FSHN 459- Unit 1 Word Scramble
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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
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