不同人群的营养

单击此处编辑母版标题样式,*,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,不同人群的营养,Life Cycle,Nutrition,1.,孕妇的营养,孕妇的营养的目的,一是要提供能满足胎体生长发育所必须的各种营养素,;,二是要满足自身的营养需求,达到预防出现的母体和胎体营养缺乏及某些并发症,.,孕妇的营养生理特点,激素的变化,人绒毛膜促性腺激素,(,安胎,),人绒毛膜生长素,(,促进蛋白质和,DNA,的合成,),雌激素,(,促进母体乳房发育,),孕酮,(,维持子宫内膜及乳房的发育,),胃肠道的变化,胃排空延迟。,胃酸下降。,消化不良,肠蠕动减弱,循环系统,血容量增加,50%,心输出增加,血红蛋白降低,泌尿系统的变化,肾小球滤过率增加大,50%,肾血浆流量增加,75%,体重增加,总体重增加,:,1113kg,胎儿,: 3.3kg,胎盘、羊水：,1.5kg,子宫：,1.0kg,血液：,1.2kg,乳房：,0.4kg,细胞间液：,1.5kg,脂肪：,24kg,怀孕期间体重的要求,BMI,（孕前）,增重,消瘦,(BMI26.029.0),7.511.5,肥胖,(BMI29.0),6.06.8,孕妇的营养需求,如何确定孕妇的最,佳营养需要量是一个复,杂科学问题,通常以组织,和体液中的营养素含量,来阐述营养素的需要量,.,热能,估计孕妇整个孕期需要增加热能,55000 kcal.,孕中后期增加,200 kcal/day,蛋白质,蛋白质也增加；,RNI: + 5g/d,孕前期,+15g/d,孕中期,+20g/d,孕后期,矿物质,钙,孕妇需要更多的钙，因为她们从尿中丢失的钙要比一般妇女多。,.,The fetus retains about 30 grams of calcium over the course of gestation. Most of the calcium is deposited in the last trimester when the fetal skeleton is growing most rapidly and the teeth are forming.,RNI 800mg,孕前期,1000mg,孕中期,1200mg,孕后期,食物来源,:,牛奶和奶制品。,铁,缺铁性贫血,低出生体重,preterm delivery,Babies born prematurely may not have had time to accumulate sufficient iron, but babies born at term usually have adequate iron even if the mother is deficient.,RNI 15mg 1,st,trimester,25mg 2,nd,trimester,35mg 3,rd,trimester,食物来源,:,红肉,绿叶蔬菜,fortified cereals,铁补充剂,锌,Zinc deficiency during pregnancy is associate with an increased risk of fetal malformation and low birth weight.,RNI 11.5mg/d 1,st,trimesrer,16.5mg/d 2,nd,trimester,16.5mg/d 3nd trimester,碘,Iodine deficiency during pregnancy increases the risk of stillbirth spontaneous abortion and can result in condition in the offspring called cretinism(,呆小病）,.,RNI,200,g/d,叶酸,and Vitamin B,12,叶酸 和,vit,B,12,是细胞分化必需的, Adequate,folate,intakes is crucial even before conception because rapid cell division occurs in the first days and weeks of pregnancy.,四氢叶酸与神经管的形成密切相关。,Deficiencies of,folate,and vitamin B,12,can also result in,megaloblastic,anemia.,维生素,megaloblastic,anemia,:,reticulocytes,cells must be constantly replenished via new synthesis of DNA and RNA,Vitamin A,High dietary intakes of preformed vitamin A (10,000IU) can cause birth defects in humans and animals.,Vitamin D,Vitamin C,营养不良对胎儿的影响,低出生体重,早产儿,脑发育受损,围生期新生儿死亡率增高,先天性畸形,乳母的生理特点,2.,乳母的营养需求,乳母的营养要求,The need for energy and many nutrient is even greater during lactation than during pregnancy. This is because the mother is still providing for all of the nutrient needs of infant who is growing faster and is mover active then the fetus.,热能,Contained in the milk itself,Needed to synthesize the components of the milk,RNI: +500kcal,蛋白质,The protein needed to produce milk increase maternal protein needs,RNI +20g,水,When fluid intake is low, the mothers urine will become more concentrated to conserve water for milk production. To avoid dehydration and ensure adequate milk production,fluid,intak,should be increased by about 1L/d.,RNIs,of some,元素,and,维生素,lactation pregnant non-pregnant,Calcium 1200mg 1200mg 800mg,Iron 25mg 35 mg 20mg,Vit.A,1200,g 700 g 700 g,Vit.B1 1.8mg 1.5mg 1.3mg,VitB2 1.7mg 1.7mg 1.2mg,热能,1,.,Basal metabolic requirement,2. Specific dynamic effect,3. Physical activity,4. Tissue growth,5. Fecal loss,3 times greater than in adults ,8595kcal/kg,4050% come from fat,high energy density small stomach,important for nervous system development,3.,婴儿的营养,nutrition,蛋白质,Tissue growth 1.62.2g/kg,Total protein intake should not exceed 20% of energy needs.,脂肪,energy/%,00.5 year,：,45%50%,0.5 : 35%40%,EFA development of nervous system,矿物质,and,维生素,Special emphasis on calcium and iron,Iron,Iron-fortified infant formulas,Iron-fortified cereal,水,Need greater than that of an adult,Infant 120150ml/kg/day,母乳喂养,人乳的营养,Human milk is very different in composition from cows milk,Unless altered,cows milk should not be used in infant feeding until the infant is 12 months old.,2.,母乳的组成,蛋白质,approximate 1/3 as in cow,s milk,whey proteins:casein=80:20 (18:20in cow,s),smaller and more flocculent curd,easier digestion,greater absorption, soft stools,脂肪,most variable macronutrient in human milk,fine emulsification,active lipase,higher degree of,unsaturation,碳水化物,lactose is higher,lower intestinal PH,improve the absorption of nitrogen, calcium,and magnesium,encourages the growth of fermentative rather,than putrefactive bacteria,components of myelin and collagen,矿物质,calcium:phosphorus,2:1 (1:1 in cow,s milk),copper is higher,iron is slightly higher, utilized more efficiently,维生素,twice as much vitamin A and niacin,four times as much as ascorbic acid and,vitE,vitamin D is low,免疫因子,S-,IgA,免疫球蛋白,Lactoferrin,乳铁蛋白,Lactobacillus,bifidus,双歧因子,Lysozymes,溶菌酶,Immune factors of human milk and cows milk,immune factors human milk cows milk,Lactoferrin(,g,/L) 1.5,痕量,Lysozymes,(,g/L) 0.5 0.0001,lgA,（,g / L,）,1.0 0.03,lymphocyte(,个,/,ul,）,800 0,Lactobacillus,bifidus,(,个,/,ul,） 有,未检出,初乳,(,colostrum,) antibodies,lactobacillus,bifidus,factor,facilitates the passage of,meconium,(,胎粪,),过渡乳,(transitional milk),成熟乳,(mature milk),初乳和,成熟乳的组成,colostrum,mature milk,protein,（,g / L,）,22.90 10.60,S-,IgA(mg,/L) 21.00 10.00,Lactose(g / L,）,57.00 71.00,lipids,（,g / L) 29.50 45.40,zinc,（,mg / L) 5.59 1.18,retinol,（,mg / L,）,1.61 0.27,母乳喂养的优点,增进婴儿的免疫力,营养物质最适合婴儿的生长发育,增进母婴之间的感情的交流,增进面部或肌肉的发育,减少呼吸道和消化道的感染,降低以后慢性病的发生,经济、方便、卫生,婴儿易消化。,母乳喂养,幸福的源泉,每年的,8,月,1,日至,7,日,Introducing Solid Foods,Nutritional need,Physiological capabilities,Physical ability,Preventing allergies,中国居民膳食指南,2007,为了给全国居民提供最基本、科学的健康膳食信息，卫生部委托中国营养学会组织专家，制订了,中国居民膳食指南,（,2007,）。,膳食指南,以先进的科学证据为基础，密切联系我国居民膳食营养的实际，对各年龄段的居民摄取合理营养，避免由不合理的膳食带来疾病具有普遍的指导意义。,今后,1020,年，是中国改善国民营养健康的关键战略时期。希望全社会的广泛参与，大力推广和运用,中国居民膳食指南,，科学改善国民营养健康素质，为全面建设小康社会奠定坚实的人口素质基础。,一般人群膳食指南,一、食物多样，谷类为主，粗细搭配,人类的食物是多种多样的。各种食物所含的营养成分不完全相同，每种食物都至少可提供一种营养物质。平衡膳食必须由多种食物组成，才能满足人体各种营养需求，达到合理营养、促进健康的目的。,谷类食物是中国传统膳食的主体，是人体能量的主要来源。谷类包括米、面、杂粮，主要提供碳水化合物、蛋白质、膳食纤维及,B,族维生素。坚持谷类为主是为了保持我国膳食的良好传统，避免高能量、高脂肪和低碳水化合物膳食的弊端。人们应保持每天适量的谷类食物摄入，一般成年人每天摄入,250g400g,为宜。另外要注意粗细搭配，经常吃一些粗粮、杂粮和全谷类食物。 稻米、小麦不要研磨得太精，以免所含维生素、矿物质和膳食纤维流失。,二、多吃蔬菜水果和薯类,新鲜蔬菜水果是人类平衡膳食的重要组成部分，也是我国传统膳食重要特点之一。蔬菜水果能量低，是维生素、矿物质、膳食纤维和植物化学物质的重要来源。薯类含有丰富的淀粉、膳食纤维以及多种维生素和矿物质。,富含蔬菜、水果和薯类的膳食对保持身体健康，保持肠道正常功能，提高免疫力，降低患肥胖、糖尿病、高血压等慢性疾病风险具有重要作用。 推荐我国成年人每天吃蔬菜,300g500g,，水果,200g400g,，并注意增加薯类的摄入。,三、每天吃奶类、大豆或其制品,奶类营养成分齐全，组成比例适宜，容易消化吸收。奶类除含丰富的优质蛋白质和维生素外，含钙量较高，且利用率也很高，是膳食钙质的极好来源。各年龄人群适当多饮奶有利于骨健康，建议每人每天平均饮奶,300ml.,饮奶量多或有高血脂和超重肥胖倾向者应选择低脂、脱脂奶。,大豆含丰富的优质蛋白质、必需脂肪酸、多种维生素和膳食纤维，且含有磷脂、低聚糖，以及异黄酮、植物固醇等多种植物化学物质。应适当多吃大豆及其制品，建议每人每天摄入,30g50g,大豆或相当量的豆制品。,四、常吃适量的鱼、禽、蛋和瘦肉,鱼、禽、蛋和瘦肉均属于动物性食物，是人类优质蛋白、脂类、脂溶性维生素、,B,族维生素和矿物质的良好来源，是平衡膳食的重要组成部分。瘦畜肉铁含量高且利用率好。鱼类脂肪含量一般较低，且含有较多的多不饱和脂肪酸；禽类脂肪含量也较低，且不饱和脂肪酸含量较高；蛋类富含优质蛋白质，各种营养成分比较齐全，是很经济的优质蛋白质来源。,幼儿营养与膳食,nutrition and dietary of preschool children,身高、体重稳步增长,消化功能仍有限,.,主要营养问题。,特点,新生儿,6,月,12,月,.,增加,1,st,year,2,nd,year,3,rd,year,Next 3y,体重,(Kg),3.0,6,9,6 (200%),2.5,2,2,身高,(Cm),50,66,75,25,(50%),10-12,7-8,7,头围,34,46,12,2,1.2,70g),Minerals,1). Calcium,l,Bone grows in volume and density as well as length,l,length increase 0.25mm/d,l,Weight increase 1.2g/d, from 1500g-3000g,RDA 13 1200mg/d 16 1000mg/d 18 800mg/d,AI 11 1000mg/d 14 1200mg/d 18 800mg/d,UL 11 2000 14 2000 18 2000,2). Iron,iron is needed for :,l,growth of body tissues,l,increase in blood volume,l,replacement of iron losses in menstrual blood,iron-deficiency anemia,RDA 10 12mg/d 13 20mg/d 18 12mg/d,AI 11 18mg/d 14 25mg/d 18 20mg/d,UL 50 50 50,3). Zinc,RDA 10 15mg/d,RNI 11 15mg/d 14 15.5mg/d 18 11.5mg/d,UL 11 34 14 35 18 37,4). Iodine,goiter,RDA 10 120g/d 13 150g/d,RNI 11 120g/d 14 150g/d,UL 11 800 14 800 18 1000,四维生素,(Vitamins),1.,Vit,. A,2.,Vit,. D,3.,B vitamins,4.,Vit,. C,一日食谱举例,Anorexia nervosa,refusal to eat enough to maintain a normal body weight,intense fear of gaining weight or becoming fat,Sufferers are of the impression that they are fat and often see themselves as being fat even though they are obviously underweight.,exercise vigorously or use slimming pills,often stop menstruating.,often very secretive about their eating habits,.,That autumn, Heather was rejected by Oxford. By now it was evident that she was very thin. At Christmas, her,behaviour,led to major upsets and rows in the family. Finally, early in the New Year, her parents persuaded her to see the family doctor. When weighed at,the surgery, she was just under six stones (37 kg). It was clear now that she was suffering from anorexia nervosa.,老年营养,The changes of aging,changes in cells and organs,随年龄增加，体细胞数目减少，各器官功能逐渐降低,.,1.,胃肠道,(gastrointestinal tract),2.,心脏,(heart),3.,肝脏,(liver),4.,肾脏,(kidney),身体成分的变化,1.,去脂组织减少,(decrease in lean body mass),每,10,年减少,6.3%,骨骼肌减少（,70,岁后减,少,40%,），内脏器官减重,2.,脂肪组织增加,(increase in body fat),3.,体内水分减少,(decrease in water),4.,骨密度降低,从,40,岁开始降低,代谢的变化,1.,基础代谢下降,减少,15%20%,2.,蛋白质代谢,按每公斤体重计算合成降低，以去脂组织为单位计算，则比青年人增高,5%10%,。蛋白质分解也增加。,3.,脂肪代谢,合成、分解和排泄均降低，导致脂类在血管和组织堆积,4.,糖代谢,对葡萄糖的氧化能力减少，糖耐量下降,激素水平的变化,1.,生长激素（,growth hormone,）,May be responsible for a decrease in lean body mass,2.,褪黑素（,melatonin,）,It is involved in regulating the bodys cycles of sleep and wakefulness,The decline has been hypothesized to influence aging by affecting body rhythms and triggering genetically programmed aging at a cellular level,It is also an antioxidant and may enhance immune function,免疫功能的变化,随年龄的增加抗病能力逐渐下降（,The ability of the immune system to fight disease decline with age.,）,Supplement of several micronutrients including zinc,beta-carotene,and vitamin E have been shown to improve immune response.,老年人的营养需求,Energy needs are typically reduced in the elderly,This occurs for several reasons:,Basal metabolic rate,physical activity,Can energy deprivation slow aging?,protein needs,The needs for protein dose not decline with age. Therefore an adequate diet for older adults must be somewhat higher in protein relative to energy,intake,Fat,carbohydrate,vitamin and mineral, Vitamin and mineral needs, Do antioxidant nutrients slow aging?, Are nutritional supplements necessary?,学习要点,食品营养价值的概念、评价方法,INQ,各类食品的营养特点,不同年龄阶段的特殊营养需要,容易出现的问题,