兒童營(yíng)養(yǎng)與相關(guān)疾病課件

ChildrenNutritionandRelativeDiseasesGroupmembersSuNanXianYixinSunYanMaLanfang

ChildrenNutritionand

RelativeDiseasesInfantfeedingandIntroductionofsolidsMalnutritionRicketsOfVitaminDDeficiencyNormalnutritionalrequirements

Infantsandchildrenhaveahighmetabolicrate,largecalorificrequirements,andcorrespondingrapidfluidturnover.Asatisfactorydietaryintakeshouldmeetthenormalrequirementsforenergyandprotein,togetherwithprovidinganadequatesupplyofvitaminsandtrace（微量）elements.Infantsandchildrenarevulnerabletounder-nutritionbecauseof:Lownutritionalstoresoffatandprotein;Growthcreatinghighnutritionaldemands(at4monthsofage,30%ofaninfant’senergyintakeisusedforgrowth,butat3yearsofagethishasfallento2%);Braingrowth:thebrainisproportionallylargerininfantsandisgrowingrapidlyduringthelasttrimester（孕期后三個(gè)月）andfirst2yearsoflife.Itisvulnerabletoenergydeprivation（剝奪）duringthisperiod.InfantfeedingAninfant’sprimarysourceofnutritionismilk,eitherhumanbreastmilkorso-called“formula”（配方）milkbasedonmodified（改良的）cow’smilk.Cow’smilkand

Modifiedcow’smilkformulas

Unmodified,whole,pasteurized（巴氏消毒的）cow’smilkisunsuitableasamaindietforinfantsundertheageof1yearbecause:Itcontainstoomuchproteinandsodium.ItisdeficientinironandvitaminsModifiedcow’smilkformulashaveamodifiedcaseintowheyratio（酪蛋白和乳清蛋白比例）,reducedmineralcontent,andarefortified（加強(qiáng)的）withironandvitamins.BreastfeedingThisisthepreferredmethodformostinfants.Ingeneral,thereisnodoubtthat“breastisbest”.DisadvantagesofbreastfeedingVolumeofintakeuncertainTransmissionofdrugsNutrientdeficiencies:InsufficientvitaminKtopreventhaemorrhagic（出血的）diseaseofthenewbornVitaminDdeficiency(rickets佝僂病)mayoccurifthereisprolongedbreast-feedinganddelayedweaning（斷奶）WeaningTheintroductionofsolidfoods(weaning)isusuallyundertakenbetween3and4monthsofage.Atthisagetheinfantcancoordinateswallowingandhasreasonableheadcontrol.After6monthsofage,breastmilkalonebecomesnutritionallyinadequateandcontinuedbreastfeedingwithoutintroductionofsolidswillleadtoenergy,vitamin,andirondeficiency.Introductionofsolids6-7monthsAbletochew,Introducelumpy（塊狀）foodsandvarietyoftastesandtextures（材質(zhì)）8-9monthsBreadandbutter,fruit12monthsAdultfoodinsmallbitsMalnutritionmalnutritionCaloricmalnutritionProteinmalnutritionCaloric-Proteinmalnutrition

InChinaCaloricmalnutritionCaloric-ProteinmalnutritionProteinmalnutritionClinicalSyndromesofprotein-energymalnutrition

Marasmus(消瘦）kwashiorkor(惡性營(yíng)養(yǎng)不良)Marasmus(消瘦）

wasted(weightlessthan60%ofmeanforage)wizenedappearance（干癟的）Withdrawn（孤僻的）Apathetic（冷漠的）ManagementNutritionmaybesuppliedEnterally,viathegastrointestinaltract:preferredParenterally,directlyintothecirculationRicketsOfVitaminDDeficiency

It’sageneralandchronicnutritionaldisease.（全身慢性營(yíng)養(yǎng)性疾?。〤a、PmetabolismdisorderDeficiencyofvitaminD

ChangesofbonesSkinundertheeffectOfultravioletlightplacentaSourceofvitaminDfoodlittlelittleMainsource胎盤DeficiencyofvitaminDinperinatalperiod（圍產(chǎn)期）DecreasedexposuretothesunFastgrowSomediseasesdisturbtheabsorptionofvitaminDVitDdeficiencyLowCaPTHPreabsorptioninkidneyOsteoclasthyperplasiaSerumCalevelrisetonormalornearnormalLowlevelofserumPandCaosteomalaciaBonesareinadequatelymineralizeddeformityOsteoidaccumulationALPSerumP破骨細(xì)胞增生骨質(zhì)礦化不全骨質(zhì)軟化畸形類骨質(zhì)堆積Neuromuscularsymptoms(asaresultofhyperexcitability)

1.Irritable（煩躁的）、easycrying2.Hidrosis（多汗）followingbaldocciput

(theinfantalwaysrubitsheadagainstbedsbecauseofhidrosis)Ⅱskeletalchanges1.Osteomalacia（骨質(zhì)軟化）Craniotabes（顱骨軟化）

Bowingoflegs

(causedbyweightbearing)2.Osteoidaccumulation（類骨質(zhì)堆積）BowedlegsO型腿（膝內(nèi)翻）KnockkneesX型腿（膝外翻）handandfootbracelet手鐲、腳鐲Squarehead方顱pigeonbreast雞胸Harrison'sgroove肋膈溝X-rayimagingDecreasedbonedensityPeriosteumthicken（骨膜增厚）Epiphysealplatewiden（骺板變寬）Cuppedmetaphyses（骨骺端杯口樣變）ricketsnormalEpiphysealplatewiden骺板增厚Cuppedmetaphyses骨骺杯口樣變BloodbiochemistrySerumcalcium:lowornormalSerumphosphorus:lowSerumparathormone(PTH):elevatedSerumalkalinephospha