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1、 不同人群的营养不同人群的营养 Life Cycle Nutrition1.Nutrition During PregnancyThe Physiology of Pregnancy A womans body undergoesA womans body undergoesmany changes during pregnancy many changes during pregnancy to develop and maintain the to develop and maintain the systems necessary to support the systems neces
2、sary to support the growing fetus.growing fetus.n nHormones changes n nGastrointestinal changesuuDelay in gastric emptyDelay in gastric emptyuuDecreased gastric acidityDecreased gastric acidityuuDigestive discomforts morning sickness,Digestive discomforts morning sickness,heart burn heart burnn nCar
3、diovascular systemuu Blood volume increases by 50%Blood volume increases by 50%uu Increase in cardiac output Increase in cardiac outputuuDecrease in albumin concentrationDecrease in albumin concentrationn nRenal function changesRenal function changesn nweight gain总体重增加总体重增加:1113kg胎儿胎儿:3.3kg胎盘、羊水：胎盘、
4、羊水：1.5kg子宫：子宫：1.0kg血液：血液：1.2kg乳房：乳房：0.4kg细胞间液：细胞间液：1.5kg脂肪：脂肪：24kgRecommend Weight Gain During Pregnancy BMI before pregnancy BMI before pregnancyWeight gainWeight gainUnderweight(BMI19.8)Underweight(BMI26.029.0)Overweight(BMI26.029.0)7.511.57.511.5Obesity(BMI29.0)Obesity(BMI29.0)6.06.86.06.8The nut
5、ritional needs of pregnancy During pregnancy,a During pregnancy,a womans nutrient intake andwomans nutrient intake andbody stores must provide allbody stores must provide all the nutrients needs to support the nutrients needs to support the growth and development the growth and development of the ba
6、by while continuing of the baby while continuing to meet the mothers needs.to meet the mothers needs.Energy A typical pregnancy has been estimated to A typical pregnancy has been estimated to require an additional 55000 kcalories.require an additional 55000 kcalories.Additional 200 kcal/day during t
7、he second and Additional 200 kcal/day during the second and third trimesters.third trimesters.Protein Protein needs are also increased during pregnancy to provide for RNI:+5g/d 1 RNI:+5g/d 1st st trimester trimester +15g/d 2 +15g/d 2ndnd trimester trimester +20g/d 3 +20g/d 3rdrd trimester trimester
8、MineralsMineralsMineralsMineralsCalciumCalciumCalciumCalciumuu Pregnant women absorb more of the calcium Pregnant women absorb more of the calcium they consume and lose less calcium in the urine they consume and lose less calcium in the urine than do nonpregnant women.than do nonpregnant women.uu Th
9、e fetus retains about 30 grams of calcium The fetus retains about 30 grams of calcium over the course of gestation.Most of the calcium over the course of gestation.Most of the calcium is deposited in the last trimester when the fetal is deposited in the last trimester when the fetal skeleton is grow
10、ing most rapidly and the teeth are skeleton is growing most rapidly and the teeth are forming.forming.RNI 800mg 1 RNI 800mg 1st st trimester trimester 1000mg 2nd trimester 1000mg 2nd trimester 1200mg 3rd trimester 1200mg 3rd trimester food source:milk and dairy products food source:milk and dairy pr
11、oducts IronIron Iron deficiency anemia low birth weight Iron deficiency anemia low birth weight preterm delivery preterm delivery Babies born prematurely may not have had Babies born prematurely may not have had time to accumulate sufficient iron,but babies born at time to accumulate sufficient iron
12、,but babies born at term usually have adequate iron even if the mother is term usually have adequate iron even if the mother is deficient.deficient.RNI 15mg 1 RNI 15mg 1st st trimester trimester 25mg 2 25mg 2ndnd trimester trimester 35mg 3 35mg 3rdrd trimester trimester food source:red meats,leafy g
13、reen vegetables,food source:red meats,leafy green vegetables,fortified cereals fortified cereals iron supplement iron supplement ZincZincZincZinc Zinc deficiency during pregnancy is associate with Zinc deficiency during pregnancy is associate with an increased risk of fetal malformation and low birt
14、h an increased risk of fetal malformation and low birth weight.weight.RNI 11.5mg/d 1 RNI 11.5mg/d 1st st trimesrer trimesrer 16.5mg/d 2 16.5mg/d 2ndnd trimester trimester 16.5mg/d 3nd trimester 16.5mg/d 3nd trimester IodineIodineIodineIodine Iodine deficiency during pregnancy increases the Iodine de
15、ficiency during pregnancy increases the risk of stillbirth spontaneous abortion and can result in risk of stillbirth spontaneous abortion and can result in condition in the offspring called cretinism(condition in the offspring called cretinism(呆小病）呆小病）呆小病）呆小病）.RNI RNI200200 g/dg/dFolic Acid and Vita
16、min BFolic Acid and Vitamin B1212 Folic acid and vitamin B Folic acid and vitamin B1212 are essential for cell are essential for cell division,Adequate folate intakes is crucial even division,Adequate folate intakes is crucial even before conception because rapid cell division before conception beca
17、use rapid cell division occurs in the first days and weeks of pregnancy.occurs in the first days and weeks of pregnancy.Folate is believed to be essential for proper Folate is believed to be essential for proper formation of neural tube.formation of neural tube.Deficiencies of folate and vitamin B D
18、eficiencies of folate and vitamin B1212 can also result in megaloblastic anemia.can also result in megaloblastic anemia.VitaminsVitaminsmegaloblasticanemiamegaloblasticanemia:reticulocytes cells must be constantly replenished via new synthesis of DNA and RNA n nVitamin AVitamin A High dietary intake
19、s of preformed vitamin A High dietary intakes of preformed vitamin A(10,000IU)can cause birth defects in humans and(10,000IU)can cause birth defects in humans and animals.animals.Vitamin DVitamin DVitamin CVitamin CMaternal Malnutrition and Pregnancy Outcomen nLow birth weightn nPrematuren nIntraute
20、rine growth retardationn nStillbirthn nIncreased early newborn deaths n nMalformationnThe physiology of lactation2.Nutrition requirement on LactationMaternal Nutrient Needs during lactation The need for energy and many The need for energy and many nutrient is even greater during lactation nutrient i
21、s even greater during lactation than during pregnancy.This is because than during pregnancy.This is because the mother is still providing for all of the mother is still providing for all of the nutrient needs of infant who is the nutrient needs of infant who is growing faster and is mover active the
22、n growing faster and is mover active then the fetus.the fetus.n n Energy uu Contained in the milk itselfuu Needed to synthesize the components of the milk RNI:+500kcaln n Protein The protein needed to produce milk increase maternal protein needs RNI +20gn nWater When fluid intake is low,the mothers
23、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 element and vitaminesn n lactation pregnant non-pregnant n nCalcium 1200mg 1200mg 800mgn nIron 25mg 35 mg 20mg
24、n nVit.A 1200 g700g700gg700g700gn nVit.B1 1.8mg 1.5mg 1.3mgVit.B1 1.8mg 1.5mg 1.3mgn nVitB2 1.7mg 1.7mg 1.2mg VitB2 1.7mg 1.7mg 1.2mg uuEnergy Energy 1 1.Basal metabolic requirementBasal metabolic requirement2.Specific dynamic effect2.Specific dynamic effect3.Physical activity3.Physical activity4.Ti
25、ssue growth4.Tissue growth5.Fecal loss5.Fecal loss 3 times greater than in adults,3 times greater than in adults,8595kcal/kg 8595kcal/kg 4050%come from fat 4050%come from fat high energy density small stomach high energy density small stomach important for nervous system development important for ne
26、rvous system development3.Infant nutritionn nProtein Tissue growth 1.62.2g/kgTissue growth 1.62.2g/kg Total protein intake should not exceed 20%of Total protein intake should not exceed 20%of energy needs.energy needs.n nFat energy/%energy/%00.5 year 00.5 year ：45%50%45%50%0.5 :35%40%0.5 :35%40%EFA
27、development of nervous system EFA development of nervous systemMinerals and Vitamins Special emphasis on calcium and iron IronIron-fortified infant formulasIron-fortified cerealn nWater Need greater than that of an adult Infant 120150ml/kg/dayBreast FeedingNutritional Qualities of Human Milk Human m
28、ilk is very Human milk is very different in composition different in composition from cows milkfrom cows milk Unless Unless altered,cowsaltered,cows milk should not be used milk should not be used in infant feeding until in infant feeding until the infant is 12 months the infant is 12 months positio
29、n of breast position of breast milkprotein protein approximate 1/3 as in cowapproximate 1/3 as in cows milk s milk whey proteins:casein=80:20(18:20in cowwhey proteins:casein=80:20(18:20in cows)s)smaller and more flocculent curd smaller and more flocculent curd easier digestion,easier digestion,great
30、er absorption,soft stools greater absorption,soft stools lipids lipids most variable macronutrient in human milkmost variable macronutrient in human milk fine emulsification fine emulsification active lipase active lipase higher degree of unsaturation higher degree of unsaturation carbohydrate carbo
31、hydrate lactose is higher lactose is higher lower intestinal PH lower intestinal PH improve the absorption of nitrogen,calcium improve the absorption of nitrogen,calcium and magnesium and magnesium encourages the growth of fermentative rather encourages the growth of fermentative rather than putrefa
32、ctive bacteria than putrefactive bacteria components of myelin and collagen components of myelin and collagen minerals minerals calcium:phosphorus 2:1 (1:1 in cow calcium:phosphorus 2:1 (1:1 in cows milk)s milk)copper is higher copper is higher iron is slightly higher,utilized more efficiently iron
33、is slightly higher,utilized more efficiently vitamins vitamins twice as much vitamin A and niacin twice as much vitamin A and niacin four times as much as ascorbic acid and vitE four times as much as ascorbic acid and vitE vitamin D is low vitamin D is lowImmune factorn nS-IgA 免疫球蛋白免疫球蛋白n nLactoferr
34、in乳铁蛋白乳铁蛋白n nLactobacillus bifidus双歧因子双歧因子n nLysozymes溶菌酶溶菌酶Immune factors of human milk and cows milk immune factors human milk cows milkimmune factors human milk cows milk Lactoferrin(g/L)1.5 Lactoferrin(g/L)1.5 痕量痕量痕量痕量 Lysozymes(g/L)0.5 0.0001 Lysozymes(g/L)0.5 0.0001 lgA lgA（g/Lg/L）1.0 0.03 1.0
35、 0.03 lymphocyte(lymphocyte(个个个个/ul/ul）800 0 800 0 Lactobacillus bifidus(Lactobacillus bifidus(个个个个/ul/ul）有有有有 未检出未检出未检出未检出 初乳初乳初乳初乳(colostrum)antibodies(colostrum)antibodies lactobacillus bifidus factor lactobacillus bifidus factor facilitates the passage of meconium(facilitates the passage of meco
36、nium(胎粪胎粪胎粪胎粪)过渡乳过渡乳过渡乳过渡乳(transitional milk)(transitional milk)成熟乳成熟乳成熟乳成熟乳(mature milk)(mature milk)composition of colostrum and mature milk 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（mg/L）1.61 0.27 Adva
37、ntages of Breastfeedingn nProvision of immunologic and enzymatic Provision of immunologic and enzymatic components components n nOptimal nutrient composition Optimal nutrient composition n nPromotes maternal-infant bonding Promotes maternal-infant bonding n nPromotes facial/muscular development Prom
38、otes facial/muscular development n nDecreased incidence of respiratory and Decreased incidence of respiratory and gastrointestinal infections gastrointestinal infections n nPossible reduced incidence of chronic diseases Possible reduced incidence of chronic diseases later in life later in life n nIn
39、expensive and convenient Inexpensive and convenient n nEasy for infant to digest Easy for infant to digest 母乳喂养幸福的源泉 每年的8月1日至7日 Introducing Solid Foodsn nNutritional needn nPhysiological capabilitiesn nPhysical abilityn nPreventing allergies 幼儿营养与膳食幼儿营养与膳食nutrition and dietary of preschool childrenn
40、 nIn n contrast contrast to to the the rapid rapid and and usually usually smooth smooth growth growth in in the the first first year,year,the the period period from from one one to to six six is is characterized characterized by by a a slower slower rate rate of of increase increase in in both both
41、 stature and weight.stature and weight.n nThe slowing of the rate of growth results in a less The slowing of the rate of growth results in a less pressing demand for nutrients than was observed in the pressing demand for nutrients than was observed in the first year.first year.n nMaturation of funct
42、ion,control of the body,and Maturation of function,control of the body,and development of social and cognitive abilities are more development of social and cognitive abilities are more pronounced than somatic growth during the preschool pronounced than somatic growth during the preschool years.years
43、.characteristics Newborn6 mo.12 mo.Increment1st year2nd year3rd yearNext 3y Weight(Kg)3.0696(200%)2.522Height(Cm)50667525(50%)10-127-87Head circumference34461221.270g)3.3.Minerals 1).Calciuml l Bone Bone grows grows in in volume volume and and density density as as well well as as length length l ll
44、ength increase 0.25mm/dlength increase 0.25mm/dl lWeight increase 1.2g/d,from 1500g-Weight increase 1.2g/d,from 1500g-3000g3000gRDA 13RDA 13 1200mg/d 161200mg/d 16 1000mg/d 181000mg/d 18 800mg/d800mg/d3.3.AI AI 1111 1000mg/d 1000mg/d 1414 1200mg/d 1200mg/d 1818 800mg/d800mg/d4.4.UL 11UL 11 2000 1420
45、00 14 2000 182000 18 200020002).Iron2).Iron iron is needed for:iron is needed for:l lgrowth of body tissuesgrowth of body tissuesl lincrease in blood volumeincrease in blood volumel l replacement replacement of of iron iron losses losses in in menstrual menstrual blood blood iron-deficiency anemiair
46、on-deficiency anemiaRDA 10RDA 10 12mg/d 13 12mg/d 13 20mg/d 18 20mg/d 18 12mg/d 12mg/dAI 11AI 11 18mg/d 14 18mg/d 14 25mg/d 18 25mg/d 18 20mg/d 20mg/dUL 50 50 50 UL 50 50 50 n n 3).Zinc3).Zinc RDA 10 RDA 10 15mg/d 15mg/d RNI 11 RNI 11 15mg/d 14 15mg/d 14 15.5mg/d 18 15.5mg/d 18 11.5mg/d 11.5mg/d UL
47、11 UL 11 34 14 34 14 35 18 35 18 37 374).Iodine4).Iodine goiter goiter RDA 10 RDA 10 120 120 g/d 13g/d 13 150 150 g/dg/d RNI 11 RNI 11 120 120 g/d 14g/d 14 150 150 g/dg/d UL 11 UL 11 800 14 800 14 800 18 800 18 1000 1000四维生素四维生素(Vitamins)1.Vit.A2.Vit.D3.B vitamins4.Vit.C一日食谱举例Anorexia nervosan n ref
48、usal to eat enough to maintain a normal body refusal to eat enough to maintain a normal body weight weight n n intense fear of gaining weight or becoming fat intense fear of gaining weight or becoming fat n n Sufferers are of the impression that they are fat and Sufferers are of the impression that
49、they are fat and often see themselves as being fat even though they are often see themselves as being fat even though they are obviously underweight.obviously underweight.n nexercise vigorously or use slimming pillsexercise vigorously or use slimming pillsn n often stop menstruating.often stop menst
50、ruating.n noften very secretive about their eating habitsoften 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 pare