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1、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
2、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,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 co
3、urse 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 ir
4、on,but babies born at term usually have adequate iron even if the mother is deficient.RNI 15mg 1st trimester 25mg 2nd trimester 35mg 3rd 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
5、 11.5mg/d 1st trimesrer 16.5mg/d 2nd 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）.RNI200g/d,叶酸 and Vitamin B12 叶酸 和 vit B12 是细胞分化必需的,Adequate folate intak
6、es 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 B12 can also result in megaloblastic anemia.,维生素,megaloblastic anemia:reticulocytes cells must be constantly replenished via new synthes
7、is of DNA and RNA,Vitamin A High dietary intakes of preformed vitamin A(10,000IU)can cause birth defects in humans and animals.Vitamin DVitamin 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 pre
8、gnancy.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
9、 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 Calc
10、ium 1200mg 1200mg 800mgIron 25mg 35 mg 20mgVit.A 1200 g 700 g 700 gVit.B1 1.8mg 1.5mg 1.3mgVitB2 1.7mg 1.7mg 1.2mg,热能 1.Basal metabolic requirement2.Specific dynamic effect3.Physical activity4.Tissue growth5.Fecal loss 3 times greater than in adults,8595kcal/kg 4050%come from fat high energy density
11、 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 IronIron-fortified i
12、nfant formulasIron-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 milkUnless 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 cows m
13、ilk whey proteins:casein=80:20(18:20in cows)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
14、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 cows milk)copper is higher iron is slightly higher,utilized more efficiently 维生素 twice as much vitamin A and niacin four times
15、 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
16、 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 milkprotein（g/L）22.90 10.60S-IgA(mg/L)21.00 10.00Lactose(g/L）57.00 71.00lipids（g/L)29.50 45.40zinc（mg/L)5.59 1.18retinol（
17、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 needPhysiological capabilitiesPhysical abilityPreventing 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）。
18、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
19、。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
20、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
21、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,1.生理变化,2.与营养有关的
22、生理变化,Fine motor coordination also progress rapidly,and manipulation of objects,including food,becomes more proficient.,3.心理和生理的改变 独立性、社会适应能力的增加社会,经济,教育、环境的影响。饮食行为的改变 Setting a good example is very important,乳和乳制品粮谷类肉,鱼,禽,蛋 和豆类 蔬菜和水果零食（Snack food）,食物的选择,良好的饮食习惯,提供生长发育所需的热能和营养素培养味觉和接受不同的食品Instill atti
23、tudes and practices which may form the basis for lifelong health-promoting eating patterns,食物选择的影响因素,家庭Lifelong habits and attitudes established during the period of independence.Shared meals=better diets.同伴(particularly strong for adolescents)媒体（Media）,幼儿的喂养,Appetite and food intake may vary tremen
24、dously.Snacks contribute significantly to total days intake.Food jags are part of normal development.Choking risks,幼儿膳食的基本要求,1.平衡膳食protein 10-15%lipids 25-30%carbohydrates 50-60%provide a wide variety of nutritious foods for children to selectgive children a large proportion of control over their fo
25、od intake,especially meal size have fast foods as an occasional treat not as an everyday food.,2.合理烹调 适合幼儿消化功能特点减少烹调过程中营养素的损失,3.合理的进餐三餐一点:早餐 20-25%中餐 30-35%午点 10-15%晚餐 30%help children adapt to the social timing of mealshave mealtimes at an appropriate time for young children,4.培养良好的饮食习惯 定时、定点、定量进餐，
26、不暴饮暴食 不偏食、挑食 培养使用杯、匙、碗、筷自己进食 不以食物作为奖惩手段 avoid using rewards or forcing or coercing a child to eatavoid force feeding childrenavoid overfeeding,5.良好的进餐环境 have mealtimes together as a family(when possible)limit distractions at mealtimes6.注意饮食卫生,青春期的营养和膳食nutrition and dietary of adolescents,青春期早期：growt
27、h spurt青春期中期：sexual maturation青春期晚期：physical growth maturity,青春前期 青春后期,青春期少女的生理和心理,青春期的生理特点1身高和体重生长突增（growth spurt）体成分（body composition）The growth spurt usually begins around 10 years of age in girls and 12 years of age in boys.In both sexes,an average of 23cm is added to height and 20-26kg to weigh
28、t.Before adolescence,both girls and boys have an average of 18%body fat.During adolescence this increases to about 28%in girls and decreases to about 15%in boys.,2性器官的发育和第二性征的出现性器官内生殖器官：阴道、子宫、输卵管和 卵巢外生殖器官：阴阜、大、小阴唇和阴蒂第二性征：乳房、阴毛、腋毛3.各组织、器官、系统的发育,性腺,腺垂体,神经垂体,下 丘 脑,组织,肾上腺,甲状腺,LHRH FSH-RH GRH PIF PRF GRI
29、H GRH TRH,雌激素孕激素睾丸酮,LHFSHACTHGHTSHPRL,肾上腺皮质素雄激素,兴奋抑制,青春期内分泌调节示意图,神经中枢,甲状腺素,青春期的营养需要Nutrient Requirements,1.Energy 16岁10.0MJ（2390Kcal）18岁 8.8MJ(2100Kcal)2.Protein positive nitrogen balance 1.61.9g/kg 80g(70g),Minerals 1).Calciuml Bone grows in volume and density as well as length llength increase 0.2
30、5mm/dlWeight increase 1.2g/d,from 1500g-3000gRDA 13 1200mg/d 16 1000mg/d 18 800mg/dAI 11 1000mg/d 14 1200mg/d 18 800mg/dUL 11 2000 14 2000 18 2000,2).Iron iron is needed for:l growth of body tissuesl increase in blood volumel replacement of iron losses in menstrual blood iron-deficiency anemiaRDA 10
31、 12mg/d 13 20mg/d 18 12mg/dAI 11 18mg/d 14 25mg/d 18 20mg/dUL 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 18 374).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.A2.Vit.D3.B vitamins4.Vit.C,一日食谱举例,Anor
32、exia 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 m
33、enstruating.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.W
34、hen 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
35、 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
36、for a decrease in lean body mass2.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 enha
37、nce 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 o
38、ccurs 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 intakeFatcarbohydrate,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,
