By Miguel Torres,2014-05-20 14:12
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Describe a healthy diet for lactation (breast feeding). Same as pregnant women, fortified ready-to-eat breakfast cereal is advised (or use of atypical


    1. Describe the desired "outcome" of a pregnancy.

    - full term (at least 38-40 weeks gestation)

    - weight of baby at birth: 3-4 kg (6-8 lbs)

    - healthy infant and mother

    2. Explain how nutrients are exchanged between mother and fetus.

    - placenta is an organ that acts as barrier between maternal and fetal blood

    - nutrients are exchanged through the umbilical cord: it attaches to belly button and

    supplies nutrients and oxygen to fetus…takes out waste products and CO2

    3. Describe the concept of "critical period" in fetal development and the related concerns

    about folate and alcohol intake.

    - critical period: first trimester( 13 weeks): if problem occurs during this time it will not

    recover…irreversible damage…includes organ development, etc.

    - concerned about too much Vitamin A (causes birth defects)

    - alcohol (causes fetal alcohol syndrome)

    - folate (neural tube defects)…spinal cord and brain defects

    now we have fortification of grain products w/folate

    4. Compare nutritional needs during pregnancy to the non-pregnant state.

    Pregnancy: low fat diary, lean meats, fruits and vegetables (for vitamin C, beta-carotene,

    folate…need more than non pregnancy), whole and enriched grains, zinc, iron (150 times non-


    - gain …with normal weight women…25-35 pounds

    5. Describe a healthy diet for pregnancy.

    - low fat milk, lean turkey and chicken, fruits and vegetables, whole wheat bread, high zinc foods,

    folate enriched breads

    6. State recommendations for use of nutrient supplements during pregnancy.

    - Iron (needs 150 times non-pregnancy)

    - Folate

    Do not supplement: preformed vitamin A

    7. List maternal risk factors for poor pregnancy outcome.

     nutritional status -

    - poverty: (not well connected to health, not enough food dollars)

    - smoking: nicotine constricts blood vessels…less transferring of nutrients, etc. ….will

    give birth to smaller babies

    - substance abuse: lifestyle

    8. Describe a healthy diet for lactation (breast feeding).

    Same as pregnant women, fortified ready-to-eat breakfast cereal is advised (or use of atypical vitamin

    and mineral supplement) to meet extra nutrient needs. Consume fish twice a week (or fish oil

    supplements) because the omega-3 fatty acids present in fish are thought to be important for brain


    Eat a balanced diet that supplies at least 1800 kcal/day, has a moderate fat content, and includes a

    variety of dairy products, fruits, vegetables, and grains. Woman should rink fluids every time the infant


    9. State three maternal benefits of breastfeeding.

    (1) economical

    (2) overfeeding unlikely…bottle fed babies are fatter

    (3) mouth and jaw development are enhanced

    (4) infant/mother bonding 10. List three reasons breast milk is the superior feeding for an infant.

    (1) Nutritionally superior

    (2) immunological factor (protect newborn from bacteria & infection)

    (3) sterile (not contaminated)

11. Explain why infant formula is an acceptable substitute for breast milk and why cow milk is


    Cow milk is for baby cows. …can use modified cow milk formula

    Commercial infant formulas are nutritionally complete

    12. Explain why a good source of iron should be added to an infant’s diet at 4-6 months of age.

    Very rapid infant growth rate…

13. State the rationale for delaying feeding an infant with a spoon until 4-6 months of age.

    Consider both nutrition and development in your answer.

    Before 4-6 months, infants are not physically mature enough to consume much solid food.

    Nutritional need: iron stores are exhausted by about 6 months of age. Either solid foods supplements are then needed to supply iron if the child is breastfed or fed a formula not supplemented with iron.

    Iron, however, is not the only nutrient missing from human milk and unfortified infant formulas.

    Vitamin D may also deserve attention, as previously mentioned. Still before 4-6 months, it’s

    unnecessary to ad solid foods.

    Physical development: three markers indicate that a child is ready for solid foods: (1) the disappearance of the extrusion reflex ( thrusting the tongue forward and pushing food out of the

    mouth), (2) head and neck control, and (3) the ability to sit up with support. These usually occur

    around 4 6 months of age, but they vary with each infant.

    Alcohol and Electrolytes 1. Explain why alcohol is both a nutrient and a drug.

    Nutrient: 7 cal/g energy

    A drug: alters normal body function; depressant on central nervous system

    2. Describe how and where alcohol is absorbed into the blood stream.

    Only nutrient absorbed through the stomach (20%); small intestine (80%); no digestion required


    Chemical properties of alcohol: lipid-soluble substances are easily absorbed across membranes.

    It can be used as a disinfectant to kill bacteria by easily passing through the cell membrane

    Alcohol is also water-soluble…so it is evenly distributed in the body’s water compartments.

    3. Describe the primary metabolic pathway for alcohol.

    Ethanol ? (NAD-NADH+) ? acetaldehydrate ? CoA (Acetyl-CoA),

     (alcohol dehydrogenase) (acetaldehyde dehydrogenase)

    (detoxifying alcohol)

    - enzymes used for energy metabolism now used to metabolize alcohol

    - metabolism of alcohol = detoxification (occurs mostly in liver)

    - primary pathway:

    o alcohol dehydrogenase pathway

    o ethanol ? are in stomach

     (30%) of alcohol taken in men o

    o acetaldehyde: a poison

    o What happens to Acetyl CoA: (1) make fat (2) to TCA cycle to make energy 4. Explain how body size, gender, ethnicity, and the amount of food in the stomach influence

    the intoxicating effects of alcohol.

    Size: small size ? less water in body ? increased concentration of ethanol

    Gender: females feel intoxicating effects more because they absorb more ethanol in the stomach. The

    ability to produce the enzyme alcohol dehydrogenase (ADH) is the key to alcohol metabolism. Women

    cannot metabolize much alcohol in the cells that line her stomach because of low activity of the

    enzyme ADH. A larger portion of the same size drink reaches the women’s bloodstream. Alcohol is

    initially metabolized by alcohol dehydrogenase from gastric juice. Men metabolize about 30% of the

    alcohol ingested, but women metabolize only 10%, since they produce smaller amounts of the enzyme.

    Ethnicity: Asians generally have lower alcohol tolerance because they have less acetaldehyde


    Amount of food in the stomach: full stomach affects the absorption of alcohol by INCREASING its


    5. State the effect of the MEOS on alcohol tolerance and on the negative health effects of

    chronic alcohol intake.

    MEOS: microsomal ETOH oxidizing System

    MEOS is used with chronic use of alcohol/high doses of alcohol (higher tolerance to intoxicating effect)

    MEOS does not affect the production of acetaldehyde, health effects of alcohol, and fat accumulation

    in liver.

    6. State the effects of chronic alcohol abuse on the esophagus and liver.

    Esophagus: cancer

    Liver: fat and large…cirrhosis 7. Describe fetal alcohol syndrome.

    Infants with mothers who drank alcohol are affected

    Symptoms of FAS: (1) learning disability (2) low IQ (3) physical malformation (4) mental retardation

    8. List three reasons alcoholics are at risk for malnutrition.

    (1) nutrient intake is poor—why? Alcoholics usually don’t eat fruit and veggies

    (2) reduced absorption: cells in G.I. tract not working well. ETOH toxic to mucosa (cell

    lining) of your G.I. tract

    (3) metabolism of nutrients after absorption is affected: liver can’t metabolize nutrients you

    do take in

    9. List two vitamin deficiencies that often occur in alcoholism.

    Thiamin, folate, niacin, B6 B12, Vit. C, all fat-soluble Vits (A,D, E, K)


    1. Define the term electrolyte.

    Charged particle (or ion) which results from the dissociation of mineral

    2. For the electrolytes sodium and potassium state the functions, food sources, and effects of

    inadequate and excessive


    Function: maintain fluid balance, muscle contractions, transmit nerve impulse

    Food sources: all processed & prepared foods: curred meats, condiments, soy sauce

    Effects of inadequate intake: muscle cramps, nausea, vomiting, dizziness, and later shock and coma.

    Effects of excessive intake: toxic (esp. when kidneys cannot excrete the excess in

    urine)…accompanied by a lack of water, increases calcium loss in the urine,


    Function: maintain fluid balance, muscle contraction, transmit nerve impulse

    Food sources: unadulterated foods: fruits and veggies, bananas

    Effect of inadequate intake: loss of appetite, muscle cramps, confusion, and

    constipation...eventually…hearts beats irregular, decreasing its capacity to pump blood.

    Effect of excessive intake: gastrointestinal upset…when kidneys function poorly, potassium builds up in

    the blood, creating a condition called hyperkalemia (inhibits heart function, causing slower heartbeat…can

    be fatal)


    After attending class and completing the assigned reading of Chap 19 the student will be able to:

    1. Define the terms: toxicology and dose response.

    Toxicology: the study of adverse effects of chemicals on living organisms.

    Dose response: dose determines toxicity

    2. Explain the "no observable effect level" as it applies to regulation of food additives.

    Food additives are tested under FDA scrutiny for safety on at least two animal species, usually rats and

    mice. Scientists determine the highest dose of the additive that produces no observable effects in the

    animals. These doses are proportionately much higher than humans are ever exposed to. The maximum

    dosage is then divided by at least 100 to establish a margin of safety for human use. So…”no

    observable effect level” is the highest dose of an additive that produces no deleterious health effects in


    3. State which group of pesticides is of greatest concern in food. Explain.

Organic chlorides ex. DDT

    - low acute toxicity

    - high persistence

    - high persistence

    - lean bioaccumulate (increased toxicity of a compound as it travels higher in the food chain

    4. Explain the concept of bioaccumulation using mercury as an example. - birth effects

    - severe neurological damage

    - most potent formismethol mercury? lipid soluble, readily cross cell membranes,

    - causes free radical damage (cell membrane)

    5. Explain how lead poisoning can lead to iron deficiency anemia and learning disabilities in


    Ingesting lead can cause anemia, kidney disease, and damage to the nervous system, which can

    interfere with nerve impulse conduction. Because lad has a high atomic weight, it is a heavy metal.

    Many heavy metals are toxic at low doses. The precise mechanism by which lead affects the brain I not clear; however, because lead is chemically similar to calcium, it can disrupt brain mechanisms that

    depend on calcium. Exposed children who eat a high-fat diet low in calcium and low in iron absorb

    more lead than do those who eat a more healthful diet.

    6. Explain the possible consequences of consuming seafood when a quarantine (eg. red tide

    warning) is in effect.

     increase in human waste leads to an increase in nutrients in ocean leads to an increase (1)algal growth

    (2) increase temperatures leads to an increase in algal growth which leads to an increase in

    toxin produces….so shellfish take up algae and thus they’re more toxic.

    Dr. Bjeldanes’ "Questions of the Day"

    1. What is the fundamental concept of toxicology?

    The dose determines toxicity

    2. What class of additives is of greatest concern for safety?

    Synthetic food colors

    3. Which group of pesticides is of greatest concern in the environment? The persistent and fat soluble organochlorine pesticides.

    4. How could St. Anthony cure the "holy fire"?

    Pilgrimages for St. Anthony separated sufferers from the fungal contaminated rye grain

    5. Why are marine poisonings on the rise?

Increased algal growth possibly because of increased nutrient pollution or increased temperatures from

global warming.

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