CommunityNutrition社区营养

1,Community Nutrition 社区营养,2,教案： Community Nutrition社区营养,授课对象：98预防专业本科生授课时数：4 学时安排：1-2学时 社区营养的内容 （15分钟） RDA （ 30分钟） DRIs（45分钟） 3-4学时 营养调查（25分钟）营养监测（20分钟) 食物结构模式（25分钟）膳食指南（20分钟）,3,重点内容,RDA DRIs 营养调查 食物结构模式 膳食指南,4,Concept: Theory、 practice and means to solve human nutritional problems in order to know how to adopt to real social life in a restrictive area.,以营养学为基础研究如何适应现实生活来解决限定区域人类营养问题的理论、实践和方法。,Community nutrition,5,Contents: Laying down RDA,-DRIsDevelopment of new food and food fortification Social Nutritional Surveillance Drawing up and modifying nutritional policy, Nutritional propaganda and education, nutritional consulting,6,Content,Nutritional Research,Nutritional Surveillance,Nutritional Policy,研究结果,作决定所需的数据,为研究提供数据,需要数据,作决定所需的数据,研究结果需要数据,7,8,Recommended Dietary Allowance (RDA),Nutritional requirement: the lowest, basic nutrition and heat energy requirement, good health, normal growth and working well. human survey ( health , patient intakes) Principle: experimental research (balance test, saturation test),9,RDA,营养生理需要量：维持人体正常生理功能所需的热能和营养素需要量（最低基本数量），低于这个数量将不能保持人体健康。 维持人体健康所必需 生理功能 应有的生长发育水平 从事正常的工作，学习，劳动，生活等,10,营养生理需要量制定原则,健康人群-摄入量 人群调查 临床病人或亚临床病人 -食物补充 平衡实验-钙,铁 实验研究 饱和实验-水溶性维生素,11,RDA膳食营养供给量,Concept: The most appropriate nutritional intake, based on nutritional requirement, referring to dietary habits, food digestibility, nutrients losing during cooking , and other various affecting factors; meanwhile, considering to social condition, financial condition, social food product and so on. (More than nutritional requirement, except heat energy) 在营养生理需要基础上,参照饮食习惯,食物的消化率,烹调损失,以及各种因素对营养素的影响,并兼顾社会条件,经济条件,社会食物生产等情况而确立的最适宜数量.一般高于生理需要,但热能不宜再高.,12,Basic Principle for RDA,1.The intake of heat energy and nutrients equals to nutritional requirement. (to get to nutritional requirement) 2. to keep nutritional balance: among nutrients, between various nutrients and heat energy 3.Considering to physical safety, special human appropriate intake (x 2s) 1.保证人体从膳食中获得的热能和营养素达到 生理需要量; 2.在各营养素之间,营养素与热能之间保持平衡; 3.以膳食为基础,考虑到生理安全性,特定人群的 适宜摄取量.,13,Characteristic of RDA,To be applicable to healthy people Based on dietary Recommendation, not a standard Authority To be involved in various nutrients. 1.对象带有宏观性, 所有健康人, 普通人适用; 2.以膳食为基础; 3.是一个推荐值,不是标准; 4.具有相当高的权威性; 5.涉及营养素种类多,14,Significance,To reflect human dietary quality As a indicating for getting to rational diet As a recommended standard to arrange cookbook and to value dietary 1.可反映人类膳食质量; 2.作为合理营养需要达到满足程度的指标; 3.作为食谱设计和膳食评估的推荐标准;以此 为依据设计人群的平衡膳食.,15,RDA的局限性,1. 无上限- 营养过剩 2. 需要大样 本,16,Purpose for RDA Modification-Dietary reference intake (DRI)膳食参考摄入量,DRIs are reference values that are quantitative estimates of nutrients intakes to be used for planning and assessing diets for healthy people. DRIs include RDA as goals for intake by individuals, but also present three new types of reference values,17,DRIs content,1. Estimated Average Requirement (EAR)估 计平均摄入量 2. RDA( Recommended Nutrition Intake, RNI)推荐摄入量 3.Adequate intake (AI)适宜摄入量 4.Tolerable upper intake level (UL)可耐受最 高摄入量,18,EAR估计平均需要量,The EAR is the amount of nutrient that is estimated to meet the nutrient requirement of half the healthy individuals in a life stage and gender group. 某一特定性别,年龄及生理状况群体中对某营养素需要量的平均值.只有一半人群能满足.,19,20,Use of EAR,1. 是一个特定人群的平均需要量，主要用于计 划和评价群体的膳食。 对于人群, EAR 用于评估群体中摄入不足的发生率, 对于个体,可以检查其摄入不足的可能性. 如果摄入 EAR+2SD-摄入不足 2. 是RNI的基础, RNI=EAR+2SD; 如样本不够时: or RNI=1.2 EAR,21,22,RNI,RNI is the dietary intake that is sufficient to meet the nutrients requirement of nearly all (97 to 98 percent) healthy individuals in a particular life stage(such as age, when applicable, pregnancy or lactation) and gender group. This appears to be quite similar to past descriptions of RDA, but in the DRI framework this is the only use of the RDA: serving as a goal for individuals. 可以满足某一特定性别,年龄及生理状况群体中绝大多数(9798%)个体的需要,长期摄入RNI水平,可以维持适当的储备. RNI是健康个体膳食营养素摄入量目标,但RNI,没有摄入不足的危险,23,24,AI适宜摄入量,The AI is provided instead of a RDA when sufficient scientific evidence is not available to calculate an EAR. The AI is based on observed or experimentally determined estimates of nutrient intake by a group of healthy people. For example, the AI for young infants, for whom human milk is the recommended sole source of food for the first 4 to 6 months, is based on the daily mean nutrient intake supplied by human milk for healthy, full-term infants who are exclusively breastfed. AI 是通过观察或实验获得的健康人群某种营养素的摄入量.如:纯母乳喂养的足月产健康婴儿,从出生直46月,其营养素全部来自母乳,其母乳的营养素含量就是婴儿的AI.,25,AI,The primary use of the AI is as a goal for the nutrient intake of individuals. In past recommendations for some nutrients, RDAs were provided even if the data available did not provide estimates of requirements, RDAs were based on observed levels of intake that appeared to maintain an acceptable level of health or growth. In this new framework, the AI reference intake is used to indicate that the judgment of the experts involved, sufficient data on requirements are lacking. The AI thus serves to underscore the need for more research on requirements for that nutrient.,26,AI 和RNI 异同点是:,AI 和RNI 相似点是: 都能满足目标人群中所有个体的需要; 在样本不够得不到EAR时, AI 可代替RNI. 不同点: AI 的准确性不如RNI. AI 主要用作个体的营养素摄入目标, 同时用作限制过多摄入的目标-达到AI, 出现营养素缺乏的危险性很小, 长期超过AI, 则可能产生副作用.,27,28,29,Tolerable upper intake level (UL)可耐受最高摄入量,UL is the highest level of daily nutrient intake that is likely to pose no risk of adverse health effects to almost all individuals in the general population. 平均每日可以摄入某营养素的最高量.几乎对所有个体都不至于损害健康. 主要用途是检查个体摄入过高的可能,避免发生中毒.,30,ULs are useful because of the increased availability of fortified foods and the increased use of dietary supplements in the USA and Canada. For many nutrients, there may be insufficient data with which to develop a UL.This does not mean that there is no potential for adverse effects resulting from high intake. When data about adverse effects are extremely limited, extra caution may be warranted.,UL,31,32,33,34,35,36,Nutritional Survey and Nutritional Surveillance,营养调查与营养监测,37,Nutritional Survey,Purpose: 1. To comprehend human dietary intake compared to human dietary allowance. 2. To understand human health status related to nutritional status. 3. To find out misbalance humans. 4. To make special scientific research.,38,Content of Nutritional Survey,Dietary Survey膳食调查 Biochemistry analysis in human nutritional level人体营养水平的生化分析 Clinical examination about nutrition deficiency营养缺乏病的临床检查 Data analysis人体测量的资料分析,39,Organization and Designation for Nutritional Survey,1. 调查对象的抽样 2. 调查地区分类 3. 地区内人群职业 4. 人群内性别，年龄及经济生活状况 5. 公共食堂，家庭不同就餐方式 6. 调查年份春，秋,40,Dietary Survey,1. Weighting称重法 2. Checking accounts查帐法 3. Reviewing24h 回顾法 4. Chemical analysis化学分析法,To Appraise Human Nutrition StatusClinic examination(nutrition deficiency)Data analysis,41,Evaluate of results,Dietary intake, food construction and origin, food resource production, applying, assignation, eating model and so on. 膳食营养摄入量，食物结果与来源，生产加工，就餐模式 Human nutrition status, growth status, variety, incidence, reason, intendance and measurement for malnutrition and over-nutrition.居民营养状况与发育状况,42,Nutritional problem to be paid attention. 值得关注的营养问题 The offspring growth trend and analysis. 第二代发育趋势及原因分析 Nutrition unbalance tendency. 营养失调趋势 Degree, experience and problem to normal or special nutrition issues. 营养问题解决程度，经验与问题,43,Nutritional surveillance,Continuous , moving nutritional observation in order to make a decision which improves human nutritional level,对社区人群进行连续动态地观察,以便作出改善居民营养的决定。 搜集分析影响因素和条件，预测可能发生的变化，并采取必要的 措施，引导人们向期望的 方向发展。,44,Differences between nutritional survey and surveillance,1. 采取措施, 保护重点保护对象. 2. 营养状况信息直接反馈并影响营养政策. 3. 长期动态观察性监测 4. 涉及社会经济及农业生产方面 5. 搜集现存资料,45,Data source and monitoring target,Social financial data, Health care Human nutrition,46,Social financial data:,Engel index= (cost in food/total income)100% 用于食品的开支/家庭 总收入 60%-贫困 5059%-勉强维持生计 4049%-小康水平 3039%-富裕 30%-最富裕,Income elasticity=increase in purchasing food (%) /income increase( %) 收入弹性=食物购买力 增长(%)/收入增长(%) Average income and average income increasing rate 人均收入与人均收入增 长率,47,Health Care Human nutrition,婴儿母乳喂养率 新生儿体重 儿童发育状况,编制食物平衡表 人均动物性食品增长率 居民蛋白质、热能平均摄入水平,48,Nutritional Policy and Measurement,49,Dietary pattern-食物结构模式,Dietary pattern: composition of dietary kinds and quantity. 居民消费的食物种类极其数量的相对构成,Developed country pattern Developing country pattern Japanese pattern,50,Developed country pattern,人年均占有8001500kg粮食，其中60%70%转化为肉奶禽蛋, 动物性食品人均消费达270kg 粮食直接消费6070kg,Japanese pattern,人均摄入粮食110 kg 动物性食品135 kg,51,Developing country pattern,年谷类及薯类达200kg 肉鱼蛋小于5 kg,1. 高谷物膳食-总体营养水平低 2. 明显不合理现象: 优质蛋白所占比例小 以猪肉为主80% 不科学,不文明的消费习惯-高浓度白酒消费 过多;优质蛋白集中消费现象严重 消费不平衡-富裕病与营养不良症并存.,缺点,52,Dietary guideline,Various food, major in cereal More vegetables, fruit and potato Enough intakes: milk, beans or bean products Usual intakes: fish, poultry, egg, lean meat, less intakes: fat and pork fat Balance between intakes and physical activity, to keep appropriate body weight Less salt food Limited alcohol intakes Clean and healthy food,53,54,Food Fortification,A kind of deep food production, by adjusting nutrients, to satisfy human requirement 根据营养需要向食品中添加营养素，或以添加 某些营养素为目的添加天然食品，以增加食品的营养价值的一种食品深加工.,55,Requirement for Food Fortification,1. 安全无毒 2. 有针对性 3. 营养合理，不破坏营养平衡 4. 有竞争力,56,Development and utilization of food resource and new food,菌类，藻类,天然植物资源,57,茶油,油茶树为我国特产的食用木本油料树种，在我国已有2000多年的栽培历史。油茶生长周期长，秋季开花，花期2至3个月，自开花到果实成熟为期一年，尽吸天然养分，日月精华。民间尚有“抱子怀胎”之说。油茶树的寿命较长，“寿经三四百年尚如新植”（明代南城诗人邓直山茶百韵）。,58,油茶树的主要产品茶油，因特有的低碘值，故稳定性较其他食用更好，不易变质，易保管；对人体有益的油酸含量居各种植物油之冠；亚油酸含量符合人体需要量，二者含量达90%以上，不含胆固醇，可抑制和预防心脑血管疾病。由于茶油营养结构合理，有益健康，资源极其稀少，因而尤显珍贵。又由于其脂肪酸的构成与橄榄油十分相似，而被誉为“东方橄榄油”。 中国食物结构改革与发展规划纲要要求大力发展的食用植物油。,59,Gingko,银杏是中国特有而丰富的经济植物资源。利用银杏果叶的有效化学成分和特殊医药保健作用加工生产保健食品，药物和化妆品，正引起国内外研究、开发、生产单位的重视，各国众多企业竞相研制生产以银杏为原料的天然绿色产品，替代对人体健康有较大副作用的合成化学品，从而为中国的银杏资源的开发利用开辟了无比广阔的前景。,The sole survivor of a 200 million year old primitive order of plants has been used for a long time in Chinese medicine. Newer scientific research has shown, that the active substances of the yellow autumn leaves1. strengthen blood vessels2. reduce free radicals3. strengthen brain function4. strengthen cell energy,60,中国的银杏资源主要分布在江苏、山东、浙江、安徽、福建、江西、河北、河南、湖北、湖南、四川、贵州、广西、广东等省的60多个县市。江苏省邳州市在银杏叶的种植和加工提取物（GBE）生产方面处于全国先进行列。中国有成千上百个用银杏果叶机器提取物为原料，研究开发保健食品，医药品、化妆品的科研、生产和教学单位，银杏的产品琳琅满目，银杏的科学研究论文不计其数，银杏的产值已在中国各银杏产区的国民经济中占有较大的比例，银杏的资源和深加工产品市场在国内外竞争激烈。,61,传统基因工程产品 将基因克隆于表达型的质粒上，转入宿主菌，靠宿主菌发酵生产，如人胰岛素，干扰素及生长激素.,3. 生物工程,62,现代基因工程产品:用转基因动物生产外源基因产品. 转基因动物:用实验方法导入外源基因在染色体基因组内稳定地整合,并能遗传给后一代的动物.,