Preconception Nutrition Conditions and Interventions

  1. what phase does PMS start?
    luteal phase
  2. Characterized by marked mood swings, depressed mood, disruptions of relationships, decreased work productivity, irritability, anxiety and physical symptoms (breast pain, HA, joint or muscle pain)
    Premenstrual Dysphoric Disorder
  3. What is the possible cause of PMS/PMDD
    • enhanced responsiveness to the normal changes in ovarian hormone levels that cause ovulation 
    • alterations in the availability of serotonin
  4. PMS Treatment (3)
    • Prevention of ovulation via oral contraceptives, estrogen patches
    • Antidepressants that contain serotonin repute inhibitors
    • Exercise and stress reduction
  5. Nutrition supplements to help PMS symptoms (2)
    • 1000 mg/day of calcium 
    • 50-100 mg/day of Vitamin B6 (involved with the synthesis of serotonin)
  6. Herbal supplment for PMS
    Chasteberry extracts

    20 mg/d have been reported to decrease irritability, mood alterations, anger, HA
  7. True/False: Chasteberry may not be safe for women who ma become or are pregnant, are taking oral contraceptive pills or have breast cancer
  8. Obesity decreases or increases likelihood of reproductive health problems?
  9. Insulin resistances and elevated insulin cause increased production of what?
    Androgens (testosterone)

    which leads to irregular menstrual cycles, delayed conception, anovolution
  10. In men, insulin resistance is associated with what fertility problem?
    reduced sperm quality
  11. Elevated BG, insulin and free fatty acid levels increase the production of what?
    reactive oxygen molecules which trigger oxidative stress and inflammation
  12. How does oxidative stress affect fertility?
    in damages sperm DNA leading to impaired function and motility
  13. True/False: not all obese individuals are at risk for fertility problems

    metabolically healthy obese ppl have a lower risk than obese individuals with elevated BP, lipid levels, glucose intolerance, increased markers of inflammation
  14. People are more fertile after bariatric surgery because...
    their hormone levels are improved and inflammation has decreased
  15. True/False: you can safely get pregnant after bariatric surgery

    recommended to wait 12-18 months after because eating very little after surgery and may not be well nourished/can't get nutrition for mom and baby

    also at risk for micronutrient deficiencies (iron, folate, calcium, thiamin, vitamin B12, vitamin D)
  16. Cessation of menstruation related in hypothalamic signals that maintain secretion of hormones required for ovulation
    Hypothalamic amenorrhea
  17. 3 or more months of no periods
  18. What causes hypothalamic amenorrhea?
    deficits in energy
  19. Suppressed activity of GnRH in hypothalamic amenorrhea causes
    won't stimulate the release of LH and FSH and therefore no ovulation
  20. Nutritional management of hypothalamic amenorrhea
    • weight gain by eating a healthy diet
    • gain of 6-11 lb typically restore fertility
  21. Decreased estrogen production by fat cells and suppressed GnRH activity (decreasing FSH secretion which decreases ovarian estrogen secretion) is caused by
    very low levels of body fat
  22. Nutritional management of eating disorders
    normalize body weight (AN) and eating behavior (BN) and multidisciplinary approach
  23. High blood glucose level during the first 2 month  of pregnancy are
  24. What is associated with a 2-3 fold increase in congenital abnormalities in pelvic, CNS and heart in newborn and higher rate of miscarriages
    diabetes mellitus prior to pregnancy
  25. Nutrition management of DM
    • Consistent CHO intake
    • low fat
    • <2300 mg sodium 
    • DRI for fiber
    • Weight loss
    • Exercise
  26. Prevention of gestational diabetes (starts in week 24-28)
    • Priority to pregnancy:
    • weight loss (if needed)
    • exercise
    • high fiber diet 
    • eating a healthy diet
  27. cystic ovaries*** (eggs and follicles that start to form and can't)
    hirsutism (growing hair in male-patterened form)
    elevated androgens*** (increases testosterone)
    Menstrual abnormalities***

    are all clinical signs of
    Polycystic ovary syndrome

    ***need 2 of 3 for PCOS diagnosis
  28. What is the leading cause of female infertility?

    infertility due to absence of ovulation
  29. What is the cause of PCOS
    • unknown but insulin resistance appears to play a role
    • genetic component, tens to run in the family
  30. Management of PCOS
    • Increase insulin sensitivity by weight loss (5-10% wt loss)
    • Exercise (>30 mins/day)
    • Insulin sensitizing drugs (metformin)
  31. True/False: PKU affects fertility

    If you have PKU in preconception period you need to take caution
  32. elevated blood PHE due to lack of phenylalanine hydroxylase which concerts PHE to tyrosine
  33. True/False: if mother has elevated serum levels of PHE during early pregnancy it can affect the baby

    • impaired CNS development in fetus (severe mental retardation, low life expectancy)
    • PHE can cross the placenta
  34. Nutrition management of PKU
    • Strict control of maternal PHE levels before conception and during pregnancy
    • Low-PHE diet (kinda like a vegan diet)
    • -excludes high phe food- (meats, fish, poultry, dairy, eggs, legumes, nuts, seeds)
  35. autoimmune enteropathy characterized by a sensitivity to prolamins found in wheat, rye and barley
    Celiac disease
  36. Chronic t-lympocyte mediated inflammatory response in response to ingested prolamins
    Celiac disease
  37. Difference between celiac disease immune reaction and food allergy immune reaction
    • Celiac--T-cells
    • Allergy--B-cells
  38. True/False: Celics is associated with sub fertility and infertility in women and men
  39. in males, untreated celiac disease causes alterations in _____ and ______
    • androgen action 
    • hypogonadism
  40. in females, untreated celiac disease is associated with ____, _______, _______, ______
    • amenorrhea
    • increased rate of miscarriage
    • fetal growth restriction
    • LBW infants (not getting enough nutrients because mom is malabsorption)
  41. infertility with celiacs is likely related to
    • direct effects of inflammation
    • malabsorption of vitamins A, E, D, folate and iron 

    *Malabsorption should stop once on gluten-free diet because intestines heal eventually
  42. Nutritional Management of Celiac Disease
    • Remove all harmful grains (wheat, barley, rye) and replace with allowed grains (quinoa, corn, potatoes, millet, rice)
    • Educate on hidden sources of gluten and risk of cross-contamination 
    • Correction of vitamin and mineral deficiencies that may have occurred
Card Set
Preconception Nutrition Conditions and Interventions
LC Exam 1 Material