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• 1 Exam One

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• Nutrition-Related Disruptions in Fertility

  1. Undernutrition
  2. Weight loss
  3. Obesity
  4. High exercise levels
  5. Intake of specific foods & components

• Body Fat & Fertility

  *Decreased fertility seen in low or high body fat due to alterations in hormones
  *Infertility lower with BMI <20 or >30

• 3 examples of the Healthy People 2020 nutrition-related objective for the preconception period

  1. Increase the proportion of women who are at a healthy weight prior to pregnancy by 10%
  
  
  2. Increase the proportion of women of childbearing potential with intake of at least 400 mcg of folic acid from fortified foods or dietary supplements by 10%
  
  3. Reduce iron deficiency among females of childbearing age by 10%

• Describe the potential effects of nutrition-related factors such as body fat content, iron status, and alcohol intake on fertility in males & females

  body fat content:
  
  *females: tend to have higher levels of estrogen, androgens, and leptin, which favor menstrual-cycle irregularity 
  
  *males: lower levels of testosterone & increased estrogen & leptin levels, which reduce sperm production & higher rates of erectile dysfunction
  
  iron status: low iron status indicates infertility due to a lack of ovulation 
  
  alcohol intake: Decrease estrogen & testosterone levels and disrupting the menstrual cycles & testicular functions 

• Develop a one-day menu for a pre-conceptional woman and a man based on the ChooseMyPlate.gov for guidance & materials

  pre-conceptional women:
  
  *consume 400 mcg of folic acid from fortified foods or supplements in addition to dietary folate from a variety of foods
  *Take no more than 10,000 IU of vitamin A (retinol or retinoid acid) from supplements
  *Limit or omit alcohol-containing beverages
  
  Calories: 2,200
  
  Vegetables: 3 cup
  Fruits: 2 cups
  Dairy: 3 cups
  Grains: 7 oz.
  Protein: 6 oz.

• Identify three nutrition-related consequences that may be related to the use of combination hormonal contraceptives, and consequence that is related to the use of estrogen or progestin contraceptives only

  1. Progestin- only hormonal contraceptives (Depo-Provera) are associated with weight gain 
  2. Progestin- only have been found to decrease bone mineral accretion in adolescents 
  3. Estradiol & progestin- associated with altered blood lipid levels, glucose metabolism, and decrease HDL & increase LDL cholesterol and triglyceride concentrations, increase blood glucose and insulin levels, and increase inflammation 

• 3 important nutrition-related components of preconceptions health care

  1. WIC program
  2. CDC's preconception Health Initiative 
  3. Decreasing Iron Deficiency in Indonesia

• Describe the 4 steps of the Nutrition Care Process

  1. Nutrition assessment
  2. Nutrition diagnosis
  3. Nutrition intervention
  4. Nutrition monitoring and evaluation 

• Cite 2 examples of how nutrient needs change during the life cycle & how nutritional status at one stage during the life cycle can influence health during another

  1. Pregnancy lack of adequate nutrients  can program gene functions that set the stage for life-long metabolic changes that increase the risk of chronic disease development 
  2. Adolescence and early adulthood need adequate vitamin D decreases breast cancer risk in older woman 
  
  Individuals require the same nutrients through-out life, but amounts of nutrients needed vary based on age, growth, and development. 

• Describe the components of individual-level nutrition assessment

  1. Clinical/physical assessment
  2. Dietary assessment
  3. Anthropometric assessment 
  4. Biochemical assessment