essays due at 5:35 pm in class on 21 november 2013 –nothing clinical and nothing relating to...
TRANSCRIPT
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ESSAYS DUE AT 5:35 PM IN CLASS ON
21 NOVEMBER 2013 –NOTHING CLINICAL
AND NOTHING RELATING TO PATHOLOGY
NO DEFICIENCIES OR TOXICITIES
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Final exam-120 multiple choice-120 marksfrom vitamins to end of course
-4 short answer questions-15 points each for a total of 60 points
covers whole course
-3 hours- 180 marks
•PLEASE SEE EXAM REGULATIONS
ON: faculty.cbu.ca/ebarre
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Beta carotene-fat soluble
Lecture 10- 14 November 2013
This lecture is based largely on Chapter 7, 12, 14, 15,16 in Understanding Normal and Clinical Nutrition by Rolfes et al.
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Lecture 10- 14 November 2013
Outline
Water -role in metabolism -role in metabolic regulation
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Outline of lecture 10
Nutrition metabolism throughout the life cycle
Pregnancy and Lactation Infancy Early Childhood Adolescence Adulthood
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More Detailed Comments
Water -role in metabolism
-carries nutrients and waste products throughout the body
-maintains structure of large molecules like proteins and glycogen
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Water -role in metabolism
-participates in metabolic reactions- eg hydrolysis (eg protein catabolism), or product of metabolism (metabolic
sink)(eg when hydrogen joins with oxygen as part of electron transport chain processes)
-solvent (provides medium for reactions)
-regulation of body temperature -maintains blood volume
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Water
-class exercise
-explain each role in metabolic regulation
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Break
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Nutrition metabolism throughout the life cycle Pregnancy and Lactation
Pregnancy
foetal growth and development -folate supplementation -prevent neural tube defects -one month before conception- why?
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Nutrition metabolism throughout the life cycle Pregnancy and Lactation Pregnancy foetal growth and development
folate supplementation -0.8 to 4 mg supplements -if have had previous neural
tube baby then 4 mg supplements may be recommended - require a prescription as high folate intake may mask pernicious anemia of a vitamin B12 deficiency
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Nutrition metabolism throughout the life cycle Pregnancy and Lactation Pregnancy critical periods
-maternal anemia during critical growth period of placental growth alters pattern of blood vessel growth which may affect cardiovascular health of infant
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Nutrition metabolism throughout the life cycle Pregnancy and Lactation Pregnancy
critical periods -infant beta cell development-poor
maternal nutrition during critical period of beta cell development (12 weeks gestation to 5 months post delivery) may cause diabetes particularly if person eats in overabundance in later life
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Nutrition metabolism throughout the life cycle Pregnancy and Lactation Pregnancy
weight prior to conception-underweight mother
-underweight mother leads to greater chance of a low birthweight infant especially if mother is unable to gain sufficient weight during the pregnancy
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Nutrition metabolism throughout the life cycle Pregnancy and Lactation Pregnancy
weight prior to conception-underweight mother
-as well rates of preterm births and infant deaths are higher for underweight women
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Nutrition metabolism throughout the life cycle Pregnancy and Lactation Pregnancy
weight prior to conception-overweight mother
overweight mother leads to greater chance of her experiencing gestational diabetes, hypertension and post-partum infections and of having a stillborn and/or other labour and delivery complications
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Nutrition metabolism throughout the life cycle Pregnancy and Lactation Pregnancy
weight prior to conception-overweight mother
-as well infants tend to be larger and have greater risk of poor health(including neural tube defects) and death than do normal weight infants
-never try to lose weight during pregnancy- lose appropriately pre-conception or post-delivery
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Nutrition metabolism throughout the life cycle Pregnancy and Lactation Pregnancy
weight gain during pregnancy
underweight 28-40 lbs correct weight 25-35 lbs overweight 15-25 lbs obese 15 lbs minimum
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Nutrition metabolism throughout the life cycle Pregnancy and Lactation Pregnancy
energy and nutrient needs during pregnancy energy add 100 kcal per day trimester 1
add 300 kcal per trimesters 2 and 3
pregnant teenagers, underweight and physically active women may require more
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Nutrition metabolism throughout the life cycle Pregnancy and Lactation Pregnancy
energy and nutrient needs during pregnancy
nutrient needs
fig 14-10
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Fig. 14-10, p. 489
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Nutrition metabolism throughout the life cycle Pregnancy and Lactation Pregnancy
energy and nutrient needs during pregnancy
nutrient needs
carbohydate- ideally 250 or more grams per day and no less than 100 grams per day
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Nutrition metabolism throughout the life cycle Pregnancy and Lactation Pregnancy
energy and nutrient needs during pregnancy
nutrient needs
protein add 5 grams per day trimester 1 add 20 grams per day trimester 2 add 25 grams per day trimester 3
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Nutrition metabolism throughout the life cycle Pregnancy and Lactation Pregnancy
energy and nutrient needs during pregnancy
nutrient needs protein most people have enough protein
to begin with in their diet to meet these protein requirements
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Nutrition metabolism throughout the life cycle Pregnancy and Lactation Pregnancy
energy and nutrient needs during pregnancy
nutrient needs protein do NOT use high protein
supplements during pregnancy-chance of low birthweights, pre-term births and still borns
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Nutrition metabolism throughout the life cycle Pregnancy and Lactation Pregnancy
energy and nutrient needs during pregnancy
nutrient needs essential fatty acids linoleic and alpha-linolenic- brain
growth and development, visual acuity
fish oil supplements are not recommended -possibility of toxins and effect on pregnancy is not known
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Nutrition metabolism throughout the life cycle Pregnancy and Lactation Pregnancy
energy and nutrient needs during pregnancy
nutrient needs
-folate, B12, iron and zinc as well as
vitamin D and calcium require particular attention
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Nutrition metabolism throughout the life cycle Pregnancy and Lactation Pregnancy
common nutrition related concerns of
pregnancy
-nausea, constipation, haemorrhoids, heartburn, food cravings and aversions, non food-cravings (pica)
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Nutrition metabolism throughout the life cycle Pregnancy and Lactation Pregnancy
malnutrition and pregnancy -malnutrition can lead to reduced
fertility for males and females -malnutrition prior to pregnancy-
prevent placenta from developing properly with subsequent potential for physical and cognitive abnormalities on the part of the infant
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Nutrition metabolism throughout the life cycle Pregnancy and Lactation Pregnancy
infants birthweight -low- premature-can catch up -have
easier time catching up in growth development if their post-delivery nutrition is good
-less than gestational age- have tougher time catching up in growth development even if their post-delivery nutrition is good
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Nutrition metabolism throughout the life cycle Pregnancy and Lactation Pregnancy
mothers age -adolescence- immaturity may lead
to poor food choices with subsequent foetal risk
-weight gain of 35
lbs for normal weight female
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Nutrition metabolism throughout the life cycle Pregnancy and Lactation Pregnancy
practices incompatible with pregnancy
alcohol and herbal supplements and nutraceuticals
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Break
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Nutrition metabolism throughout the life cycle Pregnancy and Lactation Lactation
Nutrition during lactation
mother's nutrient needs energy additional 450 kcal per day consumed-
rest comes from fat stores built up during pregnancy
figure 14-10
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Fig. 14-10, p. 489
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Nutrition metabolism throughout the life cycle Infancy energy and nutrient needs energy
infants require about 100 kcal/kg/day
protein
inadequate-consequences
too much-stress kidneys and liver figure 15-2
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Fig. 15-2, p. 517
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Nutrition metabolism throughout the life cycle Infancy
breast milk lactose improves calcium
absorption
omega 3 fatty acids
figure 15-3
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Fig. 15-3, p. 518
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Nutrition metabolism throughout the life cycle Infancy infant formula nothing beats breast milk
soya formulas-avoids allergy issue found with some non-soya formulas
- good for lactose intolerance as there is no lactose in soya formulas
avoid goats milk-low in folate table 15-2 figure 15-4
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Table 15-2, p. 519
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Fig. 15-4, p. 521
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Nutrition metabolism throughout the life cycle Infancy
special needs of pre-term infants poor absorption of calcium and lipid,
fat soluble vitamins, calcium, iron and zinc due to immature gut
solution-pre-term breast milk eg higher protein concentration than full term breast milk
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Nutrition metabolism throughout the life cycle Infancy
introducing cow's milk not until 12 months of age poor iron content and it may cause
intestinal bleeding
cows milk is higher in calcium and lower in vitamin C-thus inhibiting iron absorption
type 1 diabetes issue-this is controversial
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Nutrition metabolism throughout the life cycle Infancy
introducing solid foods
no earlier than 6 months
6-12 months
if not before end of first year there may be delayed growth
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Nutrition metabolism throughout the life cycle Infancy
introducing solid foods6-12 months
iron fortified cereals, meat or meat alternatives such as legumes
-serve with vitamin C to improve iron absorption
-vitamin C rich foods include citrus fruit juices and chopped berries
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Nutrition metabolism throughout the life cycle Infancy
introducing solid foods at one year-2-3.5 cups of milk
maximum to avoid displacement of iron rich foods plus give iron fortified cereals, fruits and vegetables to meet iron requirements
primary food in first 12 months ideally is breast milk
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Nutrition metabolism throughout the life cycle
Early Childhood energy and nutrient needs energy
1 year 1000 kcal/day 3 years-1300 kcal/day 10 years-2000 kcal/day
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Nutrition metabolism throughout the life cycle
Early Childhood energy and nutrient needs nutrient needs
protein-needs dictated by needs to maintain nitrogen balance, protein quality and added needs of growth
vitamins and minerals-met by 6 principles of dietary planning(adequacy, moderation, balance, variety, energy control and avoiding empty kcal foods)
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Nutrition metabolism throughout the life cycle
Early Childhood
hunger and malnutrition in children glucose and iron are critical to brain
functioning and subsequently to the child's behaviour
adverse reactions to foods must meet nutrient needs of child
childhood obesity excess energy intake relative to energy
expenditure
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Nutrition metabolism throughout the life cycle
Early Childhood
mealtimes at home -6 principles of good dietary planning
nutrition at school -pack lunches
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Nutrition metabolism throughout the life cycle
Adolescence
energy and nutrient needs
energy-2000-4000 kcal/day activity levels males need more than females
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Nutrition metabolism throughout the life cycle
Adolescence
nutrients vitamin D and calcium iron chronic diseases atherosclerosis type 2 diabetes hypertension
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Nutrition metabolism throughout the life cycle
Adulthood
as we age in adulthood we reduce our metabolic rate- therefore need to
reduce caloric intake while meeting the 6 principles of good dietary planning that adequately address changing nutrient intake requirements
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Nutrition metabolism throughout the life cycle
Adulthood
water- avoid dehydration-mobility and desire to consume water are issues here
protein- 0.8 g/kg/day
carbohydrate- increased fibre to offset constipation- also need more fluid
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Nutrition metabolism throughout the life cycle
Adulthood
vitamin B12, vitamin D, calcium as well as
iron are among the nutrients of primary concern
vitamin B12 -bacterial overgrowth-in
stomach results in vitamin B12
consumption by bacteria vitamin D and calcium -a concern due to
reduced dairy intake as we age as well as the risk of osteoporosis
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Nutrition metabolism throughout the life cycle
Adulthood
vitamin B12, vitamin D, calcium as well as
iron are among the nutrients of primary concern
iron- deficiency risk if low food energy
intakes-mobility and desire to consume food are issues here
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Nutrition metabolism throughout the life cycle
Adulthood
nutrient-brain relationships-table 16-2
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Table 16-2, p. 574