Gestational Diabetes

During pregnancy, hormonal changes may cause impaired glucose tolerance and higher insulin needs. If the pancreas in a pregnant woman cannot keep up with the insulin needs, the blood glucose levels will rise above desired levels. Higher than normal blood glucose levels are harmful to the woman and her fetus. About 1 in 15 women develop gestational diabetes when pregnant.

Gestational Diabetes Diagnosed• Most women have an oral glucose tolerance test between weeks 24-

28 during pregnancy, the second trimester. A high blood glucose test earlier in the pregnancy would alert the doctor to investigate sooner. The glucose challenge screening test consists of consuming 50 grams of glucose and then testing the level of glucose in the blood before the test and one hour after consuming the glucose. The one hour blood glucose should be less than 140 mg/dL. If higher, a glucose tolerance test may be ordered. A glucose tolerance diagnostic test for gestational diabetes consists of drinking 100 grams of glucose and testing blood glucose fasting and every hour for three hours. The trends in the rise of blood glucose define the diagnosis. If two or more of these values are exceeded in the oral glucose tolerance test (OGTT)

• Fasting: greater than 95 mg/dL• 1 hour: greater than 180 mg/dL• 2 hour: greater than 155 mg/dL• 3 hour: greater than 140 mg/dL

Insulin Resistance

Insulin resistance is closely linked with inflammation, which is the body’s attempt to heal itself. It is thought that in prediabetes and type 2 diabetes the body’s immune system releases a chemical called cytokines which is thought to interrupt with the action of insulin.Therefore, lower insulin sensitivity and increasing insulin resistance. Type 2 diabetes that is brought on by obesity is a result of chronic inflammation.

Symptoms of insulin resistance

One of the earliest and most noticeable symptoms of insulin resistance is weight gain, particularly around the middle. Further symptoms include:

• Lethargy• Hunger• Difficulty concentrating (brain fog)• High blood pressure is another common symptom which is

caused by high circulating levels of insulin in the blood.If insulin resistance develops into prediabetes or type 2

diabetes, the symptoms will include include increased blood glucose levels and more of the classic symptoms of type 2 diabetes.

Causes of insulin resistance:

Research is continuing to look more closely into how insulin resistance develops. It is thought that the principle cause of insulin resistance is obesity. One theory suggests that central obesity (too much fat around the belly) causes the fat cells to become starved of oxygen and die. It is thought that the body reacts with an inflammatory response which then sets off the start of insulin resistance.

With insulin resistance being a key factor in type 2 diabetes, the same risk factors for type 2 diabetes generally apply for insulin resistance.

Diets high in saturated fats, trans-fats, refined carbohydrates and processed foods have been closely linked with chronic inflammation disorders and insulin resistance.

Trace Elementsis a dietary mineral that is needed in very minute

quantities for the proper growth, development, and physiology of the organism, and are necessary for their growth, development, and health. Whereas the shortage of trace elements in the body may result in stunted growth or even death, their presence in higher amounts is also harmful. Also called trace metals.

Role of Iron

Iron plays an important role in the body. One of the main roles of iron is to help our red blood cells transport oxygen to all parts of the body.

Iron also plays an important role in specific processes within the cell that produce the energy for our body. It is for this reason that one of the first symptoms of low body iron stores is tiredness and fatigue.

Types of Iron:

Haem Iron: This type of iron is found in animal-based foods, like red meat,

poultry and fish. Haem iron is easily absorbed by the body.

Non-Haem Iron: This type of iron is found in plant-based foods like cereals,

vegetables and legumes. In contrast to haem iron, our body doesn’t absorb non-haem iron as easily. However, because it is present in the diet in much larger quantities than is haem iron, it is an important source of this mineral. We generally obtain around 65% of our iron requirements from non-haem iron.

Importance of Iron in pregnancy:

When you are pregnant, your iron requirements are much greater than at any other stage in your life. In fact, the recommended dietary intake for iron increases by an extra 10-20mg a day during pregnancy.

The main reason for this increased requirement is that your growing foetus needs to build up its own iron reserves and it does this by taking the iron from your body.

It is therefore important to eat a variety if iron-rich foods when you are expecting. In some cases, an additional iron supplement may be required. Ask your doctor about this

Normal Range for Iron in Blood

Approximately two-thirds of the total iron in our bodies can be found in the oxygen-carrying protein of red blood cells known as hemoglobin, according to the National Institutes of Health Office of Dietary Supplements. Failure to consume enough iron to keep iron stores in the body high can cause iron-deficiency anemia, a condition characterized by a low number of red blood cells. To diagnose iron-deficiency anemia, doctors take a sample of blood and run a variety of tests that work together to determine the amount of iron in the blood and its ability to function.

Serum Iron:A serum iron test determines the amount of iron in the liquid portion of the

blood. Because the amount of iron in the blood varies throughout the day, experts at Lab Tests Online recommend performing iron testing the first thing in the morning. A normal range for iron in the blood, as reported by MedlinePlus, is 60mcg/dL to 170 mcg/dL. Iron levels less than that may indicate blood loss through gastrointestinal bleeding or heavy menstruation, poor iron absorption, pregnancy or failure to consume enough dietary iron. Low serum iron levels provide one indication of iron-deficiency anemia.

Total Iron Binding Capacity:When doctors order a serum iron test, they usually also order a Total Iron Binding

Capacity test, called a TIBC. A TIBC test helps determine whether the blood carries too little or too much iron. Iron travels through the liquid portion of the blood bound to the protein known as transferrin. When they use it with the Serum Iron test, doctors can determine the transferrin saturation, a useful indicator of the iron status in the blood. A TIBC test should range from 240mcg/dL to 450 mcg/dL resulting in a normal transferrin saturation range of 20 percent to 50 percent.

Serum Ferritin:The human body retains and reuses up to 90 percent of the total amount of iron, according

to the Mayo Clinic. Of the one-third of iron not found in hemoglobin, most of it binds to the protein ferritin and gets stored in the liver, bone marrow, spleen and muscles. As blood iron levels become low, the stored iron also decreases, causing ferritin levels to drop. For women, serum ferritin normally ranges from 12 to 150 ng/dL while men range from 12ng/dL to 300ng/dL, or nanograms per deciliter. The lower the number, even within the normal range, the more likely your iron level is low.

Hemoglobin:Because most of the iron in the body occurs in hemoglobin, determining the amount of

hemoglobin helps determine the amount of iron in the blood. MayoClinic.com says normal hemoglobin ranges from 11.1g/dL to 15g/dL. Results lower than that indicate an iron deficiency causing anemia.

Hematocrit:The blood also contains white blood cells and platelets. When testing the blood for iron

levels to determine the presence and cause of anemia, it's important to determine the percentage of red blood cells in the total blood volume, a test known as a hematocrit. A normal hematocrit result ranges from 34.9 percent to 44.5 percent for women and 38.8 percent to 50 percent for men.

Why you need iron during pregnancyEven before you're pregnant, your body needs iron for several reasons:It's essential for making hemoglobin, the protein in red blood cells that carries oxygen

to other cells.It's an important component of myoglobin (a protein that helps supply oxygen to

your muscles), collagen (a protein in bone, cartilage, and other connective tissue), and many enzymes.

It helps you maintain a healthy immune system.But during pregnancy you need a lot more of this crucial mineral. Here's why:The amount of blood in your body increases during pregnancy until you have almost

50 percent more blood than usual, so you need more iron to make more hemoglobin.

You need extra iron for your growing baby and placenta, especially in the second and third trimesters.

Many women need more because they start their pregnancy with insufficient stores of iron.

Iron-deficiency anemia during pregnancy is associated with preterm delivery, low birth weight, and infant mortality.

How much iron you need:Pregnant women: 27 milligrams (mg) of iron per dayNon-pregnant women: 18 mgYou don't have to get the recommended amount of iron every day. Instead,

aim for that amount as an average over the course of a few days or a week.

Food sources of iron:Red meat is one of the best sources of iron for pregnant women. (Liver

provides the highest concentration of iron, but because it contains unsafe amounts of vitamin A, it's best avoided during pregnancy.) If your diet doesn't include animal protein, you can get iron from legumes, vegetables, and grains.

There are two forms of iron: non-heme iron, which is found in plants (as well as in meat, poultry, and fish), and heme iron, which is found only in animal products. Heme iron is easier for your body to absorb. (Iron-fortified foods and supplements provide non-heme iron.) To make sure you're getting enough, eat a variety of iron-rich foods every day

What happens if you don't get enough iron

When you're not getting enough iron, your stores become depleted over time. If you no longer have enough iron in your blood to make the hemoglobin you need, you become anemic.

Iron-deficiency anemia can sap your energy and cause a host of other symptoms, especially if it's severe. It can also make it harder for your body to fight infection.

It may also have an impact on your pregnancy. Iron-deficiency anemia – especially in early or mid-pregnancy – has been linked to a greater risk of preterm birth, having a low-birth-weight baby, and fetal or newborn death. See our complete article on iron-deficiency anemia .

If you're anemic when you give birth, you're more likely to need a transfusion and have other problems if you lose a lot of blood at delivery. And some research has found an association between maternal iron deficiency and postpartum depression.

Your baby does a good job of taking care of his iron needs while he's in your uterus. He'll get his share of what's available before you do. That said, if you're severely anemic, it may compromise your baby's iron stores at birth, raising his risk for anemia later in infancy and possibly hurting his growth and cognitive development.

Common sources of heme iron:

Red meat, poultry, and fish are all good sources of heme iron. (For easy reference, 3 ounces of meat is about the size of a deck of cards.)

3 ounces lean beef chuck: 3.2 mg3 ounces lean beef tenderloin: 3.0 mg3 ounces roast turkey, dark meat: 2.0 mg3 ounces roast turkey breast: 1.4 mg3 ounces roast chicken, dark meat: 1.1 mg3 ounces roast chicken breast: 1.1 mg3 ounces halibut: 0.9 mg3 ounces pork loin: 0.8 mg

Common sources of non-heme iron:

1 cup iron-fortified ready-to-eat cereal: 24 mg1 cup fortified instant oatmeal: 10 mg1 cup edamame (boiled soybeans): 8.8 mg1 cup cooked lentils: 6.6 mg1 cup cooked kidney beans: 5.2 mg1 cup chickpeas: 4.8 mg1 cup lima beans: 4.5 mg1 ounce roasted pumpkin seeds: 4.2 mg1 cup cooked black or pinto beans: 3.6 mg1 tablespoon blackstrap molasses: 3.5 mg1/2 cup raw firm tofu: 3.4 mg1/2 cup boiled spinach: 3.2 mg1 cup prune juice: 3.0 mg1 slice whole wheat or enriched white bread: 0.9 mg1/4 cup raisins: 0.75 mg

Zinc

Zinc is an essential trace element for humans, animals and plants. It is vital for many biological functions and plays a crucial role in more than 300 enzymes in the human body. The adult body contains about 2-3 grams of zinc. Zinc is found in all parts of the body: it is in organs, tissues, bones, fluids and cells. Muscles and bones contain most of the body’s zinc (90%). Particularly high concentrations of zinc are in the prostate gland and semen.

Zinc - vital for growth and cell divisionZinc is especially important during pregnancy, for the growing fetus whose cells are rapidly dividing. Zinc also helps to avoid congenital abnormalities and pre-term delivery. Zinc is vital in activating growth - height, weight and bone development - in infants, children and teenagers.

Zinc – vital for fertilityZinc plays a vital role in fertility. In males, zinc protects the prostate gland from infection (prostatitis) and ultimately from enlargement (prostatic hypertrophy). Zinc helps maintain sperm count and mobility and normal levels of serum testosterone.

In females, zinc can help treat menstrual problems and alleviate symptoms associated with premenstrual syndrome (PMS).

Zinc – vital for the immune systemAmong all the vitamins and minerals, zinc shows the strongest effect on our all-important immune system. Zinc plays a unique role in the T-cells. Low zinc levels lead to reduced and weakened T-cells which are not able to recognize and fight off certain infections. An increase of the zinc level has proven effective in fighting pneumonia and diarrhea and other infections. Zinc can also reduce the duration and severity of a common cold.

• Zinc – vital for taste, smell and appetiteZinc activates areas of the brain that receive and process information from taste and smell sensors. Levels of zinc in plasma and zinc’s effect on other nutrients, like copper and manganese, influence appetite and taste preference. Zinc is also used in the treatment of anorexia.

• Zinc – vital for skin, hair and nailsZinc accelerates the renewal of the skin cells. Zinc creams are used for babies to soothe diaper rash and to heal cuts and wounds. Zinc has also proven effective in treating acne, a problem that affects especially adolescents, and zinc has been reported to have a positive effect on psoriasis and neurodermitis.

Zinc is also used as an anti-inflammatory agent and can help sooth the skin tissue, particularly in cases of poison ivy, sunburn, blisters and certain gum diseases. Zinc is important for healthy hair. Insufficient zinc levels may result in loss of hair, hair that looks thin and dull and that goes grey early. There are also a number of shampoos which contain zinc to help prevent dandruff.

Zinc – vital for visionHigh concentrations of zinc are found in the retina. With age the retinal zinc declines which seems to play a role in the development of age-related macular degeneration (AMD), which leads to partial or complete loss of vision. Zinc may also protect from night blindness and prevent the development of cataracts.

Dietary Sources of Zinc & their Average Zinc Content (mg/100g)

Oysters 25 Meat ( especially red meat) 5.2 Nuts 3Poultry 1.5Eggs 1.3Milk products 1.2Cereals 1Bread 1Fish 0.8Sugars & preserves 0.6Canned vegetables 0.4Green vegetables 0.4Potatoes 0.3Fresh fruits 0.09

• How much zinc do we need?Our body regularly needs zinc. Recommended daily intakes are:

• Infants 5 mg• Children 10 mg• Women 12 mg• Pregnant Women 15 mg• Lactating Women 16 mg• Men 15 mg

Zinc in your pregnancy dietWhy you need zinc during pregnancy:Your body needs zinc for the production, repair, and

functioning of DNA – the body's genetic blueprint and a basic building block of cells. So getting enough zinc is particularly important for the rapid cell growth that occurs during pregnancy. This essential mineral also helps support your immune system, maintain your sense of taste and smell, and heal wounds.

Deficiencies in the United States are rare, but studies link a zinc deficiency to miscarriage, toxemia, low birth weight, and other problems during pregnancy, labor, and delivery.

How much zinc you needPregnant women, 19 and older: 11 milligrams (mg) per day

Pregnant, 18 and younger: 13 mgBreastfeeding women, 19 and older: 12 mg

Breastfeeding, 18 and younger: 14 mgNon-pregnant women: 8 mgYou don't have to get the recommended amount of zinc every day. Instead, aim

for that amount as an average over the course of a few days or a week.

Food sources of zincFortified cereals and red meat are good sources of this nutrient. You can also get

it from some shellfish, poultry, beans, nuts, whole grains, and dairy products.Oysters are actually the richest food source of zinc – just one of them will give

you more than a full day's supply – but experts caution against eating raw oysters during pregnancy because of the risk of food-borne illness. What's more, oysters harvested from some areas contain high levels ofmercury.

Here are some good sources of zinc for pregnant women:1 cup fully fortified breakfast cereal: 15 mg1 cup canned baked beans with pork: 14 mg3 ounces Alaskan king crab meat: 6.5 mg3 ounces lamb shoulder: 6.2 mg3 ounces braised pot roast, fat trimmed: 5.7 mg3 ounces ground beef (85 percent lean): 5.5 mg3 ounces roasted turkey, dark meat: 3.8 mg1/4 cup raw pumpkin seeds: 2.6 mg1/2 cup trail mix with chocolate chips, nuts, and seeds: 2.3 mg1/2 cup tofu, firm: 2.0 mg3 ounces cooked chicken, dark meat: 1.8 mg1 cup fruit-flavored yogurt: 1.8 mg1 cup milk: 1.8 mg1/2 cup chickpeas (garbanzo beans): 1.3 mg5 ounces raw crimini mushrooms: 1.6 mg1/2 cup boiled spinach: .69 mg(Note that 3 ounces of meat or fish is about the size of a deck of cards.)

What if we don’t get enough zinc?Zinc deficiency is a serious problem in many developing countries. Zinc deficiency is ranked

as the 5th leading risk factor in causing disease, especially diarrhea and pneumonia in children, which can lead to high mortality rates in these underdeveloped regions. Other severe deficiency symptoms include stunted growth and impaired development of infants, children and adolescents. Early zinc deficiency also leads to impaired cognitive function, behavioral problems, memory impairment and problems with spatial learning and neuronal atrophy. Public health programs involving zinc supplementation and food fortification could help overcome these problems.

In industrialized countries cases of mild zinc deficiency can be observed. The most common symptoms include dry and rough skin, dull looking hair, brittle finger nails, white spots on nails, reduced taste and smell, loss of appetite, mood swings, reduced adaptation to darkness, frequent infections, delayed wound healing, dermatitis and acne.

Mild zinc deficiency symptoms can usually be corrected by supplying the body with the right amount of zinc each day. Supplemental zinc not exceeding the recommended daily allowance might be taken. Therapies involving larger doses of zinc should always be discussed with your physician. Therapeutical doses typically range from 20 mg – 30 mg, in some rare cases doses might be higher.

The signs of a zinc deficiency:

Zinc deficiency is rare in the United States, but it can cause impaired sense of smell or taste, a loss of appetite, failure to grow (for children), and a lower immunity to infections.

copper

Importance and UsesCopper is present in minute amounts in the animal body and is essential to

normal metabolism. It is a component of hemocyanin, the blue, oxygen-carrying blood pigment of lobsters and other large crustaceans. It is needed in the synthesis of hemoglobin, the red, oxygen-carrying pigment found in the blood of humans, although it is not a component of hemoglobin.

The chief commercial use of copper is based on its electrical conductivity (second only to that of silver); about half the total annual output of copper is employed in the manufacture of electrical apparatus and wire. Copper is also used extensively as roofing, in making copper utensils, and for coins and metalwork. Copper tubing is used in plumbing, and, because of its high heat conductivity, in heat-exchanging devices such as refrigerator and air-conditioner coils. Powdered copper is sometimes used as a pigment in paints. An important use of copper is in alloys such as brass, bronze, gunmetal, Monel metal, and German silver. Compounds of copper are widely used as insecticides and fungicides; as pigments in paints; as mordants (fixatives) in dyeing; and in electroplating.

Copper in your pregnancy diet

Why you need copper during pregnancy:Copper, a trace mineral found in all plant and animal

tissues, is essential for forming red blood cells. This is especially important during pregnancy, when your blood supply doubles.

Copper also boosts your body's ability to mend tissues and break down sugars. And it keeps your hair growing and looking healthy.

During pregnancy, copper helps form your baby's heart, blood vessels, and skeletal and nervous systems.

How much copper you need:Pregnant women: 1 milligram (mg) per dayBreastfeeding women: about 1.3 mgYou don't have to get the recommended amount

of copper every day. Instead, aim for that amount as an average over the course of a few days or a week.

Food sources of copper:Here are some typical amounts of copper found in some good food sources:3 ounces canned crabmeat: 1.0 mg1/4 cup roasted pumpkin and squash seed kernels, no salt (pepitas): 0.8 mg1 ounce raw cashews: 0.6 mg1/4 cup toasted sunflower seeds, no salt: 0.6 mg1/4 cup raw hazelnuts: 0.6 mg3 ounces steamed oysters: 0.5 mg1/4 cup sesame seeds: 0.5 mg3 ounces cooked tempeh: 0.5 mg1 medium baked potato, without skin: 0.3 mg1/2 cup grilled sliced portabella mushrooms: 0.3 mg1/2 cup cooked garbanzo beans: 0.3 mg1/2 cup cooked kidney beans: 0.23 mg1/2 cup cooked navy beans: 0.3 mg1/2 cup cooked lentils 0.23 mg

The signs of a copper deficiency:

Copper deficiencies are uncommon, though women sometimes come up short in their childbearing years. If you're concerned that you're not getting enough copper, talk with your healthcare provider before supplementing.