儿科学英文课件：Nutrition-During-Childhood

NutritionDuringChildhoodNutritionDuringChildhoodThenutritionalvulnerabilityofinfantsLownutritionalstoresThenutritionalvulnerabilityBodycompositionofdifferentpopulationBodycompositionofdifferentThenutritionalvulnerabilityofinfantsLownutritionalstoresHighnutritionaldemandsforgrowthThenutritionalvulnerabilityGrowthTheenergycostofgrowthisabout:0-3months 35%12months 5%1-2years 3%mid-adolescence 1-2%lateteens negligibleGrowthTheenergycostofgrowtThenutritionalvulnerabilityofinfantsLownutritionalstoresHighnutritionaldemandsforgrowthRapidneuronaldevelopmentThenutritionalvulnerabilityThenutritionalvulnerabilityofinfantsLownutritionalstoresHighnutritionaldemandsforgrowthRapidneuronaldevelopmentEarlynutritionandfuturehealth(DOHaD)Thenutritionalvulnerability儿科学英文课件：Nutrition-During-ChildhoodOBJECTIVEListtheEARofenergy,RNIofsomenutrientsduringinfancyDescribetheadvantagesofbreastmilk&breastfeedingDescribewhen,whatandhowtostartsolidfeedingKnowthefeatureofchildenergymetabolismKnowcommonfeedingproblemsduringinfancyOBJECTIVEOutlineNutritionbasicsGastroentericdevelopmentandnutritionFeedingpracticeNutritionassessmentOutlineNutritionbasicsOutlineNutritionbasicsGastroentericdevelopmentandnutritionFeedingpracticeNutritionassessmentOutlineNutritionbasicsDietaryReferenceIntakes(DRIs)EstimatedAverageRequirement(EAR)RecommendedDietaryAllowance(RDA)orRecommendedNutrientIntakes(RNI)AdequateIntake(AI)TolerableUpperIntakeLevel(UL)DietaryReferenceIntakesEstimDietaryReferenceIntakes(DRIs)AIDietaryReferenceIntakesAICategoryofnutrientsEnergyMacronutrientsPRO,FAT,CHOMicronutrientsminerals

vitaminsOtherdietelementscellulose

water

CategoryofnutrientsEnerCategoryofnutrientsEnergyMacronutrientsMicronutrientsOtherdietelementsCategoryofnutrientsEnerComponentsofEnergyRequirementsChildrenneedenergyforthefollowing:BasalmetabolismPhysicalactivityGrowthExcretionThermiceffectoffood(TEF)ComponentsofEnergyRequiremeEnergyRequirementsDistributionDuring0~6Months020406080100120136BMRActivityTEFGrowthOthersEnergyRequirementsDistributiageEAR012mo95kcal/kg.d1yr1100kcal/d（M）2yr1200kcal/d（M）3yr1350kcal/d（M）5yr1600kcal/d（M）7yr1800kcal/d（M）10yr2100kcal/d（M）EARofEnergy(2000年，中国营养学会)ageEAR012mo95kcal/kg.d1yrCategoryofnutrientsEnergyMacronutrientsMicronutrientsOtherdietelementsCategoryofnutrientsEnerMacronutrientsProtein,carbohydrate(sugarsandstarches)andfatsallprovideenergy.Theamountsare:1gproteinprovides4kcal1gcarbohydrateprovides4kcal1gfatprovides9kcalMacronutrientsProtein,carbohyEssentialAminoAcidsAdult&Infants:leucine,isoleucine,valine,threonine,methionine,phenylalanine,tryptophan,lysine,histidineInfantsonly:cysteine,tyrosine,arginine.ProteinEssentialAminoAcidsAdult&IQuantityandproportionofessentialaminoacids.BiologicalValueofaProteinQuantityandproportionofAllanimalproteins(liver,meat,fish,cheese,milketc)arecomplete.Breast-milkproteinsandeggshavethehighestvalue.Mostvegetableproteins,exceptsoy,areincomplete.Sources–

High-qualityProteinsAllanimalproteins(liver,meageRNI0–12m1.5-3g/kg.d1y-35g/d2y-40g/d3y-45g/d4y-50g/d5y-55g/d6y-55g/d7y-60g/dRNIofProteinageRNI0–12m1.5-3g/kg.d1y-35RecommendationProteinshouldprovidearound8%~15%ofenergyapproximatelyahalfofproteinintakeisobtainedfromanimalsourcesTheRNIofproteinis1.5~3g/kg/dforinfantComplementaryactionofproteinshouldbeconsideredTokeepagoodhealth,inachild’sdiet:RecommendationProteinshouldpAttention

lowproteinininfantformulaisassociatedwithlowerweightuptoage2yr:arandomizedclinicaltrial.

AmJClinNutr.2009;89:1836-45IncreasedproteinintakeincreasetheloadofimmaturekidneyAttentionlowproteinininfanEssentialfattyacidsn-6:linoleicacid(C18:2n-6,LA)n-3:linolenicacid(C18:3n-3,ALA)EPA,C20:5DHA,C22:6arachidonicacid（C20:6,AA）FatEssentialfattyacidsn-6:linoSourceLinolenicacid&linoleicacid:plantoil

EPA、DHA:fishoilAA：animalfood–eggyolk,meat,liverBreastmilk:optimalratioofDHA&AASourceLinolenicacid&linoleiFatshouldprovidearound45%~50%ofenergy(0~6mo),35%~40%(6~24mo),30%~35%(2~7yr),25%~30%(>7yr)Atleast1%~3%ofenergyintakeshouldcomefromEFAs.RecommendationTokeepagoodhealth,inachild’sdiet:Fatshouldprovidearound45%~Highriskfactorofcardiovasculardisease

ObesityExceededSaturatedfatsintake:Attention

Inadequatefatintake:ImpactsoncognitiondevelopmentHighriskfactorofcardiovascCHOshouldprovidearound45%~55%ofenergyduringinfancyRecommendationTokeepagoodhealth,inachild’sdiet:CarbohydrateCHOshouldprovidearound45%~ExceededCHOintake(>80%E)--ObesityInadequateCHOintake(<40%E)--malnutrtionAttention

ExceededCHOintake(>80%E)--O

DistributionofEnergyIntakePRO8-15%FATCHO45-55%0-6m45-50%7-24m35-40%2-7yr30-35%>7yr25-30%

（>2yr50-60%)DistributionofEnergyIntakeCategoryofnutrientsEnergyMacronutrientsMicronutrientsOtherdietelementsCategoryofnutrientsEnerVitamins:Fat-solublevitaminsWater-solublevitaminsMinerals:Macro-mineralsTraceelementsMicronutrientsVitamins:Micronutrients

VitaminsRNIDuringInfancy

VitAVitDVitCVitB1VitA1µgRE=3.3IUVitD1µg=40IU400µgRE/d10µg/d40-50mg/d0.2-0.3mg/dLiver,milk,carrot,etalSunexposure、fishliveroil,etalFruit&freshvegetableRicebran,bean,peanut,etalVitaminsRNIDuringInfanMineralRNI/AlduringinfancyAgeCaFeIZn(mg/d)(mg/d)(ug/d)(mg/d)(m)(AI)

(AI)

0-66-1212-243004006000.310121.58.09.0505050SourceMilk,beanLiver,eggyolkMarineproductsMeat,fish,milkMineralRNI/AlduringinfancCategoryofnutrientsEnergyMacronutrientsMicronutrientsOtherdietelementsCategoryofnutrientsEnerDietaryFiberDefinedasthenon-starchpolysaccharides(cellulose,hemicelluloseA&B,gums,mucilagesandpectins)andlignin.Characteristic:notfullydigestedinthesmallintestineandenterthecolon.Function:regulatingbowelmovementSource:grain,freshfruitsandvegetableDietaryFiberDefinedasthenDietaryFiber–AI

--(NorthAmerican)LifestagegroupTotalfiber(mg/d)MaleFemaleInfants0-6moND7-12moNDChildren1-3yr194-8yr25Adolesce