1 / 32

News on Vitamins

News on Vitamins. Obesity is associated with Vit D deficiency. Vit D is stored in fat cells and can be unavailable. ↓ BMI = ↑ bioavailability Dark pigmentation ↓ Vit D absorption via skin. Pigmentation acts as UV protection. Daily doses of moderate/excess Vit A can weaken bones.

ronni
Télécharger la présentation

News on Vitamins

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. News on Vitamins • Obesity is associated with Vit D deficiency. Vit D is stored in fat cells and can be unavailable. ↓ BMI = ↑ bioavailability • Dark pigmentation ↓ Vit D absorption via skin. Pigmentation acts as UV protection. • Daily doses of moderate/excess Vit A can weaken bones. • LDL and polyunsaturated lipids in cell membranes have ↑ chance of free radical damage. Vit E suppresses free radicals. ↑ PUFA=↑ Vit E

  2. Nutrition During Pregnancy and Lactation Ch 10

  3. Energy Needs Increase • Increased fuel demand • Spare protein for added tissue building • ↑ 340kcal/day during 2nd trimester • ↑ 450kcal/day during 3rd trimester • Increase of 15-20% over the energy needs of a nonpregnant women • Sufficient wt gain is vital

  4. Protein Needs Increase • Building blocks for growth of body tissue - ↑ 25g/day • Development of the placenta • Growth of fetus • Growth of maternal tissues • Increased maternal blood volume • Plasma volume increases by 40-50% • ↑ hemoglobin – supply oxygen to growing cells • ↑ albumin – regulate blood volume • Amniotic fluid • Storage reserves for labor

  5. Complete and Incomplete Protein Sources • Complete- ↑ biological value • 1. Egg • 2. Milk • 3. Cheese • 4. Soy • 5. Meat • Incomplete 1. Beans 2. Legumes 3. Grains • Protein rich foods also contribute other nutrients such as: iron, B-vitamins, and Calcium

  6. Vit and Minerals Increase • Minerals • Calcium • Iron, DRI 27mg (non pregnant 18mg) • Vitamins • A • C • B-complex • D (preeclampsia, GDM) *Meet the requirements with 3 cups fortified milk daily • Folate, DRI 600mcg/d (non pregnant 400mcg) • Neural Tube defects – most common: spine ebifida

  7. Question of the DayWhat are good sources of Iron? • Heme Iron: • Best absorbed • Derived from hemoglobin found in animal foods: • Beef or chicken LIVER (3.5mg/serving) • Clams, mussels, oysters (3.5mg) • Cooked beef, sardines, turkey (3.1mg) • Chicken, halibut, salmon, veal, tuna, ham (0.7 mg) • Non Heme Iron • Less efficiently absorbed • Found in plants and fortified foods: • Breakfast cereals, cooked beans, tofu, 1oz pumpkin/sesame seeds (3.5mg) • Lima, kidney, split, chickpeas, dried apricots, backed potato, broccoli (2.1mg) • Peanuts, almonds, walnuts, spinach, green pepper, rice, bread, pasta (0.7mg)

  8. Daily Food Intake • General Guidelines • Regular meals – don’t skip • Eat enough food • Eat fruits and vegetables • Protein sources • Cultural aspects of eating

  9. Rate of Weigh Gain • ~2-4# in 1st trimester • ~ 1#/wk for the remainder of the pregnancy • Sharp wt ↑ may be water retention • Low maternal wt gain ↑ risk of intrauterine growth restriction

  10. Common Problems • N/V (nausea and vomitting) • Hyperemesis Gravidarum [n/v <1st tri] (persisting past 1st trimester) • Constipation • Hemorrhoids • Heartburn

  11. High Risk • Identify as soon as possible • Based on clinical evidence of inadequate nutrition • Patterns that do not support optimal maternal and fetal health 1. Insufficient food intake 2. Poor food selection 3. Poor distribution throughout the day • Teenage pregnancy • Special care must be given • DRI recommendation for ˂18 yo

  12. Special Needs • Age (when having kids as teenagers or < 35yr olds) • High Parity Rate • Alcohol (spectrum of disorders caused by intaking alcohol) [leading cause of preventable disorders – fetal alcohol syndrome] • Smoking [connected to fetal abnormalities]

  13. Special Needs (con’t) • Drug Abuse [goes through the placenta] • Caffeine [goes through the placenta as well] • Pica [cravings for non-food products] • Social economic problems

  14. Complications of Pregnancy • Anemia [more prevalent in poor women] Women need more iron or anemia will occur • IUGR (inter uterine growth restriction) – leads to more chronic disease. Just read the damn book • PIH (pregnancy induced hypertension) – spilling out proteins in urine? • Gestational Diabetes – diabetes during pregnancy

  15. Pre-Existing Conditions • DM – diabetes mellitus • PKU – unable to absorb phenyl alanine urea • Food Allergies • Celiac (disease) – limits the food you can eat • Lactose Intolerance – most high Ca foods come from dairy

  16. Breast Feeding • Best nutrition for baby for 1st 6 months • Milk production • Prolactin – stimulates milk production • Oxytocin – release of milk

  17. Breast Milk Composition • Colostrum – 1st milk – yellow • Mature milk – occurs in a couple of days (protein is higher in the 1st couple of days then decreases) • Hind milk – has essential fatty acids • Cows milk is not appropriate for infants under one year of age • (Too harsh for the baby in the early years)

  18. Nutrition Needs for Lactation • Prenatal Supplements should continue • Energy needed for process and product • 330 kcal/day in first 6 months • 400 kcal/day last 6 months • ↑ 25g protein/day • Fluid intake ~3/L day

  19. Question of the Day • Prenatal MVI’s for non – pregnant women • It’s OK if you need the nutrients • Look at overall diet then make a decision • Fat Souble vitamins are stored in tissue, not needed everyday • Absorption is best with food • If its for hair and nails decide if this is what you want long term • Costly • Weigh out benefits/long term effects unknown/continual usage/cost • *Excessive Vitamin A over time make weaken bones • *Vitamin E supplementation may slightly ↑ mortality

  20. Benefits of Breastfeeding Infant: • Decrease in severity or incidence of infectious dx • Increase cognitive performance • Decrease rate of SID syndrome, DM 1 and 2, lymphoma, leukemia, obesity, hypercholesterolemia, asthma Mother: • Earlier return to pre pregnancy weight • Decreased risk of breast cancer, ovarian cancer, osteoporosis

  21. Nutrition During Infancy Childhood and Adolescence • Ch 11

  22. Measuring Growth • Infancy • WHO growth chart (birth to 24 months) • Head circumference • Childhood/Adolescence • CDC growth chart (2-18) • BMI

  23. Energy and Nutrient Needs Premature: 110-130kcal/kg 1-3 yo: 80-120kcal/kg • Adult 30-40kcal/kg bodyweight Macronutrients • Carbohydrates are main energy source and spare protein • Protein for the 6 months of life: 1.5g/kg • Adults: 0.8g/kg • Fat is necessary for growth • Back up source of energy

  24. Nutrient Needs • Water • Infant consumes 10-15% body weight in fluid • Adult 2-4% • Vitamins • Needed in supplement form: Vitamin D (400 iu) and vitamin K • Minerals • Ca – bone development • Fe – hemoglobin synthesis (cognitive and behavioral performance)

  25. Age Group Needs Premature: ˂2500g • TPN ˃ Enteral ˃ Trophic feeds ˃ Oral feeds • Breast milk with fortification is optimal • Premature BM is higher in nutrients • Donor milk Term Infants • Iron fortified foods added ~6 months of age (early introduction of meat) • Bottle feeding • AA based formulas/Fat malabsorption

  26. Age Group Needs (con’t) • Childhood (1-3) • Energy needs are still high • Food preferences • 19g fiber/day to prevent constipation Preschool- Aged (3-5) • Patterns and food jags (food jags are very particular food) • Food variety, appropriate portion, role model • Growth is in spurts

  27. Age Group Needs (con’t) • School Aged (5-12) • Growth is irregular • Reserves occur 1-2 years before adolescence • Girls growth bypasses boys • Food preferences and new stimuli • Food choices at school Nutritional Problems • FTT • Anemia (milk anemia) – no iron in milk • Obesity • Lead poisoning

  28. Age Group Needs (con’t) • Adolescence (12-18) • Final growth spurt • Timing of sexual maturation • Eating habits • Eating Disorders – more commonly found in girls

More Related