diet pregnancy

8/13/2019 Diet Pregnancy

1/62

Click to edit Master subtitle style

9/6/12

Report by: Rio and Ria Nofuente


2/62

9/6/12Body composition

changes duringpregnancy


3/62

9/6/12

Following conception andcontinuing until parturition

(childbirth), any etabolic,anatoic, horonal,p!ychologic, and phy!iologic

change! ta"e place in theother#


4/62

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


5/62

9/6/12

$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#


6/62

9/6/12

$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#


7/62

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!#


8/62

9/6/12

$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#


9/62


10/62

9/6/12

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#


11/62

9/6/12

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#


12/62

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#


13/62

9/6/12

*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#


14/62

9/6/12

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


15/62

9/6/12

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.


16/62

9/6/12

"#$R%$%&"

'#R%"()R*("A"C+


17/62

9/6/12

*nergy and nutrient needs duringpregnancy

$he dietary reference inta"e!(ER*!) recoend increa!e!during pregnancy of all nutrient!

++&$


18/62

9/6/12


19/62

9/6/12


20/62

9/6/12

*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)

&regnantoan

(8rdtrie!ter)


21/62

9/6/12

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.


22/62

9/6/12

*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 #


23/62

9/6/12

+tra !andwich and a gla!! of il" canea!ily pro'ide the additional 800 "calper day, pro'iding !he wa! eating wellbefore pregnancy#


24/62

9/6/12)R&$*%"-

Recoended Eietary 3llowance(RE3) for protein during pregnancy i!60 gra! per day for adole!cent and

adult woen#

&regnant &atient! ay be counceled to

include appropriate !ource! of proteinthat pro'ide! 'it, ineral!, andoderate aount! of fat#


25/62

9/6/12

Changes in the daily food guidepyramid during pregnancy andlactation

Food roup Nonpregnant &regnant or


26/62

9/6/12

-ample menu for pregnantwomen

BR*A./A-$

hole grain toa!t

anana

ateal

%"i il" or orange Juice


27/62

9/6/12

-nack

ereal (ready to eat)

%"i il"


28/62

9/6/12

lunch

Roa!t beef (lean) !andwich on whole grainbread with lettuce and toato#

reen !alad

range wedge!

%"in il"


29/62

9/6/12snack

3pple with chee!e, or fruit and yogurt !ha"e#


30/62

9/6/12

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"


31/62

9/6/12snack

Fig or oateal rai!in coo"ie! or open face!peanut butter !andwich#


32/62

9/6/12

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!#


33/62

9/6/12

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.


34/62

9/6/12

%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#


35/62

9/6/12

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#


36/62

9/6/12

!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#


37/62

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#


38/62

9/6/12left lip or palate


39/62

9/6/12

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#


40/62

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#


41/62

9/6/12

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#


42/62

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


43/62

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#


44/62

9/6/12/etal alcohol syndrome


45/62

9/6/12


46/62

9/6/12tobacco

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#


47/62

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#


48/62

9/6/12

(uidelines for exercise duringpregnancy2

K


49/62

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!#


50/62

9/6/12preeclampsia

3"a pregnancy1inducedhypertension )%H!,

i! a cople!yndroe of deficient'a!culari7ation,

platelet dy!function,hyperlipideia, andaltered cyto"inele'el!#


51/62

9/6/12

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


52/62

9/6/12

&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


53/62

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


54/62

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#

9


55/62

9/6/12

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#

9


56/62

9/6/12

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#

9


57/62

9/6/12

(*-$A$%&"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!#

9


58/62

9/6/12

$R*A$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#

9


59/62

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


60/62

9/6/12$he child on the left has ).#

9


61/62

9/6/12Hi5 infection

&regnancy 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!#

9


62/62

/6/12

en$han" you for li!tening)

diet pregnancy

Documents