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Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,营养障碍疾病医疗管理分析,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,营养障碍疾病医疗管理分析,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,营养障碍疾病医疗管理分析,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,营养障碍疾病医疗管理分析,*,营养障碍疾病医疗管理分析,2,营养障碍疾病医疗管理分析,Objectives and Demands,The principles of infant feeding and introducing supplemental foods into a babys diet,The diagnosis,treatment and prophylaxis of Protein-energy,malnutrition,The diagnosis and treatment of obesity in children,To master,3,营养障碍疾病医疗管理分析,Nutritional Requirements and Infant Feeding,营养基础及婴儿喂养,4,营养障碍疾病医疗管理分析,Introduction,Low nutritional stores,High nutritional demands for growth,Rapid neuronal development,Infants and children are more vulnerable to poor nutrition than are adults,5,营养障碍疾病医疗管理分析,dietary reference intakes,（,DRIs,）,平均需要量,EAR(estimated average requirement),推荐摄入量,RNI(recommended nutrient intake),适宜摄入量,AI(adequate intake),可耐受最高摄入量,UL(tolerable upper intake level),一个人群的,RNI=EAR+2SD,6,营养障碍疾病医疗管理分析,requirements of energy,Including:,basal metabolism 50%,for thermic effect of food(TEF)78%,for physical activity,for excreta 10%,for growth,7,营养障碍疾病医疗管理分析,requirements of nutriment,Energy,Macronutrient:,protein,、,fat,、carbohydrate,Micronutrient:mineral、vitamin,Other element:food fiber、,water,8,营养障碍疾病医疗管理分析,Changes in energy and water requirements with age,Age,(,year),Energy（kcal/kg）,Water（ml/kg）,Infant 110 150,13 100 125,47 90 100,79 80 75,1012 70 75,1315 60 50,Adult 4050 4050,9,营养障碍疾病医疗管理分析,Sources of protein,Animal protein,Plant protein,The quality of protein depends on its amino acid composition,10,营养障碍疾病医疗管理分析,Essential amino acid,Adult:8,Infant:histidine,Preterm infant:cystine,tyrosine,arginine,taurine,11,营养障碍疾病医疗管理分析,Sources of fat,essential fatty acid,12,营养障碍疾病医疗管理分析,Infant feeding,Breast feeding,Mixed feeding,Artificial feeding,Transitions in infant feeding,13,营养障碍疾病医疗管理分析,Breastfeeding and complementary feeding terms and definitions,EXCLUSIVE BREASTFEEDING:,the infant takes only breast milk and no additional food,water,or other fluids with the exception of medicines and vitamin or mineral drops.,MIXED FEEDING:,the infant is given some breast feeds and some artificial feeds,either milk or cereal,or other food or water.,ARTIFICIAL FEEDING:,the infant is given breast-milk substitutes and not breastfeeding at all.,14,营养障碍疾病医疗管理分析,Breast,feeding,15,营养障碍疾病医疗管理分析,Cow milk for cow babies,human milk for human babies,16,营养障碍疾病医疗管理分析,Babies are born to be breastfed,Its too important not to!,17,营养障碍疾病医疗管理分析,Advantages of breastfeeding,The ideal and natural food for infants:,Nutrition,，,Immunity,，,Brain development and growth,Reduce disease risk,Economic and convenience,Establish an intimate,loving relationship,Mothers health,18,营养障碍疾病医疗管理分析,Why is Breastfeeding Important?,Nutritionally,contains the correct balance of all nutrients when they are needed,Protein quality:More easily digested curd(1:4 casein:whey ratio),Rich in beta lactose,Lipid quality:Rich in olein acid.Improved digestibility and fat absorption,Calcium:phosphorus ratio of 2:1,Low renal solute load,(infant formula does not change with babys changing needs),19,营养障碍疾病医疗管理分析,Immunity,-breastmilk contains protection against infections and inflammation,no matter what age or stage of breastfeeding.(secretory IgA,bifidus factor,lysozyme,lactoferrin,oligose,interferon,living cells),Why is Breastfeeding Important?,20,营养障碍疾病医疗管理分析,eczema,21,营养障碍疾病医疗管理分析,Breastfeeding decreases the risk of allergic disorders a prospective birth cohort study,Type of feeding,Asthma,Atopic dermatitis,Allergic rhinitis,Children exclusively breastfed 4 months or more,7.7%,24%,6.5%,Children breastfed for a shorter period,12%,27%,9%,Adapted from Kull I.et al.Breastfeeding and allergic diseases in infants-a prospective birth cohort study.Archives of Disease in Childhood 2002:87:478-481.,22,营养障碍疾病医疗管理分析,DIARRHEAL ILLNESS,AMONG BREASTFED and FORMULA FED INFANTS,Adapted from:Dewey et al(1995):699-700,%,Days ill,%,Days ill,OTITIS MEDIA,AMONG BREASTFED and FORMULA FED INFANTS,23,营养障碍疾病医疗管理分析,Duration of breastfeeding associated with higher IQ scores in young adults,Denmark,Adapted from:Mortensen EL,Michaelsen KF,Sanders SA,Reinisch JM.The association between duration of breastfeeding and adult intelligence.,JAMA,2002,287:2365-2371.,25,营养障碍疾病医疗管理分析,Economic benefits,breastfeeding costs less than artificial feeding,no special diet,for mother(digestion+),;health care,$,reduced,when babies/moms healthier;,no cost,of formula($600-$3000/yr),breastfeeding results in lower medical care costs,Diabetes,childhood cancers,ear infections,Crohns,morbidity etc,26,营养障碍疾病医疗管理分析,Always ready!,No waste!,Why is Breastfeeding Important?,27,营养障
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