Minerals and vitamins play an important role in pregnancy outcomes. Deficiencies in iron, calcium, magnesium, zinc, selenium, vitamins A, B-complex, folate, B12, C, D and E can negatively impact fetal growth and development. The document reviewed studies on the effects of supplementing with individual minerals and vitamins as well as multiple micronutrients during pregnancy. While certain supplements like folic acid and iron were found to improve outcomes, the roles of other vitamins are still unclear and some like vitamin E may increase health risks.
Micronutrient deficiencies can cause visible and dangerous health conditions, but they can also lead to less clinically notable reductions in energy level, mental clarity and overall capacity. This can lead to reduced educational outcomes, reduced work productivity and increased risk from other diseases and health conditions.
The document summarizes several World Health Organization (WHO) guidelines related to nutrition. It discusses WHO guidelines on calcium and vitamin supplementation during pregnancy and for infants/children, daily iron supplementation, sodium and sugar intake recommendations, vitamin E supplementation, breastfeeding guidance in the context of Zika virus, and WHO child growth standards. The guidelines provide evidence-based recommendations on various nutrition-related public health interventions aimed at improving health outcomes.
This document provides information on nutrition for pregnant mothers, including recommended daily allowances of key nutrients, factors affecting nutritional status, roles of important nutrients, and dietary guidelines. The recommended daily allowances table shows increased calorie and nutrient needs for sedentary, moderate and heavy activity levels. Dietary guidelines emphasize a well-balanced diet with plenty of fruits and vegetables, adequate protein and key nutrients like iron and folic acid. Maintaining proper nutrition is essential for supporting fetal growth and development.
This document provides an overview of common vitamin deficiencies, including vitamins A, B complex, C, D, and E. It discusses the roles of each vitamin, sources of each vitamin, clinical features of deficiencies, diagnosis, and treatment. Some key points include:
- Vitamin A deficiency can cause vision problems and increase susceptibility to infections. It is highly prevalent in Uganda.
- Thiamine (B1) deficiency can cause beriberi with symptoms like edema, heart failure, and neurological issues.
- Pellagra results from niacin (B3) deficiency and presents as dermatitis, diarrhea, and dementia.
- Vitamin D deficiency in children causes rickets, resulting in bone
The document discusses nutrition and malnutrition in India. It notes that India has a large population with many people living in rural areas with low socioeconomic status and illiteracy. From a nutritional perspective, most Indians are undernourished, with only a small group being well-fed. Common nutritional deficiencies in India include protein-energy malnutrition, anemia, and vitamin A deficiency. The causes of malnutrition are multi-factorial and include poverty, lack of awareness, population growth, and cultural influences. The document outlines various types of undernutrition and overnutrition, their signs and symptoms, and prevention strategies. It also discusses several government programs aimed at improving nutrition.
This document defines malnutrition and identifies its types and preventative measures. Malnutrition is poor nutrition resulting from an insufficient or imbalanced diet, poor digestion, or inability to absorb foods. It affects infants, children, the elderly, disabled, and ill. There are two main types: undernutrition and overnutrition. Undernutrition includes protein-energy malnutrition and micronutrient deficiencies like iron deficiency anemia, rickets, and vitamin A deficiency. Overnutrition refers to excessive caloric intake leading to obesity. The document identifies at-risk groups and signs of various deficiencies. It emphasizes preventative measures like nutrition education, food fortification, and supplementation programs.
This document discusses fortification of staple foods like wheat and maize flours, and rice with micronutrients. It outlines how iron, folic acid, and other B vitamins added through fortification can reduce anemia and birth defects. The document also addresses constraints of fortification like nutrient stability and costs, as well as the status of fortification in Qatar where wheat and rice are imported and voluntary fortification occurs.
Micronutrient deficiencies can cause visible and dangerous health conditions, but they can also lead to less clinically notable reductions in energy level, mental clarity and overall capacity. This can lead to reduced educational outcomes, reduced work productivity and increased risk from other diseases and health conditions.
The document summarizes several World Health Organization (WHO) guidelines related to nutrition. It discusses WHO guidelines on calcium and vitamin supplementation during pregnancy and for infants/children, daily iron supplementation, sodium and sugar intake recommendations, vitamin E supplementation, breastfeeding guidance in the context of Zika virus, and WHO child growth standards. The guidelines provide evidence-based recommendations on various nutrition-related public health interventions aimed at improving health outcomes.
This document provides information on nutrition for pregnant mothers, including recommended daily allowances of key nutrients, factors affecting nutritional status, roles of important nutrients, and dietary guidelines. The recommended daily allowances table shows increased calorie and nutrient needs for sedentary, moderate and heavy activity levels. Dietary guidelines emphasize a well-balanced diet with plenty of fruits and vegetables, adequate protein and key nutrients like iron and folic acid. Maintaining proper nutrition is essential for supporting fetal growth and development.
This document provides an overview of common vitamin deficiencies, including vitamins A, B complex, C, D, and E. It discusses the roles of each vitamin, sources of each vitamin, clinical features of deficiencies, diagnosis, and treatment. Some key points include:
- Vitamin A deficiency can cause vision problems and increase susceptibility to infections. It is highly prevalent in Uganda.
- Thiamine (B1) deficiency can cause beriberi with symptoms like edema, heart failure, and neurological issues.
- Pellagra results from niacin (B3) deficiency and presents as dermatitis, diarrhea, and dementia.
- Vitamin D deficiency in children causes rickets, resulting in bone
The document discusses nutrition and malnutrition in India. It notes that India has a large population with many people living in rural areas with low socioeconomic status and illiteracy. From a nutritional perspective, most Indians are undernourished, with only a small group being well-fed. Common nutritional deficiencies in India include protein-energy malnutrition, anemia, and vitamin A deficiency. The causes of malnutrition are multi-factorial and include poverty, lack of awareness, population growth, and cultural influences. The document outlines various types of undernutrition and overnutrition, their signs and symptoms, and prevention strategies. It also discusses several government programs aimed at improving nutrition.
This document defines malnutrition and identifies its types and preventative measures. Malnutrition is poor nutrition resulting from an insufficient or imbalanced diet, poor digestion, or inability to absorb foods. It affects infants, children, the elderly, disabled, and ill. There are two main types: undernutrition and overnutrition. Undernutrition includes protein-energy malnutrition and micronutrient deficiencies like iron deficiency anemia, rickets, and vitamin A deficiency. Overnutrition refers to excessive caloric intake leading to obesity. The document identifies at-risk groups and signs of various deficiencies. It emphasizes preventative measures like nutrition education, food fortification, and supplementation programs.
This document discusses fortification of staple foods like wheat and maize flours, and rice with micronutrients. It outlines how iron, folic acid, and other B vitamins added through fortification can reduce anemia and birth defects. The document also addresses constraints of fortification like nutrient stability and costs, as well as the status of fortification in Qatar where wheat and rice are imported and voluntary fortification occurs.
NATIONAL VITAMIN A DEFICIENCY PROPHYLAXIS PROGRAMMESKanikaRastogi13
this presentation is about the governmental organised national vitamin A prophylaxis programme which aims to reduce or to prevent the prevalence of vitamin A deficiency.
This document discusses vitamin A deficiency, its causes, effects, and prevention through supplementation programs in India. It notes that vitamin A is essential for vision, immunity, growth and reproduction. Deficiency can lead to increased infections and blindness in children. India has a high prevalence of deficiency, especially in preschoolers and pregnant women. The national prophylaxis program aims to prevent blindness through supplementation of vitamin A to children from 9 months to 5 years at doses of 100,000 IU every 6 months. Food fortification and dietary diversification can also help prevent deficiency. Regular supplementation is important as vitamin A stores deplete within 4-6 months.
The public health importance nutritional deficiency states in.pptxmeseret49
Iron deficiency anemia is a major nutritional problem in Ethiopia. According to a 2016 survey, 24% of pregnant and non-pregnant women and 57% of preschool children in Ethiopia are anemic. Causes of iron deficiency anemia include low dietary iron intake, poor absorption, and parasitic infections. Prevention strategies include iron supplementation, food fortification, improving dietary diversity, and public health measures. Iodine deficiency also affects Ethiopia, with over 50% of households consuming inadequately iodized salt. Iodine deficiency can cause physical and mental impairments. Prevention focuses on iodizing salt and other food vehicles. Vitamin A deficiency is associated with increased child mortality and blindness in Ethiopia
This document discusses micronutrients, focusing on vitamin A. It defines vitamins and minerals as essential organic or inorganic compounds that must be obtained through diet. Vitamin A exists in preformed and pro-vitamin forms that facilitate growth, health and physiological processes. Vitamin A deficiency can result from inadequate intake, poor bioavailability, infections, increased needs, and socioeconomic factors. The document outlines factors that influence vitamin A absorption and interaction with other nutrients like iron and zinc. It provides recommendations for daily vitamin A intake at different life stages.
Micronutrient deficiencies, also known as hidden hunger, affect millions of children and cause stunted growth, cognitive delays, and weakened immunity. Common deficiencies include iodine, vitamin A, iron, zinc, and calcium/vitamin D/folate during pregnancy. These deficiencies can be addressed through supplementation, food fortification, and biofortification programs. The National Plan of Action on Nutrition Malaysia III aims to reduce micronutrient deficiencies through universal salt iodization, prenatal vitamin distribution, and nutrition education.
Malnutrition is poor nutrition due to an insufficient, poorly balanced diet, faulty digestion or poor utilization of foods. (This can result in the inability to absorb foods).
Malnutrition is not only insufficient intake of nutrients. It can occur when an individual is getting excessive nutrients as well.
The document summarizes the nutritional status and issues among high risk groups in Nepal. It finds that over 1/3 of children are stunted, 1/10 are wasted, and over 1/4 are underweight. Major nutritional problems include protein energy malnutrition, anemia, and mineral deficiencies like iodine and calcium deficiencies. Iodine deficiency causes endemic goiter while calcium deficiency can lead to osteoporosis. The document recommends interventions like nutritional education, supplementation, fortification, and treatment of underlying infections to address malnutrition in Nepal.
Maternal nutrition is important for both mother and baby's health. The document discusses maternal nutrient requirements including calories, proteins, vitamins and minerals. It identifies nutritional risk factors like anemia, substance abuse, chronic diseases, and discusses common pregnancy symptoms and interventions. Daily food plans and lactation requirements are provided to help meet increased nutrient needs during pregnancy and breastfeeding.
This document discusses protein energy malnutrition (PEM) and its effects on oral health. It begins by defining nutrition and malnutrition, explaining the types of malnutrition including undernutrition and overweight/obesity. It then discusses protein, its roles, requirements, and digestion/absorption. PEM, or protein deficiency combined with calorie deficiency, is described as being caused by direct factors like inadequate food intake and indirect factors like infection. The main types of PEM - kwashiorkor, marasmus, and marasmic-kwashiorkor - are explained in terms of their causes, signs, and oral manifestations. Laboratory findings for kwashiorkor are also outlined. Overall PEM is presented as a significant health problem in developing countries and
Food fortification involves adding nutrients to foods that naturally lack them. For pregnant women in developing countries, food fortification can help address common nutrient deficiencies and improve pregnancy outcomes. Micronutrient deficiencies are widespread in these populations, putting pregnant women at risk. While food fortification has been shown to effectively reduce deficiencies, evaluations of programs need stronger methodologies to fully assess impact on health. Improving program design, implementation, and using standardized evaluation methods can generate higher quality evidence of food fortification's effects.
This document discusses maternal nutrition and nutritional requirements during pregnancy and lactation. It defines maternal nutrient needs, explains the importance of pre-conception nutrition, and discusses various nutritional risk factors during pregnancy such as adolescents, multiple pregnancies, poverty, and substance abuse. Common pregnancy symptoms like nausea and constipation are described along with interventions. Nutritional needs increase during lactation to support breastfeeding.
Biofortification of staple food crops: Justification, progress, and future a...ExternalEvents
Biofortification of staple food crops: Justification, progress, and future activities presentation by Howarth Bouis, International Food Policy Research Institute, Washington D.C., United States of America
1. Immunonutrition involves providing specific nutrients to manipulate the immune system and maintain balance between pro-inflammatory and anti-inflammatory responses.
2. Key components of the immune system that can be modulated through immunonutrition include antioxidants like selenium and zinc, amino acids like glutamine and arginine, and omega-3 fatty acids.
3. Immunonutrition aims to downregulate the immune response during critical illness, prevent downstream organ damage, and limit inflammation.
This document discusses food fortification with vitamins and minerals. It notes that wheat, maize and rice are commonly fortified with iron, folic acid and B vitamins. These micronutrients play important roles in physical and cognitive development, productivity and reducing health risks like anemia and neural tube defects. The document outlines various micronutrients used for fortification, their health benefits, and considerations for effective fortification programs like identifying target groups, suitable vehicles, levels of addition and ensuring stability of added nutrients. It also addresses limitations, costs and legislation around national fortification programs.
Nutritional deficiency disorders in childrenkiran kaur
This document discusses various nutritional deficiency disorders, including:
1. Protein-energy malnutrition (PEM), which can manifest as kwashiorkor or marasmus. PEM is classified by severity.
2. Vitamin deficiencies like vitamins A, D, E, K, and various B vitamins. Deficiencies can cause conditions like rickets, night blindness, anemia, and dermatitis.
3. Mineral deficiencies are also discussed. Prevention focuses on balanced diets, supplementation, and treating underlying illnesses. Management involves rehabilitation centers, hospitalization, dietary changes, and vitamin/mineral administration.
1. Maternal nutrition is critical for reducing maternal and infant mortality and morbidity. Proper nutrition is needed to support the growth of the fetus and meet increased nutrient demands during pregnancy.
2. Certain groups are at higher risk of nutritional deficiencies during pregnancy, including adolescents, underweight or obese women, and those with low socioeconomic status.
3. Regular nutritional assessments are recommended during pregnancy to identify nutritional risks and form individualized care plans. Assessments evaluate medical history, diet history, weight gain, and lab tests. This helps ensure maternal and infant health.
The document discusses various nutritional problems including undernutrition and overnutrition. It defines undernutrition as a deficiency of essential nutrients and lists several types:
- Protein-energy malnutrition (PEM) which includes conditions like kwashiorkor and marasmus caused by inadequate protein and calorie intake.
- Low birth weight (LBW) which is defined as birth weight less than 2.5kg.
- Vitamin A deficiency which can cause night blindness and increased susceptibility to infections.
- Nutritional anemia due to insufficient iron intake.
- Iodine deficiency disorder (IDD) which can cause goiter and hypothyroidism.
It also briefly discusses eating disorders like anorexia nervosa
The document discusses nutrition requirements during pregnancy and lactation. It recommends increased calorie, protein, vitamin and mineral intake during these stages. Key recommendations include 300 extra calories per day during pregnancy, 10-12 kg total weight gain, and extra 20-30g protein during lactation. Deficiencies of iron, iodine, calcium and vitamin D can lead to complications. A balanced diet with milk, fruits and vegetables can meet nutritional demands.
This document provides an overview of basic nutrition concepts including:
- Essential nutrients like carbohydrates, proteins, fats, vitamins, minerals and water along with their food sources and roles in the body.
- Causes and consequences of undernutrition like stunting, wasting and nutrient deficiencies.
- Strategies to address undernutrition such as improving food security, nutrition education and supplementation programs.
- Specific deficiencies like anemia, iodine deficiency and vitamin A deficiency are described along with their signs, causes and treatment approaches.
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NATIONAL VITAMIN A DEFICIENCY PROPHYLAXIS PROGRAMMESKanikaRastogi13
this presentation is about the governmental organised national vitamin A prophylaxis programme which aims to reduce or to prevent the prevalence of vitamin A deficiency.
This document discusses vitamin A deficiency, its causes, effects, and prevention through supplementation programs in India. It notes that vitamin A is essential for vision, immunity, growth and reproduction. Deficiency can lead to increased infections and blindness in children. India has a high prevalence of deficiency, especially in preschoolers and pregnant women. The national prophylaxis program aims to prevent blindness through supplementation of vitamin A to children from 9 months to 5 years at doses of 100,000 IU every 6 months. Food fortification and dietary diversification can also help prevent deficiency. Regular supplementation is important as vitamin A stores deplete within 4-6 months.
The public health importance nutritional deficiency states in.pptxmeseret49
Iron deficiency anemia is a major nutritional problem in Ethiopia. According to a 2016 survey, 24% of pregnant and non-pregnant women and 57% of preschool children in Ethiopia are anemic. Causes of iron deficiency anemia include low dietary iron intake, poor absorption, and parasitic infections. Prevention strategies include iron supplementation, food fortification, improving dietary diversity, and public health measures. Iodine deficiency also affects Ethiopia, with over 50% of households consuming inadequately iodized salt. Iodine deficiency can cause physical and mental impairments. Prevention focuses on iodizing salt and other food vehicles. Vitamin A deficiency is associated with increased child mortality and blindness in Ethiopia
This document discusses micronutrients, focusing on vitamin A. It defines vitamins and minerals as essential organic or inorganic compounds that must be obtained through diet. Vitamin A exists in preformed and pro-vitamin forms that facilitate growth, health and physiological processes. Vitamin A deficiency can result from inadequate intake, poor bioavailability, infections, increased needs, and socioeconomic factors. The document outlines factors that influence vitamin A absorption and interaction with other nutrients like iron and zinc. It provides recommendations for daily vitamin A intake at different life stages.
Micronutrient deficiencies, also known as hidden hunger, affect millions of children and cause stunted growth, cognitive delays, and weakened immunity. Common deficiencies include iodine, vitamin A, iron, zinc, and calcium/vitamin D/folate during pregnancy. These deficiencies can be addressed through supplementation, food fortification, and biofortification programs. The National Plan of Action on Nutrition Malaysia III aims to reduce micronutrient deficiencies through universal salt iodization, prenatal vitamin distribution, and nutrition education.
Malnutrition is poor nutrition due to an insufficient, poorly balanced diet, faulty digestion or poor utilization of foods. (This can result in the inability to absorb foods).
Malnutrition is not only insufficient intake of nutrients. It can occur when an individual is getting excessive nutrients as well.
The document summarizes the nutritional status and issues among high risk groups in Nepal. It finds that over 1/3 of children are stunted, 1/10 are wasted, and over 1/4 are underweight. Major nutritional problems include protein energy malnutrition, anemia, and mineral deficiencies like iodine and calcium deficiencies. Iodine deficiency causes endemic goiter while calcium deficiency can lead to osteoporosis. The document recommends interventions like nutritional education, supplementation, fortification, and treatment of underlying infections to address malnutrition in Nepal.
Maternal nutrition is important for both mother and baby's health. The document discusses maternal nutrient requirements including calories, proteins, vitamins and minerals. It identifies nutritional risk factors like anemia, substance abuse, chronic diseases, and discusses common pregnancy symptoms and interventions. Daily food plans and lactation requirements are provided to help meet increased nutrient needs during pregnancy and breastfeeding.
This document discusses protein energy malnutrition (PEM) and its effects on oral health. It begins by defining nutrition and malnutrition, explaining the types of malnutrition including undernutrition and overweight/obesity. It then discusses protein, its roles, requirements, and digestion/absorption. PEM, or protein deficiency combined with calorie deficiency, is described as being caused by direct factors like inadequate food intake and indirect factors like infection. The main types of PEM - kwashiorkor, marasmus, and marasmic-kwashiorkor - are explained in terms of their causes, signs, and oral manifestations. Laboratory findings for kwashiorkor are also outlined. Overall PEM is presented as a significant health problem in developing countries and
Food fortification involves adding nutrients to foods that naturally lack them. For pregnant women in developing countries, food fortification can help address common nutrient deficiencies and improve pregnancy outcomes. Micronutrient deficiencies are widespread in these populations, putting pregnant women at risk. While food fortification has been shown to effectively reduce deficiencies, evaluations of programs need stronger methodologies to fully assess impact on health. Improving program design, implementation, and using standardized evaluation methods can generate higher quality evidence of food fortification's effects.
This document discusses maternal nutrition and nutritional requirements during pregnancy and lactation. It defines maternal nutrient needs, explains the importance of pre-conception nutrition, and discusses various nutritional risk factors during pregnancy such as adolescents, multiple pregnancies, poverty, and substance abuse. Common pregnancy symptoms like nausea and constipation are described along with interventions. Nutritional needs increase during lactation to support breastfeeding.
Biofortification of staple food crops: Justification, progress, and future a...ExternalEvents
Biofortification of staple food crops: Justification, progress, and future activities presentation by Howarth Bouis, International Food Policy Research Institute, Washington D.C., United States of America
1. Immunonutrition involves providing specific nutrients to manipulate the immune system and maintain balance between pro-inflammatory and anti-inflammatory responses.
2. Key components of the immune system that can be modulated through immunonutrition include antioxidants like selenium and zinc, amino acids like glutamine and arginine, and omega-3 fatty acids.
3. Immunonutrition aims to downregulate the immune response during critical illness, prevent downstream organ damage, and limit inflammation.
This document discusses food fortification with vitamins and minerals. It notes that wheat, maize and rice are commonly fortified with iron, folic acid and B vitamins. These micronutrients play important roles in physical and cognitive development, productivity and reducing health risks like anemia and neural tube defects. The document outlines various micronutrients used for fortification, their health benefits, and considerations for effective fortification programs like identifying target groups, suitable vehicles, levels of addition and ensuring stability of added nutrients. It also addresses limitations, costs and legislation around national fortification programs.
Nutritional deficiency disorders in childrenkiran kaur
This document discusses various nutritional deficiency disorders, including:
1. Protein-energy malnutrition (PEM), which can manifest as kwashiorkor or marasmus. PEM is classified by severity.
2. Vitamin deficiencies like vitamins A, D, E, K, and various B vitamins. Deficiencies can cause conditions like rickets, night blindness, anemia, and dermatitis.
3. Mineral deficiencies are also discussed. Prevention focuses on balanced diets, supplementation, and treating underlying illnesses. Management involves rehabilitation centers, hospitalization, dietary changes, and vitamin/mineral administration.
1. Maternal nutrition is critical for reducing maternal and infant mortality and morbidity. Proper nutrition is needed to support the growth of the fetus and meet increased nutrient demands during pregnancy.
2. Certain groups are at higher risk of nutritional deficiencies during pregnancy, including adolescents, underweight or obese women, and those with low socioeconomic status.
3. Regular nutritional assessments are recommended during pregnancy to identify nutritional risks and form individualized care plans. Assessments evaluate medical history, diet history, weight gain, and lab tests. This helps ensure maternal and infant health.
The document discusses various nutritional problems including undernutrition and overnutrition. It defines undernutrition as a deficiency of essential nutrients and lists several types:
- Protein-energy malnutrition (PEM) which includes conditions like kwashiorkor and marasmus caused by inadequate protein and calorie intake.
- Low birth weight (LBW) which is defined as birth weight less than 2.5kg.
- Vitamin A deficiency which can cause night blindness and increased susceptibility to infections.
- Nutritional anemia due to insufficient iron intake.
- Iodine deficiency disorder (IDD) which can cause goiter and hypothyroidism.
It also briefly discusses eating disorders like anorexia nervosa
The document discusses nutrition requirements during pregnancy and lactation. It recommends increased calorie, protein, vitamin and mineral intake during these stages. Key recommendations include 300 extra calories per day during pregnancy, 10-12 kg total weight gain, and extra 20-30g protein during lactation. Deficiencies of iron, iodine, calcium and vitamin D can lead to complications. A balanced diet with milk, fruits and vegetables can meet nutritional demands.
This document provides an overview of basic nutrition concepts including:
- Essential nutrients like carbohydrates, proteins, fats, vitamins, minerals and water along with their food sources and roles in the body.
- Causes and consequences of undernutrition like stunting, wasting and nutrient deficiencies.
- Strategies to address undernutrition such as improving food security, nutrition education and supplementation programs.
- Specific deficiencies like anemia, iodine deficiency and vitamin A deficiency are described along with their signs, causes and treatment approaches.
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Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
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3. Introduction
• Nutrient metabolism and energy requirements should be
continuously and physiologically adjusted during pregnancy as
the pre-pregnancy nutritional status affects maternal health
and fetal growth.
• Fetal growth is mainly affected by low pre-pregnancy body
mass index and low gestational weight gain.
• Malnourished women have increased risk for fetal disorders
and nutrition of pregnant women is controlled.
• Mineral and vitamin supplements are usually given to prevent
fetal diseases.
• Since deficiencies in minerals and vitamins influence
pregnancy outcome, indications for nutritional support were
investigated.
4. Methodology
• Data was screened non-systematically
through
Journals about nutrition
Observational studies
Meta-analysis
Randomised controlled trials
Reviews
5. MINERALS
• Minerals are chemical elements required by humans’
body to maintain physical health and life functions.
• Classified into major (macrominerals) and trace
elements.
• Major minerals sodium, chloride, potassium,
calcium, phosphorus and magnesium.
• Trace elements iron, zinc, iodine, selenium, copper
and fluorine. These are needed in smaller amounts.
6. Iron
• Compulsory for haemoglobin synthesis and proper
functioning of organs.
• Being the most prevalent nutrient deficiency in the
world, lack of Fe affects more than 50% of pregnant
women.
• Major impact of this deficiency is the inhibition of fetal
growth as neonatal Fe depends on status of maternal
Fe.
• This leads to anaemia, intrauterine growth retardation,
neonates small for gestational age and oxidative
damage to fetal erythrocytes. Cortisol production as well
as maternal and fetal stress are increased.
7. Iron
• Prolonged gestational Fe deficiency leads to cognitive
and behavioural problems in childhood.
• Fe is supplemented in case of low haemoglobin and
plasma ferritin.
• Surplus of Fe increases the risk for gestational DM and
preterm delivery.
• Sources include red meats, dark green leafy
vegetables and dried fruits.
8. Calcium
• Essential for bone development, muscle and cell membrane
functions, nerve impulse transmission and blood coagulation.
• Ca demand is increased during pregnancy as it is needed for
mobilisation from skeleton and doubling of intestinal
absorption.
• Hypocalcaemia causes pre-eclampsia and intrauterine growth
retardation but it occurs rare in pregnant women.
• However, statistics reveals that low birth weight can be
associated with low intake of milk and vitamin D during
pregnancy.
• Sources: milk and dairy products.
9. Magnesium
• Common enzyme cofactor and activator, Mg is needed for
muscle contraction, nerve transmission and protein
manufacture.
• Mg deficiency during pregnancy interrupts fetal growth and
development which eventually causes haematological and
teratogenic harm.
• Diabetic pregnant women with hypomagnesaemia increases
the risk for both maternal and fetal hypoparathyroidism and
hypocalcaemia.
• Sources: nuts, green leafy vegetables and chocolates.
10. Zinc
• Required for the activity of about 100 enzymes, Zn has also
antioxidant properties, protects immune system and is involved
in embryogenesis and growth.
• Gestational Zn deficiency affects fetal growth which can lead to
severe teratogenic effects.
• Fetal demand for Zn occurs through absorption in intestine but
the transfer of Zn depends on the maintenance of maternal Zn
concentration.
• Zn absorption is altered by high intake of Fe, GI dysfunction
and cereal-based diets rich in phytate.
• Excess of Zn during pregnancy can increase birth weight of
neonates.
• Sources: meat, poultry, fish and whole grains.
11. Selenium
• Requested for its good antioxidant properties, Se protects the
immune and reproductive systems.
• Low level of Se during pregnancy is associated with pre-
eclampsia, intrauterine growth retardation and abortion.
• Studies have proved that Se supplementation decreases the
prevalence for pre-eclampsia.
• Sources: seafood, grains and meat.
12. VITAMINS
• Organic compounds
– Fat soluble or water soluble
• Required in small quantities
• Support of normal physiologic functions
• Humans do not biosynthesize enough to meet the needs of the
body
• 20-30% of pregnant women suffer from vitamin deficiency
• About 75% vitamin deficiency was observed without
prophylaxis
• In a study, despite vitamin supplementations, reduced level of
vit A, B6, B3, B1, and B12 was observed during all pregnancy
trimesters.
13. Vitamin A
• Fat soluble vitamin essential for the following:
– Gene regulation, cell differentiation, proliferation and growth, innate and
adaptive immune system, maintenance of mucosal surfaces, intestinal iron
uptake, haematopoiesis, vision and reproduction.
• Vit A deficiency is prevalent in developing countries while
overdose is mostly common in developed countries.
• Vit A is beneficial in right amount while teratogenic in high
amount
– The recommended dose is 5000 IU/day;
– High doses (8000-10000 IU/day) may not result in malformations
• Vit A supplementation lead to improvement in birth weight and
growth is observed among infants born to HIV-infected women
due to enhanced immunity.
14. Vitamin B1-Thiamine
• Water soluble
• Acts as coenzyme essential in metabolism and lipid &
nucleotide synthesis
• Deficiency is more common in developing countries
especially during pregnancy which may result in impairment
of brain development and impair fetal growth
• Higher level are encountered in fetus than in maternal blood
due to specific active placental transport systems.
• However, there is lack of data on the role of Vit B1 in
pregnancy.
15. Vitamin B6
• Also known as pyridoxine, pyridoxal & pyridoxamine
• Water soluble- works as coenzyme in protein metabolism in
the development of CNS
• Deficiencies do not occur alone but with deficiencies of B-
Complex vitamins
– Pre-eclampsia, gestational carbohydrate intolerance, hyperemesia,
gravidarum, & neuronal disease of infants.
• Clinical benefits of Vit B6 supplementation in pregnancy has
not been detected
– One trial suggested protection against dental decay.
16. Folate
• Water soluble
• Co-enzymatic role in carbon metabolism and in synthesis of
DNA, RNA and certain amino acids.
• Deficiency is prevalent in developing countries
– 25% of pregnant women in India
– Lead to congenital malformations and complications in pregnancy
• Daily supplemental dose of 400ug/day is recommended
– Higher doses (5mg) is recommended in conditions such as obesity,
diabetes & epilepsy
• Study showed that folate supplementation in pregnancy
resulted in reduced congenital anomalies
17. Vitamin B12-Cobalamine
• Important support for erythropoiesis
• Increased prevalence in low plasma B12 during pregnancy
• Long term vegetarian pregnant women have an increased risk
of Vit B12 deficiency.
• Decline in plasma cobalamine despite an adequate diet
resulting in –ve fetal outcome
– Alterations in haptocorrin-bound cobalamine
– Impairment of intestinal absorption
• Strong association between fetal and maternal plasma at
delivery
– Maternal B12 levels affects fetal vitamin level at birth
– Low level reduced fetal growth
18. Vitamins C & E
• Vit C (water-soluble; ascorbic acid) and Vit E (fat-soluble; a-
tocopherol) are powerful antioxidants for prevention & treatment
of pre-eclampsia (PE) caused by oxidative stress
• Increased Ox. markers and decreased in Vit C (<85mg) & E in
PE
• From a report Use of any antioxidants lead to 39% decreased
risk of PE
• From other survey
– Use of Vit C & E suppl. in pregnancy does not reduce risk of PE
– Vit E may increase incidence of PE due to ability to induce Th1 cytokines
(pro-inflammatory)
– Use of Vit E may cause gestational hypertension, LBW, placental ischemia
• Vit C may be advantageous but Vit E is not recommended
19. Vitamin D
• Fat-soluble; Important role in immune function, cell
differentiation, bone growth & reduction of inflammation.
• Essential for calcium homeostasis & reduction of chronic
diseases.
• Biologically inactive metabolised to active form
– 25-hydroxyvitamin [25(OH)D]
• 40% African American women and 4% caucasian-non-hispanic
women have low plasma Vit D conc.
• Deficiency is associated with osteomalacia, poor fetal and
infant skeletal growth & tooth mineralisation.
• No evidence in general suppl. has been found except that it
improve neonatal handling of Ca in population at risk.
20. Multiple micronutrients (MMN)
• Micronutrient deficiencies are caused due to
– Unavailability of adequate food quality
– Cultural differences
– Seasonal variations
– Poverty & infection in a population
• Several studies showed improved pregnancy upon use of
MMN e.g. reduced LBW.
• Large scale blood tests are scarce thus little are known
about the range & extent of nutrient deficiencies
• Evidence from studies shows that prevalent deficiencies of
Ca, Fe, Vit D, A, Zn and folate are most common in
developing countries.
21. Comments
• Vitamin suppl. considered solely as health promoting
• Deficiencies may result in morbidity
– Negative consequences to fetus & child health
– Effect of vitamins in pregnancy is poorly understood but vit treatment can
be curative
• Quantification of individual food component are difficult and
unreliable
– Non-homogenous population
– MMN may contain unnecessary and harmful overdoses
– Nutrient interactions are numerous
– Despite antioxidant properties of vit C & E; may lead to complication
• MMN important to prevent adverse pregnancy outcome are:
folic acid, Zn, Fe.
22. Conclusion
• Substitution therapy and supplementation may be beneficial
during pregnancy but deficiencies should be sought
• Pre- and early pregnancy folate suppl. has been confirmed
via reliable studies
• Fe treatment in Fe deficiency also has beneficial effects
• Vegetarian pregnant women lacks Vit B12, thus suppl. is
needed.
• Vit D and C are beneficial in PE treatment but Vit E is not
recommended.
23. References
• ANON, 2014. Minerals: Their functions and sources-
Topic overview. WebMD [online]. Available from:
http://www.webmd.com/vitamins-and-
supplements/tc/minerals-their-functions-and-sources-
topic-overview [Accessed on 22 January 2016].
• HOVDENAK, N., HARAM, K., 2012. Influence of mineral
and vitamin supplements on pregnancy outcome.
European Journal of Obstetrics & Gynecology and
Reproductive Biology; 164(2012), 127-132.