How is the graphic different from the 2020 MyPlate? : My plate was a plate divided the five food groups (fruits, vegetable, grains, proteins, and dairy). The new graphic is more focused on whole foods protein, fruits/vegetables and healthy fats in a shape of a upside down triangle. What are key messages surrounding food selection? Choose a variety of healthy foods including fruits, vegetables, whole grains, proteins and dairy. To choose foods high in nutrients & limit foods in added sugars, sodium & unhealthy fats. What are the 4 steps of the Nutrition Care Process? Nutrition Assessment, Nutrition Diagnosis, Intervention, Monitoring & evaluation. What are examples of information collected in each domain of nutrition assessment? Assessment: Food intake, height & weight. BMI, lab results, physical symptoms, medical history, medication lifestyle habits. Diagnosis: A specific nutrition problem based on the info collected during the assessment (p-problem) Intervention: The steps taken to help fix or improve a person’s nutrition problem (E-Etiology). Monitoring & evaluation: Checking to see if the nutrition plan is working and if the person is improving. What is the appropriate format for writing a nutrition diagnosis? What information is included in the P, E, and S? It explains the nutrients problem, what’s causing it, and evidence showing the problem. P: Problem E: Etiology S: Sign/symptoms What are advantages and disadvantages of a 24 hour recall, FFQ, and food record when collecting nutrition intake data? 24hr recall: Advantages: Free, can get a glimpse of patterns, quicker way to collect data & get a diagnosis. Disadvantages: Only records 1 day, not being reliable on them remembering what they ate, food consumption changes daily. Food Frequency Questionnaire (FFQ): Advantages: Collects very specific data on a lot different food groups, quick, good diagnosis plan for long-term issues. Disadvantages: Less specific, more general, patients can be unreliable, literacy demand, zero meal pattern. Food Record: Advantages: Wide range & very specific, track patterns, multiple days, more accuracy tailor/variety. Disadvantages: Harder for patient to track because of higher expectations, time consuming for patient, and dietitian, eat differently. When evaluating growth, why is it helpful to have multiple plots to assess? To help track growth over time & identify changes or patterns to see if the child is growing normally or if there may be a concern. Why is it important to evaluate weight for age along with BMI when evaluating growth? Weight-for-age shows how a child’s weight compares to other children that are the same age while BMI shows weight in relation to height. Which together give more complete picture of the child’s growth overall. Why should you be cautious when assessing BMI during childhood? BMI charts are always going up & down because a child will plump before they hit a growth spurt. What are benefits of pre-conception health screening and care? Higher folic acid intake, current vaccinations, less wight-gain at the beginning of their pregnancy, fewer pregnant complications, fewer preterm or with low-birth-weight infants. What are the recommendations for calories, carbohydrate, and protein during pregnancy? Calories: Carbohydrates:175 g per day. Proteins:71g per day. Why are the following nutrients important during pregnancy? (Folic acid, iron, B complex, sodium, calcium) All of these nutrients help support the baby’s growth and development and help keep the mother healthy during pregnancy. Why caution about fish intake during pregnancy? Cold deli meat? - Fish contain high mercury, and high mercury can harm the baby’s development in brain & nervous system. - Cold deli meats contain Listeria Bacteria; causes illness & pregnancy complications. But heating the deli meat until steaming hot reduces the risks. What are the AND nutrition interventions/recommendations for PMOS (PCOS)? At least 4-5 meals and snacks daily, including breakfast. Avoid skipping meals. A variety of different foods like fruits, vegetables, grains, protein foods & dairy. With healthy fats (walnuts, and almonds). What are nutrition interventions/recommendations celiac disease? (general and examples of foods) To follow strict gluten-free diet and choose naturally gluten free foods while making sure to get enough important nutrients. Gluten-free oats, rice, corn tortillas, potatoes. What are interventions/recommendations gestational diabetes? Eat balanced meals, control carbohydrates portions, limit added sugars & monito blood sugar to help keep glucose levels in a healthy range. What is a consistent CHO diet? How would you go about establishing a consistent CHO diet for an individual? What information do you need and what will you do with the information? A diet designed to help normalize blood glucose levels as impacted by food consumption. Start by determining the person’s calories needs, and then distributing a similar amount of carbohydrates evenly throughout meals and snacks each day. You will need info about people’s calorie needs, CHO needs, usual meals & snack times to spread CHO evenly, usual food intake/preferences to create meals people will eat blood glucose levels to see how the amount & timing of CHO affects blood sugar. What change occurs in cholesterol levels during pregnancy? Why does this happen? It increases during pregnancy bc the body needs more fat and cholesterol to support the developing baby and placenta. What are weight gain recommendations for pregnancy? 25-35 pounds What are reasons for slow weight gain during pregnancy? Because of nausea & vomiting, poor fetal growth, resolved Adema (swelling and fluid), medical problems or serious infections. What complications result from changes in the GI tract during pregnancy? What diet-related recommendations exist for managing these complications? Changed in the GI tract can cause slow digestion and cause problems such as nausea, heartburn constipation, and bloating. Recommendations would be eating smaller meals, staying hydrated. Be able to describe/define these terms: Ovulation – Egg is released from the ovary released into the fallopian tube. pre-term birth – babies born before 37 weeks of gestation. follicular phase – The first part of the menstrual cycle, when an egg develops in the ovary. luteal phase – The part of the menstrual cycle after ovulation, when the body prepares corpus luteum – A structure in the ovaries that produce hormones, especially progesterone, to help support a possible pregnancy Spina bifida – a neural tube defect in which the spinal column does not completely close around the spinal cord during fetal development. Teratogen - Something in the environment of the embryo that can cause birth defects. Hyperemesis gravidarum – Severe persistent committing during pregnancy that results in wight loss and dehydration and that often requires hospitalization. Pre-Eclampsia -Hypertension with onset following 20 weeks of pregnancy that is characterized by a sudden rise in blood pressure, excessive weight gain, generalized edema and may result in eclampsia if untreated. Pica – An eating disorder characterized by consuming nonnutritive substances such as clay, paper, starch, chalk, and soil. Amenorrhea – Absence of menstruation. What happens during each of the stages of lactation: Secretory differentiation – Happens during pregnancy. The breast develops and prepares the milk producing cells. Small amounts of colostrum begin to form. Secretory activation – Copious milk production after delivery, usually 2-4 days after birth Galactopoesis – on-going milk production Involution – Return to pre-pregnancy. Briefly describe each of these components of breastmilk- CHO, Protein, Fat, HMOs CHOS – Lactose is the primary CHO in breastmilk it provides energy and helps with calcium absorption. Protein- Breastmilk protein supports growth and development with whey helping digestion and casein helping the baby absorb calcium. Fat – The fat in the breastmilk varies, with more fat toward the end of a feeding & the type and amount can be influenced by the mother’s diet. HMOS/ Human Milk Consumption – Special sugar that help protect the baby from infections & support a healthy gut. What are calorie recommendations for a lactating woman in the first 6 months/second 6 months? How /why has the recommendation been adjusted? First 6 months 330 cal. Second 6 months 400 cal. How many calories are in one ounce of a standard infant formula? 20 calories per ounce What are infant signs of hunger- early, middle, late? Early: stirring, mouth opening, turning head, seeking rooting Middle: Stretching, increasing physical movements, hands to mouth Late: Crying, agitated body movements, turning red. Which vitamin supplement is recommended for all breastfed infants? AAP recommended 400 IU/day What are the functions of the hormones of breastfeeding- oxytocin and prolactin? Oxytocin – Causes milk to be released (let down) from breast. Prolactin – Stimulates the breast to produce milk. What are signs of a “good” latch? Cheeks are plumpled and round, mouth at a 140 degree angle, lips are flanged out, ears and shoulder are aligned. What are examples of healthcare practices that can encourage/support breastfeeding mothers? Encouraging skin to skin contact after birth, teaching proper latching & positioning What are examples of healthcare practices that can discourage/impede breastfeeding mothers? Not providing education or support, giving babies formulas when it is not medically necessary. What anthropometric measurements are used to monitor infant growth? Weight, length, head circumference Describe appropriate bottle-feeding- preparation, positioning, and feeding frequency. • Preparation: Wash hands, clean bottles and nipples, and prepare formula exactly according to the instructions. Do not dilute or concentrate formula. • Positioning: Hold the baby semi-upright, support their head and neck, and keep the bottle angled so the nipple stays filled with milk. Never prop the bottle. • Feeding frequency: Feed the infant on demand, watching for hunger and fullness cues. Newborns typically feed about 8–12 times per day. What appropriate complementary foods? First foods/safe foods meats, mushed food (vegetables)/steamed, shellfish, nut butters, eggs, wheats Appropriate beverages for infants, Water, and plain milk What are internal and external causes of failure to thrive or growth faltering? Internal would-be food allergies, growth development delays. External would-be parents, not shaking formula well. Summarize the Satter Division of Responsibility in feeding infants/toddlers/children Children throughout the years build on their natural ability and become eating competent. While the parents let them learn and grow with eating when they follow the Division of Responsibility in feeding.