Nutrition in Pregnancy: A Case Study and Biochemical Assessment

1. Apply underlying concepts and principles of nutrition to human health and wellbeing in early age, adolescence, older age, pregnancy and lactation.

4. Demonstrate knowledge and critical understanding of the principles of assessment of nutritional status (including dietary, anthropometry, laboratory and clinical), and of the way in which those principles have developed.
   
   
5. Display a critical understanding of the interactions between nutritional status and physiological, social and psychological factors, genetic variations, and lifestyle factors.
6. Demonstrate knowledge of the main methods of enquiry in evidence based practice in nutrition, and ability to critically evaluate the appropriateness of different approaches to problem solving in nutrition.

Wendy is a 32-year old graphic designer. She is 12 weeks pregnant and has a 6-year old daughter.  Six months before her second pregnancy, she became vegan. She hasn’t gained any weight since the beginning of pregnancy and is not sure whether this is normal.  She aims to have a varied diet but her busy schedule keeps her from cooking. She likes sweets and wants to know whether she is having too much. Wendy walks around 4 miles a day when taking her daughter to school. She drinks coffee once a day.  Her height is 170 cm and her preconception weight was 60 kg, which hasn’t changed after 12 weeks.  She suffered from Bulimia Nervosa when she was 16 years old, but has been in remission since she was 18.  She has been referred to a dietitian to discuss her diet.

Wendy’s blood tests results are listed below. She has a normal blood pressure.

A typical sample of one-day menu from Wendy’s diet is presented in the table below:

• Serum Haemoglobin levels: 105 g/L.
• Fasting Blood glucose: 5 mmol/l
• Lipid levels:

 
Critically assess Wendy’’s nutritional status and discuss additional information that you require to better understand her status.

Compare her one-day food intake with UK’s relevant dietary recommendations.

Discuss nutritional demands that arise in response to the physiological changes during pregnancy as well as the nutrients that should be particularly considered when assessing a vegan diet. Provide suggestions for her exercise routine for favourable pregnancy outcomes.

Evaluate her pregnancy weight gain and compare it to recommendations.  

Assess her iron status and use recent evidence from the literature to assess the use of non-nutritive sweeteners and caffeine during pregnancy.

In your answer, you should demonstrate your knowledge of evidence-based practice (EBP) and critical knowledge of interactions between nutritional status and other factors such as physiological, social, psychological and lifestyle factors.