(儿科学英文课件)04 nutrition..pptx
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(儿科学英文课件)04 nutrition..pptx
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1,NutritionandFeeding,Prof.ChengQianDept.ofChildHealthCareCMUC,2,Lownutritionalstores,Thenutritionalvulnerabilityofinfantsandchildren,Highnutritionaldemandsforgrowth,Rapidneuronaldevelopment,contributiontobasalmetabolicrate,4,Contents,NutrientneedsofthenormalinfantandchildThenutrition-relatedcharacteristicsofgastrointestinaltractininfantDietofthenormalInfantDietofthenormalchildandadolescentNutritionalassessment,5,toacquaintedwiththeenergyrequirementatdifferentagegroup,especiallyininfancytoacquaintedwiththeidealproportionofenergyproducedbymacronutrientstolisttheRNIorAIofsomemicronutrients(VitA,B,C,D,iron,calcium,zinc,iodine),OBJECTIVES1,Nutritionalassessment,6,Contents,NutrientneedsofthenormalinfantandchildThenutrition-relatedcharacteristicsofgastrointestinaltractininfantDietofthenormalInfantDietofthenormalchildandadolescent,7,Dietaryreferenceintakes,DRIs营养素参考摄入量,EstimatedAverageRequirement,EAR平均需要量,RecommendedNutrientIntake(RecommendedDietaryAllowances),RNI(RDA)推荐摄入量AdequateIntake,AI适宜摄入量,TolerableUpperLimit,UL可耐受最高摄入量,RNI=EAR+2SD,AMDR,宏量营养素素接受范围,PI-NCD建议摄入量,SPI,特定建议量,PreventionforChronicillness,RelationshipofDietaryReferenceIntakestoRNI,EARandUL,8,Nutrientneedsofthenormalinfantandchild,9,10,Categoryofnutrients,EnergyMacronutrientsPro,Fat,CHO,Micronutrients,mineralstraceelementsvitamins,Otherdietelements,cellulose(纤维素)water,*Chinesenutritionsociety2000,2013,11,Energy,theenergyintakeisusedforgrowthandsynthesisofnewtissue,metabolicprocesses,physiologicalfunctionsandactivityTheRNIsofenergyarethesameastheestimatedaveragerequirement(EAR).TheEARistheaveragedietaryenergyintakepredictedtomaintainenergybalanceinahealthyindividualofdefinedgroup.TheEARaccountforage,gender,weight,stature,andphysicalactivitylevel.,12,Energyrequirementsofinfants(fromHanley&Belfus1988.),mo,012m95kcal/kg.d1y1100kcal/d2y1200kcal/d3y1350kcal/d5y1600kcal/d7y1800kcal/d10y2100kcal/d,RequirementsofTotalEnergy,(2000ChineseDietaryReferenceIntakes),13,14,Macronutrients,ProteinFatCarbohydrateareenergysourcesandareessentialforcellularhomeostasis.,15,Protein,Proteinintakeisrequiredtosupplyforthesynthesisofconstituentproteinandothernitrogen-containingcompoundssuchaspolypeptidehormons.,16,EEAcannotbesynthesizedbyhuman.Theseaminoacidsareessentialorindispensabletothediet.Infantsrequirealloftheindispensableaminoacidsthatadultsrequire,aswellascysteine(半胱氨酸)andtyrosine(酪氨酸)(andperhapsarginine精氨酸)earlyinlife;theseadditionalaminoacidsareindispensableforthisstage,duetotheimmaturityofhepaticcystathionase(胱硫醚酶)inearlyinfancy.,17,Proteinquality,thedistributionofaminoacidstheproportionofaminoacidsAproteinofhighqualitycontainsalargepropotionofessentialaminoasids.*Humanmilksoy-basedinfantformula+methionine(蛋氨酸),RNIforProtein,AgeProtein0-12m1.53g/kg.d1y-35g/d2y-40g/d3y-45g/d4y-50g/d5y-55g/d6y-55g/d7y-60g/d,18,19,FATFatisthemostcaloricallydensemacronutrient.,Themaindietarysourcesoffatincludeanimalproducts,vegetableoils,margarine,bakedgoods,andfriedfoods.Fatspalysignificantstructuralandfunctionroles.TheAMDRforfatsis30-40%ofthetotalenergyintakeforchildren1-3yrofageand25-35%forchildren4-18yr(USA).,20,Saturatedfats:
animalfatsUnsaturatedfats:
vegetablefats,polyunsaturated:
fishoil,plants(多不饱和脂肪酸)linolenicacid(ALA,亚麻酸)andlinoleicacid(LA,亚油酸)arethemostimportantunsaturatedfats,alsoareimportantessentialfattyacids.HumansareincapableofsynthesizingtheprecursorALAandLAanddependentondietarysourcesfortheseessentialfattyacids.,21,Carbohydrate,CHOisthemajorresourcesoftheenergy.Carbohydratesareabundantinmanyfoodsincludingcereals,grains,fruits,andvegetables.Dietarycarbohydratesincludemonosaccharides(单糖),disaccharide(双糖),oligosaccharides(低聚糖),andpolysaccharides(多糖)。
Theprimaryfunctionofcarbohydratesistoserveasanenergysourceforallcells,withthecentralnervoussystemanderythrocytesdependingmostonglucoseasanenergysubstrates.,22,OptimalDistributionofEnergy,Fatcontributes50%oftotalenergyinbreastmilkorstandardinfantformula.Theaveragedietofolderchildrenprovides25-30%oftotalenergyfromfat.45-55%fromcarbohydrateandabout8-15%fromprotein.,0-6m45-50%7-24m35-40%,23,Micronutrients(微量营养素),mineralstraceelements(微量元素)vitamins,24,Themajormineralsarethatrequireintakesofmorethan100mg/dayandcontributeatleast0.1%oftotalbodyweight.Calcium(Ca),phosphorus(P),magnesium(Mg),sodium(Na),potassium(K),chloride(Cl),andsulfur(S),Minerals,Summaryofclinicallyrelevantinformationonminerals,BiochemicalAction,EffectsofdeficiencyEffectsofToxicityDietarySources,Structureofboneandteeth;activates,smooth,skeletal,contractionand
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