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1、Nutrition During ChildhoodProf. Yan HuThe nutritional vulnerability of infantsLow nutritional storesBody composition of different populationThe nutritional vulnerability of infantsLow nutritional storesHigh nutritional demands for growthGrowthThe energy cost of growth is about: 0-3 months35% 12 mont
2、hs 5% 1-2 years 3% mid-adolescence 1-2% late teensnegligibleThe nutritional vulnerability of infantsLow nutritional storesHigh nutritional demands for growthRapid neuronal developmentThe nutritional vulnerability of infantsLow nutritional storesHigh nutritional demands for growthRapid neuronal devel
3、opmentEarly nutrition and future health (DOHaD)OBJECTIVEList the EAR of energy, RNI of some nutrients during infancyDescribe the advantages of breast milk & breastfeedingDescribe when, what and how to start solid feeding Know the feature of child energy metabolismKnow common feeding problems during
4、infancy Outline Nutrition basicsGastroenteric development and nutritionFeeding practiceNutrition assessmentOutline Nutrition basicsGastroenteric development and nutritionFeeding practiceNutrition assessmentDietary Reference Intakes(DRIs)vEstimated Average Requirement (EAR) vRecommended Dietary Allow
5、ance (RDA) or Recommended Nutrient Intakes (RNI)vAdequate Intake (AI) vTolerable Upper Intake Level (UL) Dietary Reference Intakes(DRIs)AI Category of nutrientsEnergyMacronutrients PRO,FAT,CHOMicronutrients minerals vitaminsOther diet elements cellulose water Category of nutrientsEnergyMacronutrient
6、sMicronutrientsOther diet elementsComponents of Energy RequirementsChildren need energy for the following:vBasal metabolismvPhysical activity vGrowthvExcretion vThermic effect of food (TEF)Energy Requirements DistributionDuring 06 Months020406080100120136BMRActivityTEFGrowthOthersageEAR 0 12mo 95 kc
7、al/kg.d1yr1100 kcal/d（M）2yr1200 kcal/d（M）3yr1350 kcal/d（M）5yr1600 kcal/d（M）7yr1800 kcal/d（M）10yr2100 kcal/d（M）EAR of Energy(2000(2000年，中国营养学会年，中国营养学会 ) ) Category of nutrientsEnergyMacronutrientsMicronutrientsOther diet elementsMacronutrientsProtein, carbohydrate (sugars and starches) and fats all p
8、rovide energy.The amounts are: 1 g protein provides 4 kcal 1 g carbohydrate provides 4 kcal 1 g fat provides 9 kcalEssential Amino AcidsAdult & Infants: leucine, isoleucine, valine, threonine, methionine, phenylalanine, tryptophan, lysine, histidineInfants only: cysteine, tyrosine, arginine. Protein
9、 Quantity and proportion of essential amino acids.Biological Value of a Protein vAll animal proteins (liver, meat, fish, cheese, milk etc) are complete.vBreast-milk proteins and eggs have the highest value.vMost vegetable proteins, except soy, are incomplete.Sources High-quality ProteinsageRNI0 12m1
10、.5-3g/kg.d1y- 35g/d 2y- 40g/d3y-45g/d4y-50g/d5y-55g/d6y-55g/d7y-60g/dRNI of ProteinRecommendationProtein should provide around 8%15% of energyapproximately a half of protein intake is obtained from animal sourcesThe RNI of protein is 1.53g/kg/d for infantComplementary action of protein should be con
11、sideredTo keep a good health, in a childs diet:Attention low protein in infant formula is associated with lower weight up to age 2yr:a randomized clinical trial. Am J Clin Nutr.2009;89:1836-45Increased protein intake increase the load of immature kidneyEssential fatty acidsn-6: linoleic acid(C18:2n-
12、6,LA) n-3:linolenic acid (C18:3n-3, ALA) EPA,C20:5DHA,C22:6arachidonic acid（ C20:6 , AA）FatSourceLinolenic acid & linoleic acid: plant oil EPA、DHA: fish oilAA：animal food egg yolk,meat,liverBreast milk: optimal ratio of DHA &AAFat should provide around 45%50% of energy(06mo), 35%40% (624mo), 30%35%(
13、27yr), 25%30%( 7yr)At least 1%3% of energy intake should come from EFAs.RecommendationTo keep a good health, in a childs diet:High risk factor of cardiovascular diseaseObesityExceeded Saturated fats intake:Attention Inadequate fat intake:Impacts on cognition developmentCHO should provide around 45%5
14、5% of energy during infancyRecommendationTo keep a good health, in a childs diet:Carbohydrate Exceeded CHO intake(80%E) -ObesityInadequate CHO intake(7yr 25-30% （2yr 50-60%) Category of nutrientsEnergyMacronutrientsMicronutrientsOther diet elementsVitamins:vFat-soluble vitaminsvWater-soluble vitamin
15、sMinerals:vMacro- mineralsvTrace elementsMicronutrients Vitamins RNI During Infancy Vit A Vit D Vit C Vit B1Vit A 1 gRE = 3.3IU Vit D 1 g = 40IU 400 gRE /d10 g /d40-50 mg /d0.2-0.3 mg /d Liver,milk,carrot,et alSun exposure、fish liver oil,et alFruit & fresh vegetableRice bran,bean,peanut,et alMineral
16、 RNI / Al during infancyAge Ca Fe I Zn (mg/d) (mg/d) (ug/d) (mg/d)(m) (AI) (AI) 0- 6 6-12 12-24 300 400 600 0.3 10 12 1.5 8.0 9.0 50 50 50 SourceMilk,beanLiver,egg yolkMarineproductsMeat,fish,milk Category of nutrientsEnergyMacronutrientsMicronutrientsOther diet elementsDietary Fiber Defined as the
17、non-starch polysaccharides (cellulose, hemicellulose A & B, gums, mucilages and pectins) and lignin. Characteristic: not fully digested in the small intestine and enter the colon.Function: regulating bowel movementSource: grain,fresh fruits and vegetableDietary Fiber AI -(North American)Life stage g
18、roupTotal fiber (mg/d)MaleFemaleInfants 0-6 moND 7-12 moNDChildren 1-3 yr19 4-8 yr25Adolescents 9-13 yr312614-18 yr3826low fiber intake: constipation,some gut diseases High fiber intake: possible trace metals deficiencyVery high fiber intake: reduction of caloric intakeAttention Water Water requirem
19、ent: infant adultAs long as adequate milk intake, other fluid is not necessary during infancy. Water AI -(North American)Life stage groupTotal water (L/d)MaleFemaleInfants 0-6 mo0.7 7-12 mo0.8Children 1-3 yr1.3 4-8 yr1.7Adolescents 9-13 yr2.42.114-18 yr3.32.3 Water AI of ChineseAge（yr）AI（L/d）Total liquidwater00.7-0.50.9-11.3-41.70.971.81.1
