The document discusses the importance of nutrition during pregnancy. It notes that optimal nutrition prior to and during pregnancy promotes healthy fetal growth and development and reduces risk of diseases later in life. The fetus relies on maternal nutrition for growth and development. Key nutrients discussed include carbohydrates, proteins, fats, vitamins and minerals. Guidelines are provided around healthy eating, nutrient requirements, and gestational weight gain during pregnancy.
Nutrition For Lactating and pregnant womanCM Pandey
Knowledge of Nutrition is essential to prevent maternal and infant malnutrition and mortality. To share some knowledge I have gained, I have shared here my and my friend's class seminar on the topic 'Nutrition for Pregnant and Lactating Women'
WHAT IS INFERTILITY?
Couples that have been enable to conceive a child after 12 months of regular sexual intercourse without birth control.
Women who have repeated miscarriages are also said
to be infertile.
Right nutrition in early days of life is very important. Nutritional requirements are different for kids and adults in the family. They are in their growing age, they need balanced nutrition but not only high calorie foods, In growing years different age groups have different requirements. Discussion with experts helps in dealing with the situation.
Nutrition For Lactating and pregnant womanCM Pandey
Knowledge of Nutrition is essential to prevent maternal and infant malnutrition and mortality. To share some knowledge I have gained, I have shared here my and my friend's class seminar on the topic 'Nutrition for Pregnant and Lactating Women'
WHAT IS INFERTILITY?
Couples that have been enable to conceive a child after 12 months of regular sexual intercourse without birth control.
Women who have repeated miscarriages are also said
to be infertile.
Right nutrition in early days of life is very important. Nutritional requirements are different for kids and adults in the family. They are in their growing age, they need balanced nutrition but not only high calorie foods, In growing years different age groups have different requirements. Discussion with experts helps in dealing with the situation.
The human body cannot make protein from carbohydrate or fat. So, we must eat adequate protein everyday.
Protein intake of both quantity and quality, during the first 2 years of life has important effects on growth, neurodevelopment, and long-term health.
In early life, the diet of children and adolescents is characterized by a higher protein intake than recommended.
The journey of pregnancy is a truly remarkable and transformative experience for any woman. As an expecting mother, it is natural to prioritize your health and nourishment to ensure the best possible outcome for both you and your precious little one.
One of the most important aspects of a healthy pregnancy is a well- balanced and nutritious diet. Packed with essential nutrients, vitamins, and minerals, certain foods can provide the optimal foundation for your baby's growth and development.
Join us as we delve into the world of pregnancy nutrition, exploring the incredible array of foods that are not only safe but highly beneficial for this extraordinary chapter in your life.
Discover the power of all the delicious and wholesome ingredients that can enhance your well-being and create a truly nourishing environment for your little bundle of joy.
The intense fetal growth and development during pregnancy requires maternal physiologic adaptation and a change in nutritional needs.
Adequate maternal intake of macronutrients and micronutrients promotes normal embryonic and fetal development.
Importantly, maternal nutritional status is a modifiable risk factor that can be evaluated, monitored, and, when appropriate, improved.
Beginning this process before conception is important since addressing diet during pregnancy can impact some outcomes (eg, gestational weight gain), but may not be sufficiently early to affect others, such as the occurrence of gestational diabetes related to obesity .
A manual with information on the key practicable points for diets and physical activity for
Indians to ensure optimal health and freedom from disease was proposed for the first time in 1998 by the National Institute of Nutrition (NIN).
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
1. PRESENTERS: Arunima Singh (19)
Ashi Tyagi (20)
MODERATED BY: Dr Mandvi
DEPARTMENT: Obstetrics and
Gynaecology
2. IMPORTANCE OF NUTRITION IN PREGNANCY
❏ The pivotal role of nutrition in pregnancy is well
established and has important implications on
subsequent maternal and offspring health,
including outcomes in later adult life.
❏ Optimal nutrition periconception, if maintained
throughout pregnancy, promotes optimal foetal
growth and development.
❏ Growth trajectories in utero and size at birth are
related to the offspring’s risk of developing
disease in later life, especially chronic non-
communicable diseases such as hypertension,
diabetes and coronary heart disease (the Barker
hypothesis).
3.
4. ❏ The fetus relies on maternal nutrition for growth and development. Additionally,
nutrition forms the basis of maternal wellbeing and equips the mother for
delivery and recovery postnatally.
❏ The placenta links maternal and foetal circulation with syncytiotrophoblasts
lining placental villi and consisting of two polarized membranes: microvillous
membrane facing maternal circulation and basal plasma membrane facing
foetal capillary epithelium.
❏ Thus, nutrients must pass through these two membranes before crossing the
foetal capillary epithelium to enter the foetal circulation. The expression and
activity of transporter mechanisms within the placental-foetal unit have been
found to be associated with foetal growth restriction, macrosomia, diabetes,
obesity and maternal nutrient availability.
PHYSIOLOGY OF NUTRITION
5. First point
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6. HEALTHY EATING IN PREGNANCY
❏ The focus lies on healthy eating approaches.
❏ Calorie restriction is not advised and recommendations focus on achieving and maintaining a
healthy weight during pregnancy by basing meals on starchy foods (wholegrain if possible),
eating fibre rich foods and consuming at least five portions a day of fruit and vegetables.
❏ Food high in fat and sugar (including fried, some drinks and confectionery) should be
avoided.
❏ Pregnant women are also advised to eat breakfast, and to watch portion sizes and how often
they are eating.
❏ Low-fat dairy foods for a source of calcium are encouraged with a daily intake of protein in
the form of lean meat, two portions of fish a week (one of which should be oily) or lentils,
beans and tofu.
❏ Important components include macronutrients (carbohydrate, fibre, protein, fats) and
micronutrients (iron, folate, vitamin B12, vitamin D, calcium, iodine).
❏ A high fibre, low glycemic index diet aids glucose homeostasis in diabetic women.
❏ PUFAs may beneficially increase gestational length and reduce risk of preterm birth through
their role in inflammation.
❏ Food can carry teratogens (mercury, lead) and pathogens (listeriosis, salmonella,
toxoplasmosis)
7. NUTRIENT REQUIREMENT IN PREGNANCY
❏ CARBOHYDRATES AND FIBRE
❏ PROTEIN
❏ FATS AND ESSENTIAL FATTY ACIDS
❏ VITAMIN B12, FOLATE AND IRON
❏ VITAMIN C
❏ VITAMIN D AND CALCIUM
❏ IODINE
❏ ZINC
❏ OTHER MICRONUTRIENTS
The following slides will go into detail the necessity and requirements
of each major food group in pregnancy and the sources with which we
could obtain those.
8. INCREASED DEMANDS OF PREGNANCY
PREGNANT
WOMAN
+350
kcal/day
● MOST OF THIS NEEDED IN LAST
TWO TRIMESTERS
● SHOULD BE BALANCED
PROPORTIONATELY WITH
CARBS, PROTEINS AND FATS.
LACTATION
(initial 6 months)
+600
kcal/day
● TO MEET THE
REQUIREMENTS OF MILK
PRODUCTION.
● TO COMPENSATE THE
CALORIES FOR
BREASTFEEDING.
LACTATION
(next 6 months)
+520
kcal/day
● WEANING COMPLEMENTS
WITH BREASTFEEDING.
● ENERGY REQUIRED TO
TAKE CARE OF SELF AND
BABY.
9. CARBOHYDRATES
❏ Carbohydrates form the main substrate for foetal growth, fuelling maternal and foetal organ
function,biosynthesis and are additionally used in structural components of cells, co enzymes and DNA.
❏ Maternal and foetal brain functions use glucose from carbohydrate as their preferred source of energy with
glucose providing at least 75% of foetal energy requirements.
❏ Glucose crosses the placenta by facilitated diffusion along a concentration gradient through members of
the glucose transporter family (GLUT).
❏ Carbohydrate type and quantity can affect glucose homeostasis via release of insulin.
❏ A low Glycemic Index suggests slower rates of digestion and absorption of a food’s carbohydrate,
potentially relating to a lower insulin demand. It is therefore a modifiable macronutrient in the management
of diabetes mellitus (gestational, type 1 and type 2), however, there is no evidence to support a low
glycemic index diet for healthy pregnant women.
❏ Thus it becomes a necessity to check for blood glucose in diabetic and non diabetic pregnant woman.
❏ Refined sugars must be limited.
❏ Fresh and seasonal fruits and vegetables, nuts, dairy products, whole grain breads and rotis, pulses with
rice can be good sources of carbohydrates.
10.
11. FIBRES
❏ Fibre affects the postprandial insulin response by influencing the accessibility of
carbohydrates and nutrients to digestive enzyme thus delaying their absorption.
❏ Fibre supports maternal digestive health, providing bulk to stool and absorbing
water to aid transit time.
❏ This is especially beneficial as progesterone levels in pregnancy can result in
constipation by increasing relaxation of intestinal smooth muscle.
❏ Wholegrain breakfast cereals,whole grain bread and oats, barley and rye.
❏ Fruit such as berries, pears, melon and oranges.
❏ Vegetables such as cucumbers, broccoli, carrots and sweetcorn.
❏ Peas, beans and pulses.
❏ Nuts and seeds.
❏ Potatoes with skin.
12.
13. PROTEIN
❏ Protein requirement for women is 0.83g/day.
❏ For 10 kg gestational weight gain the requirement increases by 1, 7 and 23 g/day
in 1st, 2nd and 3rd trimester respectively.
❏ Protein forms the building blocks for both structural and functional components
of cells.
❏ Requirements are highest during the second and third trimesters due to extra
development and growth of both maternal and foetal tissue.
❏ It is an alternative energy source when carbohydrate intake is insufficient.
❏ Therefore adequate carbohydrate intake is required in order for cell synthesis to
continue.
❏ Low socioeconomic status and women with limited dietary variety are at risk of
suboptimal protein intake.
❏ Plasma concentrations of most amino acids are higher in foetal circulation.
❏ Over 15 different amino acid transporters mediate their transport against a
concentration gradient.
14.
15. FATS AND ESSENTIAL FATTY ACIDS
❏ Pregnant women RDA for fat is 30g per day.
❏ Fat aids transport of fat-soluble vitamins A, K, D and E and are required for structural
(e.g.membrane lipids) and metabolic functions (e.g. precursor for steroid hormones).
❏ PUFAs (poly unsaturated fatty acids) are important for neurological development
including foetal brain, nervous system and retina.
❏ Essential fatty acids linoleic and alpha linolenic acid are precursors for n-6, n-3 LCPUFA
and prostaglandins; these are components of the inflammatory process with a role in
diseases characterized by inflammation, reproductive health, cervical ripening and
initiation of labour.
❏ There is a beneficial effect on increasing gestational length and reducing risk of preterm
birth.
❏ Placental triglyceride lipases break down triglycerides into fatty acids.
❏ Fatty acids and ketone bodies (produced by maternal lipolysis) cross the placenta by
diffusion. Cholesterol-carrying lipoproteins LDL, HDL and VLDL transport cholesterol into
foetal circulation.
16. ❏ Oily fish, nuts, seeds, vegetable oils, margarines and green leafy vegetables are
encouraged to obtain a greater intake of PUFA.
17. VITAMIN B12, FOLIC ACID AND IRON
❏ Pregnant women require 1.2mcg of vitamin B12 daily.
❏ Reproductive women should take WEEKLY IFA of 60mg elemental iron and 500mcg of folic acid.
❏ Pregnant women should take DAILY IFA 60mg elemental iron and 500mcg of folic acid. (RED
PILL)
❏ Folate and Vitamin B12 are associated with a reduction in megaloblastic anaemia, placental
vascular disorders, preterm birth, low birth weight and SGA via regulation of circulating
homocysteine levels.
❏ Folic acid prevents neural tube defects.
❏ Iron is a component of haemoglobin required for foetal development, placental growth and
expansion of maternal red blood cell mass.
❏ Vulnerability to iron deficiency occurs, especially in late pregnancy as iron transfer to the fetus
becomes marked in order to meet increased demands. Deficiency has been associated with a
higher risk of preterm delivery, low birth weight, infant iron deficiency and long-term cognition and
brain function.
❏ Replete stores are required in preparation for childbirth as significant blood loss may occur
intrapartum.
❏ Iron transfer to the fetus is facilitated through placental transferrin receptors for endocytosis of
transferrinbound iron.
18.
19.
20. VITAMIN C
❏ Vitamin C aids iron absorption and competes for placental receptors with
glucose, however maternal hyperglycaemia does not result in foetal
hypovitaminosis C.
❏ Supplementation with vitamin C alone reduces the risk of preterm PROM and
term PROM but the risk of term PROM was increased when supplementation
included vitamin C with vitamin E.
❏ The risk of stillbirth, neonatal death, IUGR and pre-eclampsia were not affected
by vitamin C supplementation.
❏ Citrus fruit, such as oranges guava and amla.
❏ Peppers.
❏ Strawberries.
❏ Blackcurrants.
❏ Broccoli, brussels sprouts.
❏ Potatoes.
21.
22. VITAMIN D AND CALCIUM
❏ Pregnant women RDA for calcium is 1200 mg/day.
❏ Vitamin D is required for immune and nervous system function and mediates the
accumulation of foetal calcium from maternal stores in skeletal growth.
❏ Vitamin D deficiency can result in rickets, craniotabes and osteopenia.
❏ Calcium supplementation reduces the development of hypertensive disorders of
pregnancy (eclampsia and pre eclampsia) and an increasing body of evidence
demonstrates a relationship between vitamin D deficiency and low birth weight,
preterm delivery, gestational diabetes mellitus and pre-eclampsia.
❏ Individuals particularly at risk for vitamin D deficiency include those of South Asian,
African, Caribbean or Middle Eastern origin, a body mass index >30 kg/m2 and low sun
exposure.
23.
24. IODINE
❏ Iodine is required for foetal thyroid function and
neurological development.
❏ Iodine deficiency has been linked to mental retardation
and cognitive deficit.
❏ Periconceptional and antenatal supplementation in
regions of severe iodine deficiency have been found to
reduce the risk of cretinism and improve motor
function.
❏ Reports of gestational iodine deficiency and potential
benefits of iodine supplementation are emerging.
31. SUMMARISED GUIDELINES
1. Promotion of a varied, healthy diet with supplementation or
fortification of foods when necessary.
2. Encouraging the adoption of healthy dietary habits pre-
pregnancy.
3. Early access to prenatal care to provide the following:
a. nutrition counselling
b. recognition and appropriate intervention of micronutrient
deficiencies
c. treatment of co-existing conditions e.g. malaria, TB, HIV,
gastrointestinal infections and non-communicable diseases.
32. SUMMARISED GUIDELINES (cont.)
4. Importance of pre-pregnancy BMI
a. Both low and high BMIs may lack either nutritional quality or quantity balance,
resulting in poorer pregnancy outcomes.
5. Avoidance of detrimental behaviours including smoking, alcohol intake and
recreational drug use before, during and after pregnancy as well as food borne
illness and teratogens.
6. Exercise and energy requirement recommendations:
a. dietary energy intake should only involve a moderate
increase of 340-450 kcal per day in the second and third
trimester
b. moderate exercise of 30 minutes per day and avoidance of hard physical
labour during late pregnancy.
7. Monitoring of appropriate gestational weight gain.