Health And Nutrition

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Hyperemesis

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excessive vommiting

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Lactation

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The period of secretion of milk

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Pica

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hunger/cravingg - appetite for nonfood substances like laundry starch - clay,dirt. practiced by some during pregnancy

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Zygote

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first 2 weeks following conception

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Embryo

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Weeks 2-8 following conception

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Critical Periods of Development

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Different tissues, organs have unique special timelines when their most crucial development begins

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Avoiding mercury in foods during Pregnancy

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Limit the Consumption of these fish to 1 serving/month

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Nutrient pregnant women should not have

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vitamin A (toxicity potential during pregnancy)

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Nutrients to be taken by pregnant women

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Calcium phosphorus, Vitamin D, iron, folate.

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increased needs for kcals during pregnancy are

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-/+ 300 kcals during the 2nd and 3rd trimester

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Increased need for protein during pregnancy

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+/- 10-15 grams/day

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theory of caffeine

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caffeine decreases blood flow through the placenta

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Fetal Alcohol Syndrome characteristics

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smaller head size, droopy eyelids, broad flat noses

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Altered Glucose Tolderance or Gestational Diabetes

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- No evidence of altered glucose metabolism prior to the pregnancy
- increased risk of obese for the baby
- Mom can later become Type II diabetes

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Magnesium sulfate

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Treatment of choice for the pre eclampsia and eclampsia (serious complication of pregnancy)

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Pregnancy Induced Hypertension

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Associated with poverty, poor prenatal care, poor nutritional intake (especially inadequate protein and calcium)

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kcal demand of lactation

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+/- 500 kcals/day (200 more during the 2nd and 3rd trimester of pregnancy)

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Breast feeding: PROLACTIN HORMONE (from anterior pituitary)

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stimulates milk production when the breast is emptied

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Breast feeding: OXYTOCIN HORMONE (from the posterior pituitary)

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stimulates relase of milk from the breast in resonse to suckling and also stimulates uterine contractions, may be a decreased risk of breast cancer

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Low-birth weight

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Infants born at 2,500g

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Premature baby

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born at less than 37 weeks gestational age - many die in the first month of life and many of the rest do not live out their first year of life

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feeding of premature infants

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- increased mineral needs (calcium, phosphorus, iron
- essential amino acids (tyrosine, cysteine)
- importance of adquate omega 3 fatty acids (DHA)
- carnitine (a vitamin-like compound needed for oxidation)
- inositol (in-cell membranes)

** all found in breast milk!**

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reflex absent in infants and when

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- suckling reflex
- infants born before 34-37 weeks of gestational age

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Growth charts/parameters

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- used to measure height, length and head circumference to watch patterns of growth
- helps clinicals to identify overweight/obese kids

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Milk anemia

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Iron deficiency anemia resulting from a dependency on iron poor cow's milk (common in 1-2 year olds)

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Goat's milk

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- similair to cow's milk
- good source of calcium and B2 but a poor source of vitamin D and folate
- goats milk may not be pasteurized which could lead to severe diarrhea

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Solid Foods

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- readiness at 4-6 months
- does not accelerate mental or physical development

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Food intolerance

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- much more common than a food allergy and usually not life threatening, often related to an enzyme deficit (lactase), symptoms are flatulence, cramps and nausea.

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Food Allergy

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- less common and if anaphylactic may be life treatening, often related to a protein component, antibody (IgE)/antigen response (immune system response)
- symptoms are nausea cramps, wheezing, rashes/hives

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Child care food program

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designed to meet 1/3 of the DRI

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child care food program - lunch and breakfast

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- lunch designed to meet 1/3 of the DRI
- breakfast designed to meet 1/4 of DRI
* proglems can occur if kids don't eat the full meal

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Ketogenic Diet - related to child epilepsy

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diet begins with 2-3 days controlled fats, gradually switch to a high fat diet.

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Oral rehydration therapy

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best treatment for infantile diarhea

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Girls puberty

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begins age 10-14 years old; average peak is 12 years old

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Boys puberty

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begins age 12-16 years old; average peak of puerbety is 14
- boys gain more lean body mass than girls

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DRI energy needs for males:
Age 11-14
Age 15-18

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- 2,500 kcals
- 3,000 kcals

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DRI energy needs for females:
AGE 11-18

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2,200 kcals

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Vitamins that that teens lack

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- Vitamin A
- Vitamin C
- Iron
- Calcium

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Acne

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over activity of the sebaceous glands responding to hormone output
- BLOCKED DUCTS = LOCALIZED SWELLING - from fat blocking sebaceous glands

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Solutions to acne

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- vitamin A based products
Retin-A: topical creams
Accutane: severe, cystic acne

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Geriatrics

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Medical Aspect of elders - the branch of medicine concerned with health problems of the elderly

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Gerontology

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Lifestyle of elders - study of aging processl concerned with social, economic and medical problems of the elderly

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Nutrients most commonly deficient with the elderly

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- Protein
- vitamin D
- Vitamin B12
- Folate

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Changes in the BMR and aging

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On average, the BMR decreases about 3% per decade after the age of 30

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Elderly people: Program Theories

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Every individual has cells genetically preprogrammed as to their rate and timing of growth, maturation and death

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Elderly: Error Theories

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As one ages, one becomes less efficient at repairing cellular damage

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Anorexia/xerostomia

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medication related: this prescription drug has a side effect that causes a lack of appetite

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- dehydration serum sodium level
- normal serum sodium level

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- 148 mmol/L or higher
- 140 mmol/L (normal)

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Dehydration for elderly people : water intake?

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8 or more servings of water

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Term for swallowing difficulties

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Dysphagia

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oldest RDA age group

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age 51 +

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Alzheimer's & Aluminum

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contact with aluminum is a result of the disease process but not the cause

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Alzheimer's enzyme

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Protease enzyme

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recommended use of multi vitamin and mineral supplements with the elderly

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- Vitamin B12
- calcium
- Vitamin D

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DHEA (OTC)- hormone supplement to stimulate cell growth

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hormone percursor synthesized by the adrenal glands.
- decline in DHEA may lead to obesity, diabetes, coronary heart disease, cancer

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Effects of DHEA

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acne, facial hair, breast/prostate cancer, etc.

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Melatonin

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Hormone which promotes sleep

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Gingko Biloba

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slows progression of dementia
- improvement in cognitive performance and social function measures
- NOT a memory enhancer

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Glucosamine

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Stimulates production of compounds thought to be the buildilng blocks of cartilage

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Chondriotin

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Part of the body protein that gives cartilage its springy quality

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Obesity

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- >/= 120% of ideal body weight
- MALEs >/= 25%
- Females 30%

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Overweight

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- BMI greater than 25-29.9
- greater than 110% but less than 120% of IBW (ideal body weight)

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Herbal weight loss suplement: Meridia

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targets brain neurotransmitter, may cause increased BP and heart rate, modestly enhances wt. loss

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HWLS: Phentermine

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a modest appetite suppressant effect, may be used in combination with anti-depressants

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HWLS: Xenical

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lipase inhibitor, blocks fat absorption, may also help lower LDL works on genes that affect appetite regulation

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Ephedra's (related to weight loss)

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can cause heart palpitations, dizziness, strokes and death

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Very low kcal diets

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- 600-800 kcals/day
- powerder, mix with water
- Nutrimed - 420 kcals/day

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to loose one pound how many kcals should be decreased per day

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500kcals

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kcal level for Males on diet

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no lower than 1200-1500kcals/day

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kcal level for Females on diet

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1000-1200 kcals/day

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dieting - ketosis (promoted by atkins diet)

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can decrease one's appetite

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Barry Sear's Zone Diet Plan

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40/30/30 - (40% cals from carbs,20% cals from proteins, 30% cals from fat)

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South Beach Diet

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- 3 phases
1) intro/detox phase - bands simpler carbo food sources
2) second phase - encourages fibrous whole foods or more moderate glycemic index carbs, less processed foods
3) third phase - can eat just about anything in moderation

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average # of kcals/week most people burn with exercise

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2,800 kcals

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establishing a diet

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- it takes 21 days to establish a pattern
- 100 days to make it automatic
- permanent lifestyle changes take time

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what do drugs do?

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can alter food intake and the absorption, metabolism and excretion of nutrients

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xerstomia

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dry mouth - 400+ in drugs

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- meds are taken for long periods of time
- multiple meds are taken
- nutritional status is poor or deteriorating
- nutrient needs are high

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Adverse drug interactions occur if these happen

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PDR

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physicians' desk reference

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drugs and alcohol do not mix

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alcohol can cause liver damage and stomach bleeding

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Antineoplastic Agents (cancer drugs) ex. methotrexate, cisplatin

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- anorexia
- nausea/vomitting
- mouth and GI ulcers
- Methotrexate = folate and B12 antagonist

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Antihypersensitives (diuretics) - ex. Diuril, Lasix, Captopril

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- causes POTASSIUM Mand MAGNESIUM wasting or sparing
- along w/antihypersensitives, antidepressants, antidiarrheals, Decongestants and antihistamenes
- it causes dry mouth (xerostomia) which leads to mouth sores, difficulty swallowing and dental decay

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AntiCoagulants ex. Coumadin

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- Avoid excessive Vit K rich foods (grean leafy veggies, cabbage, liver)

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NSAIDS ex. IBUprofen and aspirin

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can cause GI irritation, ulcers and iron loss w/aspirin

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Certain antiboitics ex. TETRACYCLINE, cipro, levaquin, floxin, trevan

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- NO MILK PRODUCTS WITHIN 2-3 hours

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Erythromycin

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can cause nausea, vomiting and diarrhea

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Penicillin

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(uncoated erthromycin) - avoid citrus juices, wine, cola (acids destroy these)

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Corticosteroids ex. prednisone

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- reduces pain and inflammation
- used to treat arthritis and severe asthma

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MAO inhibitors (antidepressants) ex. isocarboxide

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- AVOID TYRAMINE containing foods (red wine, aged cheese, liver)

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Lipid Lowering Agents ex. Lovastatin, Nicotine acid

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- bind phosphorus and m ay lead to osteomalacia over time