MINERALS:
 Pertain to the elements in their simple
inorganic form.
 Referred to as mineral elements or, they are
known as trace elements or trace minerals.
MINERAL COMPOSITION OF THE BODY
 Mineral elements exist in the body and in
food in organic and inorganic combinations.
A. GROUP I: MAJOR MINERALS
Calcium-approximately 1.5%-2.2% is calcium.
 99% present in bones and teeth and the
remaining 1% found in soft tissue and body
fluids.
Functions:
 Combines with phosphorus to form calcium
phosphate, which is the hard material of
bones and teeth.
 Participates in muscular contraction and
relaxation.
 Promotes blood coagulation.
 Affects transport function of cell membrane
and acts as membrane stabilizer.
 Required in nerve transmission and
regulation of heartbeat.
Utilization:
 Absorption is better during period of
increased body needs such as in
growth, pregnancy, and lactation.
 Vitamin D enhances the optimum
absorption calcium by increasing
permeability.
 Low gastric pH favors the absorption of
calcium, hypochlorhydria causes
precipitation of mineral.
 High intakes of meat increase excretion
of calcium.
 The ratio of calcium and phosphorus is
important in absorption of both
minerals in infants.
 Oxalic and phytic acids interfere with
absorption of calcium by forming
insoluble salts.
 Fats form insoluble soaps with calcium.
 Increase in GI motility can cause
decrease of absorption of calcium.
 Lack of exercise may cause loss of bone
calcium.
 Mental stress or emotional instability
 Alcohol intake
 Caffeine
Effects of deficiency or excess
Deficiency:
 Retarded Growth
 Rickets
 Osteomalacia
 Tetany
Excess:
 Hypercalcemia
Magnesium-about 50% is present in bones with
the combination of phosphate and calcium.
Functions:
 Part of many enzymes are responsible for
the transfer of energy.
 Core of chlorophyll molecule, important in
photosynthetic reactions.
 Essential in cellular metabolism.
 Regulates blood phosphorus level.
 Promote conduction if nerve impulses and
allow normal muscle contraction.
 Stability of calcium in the tooth enamel.
Effects of deficiency or excess
Deficiency:
 Hypomagnesemic tetany-observed with
people suffering from kwashiorkor.
 Hypermagnesemia-toxicity stage of
magnesium results in hypertension,
arrhythmia etc.
Sodium-50% found in extracellular fluids, 10%
within the cell, 40% found in skeleton.
Functions:
 Maintaining fluid balance.
 Maintaining acid-base balance.
 Allows passage of materials like glucose.
Recommended dietary allowances
 Allowances and requirements have not been
determined but should be equal to the
body’s need for growth.
Effects of deficiency or excess
Deficiency:
Hyponatremia-occur in dehydration as in heat
exhaustion.
Excess-accumulates principally in the
extracellular fluid and may result in edema.
Potassium-principal cation present in cells or
intracellular fluids.
Functions:
 Maintains fluid and electrolyte balance.
 Influence acid-base balance, and role in
skeletal and cardiac muscles activity.
 Act as muscle relaxant.
 Important in carbohydrate and protein
metabolism.
Recommended dietary allowances
 Diet should contain 2-6 gm potassium.
Effects of deficiency or excess
Deficiency:
 Hypokalemia-prolonged wasting disease
with tissue destruction.
 Apathy
 Muscular Weakness
 Mental Confusion
 Abdominal distension
Excess:
Hyperkalemia-elevated serum potassium occurs
in kidney.
Phosphorus-contains 1%, 85% in inorganic phase
of bones and teeth.
Functions:
 Component of bones and teeth.
 Component of every cell.
 Important in pH regulation as principal
anion of cell.
 Involved in chemical reactions.
Effects of excess:
 Causes no harm, usually voided in stools.
 Elemental phosphorus is highly poisonous
as it causes erosion of the bone.
Sulfur-occurs in every protein cell and comprises
about 0.25% of body weight.
Functions:
 Maintains protein structure.
 Activates enzymes.
 Participates in detoxification reactions.
Chlorine-major anion in extracellular
Cerebrospinal fluid has most chloride.
Functions:
Maintains fluid and electrolyte and acid-base
balance.
Contributes to acidity.
Food sources-table salt (NaCl)
Effects of Deficiency
Alkalosis-excessive loss of chloride ions.
GROUP II: TRACE MINERALS
Iron-contains 75 mg/kg fat-free of body weight of
iron.
Functions:
 Constituent hemoglobin and myoglobin,
serve as carrier of oxygen.
 Hemoglobin formation.
 Active component of tissue enzyme.
Utilization
 Better absorbed than in ferric form.
Types of Iron
Heme-found only in meat, and more absorbed by
the body.
Non-Heme-comes from other iron-containing
foods.
Body needs:
• Transferring of saturated iron, the absorption
decreases
• Iron deficiency=absorption is high
Bulk in the diet:
•Increase fiber=interferes with absorption of
iron
• Iron in green leafy vegetables is poorly
absorbed
Intake of Coffee:
• Coffee taken in an hour after a meal or with the
meal, iron absorption is reduced
Presence of ascorbic acid:
• 40 to 50 mg of ascorbic acid added to meal
increases iron absorption
Effects of deficiency or excess
Deficiency:
• Anemia-reduction of size of RBC
Causes:
fluid.
• Inadequate intake of iron
• Excessive excretion of iron
• Inadequate formation of RBC
Symptoms: • Increases storage of thiamine
• Pallor Effect of deficiency or excess
• Easy fatigue • No incidence of manganese deficiency or toxicity
• Dizziness Cobalt-found in trace amounts of body
• Insomnia Functions:
• Lack of appetite • Constituent of vitamin B12
Excess: • Necessary for RBC formation
Hemosiderosis-amount of Fe in the body • Essential for normal functioning of all cells
Causes: Requirements:
• Excessive iron • Nutritional requirement is restricted for body's
• Failure to regulate iron need of vit B12
Excessive Iron Intake is common among: Effects of deficiency or excess
• Cooking in iron pots Deficiency-pernicious anemia
• Given more amounts than the body needs Excess-polycythemia or increase in the no. of RBC.
• Multiple blood transfusion • Hyperplasia-bone marrow
Hemochromatosis-absorption of unusually large Zinc-occurs in varying concentrations of all human
amounts of iron cells.
Copper-all tissues contain copper, large amounts Functions:
found in liver, brain, heart, and kidney. • Zinc is involved in a wide range of cellular
Functions: functions
• Formation of hemoglobin • It is present in the RNA
• Promotes absorption of iron from GIT • Related to insulin, glucagon, ACTH, growth
• Valuable catalyst in oxidation-reduction hormone, gonadotropin, and testosterone
• Maintain integrity of myelin sheath • Enhances wound healing and maintain normal
• Part of tyrosinase, formation of melanin pigment sense of taste
Effects of deficiency: Effects of deficiency or excess:
• Depigmentation of skin and hair Deficiency:
• CNS abnormalities • Slow growth
• Hypotonia • Alopecia
• Hypothermia • Disturbances in keratinization
• Chronic microcytic anemia • Hypospermia
• Skeletal mineralization in infants and children • Delayed sexual menstruation
Effects of excess: • White cell defects
• Wilson's disease-excessive accumulation of • Night blindness
copper Excess:
Iodine-adult body contains 20 to 30 mg of iodine. • Nausea
Functions: • Vomiting
• Needed for the production thyroid hormone, • Abdominal cramps
required for synthesis of thyroxine. • Diarrhea
Effects of Deficiency: • Fever
• Goiter-enlargement of thyroid gland Molybdenum-9 mg present in the body, important
•Cretinism-caused by insufficient iodine intake to health
• Myxedema-low iodine intake Functions:
Manganese-about 10 to 20 mg present in adult • It is present inbound as an integral part of the
body. various enzyme molecules
Functions: Three enzymes:
• Activator of metabolic reactions • Xanthine oxidase
• Acts as catalyst of a no. of enzymes • Aldehyde oxidase
• Flavoprotein-catalyzing oxidation • Pancreatic degeneration
Requirements: • Hemolytic anemia
• Daily intake of 50 to 500 mg considered safe Chromium-fatal body content of chromium is
Effects of deficiency: about 6 to 10 mg
• Headache Functions:
• Irritability • Raises abnormally low fasting blood sugar levels
• Night blindness and improves uptake of sugar
• Lethargy • Stimulates synthesis of fatty acids and
• Coma cholesterol
•Abnormal metabolism of sulfur containing Requirement:
amino acids • Normal adults-50
• Abnormal degradation of nucleic acids Vanadium-constituent of human tissues
Function:
GROUP III: OTHER TRACE MINERALS • Involve in the appetite crystal formation of tooth
Fluorine-found primarily in the bones and teeth enamel, may contribute resistance to dental decay
and trace amounts in the thyroid gland and skin Requirement:
Functions: • 0.1 to 0.3 mg/day
• Forms a more stable compound in the dentine
and enamel of the teeth CHAPTER 5: PROCESS OF METABOLISM
• Treatment for osteoporosis Metabolism-chemical reaction to maintain living
Effects of deficiency or excess stage of cells and organism.
Effect of deficiency:
CATEGORIES OF METABOLISM
• Dental caries
Effects of excess: Catabolism-breakdown of molecules to obtain
energy.
• Dental fluorosis-melting of the enamel (2-8 ppm)
• Osteosclerosis (8-20 ppm) Anabolism-synthesis of all compounds need by the
• Growth depression (50 ppm or more) cells.
• Fatal poisoning (extremely high levels) Bioenergetics-biochemical or metabolic pathways
Distribution of Fluorides: by cell obtaining energy.
• Teeth and skeleton have the highest
NUTRITION, METABOLISM AND ENERGY
concentrations of fluoride, due to the affinity of
fluoride to calcium.  Nutrition is the key to metabolism.
Role of Fluorides in nutrition and dental health  Pathways of metabolism rely to the
nutrients that break down to produce
• Nutrition and diet affect the development and
energy.
integrity of the oral cavity as well as the  Food provides substances that are essential
progression of diseases of the oral cavity. for building etc.
Prevention of cavities by fluoride:
CARBOHYDRATES IN METABOLISM
• Concentrates in the growing bones and
developing teeth of children. 3 FORMS OF CARBO:
Selenium-dependent on the soil content where the Starch and Sugar-major sources of energy for
food source is grown. humans.
Functions:
Cellulose (Fiber)-provide bulk in diet.
• Reduces or prevents effects if vitamin E
deficiency  Body tissues rely on GLUCOSE for all
• Component of glutathione peroxidase, activities.
 Carbo and Sugars produce glucose by
responsible for inactivating peroxides
digestion or metabolism.
Effects of deficiency or excess PROTEINS IN METABOLISM
• Muscle pain and tenderness
 Proteins-main builders of the body.  Niacin or Nicotinic Acid
 Aid in cell structure functions and  Pantothenic Acid
hemoglobin formation to carry oxygen and METABOLIC PATHWAYS
enzymes.  Allows basic chemicals from nutrition to be
 Supplies nitrogen for DNA and RNA genetic changed into another chemical, by a
material and energy production. sequence of enzymes.
 Contains amino acid which is needed for  Enzymes are vital to metabolism, allows
nutrition. organisms to drive reactions that requires
8 ESSENTIAL AMINO ACIDS THAT THE energy.
BODY CAN’T PRODUCE  Allows the regulation of metabolic pathways
 Lysine in response to changes in cell’s
 Tryptophan environment or signals from other cells.
 Methionine
 Leucine CHAPTER 6: PHYSIOLOGIC VALUE OF
 Isoleucine FOOD
 Phenylalanine Food-refers to solid and liquid materials
 Valine taken into digestive tract.
 Threonine Organic Compounds:
-Foods with high biologic value are eggs,  Proteins
milk, soybeans, meats, vegetables, and  Lipids
grains.  Carbohydrates
FAT IN METABOLISM  Vitamins
Fats-concentrated sources of energy. Inorganic Elements:
FUNCTIONS OF FATS:  Water
 Helps to form cellular structure.  Minerals
 Form protective cushion and insulation 3 MAJOR NUTRIENTS
around vital organs.  Carbohydrates
 Help absorb fat soluble vitamins.  Proteins
 Provide reserve storage of energy.  Fats
Essential Fatty Acids-unsaturated fatty  Vitamins and minerals act as catalysts that
acids that includes: prompt the 3 major nutrients to interact.
 Linoleic
METABOLISM
 Linolinic
 Arachidonic Metabolism-derived from the Greek word
Saturated Fats: “metabolismos” which means to change or alter.
 Cholesterol
MINERALS AND VITAMINS IN  Chemical process of transforming food into
METABOLISM complex tissue elements and transforms
Important Minerals: complex to simple substances.
 Calcium  Produces heat and energy.
 Phosphorus Energy-force or power that enables the body to do
 Iron its work.
 Sodium
 Potassium ENERGY FROM FOOD
 Chloride Ions THE CALORIE
 Copper
 Cobalt  Unit of energy commonly used in human
 Manganese nutrition is KILOGRAM CALORIE (kcal) or
 Zinc simply CALORIE.
 Magnesium  It is the measurement for the energy that
 Fluorine the body gets from food.
 Iodine  They are the by-products of carbohydrates,
Important Vitamins: proteins and fats that are oxidized in the
 Vit A body.
 B2 (Riboflavin)
THE JOULES
Joules-is the measure of energy in the metric
system.
COMPONENTS OF ENERGY EXPENDITURE
BASAL METABOLISM
Basal Metabolism-also known as the required
energy expenditure (REE).
It is the measure of energy needed by the body at
rest for all its internal chemical activities.
Basal Metabolic Rate (BMR)-rate of basal
metabolism in each person at a given time and
situation.
CONDITIONS FOR BMR:
 Subjects must be in fasting or post-
absorptive state, at least 12 hours after
meal.
 Should be awake, quiet, free from physical
fatigue, nervousness, or tension.
 Temperature 20 degrees C to 25.
FACTORS THAT AFFECT THE BMR
Surface Area-the greater BSA, the greater the
necessary heat produced by the body.
Sex-women have a metabolism of 5% to 10% less
than men.
Age-younger=fast, older=slower.
Body Composition-inactive adipose tissue lowers
the BMR.
State of Nutrition-decrease in mass of active
tissue.
Sleep-during sleep metabolic rate falls.
Endocrine Glands-regulators of metabolic rate.
Fever-increases BMR about 7%.
PHYSICAL ACTIVITY
 The more vigorous physical work, the
greater the calorie cost.
SPECIFIC DYNAMIC ACTION OF FOOD
 Carbohydrate or Fat increases heat
production of about 5% of the total calories
consumed.
ENERGY BALANCE
 The amount of energy taken in by an
individual should be equal to the amount of
energy expended during the day.
CHAPTER 7: WATER AND ELECTROLYTE
BALANCE
Water-constitutes about 60% to 70% of total body
weight.
 10% loss will cause an illness.
 20% loss will cause death.
 Water in a normal adult=45 liters, 30 liters
found in cell while 15 liters outside the cell.
FUNCTIONS:
 It is the universal solvent.
 Serves as a catalyst, especially in digestion,
absorption, and circulation.
 Vital component tissues, muscles, glycogen
etc.
 Act as a lubricant of the joints and the
viscera in the abdominal cavity.
 Regulator of body temperature through its
ability to conduct heat.
WATER INTAKE
 Amount of water needed by the body may
be met by direct intake of water.
WATER OUTPUT
 Water leaves the body via several channels
such as skin as an insensible perspiration.
 Lungs as water vapor in the expired air.
 Gastrointestinal tract as feces.
 Kidneys as urine.
 Electrolytes through tears.
 Stomach suction.
 Breathing
 Vomiting
 Bleeding
 Perspiration
 Drainage from burns
 Discharge from ulcer, skin diseases, and
injured or burned areas.
ABNORMALITIES OF WATER BALANCE
OVERHYDRATION AND INTOXICATION
 When large amounts of water are lost in the
body usually caused by high environmental
temperature, sodium is also lost.
 If water intake increased w/o corresponding
increase intake of sodium, water
intoxication results.
  If too much water, cells and tissues become
water-logged and diluted. May cause
anorexia and vomiting, if continues the
brain will lead to convulsion, coma, and
death.
DEHYDRATION
 Condition becomes serious if the loss is
about 10% of the total body water.
 Fatal if the loss is from 20% to 22%.
 Skin becomes loose and inelastic.
CHAPTER 8: NUTRITIONAL ASSESSMENT
RECOMMENDED DIETARY ALLOWANCES (RDA)
TO RECOMMENDED ENERGY AND NUTRIENT
INTAKES (RENI)-to emphasize that the standard is
in terms of nutrients and not foods or diets.
Average Physiologic Requirements (AR)-where
most nutrients are equal to.
Standard Deviations (SD) or Coefficient of
Variation (CV)-to cover the needs of all individuals
in the population.
Adequate Intake (AI)-based on the experimentally
observed average intake of healthy individuals.
ESSENTIALS OF AN ADEQUATE DIET
Milk Group-to provide most of calcium
requirements.
Meat Group-provides number of high-quality
proteins.
The Bread and Cereal Group-furnishes thiamine,
protein, iron, niacin, carbohydrate, and cellulose at
a low cost.
The Vegetable-Fruit Group-important supplier of
fiber, minerals, and vitamins specifically A and C.
ASSESSMENT OF NURTITIONAL STATUS
 It is the degree to which the individual’s
psychological need for nutrients is being
met by the food the person eats.
 Balance between nutrient intake and
nutrient expenditure or need.
Aspects to Consider:
 Dietary history and intake data
 Biochemical Data
 Clinical Examination
 Anthropometric Data
 Psychological Data
METHODS OF ASSESSING DIETARY INTAKE
24 HOUR RECALL-to recall everything that he/she
ate within the last 24 hours or the previous day.
FOOD FREQUENCY QUESTIONNAIRE-questions
are modified based on the information from the 24-
hour recall.
DIETARY HISTORY-more complete, but it
includes both sources from the first two.
FOOD DAIRY OR RECORD-involves time,
understanding, and motivation on the part of the
patient or client.
OBSERVATION OF FOOD INTAKE-most accurate
method of dietary intake assessment but the most
time-consuming, expensive, and difficult.
 Requires knowing the amount and kind of
food presented to the person and the record
of the amount eaten.
EVALUATION OF THE FOOD INTAKE DATA
EVALUATION BY FOOD GROUP METHOD
 Simplest, fastest and yet the crudest way to
evaluate food intake data to determine how
many servings from each of the four groups
were consumed.
MEAL PATTERNS-helpful in planning but they
must take into the family’s habit and needs.
PLANNING FOR THE WEEK-in hospitals they
used “CYCLE MENU”.
NUTRITION SURVEY-epidemiological investigation
of the nutritional status of the population by
various methods.
FEATURES OF METHODS AND REFERENCE
STANDARDS USED
CLINICAL ASSESSMENT-deals with the
examination of changes that can be seen or felt in
superficial tissues.
CLINICAL SYMPTOMS:
Protein-Energy Malnutrition-mild to moderate,
severe.
 Marasmus-dry form
 Kwashiorkor-edematous form
 Marasmic Kwashiorkor
Xerophthalmia-impairment of night vision.
Symptoms:
 Impaired Night Vision
  Smokey conjunctiva Fetus=7.5
 Dry Eyes
Uterus=2.0
 Cornea softening and ulcers
Placenta=1.5
Anemia-sole reliance on breast milk for children
beyond six months lead to anemia. Amniotic Fluid=2.0
Symptoms: MATERNAL WEIGHT

 Tiredness UNDERWEIGHT-high risk of having low-birth

 Paleness under the eyelid
 Breathlessness
 Heart palpitations
 Paleness under nails
 Edema
Goiter-enlargement of the thyroid glands is
due to its need for iodine.
Symptoms:
 Swelling of the neck
 Difficulty in swallowing
 Difficulty in breathing
 Tight feeling in the throat
Vitamin B2 or Riboflavin Deficiency
Symptoms:
 Magenta Red Tongue
 Sores at the angle of the mouth and folds
of the nose
 Itching and scaling of skin around nose,
mouth, scrotum, forehead, ears, scalp
BIOCHEMICAL ASSESSMENT-estimation of time
desaturation, enzyme activity, or blood
composition.
ANTHROPOMETRIC MEASUREMENTS-
measurement of variations of the physical
dimensions and gross compositions of the human
body.
weight infants.
 Higher rates of preterm deaths and
infant deaths.
OVERWEIGHT AND OBESE-hypertensions,
gestational diabetes, and postpartum infections.
 Complications of labor and delivery
 Trauma, cesarean section
 Neural tube defects
PROTEIN ALLOWANCES
REASONS FOR ADDITIONAL PROTEINS:
 Provide storage of nitrogen
 Protect mother against complications.
 Growth of uterus, placenta, and tissues
 Meet the needs of fetal growth.
 Growth of mammary tissues
 Hormonal preparation for lactation
CALCIUM ALLOWANCES-calcium and phosphorus
deposition takes early in pregnancy, but the
amounts are small.
Adequate amount of vitamin D to calcify the fetal
bones and teeth.
IRON ALLOWANCES-at least 700 to 1,000 mg
must be absorbed and utilize by the mother.
IODINE ALLOWANCES-meet the needs for fetal
development, inadequate amount result to goiter of
mother or child.

VITAMIN ALLOWANCES-thiamine and niacin are

CHAPTER 9: PREGNANCY AND LACTATION
increased in proportion to calorie.
Pregnancy-period when the fertilized ovum
 Riboflavin increased according to protein.
implants itself in the uterus, undergoes
differentiation, and grows until it can support  Vit A=good vision
extra-uterine life.  Folic Acid and B12=synthesis of RBC
 Vit B6=pyridoxine requirement
CALORIE ALLOWANCES
COMPLICATIONS OF PREGNANCY AND
Total cost of storage plus maintenance=80,000 POSSIBLE DIETARY MODIFICATIONS
kcal
Nausea, vomiting, improper body weight, and
Energy cost=300 kcal per day toxemia.
WEIGHT GAIN
Influenced by intake, digestion, absorption, and
utilization of essential nutrients.
TOXEMIA-rapid weight gain, edema, high bp,
excretion of albumin in the urine, and convulsions.
Acute Toxemia-onset after 14th week.
Pre-eclampsia-hypertension with proteinuria and
edema
Eclampsia-convulsions or coma usually associated
with hypertension, proteinuria, and edema.
Chronic hypertensive
 W/ or 2/O superimposed=acute toxemia
ANEMIA-deficiency in iron and folic acid.
DIABETES-prone to develop pre-eclampsia,
pyelonephritis and polyhydramnios and baby
would be risk at dying.
CONSTIPATION-pressure by the fetus, lack of
exercise and insufficient bulk in diet cause
constipation.
SOCIO-ECONOMIC AND CULTURAL FACTORS
ALCOHOL, CAFFEINE, AND NICOTINE
MOTHERS AGE AND ASSOCIATED HEALTH
CONCERNS AND RISKS
PREGANCY IN ADOLESCENTS
 Iron deficiency anemia
 Prolonged labor
 Higher rates of stillbirths, preterm births,
and low-birth weight infants.
PREGNANCY IN OLDER WOMEN
 Hypertension and diabetes
 Premature births and low birth rate
 Birth defects
 Fetal death
REPEATED PREGNANCIES-as parity increases,
lower nutrient intake also increases.
LACTATION-assuring an adequate supply of good
quality breast milk must begin at the onset of
pregnancy.
NUTRITION IN LACTATION
CALORIE ALLOWANCES-extra calories are needed
for additional activity necessitated by the care of
the infant.
PROTEIN ALLOWANCES-essential in preparation
for lactation.
REASONS FOR ADDITIONAL PROTEINS:
 Provide storage of nitrogen
 Protect mother against complications
 Growth of uterus, placenta, and tissues
 Meet the needs of fetal growth
 Growth of mammary tissues
 Hormonal preparation for lactation
CALCIUM ALLOWANCES-calcium and phosphorus
deposition takes early in pregnancy, but the
amounts are small.
Adequate amount of vitamin D to calcify the fetal
bones and teeth.
IRON ALLOWANCES-at least 700 to 1,000 mg
must be absorbed and utilize by the mother.
IODINE ALLOWANCES-meet the needs for fetal
development, inadequate amount result to goiter of
mother or child.
VITAMIN ALLOWANCES-thiamine and niacin are
increased in proportion to calorie.
 Riboflavin increased according to protein.
 Vit A=good vision
 Folic Acid and B12=synthesis of RBC
 Vit B6=pyridoxine requirement
COMPLICATIONS OF PREGNANCY AND
POSSIBLE DIETARY MODIFICATIONS
Nausea, vomiting, improper body weight, and
toxemia.
Influenced by intake, digestion, absorption, and
utilization of essential nutrients.
TOXEMIA-rapid weight gain, edema, high bp,
excretion of albumin in the urine, and convulsions.
Acute Toxemia-onset after 14th week.
Pre-eclampsia-hypertension with proteinuria and
edema
Eclampsia-convulsions or coma usually associated
with hypertension, proteinuria and edema
Chronic hypertensive
 W/ or 2/O superimposed=acute toxemia
ANEMIA-deficiency in iron and folic acid.
DIABETES-prone to develop pre-eclampsia,
pyelonephritis and polyhydramnios and baby
would be risk at dying.
CONSTIPATION-pressure by the fetus, lack of FOOD NEEDS IN LACTATION
exercise and insufficient bulk in diet cause
constipation. NUTRITIONAL REQUIREMENTS

SOCIO-ECONOMIC AND CULTURAL FACTORS Calories-1,000 calories above normal allowance is

needed, approx. 120 calories to produce 100 ml of
ALCOHOL, CAFFEINE, AND NICOTINE milk.

MOTHERS AGE AND ASSOCIATED HEALTH Protein-additional 20g to the normal allowance is
CONCERNS AND RISKS needed to compensate for the protein lost in milk.

PREGANCY IN ADOLESCENTS Calcium and Phosphorus-increase of 0.5 mg to

 Iron deficiency anemia
 Prolonged labor
 Higher rates of stillbirths, preterm births,
and low-birth weight infants.
PREGNANCY IN OLDER WOMEN
 Hypertension and diabetes
 Premature births and low birth rate
 Birth defects
 Fetal death
REPEATED PREGNANCIES-as parity increases,
lower nutrient intake also increases.
LACTATION-assuring an adequate supply of good
quality breast milk must begin at the onset of
pregnancy.
NUTRITION IN LACTATION
CALORIE ALLOWANCES-extra calories are needed
for additional activity necessitated by the care of
the infant.
the normal allowance is needed to prevent severe
depletion of maternal calcium.
Iron-additional intake for blood lost in parturition.
Vitamin A-additional of 2,000 IU to the normal
allowance is needed to provide the amount of
vitamin A.
Vitamin B1-additional amount of thiamine is
needed in milk.
•Glyoxaline-low in thiamine, that accumulates
thiamine deficiency.
Riboflavin, Vitamin C, etc.-additional allowance
for milk secretion.
Fluids-intake of 8 glasses or more.
• Colostrum-acts as a laxative and contains
antibodies which help resist infection.
BREASTFEEDING MISCONCEPTIONS
•Mother with tuberculosis cannot breastfed.

PROTEIN ALLOWANCES-essential in preparation • Breast milk not good if the mother stayed long
for lactation. under the sun.

• Increase breast milk, but lower protein decreases • Cannot breastfeed during pregnancy.
breast milk.
• Cannon breastfeeds with only one breast if the
• Average protein for a lactating mother is an other is painful.
additional of 20.2 g of protein.
• Cannot breastfeed if sick.
CALCIUM, PHOSPHORUS, AND VITAMIN D
• Not good when caught sudden shower.
ALLOWANCES
ADVANTAGES OF BREASTFEEDING
• Demand for calcium and phosphorus is increased
above the requirement of the pregnant woman. • Provides passive antibody
IRON ALLOWANCES • Limits growth of disease-producing germs in GI
tract
• Iron levels should be sufficient to avoid anemia
and should be the same level during pregnancy. • Babies have no difficulties with regulation of
calcium-phosphorus level
VITAMIN ALLOWANCES
• Bottle feeding affects dental arch
• Need in demand for vitamin A, niacin, riboflavin,
thiamine, and ascorbic acid above the • Cow's milk protein causes allergy
requirements of pregnancy during lactation.
Benefit to Mother's
• Less incidence to breast cancer

• Less incidence of thrombophlebitis or

inflammation

• Rapid return of the original size of uterus

FACTORS AFFECTING MILK SECRETION

Diet:

• Volume of milk affected by diet

• Galactagogues-meat, vegetables etc.

• Water should not be drunk beyond natural thirst,

because it suppresses milk secretion

Nutritional State of Mothers:

• Energy-yielding constituents of human milk

maintained

• Sufficient nutrient reserves in the mother's tissue

• Malnutrition and Illnesses, lessens the quality

and quantity of milk flow

Emotional and Physical States:

•Attitude affects milk secretion

•Relaxed temperament, pleasant surroundings,

rest, and sleep enhance milk secretion

Suckling:

• Stimulate milk-producing glands

•Supply of milk increases in proportion to the

body's demands

• Increased frequency of nursing associated with

infant weight and lactation period

Use of Contraceptives and Drugs:

• Contraceptives depress milk flow as well as drugs