
testosterone synthesis
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| What has zinc been investigated for? | potential infertility role
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| What type of diet has been associated with reduced ___ and _____ periods? | low-fat, high fiber;
irregular
plant food diet
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| Isoflavones | from soy, decreases levels of gonadotropins, estrogen, and progesterone
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| infertility rates are lower in women who use ___ supplements or ____ from plant foods | iron; iron
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| What is linked to preterm delivery and low iron status of infant? | pre-pregnancy iron deficiency
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| What percentage of women in the US enter pregnancy with inadequate ___ store? | 50%;
iron
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| What is the correlation with caffeine and pregnancy? | caffeine appears to prolong the time to conception
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| Daily caffeine intake & reduction in conception is: | 300mg results in ~27% decrease
500mg results in ~50% decrease
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| What effect does alcohol have on fertility? | may decrease estrogen and testosterone lveles or disrupt menstrual cycle
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| What did studies show on the weekly drink consumption to conception? | 1-5 drinks, 39% decrease
greater than 10 drinks, 66% decrease
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| What do antioxidant nutrients do? | protect sperm from oxidative damage
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| What has little effect on fertility? | vitamin D
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| Alcohol intake has a toxic effect on what? | testes
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| Exposure to what impacts males? | heavy metals impacts sperm and testes
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| Effect of lead | impacts testes and sperm
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| Effect of mercury | decreases sperm and semen
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| What are some other factors that contribute to infertility in males? | glycols, hormones (DDT), heat, steroid abuse
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| Oral contraceptives, contraceptive injections and contraceptive implants are all related to? | weight gain, bad LDL cholesterol increase but increase in HDL also, blood clot risk increase, etc
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| Folate vs conception | prevents neural tube defects
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| What did the government make mandatory in grains? | fortified with folic acid
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| Diets for preconceptional women involve two things. | moderation and variety
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| Why moderation and variety for a preconceptional women? | Because then they will not get bored with their food choices and the extra nutrient amounts they need will be sufficient
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| Examples of model preconceptional nutrition programs | WIC
decreasing iron deficincy in preconceptional women in indonesia
preconceptional care
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| What does the CDC recommend for primary health care visits? | education
screening for vaccination, weight, iron, and folate status
assessment of alcohol use
management of diabetes and celiac disease
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| Nutrition Care Process | 1)assessemnt
2) diagnosis
3) intervention
4) monitoring and evaluation
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