(儿科学英文课件）04 nutrition..pptx

(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