Diet Pregnancy
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Transcript of Diet Pregnancy
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8/13/2019 Diet Pregnancy
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9/6/12
Report by: Rio and Ria Nofuente
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9/6/12Body composition
changes duringpregnancy
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Following conception andcontinuing until parturition
(childbirth), any etabolic,anatoic, horonal,p!ychologic, and phy!iologic
change! ta"e place in theother#
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9/6/12Hormones of pregnancy
$here are nuerou! !teriod horone!,peptide horone!, and pro!taglandin! thatinfluence the cour!e of pregnancy#
%oe of the, !uch a! the placentalhorone! human placental lactogen andhuman growth hormones, are produced only
during pregnancy#
&roge!terone and e!trogen ha'e a particularly!trong influence on pregnancy
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$he action of proge!terone proote! thede'elopent of the endoetriu and relae!the !ooth u!cle cell! of the uteru!
$hi! relaation !er'e! both to help the uteru!epand a! the fetu! grow! and to pre'ent anypreature contraction! of the uteru!#
$he !ae effect al!o influence! other !oothu!cle cell!, !uch a! the ga!trointe!tinaltract#
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$he re!ulting !lowing of the * tract duringpregnancy ay increa!e the ab!orption of!e'eral nutrient!, o!t notably iron andcalciu#
&roge!teron cau!e! increa!ed renal !odiuecretion during pregnancy#
+!trogen proote! the growth of the uteru!and brea!t! during pregnancy and render! theconnecti'e ti!!ue! in the pel'ic region ore
fleible in preparation for birth#
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9/6/12Metabolic changes
$he ba!al etabolic rate (-R) ri!e! duringpregnancy by a! uch a! 1. to 20 byter#
$hi! increa!e i! cau!ed by the increa!ed oygenneed! of the fetu! and the aternal !upportti!!ue!#
$he fetu! prefer! to u!e gluco!e a! it! priaryenergy !ource#
hange! occur in aternal etaboli! toaccoodate thi! need of the fetu!#
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$he adaptation allow! the other to u!e fata! the priary fuel !ource, thu! perittinggluco!e to be a'ailable to the fetu!#
*ncrea!ed acronutrient and icronutrientinta"e by the other during pregnancyen!ure! that the!e increa!ed etabolic need!
are et#
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ardiac hypertrophy occur! to accoodatethi! increa!ed blood 'olue, accopanied byan increa!ed 'entilatory rate#
*n the "idney!, the gloerular filtration rate(FR) increa!e! to accoodate theepanded aternal blood 'olue being
filtered and to carry away fetal wa!teproduct!#
3! a re!ult of thi! increa!e in FR, !all4uantitie! of gluco!e, aino acid!, and water5!oluble 'itain! ay appear in the urine#
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3lthough inor lo!!e! ay be acceptable, awoan who ecrete! large aount! of proteinay eperience a ore !eriou! problecalledpregnancy-induced hypertension,
which need! !trict edical onitoring#
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9/6/12Weight gain in pregnancy
$here are three coponent! toaternal weight gain:
1# -aternal body copo!ition change!
including increa!ed blood andetracellular fluid 'olue
2# $he aternal !upport ti!!ue! !uch a!
the increa!ed !i7e of the uteru! andbrea!t! and
8# the product! of conception, includingthe fetu! and the placenta#
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*nade4uate weight gain by the other duringpregnancy !ugge!t! !he ay not ha'erecei'ed the proper nutrient! duringpregnancy#
&oor weight gain ay then lead tointrauterine growth retardation in the infant#
*nfant! born !all for ge!tational age (%3) orlow birth weight are ore li"ely to re4uiredprolonged ho!pitali7ation after birth or be ill or
die during fir!t year of life#
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3dditionally, infant ortality rate, which inpart reflect! aternal weight gain, i! regardeda! one ea!ure of a country! health and wellbeing#
Recommended total eight gain
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Recommended total weight gainranges for pregnant women, byprepregnancy body mass index
bmi!eight5for5heightcategory
Recoended
$otal gain
;g lb
) 12#.51> 2>5?0
Noral (-* of 19#> @26#0) 11#.516 2.58.
AighB (-* of C 26529) D511#. 1.52.
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"#$R%$%&"
'#R%"()R*("A"C+
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*nergy and nutrient needs duringpregnancy
$he dietary reference inta"e!(ER*!) recoend increa!e!during pregnancy of all nutrient!
++&$
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*ncluding pho!phoru!, fluoride, calciu, andbiotin# $here are !eparate dietaryrecoendation! for adole!cent! who are
pregnant#'R%s to Meet "eeds of )regnancy andactation3dult
oan
(2.5?9 yr! ofage)
®nantoan
(8rdtrie!ter)
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Ribofla'in(g)
1#1 1#? 1#6
Niacin (N+g)
1? 1> 1D
Git 6 (g) 1#8 1#9 2#0
Folate (cg) ?00 600 .00
Git 12 (cg) 2#? 2#6 2#>alciu (g)t 1000 1000 1000
&ho!phoru!
(g)
D00 D00 D00
*ron (g) 1. 80 1.
Iinc (g) 12 1. 19
*odine (cg) 1.0 1D. 200
%eleniu .. 6. D.
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*nergy
e!t e!tiate! energy co!t of pregnancyi! !oewhere between 6>,000 "cal and>0,000 "cal#
*ncrea!e accoodate! the ri!e inaternal -R during pregnancy a! wella! the !ynthe!i! and !upport of theaternal and fetal ti!!ue!#
$he current recoendation i! forwoan to con!ue an etra 800 "cal per
day during the 2nd and 8rd trie!ter! ofre nanc #
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+tra !andwich and a gla!! of il" canea!ily pro'ide the additional 800 "calper day, pro'iding !he wa! eating wellbefore pregnancy#
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Recoended Eietary 3llowance(RE3) for protein during pregnancy i!60 gra! per day for adole!cent and
adult woen#
®nant &atient! ay be counceled to
include appropriate !ource! of proteinthat pro'ide! 'it, ineral!, andoderate aount! of fat#
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Changes in the daily food guidepyramid during pregnancy andlactation
Food roup Nonpregnant ®nant or
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-ample menu for pregnantwomen
BR*A./A-$
hole grain toa!t
anana
ateal
%"i il" or orange Juice
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-nack
ereal (ready to eat)
%"i il"
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lunch
Roa!t beef (lean) !andwich on whole grainbread with lettuce and toato#
reen !alad
range wedge!
%"in il"
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9/6/12snack
3pple with chee!e, or fruit and yogurt !ha"e#
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dinner
%e!ae chic"en (or fi!h) with broccoli and pa!ta
-ied !alad (carrot!, toatoe!, !pinach,roaine lettuce)
*talian bread and butter
Fre!h fruit !alad
%"i il"
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9/6/12snack
Fig or oateal rai!in coo"ie! or open face!peanut butter !andwich#
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0itamin and mineralsupplementation
$he ER*! are increa!ed during pregnancy foro!t 'itain! 3 and E#
-icronutrient need! ay be et with abalanced diet, with a few notable eception!including folate and iron#
3ll !uppleentation during pregnancy !houldbe in the for of prenatal type ulti'itainineral !uppleent! are recoended bypriary healthcare pro'ider! or dietitian!#
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Folate. %ub!tantial re!earch ha! deon!tratedthat folate i! iportant for the pre'ention of
neural tube defect! (N$E!) !uch a! !pina bifidaand anencyphaly, one of the o!t cooncongenital alforation! in the united !tate!#
Iron. $he RE3 for iron during pregnancy i! 80g/day# $hi! le'el ay be difficult to achie'ewith a noral diet, which aintain!recoended fat and "caloric guideline!#
Therefore all woman should take asupplement with 30mg ferous iron dailybeginning in the 2nd trimester to preventiron deficiency anemia in pregnancy.
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%ron deficiency anemia
K one of the o!t coon coplication! ofpregnancy#
K an ean ipaired oygen deli'ery to thefetu!, which ay ha'e !e'ere con!e4uence!#
*n addition, during the la!t trie!ter, the fetu!!tore! iron in it! li'er to u!e during the 1!t
?onth! of life#
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ica
K haracteri7ed by a hunger and appetite fornon5food !ub!tance! including ice, corn!tarch, clay, and e'en dirt#
K $he!e !ub!tance! contain no iron and aylead to lo!! of additional ineral!, particularlywhen clay and dirt are con!ued#
K *nte!tinal bloc"age! cau!ed by con!uptionof the!e !ub!tance! ay be life5threatening#
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!alcium. $he 3de4uate *nta"e (3*) forcalciu i! 1000 g/day for woen and 1800g/day for adole!cent!, neither of which i! anincrea!e o'er the non5pregnant !tate#
3lthough calciu need! are great duringpregnancy, particularly for inerali7ation ofthe fetal !"eleton, change! occur in aternalcalciu hoeo!ta!i!, which re!ult! in anincrea!e in inte!tinal calciu ab!orption#
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9/6/12"utrition1related concerns
3 nuber of non5nutriti'e !ub!tance! thatwoen ay be epo!ed to during pregnancyay ha'e the capability to act a! teratogen!#
$eratogen an agent capable of producing aalforation or a defect in the unborn fetu!#
%oe anoalie! are apparent at birth or !hortlyafter, !uch a! N$E! or a cleft lip or palate#
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9/6/12left lip or palate
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ther defect! !uch a! delayed growth orlearning deficit! ay not be noticeable for!e'eral onth! or e'en year!#
&otential teratogen! include caffeine, drug!,alcohol, and tabacco#
ther concern! affecting the cour!e and
outcoe of pregnancy include !trenou!eerci!e, aternal age, and edical condition!re4uiring nutrition inter'ention !uch a!hyperten!ion, diabete!, phenyl"etunoria, andhuan iuneodeficiency 'iru! (A*G) infection#
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9/6/12caffeine
hether a woan !houldrefrain fro caffeinecon!uption duringpregnancy ha! been a
atter of debate#
affeine (15, 85, D5triethyanthine) ay alterdeoyribonucleic acid (EN3)and, in !oe indi'idual!,ay alter circulating le'el!of neurotran!itter! and
increa!e blood pre!!ure#
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Aowe'er there i! now enough e'idence!tating that caffeine i! not a huanteratogen, and e'en at ode!t do!e! (=800g/day or about 2 cup! or le!! of coffee,
there i! no increa!ed ri!" of !pontaneou!abortion or preter labor#
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9/6/12drugs
3 pregnant woan!hould not con!ue anyco'er5the5counter orpre!cription edication!
unle!! pre!cribed by herpriary healthcarepro'ider#
3lthough not a directnutrient concern, theacne edicationi!otretinion (accutane)
contain! high le'el! of
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9/6/12alcohol
L!e of alcohol during pregnancy ay produce
/etal alcohol syndrome /A-!
rfetal alcohol spectrum disorder /A-'!
in the infant#
%ypto! include !pecific anatoic defect!!uch a! a low na!al bridge, !hort no!e, flatidface, and !hort palpebral#
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9/6/12/etal alcohol syndrome
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oen who !o"e during pregnancy are atgreater ri!" for !e'eral ad'er!e outcoe!including the following: preaturity, low birthweight, %3, !tillbirth, placenta pre'ia
(location in lower uterine area), placentaeabruptio (!eparation fro uterine wall), andpo!tnatally, !udden infant death !yndroe(%*E%)#
%o"ing during pregnancy ay cau!eprolonged effect! of ipaired intellectualperforance and decrea!ed attention !pan in
the off!pring#
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9/6/12exercise
%trenuou! eerci!e wa! thought to di'ertblood to the eerci!ing u!cle! and thu!reduce the blood !upply to the fetu!#
*f a woan choo!e! to eerci!e duringpregnancy !he u!t reeber to drin" fluid!before, after, and if nece!!ary, during eerci!eand to choo!e nutritiou! !nac"! before andafter eerci!e#
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(uidelines for exercise duringpregnancy2
K
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9/6/12Maternal age
3dole!cent! and woen older than8. year! of age are at higher ri!"for poor pregnancy outcoe#
oen who becoe pregnantafter the age of 8. yr! ha'edi!tinct nutritional need!,reflecting their longer edical
hi!tory, potential long5ter u!e oforal contracepti'e! (which ayaffect folate le'el!) and thepo!!ibility of a longer hi!tory of
poor eating habit!#
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9/6/12preeclampsia
3"a pregnancy1inducedhypertension )%H!,
i! a cople!yndroe of deficient'a!culari7ation,
platelet dy!function,hyperlipideia, andaltered cyto"inele'el!#
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Risk factors and symptoms ofpreeclampsia
)R*1)R*("A"C+ /AC$&R- $HA$ MA+ *A' $&$H* '*0*&)M*"$ &/ )R**CAM)-%A
%"C#'* $H* /&&W%"(2
No pre'iou! pregnancie!
*nade4uate dietary inta"e
Eiabete! ellitu! (type1 type 2)
3ge at conception: 20 year! or younger
8. year! or older
Faily hi!tory: hyperten!ion, 'a!cular di!ea!e
& l i i li i
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&reelap!ia in earlier pregnancie!
&o'erty that effect! acce!! to prenatal care
-+M)$&M- '#R%"( )R*("A"C+ %"C#'*$H* /&&W%"(2
Ayperten!ion (changed copared with u!ual
le'el)
Aeadache! (continuou! and !e'ere)
Ei77ine!! and blurred 'i!ion
+dea of hand! and face
%udden weight gain
Lpper abdoinal pain
%lowed fetal growth
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9/6/12'iabetes mellitus
oen with pre ei!tingdiabete! ellitu! (E-)(type 1 and type 2 E-)re4uire! !peciali7ed care
during pregnancy#
ther coplication!include fetal acro!oia,
dy!tocia, operati'edeli'ery, neonatalhypoglyceia andneonatal re!piratory
di!tre!! !yndroe#
9
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9/6/12Ma3or defects4
ardiac defect!
Ner'ou! !y!te defect! including N$E!
;idney alforation!,
3nd !"eletal anoalie!#
$he!e infant! ay eperience hypoglyceiaafter birth#
$he aternal !ource of gluco!e i! no longera'ailable, and becau!e gluco!e readily cro!!e!the placenta, le'el! of gluco!e in utero tend tobe high, e!pecially if the diabete! ha! been
poorly controlled#
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Current recommendation for women toachie5e tight glucose control beforeconception
K -aii!e the li"elihood of a healthy otherand infant, while a'oiding perinatal ri!"!#
K ontrol include! prudent blood gluco!eonitoring, adherence to diet, oderateeerci!e, and !trict adherence to thepre!cribed in!ulin regien#
K $otal energy inta"e and energy di!tributionwill li"ely need odification during pregnancybecau!e of the increa!ed energy need! ofpregnancy#
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K *n!ulin do!age! will re4uire adJu!tentbeacu!e any of the horone! of pregnancy,!uch a! e!trogen, proge!teron, huanchorionic, !oatotropin, and aternal
corti!ol, act in an antagoni!tic fa!hion within!ulin#
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(*-$A$%&"A '%AB*$*- M*%$#- ('M!
K For of diabete! that occur! during pregnancy5o!t coonly after the 20th wee" ofge!tation#
K & eperience abnoral carbohydrateetaboli! in a anner !iilar to otherper!on! with diabete!#
K E- i! the o!t coon, affecting 2 to 8of all pregnancie!#
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$R*A$M*"$ &/ ('M
K &riarily of dietary control cobined withoderate eerci!e leading to an appropriateweight gain#
K *n!ulin ay be re4uired if glyceic control i!not achie'ed through dietary control and
eerci!e#
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9/6/12Maternal phenylketonuria
&henyl"etonuria (&;L) an inbornerror of etaboli! characteri7edby etreely low le'el! of the
en7ye phenylalaninehydroyla!e, which cataly7e! thecon'er!ion of phenylalanine to
tyro!ine#
9
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9/6/12$he child on the left has ).#
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9/6/12Hi5 infection
®nancy ay put an additional !train on thealready fragile iune !y!te becau!e thehorone! and protein! of pregnancy(including e!trogen, proge!terone, huan
chorionic gonadotropin, alfafetoprotein,cortico!teroid!, prolactin, and alphaglobulin)ha'e iuno!uppre!!i'e effect!#
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en$han" you for li!tening)