临床营养学课程教学课件全册教学课件汇总

1、授课人：XX XX 临床营养学XX学院 XX 专业【全套课件】第1页，共1350页。 第1章 能量 第2章 蛋白质第3章 碳水化合物第4章 脂类 第5章 维生素目录精品课程第6章 矿物质和水第2页，共1350页。 第7章 植物性非营养生物活性物质 第8章 食物与药物的相互作用第9章 住院病人的营养膳食第10章 食谱的制定 第11章 营养与呼吸系统疾病目录精品课程第12章 营养与循环系统疾病第3页，共1350页。 第13章 营养与消化道疾病 第14章 营养与肝、胆、胰疾病第15章 营养与肾脏疾病第16章 营养与糖尿病 第17章 营养与肥胖病 目录精品课程第18章 营养与痛风第4页，共1350页。

2、 第19章 食物、营养与癌症 第20章 营养与烧伤第21章 创伤和手术病人的营养支持 第22章 营养与儿科疾病 第23章 营养与妇科疾病目录精品课程第24章 营养与其他疾病第5页，共1350页。临床营养学上 篇主页目录-Home第6页，共1350页。基本 概念 主页目录-Home第7页，共1350页。营养（nutrition）是指人体摄取、消化、吸收、转运和利用食物中营养物质以满足机体生理需要并排除废物的生物学过程。It is a biological process which nutrients and functional compositions in the foods are in

3、gested , digested, absorbed, transported , utilized and the waste materials are excreted.主页目录-Home第8页，共1350页。营养学（nutriology）研究膳食、营养与人体健康关系的科学，广义的营养学，还包括社会、经济、文化、生活习惯和膳食心理等多种领域和学科。 It is a science of foods and the nutrients and other substances they contain, and of their actions within the body. A br

4、oader definition includes the social, economic, cultural, and psychological implications of food and eating. 主页目录-Home第9页，共1350页。营养素（nutrients）食物中可给人体提供能量、机体构成成分和组织修复以及有生理调节功能的化学成分。Chemical substances obtained from food and used in the body to provide energy, structural materials, and repair of the

5、bodys tissues; Nutrients may also reduce the risk of some diseases. 主页目录-Home第10页，共1350页。 protein lipids carbohydrate (dietary fiber) minerals vitamin water macronutrientsmicronutrients植物化学物：phytochemicals 非营养素 植物的次级代谢产物Classification of Nutrients主页目录-Home第11页，共1350页。营养素生理需要量（Nutritional Requirement

6、）是指能保证人体健康，达到应有发育水平并能充分有效地完成各项体力、脑力活动所需要的能量和各种营养素的必需的量。The lowest continuing intake of energy and nutrients that maintain the specified criterion of adequacy (that will maintain the specific biochemical and physiological functions of the body)最低需要量：指仅能维持生理平衡或不致发生营养缺乏病的量。 适宜需要量：指维持人体健康、促进生长发育、保证最高劳动效

7、率的量。主页目录-Home第12页，共1350页。营养素推荐摄入量（Recommended Nutrient Intake，RNI），是指通过膳食，满足某一特定性别、年龄及生理状况群体中绝大多数（97%98%）个体需要的能量和各种营养素的量。 Reference Nutrient Intake (RNI): The RNI is the amount of a nutrient that is enough to ensure that the needs of nearly all the group (97.5%) are being met . 主页目录-Home第13页，共1350页。

8、第一章 能量Energy 主页目录-Home第14页，共1350页。单位 1J：一牛顿力把1kg物体移动1m所需要的能量 1 kcal=4.184KJ 1kJ=0.239 kcal 1000 kcal=4.184MJ 1MJ=239 kcal产能营养素 碳水化合物：（1g4kcal）：55%65% 蛋白质：（1g4kcal）：10%15% 脂 肪：（1g9kcal）：20%30% 酒（乙醇）：1g7kcal主页目录-Home第15页，共1350页。 第一节 人体的热能消耗 Section 1 The body spends energy （一）基础代谢（60%75%）（二）体力活动(15%30

9、%)（三）食物的特殊动力作用（TEF）(10%)主页目录-Home第16页，共1350页。(一) Basal Metabolism 1.Definition The energy needed to maintain life when a body is at complete rest after a 12-hour fast (禁食). 2. Basic energy expenditure, BEE (基础代谢的热能消耗) (1) Basal metabolic rate, BMR (基础代谢率) Definition The rate of energy used for metab

10、olism under basal condition, usually expressed as kcal per surface of body per hour (or kcal per kilogram body weight per hour) 主页目录-Home第17页，共1350页。3. Calculation of BEE BEE = BMRbody surface areatimeBMR (refer to the table)body surface area()0.0065body size(cm) 0.0126body weight(kg) 0.1603 1). Acc

11、ording to BMR主页目录-Home第18页，共1350页。表1-10 人体基础代谢率年龄(岁) 男 女 年龄 男 女kJ/m2 kcal/m2 kJ/m2 kcal/m2 (岁) kJ/m2 kcal/m2 kJ/m2 kcal/m2 1221.853.0221.853.030154.036.8146.935.13214.651.3214.251.235152.736.5146.435.05206.349.3202.548.440151.936.3146.034.97197.747.3200.045.445151.536.2144.334.59189.945.2179.142.850

12、149.835.8139.733.911179.943.0175.742.055148.135.4139.333.313177.042.3168.640.360146.034.9136.832.715174.941.8158.837.965143.934.4134.732.217170.740.8151.936.370141.433.8132.631.719164.039.2148.535.575138.933.2131.031.320161.538.6147.735.380138.133.0129.330.925156.937.5147.335.2引自营养与食品卫生学，第三版，第21页。主页

13、目录-Home第19页，共1350页。2). Harris and Benedict formula 4). The method suggested by WHO: refer to the Table BEE(man)66.4730+13.75bw.(kg)+5.0033bs.(cm) - 6.7550age(y) BEE(woman)65.0955+9.463bw.(kg)+ 1.8496bs.(cm) - 4.6756age(y)Man BEE (per hour) 1.00 kcal/kg.hr body weight (kg)Woman BEE (per hour)0.95 kca

14、l/kg.hr body weight (kg)3). Simple formula ( for adult ) Resting Metabolic Rate, RMR ( 静息代谢率 ) energy expenditure of body under the rest after 4-hour fast. RMR is more than BMR. 主页目录-Home第20页，共1350页。WHO 建议的计算基础代谢公式年龄(y)公式（男）公式（女）03(60.9 W)-54(61.0W)-51310(22.7 W)+495(22.7 W)+4991018(17.5 W)+651(12.2

15、W)+7461830(15.3 W)+679(14.7 W)+4963060(11.6 W)+879(8.7W)+82960(13.5 W)+487(10.5 W)+596注:W为体重(kg)。摘自Technical Report Series724,Geneva,WHO,1985。主页目录-Home第21页，共1350页。表1-12 人体24小时静息代谢参考值(Kcal)年龄(y)40 50 57 64 70 77 84 91 100体重（kg） 男性10181351152616481771187619982121224324011830129114441551165817501857196

16、4207122093060134314591540162116911772185319352039 60102711621256135114231526162117161837女性10181234135614411527160016851771185619661830108412311334143715251628173118331966306011771264132513861438149915601621169960101611211195126813311404147815521646摘自Nutrition Science and Application,第二版，第190页,1997。主

17、页目录-Home第22页，共1350页。4. The factors affecting BMR (1) Body surface area: (or lean mass fatty tissue)(2) Gender: male female (3) Age: 2% of decline per 10 years after age 30 5% of decline per 10 years after age 60 (4) Nutrition state: Low energy intake decreases BMR about 10%-20% (5) Physiological sta

18、tus: Pregnancy increases BMR (6) Body temperature: Fever increases BMR (7) High or low air temperature, hormone system activity, nerve and eating too much increase BMR (Adaptive Thermogenesis , 适应性生热作用) (8) Caffeine and tobacco increase BMR 主页目录-Home第23页，共1350页。(二) Physical Activity The energy neede

19、d during physical activity depends on body lean mass, intensity (强度) and time of activity. The energy is about 15%-30% of total energy use in sedentary(久坐的) people. 主页目录-Home第24页，共1350页。(三) Specific dynamic action (or Thermic Effect of Food, TEF)食物特殊动力作用或食物热效应 1. Definition The amount of extra energ

20、y used by body during digestion, absorption, metabolism, and storage of energy-yielding nutrients. 2. Energy expenditure 5%-6% of total calorie produced by carbohydrates carbohydrateslipids 4%-5% of that protein 30% of that mixed food 10% of total energy consumed（消耗） 主页目录-Home第25页，共1350页。3. The mech

21、anism Energy storage: ATP and fat ATP: protein 32%-34% carbohydrate and lipids:38%-40% FAT: lipids fat glucose glycogen or fat amino acid protein or fat主页目录-Home第26页，共1350页。4.Affecting factors of TEF(1)protein-rich food is much higher than others(2) large meals show higher values than normal meals(3

22、) TEF decreases with advancing age. (4) Meal frequency. 主页目录-Home第27页，共1350页。(一) 计算法calculation 三、Estimating energy requirem 能量需要量的确定 能量消耗的计算=BEEPAL（physical activity level） 活动水平工作内容举 例PAL系数男女轻中重办公室工作、修理电器钟表、售货员、酒店服务员、化学实验操作、讲课等学生日常活动、机动车驾驶、电工安装、车床操作、金工切割等非机械化农业劳动、炼钢、舞蹈、体育运动、装卸、采矿等1.551.782.101.561.

23、641.82中国营养学会建议的我国成人活动水平分级(2001年)主页目录-Home第28页，共1350页。 中国1859岁居民能量推荐摄入量估算年龄/岁 RNI/(kcal/d) 年龄/岁 RNI/(kcal/d) PAL 男 女 男 女 男 女 18495059参考体重(kg) 63 56 参考体重(kg) 65 58 BEE1561 1253BEE1551 1267轻2420 1955轻2404 19761.55 1.56中2779 2055中2761 20791.78 1.64重3278 2280 重3257 2306 2.10 1.82 摘自葛可佑主编中国营养科学全书，第27页主页目录

24、-Home第29页，共1350页。（一）计算法2. Nutritional survey (or Dietary survey) 膳食调查 57天 摄入食物种类数量， 食物成分表或食物成分分析软件三、Estimating energy requirements 能量需要量的确定 主页目录-Home第30页，共1350页。(二)测量法measuring energy use by body直接测热法（direct calorimetry）： 测热装置，水温变化间接测热法(indirect calorimetry) （产生CO2量/耗氧量=呼吸商）生活观察法 24h 各种活动及其时间，查日常活动能

25、量消耗表能量平衡法：1kg体重=29MJ（6931 kcal）三、Estimating energy requirements 能量需要量的确定 体重增加（能量正平衡）日能量消耗量(MJ)= 能量摄入量(MJ)平均体重增加量(kg)29MJ/调查天数(d)体重减少（能量负平衡）日能量消耗量(MJ)= 能量摄入量(MJ)+平均体重减少量(kg)29MJ/调查天数(d)主页目录-Home第31页，共1350页。Energy Recommended Nutrition Intake, RNI 热能推荐摄入量 中国居民膳食能量推荐摄入量(RNIs)年龄/岁RNI/(MJ/d) 男 女RNI/(kcal

26、/d) 男 女婴儿00.4MJ/(kg.d) 95kcal/(kg.d)0.50.4MJ/(kg.d) 95kcal/(kg.d) 主页目录-Home第32页，共1350页。 年龄/岁 RNI/(MJ/d) 男 女 RNI/(Kcal/d) 男 女儿童14.604.401100105025.024.811200115035.645.431350130046.065.831450140056.706.271600150067.106.671700160077.537.101800170087.947.531900180098.367.9420001900108.808.3621002000111

27、0.049.20240022001412.009.6229002400（续表）中国居民膳食能量推荐摄入量(RNIs)主页目录-Home第33页，共1350页。（续表）中国居民膳食能量推荐摄入量(RNIs) 年龄/岁 RNI/(MJ/d) 男 女 RNI/(kcal/d) 男 女成年 18 轻体力活动10.038.8024002100 中体力活动11.299.6227002300 重体力活动13.3811.3032002700 孕妇 46个月+0.84+200 79个月+0.84+200 乳母+2.09+500注：AI,非乳母喂养应增加20%。主页目录-Home第34页，共1350页。（续表）中

28、国居民膳食能量推荐摄入量(RNIs) 年龄/岁 RNI/(MJ/d) 男 女 RNI/(MJ/d) 男 女 50 轻体力活动9.628.0023001900 中体力活动10.878.3626002000 重体力活动13.009.2031002200 60 轻体力活动7.947.5319001800 中体力活动9.208.3622002000 70 轻体力活动7.947.1019001700 中体力活动8.808.0021001900 807.747.1019001700主页目录-Home第35页，共1350页。QuestionDescribe each component of energy

29、expenditure. What factors influence each? How can energy expenditure be estimated? 主页目录-Home第36页，共1350页。第二章 蛋白质Protein 主页目录-Home第37页，共1350页。含量：体重 16%19%更新： 动态平衡，不断更新，每天约3%，肠和骨髓最快。功能： 1.机体构成成分 2.构成各种生理活性物质和重要的生理功能 3.提供热能 人体中蛋白质主页目录-Home第38页，共1350页。人体组织的构成成分 Required for building and repair of body ti

30、ssues 构成各种生理活性物质和重要的生理功能 Enzymes, hormones, and many immune molecules are proteins. Essential body processes such as water balancing, nutrient transport, and muscle contractions require protein to function. 提供热能 Protein is a source of energy。肽、氨基酸特有的生理功能 第一节 蛋白质功能Section 1 Functions of protein主页目录-H

31、ome第39页，共1350页。The first structure 蛋白质(protein) 氨基酸（Amino acid, AA） 非必需AA(nonessential-)：9种 半必需AA（条件必需AA）：2种 （semi-,or conditionally-）必需AA（essentional-）：9种 多肽（poly-）10 AA以上寡肽（oligo-）410 AA以下 3肽（tri-）3AA 2肽（di-）2AA 肽(peptide) 主页目录-Home第40页，共1350页。1. 种类：20种 (1) 必需AA（EAA） (2) 非必需氨基酸（NEAA） (3) 半必需氨基酸 (

32、semi-EAA or conditional EAA) 半胱酸（Cysteine）蛋氨酸（Methionine） 酪氨酸（Tyrosine）苯丙氨酸（Phenylalanine）2. 必需氨基酸： 人体不能合成或合成速度不能满足机体需要，必需从食物中直接获得的AA。 Amino acids that the body cannot synthesize in amount sufficient to meet physiological needs and has to obtain them from foods. 第二节 氨基酸和必需氨基 Section 2 Amino acid and

33、 EAA主页目录-Home第41页，共1350页。氨基酸英文氨基酸英文必需氨基酸非必需氨基酸异亮氨酸Isoleucine (Ile)丙氨酸Alanine (Ala)亮氨酸Leucine (Leu)精氨酸Arginine (Arg)赖氨酸Lysine (Lys)天门冬氨酸Aspartic acid (ASP)蛋氨酸Methionine (Met)谷氨酸Asparagine (Asn)苯丙氨酸Phenylalanine (Phe)谷氨酰胺Glutamic acid (Glu)苏氨酸Threonine (Thr)甘氨酸Glycine (Gly)色氨酸Tryptophan (Trp)脯氨酸Prolin

34、e (Pro)缬氨酸Valine (Val)丝氨酸Serine (Ser)组氨酸*Histidine (His)天冬酰胺Asparagine (ASN)条件必需氨基酸半胱氨酸Cysteine (Cys)酪氨酸Tyrosine (Tyr)表 1-1 人体内的氨基酸*组氨酸为婴儿必需氨基酸，成人需要量可能较少。 摘自Modern Nutrition in Health and Disease,第9版,第14页,1999。主页目录-Home第42页，共1350页。氨基酸模式(AA Pattern)和限制氨基酸 (limiting AA)1. 氨基酸模式 (AA Pattern) ： 蛋白质中各种必需

35、氨基酸的构成比例。主页目录-Home第43页，共1350页。氨基酸人体全鸡蛋牛奶牛肉大豆面粉大米异亮氨酸4.0亮氨酸7.0赖氨酸2.3蛋氨酸+半胱氨酸2.3苯丙氨酸+酪氨酸6.0苏氨酸4.0缬氨酸5.0色氨酸1.01.01.01.01.01.01.0表1-2 几种食物和人体蛋白质氨基酸模式数据摘自营养与食品卫生学，第3版，第9页。主页目录-Hom

36、e第44页，共1350页。限制氨基酸 （limiting amino acid） 与人体蛋白质模式比较，食物蛋白质中含量相对较低的必需AA。 The essential amino acid found in the shortest supply relative to the amount needed for protein synthesis in the body. FourAA are mostlikelytobe limiting: Lysine，Methionine，Threonine，Tryptophan .主页目录-Home第45页，共1350页。参考蛋白、完全蛋白和蛋白质

37、的互补作用参 考 蛋 白用于测定食物蛋白质质量的标准蛋白。 Reference Protein: A standard against which to measure the quality of other proteins.完 全 蛋 白必需氨基酸模式与人体蛋白质相对一致，能满足机体蛋白质合成需要的食物蛋白质。 Complete Protein: A dietary protein containing all the essential amino acids in relatively the same amounts that human being required. (incl

38、uding animal protein and soy protein ) Incomplete protein蛋 白 质 互 补 将两种或两种以上的食物蛋白质混合事用，使不同食物中必需氨基酸以多补少，从而提高膳食蛋白质的营养价值。 Complementary Protein: Two or more proteins whose amino acids assortments complement each other in such a way that the essential amino acids missing from one are supplied by the othe

39、r.主页目录-Home第46页，共1350页。第三节 蛋白质的消化、吸收和代谢 消化和吸收（digestion and absorption） 主页目录-Home第47页，共1350页。Gastric Juice : 1. Acid denaturation 2. 胃蛋白酶Pepsin- not highly specific but preferential attack on bonds adjacent to aromatic AA and 亮氨酸(leucine). 3.Carboxypeptidase-terminal aromatic or branch-chained; argi

40、nine or lysine; neutral- dietary Protein Panc- elastase(弹性蛋白酶)- arometic AA reatic trypsin(胰蛋白酶)- NH2- juice chymotrypsine(糜蛋白酶) - lysine, arginine dipeptide , tripeptide and free AA absorbed through the mucosal cells of small intestine 肽酶peptidase through three active free AA transport systems neut

41、ral-,basic- and acidic-. Liver and other organs 主页目录-Home第48页，共1350页。代谢与氮平衡 (metabolism and nitrogen balance)1.代谢摄入蛋白质90克 消 化 道(30%)肌肉(50%)器官体液其它机体蛋白质氨基酸池粪便10g(1.6gN)尿75g(12gN)其它5g(0.8gN)(20%)肠道内源性蛋白质70g消化、吸收蛋白质150g图1-1 蛋白质代谢及氮平衡主页目录-Home第49页，共1350页。氮平衡（Nitrogen balance）(1)必要的氮损失（obligatory nitrogen

42、 losses） (2) 氮平衡： BI（UFS）Positive nitrogen balanceN in N outN in = N outNitrogen equillibriumNegativenitrogen balanceN in N out主页目录-Home第50页，共1350页。第四节 食物蛋白质营养学评价 (一)蛋白质含量 (content）(2)表观消化率（apparent -）:(二)蛋白质消化率(digestibility)(1)真消化率（true -）主页目录-Home第51页，共1350页。(三)蛋白质利用率（utilization）1.Biological val

43、ue, BV:生物价 The amount of protein nitrogen that is retained for growth and maintenance,expressed as a percentage of the protein nitrogen that has been digested and absorbed. To determine the actual value of an absorbed protein as it is used by the body. 主页目录-Home第52页，共1350页。2.Net Protein Utilization,

44、NPU蛋白质净利用率 The amount of protein nitrogen that is retained from a given amount of protein nitrogen eaten. To determine the amino acid composition and digestibility of a test protein.主页目录-Home第53页，共1350页。 3.Protein Efficiency Ratio, PER: 蛋白质功效比值 A measure of protein quality assessed bydetermining how

45、 well a given protein supportsweight gain in growing rats. Used to establish the protein quality for infantformulas and baby foods.主页目录-Home第54页，共1350页。4.Amino Acid Score,AAS氨基酸评分 The lowest score is the score of limiting AA which is the AAS of the protein. A method of evaluating protein quality by

46、comparing a test proteins amino acid pattern with that of a reference protein; sometimes called chemical scoring. 主页目录-Home第55页，共1350页。表1-4 几种食物和不同人群需要的氨基酸评分模式氨基酸人群（mg/g 蛋白质）1岁以下 25岁 1012岁 成人食物(mg/g蛋白质)鸡蛋 牛奶 牛肉组氨酸26191916222734异亮氨酸46282813544748亮氨酸93664419869581赖氨酸66584416707889蛋氨酸+半胱氨酸4225221757334

47、0苯丙氨酸+酪氨酸726322199310280苏氨酸4334289474446缬氨酸55352513666450色氨酸171195171412总计460339241127512504479摘自WTO Technical Report Series 724,第12页,1985年。主页目录-Home第56页，共1350页。表1-5 常见几种食物蛋白质质量食物BVUPN(%)PERAAS全鸡蛋94843.921.06全牛奶87823.090.98鱼83814.551.00牛肉74732.301.00大豆73662.320.63精制面粉52510.600.34大米63632.160.59土豆6760

48、0.48摘自“营养与食品卫生学”，第3版，第11页。主页目录-Home第57页，共1350页。5.Protein Digestibility corrected AAS, PDCAAS:（经消化率校正的氨基酸评分） A measure of protein quality assessed bycomparing the amino acid score of a food proteinWith the amino acid requirements of preschool-ageChildren and then correcting for the truedigestibility

49、of the protein; Recommended by the FAO/WHO and used toestablish protein quality of foods for daily valuepercentage on food labels. 主页目录-Home第58页，共1350页。表1-6 几种食物蛋白质的PDCAAS食物蛋白PDCAAS食物蛋白PDCAAS酪蛋白1.00斑豆0.63鸡蛋1.00燕麦粉0.57大豆分离蛋白0.99花生粉0.52牛肉0.92小扁豆0.52豌豆粉0.69全麦0.40菜豆0.68摘自Understanding Nutrition, 第7版，第21

50、5页，1996年。主页目录-Home第59页，共1350页。 第五节 蛋白质营养不良、营养状况评价及食物供给 Kwishiorkor: A Ghanaian word meaning “the evil spirit that infects the first child when the second child is born”. The second child suddenly switched from nutrient dense, protein-rich breast milk to a starchy, protein-poor cereal, soon begins to

51、 sicken and die.Marasmus: A severe deprivation of food over a long time (chronic PEM) and therefore is caused by an inadequate energy and protein intake ( and by inadequate essential fatty acids,vitamins, and minerals as well).主页目录-Home第60页，共1350页。蛋白质营养不良KwashiorkorMarasmus主页目录-Home第61页，共1350页。Maras

52、mus Kwashiorkor Infancy(less than 2 yr) older infants and young children(1-3 yr) Develops slowly;chronic PEM rapid onset; acute PEM Severe weight loss some weight loss Severe muscle wasting, with fatSome muscle wasting,with retention of some body fatGrowth:60% weight-for-age growth:60%-80% weight-fo

53、r-age 主页目录-Home第62页，共1350页。No detectable edema edemaNo fatty liver enlarged fatty liver Anxiety焦急, apathy淡漠 apathy, misery痛苦, irritability易怒, sadness Good appetite possible loss of appetite Hair is sparse,thin and dry; Easily pulled out hair is dry and brittle; easily pull out; changes color; become

54、s straight Skin is dry, thin, and easily wrinkles skin develops lesion主页目录-Home第63页，共1350页。 高蛋白质膳食过多的危害problems of excess protein） Adult Bone Loss (Osteoporosis骨质疏松): Calcium excretion rises as protein intake increases. Recommen-dation of calcium-to-protein is more than 20(mg) to 1(g). Cancer: popul

55、ation studies suggest a correlation between high intakes of animal protein and some type cancer ( cancer of colon, breast,kidneys, pancreas, and prostate) Gain Weight: Protein-rich foods are often fat-rich foods. Others. Heart Disease: Foods rich in animal protein tend tobe rich in saturated fats an

56、d cholesterol; homocystei（高半胱氨酸）may be an independent risk factor for heart disease.主页目录-Home第64页，共1350页。蛋白质营养状况评价Assessment of protein nutrition in human bodySerum albumin: 35-50g/L Serum transferritin: 2.2-4g/L Retinol-binding protein: 26-76mg/L Thyroxine-binding-albumin:280-350mg/L主页目录-Home第65页，共

57、1350页。蛋白质供给量和食物来源 （DRIs and Food source） RNI: 1) 数量 2）质量 (优质蛋白质)Food Source: animal and plant foods. Milk and Soy been主页目录-Home第66页，共1350页。中国居民膳食蛋白质的推荐摄入量: RNI与RDAAge (year)RNI（2000）RDA（1988）manwomanmanwoman01.53.0g/kg.bw.2.04.0g/kg.bw.0.51353535352404040403454545454505050455555555506555555557606060

58、608656565609656565651070657065主页目录-Home第67页，共1350页。RNI与RDA：续表Age (year)RNI（2000）RDA（1988）manwomanmanwoman11757570807080148580809080轻7565807018中80709080重908010090孕期早+5中+15+15晚+20+25乳 母+20+256075657565主页目录-Home第68页，共1350页。QuestionWhat is the difference between essential and nonessential amino acids? E

59、xplain these terms: protein-sparing effect, amino acid pattern, protein complementary action . How to evaluate the food protein What are the health consequences of ingesting inadequate protein and energy? 主页目录-Home第69页，共1350页。 第三章 碳水化合物 carbohydrate 李 李主页目录-Home第70页，共1350页。单糖(monosaccharide) 双糖(disa

60、ccharide) 寡糖(oligosaccharide) 多糖(polysaccharide)一、分类Classification主页目录-Home第71页，共1350页。（一）单糖 (monosaccharide)1.葡萄糖（Glucose）: D-and L-. A little in the natural foods.2.果糖（ Fructose）: 主要存在于水果和蜂蜜中，人工制造的玉米糖浆中含 40%-90% 。 Glucose主页目录-Home第72页，共1350页。3. 半乳糖（Galactose）：以乳糖形式存在于 天然食物中。 It is not usually foun