1. 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.

2. 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

3. 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.

4. 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.

5. 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.

6. Trace Elements
is 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.

7. 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.

8. 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.

9. 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

10. 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.

11. 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.

12. 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.

13. Why you need iron during pregnancy
Even 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.

14. How much iron you need:
Pregnant women: 27 milligrams (mg) of iron per day
Non-pregnant women: 18 mg
You 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

15. 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.

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

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

18. 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.

19. Zinc - vital for growth and cell division
Zinc 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 fertility
Zinc 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 system
Among 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.

20. • Zinc – vital for taste, smell and appetite
Zinc 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 nails
Zinc 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 vision
High 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.

21. Dietary Sources of Zinc & their Average Zinc Content (mg/100g)
Oysters 25
Meat ( especially red meat) 5.2
Nuts 3
Poultry 1.5
Eggs 1.3
Milk products 1.2
Cereals 1
Bread 1
Fish 0.8
Sugars & preserves 0.6
Canned vegetables 0.4
Green vegetables 0.4
Potatoes 0.3
Fresh fruits 0.09

22. • 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

23. Zinc in your pregnancy diet
Why 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.

24. How much zinc you need
Pregnant women, 19 and older: 11 milligrams (mg) per day
Pregnant, 18 and younger: 13 mg
Breastfeeding women, 19 and older: 12 mg
Breastfeeding, 18 and younger: 14 mg
Non-pregnant women: 8 mg
You 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 zinc
Fortified 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.

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

26. 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.

27. 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.

28. copper
Importance and Uses
Copper 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.

29. 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.

30. How much copper you need:
Pregnant women: 1 milligram (mg) per day
Breastfeeding women: about 1.3 mg
You 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.

31. Food sources of copper:
Here are some typical amounts of copper found in some good food sources:
3 ounces canned crabmeat: 1.0 mg
1/4 cup roasted pumpkin and squash seed kernels, no salt (pepitas): 0.8 mg
1 ounce raw cashews: 0.6 mg
1/4 cup toasted sunflower seeds, no salt: 0.6 mg
1/4 cup raw hazelnuts: 0.6 mg
3 ounces steamed oysters: 0.5 mg
1/4 cup sesame seeds: 0.5 mg
3 ounces cooked tempeh: 0.5 mg
1 medium baked potato, without skin: 0.3 mg
1/2 cup grilled sliced portabella mushrooms: 0.3 mg
1/2 cup cooked garbanzo beans: 0.3 mg
1/2 cup cooked kidney beans: 0.23 mg
1/2 cup cooked navy beans: 0.3 mg
1/2 cup cooked lentils 0.23 mg

32. 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.