What is the Foetal Origins of Adult Disease (FOAD) concept?
The concept that early-life nutrition and environment influence chronic disease risk later in life.
Undernutrition or overnutrition in utero leads to epigenetic changes that increase the risk of obesity, cardiovascular disease, type 2 diabetes, and hypertension.
What are the key physiological changes during pregnancy?
- ↑ Blood volume and plasma expansion
- ↑ Cardiac output
- ↑ Renal filtration rate
- ↑ Oxygen needs
- Hormonal changes (progesterone, oestrogen)
- Weight gain necessary for healthy pregnancy outcomes
These changes can lead to dilutional ‘physiological anaemia’ among other adaptations.
What is the total energy requirement in the 1st trimester?
No additional energy required.
Energy requirements increase in the 2nd and 3rd trimesters.
What is the additional energy requirement during the 2nd trimester?
+1400 kJ/day.
The energy requirement further increases in the 3rd trimester.
What is the additional protein requirement during pregnancy?
+14 g/day (~1.0–1.1 g/kg).
Protein is essential for fetal growth and development.
What are the risks associated with excessive gestational weight gain (GWG)?
- Higher risk of gestational diabetes
- Hypertension
- Macrosomia
Excessive GWG can lead to complications for both the mother and the baby.
What are the risks associated with insufficient gestational weight gain (GWG)?
- Preterm birth
- Low birth weight (LBW)
Insufficient GWG can have serious implications for fetal health.
What are the supplementation guidelines for folate during pregnancy?
400–500 µg/day ≥1 month before conception through 1st trimester.
Folate is crucial for preventing neural tube defects.
What is the recommended iodine supplementation for pregnant women in Australia?
150 µg/day.
This recommendation is for all pregnant women to prevent deficiency.
What should pregnant women do regarding iron supplementation?
Supplement only if deficiency diagnosed.
Routine supplementation is not recommended without diagnosis.
What is the recommendation for vitamin D supplementation during pregnancy?
If deficiency risk (limited sun exposure, darker skin).
Vitamin D is important for calcium metabolism and fetal bone development.
Name three foods to avoid due to the risk of Listeria during pregnancy.
- Soft cheeses
- Deli meats
- Unpasteurised dairy
These foods can pose a risk of foodborne illness that is particularly dangerous during pregnancy.
What is the maximum recommended caffeine intake for pregnant women?
<200 mg/day.
High caffeine intake can be associated with adverse pregnancy outcomes.
Is any level of alcohol consumption considered safe during pregnancy?
None considered safe.
Alcohol can lead to fetal alcohol spectrum disorders.
What are the dietary recommendations for pregnant women regarding meal frequency?
Encourage small, frequent, nutrient-dense meals.
This helps maintain energy levels and nutrient intake.
What is the recommended daily hydration for pregnant women?
~2.3 L/day.
Adequate hydration is essential for overall health during pregnancy.
What is mandatory fortification in Australia regarding wheat flour?
Wheat flour for bread fortified with folic acid and iodised salt since 2009.
This fortification has led to a significant reduction in neural tube defects (NTDs).
What percentage reduction in NTDs among teenage mothers occurred post-fortification in Australia?
~55%.
This demonstrates the effectiveness of fortification policies.
Which groups are considered at-risk for nutrient deficiency during pregnancy?
- Adolescents
- Vegetarians/Vegans
- Aboriginal & Torres Strait Islander women
These groups have higher nutrient demands or specific deficiencies.
What is the global prevalence of iron deficiency among pregnant women as of 2011?
~38.2%.
This statistic highlights the widespread nature of the issue.
What is the prevalence of anaemia among pregnant women in Australia?
7–10%.
This indicates a significant public health concern.
Explain the rationale for folic acid fortification in Australia.
To reduce the incidence of neural tube defects (NTDs) among newborns.
Fortification has proven effective in improving maternal and fetal health outcomes.
Describe Listeria-related food safety recommendations during pregnancy.
Avoid soft cheeses, deli meats, unpasteurised dairy, and pre-prepared salads.
These foods are at higher risk for Listeria contamination.
List three critical micronutrients for pregnancy and their functions.
- Folate: Prevents neural tube defects
- Iron: Supports increased blood volume and fetal growth
- Iodine: Essential for thyroid function and fetal brain development
Adequate intake of these micronutrients is vital for pregnancy health.
