Nutrition 101 Exam 3 Review Session

TAs: Helen Corless

and Delma Betancourt

Chapter 15Life Cycle Nutrition:

Pregnancy and Lactation

Which of the following is not likely to affect male fertility?

a) Alcoholb) Vitamin Cc) Vitamin Ed) Zince) Iron

Which of the following is not likely to affect male fertility?

a) Alcoholb) Vitamin Cc) Vitamin Ed) Zince) Iron

Heavy alcohol use can lower sperm production, but light to moderate intake does not appear to have an effect

Vitamin C&E are antioxidants, and men with diets rich in antioxidant nutrients have higher sperm counts and motility

A deficiency of zinc can impair male fertility but this can be reversed over time with supplementation.

Overweight and obesity also can impair fertility, as obese men have low sperm counts and hormonal changes that reduce fertility

A fertilized ovum is called a…

a) Blastocyst

b) Zygote

c) Embryo

d) Fetus

A fertilized ovum is called a…

a) Blastocyst

b) Zygote

c) Embryo

d) Fetus

Egg + Sperm = Zygote

A blastocyst is a fertilized ovum by the time it is ready to implant

Embryo: 2-8 weeksFetus: week 9-delivery

Name the three structures that develop during pregnancy to help protect and nourish the growing fetus

Placenta: metabolically active organ embedded in the uterine wall; performs the respiratory, absorptive, and excretory functions that the fetus’ lungs, digestive system, and kidneys will provide after birth

Umbilical cord: a ropelike structure containing fetal blood vessels that extends through the fetus’s belly button-to-be to the placenta

Amniotic sac: a fluid-filled balloon-like structure that houses the developing fetus

True or False?

Maternal and fetal blood mingles in the placental villi, allowing oxygen, nutrients, and waste products to be exchanged.

FALSE!

Organs start developing during which of the following stages of fetal development?

a) Zygotic stage

b) Embryonic Stage

c) Fetal Stage

Organs start developing during which of the following stages of fetal development?

a) Zygotic stage

b) Embryonic Stage

c) Fetal Stage

By the end of 8 weeks, the embryo has a complete central nervous system, a beating heart, a digestive system, well-defined fingers and toes and the beginnings of facial features

Which of the following best characterizes the fetal stage?

a) It is a critical period for major organs, such as the central nervous system

b) It is a period of rapid cell division, in which cells differentiate into fetus and placenta

c) It is a period of rapid growth, in which the fetus grows significantly larger and heavier

Which of the following best characterizes the fetal stage?

a) It is a critical period for major organs, such as the central nervous system

b) It is a period of rapid cell division, in which cells differentiate into fetus and placenta

c) It is a period of rapid growth, in which the fetus grows significantly larger and heavier

What is a “critical period”?

• Times of intense development and rapid cell division

• Window of opportunity: certain cellular activities can only occur during these times

• Organ and tissue development most vulnerable to adverse influences

• Occur in first trimester• Each organ has its own critical period

Name the two most common types of neural tube defects and explain the difference between them.

Anencephaly: – Failure of the upper end of the neural tube to

close– Brain either missing or fails to develop

Spina bifida: – Incomplete closure of spinal cord and its bony

encasement – Meninges membranes covering the spinal cord

often protrude as a sac, which can rupture and lead to meningitis

– Varying degrees of paralysis depending on damage to spinal cord

Which nutrient has been shown to prevent neural tube defects?

FOLATE!

• Prevents & reduces severity of neural tube defects

• Folate status important prior to pregnancy and during 1st trimester

Which of the following has been proven to cause neural tube defects?

a) Maternal diabetes

b) Maternal obesity

c) Anti-seizure medications

d) Mutations in enzymes

e) Folate deficiency

Which of the following has been proven to cause neural tube defects?

a) Maternal diabetes

b) Maternal obesity

c) Anti-seizure medications

d) Mutations in enzymes

e) Folate deficiency

TRICK QUESTION:

We don’t know what causes neural tube defects!

*It is important to realize that folate deficiency does not necessarily ‘cause’ neural tube defects.

What is the DRI for folate during pregnancy?

a) 200 g/day

b) 400 g/day

c) 600 g/day

d) 800 g/day

What is the DRI for folate during pregnancy?

a) 200 g/day

b) 400 g/day

c) 600 g/day

d) 800 g/day

DRI for folate:

Non-pregnant women: 400 g/day

Pregnant women: 600 g/day

Infants are considered full term if they are born between ____ weeks gestation.

a) 30-34b) 34-38c) 38-42d) 42-46

Infants are considered full term if they are born between ____ weeks gestation.

a) 30-34b) 34-38c) 38-42d) 42-46

If a baby is born at 38 weeks and weighs 4lbs, he/she would be considered:

a) Pretermb) Small for gestational agec) Within normal range

If a baby is born at 38 weeks and weighs 4lbs, he/she would be considered:

a) Pretermb) Small for gestational agec) Within normal range

Remember…

Preterm infants may be small, but if their size and weight is appropriate for their gestational age, they have potential for catch-up growth given adequate nutritional support

Remember…Infants who are small for gestational age (SGA) have suffered growth failure in utero and do not catch up as well

It’s all about whether the infant’s weight is appropriate for their gestational age

What is the name of the theory which proposes that maternal nutrition status may change gene expression in the fetus in a way that sets the stage for chronic diseases later in life?

Fetal programming!

…can anyone give me an example?

How much weight should a healthy-weight woman carrying a single fetus gain during pregnancy?

a) 5-15 pounds

b) 15-25 pounds

c) 25-35 pounds

d) 35-45 pounds

How much weight should a healthy-weight woman carrying a single fetus gain during pregnancy?

a) 5-15 pounds

b) 15-25 pounds

c) 25-35 pounds

d) 35-45 pounds

What is the recommendation for overweight pregnant women?

a) They should try to lose 5-10lbs through diet alone

b) They should try to lose 5-10lbs through a combination of diet and exercise

c) They should gain less weight than a normal weight pregnant woman: about 10-15lbs

d) They should gain less weight than a normal weight pregnant woman: about 15-25lbs

What is the recommendation for overweight pregnant women?

a) They should try to lose 5-10lbs through diet alone

b) They should try to lose 5-10lbs through a combination of diet and exercise

c) They should gain less weight than a normal weight pregnant woman: about 10-15lbs

d) They should gain less weight than a normal weight pregnant woman: about 15-25lbs

Dieting while pregnant is never a good idea! A healthy weight should try to be achieved prior to pregnancy.

Overweight women:15-25lbsHealthy weight: 25-35lbsUnderweight: 28-40lbs

Which of the following is true of exercise and pregnancy?

a) Pregnant women should exercise very little and rest as much as possible

b) Pregnant women should get as much exercise as possible, even if they did not exercise prior to getting pregnant

c) Pregnant women can continue an exercise regimen that they had prior to getting pregnant with some adjustments

Which of the following is true of exercise and pregnancy?

a) Pregnant women should exercise very little and rest as much as possible

b) Pregnant women should get as much exercise as possible, even if they did not exercise prior to getting pregnant

c) Pregnant women can continue an exercise regimen that they had prior to getting pregnant with some adjustments

True or false:

Pregnant women have little to no increased caloric need during the first trimester.

TRUE!

Caloric needs during pregnancy• First trimester: No or little extra• Second trimester: +340 kcals/day• Third trimester: +450 kcals/day

Increase in BMR occurs in second and third trimester

Why is adequate carbohydrate intake during pregnancy so important?

*Ample carbohydrate is necessary to fuel fetal brain

*Also, remember carbohydrate’s protein-sparing action -> proteins are vital to the growth and development of fetus

Which of the following nutrients should a woman avoid in supplement form during pregnancy?

a) Vitamin A b) Ironc) Vitamin B12 d) Folate

Which of the following nutrients should a woman avoid in supplement form during pregnancy?

a) Vitamin A b) Ironc) Vitamin B12 d) Folate

Pregnant women have increased needs for all but which of the following nutrients?

a) Vitamin B12 b) Calciumc) Zinc d) Iron

Pregnant women have increased needs for all but which of the following nutrients?

a) Vitamin B12 b) Calciumc) Zinc d) Iron

The AI levels for calcium and vitamin D do not increase during pregnancy; however it is important for pregnant women to get sufficient amounts of these nutrients in their diet

Vitamin B12: 2.4->2.6 g/dayIron: 18->27 mg/dayZinc: 8->11 mg/dayFolate: 400->600 g/day

What are some nutrient deficiencies that vegan and vegetarian pregnant women are particularly at risk for?

Iron Vitamin B12Vitamin DCalcium

What are some of the benefits of breastfeeding for infants?

• Immune protection • Fewer allergies and intolerances• Fewer respiratory, GI, and ear infections• Cognitive benefits • May protect against some chronic diseases later

in life, such as obesity, heart disease, and diabetes

For Infants:

What are some of the benefits of breastfeeding for mothers?

• Reduced risk of postpartum blood loss• Possible reduced risk of breast and ovarian

cancers • Amenorrhea and decreased fertility• Promotes mother-infant bond• Weight loss• Convenience• Economic benefits

For Mothers:

List the two hormones involved in human lactation and describe their functions

Prolactin: responsible for the production of milk; released in response to sucking stimulus

Oxytocin: responsible for let-down reflex

What is colostrum?

Colostrum:

• First milk

• Thick, yellowish, small amounts

• Rich in immune factors and protein–Important nutrition for the baby!

• About 20 kcal/oz

• Bifidus flora

Describe the key nutrient requirements for lactating women

Lactating women:

– Increased caloric need of 500kcal/day

• Helps with postpartum weight loss

– Increased need for carbohydrate

• Glucose used to make lactose

• Proteins and fats about the same

– Increased fluid needs

True or False?

It is safe for a pregnant woman to consume up to 1 alcoholic drink per day

FALSE!

Even one drink a day threatens neurological development and behaviors of her infant

Chapter 16Life Cycle Nutrition:

Infancy, Childhood, and Adolescence

What are some factors that may influence a child’s growth pattern

– Gestational age

– Birth weight

– Parental stature

– Nutritional status

The most rapid growth occurs during…

a) Infancy

b) Childhood

c) Adolescence

d) Adulthood

The most rapid growth occurs during…

a) Infancy

b) Childhood

c) Adolescence

d) Adulthood

Birth weight doubles in the first 4-6 months and triples in the first year of life. It takes 5 more years to double the weight seen at 1 year. Growth is never again as rapid as it is during this time.

Energy and protein needs are highest during infancy (proportionately i.e. per kg body weight) of any life cycle stage

Infants require about 100 kcal/kg of body weight per day, whereas most adults need fewer than 40

Which of the following nutrients provides most of the energy in breastmilk and formula to support the infant’s rapid growth?

a) Carbohydrateb) Proteinc) Fat

Which of the following nutrients provides most of the energy in breastmilk and formula to support the infant’s rapid growth?

a) Carbohydrateb) Proteinc) Fat

Carbohydrate is important for brain development - the infant’s brain uses relatively more glucose than adults (because their brain is relatively bigger!)

Fat provides most of energy that supports rapid growth (high energy needs, small stomach!)

Protein is essential to growth, as it is the basic building material of the body’s tissues; highest needs of any life cycle

Nutrients of special interest for infants:

Vitamins: K, D, B12

Minerals: iron, zinc, fluoride

Water

When can parents begin to introduce solid foods

a) 3-5 months

b) 4-6 months

c) Only after 6 months

d) It doesn’t matter

When can parents begin to introduce solid foods

a) 3-5 months

b) 4-6 months

c) Only after 6 months

d) It doesn’t matter

The AAP supports exclusive breastfeeding for 6 months but recognizes that infants are often developmentally ready to accept complementary foods between

4 and 6 months of age

The pincer grasp generally develops when the infant is how old?

a) 4-6 months

b) 6-8 months

c) 8-10 months

d) 10-12 months

The pincer grasp generally develops when the infant is how old?

a) 4-6 months

b) 6-8 months

c) 8-10 months

d) 10-12 months

The loss of the extrusion reflex usually occurs when the infant is how old?

a) 4-6 months

b) 6-8 months

c) 8-10 months

d) 10-12 months

The loss of the extrusion reflex usually occurs when the infant is how old?

a) 4-6 months

b) 6-8 months

c) 8-10 months

d) 10-12 months

The ability to stand alone without support generally develops when the infant is how old?

a) 4-6 months

b) 6-8 months

c) 8-10 months

d) 10-12 months

The ability to stand alone without support generally develops when the infant is how old?

a) 4-6 months

b) 6-8 months

c) 8-10 months

d) 10-12 months

The ability to sit with little to no support generally emerges when the infant is how old?

a) 4-6 months

b) 6-8 months

c) 8-10 months

d) 10-12 months

The ability to sit with little to no support generally emerges when the infant is how old?

a) 4-6 months

b) 6-8 months

c) 8-10 months

d) 10-12 months

Which of the following is an appropriate solid food to introduce in the first year of life?

a) Honey

b) Cow’s milk

c) Chopped meat

d) Hot dogs

Which of the following is an appropriate solid food to introduce in the first year of life?

a) Honey

b) Cow’s milk

c) Chopped meat

d) Hot dogs

Macronutrient needs during childhood

Fat: Higher proportion of total energy intake for first three years of life (30-40% vs. 25-35%)

Protein: Needs increase after first three years of life, but decrease proportionately

Carb: After 1 yr same as adults

Macronutrient needs during childhood

Fat: Higher proportion of total energy intake for first three years of life (30-40% vs. 25-35%)

Protein: Needs increase after first three years of life, but decrease proportionately

Carb: After 1 yr same as adults