This book focuses on nutrition services beginning in the preconceptional period and extending well beyond birth. It provides the rationale for the recommended nutritional services; briefly describes the necessary elements of these services; and indicates the personnel, knowledge, skills, and specialized education or training that may be needed to deliver them. It will be useful to policymakers, hospital administrators, directors of health centers, physicians in private or group practices, and others responsible for setting such standards and for overseeing health care services for expectant and new mothers and their infants.
In Part I of Nutrition During Pregnancy, the authors call for revisions in recommended weight gains for pregnant women. They explore relationships between weight gain during pregnancy and a variety of factors (e.g., the mother's weight for height before pregnancy) and places this in the context of the health of the infant and the mother. They present specific target ranges for weight gain during pregnancy and guidelines for proper measurement. Part II addresses vitamin and mineral supplementation during pregnancy, examining the adequacy of diet in meeting nutrient needs during pregnancy and recommending specific amounts of supplements for special circumstances. It also covers the effects of caffeine, alcohol, cigarette, marijuana, and cocaine use and presents specific research recommendations.
In this final report on the 'The influence of maternal, fetal and child nutrition on the development of chronic disease in later life', the Subgroup on Maternal and Child Nutrition (SMCN) reviews the evidence that early life nutrition exerts long-term effects and influences the risk of chronic disease in adulthood, bringing together findings from both observational and experimental studies, and considering implications for maternal and child nutrition in the UK. SACN concludes that there is cause for concern about the later health consequences of compromised or excessive nutrient supply during early fetal and infant life. It notes that in the context of reproduction, the impact of current dietary patterns on women and girls is of particular concern, and considers that improving the nutritional status of women of childbearing age, infants and young children has the potential to improve the health of future generations. The Committee also offers recommendations for future research in this area, particularly emphasising the need for data which better characterise dietary patterns and patterns of pre and postnatal growth.
Influence of Pregnancy Weight on Maternal and Child Health: Workshop Report summarizes a one and a half day workshop convened in May 2006 that reviewed U.S. trends in maternal weight (prior to, during, and after pregnancy) among different populations of women; examined the emerging research findings related to the complex relationship of the biological, behavioral, psychological, and social interactions that affect maternal and pregnancy weight on maternal and child health outcomes; and discussed interventions that use this complex relationship to promote appropriate weight during pregnancy and postpartum. Given the unprecedented environment in the United States in which two-thirds of the adult population meets the criteria for being overweight or obese, the implications for women in the reproductive age period are unique in the history of the country. The concerns for maternal and infant health are real. The questions and answers tackled by committee members and workshop participants were not easy. Nevertheless, having an opportunity to explore what is known, examine the gaps in knowledge, and explore what to do now and in the future build a pathway for further inquiry and action. This report summarizes the workshop proceedings and highlights key themes that deserve further attention. The participants in this workshop describe what is known about recent trends in maternal weight gain and the impact of maternal weight during pregnancy on the health of mothers and their children. The workshop provided a valuable opportunity to assess trends that have occurred since the publication of an earlier study by the Institute of Medicine (IOM), which included guidelines for recommended weight gain during pregnancy.
Human milk is considered the biologic norm for feeding the human infant during the first 6 months of life, and it is a preferred food from 6 to 12 months. It is a complex food and exerts its biologic effects well beyond its known nutritional value; however, human milk composition and the complexity of its composition is not wholly known or understood. Thus, defining the composition of milk, as well as both the individual and combined effects of milk components and the volume consumed on infant growth and development, is central to optimizing infant health. Furthermore, defining human milk composition, volume, and the myriad factors that influence milk components is needed for developing future Dietary Reference Intake (DRI) standards for nutrient intakes during the first 12 months of life. Scanning for New Evidence on the Nutrient Content of Human Milk examines the new and emerging evidence describing the nutrient content of human milk as well as the volume of milk consumed, both of which are needed to understand nutrient consumption by healthy breastfed infants. An evidence scan approach was used to summarize the status of the published literature on the nutrient content of human milk and to identify new evidence on nutrients in human milk that could inform the need for a systematic review as a component of the DRI process.
As women of childbearing age have become heavier, the trade-off between maternal and child health created by variation in gestational weight gain has become more difficult to reconcile. Weight Gain During Pregnancy responds to the need for a reexamination of the 1990 Institute of Medicine guidelines for weight gain during pregnancy. It builds on the conceptual framework that underscored the 1990 weight gain guidelines and addresses the need to update them through a comprehensive review of the literature and independent analyses of existing databases. The book explores relationships between weight gain during pregnancy and a variety of factors (e.g., the mother's weight and height before pregnancy) and places this in the context of the health of the infant and the mother, presenting specific, updated target ranges for weight gain during pregnancy and guidelines for proper measurement. New features of this book include a specific range of recommended gain for obese women. Weight Gain During Pregnancy is intended to assist practitioners who care for women of childbearing age, policy makers, educators, researchers, and the pregnant women themselves to understand the role of gestational weight gain and to provide them with the tools needed to promote optimal pregnancy outcomes.
Since 1990, when the last guidelines for weight gain during pregnancy were issued, the average body weight of women entering their childbearing years has increased considerably, with a greater percentage of these women now classified as overweight or obese. Women of childbearing age are also more likely to have chronic conditions such as high blood pressure or diabetes and to be at risk for poor maternal and child health outcomes. All of these factors increase the likelihood of poor pregnancy outcomes for women and their infants. As part of the continuing effort of The Institute of Medicine (IOM) and the National Research Council (NRC) to promote the revised pregnancy weight gain guidelines recommended in their 2009 study Weight Gain During Pregnancy: Reexamining the Guidelines, the IOM and NRC convened a workshop in March, 2013, to engage interested stakeholders, organizations, and federal agencies in a discussion of issues related to encouraging behavior change that would reflect the updated guidelines on weight gain during pregnancy. During the workshop, the IOM and NRC presented newly developed information resources to support guidance based on the recommendations of the 2009 report. Leveraging Action to Support Dissemination of the Pregnancy Weight Gain Guidelines summarizes the workshop's keynote address and the various presentations and discussions from the workshop, highlighting issues raised by presenters and attendees. Interested stakeholders, organizations, health professionals, and federal agencies met to discuss issues related to encouraging behavior change that would reflect the updated guidelines on weight gain during pregnancy. This report discusses conceptual products as well as products developed for dissemination, ways to facilitate and support behavior change to achieve healthy weight pre- and postpregnancy, and how to put the weight gain guidelines into action to implement change.
This book reviews the scientific basis for nutrition risk criteria used to establish eligibility for participation in the U.S. Department of Agriculture's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). The volume also examines the specific segments of the WIC population at risk for each criterion, identifies gaps in the scientific knowledge base, formulates recommendations regarding appropriate criteria, and where applicable, recommends values for determining who is at risk for each criterion. Recommendations for program action and research are made to strengthen the validity of nutrition risk criteria used in the WIC program.
This book reviews the scientific basis for nutrition risk criteria used to establish eligibility for participation in the U.S. Department of Agriculture's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). The volume also examines the specific segments of the WIC population at risk for each criterion, identifies gaps in the scientific knowledge base, formulates recommendations regarding appropriate criteria, and where applicable, recommends values for determining who is at risk for each criterion. Recommendations for program action and research are made to strengthen the validity of nutrition risk criteria used in the WIC program.
On the basis of a comprehensive literature review and analysis, Nutrition During Lactation points out specific directions for needed research in understanding the relationship between the nutrition of healthy mothers and the outcomes of lactation. Of widest interest are the committee's clear-cut recommendations for mothers and health care providers. The volume presents data on who among U.S. mothers is breastfeeding, a critical evaluation of methods for assessing the nutritional status of lactating women, and an analysis of how to relate the mother's nutrition to the volume and composition of the milk. Available data on the links between a mother's nutrition and the nutrition and growth of her infant and current information on the risk of transmission through breastfeeding of allergic diseases, environmental toxins, and certain viruses (including the HIV virus) are included. Nutrition During Lactation also studies the effects of maternal cigarette smoking, drug use, and alcohol consumption.
In Part I of Nutrition During Pregnancy, the authors call for revisions in recommended weight gains for pregnant women. They explore relationships between weight gain during pregnancy and a variety of factors (e.g., the mother's weight for height before pregnancy) and places this in the context of the health of the infant and the mother. They present specific target ranges for weight gain during pregnancy and guidelines for proper measurement. Part II addresses vitamin and mineral supplementation during pregnancy, examining the adequacy of diet in meeting nutrient needs during pregnancy and recommending specific amounts of supplements for special circumstances. It also covers the effects of caffeine, alcohol, cigarette, marijuana, and cocaine use and presents specific research recommendations.
Thanks to increased knowledge about nutrition, many threats to human health have been curbed. But there is much more to be learned. This new volume identifies the most promising opportunities for further progress in basic and clinical research in the biological sciences, food science and technology, and public health. The committee identifies cross-cutting themes as frameworks for investigation and offers a history of nutrition and food science research with nine case studies of accomplishments. The core of the volume identifies research opportunities in areas likely to provide the biggest payoffs in enhancing individual and public health. The volume highlights the importance of technology and instrumentation and covers the spectrum from the effects of neurotransmitters on food selection to the impact of federal food programs on public health. The book also explores the training of nutrition and food scientists. This comprehensive resource will be indispensable to investigators, administrators, and funding decisionmakers in government and industry as well as faculty, students, and interested individuals.
How we raise young children is one of today's most highly personalized and sharply politicized issues, in part because each of us can claim some level of "expertise." The debate has intensified as discoveries about our development-in the womb and in the first months and years-have reached the popular media. How can we use our burgeoning knowledge to assure the well-being of all young children, for their own sake as well as for the sake of our nation? Drawing from new findings, this book presents important conclusions about nature-versus-nurture, the impact of being born into a working family, the effect of politics on programs for children, the costs and benefits of intervention, and other issues. The committee issues a series of challenges to decision makers regarding the quality of child care, issues of racial and ethnic diversity, the integration of children's cognitive and emotional development, and more. Authoritative yet accessible, From Neurons to Neighborhoods presents the evidence about "brain wiring" and how kids learn to speak, think, and regulate their behavior. It examines the effect of the climate-family, child care, community-within which the child grows.
Since 1941, Recommended Dietary Allowances (RDAs) has been recognized as the most authoritative source of information on nutrient levels for healthy people. Since publication of the 10th edition in 1989, there has been rising awareness of the impact of nutrition on chronic disease. In light of new research findings and a growing public focus on nutrition and health, the expert panel responsible for formulation RDAs reviewed and expanded its approachâ€"the result: Dietary Reference Intakes. This new series of references greatly extends the scope and application of previous nutrient guidelines. For each nutrient the book presents what is known about how the nutrient functions in the human body, what the best method is to determine its requirements, which factors (caffeine or exercise, for example) may affect how it works, and how the nutrient may be related to chronic disease. The first volume of Dietary Reference Intakes includes calcium, phosphorus, magnesium, vitamin D, and fluoride. The second book in the series presents information about thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin, and choline. Based on analysis of nutrient metabolism in humans and data on intakes in the U.S. population, the committee recommends intakes for each age groupâ€"from the first days of life through childhood, sexual maturity, midlife, and the later years. Recommendations for pregnancy and lactation also are made, and the book identifies when intake of a nutrient may be too much. Representing a new paradigm for the nutrition community, Dietary Reference Intakes encompasses: Estimated Average Requirements (EARs). These are used to set Recommended Dietary Allowances. Recommended Dietary Allowances (RDAs). Intakes that meet the RDA are likely to meet the nutrient requirement of nearly all individuals in a life-stage and gender group. Adequate Intakes (AIs). These are used instead of RDAs when an EAR cannot be calculated. Both the RDA and the AI may be used as goals for individual intake. Tolerable Upper Intake Levels (ULs). Intakes below the UL are unlikely to pose risks of adverse health effects in healthy people. This new framework encompasses both essential nutrients and other food components thought to pay a role in health, such as dietary fiber. It incorporates functional endpoints and examines the relationship between dose and response in determining adequacy and the hazards of excess intake for each nutrient.
This book focuses on nutrition services beginning in the preconceptional period and extending well beyond birth. It provides the rationale for the recommended nutritional services; briefly describes the necessary elements of these services; and indicates the personnel, knowledge, skills, and specialized education or training that may be needed to deliver them. It will be useful to policymakers, hospital administrators, directors of health centers, physicians in private or group practices, and others responsible for setting such standards and for overseeing health care services for expectant and new mothers and their infants.
This book considers two important international nutrition issues, provides a scientific evaluation, and proposes strategies for intervention at the community level. Part I, Diarrheal Diseases, considers the dietary and nutritional factors that may affect the risk of contracting diarrheal disease and presents programmatic implications of these findings. Part II, Diet and Activity During Pregnancy and Lactation, examines data on the extent to which women in the developing world are known to reduce or otherwise alter their activities and diets as a result of childbearing.
The relative lack of information on determinants of disease, disability, and death at major stages of a woman's lifespan and the excess morbidity and premature mortality that this engenders has important adverse social and economic ramifications, not only for Sub-Saharan Africa, but also for other regions of the world as well. Women bear much of the weight of world production in both traditional and modern industries. In Sub-Saharan Africa, for example, women contribute approximately 60 to 80 percent of agricultural labor. Worldwide, it is estimated that women are the sole supporters in 18 to 30 percent of all families, and that their financial contribution in the remainder of families is substantial and often crucial. This book provides a solid documentary base that can be used to develop an agenda to guide research and health policy formulation on female healthâ€"both for Sub-Saharan Africa and for other regions of the developing world. This book could also help facilitate ongoing, collaboration between African researchers on women's health and their U.S. colleagues. Chapters cover such topics as demographics, nutritional status, obstetric morbidity and mortality, mental health problems, and sexually transmitted diseases, including HIV.
Core Curriculum for Interdisciplinary Lactation Care, Second Edition provides a trustworthy source for lactation-specific information and education for students, interns, certification candidates, instructors, and clinicians-in any discipline or specialty-who provide care to breastfeeding families. Published in association with the Lactation Education Accreditation and Approval Review Committee (LEAARC), it reflects the current state of practice and serves as a fundamental resource for beginning clinicians, orienting staff, and planning continuing education programs.Organized in three sections, Core Curriculum for Interdisciplinary Lactation Care, Second Edition focuses on the science, management, and professional aspects of lactation care. With contributions from a team of clinical lactation experts from several countries around the world, it emphasizes an interdisciplinary approach to provide comprehensive care for breastfeeding families. Written to complement the LEAARC curriculum used in recognition of lactation education programs, the text includes clinical applications that move from theory to practice, including key learning points, clinical case studies, and real-life stories from parents and the healthcare team"--
This book summarizes information related to public health measures on the prevention, detection, and management of iron deficiency anemia. It presents draft guidelines and recommendations related to this area, as applicable in primary health care and public health clinic settings, and it formulates recommendations for research. This volume is intended both to provide a common frame of reference for health professionals in preventing and treating iron deficiency anemia and to enable the U.S. Centers for Disease Control and Prevention to prepare national guidelines and recommendations for the prevention and control of iron deficiency anemia.
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