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352 Cards in this Set
- Front
- Back
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chemical substances in food that are used by the body for growth nd health
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nutrients
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substances required for growth and health that cannot be produced or produced in sufficient amount bye hte body/ they must be obtained from the diet
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essential nutrients
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nutrients required for growth and health that can be preduced by the body from other components of the diet
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nonessential nutrients
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access at all times to a sufficient supply of safe
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food security
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limited or uncertain availability of safe, nutritious foods, or the ability to acquire them in socially acceptable ways
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food insecurity
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a unit of measure of the amount of energy supplied by food.
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calorie; also know as kilocalorie , kcal, large calorie
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scientifically agreed upon standards for daily intakes of nutrients from the diet developed for use on nutrition lables
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daily values
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the replacement of thiamin, niacin, riboflavin, and iron that were lost when grains are refined
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enrichment
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the addition of one or more vitamins/minerals to a food product
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fortification
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the "building blocks" of protein. Unlike carbohydrates and fats, ____ contain nitrogen
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Amino acids
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components of fat that are a required part of the diet (ie. Linoleic and alpha-linolenic). Both contain unsaturated fatty acids
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essential fatty acids
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a group of physiologically active substances derived from the EFA's. They are present in many tissues and perform such functions as the constriction or dilation of blood vessels and stimulation of smooth muscles and the uterus
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protaglandins
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fat in which adjacent carbons in the fatty acids components are linked by single bonds only
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saturated fatty acids
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fats in which adjacent carbons in one or more fatty acids are linked b y one or more double bonds
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unsaturated fatty acids
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fatty acids that have unusual shapes resulting from the hydrogentation of polyunsaturated fatty aicds. ____ also occur naturally in small amounts in foods such as dairy products and beef
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trans fat
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a fat soluble, colorless liquid primarily found in animals. is used by the body to form hormones such as testosterone and estrogen and is a component of cell membranes
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cholesterol
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chemical substances that prevent or repair damage to cells caused by exposure to oxidizing
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antioxidants
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chemical substances in plants, some of which affect body processes in human that may benefit health
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phytochemical
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the science of gene-nutrient interactions
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nutrigenomics
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malnutrition that result directly from inadequate or excessive dietary intake of energy or nutrients
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primary malnutrition
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malnutrition that results from a condition (e.g. disease, surgical procedure, medication use) rather than primarily from dietary intake
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secondary malnutrition
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foods that contain relatively high amounts of nutrients compared to their caloric value
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nutrient dense foods
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any product intended to supplement the diet, including vitamin/mineral, proteins, enzymes, amino acids, fish oils, fatty acids, hormones and hormone precursor, and herbs and othe rplant extracts. In the US these must be labeled as __________
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dietary supplement
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generally taken to mean food, fortified foods, and enhanced food products that may have helath benefits beyond the effects of essential nutrients they contain
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functional foods
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strains of lactobacillus and bifidobacteria that have beneficial effects on the body also called friendly bacteria
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probiotics
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certain fiberlike forms of indigestible carbohydrates that support the growth of benefical bacteria in the lower intestine ; named intestinal fertilizer
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prebiotics
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the chemical changes that take place in the body; the conversion of glucose to energy or body fat is an example of a ______ process
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metabolism
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an individual who has acquired knowledge
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rd
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an individual who has acquired knowledge and skills necessary to pass a national registration examination and who participates in continuing professional education
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Registered dietitian
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the science of measuring the human body and its parts
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anthropometry
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assessment of dietary or nutrition status at intermittent times with the aim of detecting changes in the dietary or nutritional status of a population
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nutrition monitoring
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continuous assessment of nutritional status for the purpose od detecting changes in trend or distribution in order to intiate corrective measures
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nutrition surveillance
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actual production of children. The word best applies to specific vital statistic rates, but is commonly taken to mean the ability to bear children
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fertility
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commonly used to mean biological inability to bear children
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infertility
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reduced level of fertility characterized by unusually long time to conception ( over 12 months) or repeated early pregnancy losses
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sub fertility
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biological ability to bear children
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fecundity
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biological inability to bear children after 1 year of unprotected intercourse
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infecundity
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generawlly defined as the loss of a conceptus in the first 20 weeks of prengnacy, also called spontaneous abortion
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miscarriage
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a system of ductless glands such as the thyroid, adrenal glands, ovaries and testes , that produces secretions that affect body functions
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endocrine
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the developing organism from conception through 8 weeks
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embryo
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the developing organism from 8 weeks after conception to the moment of birth
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fetus
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an approximately 4 week interval in which hormones direct a buildup of blood and nutrient stores within the wall of the uterus and ovum maturation and release. If the ovum is fertilized by a sperm, the stored blood and nutrients are used to support the growht of the fertilized ovum. if fertilization does not occur, they are released from the uterine wall over a period of 3 to 7 days. The period of blood flow is called the menses or the ______.
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menstrual cycle
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a tissue about 12 mm in diameter formed from the follicle that contained the ovum prior to its release. It produces estrogen and progesterone. The "yellow body" derivation comes form the accumulation of lipid precursors of these hormones in the ______
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corpus luteum ( corpus = body; luteum = yellow)
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a group of physiologically active substances derived from essential fatty acids. They are present in many tissues and perform such functions as the contriction or dialation of blood vessels, and stimulation of smooth msucles and the uterus
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prostaglandins
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a general term applied to infections of the cervis, uterus, fallopiantubes, or ovaries. occurs predominately in youung womenand is generally caused by infection with a sexually transmitted disease such as gonorrhea or chlamydia, or with intrauterine device (IUD) use
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androgens pelvis inflammatory disease
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a protein secreated by fat cells that by binding to specific receptor sites in the hypothalamus, decreases appetite, increases energy expenditure, and stimulate gonadotropin secretion. ____ levels are elevated by high and reduced by low levels of body fat
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leptin
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an index that correlates with total body fat content or percent body fat, and is an acceptable measure of adiposity or body fatness in children and adults. It is calculated by divind weight in Kg by the square of heigh in meters
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Body mass index ; 1 inch = .0254 meters , lbs/2.2 = kg
BMI= Kg/ meters^2 |
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absence of menstrual cycle
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amenorrhea
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menstrual cycles in which ovulation doesn't occur
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anovulatory cycle
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a condition caused by ingestion of high amoutns of carotenoids or carotenes from plant foods in which the skin turns yellowish orange
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carotenemia
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spina bifida and other malformaiton of the neural tube, ____ results from incomplete formation of the _______ during the first month after conception
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Neural tube defects (NTD)
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around the time of conception, generally defined as the month before and the month after conception
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periconcceptual period
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a condition occuring among women of reproductive age that includes a group of physical, psychological and behavior symptoms with onset in the luteal phase and subsiding with menstrual bleeding, Also called PMDD
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premenstrual syndrome ( premenstrual = the period of time preceding menstrual bleed, syndrome - a constellation of symptoms)
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painful menstration due to adbominal cramps, back pain, head ache, and/or other symptoms
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dysmenorrhea
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a protein that binds with the sex hormones testosterone and estrogen. Also called steroid hormone binding globulin, because testosterone and estrogen are produced from choldesterol and are thus considered to be steriod hormones. These hormones are inactive when bound to ____, but are available for use when needed. Low levels of _____ are related to increased availablilty of testosterone and estrogen in the body
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Sex hormone binding globulin (SHBG)
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a condition in which cells "resist" the action of insulin in facillitating the passage of glucose into cells
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insulin resistance
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cessation of menstruation related to changes in hypothalamic signals that maintain the secretion of hormones required of ovulation, Changes in hypothalamic signals appear to be triggered by an energy deficit. Also called functional amenorrhea and weight-related amenorrhea
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hypothalamic amenorrhea
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a disorder characterized by extreme underweight, malnutrition, amenorrhea, low bone density, irrational fear of weight gain, restricted food intake, hyperactivity and disturbances in body image
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anorexia nervosa ( anorexia = poor appetite) , nervose = mental disorer )
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a disorder characterized by repeated bouts of uncontrolled, rapid ingestion of large quanitities of food (binge eating) followed by self-induced vomiting, lacative or diuretic use, fasting or vigorous exercise in order to prevent weight gain. binge eating is often followed by feelings of disgust and guilt. MEnstrual cycle abnormalities ma accompany this disorder
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bulimia nervosa
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exposures that produce malformations in embryos or fetuses
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teratogenic
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a structural, functional, or metabolic abnormality present at birth. Also called _____ anomalies. These may be caused by environmental or genetic factors, or by a combination of the two. Structural ____ are generally regerred to as a _____ ,malformation and metabolic abnormailites as inborn errors of metabolism
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congenital abnormalities
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a condition in females characterized by insulin resistance, high blood insulin and testosterone levels, obesity, polycystic ovaries, menstrual dysfunction, amenorrhea, infertility, hirsutism (Excess of body hair) and acne
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Polycystic ovary syndrome (PCOS)
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a measure of the extent to which blood glucose levels are raised by a specific amount of carbohydrate containing food compared to the same amount of glucose or white bread
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Glycemic index
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an inherited error in phenylalanine metabolism most commonly caused by a deficiency of phenylalanine hydroxylase, which converts the essential amino acid phenylalanine to the non essential amino acid tyrosine . Also called hyperphenylalanine
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Phenylketonuria (PKU)
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an auto immune disease that causes malabsorption due to an inherited sensitivity to the gliadin portion of gluten in wheat, rye, and barley. It is often responsible for iron, folate, zinc, and other deficiencies. Also called ___ sprue and nontropical sprue
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celiac disease
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there are 3 major types of _____; all types are characterized by abnoramally high blood glucose levels or fasting levels of 126 mg/dl or higher. people with ______ are considered to be "carbohydrate intolerant" because carbohydrate consumption tends to raise blood glucose levels
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diabetes
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a disease characterized by high blood glucose levels resulting from destruction of the insulin-producing cells of the pancrease. This type of diabetes was called juvenile-onset diabetes and insulin-dependent diabetes in the past and its offical name is ______
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type 1 diabetes mellitus
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a disease characterized by high blood glucose levels due to the body's inability to use insulin normally, or to produce enough insulin.This type was called adult onset diabetes and non-insulin dependent diabetes in the past, its offical name is ______
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type 2 diabetes mellitus
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carbohydrate intolerance with onset or first recognition in pregnancy
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gestiational diabetes
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a constellation of metabolic abnormalities that increase the risk of type 2 diabetes, heart disease and other disorders. Insulin resistance, adbominal obesity, high blood pressure and triglyceride levels, low levels of HDL cholesterol and imapried glucose tolerance characerize it. Also called Syndrome X and insulin-resistance syndrome
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Metabolic syndrome
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The world health organization developed a standard definition of ______ to be used by all countries when assessing an infant's status at birth. By this definition a ______ is the outcome of a delivery when a completely expelled or extracted fetus breathes or shows any sign of life such as beating of the heart, pulsation of the umbilical cord, or definate movement of voluntary muscles, whether or not the cord has been cut of the placenta is still attached
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Liveborn infant
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a disk shaped organ of nutrient and gas interchange between mother and fetus. At term, the ______ weight about 15% of the weight of the fetus
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placenta
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swelling (usually of the legs and feet, but can also extend throughout the body) due to an accumulation of extracellular fuild
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edema
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hormones such as progesterone, estrogen, and testosterone produced primarily from cholesterol
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steroid hormones
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amino acids such as alanine and glutamate that can be converted to glucose
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glucogenic amino acids
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metabolic by-products of the rbeakdown of fatty acids in energy formation. B-hydroxybutyric acid, acetoacetic acid, and acetone are the major ketones or "ketone bodies"
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ketones
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the fuild contained in the amniotic sac that surrounds the fetus in the uterus
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amniotic fluid
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increase in an organism's size through cell multiplication (hyperplasia) and enlargement of cell size (hypertrophy)
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growth
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progression of the phsycial and mental capabilities of an organism through growth and differentitation of organs and tissues and integration of functions
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development
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cellular acquisition of one r more characteristics of functions different from that of the original cells
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differentiation
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preprogrammed time periods during embryonic and fetal development when specific cells, organs , and tissues are formed and integrated or ffunctional levels established. also called sensitive periods
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critical periods
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newborn weight is less than or equal to 10th percentile for gestioanl age. also called small for date (SFD)
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small for gestional age (SGA)
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newborn weight is less than or equal to the 10th percentile of weight for gestational age; length and head circumference are normal also called asymmetrical SGA
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dSGA - disproportionately small for gestational age
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new born weight, length, and head circumference are less than or equal to the 10th percentile for gestational age. Also called symmetrical SGA
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pSGA - proportionately small for gestational age
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weight , length, and head circumference are between the 10th and 90th th percentiles for gestational age
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AGA - appropriate for gestational age
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weight for gestation age exceeds the 90th percentile for gestational age ; also defined as birth weight greater than 4500 g or greater than or equal to 10 lbs and referred to as excessively sized for gestational age or macrosomic
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LGA - large for gestational age
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a group of disorders characterized by impaired muscle activity and coordination present at birth or developed during early childhood
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cerebral palsy
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the theory that exposures to adverse nutritional and other conditions during critical or sensitive periods of growth and development can permanently affect body structures and functions. Such hanges may predispose individuals to cardiovascular diseases, type 2 diabetes, hypertension , and other disorders later in life. Also called metabolic programming and the Barker Hypothesis
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Fetal origins hypothesis
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the process by which exposure of the fetus to certain levels of evergy and nturients modify the function of genes in way that affect metabolism and the development of diseases later in life
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nutrition programming
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number of pregnancies a woman has experienced
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gravida
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the number of previous deliveries experienced by a woman
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parity
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no previous deliveries
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nulliparous
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one previous delivery
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primiparous
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two or more previous deliveries
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multiparous
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Women who have delivered infants are considered to be _____
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parous
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a pregnancy specific condition that usually occurs after 20 weeks of pregnancy but may occur earlier. it is characterized by increase blood pressure and protein in the urine and is associated with decreased blood flow to maternal organs and through the placenta
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preeclampsia
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a condition often marked by low hemoglobin levels. it is characterized by the sign of iron deficiencies plus paleness, exhaustion, and a rapid heart rate
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iron-deficiency anemia
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an eating disorder characterized by the compulsion to eat substances that are not food
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pica
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compulsive consumption of clay or dirt
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geophagia
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a food borne bacterial infection that can lead to preterm delivery and still birth in pregnant women. _____ is commonly associated with ingesiton of soft cheeses, unpasteurized milk, ready to eat deli meats and hot dogs
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L. monocytogenes (listeria)
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a parasitic infection that can impair fetal brain development. The source of the infection is often hands contamination with soil or the contents of a cat litter box; or raw or partially cooked meats.
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T. Gondii (tomoplasmosis)
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What are the principles of human nutrition? (10)
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1. food is a basic need of humans
2. foods provide energy(calories), nutrients, and other substances needed for growth and health 3. health problems related to nutrition originate within cells 4. poor nutrition can result from both inadequate and excessive levels of nutrient intake 5. humans have adaptive mechanisms for managing fluctuations in food intake 6. malnutrition can result from poor diets and from disease states, genetic factors, or combinations of these causes 7. some groups of people are at higher risk of becoming inadequately nourished than others 8. poor nutrition can influence the development of certain chronic diseases 9. adequacy, variety, and balance are key characteristics of a healthy diet 10. there are no "good" or "bad" foods |
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What are the 6 categories of nutrients?
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1. carbohydrates
2. proteins 3. fats (lipids) 4. vitamins 5. minerals 6. water |
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chemical substances in foods that consist of a single sugar molecules or multiples of sugar molecules in various forms. Sugar, fruit, starchy vegetables, and whole grain products are good dietary sources
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carbohydrates
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chemical substances in foods that are made up on chains of amino acids. Animal products and dried beans are examples of _____
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proteins
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components of food that are soluble in fat but not in water. They are more properly reffered to as lipids. Most are compoased of glycerol attached to three fatty acids. Oil, butter, sausage and avacado are examples of rich dietary sources
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fats/ lipids
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thirteen specific chemical substances that perform specific functions in the body. are present in many foods and are essential components of the diet. Vegetables fruits and grains are good dietary sources
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vitamins
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in the context of nutrition, ____ consist of 15 elements found in foods that perform particular functions in the body. Milk, dark leafy vegetables, and meat are good dietary sources
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minerals
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an essential component of the diet provided by food and fluids
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water
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What are the essential nutrients? (6)
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carbohydrates, certain amino acids, essential fatty acids( linoleic and alpha-linolenic acid) , vitamins, minerals, water
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What are the nonessential nutrients? (3)
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cholesterol, creatine, and glucose
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What are the factors that impact nutrient needs? (9)
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1. age
2. body size 3. gender 4. genetic traits 5. growht 6. illness 7. lifestyle habits 8. medications 9. pregnancy/lactation |
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this is the general term used for the nutrient intake standards for healthy people
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Dietary reference intakes (DRIs)
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these are levels of essential nutrient intake judged to be adequate to meet the known nutrient needs of practially all healthy persons while decreasing the risk of certain chronic diseases
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Recommended dietary allowances (RDAs)
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"tentative" RDAs. are based on less conclusive scientific information than are the RDAs
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AI - Adequate intakes
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nutrient intake values that are estimated to meet the requirements of halfh the healthy indiviudals in a group. are used to assess adequacy of intakes of popluation groups
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EARs - estiamted average requirements
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upper limits of nutrient intake compatible with health. do nto reflect desired levels of intake . rather they represent total, daily levels of nturient intake from food, fortified foods, and supplements that should not be exceeded
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Tolerable upper intake levels - ULs
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What are the simple carbohydrates?
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monosaccharides and disaccharides
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What are the complex carbohydrates?
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starches, glycogen, fiber
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AMDR
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acceptable macronutrient distribution range
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What is the AMDR for Carbohydrates?
for added sugars? |
CHO - 45-65% of calories
added sugars - less than 25% of calories |
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Carbohydrates and protein provide _____calories per gram of energy
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4kcal/gram
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Lipids(fats) provide ____ calories per gram.
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9 kcal/gram
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What is the AMDR for fiber/day for females
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21-35g fiber/day
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What is the AMDR for fiber/day for males?
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30-38 g fiber/day
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____ provide all essential amino acids ; these include a balanced assortment of all of the essential amino acids
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high quality proteins
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What are examples of high quality?
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milk, cheese, meat, eggs and other animal products is considered high quality
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Combinations of plant foods such as grains or seeds with dried beans, yield high-quality proteins ; the amino acids found in these individual foods _____ each other, and are known as _______
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complementary proteins
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The AMDR for protein is ________
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10-35% of calories
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____ are solid at room temp
____ are liquid at room temp |
fats = solid
oils = liquid |
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glycerol with 3 fatty acids attached
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triglycerides
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What is the desirable ratio of omega 6 to omega 3?
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4(or less) to 1
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Linoleic acid is known as ____
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omega 6
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alpha-linolenic acid is known as ____
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omega 3
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saturated fatty acids have _____ bonds
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no double bonds
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monounsaturated have ____ bonds
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one double bond
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polyunsaturated have ___ bonds
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2 or more double bonds
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____ adds hydrogen to unsaturated fatty acids; it changes the structure of fatty acids from cis to trans
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hydrogenation
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_______ and ______ have trans fats naturally
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fatty meats and whole milk
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a fat soluble clear liquid found in animal products; a precursor of estrogen, testosterone, and vitamin D (meaning it converts them to their active form) ; only found in animal products
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cholesterol ; the body makes about 1/3 cholesterol
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What are the leading sources of dietary cholesterol?
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egg yolks, meat, milk, and milk products and fats such as butter
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The health promoting intake of cholesterol is ____
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less than 200 mg/ day
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What are the "unhealthful" fats?
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the fats that raise LDL - cholesterol ; trans, saturated fats and cholesterol
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What are the "healthful" fats?
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those that raise the HDL-cholesterol; monounsaturated , polyunsaturated, linolenic (omega 3), EPA and DHA
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What is the AMDR of Fats?
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20-35% of calories from fat, limiting the unhealthful fats as much as possible ; less than 10% of saturated and less than 1% or non of trans fat
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What is the recomended intake for Linoleic acid?
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17 g/day for men
12g/day for women |
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What is the recomended intake for alpha linolenic acid?
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1.6 g/day for men
1.1g/day for women |
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What are the water-soluble vitamins? (10)
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thiamin, riboflavin, niacin, pantothenic acid, choline, B6, B12, folate, biotin, and viamin C
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What are the Fat Soluble vitamins?(4)
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Vitamin A (retinol, beta-carotene)
Vitamin D (1,25 dihydroxycholecalciferol) Vitamin E ( alpha-tocoperol) Vitamin K |
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required for synthesis of blood clotting proteins
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Vitamin K
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required for calcium and phosphorous metabolism in the intestine and bone, and for their utilization in bone and teeth formation, nerve and muscle activity .
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Vitamin D
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required for normal appetite and for the growth and maintenance of nere and muscle tissues
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Thiamin, B1
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required for normal development of memory and attention processes during early life
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choline
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coenzyme in the conversion of tryptophan to niacin
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Vitamin B6
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needed for vision in dim light
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Vitamin A
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required for collagen synthesis; acts as an antioxidant ; protects LDL cholesterol, eye tissues
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Vitamin C
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required for normal red blood cell development; Def: neural tube defects
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Folate
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Consequences of deficiency are rickets, osteomalacia, osteoporosis
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calcium
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transports oxygen as a component of hemoglobin in red blood cells
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iron
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consequences of deficiency are growth failure, delayed sexual maturation, slow wound healing and loss of appetite
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zinc
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deficiency disease include tooth decay and other dental diseases
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fluoride
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component of thyroid hormones that help regulate energy production and growth
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Iodine
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Wilson's disease occurs from over dose
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copper
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regulation of acid base balance in body fluids ; maintenance of water balance in body tissues
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sodium
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What are the 15 essential minerals?
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1. calcium
2. phosphorus 3. magnesium 4. iron 5. zinc 6. fluoride 7. iodine 8. selenium 9. copper 10. manganese 11. chromium 12. molybdenum 13. sodium 14. potassium 15. chloride |
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Adults are ____ % water. What is the recommended daily intake for men and women?
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60-70% water ; men - 12-16 cups ; women - 11 cups ; 75% from fluids and 25% from foods
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consistancy of internal environment (bp, bs, temp, etc)
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homeostasis
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dietary changes introduced to improve intake of one nutrient affect intake level of other nutrients
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"ripple effect" ; the nutrients often go hand-n-hand
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What are the adaptive mechanisms humans have for managing fluctuations in food intake?
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nutrient storage, regulation of absorption, and regulation of appetite
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a very rare disorder caused by the lack of the enzyme phenylalanine hydroxylase. Lack of this enzyme causes phenylalanine, an essential amino acid, to build up in the blood. High blood levels of phenylalanine during growth leads to mental retardation, poor growth, and other problems. treated with a low phenylalanine diet
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Phenylketonuria (PKU)
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an intestinal malabsopriton disorder caused by an inherited intolerance to gluten and wheat, rye, barley. It causes multiple nutrient deficinces and is treated with gluten free diets.
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celiac disease
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a common disorder in adults in many countries resulting from lack of the enzyme lactase; ingestion of lactose in dairy products causes gas, cramps, and nausea due to the presence of undigested lactose int he gut
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lactose intolerance
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a disorder affecting 1 in 200 people that occurs due to a genetic deficency of a protein that helps regulate iron absorption. Individuals with this absorb more iron than normal and have excessive levels of body iron. High levels of body iron have toxic effects on tissues such as the liver and heart. The disorder can also be produced by excessive levels of iron intake over time and frequent iron injections or blood transfusions
|
Hemochromatiosis
|
|
|
contain high amounts of nutrients to calories
|
nutrient dense foods
|
|
|
contian low amounts of nutrients to calories
|
empty calorie foods
|
|
|
must list fat, saturated fat, trans fat, cholesterol, sodium, total CHO, fiber, sugars, protein , vitamins A and C, calcium and iron ; and also give % DV
|
Nutrition Facts panel
|
|
|
All ___ products must be enriched , its mandated
|
white products
|
|
|
considered dietary supplements by FDA, some act like drugs and have side effects, vary in their safety and effectiveness, amount taken, duration of use and user's age, stage, and health status impact effect on health risk
|
Herbal remedies
|
|
|
Sources of probiotics?
|
yogurt with live cultures, buttermilk, kefir, cottage cheese,
|
|
|
sources of prebiotics?
|
chicory, wheat, barley, rye, onions, garlic, leeks
|
|
|
assessing a community's "state of nutritional health" ; uses statistics data, surveys, and observations
|
community level assessment
|
|
|
clinical/physical assessment, dietary assessment, anthropometric assessment, and biochemical assessment data
|
the tools used for Nutrition assessment of an individual
|
|
|
inspection for features that may be related to malnutrition
|
clinical/physical assessment
|
|
|
24 hour dietary recalls and records, dietary history, food frequency questionnaires , resources: instruments and computer software
|
dietary assessment
|
|
|
computerized, interactive method to collect 24-hr diet recalls; used in government-sponsored nutrition studies; Five steps
|
USDA automated multiple pass method
|
|
|
What are the 5 steps of the USDA multiple pass method?
|
1. quick list
2. forgotten food list 3. time and occasion list 4. the detail cycle 5. final probe review |
|
|
measurements of body size and shape
|
anthropometric assessment
|
|
|
nutrient and enzyme levels, DNA characteristics, and other biological markers
|
Biochemical assessment
|
|
|
community programs, state level programs, and federal programs (school lunch programs, special supplemental nutrition program for women, infants and children (WIC)
|
public food and nutrition programs
|
|
|
U.S. Nutrition and health guidelines , Dietary Guidelines for Americans, MyPyramid Food Guide, HEalthy people 2010 :objectives for the nation
|
NAtion wide priorities for improvements
|
|
|
aproximately _____ of couples are infertile
|
15.1 %
|
|
|
____ % of couples diagnosed as "infertile" will conceive within 3 years withou use of technology
|
40%
|
|
|
healthy couples have a ________ chance of conception within a given menstrual cycle
|
23-30% chance
|
|
|
What are the causes of miscrriages?
|
defect in fetus, maternal infection, structural abnormailites of uterus, endocrine or immunological disturbances
|
|
|
about ___% of couples are subfertile
|
18%
|
|
|
period in which humans becomes biologically capable of reproduction
|
puberty
|
|
|
eggs females produces and store within the ovaries
|
ova
|
|
|
~4 week interval in which hormones direct buildup of blood and nutrient stores within uterus; ovum matures and is released
|
menstrual cycle
|
|
|
development of female and male reproductive systems begins during first months after conception and they continue to grow and develop through _________
|
puberty
|
|
|
capacity for ______ establishes during puberty when hormonal changes stimulate maturation of reproductive system
|
reproduction
|
|
|
women are born with life-time supply of ~ ______ immature ova
|
7 million
|
|
|
______ ova will mature and be released during fertile years
|
~400-500
|
|
|
_____ in ova may be damaged by oxidation, radioactive particle exposure, & aging
|
chromosomes
|
|
|
______ are more likely to have disorders related to chromosomal defects than younger women
|
women >35 years
|
|
|
Sperm production begins during puberty, decreases somewhat after age _____ with production continuing to old age
|
35 years
|
|
|
stimulates pituitary to relase FSH and LH
|
gonadotropin - releasing hormone (GnRH)
|
|
|
stimulates maturation of ovum and sperm
|
Follicle-stimulating hormone (FSH)
|
|
|
stimulates secretion of estrogen, progesterone, and testosterone
|
Luteinizing hormone (LH)
|
|
|
stimulates release of GnRH in follicular phase and follicle growth and maturation of follicle; stimulates vascularity and storage of glycogen and other nutrients within uterus
|
estrogen
|
|
|
prepares uterus for fertilzied ovum, increases vascularity of endometrium and stimulates cell division of fertilized ova
|
progesterone
|
|
|
What are the two phases of the menstrual cycle?
|
1. follicular phase
2. luteal phase |
|
|
follicle growth and maturation; main hormones : GnRH , FSH, estrogen and progesterone
|
follicular phase
|
|
|
after ovulation, formation of corpus luteum, decrease in estrogen and progesterone stimulate menstrual flow ; prostaglandins and cramps
|
luteal phase
|
|
|
interactions among hypothalamus, pituitary glad, and testes; androgens (testosterone) ; sperm are stored in the ______ and released in the semen
|
Male reproductive system: epididymis
|
|
|
What are sources of disruptions in fertility? (6)
|
adverse nutritional exposure, contraceptive use, severe stress, infection, tubal damage or other structural damage, chromosomal damage
|
|
|
What are the Nutrition related disruptions in fertility? (5)
|
under nutrition, weight loss, obesity, high exercise levels, intake of specific foods and food components
|
|
|
primary effect: birth of small and frail infants with high likelihood of death in the first year of life
|
chronic under-nutrition
|
|
|
associated with a dramatic decline in fertility that recovers when food intake does
|
acute under-nutrition
|
|
|
______ is seen with low or high body fat due to alterations in hormones
|
decreased fertility
|
|
|
________ levels increased with high body fat and reduced with low body fat ; both extremes lower fertility
|
Estrogen and Leptin
|
|
|
Infertility lowers with a BMI of _____________
|
< 20 or > 30 .
|
|
|
Weight loss of _______ of usual weight decreases estrogen; results in amenorrhea, anovulatory cycles and short or absent luteal phases; treatment with fertility drug Clomid not effective in underweight women.
|
> 10-15%
|
|
|
Sperm viability and motility decrease with wt __________ and cease at wt loss _________
|
10 to 15% < normal, and > 25% normal wt.
|
|
|
_______ are linked to reduced estrogen and irregular periods
|
low-fat and high fiber diets
|
|
|
______ decrease levels of gonadotropins, estrogen, and progesterone
|
Isoflavones (from soy)
|
|
|
diets with ______ of the kcal coming from fat can lead to infertility
|
<20%
|
|
|
high intake of _______ is linked to amennorhea and menstrual dysfunction
|
beta carotene
|
|
|
Skin color and fertility return to normal within _____ after discontinuation of beta carotene
|
2-6 weeks
|
|
|
What are the adverse effects of intense physical activity ?
|
delayed age at puberty, lack menstrual cycles, appear to be related to hormonal and metabolic changes, related to caloric deficits, reduced levels of estrogen, low levels of body fat, decreased bone density
|
|
|
Oxidative stress in men decreases _________, and reduces ability of sperm to __________.
|
sperm motility, fuse with egg
|
|
|
Oxidative stress in women harm __________________, interfere with __________, and interefere with implantation of _____
|
egg and follicular development , corpus luteum function, the egg
|
|
|
the Rate of infertility lowers in women who use iron supplements or iron from plant foods ; pre-pregnancy iron deficiency is linked to ___________&___________ ; ~1/2 of US women enter pregnancy with inadequate iron stores
|
preterm delivery and low iron status of infant
|
|
|
What is the intake requirement of iron for a pregnant woman or an woman trying to conceive?
|
~18 mg/day and regular consumption of vitamin C rich fruits and veggies along with plant sources of iron, iron fortified cereals and lean meats
|
|
|
Daily caffeine intake and reduction in conception is:
300 mg results in ~____ reduction 500 mg results in ~ ____ reduction |
27% and 50%
|
|
|
Alochol may decrease estrogen and testosterone levels or disrupt menstrual cycles ; 1-5 drinks lead to a ___decrease in conception , >10 drinks leads to a ____ decrease in conception
|
39% and 66%
|
|
|
What are the factors contributing to infertility in males?
|
lack of antioxidant nutrients, lack of Vitamin D, alcohol intake, heavy metal exposure, halogens, glycols, hormones (synthetic estrogens DDT, PEs, PCBs), heat , steriod abuse
|
|
|
What are some preconceptual nutrition concerns?
|
early pregnancy exposure to teratogens, poor folate status prior to conception
|
|
|
What does the CDC's preconceptional health initiative recommend that primary health care visits include ?
|
preconception health and pregnancy outcome education, screen for vaccination, Wt, iron, and folate status, assessment of alcohol use , management of diabetes and celiac disease
|
|
|
What are the preconceptional benefits of the WIC program?
|
women are eligible when pregnant. they are provided WIC food supplements, and nutrition education during and between consecutive pregnancies. These women who received the benefits and continued through the first two months of the next pregnancy had better iron status and delievered new borns with higher birth weights and greater lengths than did women who received WIC benefits during pregnancy only.
|
|
|
Premenstrual syndrome symptoms occur in ____ of women of childbearing age
|
40%
|
|
|
What are some common signs and symptoms of PMS?
|
fatigue, abdominal bleeding , swelling of the hands or feet, headache, tender breasts, nausea, craving for sweet or salty foods, depression, irritability, mood swings, anxiety, social withdrawl
|
|
|
characterized by marked mood swings, depressed mood, irritability, and anxiety; physical symptoms are breast tenderness, headache, and joint and muscle pains
|
Premenstrual dysphoric Disorder
|
|
|
What are the possible causes of PMS?
|
thought to be related to abnormal serotonin activity following ovulation, antidepressants that contain serotonin uptake inhibitors reduce PMS
|
|
|
Daily phsycial activity and reducing daily stress decrease symptoms of ______
|
PMS
|
|
|
Treatment of PMS:
the following can help treat PMS Magnesium - ___ mg/day Calcium - _____ mg /day Vitamin D - _____ IU/day Vitamin B6 - _____ mg/day |
200 mg/day
1200 mg/day 706 IU/day 50 to 100 mg/day |
|
|
_____ increases the likelihood of reproductive health problems
|
obesity
|
|
|
What are some biological bases of infertility in obese men?
|
low testosterone and sex hormone binding globulin levels, elevated leptin, follicle stimulating hormone, and estrogen levels ; decreased sperm count, sperm motility; increase malformed sperm, oxidative stress inflammation
|
|
|
What are some biological bases of infertility in obese women?
|
high estrogen, free-testosterone, and leptin levels; reduced levels of sex hormone binding globulin; insulin resistance; oxidative stress , inflammation
|
|
|
______ increases time required to conceive
|
central obesity
|
|
|
_____ should be the first fertility therapy for obese people
|
weight loss; loss of 7 to 22 pounds in overweight women and 100 pounds in massively obese men increases fertility
|
|
|
Bariatric surgery increases risk for the following deficiencies?
|
iron, folate, calcium and vitamins A, B12 , and K
|
|
|
Pregnancy is not recomended during the ______ after surgery
|
1st year
|
|
|
______ is diagnosed when 3 of the 5 conditions exist:
1. waist circumference of >40 " in men and >35" in women 2. blood triglyceride >= 150 mg/dl 3. HDL-cholesterol: <40 mg/dl in men and <50mg/dl in women 4. blood pressure >130/85 mm Hg 5. fasting blood glucose >= 110 mg/dl |
Metabolic Syndrome ( Syndrome X)
|
|
|
central obesity, high blood pressure, high triglycerides, low HDL-cholesterol, insulin resistance
|
metabolic syndrome
|
|
|
Metabolic syndrome has a prevalence of _______ in US adults, consquences _________________, What are the therapy ?
|
1 in 5, increase risk of CVD and type 2 diabetes ; Dietary modification, weight reduction, and exercise.
|
|
|
cessation of menstruation related to changes in hypothalmic signals that maintain secretion of hormones required for ovulation ; caused by deficits in energy and nutrietns; most common in those exposed to social stress or intellecutal professionals
|
Hypothalmic amenorrhea
|
|
|
What is the treatment for Hypothalmic amenorrhea?
|
first treatment is weight gain by eating healthful diet , gains or 6-11 pounds typically restore fertility
|
|
|
What does the female athletic triad consist of ?
|
amenorrhea, disordered eating, and osteoporosis
|
|
|
the female athetic triad is triggered when energy intake is _____% less than requirement, it results in decrease in luteinizing hormone and lack of estrogen. Low hormone levels lead to reduction in bone density
|
~30%
|
|
|
How to treat the Female athletic Triad?
|
increased calories to restore energy, and Vitamin D and calcium supplements to facilitate bone development
|
|
|
_____ is common in anorexia; _______ is seen with buliam
|
amenorrhea, and oligomenorrhea
|
|
|
In people with eating disorders and fertility _____ typically resumes with wt. gain
|
menses
|
|
|
What is the intervention with Anorexia nervosa?
|
normalize body wt, accomplished by long term multidisciplinary services
|
|
|
What is the intervention with Bulimia nervosa?
|
normalize eating behaviors, accomplished with cognitive behavioral therapy and psychotherapeutic medications
|
|
|
_______ during the first 2 months of pregnancy are teratogenic
|
high blood glucose levels
|
|
|
______________ prior to pregnancy is associated with a 2-3 fold increase in congenital abnormalities in new born
|
Diabetes Mellitus
|
|
|
_________ are linked to malformations of pelvis, CNS, and heart seen in newborns and higher rates of miscarriage
|
Diabetes mellitus
|
|
|
The main goals of management of type 1 diabetes are?
|
blood glucose control, resolution of coexisting health problems, health maintenance ; diets are controlled in CHO content ; insuling use; physical activity
|
|
|
Diet management may be handled in what ways for Diabetes type 1?
|
CHO control, insulin to CHO ratios are used , CHO counting, and diabetes exchange system
|
|
|
Nutritional management of type 2 diabetes, what is it managed with?
|
diet and exercise, oral medication to increase insulin production and insulin sensitivity ; the preferred management program is individualized diet and exercise recommendations, an educational and follow - up program by RD's CDE's MDs and RNs
|
|
|
Management of Type 2 diabetes:
weight loss, Calories ( _____ from protein, ____ from fat, ____ from CHO) SFA ____ and Trans ___ , ____ cholesterol . ____g of fiber per 1000 calories |
15-20% protein, <30% from fat and 50% from CHO.
<7% SFA least amount of trans fat possible <200 mg cholesterol 14 g of fiber per 1000 calories |
|
|
each cell membrane normally has ~________ active insulin receptors that open "doorS" for glucose
|
20,000
|
|
|
insulin resistant cells only have ~______ functioning receptors that lower uptake by cell
|
5,000
|
|
|
What are the risk factors for insulin resistance?
|
obesity, central obesity, physical inactivity, and small size at birth
|
|
|
______ is associated with :
polycystic ovary syndrom metabolic syndrome type 2 diabetes gestational diabetes heart disease |
insulin resistance
|
|
|
measure of extent to which 50 grams of CHO-containing foods raise 2 hour postprandial blood glucose levels compared to levels raised after consumption of 50 g of glucose or white bread
|
glycemic index (GI)
|
|
|
calculated by multiplying the GI of food by grams of CHO contained in the amount of foods consumed divided by 100
|
Glycemic load (GL)
|
|
|
Management for type 2 diabetes?
|
diets to lower LDL cholesterol without lowering HDL cholesterol & lower triglyceride levels ; consume 2 to 3 servings fish per week ; weight loss --> lowers blood glucose and blood pressure, improves lipid profile and increases insulin sensitivity
|
|
|
To reduce the risks of type 2 diabetes make improvements in ___, ___,___.
|
body weight, dietary intake, physical activity
|
|
|
10% of women of childbearing age, the leading cause of female infertility, many with ____ are obese or have high levels of intra-abdominal fat ; cause is uncertain
|
polycysitic ovary syndrome
|
|
|
Nutrional mangagement for women with PCOS: the primary goal is to ___________, use ___________, weight loss and exercise improve prognosis.
|
increase insulin sensitivity, insulin-sensitizing drugs
|
|
|
What are the diet recommendations of women with PCOS?
|
omega 3 fatty acids, whole grains, fruits and veggies, regular meals, non fat dairy, and low glycemic foods
|
|
|
What are 2 disorders of metabolism?
|
PKU, and celiac disease
|
|
|
a substance in wheat and other grains, may be found in a variety of foods including breads, cakes, cereals , pasta, commercial dairy products and alcoholic beverages
|
gluten
|
|
|
may releive PMS symptoms
|
Chase tree berry extract
|
|
|
not effective for PMS relief
|
evening primrose oil
|
|
|
increases sperm motility
|
coenzyme Q10
|
|
|
increase pregnancy rates in women with mild endometriosis
|
bee propolis
|
|
|
reflects general health status of a population, decreases in mortality related to improvements in social circumstances, safe and nutritious food supply, and infectious disease control
|
infant mortaility
|
|
|
low birth weight or preterm infants at high risk of dying during _________
|
the first year of life
|
|
|
_____ of birthds are LBW yet compires ____ of infant deaths
|
8.2%, and 66%
|
|
|
____ are born preterm yet acccount for high indcidence of infant deaths
|
12.7%
|
|
|
What is the desireable birth weight for newborns?
|
3500-4500 grams
|
|
|
Infants born with desireable wt are less likely to develop: ___ ,___, ___
|
heart and lung disease, diabetes, hypertension
|
|
|
The health objectives for 2010 in relation to pregnant women and infants focuses on what 4 things?
|
1. the reduction of low birth weight
2. preterm delivery 3. infant mortality 4. a number of the objectives related to nutrition |
|
|
What are the nutrition related objectives in relation to pregnant women and infants?(4)
|
1. reduce anemia in pregnant females
2. reduce incidence of spina bifida 3. increase abstinence from alcohol use and reduce the icidence of fetal alcohol syndrome 4. increase appropriate weight gain during pregnancy |
|
|
assessed from date to conception; average pregnancy is 38 weeks
|
gestational age
|
|
|
assessed from onset of last menstrual period ; average pregnancy is 40 weeks
|
menstrual age
|
|
|
what are the two phases of change during pregnancy?
|
1. maternal anabolic changes
2. maternal catabolic changes |
|
|
takes place in the 1st half of pregnancy; building up of mother's blood and nutrients
|
maternal anabolic changes
|
|
|
takes place in the 2nd half of pregnancy, 90% of fetal growth occurs; energy, nutrients delivered to fetus
|
maternal catabolic changes
|
|
|
What are the body water changes that occur during pregnancy?
|
it increases from ~7 to 10 L - results from increased blood and body tissues and extracellular volume and amniotic fluid. ;
edema - swelling due to accumulation of extracellular fluid |
|
|
_____ is preffered fuel for the fetus; "diabetogenic effect of pregnancy" results from maternal insulin resistance
|
Glucose
|
|
|
CHO metaboism in _______: high estrogen & progesterone stimulate insulin which increases glucose --> (stored as) glycogen and fat
|
early pregnancy
|
|
|
CHO metabolism in ________: human chorionic somatotropin (hCS) & prolactin inhibit conversion of glucose to glycogen and fat.
|
late pregnancy; hCS and prolactin keep glucose readily available for the fetus to consume
|
|
|
about ____ of protein accumulate during pregnancy
|
~925 g of protein
|
|
|
protin and amino acids conserved during pregnancy, the needs must be met by ____________
|
the mother's intake of protein
|
|
|
The fat stores are accumulated during ________, ___________. Blood lipid levels increase during pregnancy, increased cholesterol is a substrate for steroid hormone synthesis
|
accumulate in the first half of pregnancy, and enhanced fat mobilization in last half
|
|
|
______ is linked to increased bone turnover and reformation
|
calcium
|
|
|
accumulation in mother, placenta and fetus
|
sodium; restriiton of sodium potentially harmful
|
|
|
What are the functions of the placenta?
|
hormones & enzyme production , nutrient and gas exchange, remove waste from fetus
|
|
|
What is structure of the placenta?
|
double lining of cells separating maternal and fetal blood
|
|
|
What are the factors that affect the nutrient transfer between the placenta?
|
size and charge of molecules, small molecules pass through most easily, lipid solubility of particle, concentration of nutrients in maternal and fetal blood
|
|
|
The nutrients are first used for the maternal stores, then the placenta, lastly for fetal needs
|
nutrient transfer ; true
|
|
|
_________ is at the highest level during the 9 months of gestation
|
growth and development
|
|
|
What are the four periods of growth and development during pregnancy?
|
1. hyperplasia
2. hyperplasia and hypertrophy 3. hypertrophy 4. maturation |
|
|
variations in fetal growth are linked to : energy, nutrient, and oxygen availability; genetically programmed growth and development. ________ is main fetal growth stimulator
|
insulin-like growth factor ; inadequate nutrition decreases levels of IGF-1
|
|
|
calculated by wt in grams divided by cube of ht times 100; for normal weight ~23-25
|
similar to BMI; Ponderal Index = PI
|
|
|
thought to be caused by genetic, uterine, or hormonal abnormailities , underweight = higher risk, high cholesterol/triglycerdies = high risk, supplement MV (early preg) = decreased risk
|
miscarriages
|
|
|
infants born ____ are at risk for death , neurological problems, congenitial malformations and chronic health problems
|
preterm delivery
|
|
|
____ weight should be gained in the first trimester
|
~2-5 lbs
|
|
|
the fetus is about ___ of the total weight gain
|
1/3
|
|
|
The balance of the weight gain is related to __________.
|
body fat changes, amniotic fluid, increase of extracellular fluids, and blood supply of the mother
|
|
|
~15 lbs are lost during delivery, wt loss is difficult in women who gained > 45 lbs or with low activity levels , women with recommended wt gain in pregnancy are ~2 lbs heavier at 1 year post partum ; lactating women lose slightly more
|
true ; post partum weight retention
|
|
|
What is the protein suggested requirement during pregnancy?
|
+25 g or 71 g /day
|
|
|
pregnant women consume _____ total calories from fat; fat consumed in food used as an energy source for fetal growth and development ; fat serves as a source of fat soulble vitamins ; it also provides essential fatty acids
|
33%
|
|
|
Adequate EPA and DHA during pregnancy and lactation are linked to _________________.
|
higher intelligence, better vision and more mature CNS
|
|
|
Dietary intake for EPA and DHA do not exceed ______
|
3 g /day
|
|
|
the need for water during pregnancy , met by increased levels of thirst; ~ _____
|
9 cups fluid per day
|
|
|
known to be associated with anemia and reduced fetal growth, the requirement of this increases for extensie organ and tissue growth; its function is metabolic reactions, and deficicies lead to adnormal cell division and tissue formation
|
folate and pregnancy
|
|
|
What are the 3 main types of NTD?
|
spina bifida, anencephaly, encephalocele
|
|
|
What is the recommended intake of folate?
|
600 mcg DFE
|
|
|
needed for cell differentitation ; in the US the big concern is toxicity
|
Vitamin A
|
|
|
supports fetal growth, supports immune system
|
Vitamin D
|
|
|
teeth begin to develop, not recommended to supplement
|
fluoride
|
|
|
needed for fetal skeletal mineralization and maintain maternal bones, low intakes are related to increased release of lead which is harmful to the fetus; needs can be met with 3 cups of milk a day
|
calcium
|
|
|
additional needs for pregnancy (iron):
_____ for fetus and placenta _____ lost at delivery _____ for increased RBC |
300 mg, 250 mg, 450 mg
|
|
|
early pregnancy risk of preterm delivery; late pregnnacy lower scores on intellegence , language, gross motor and attention tests.
|
iron deficency aniemia in pregnancy
|
|
|
Iron is absobred better from supplements containing iron only than when mixed with other minerals ; amount absorbed depends ont he need and the amount of iron in the supplement; side effects of this are nausea . cramps, gas and constipation
|
true; pros and cons of iron supplementation
|
|
|
what is a new concern of ion supplementation?
|
free radicals in the GI tract cause infllammation and mitochonrial damage to cells; may interfere with zinc absorption
|
|
|
What is the recommendation for iron supplementation during pregnancy?
|
30 mg daily after the 12th week of pregnancy; the Upper limit is set at 45 mg per day
|
|
|
required for thyroid function and energy production and for fetal brain development
|
iodine
|
|
|
restriction not indivated in normal pregnancy or for control of edema or high blood pressure ; plays a critical role in maintaing body's water balance
|
sodium
|
|
|
generally ____ cups of coffee is safe intake of caffeeine
|
4 cups
|
|
|
eating disorder of eating non food substances
|
pica
|
|
|
What is the exercise recommendation for pregnant women?
|
3-5 times each week for 30 minutes at 60-70% VO2 max
|
|
|
high levels in large, long-lived predatory fish , lower content in bottom feeders, avoid shark, swordfish, king mackerel, and tile fish
|
mercury contamination
|
|
|
severe nausea and vomiting during most of pregnancy
|
hyperemesis gravidarum
|
|
|
how do you handle management of nausea and vommiting?
|
separate liquid and food intake, avoid odors and foods that trigger it; treat with vitamin B6, multivitamins, and ginger
|
|
|
How to manage heartburn?
|
ingest small meals frequently , do not go to bed with full stomach, avoid foods that make heartburn work (acid foods)
|
|
|
how to prevent constipation?
|
consume dietary fiber, drink water along with fiber, laxative pills are not recommended
|
|
|
provides nutritonal assessment , education and counseling, improved outcomes
|
THE WIC program
|
