Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
FSHN 459- Unit 1
| Question | Answer |
|---|---|
| trickle down theory of preconception health | health prior to pregnancy-> healthy pregnant women -> healthy newborns -> health prior to pregnancy |
| preconception intervention too late- why? | critical periods start immediately after missed period |
| reproductive physiology of women | 7 million ova, 400-500 used in life, egg quality decline as age increases |
| reproductive physiology of men | sperm production begins at puberty; decreases after 35 |
| estrogen functions (3) | stimulates GnRH, stimulates storage of glycogen/vascularity, inhibits luteal phase |
| GnRH function | stimulates releaseof FSH and LH |
| FSH functions (2) | stimulates maturation of follicles, estrogen production |
| LH function | stimulates progesterone secretion |
| progesterone functions (3) | prepares uterus, vascularity of endometrium, cell division of fertilized ova |
| male reproductive system | ongoing; sperm mature in 70-80 days; stored in epididymis |
| nutrition related disruptions in fertility (5) | undernutrition, weight loss, obesity, high exercise, specific foods |
| body fat and fertility | BMI <20 or >30; adipocytes produce estrogen, testosterone, leptin |
| zinc and male fertility | zinc helps to decrease oxidative stress, help maturation, help testosterone synthesis (low concentration/abnormal shapes if deficient) |
| folate status and fertility | increased fertility in both sexes |
| iron status and fertility | (women- if deficient) lack of ovulation, low iron stores in infant, preterm delivery |
| vitamin D and fertility | low sperm count in males |
| alcohol and fertility (women) | decreased estrogen levels/disrupted menstrual cycles |
| alcohol and fertility (men) | decreased testosterone levels/toxic effects on the testes |
| halogens/glycols and fertility | pesticides, antifreeze, solvents all reduce sperm count |
| other reproductive hazards for males and females (6) | drugs, smoking, medicines, radiation, chemicals, animal feces |
| supplement use and preconception | any contraindicated in pregnancy=contraindicated in preconception |
| pms cause | enhanced responsiveness to changes in hormones; alteration in availability of serotonin |
| pm dysphoric disorder | >5 pms symptoms |
| pms treatment | calcium, b6, chasteberry; vitamin d, magnesium |
| obesity in males | high estradiol (inhibits FSH and LH) |
| obesity in females | testosterone production |
| SHBG | steroid hormone binding globulin (estrogen/testosterone) |
| chronic inflammation associations (2) | high body fat, low vitamin D |
| polycystic ovary syndrome | hardening, ovum isn't released, insulin resistance |
| polycystic ovary syndrome causes (3) | intra-abdominal fat, environment gene interactions, vitamin D deficiency |
| hypothalamic amenorrhea | decreased secretion of GnRH-> decreased FSH and LH |
| female athlete infertility triad | low energy availability, menstrual dysfunction, altered bone mineral density |
| female athlete triad risk factors (4) | restricted kcal, excessive exercise, vegetarian, social |
| PKU | cannot convert phenylalanine to tyrosine |
| PKU risk factors | (fetus) CNS development, heart defects |
| management of PKU | less meat and wheat |
| celiac and infertility | may be correlated, may not be (US yes UK no) |
| status of pregnancy outcomes | better in better socioeconomic areas |
| infant birth weight outcomes | 3000-4000g (decreases chances of heart disease, lung disease, HTN, DM) |
| blood volume during pregnancy | starts to increase at 10 weeks, plasma 50% developed by 34 weeks |
| hemodilution | RBC mass ^ 30% vs plasma ^ 50% |
| blood lipid/glucose levels during pregnancy | higher for all (TG 3x), insulin resistance |
| circulatory system pregnancy | increased HR, SV-> decreased BP (1st half) |
| respiratory system pregnancy | increased breathing rate, tidal volume, oxygen consumption |
| GI changes pregnancy | decreased muscle tone |
| immune system pregnancy | suppressed immunity (especially urinary and reproductive tract) |
| hCG pregnancy | increases early in pregnancy, stimulates estrogen, progesterone, and endometrium growth |
| progesterone pregnancy (3) | lipid deposition, breasts, endometrium |
| estrogen pregnancy | lipid synthesis and storage, protein synthesis, ligament flexibility |
| leptin pregnancy | decreased in late pregnancy |
| carbohydrates pregnancy | (1st half): increased insulin production (2nd half): inhibition of glucose-> fat/glycogen (for fetus) |
| fats pregnancy | 1st half: promote accumulation 2nd half: mobilization |
| protein pregnancy | increased protein needed, decreased excretion |
| placenta function (3) | hormone/enzyme production, nutrient/gas exchange, waste removal |
| placenta structure | double lining of cells |
| immunological protection by placenta | barrier to RBCs, bacteria, large proteins |
| maternal/fetal circulation | separate (maternal and umbilical) |
| transfer across placenta depends on (3) | size/charge, solubility, concentration |
| what (nutrient-wise) does not cross placenta? | insulin |
| placenta produces what? | hCS, hCG |
| nutrient utilization order | mom first, fetus second |
| catabolic/anabolic phases of pregnancy | an= 0-20 weeks; cat= >20 weeks |
| miscarriage common causes (4) | chromosome, thyroid, hormone, infections |
| highest risk for miscarriage (3) | underweight, obese, elevated blood lipids |
| variation in fetal growth (3) | energy/nutrient/O2 availability, genetics, IGF-1 |
| fetal origins hypothesis | risk of adult disorders influenced by prenatal exposures (epigenetics) |
| fetal programming | certain levels of energy/nutrients affect metabolism/diseases later in life |
| epigenetics in pregnancy | fetus adapts by modifying function of certain genes |
| epigenetics glucose example | high BG and insulin later in life if low during pregnancy |
| diseases associated with FoAD hypothesis | immune dysfunction, bone mass, Alzheimer's |
| parity | # of previous deliveries |
| factors influencing birth weight | gestation duration, smoking, maternal health, gravida, parity |
| gravida | # of pregnancies |
| dramatic changes in US population having babies (4) | ethnic diversity, twin/triplet, age, percentage obese |
| low weight gain in pregnancy (3) | LBW, decreased development, DM, HTN, CVD |
| excessive weight gain in pregnancy | LBW, insulin resistance, macrosomia |
| how many kcal's per day 1st trimester | 0 |
| how many kcal's per day 2nd trimester | 340 |
| how many kcal's per day 3rd trimester | 452 |
| vegetarian diets/ protein during pregnancy | may need up to 30% higher |
| vegetarian deficiencies pregnancy | B12, D, Ca, Zn, N3 FAs, riboflavin |
| alpha linolenic acid conversion | 9% in women (essential in diet) |
| DHA and fetal development | signal transduction, neurotransmission, neurogenesis (cell membranes) |
| DHA/EPA pregnancy | EPA needed for DHA transport, highest accretion into fetal brain during 3rd trimester |
| seafood and mercury pregnancy | passes through placenta (carnivorous fish) |
| EPA DHA pregnancy research findings | intelligence, vision, CNS function, less preterm delivery |
| folate function | homocysteine to methionine (CH3 donor) |
| folate deficiency pregnancy | abnormal tissue formation (placental rupture, stillbirth, preterm, defects, LBW) |
| neural tube defects | first 3 weeks, 70% prevented consumption of adequate folate |
| vitamin a function | cell differentiation |
| vitamin A deficiency pregnancy | preventable blindness, malformation of lungs/urinary tract/heart |
| vitamin D deficiency pregnancy (5) | preeclampsia, IR, GDM, small for gestational age, hypocalcemia |
| calcium | 250 mg/day transferred to fetus |
| calcium requirements pregnancy | last 1/4 (300 mg/day increase) |
| calcium and lead | if bones demineralize, lead is released (CNS development, CNS development) |
| maternal iron depletion | iron deficiency anemia in infants, postpartum depression |
| iron deficiency anemia during pregnancy (6) | decreased oxygen to fetus, infection, CNS function, preterm delivery, LBW, stillbirth |
| iron absorption | depends on woman's need (higher if need more) |
| iodine pregnancy | thyroid/energy; affects brain development |
| sodium pregnancy | do not restrict during pregnancy |
| caffeine pregnancy | mom: slower metabolism fetus: unable to metabolize |
| caffeine pregnancy recommendations | <200 mg per day (modulation of synaptic efficacy and plasticity) |
| nutrition and depression during pregnancy | folate, B12, Ca, Fe, Se, Zn, N3 FAs |
| phytochemicals pregnancy | need more antioxidants (protect from damage) |
| maternal weight gain | promotoe IOM rate and total weight gain (based on weight); if inappropriate, assess possible cause |
| effect of taste and smell on diet (pregnancy) | meats, gas, cleaning products-> hormonal changes? |
| pica | compulsion to eat non-food substances |
| geophagia | compulsion to eat clay or dirt |
| pagophasia | compulsion to eat ice or freezer frost |
| amylophagia | compulsion to eat cornstarch or laundry starch |
| nausea and vomiting pregnancy | (nausea 7/10, vomiting 4/10) high levels of hormones, iron supplements |
| hyperemesis gravidarum | extreme nausea during pregnancy |
| heartburn pregnancy | progesterone relaxes GI muscles, LES allows contents from stomach into esophagus |
| heartburn pregnancy management | small meals, don't eat before bed |
| herbal remedies and pregnancy | have side effects and rarely tested (do not need to prove they are safe) |
| artificial sweeteners pregnancy | limited research; probably shouldn't eat during pregnancy |
| food safety issues pregnancy | suppressed immunity from progesterone |
| primary concern pathogens pregnancy (3) | Listeria monocytogenes, Salmonella, Taxoplasma gondii |
| Listeria monocytogenes pregnancy | trophoblastic cells trap bacteria; may induce severe fetal infection (stillborn/abortion); grow at refrigerated temperatures |
| Listeria monocytogenes foods pregnancy | deli meats/cold meats, soft cheese, raw milk |
| salmonella sources pregnancy | baby poultry (Easter), raw eggs |
| taxoplasma gondii pregnancy | protozoan that can cause disability, blindness, seizures, death |
| taxoplasma gondii sources pregnancy | cats, raw meats, unclean produce |
| pregnancy and exercise | continue regimens (if safe), start exercising gradually if don't |
| benefits of exercise pregnancy | decreased risk of preeclampsia, GDM, preterm |
| exercise, pregnancy, and brain function | lab animals have demonstrated enhanced cognition, and decreased anxiety like behavior |
| exercise patterns during pregnancy | few pregnant women are meeting exercise guidelines |
| bariatric surgery pregnancy | should wait 2 years after; fat malabsorption; D/B12/Fe/Ca/folate deficiencies possible |
| components of all hypertensive disorders (3) | inflammation, oxidative stress, damage to endothelium of blood vessels |
| factors that increase oxidative stress (6) | high fat/processed meats, trans fats, smoking, visceral fat, inactivity, sugary beverages |
| factors that decrease oxidative stress (4) | colorful fruits, EPA/DHA, vit D, activity |
| chronic hypertension | (before pregnancy/early pregnancy diagnosis), >140 systolic or >90 diastolic |
| hypertension risk factors pregnancy | black, obese, >35, high BP in previous pregnancy |
| risks of HTN pregnancy (4) | preterm, growth retardation, placenta abruption, c section |
| gestational HTN diagnosis | no proteinuria, normal 12 weeks postpartum |
| preeclampsia diagnosis | after 20 weeks, >140 or >90, proteinuria (4% pregnancies, 2% subsequent) |
| preeclampia characterized by | immune system responses to the placenta |
| risk factors for preeclampsia | mother was SGA, deficient in vit D and/or Ca |
| preeclampsia outcomes | maternal acute renal dysfunction, infant growth restriction |
| gestational diabetes | higher incidence with obesity, 50% develop type 2 diabetes later in life |
| risk factors for gestational diabetes (4) | underweight, overweight, obesity, poor diet |
| potential adverse fetal outcomes: GDM | increased insulin production (glucose/FA in cells), risk of DM later, LGA |
| potential adverse maternal outcomes: GDM (3) | preeclampsia, DM later, c-section |
| nutritional management of GDM | exercise, BG control, urinary ketone results (some spillage normal in pregnancy) |
| normal glycemia in pregnancy | spread out kcals, high fiber foods |
| TIDM pregnancy | fetal growth determined 1st half (if not managed preconception) |
| risks to mother multifetal pregnancy (5) | preeclampsia, iron deficiency, GDM, c-section, preterm |
| risks to fetus multifetal pregnancy | death, abnormalities, intraventricular hemorrhage, cerebral palsy |
| HIV pregnancy complications | fat malapsorption, infections |
| HIV pregnancy when transmitted | pregnancy, delivery, breastfeeding |
| eating disorders pregnancy | often diminish during, return after |
| alcohol pregnancy | no safe dose during pregnancy |
| effects of alcohol pregnancy | organ and tissue formation, intellectual development |
| adolescent pregnancies | one of highest in US of all developed countries, risk for inadequate calories/nutrients |
| obesity and adolescent pregnancy | increased rates of overweight/obesity |
| US stats for BF of any duration | 1900: >90%, 1950s-1960s: <30%, steadily increasing now |
| healthy people 2020 targets BF | 80% postpartum, 60% 6 months, 35% 1 year |
| exclusive breastfeeding goals WHO/LLL | 6 months both |
| any breastfeeding goals WHO/LLL | >2 years, >1 year |
| _% of women capable of breastfeeding | 98% |
| _% exclusively breastfed after 6 months | 18% |
| lactogenesis I | milk production, not secreting b/c of prolactin inhibitor |
| lactogenesis II | 2-5 days postpartum, milk comes in |
| Lactogenesis I and II are ___ driven | hormonally; occur whether breastfeeding or not |
| lactogenesis III | 10 days after birth; maintenance of production (removal is control mechanism for supply) *autocrine |
| prolactin | stimulates milk production (suckling, stress, sleep, and sex), inhibits ovulation |
| oxytocin | stimulated by sexual arousal, thinking about nursing, suckling (uterus contractions too) |
| prolactin released from | anterior pituitary |
| oxytocin released from | posterior pituitary |
| Variation in composition breastmilk | during feeding, gestation length, infant age, infection, menses, nutritional status |
| Colostrum vs mature milk | higher protein, lower fat, lower CHO, mononuclear cells, higher Na, K, Cl, vit A |
| Water and breast milk | isotonic with maternal plasma; suspension of water soluble vitamins and proteins |
| Quantity of protein in BM | affected by age of intant, antibiotic effects, anti-inflammation |
| Quality of protein in BM | casein holds in Ca, whey contains enzymes/immunoglobulins |
| Carbohydrates milk | lactose= dominant, poly/oligo, protein-bound CHOs |
| Oligosaccharides in breastmilk | free or bound, stimulate bifidus bacteria |
| Lipid content foremilk vs hindmilk | more fat in hindmilk |
| Lipid composition in BM | types of FA varies with diet, but content doesn’t |
| Trans fatty acids and breastmilk | higher insulin resistance later in life for infant |
| BM consumption and cholesterol | high BM consumption related to low blood cholesterol later in life |
| Fat soluble vitamins BM | vit A high in colostrum, vitamin E adequate for full-term infants but not preterm, vit D may be inadequate |
| B12 and folic acid BM | malapsorption disorders/vegans low in B12, folate adequate in BM |
| Minerals in BM | low concentration, but high bioavailability |
| Flavor exposures in utero | volatile compounds passed through amniotic fluid |
| Flavor exposures in vivo | exposure to different flavors, profound effects on appetite regulation/food preference/food intake |
| Milk production and breast size | does not determine production tissue, but does limit storage |
| Feeding frequency | not related to milk production; responds to degree of emptying |
| Feedback inhibitor of lactation | whey protein that inhibits milk secretion |
| Maternal benefits of breastfeeding | oxytocin, lower breast/ovarian cancer, psychological benefits, economical |
| BF and CVD | (maternal) >13 months highest correlation |
| Nutritional benefits BF | balance of nutrients |
| Breastfeeding microbiota | enteromammary pathway transfers microorganisms from maternal gut via BM |
| Secretory immunoglobulins BM | decreased binding of microorganisms w/ enterocytes, limiting antigens that cross mucosal barrier |
| Bifidus factor | supports Lactobacillus bifidus (enhances phagocytosis of antigens) |
| Additional immunological components BM | antimicrobial, maturation of GI tract |
| Acute illness and BF | diarrhea, GI, ear infections, coughing, vomiting, meningitis |
| Chronic illness and BF | allergies, DM, obesity, many more |
| Childhood overweight and BF | lowers risk of overweight and obesity (metabolic programming, self-regulation) |
| Cognitive benefits BF | higher IQ with duration of BF (emotional behaviors, PUFAs, or IGF-1) |
| Weight loss during lactation | prolactin promotes use of FAs from stores and diet |
| Vitamins and minerals BF | well nourished women don’t need supplement (monitor D, C, E, A, Ca, folate, Fe, thiamin, Zinc) |
| Iron needs BF | less than NPNL because lactating women aren’t menstruating |
| Vegetarian diet BF | multivitamin/mineral supplement (B12 may be low in milk even w/out deficiency symptoms) |
| Caffeine BF | may accumulate and interfere with sleep (monitor reaction) |
| Infant feeding frequency | 1.5-3 hours, should consume foremilk and hindmilk |
| Oral contraceptives and lactation | may reduce milk volume (estrogen), alternative contraception recommended |
| Herbal supplements and BF | not regulated, but some affect milk flow or other symptoms |
| Alcohol BF | wait 2-3 hours, decreases milk yield and ejection |
| Smoking and BF | BM 1.5-3.0x nicotine in BM |
| Environmental exposures and BF | accumulates and may harm infant (benefits of BM still outweigh this) |
| Neonatal jaundice | bilirubin (too much can cause neurological damage) |
| Infant allergies | do not avoid food allergens |
| When should solid foods be introduced? | 6 months |
| Infant colic | garlic, onions, other produce; avoid only if causes problems |
Created by:
melaniebeale
Popular Medical sets