March 15

C. Energy 1. Milk energy will be obtained from maternal lipid stores and the diet ? 1st thing: RMR (below) ? Cant use body composition ? Mifflin St. Jor equation for first 6 weeks 2. Resting Metabolic Rate (RMR) a. 6 weeks postpartum use equations based on body weight b. 6 weeks use equations based on body 3. Subtract 500 kcal/day for safe rate of body fat loss 4. Add requirements for milk production a. 330 kcal/d for 6 months postpartum b. 400 kcal/d for 6 months postpartum 5. Importance of nutrient density a. the additional energy required is not as great as the increased need for other nutrients b. therefore the increase in energy should be supplied by nutritional dense foods 6. Avoid fasting and meal skipping Will lose lean body fat " Dont want 7. Adolescents have greater energy needs and should not use equations designed for adults Lactating: make sure you dont use adult D. Protein 1. 1.1 g protein/kg body weight (15 % of kcal) ? 0.8 is DRI " doesnt need to increase usually 2. protein quality HIGH QUALITY " SOY, CHICKEN, BEANS E. Carbohydrate ? Very very bad ? High ketone bodies ? Influence milk production ? Wants to lose body fat " simple carbs watch 1. negative impact of severe carbohydrate restriction F. Lipid 1. Fatty Acids (Type) ? What type attached to triglycerides ? Situation 1 ? o Eating high carb diet ? o 65% kcal carb ? More MCTs ? More digestible for baby ? Shorter than ones in our adult diet ? In milk ? Situation 2 ? o High fat diet ? o 30$ kcal fat ? o Diet fatty acids will end up as milk fatty acids ? o Eating a lot of fast food " trans in milk ? o Saturated fat " butter, dairy products, beef " saturated in milk ? o Omega 3s " olive oil, canola oil " monos in milk ? Dont get enough fat ? o 20% kcal from fat ? o Or low kcal (neg energy balance) ? o Come from body fatty acids (the milk fatty acids) ? Could come from fat from 6 months ago, 9 months ago ? Ate fast food then, those trans fats will end up in milk ? Amount of omegas: 2. importance of omega 3 fatty acids a. DRI for alpha-linolenic acid (ALA) = 1.3 g/d ? i.should maintain a 6:1 ratio of w6:w3 ? 1. G. Micronutrients (Vitamins and Minerals) 1. DRIs are the same or greater during lactation compared to pregnancy, except for: ? Certain vits and mins to watch: ? Same or greater DRI as in pregnancy a. thiamin ? Found in whole grains, flour ? Pork, meats ? Low: usually not enough complex carbs b. niacin ? Found in whole grains, flour c. folate ? Grains, orange juice, cereal fortified d. magnesium ? Dairy, nuts, meat e. iron ? Support bigger organism, need to be in milk ? Milk preserved at her own expense ? o Milk has it, women may become anemia 2. The concentration of micronutrients in the milk will be preserved at the expense of maternal status 3. vegans ? Worried about: ? o Protein ? High quality: soy, beans, grains (b and g within 3 hrs of each other) ? o B12 ? Added to soy foods, part of manufactured fortified foods ? Tempe, tofu, fermented veggies kimchee, sauerkraut ? Anything with bacteria added ? o Vitamin D ? o Iron, Magnesium, Calcium ? o