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1、特殊人群的營養(yǎng)Dietaryrequirementsforspecificpopulations李穎營養(yǎng)與食品衛(wèi)生學(xué)教研室DepartmentofNutritionandFoodHygienespecificpopulationsPregnantwomenandlactatingmothersInfants、children、adolescenceandolderpeopleAthletesspecificenvironmentofgroups第一節(jié)孕婦和母乳的營養(yǎng)與膳食Nutrientanddietaryrequi
2、rementsof pregnantwomenandlactationmotherspregnancylactationDietaryenergyrequirementsDeficientenergyneedslowbirthweightinfantslimitsthesuccessofbreastfeeding一、pregnantwoman（一）妊娠期的生理特點(diǎn)（physiologicalchangsinpregnancy）1．內(nèi)分泌(endocrine)2．血液(blood)3．腎臟(renalsystem)4．
3、消化(gastrointestinalsystem)5．體重(bodyweight)（一）physiologicalchangsinpregnancy1．內(nèi)分泌(endocrine)（1）人絨毛膜促性腺激素（humanchorionicgonadotropin，HCG）（2）人絨毛膜生長素（humanchorionicsomatomammotropin，HCS）（3）雌激素(estrogen)（4）孕酮（progesterone）pregnantwomanEstrogen(pg/ml)雌激素HCG絨毛膜促性腺激素pr
4、ogesterone孕酮RegulationofhormonechangesinpregnancyWeeksofgestationWeeksofgestationWeeksofgestationWeeksofgestationTSH(1)Bloodvolume45%~50%15%~20%2．BloodPhysiologicAnemiaofPregnancyNon-pregnantNon-pregnantlLatepregnancyLatepregnancyPlasmaproteinPlasmaalbumen(2)Pl
5、asmaprotein70g/L60g/L40g/L25g/LRelativelydilutionofblood3．RenalsystemRenalplasmaflow75%Glomerularfiltrationrate50%Renalreabsorption腎小球?yàn)V過率腎小管的重吸收腎血漿流量蛋白質(zhì)代謝產(chǎn)物尿素（urea）、尿酸(uricacid)、肌酸(creatine)、肌酐(creatinine)等排泄增多;尿中葉酸、葡萄糖排出量增加，出現(xiàn)糖尿。4．GastrointestinalsystemEndocri
6、nechangesareprobablyresponsibleforthesymptomsofnausea(惡心)、vomiting(嘔吐)、waterbrash(反酸)、dyspepsia(消化不良)、constipation(便秘).Prolongedtransittimeoffoodincreasenutrientabsorption,suchascalcium（鈣）、iron（鐵）、folicacid(葉酸)、VitaminB12(維生素B12).5．BodyweightThenutritionalcosto
7、fpregnancytheproductsofconception,胎兒(fetus)、羊水(amnioticfluid)和胎盤(placenta)母體血液(motherblood),細(xì)胞外液(extracellularfluid)，子宮(uterus),乳腺(mammaryglands)5．BodyweightBMIRecommendedweightgain（kg）malnutrition<19.812.5～18.0normal19.8～26.011.5～16.0overweight>26.0～29.07.0～11
8、.5obesity>29.06.0～6.8（二）妊娠期的營養(yǎng)需要(Nutrientrequirementsofpregnancy)1．能量(energycostsofpregnancy)ReferenceNutrientIntakes(RNI):mid-andlate-gestation:+0.83MJ.2．蛋白質(zhì)(protein)Refere
