《预防医学英文版课件：2-fat,energy,vitamin and minerals》由会员分享，可在线阅读，更多相关《预防医学英文版课件：2-fat,energy,vitamin and minerals（89页珍藏版）》请在金锄头文库上搜索。
1、 Lipid Lipid fat/triglyceridesaturatedfattyacidfattyacidLipidunsaturatedfattyacid(MUFA,PUFA)lipoid:phospholipid,glucolipid,steroids,lipoproteinsGlycerin/GlycerolClassificationClassificationTriglycerides of human body mainly distribute Triglycerides of human body mainly distribute among abdomen, subc
2、utaneous tissue and among abdomen, subcutaneous tissue and muscular fiber. muscular fiber. Saturation Saturation refers to the refers to the number of number of hydrogens a hydrogens a fatty acid fatty acid chain is chain is holding. holding. Function:uStoreandprovideenergy:37.7kJ/g(9kcal/g)uconstit
3、utebodytissue,andendocrine.usupplyessentialfattyacid(EFA)upromoteabsorptionoffat-solublevitaminuPromoteappetiteandfoodsatietyEssential fatty acid, EFA Essential fatty acid, EFA Definition:afattyacidrequiredinthedietbecausethebodycannotsynthesizeit.Twofattyacids:linoleicacid（亚油酸）（亚油酸）andalpha-linolen
4、icacid（ -亚麻酸）亚麻酸）Linoleicacidistheprimarymemberofagroupoffattyacidsnamedtheomega-6fattyacidfamily.AALinolenicacidistheprimarymemberoftheomega-3fattyacidfamily.DHA、EPAEFAEFA缺乏：颈前、腋下出现缺乏：颈前、腋下出现皮肤干燥，鳞状脱屑发红及皮肤干燥，鳞状脱屑发红及增厚等湿疹样改变增厚等湿疹样改变该病例经该病例经EFAEFA治疗治疗2 2个个月后，症状消退。月后，症状消退。Sources and RNISources and RN
5、IuplantoilandanimalfatsuPlantoilandnut:PUFAuAnimalfats:SFAandMUFAS:M:P=1：1：1uRNI:adult20%30%oftotalenergyuEFA3%oftotalenergyucholesterol:300mg/d食物食物脂肪含量脂肪含量% %食物食物脂肪含量脂肪含量% %花生花生39.239.2猪肉（瘦）猪肉（瘦）28.828.8黄豆（干）黄豆（干）18.418.4牛肉（腰）牛肉（腰）19.119.1葵花子葵花子51.151.1羊肉羊肉13.613.6核桃核桃63.063.0兔肉兔肉0.90.9杏仁杏仁49.649.6
6、鸡肉鸡肉 2.52.5松子松子63.363.3鸭肉鸭肉7.57.5榛子榛子49.749.7鹅肉鹅肉11.211.2芝麻芝麻61.761.7大黄鱼大黄鱼0.80.8西瓜子西瓜子49.949.9青鱼青鱼5.25.2鸡蛋鸡蛋11.611.6鸡蛋黄鸡蛋黄30.030.04.EnergyUnit:J,kJ,MJ;cal,kcal1kcal=4.184kJ1kJ=0.239kcalTheenergyexpenditureuBasalMetabolism(BM)uThermicEffectofFood(TEF)orSpecificDynamicAction(SDA)uActivityBM:theenergy
7、expenditureneededtomaintenancebasiclifeactivity(themainenergyexpenditure,60%-70%)BMR:thebasalmetabolismenergyexpenditureofeachm2bodysurfaceinanhour.Unit:KJ/(m2.h)FactorsinfluencingBM:uSurfaceareaofbody,leanbodymassuPhysiologicandpathologicalstatusuSexuEnvironmentalfactorsSpecificdynamicaction(SDA)Th
8、ermiceffectoffood(TEF)DefinitionExtraexpenditureofenergyresultedfromfoodintake.Energyproducedbyitself:protein30%carbohydrate5%6%fat4%5%Mixedfoods:10%ofBMActivity:themainfactorinfluencingenergyexpenditure,15%-30%strength,durationoflabor,physicalactivityClassificationuLightlaboruModeratelaboruHeavylab
9、orRNIandSourcesCarbohydrate16.7kJ/gor4kcal/gFat37.7kJ/gor9kcal/gProtein16.7kJ/gor4kcal/gTheratioofenergyCarbohydrate:55%65%Fat:20%30%Protein:10%15%DefinitionOrganicdietarysubstances,notascarbohydrate,fat,orprotein,whichneitherproduceenergynorconstitutebodytissue,buttheyareusuallynecessaryinonlyverys
10、mallquantitiestoperformaparticularmetabolicfunctionortopreventanassociateddeficientdisease.Itcannotbesynthesizedbythebodyandthereforemustbesuppliedbyfood.VitaminsVitaminsDeficiencyprimary:intakeinsufficiencysecondary:absorptiondecreaseorrequirementincreaseProcess:decreaseintissuestoragephysicalandbi
11、ochemistrychangeclinicalsymptomVitaminNamesFat-solublevitaminsWater-solublevitaminsVitaminAVitaminDVitaminEVitaminKBvitamins Thiamin(B1)Riboflavin(B2)Niacin(B5)FolateVitaminB12VitaminB6BiotinPantothenicacidVitaminC 1.Fat-soluble 1.Fat-soluble (1)VitaminAalsocalledretinol(视黄醇视黄醇)retinolretinalretinoi
12、cacid视黄醇视黄醇视黄醛视黄醛视黄酸视黄酸uSourceAnimals：preformedvitaminAPlants：provitaminAVitaminA-Carotene-Carotene-Carotene-cryptoxanthin(隐黄素隐黄素)Totalretinolequivalent(gRE)=retinol(g)+-carotene(g)0.167(1/6)+otherprovitaminA0.084(1/12)uPhysiologicalfunctionMaintenancethenormalvision.visualpurpleIncreasegrowthanddif
13、ferentiationofepithelialcells，maintenancethenormalstructureofskin.Reproductionfunction.Improvingimmunityfunction,increaseresistanceofinfectionandanti-carcinomaoflung(antioxidantactions).Promotethedevelopmentofbones.uDeficiencyEye:darkadaptation,nightblindness.Injuryofconjunctiva,ulcerofcornea,eyedry
14、,xerophthalmia,Bitotsspots(毕脱氏斑毕脱氏斑)Skin:dry,squamous（有鳞片的），（有鳞片的），Immunitydecrease:respiratory tract respiratory tract infection,diarrheauSourcesandRNISourcesanimalfoodsliver,codliveroil,egg,milkandmilkproductsplantfoods-carotene,greenandyellowvegetable,somefruits.RNIadultman:800ugREadultwoman:700u
15、gRE(2)Vitamin D(2)Vitamin D VitaminD2(ergocalciferol)麦角钙化醇麦角钙化醇VitaminD3(cholecalciferol)胆钙化醇胆钙化醇VitaminD25-OH-VD31,25-(OH)2-VD3LIVERLIVERKIDNEYKIDNEYuFunctionIncreasingCaandPabsorptionandregulatingCaandPmetabolismuDeficiencychildren:ricketsadult:osteomalaciaosteoporosis方颅：以额骨和顶骨为中心向外隆起，使头部成方形方颅：以额骨
16、和顶骨为中心向外隆起，使头部成方形改变，常见于改变，常见于78个月的佝偻儿个月的佝偻儿郝氏沟：膈肌牵引软化肋骨，导致肋弓缘上部内陷，形成沟状肋骨骺部膨大，呈串珠样膝及踝肿大，两腿呈“O”形弓形腿膝及踝明显肿大，两腿弯曲呈“X”形uRNIandsourcesRNIadult:5ug/d.childandoldman:10ug/d.Sourcescodliveroil,yolk,liver,fish. (3)VitaminE(tocopherols）uFunctionAntioxidantactionspreventarteriosclerosis,anti-cancer,improvingimm
17、unityfunction,delayaging.PromoteproteinsynthesizeRelatedwithreproduction -tocopherolsuSourcesandRNIRNIAdult:14mg/dsourcesplantoil,nut,seeds,wheatgerm,legume2. water-soluble vitamin2. water-soluble vitamin(1)VitB1（thiamine）uFunctionMainlytakepartinenergymetabolismintheformofTPP(thiaminepyrophosphate)
18、.(焦磷酸硫胺素焦磷酸硫胺素)Otherforms:TMP,TDP,TTP.Maintainingthenormalfunctionofnerve,muscular,circulationsystem. Carbohydrate, Fat, ProteinCarbohydrate, Fat, Protein 丙酮酸丙酮酸, ,酮戊二酸酮戊二酸 氧化脱羧氧化脱羧( (TPPTPP是氧化脱羧酶的辅酶是氧化脱羧酶的辅酶) ) 乙酰乙酰CoA,CoA,琥珀酰琥珀酰CoACoA 三羧酸循环三羧酸循环 ATPATP磷酸戊糖通路中磷酸戊糖通路中transketolation-transketolation-
19、转酮醇作用转酮醇作用( (TPPTPP是转酮醇酶的辅酶是转酮醇酶的辅酶) )是核酸合成的戊糖及脂肪酸合成是核酸合成的戊糖及脂肪酸合成中的中的NADPHNADPH的重要来源的重要来源uDeficiency:Deficiency: Beriberi Beriberi dry beriberi: neuritisdry beriberi: neuritiswet beriberi: wet beriberi: mixed beriberi:mixed beriberi:干性脚气病（dry beriberi） 以多发性周围神经炎症状为主，出现上行性周围神经炎，表现为指（趾）端麻木、肌肉酸痛、压痛，尤以
20、腓肠肌为甚。膝跳反射在发病初期亢进，后期减弱甚至消失。向上发展累及腿伸屈肌、手臂肌群，而出现垂足、垂腕症状。湿性脚气病（wet beriberi） 多以水肿和心脏症状为主。由于心血管系统障碍，出现水肿，右心室可扩大，有心悸、气短、心动过速，如处理不及时，常致心力衰竭。混合型脚气病的特征是既有神经炎又有心力衰竭和水肿。 uRNI and sources RNI and sources RNI RNI Male:1.4mg/d, Female:1.3mg/d Male:1.4mg/d, Female:1.3mg/d SourcesSources animal organ such as liver
21、, kidney, animal organ such as liver, kidney, brain, lean meat, grain, legume, nut, brain, lean meat, grain, legume, nut, yeast yeast (2)Vit B2 (2)Vit B2 （riboflavinriboflavin）uFunction Function Mainly take part in energy Mainly take part in energy metabolism in the form of metabolism in the form of
22、 FMNFMN (flavin mononucleotide) (flavin mononucleotide) FAD FAD (flavin adenine dinucleotide) (flavin adenine dinucleotide)uDeficiency (oro-genital syndrome)Deficiency (oro-genital syndrome)MouthMouth angular stomatitis, cheilosis, glossitis angular stomatitis, cheilosis, glossitisEye Eye corneal in
23、flammation corneal inflammation SkinSkin seborrheic dermatitis seborrheic dermatitis（脂溢性皮炎）（脂溢性皮炎）uRNI and sourcesRNI and sources RNI RNI Male: 1.4mg/d, Female: 1.2mg/dMale: 1.4mg/d, Female: 1.2mg/d Sources Sources animal foods such as liver, kidney, heart, animal foods such as liver, kidney, heart,
24、 egg, milk, legume, fish, green vegetableegg, milk, legume, fish, green vegetable(3)Vitamin pp (niacin )(3)Vitamin pp (niacin )uFunctionFunction Take part in the metabolism of nutrients in Take part in the metabolism of nutrients in the form ofthe form of Co and CoCo and CouDeficiency:Deficiency: pe
25、llagra pellagra“three Dthree D” symptoms symptomsdiarrhea diarrhea ( (腹泻腹泻) )dermatitisdermatitis（皮炎）（皮炎）dementiadementia（痴呆）（痴呆）(4)Vit B6(4)Vit B6uuFunctional forms Pyridoxine, PN (吡哆醇) Pyridoxal, PL (吡哆醛) Pyridoxamine, PM (吡哆胺) uFunctionFunctionAmino acid metabolism.Amino acid metabolism.Glycogen
26、and fatty acid metabolism.Glycogen and fatty acid metabolism.Others.Others.uDeficiencyDeficiency cheilosis, glossitischeilosis, glossitisseborrheic dermatitisseborrheic dermatitis（ seborrheic seborrheic dermatitisdermatitis( (脂溢性皮炎脂溢性皮炎) ) uSources and RNISources and RNISourcesSources meat, vegetabl
27、e, fruits, nut and cereals. meat, vegetable, fruits, nut and cereals. AI AI adult:1.2mg/d; adult:1.2mg/d; pregnant and lactating woman:1.9mg/d pregnant and lactating woman:1.9mg/d(5)Folacin, FA(5)Folacin, FAAlsoAlso called pteroylglutamic acid, PGA.called pteroylglutamic acid, PGA.蝶酰谷氨酸蝶酰谷氨酸 FA FA T
28、HFA (THFA (活性形式活性形式) ) terahydrofolateterahydrofolate（四氢叶酸）（四氢叶酸） uDeficiencyhighhomocysteinemiaCongenitalmalformation(neuraltubedefects,NTDs)homocysteineuSourcesandRNISources:Liver,beans,nut,greenvegetableandfruits.RNI:Dietaryfolateequivalent(DFE)foradultis400g/day.(6)Vitamin C (ascorbic acid)(6)Vi
29、tamin C (ascorbic acid)FunctionnInvolveinthereactionofhydroxides,promotetheformationofcollagennFe3+Fe2+,folicacidtetrahydrofolicacidnEnhancetheresistancetodiseasesnAntioxidantactions.Acceleratethetoxintoexcrete Deficiency:Deficiency:scurvyscurvyuSources and RNISources and RNIFresh fruit and vegetabl
30、e: orangeFresh fruit and vegetable: orange，strawberrystrawberry RNI: adult 100mg/d RNI: adult 100mg/d ClassificationClassification macroelementsmacroelements: : 0.01% bw0.01% bw Ca Ca Mg K Na P S Cl Mg K Na P S Cl microelementsmicroelements: : 0.01% bw0.01% bw FeFe Zn I Se Cu Mo Cr Ni F Zn I Se Cu M
31、o Cr Ni F MnMnFunctionsFunctions The constituents of the body The constituents of the body Regulation Regulation The constituents and activating factors of The constituents and activating factors of enzymes enzymes MineralsMinerals1. Calcium1. Calcium bone and teeth (99%) bone and teeth (99%) miscib
32、le calcium pool (1%) miscible calcium pool (1%)FunctionFunction constituents of bone and teethconstituents of bone and teethmaintaining nerve-muscle irritability maintaining nerve-muscle irritability activity factors of enzymesactivity factors of enzymeskeeping acid-base equilibriumkeeping acid-base
33、 equilibriumFactors influencing Ca absorptionFactors influencing Ca absorptionIncreasing factorsIncreasing factors Decreasing factorsDecreasing factorsvitamin D vitamin D phytic acid in cereals phytic acid in cerealsprotein protein oxalic acid in vegetableoxalic acid in vegetablelactose lactose fatt
34、y acidfatty acidacid drugs acid drugs dietary fiberdietary fiberbody needbody need basic drugsbasic drugs body need body need Deficiency Deficiency Rickets: childrenRickets: childrenOsteomalacia: adultsOsteomalacia: adultsOsteoporosis: olderOsteoporosis: olderRNI and SourcesRNI and SourcesnRNI: Adul
35、t: 800mg/d RNI: Adult: 800mg/d Children: 1000mg/d Children: 1000mg/dnSources: milk and milk products Sources: milk and milk products dried small shrimps dried small shrimps soybean and soybean products soybean and soybean products2. Iron2. Iron Distribution :Distribution : 45g, 45g, Functional ironF
36、unctional ironhemoglobinhemoglobin： 60%-75 %60%-75 %myoglobin myoglobin ： 3%3%Enzymes: 1%Enzymes: 1% S Stored iron tored iron 25% ferritin 25% ferritin（铁蛋白）（铁蛋白）,hemosiderin,hemosiderin（含铁血（含铁血黄素）黄素）Function Function oxygen transport. oxygen transport. Formation and maturing of RBCFormation and matu
37、ring of RBCOthers: -carotene VAOthers: -carotene VA Factors influencing Fe absorptionFactors influencing Fe absorption body needbody need：can influence Heme-Fe and Non-Heme Fe can influence Heme-Fe and Non-Heme Fe absorption absorption H Heme Fe :eme Fe : exist in animal foods, 10%30% exist in anima
38、l foods, 10%30% Non-Heme Fe:Non-Heme Fe: exist in both animal and plant foods, exist in both animal and plant foods, 10%.10%. favourable factors:favourable factors: Vit C, Vit A, meat factors, glucose, fructose, Vit C, Vit A, meat factors, glucose, fructose, acid drugsacid drugs unfavourable factors
39、:unfavourable factors: phytic acid, oxalic acid, Zn, Cu, phytic acid, oxalic acid, Zn, Cu, basic drugsbasic drugs Dietary ironDietary ironHeme(small Heme(small portion)portion)Nonheme(largest portion)Nonheme(largest portion)Food Food sourcessourcesAbsorption Absorption raterateNone None in in plant
40、plant sources; sources; 40% 40% of of iron iron in in animal animal sourcesourceRapid; Rapid; transported transported and absorbed intactand absorbed intactAll All plant plant sources sources of of iron; iron; 60% 60% of of iron iron in in animal animal sourcessourcesSlow; Slow; tightly tightly boun
41、d bound in in organic moleculesorganic moleculesCharacteristicsofhemeandnonhemeportionsofdietaryironDeficiencyDeficiencyStages of anemiaStages of anemiaIron deficiency store (ID):Iron deficiency store (ID): Fe storedFe stored (serum ferritin) (serum ferritin)Iron deficiency erythropoiesis ( IDE):Iro
42、n deficiency erythropoiesis ( IDE):serum ferritin, serum Fe , FEP serum ferritin, serum Fe , FEP Iron deficiency anemia, IDAIron deficiency anemia, IDAHb Hb ，anemia anemia RNI and sourcesRNI and sourcesnadult: man 15 mg/d adult: man 15 mg/d woman 20 mg/d woman 20 mg/dpregnant and lactating woman 253
43、5 mg/dpregnant and lactating woman 2535 mg/dnSources: animal liver, blood products, meat, Sources: animal liver, blood products, meat, fish, agaric(fish, agaric(蘑菇蘑菇), green vegetable.), green vegetable.n egg, milkegg, milk3. Zinc , Zn3. Zinc , ZnFunctionFunction the constituents and activator of at
44、 least 200 the constituents and activator of at least 200 enzymesenzymesInfluencing factorsInfluencing factors Decreasing factors: Decreasing factors: phytic acid, oxalic acid, fiber, Cu, Fe phytic acid, oxalic acid, fiber, Cu, Fe Increasing factors: Increasing factors: protein, AA, GSH, VD protein,
45、 AA, GSH, VDDeficiency:Deficiency: children children growth retardationgrowth retardationanorexia anorexia wound malunion, infectionwound malunion, infectionacrodermatitis enteropathica acrodermatitis enteropathica ( (肠源性肢皮炎肠源性肢皮炎) ) RNI and SourcesRNI and Sourcesadult: man 15 mg/dadult: man 15 mg/d
46、 woman 11.5 mg/d woman 11.5 mg/d sources: mainly animal foods. such sources: mainly animal foods. such as oysters as oysters ，sea foods, liver, meat, sea foods, liver, meat, egg, egg, legumeslegumes4. Iodine4. Iodine Function:Function: The material of synthesizing thyroxine The material of synthesiz
47、ing thyroxine The material of synthesizing thyroxine The material of synthesizing thyroxine( ( ( (甲状腺素甲状腺素甲状腺素甲状腺素) ) ) )DeficiencyDeficiencygoistergoistergoistergoister（甲状腺肿大）（甲状腺肿大）（甲状腺肿大）（甲状腺肿大）severe deficiency of pregnant will cause the severe deficiency of pregnant will cause the severe defici
48、ency of pregnant will cause the severe deficiency of pregnant will cause the growth stasis, cretinismgrowth stasis, cretinismgrowth stasis, cretinismgrowth stasis, cretinism（克汀病）克汀病）克汀病）克汀病） (1) Goiter cretinism.RNI and sourcesRNI and sourcesRNIRNInadult: 150 ug/d adult: 150 ug/d ninfant, children:
49、50120 ug/dinfant, children: 50120 ug/dSources Sea foods, such as fish, kelpSources Sea foods, such as fish, kelp， adding Iodine into salt.adding Iodine into salt.5. Selenium, Se5. Selenium, SeFunction and deficiencyFunction and deficiency The constitute of enzyme GSH-PxThe constitute of enzyme GSH-P
50、xThe constitute of enzyme GSH-PxThe constitute of enzyme GSH-Px Keep heart and vascular health: Keshan disease Keep heart and vascular health: Keshan disease Keep heart and vascular health: Keshan disease Keep heart and vascular health: Keshan disease Relation to immunity function Relation to immuni
51、ty function Relation to immunity function Relation to immunity functionRNIRNI adult: 50 ug/d adult: 50 ug/d adult: 50 ug/d adult: 50 ug/d Sources Sources Sources Sources liver, kidney, seafood, meat, garlicliver, kidney, seafood, meat, garlicliver, kidney, seafood, meat, garlicliver, kidney, seafood, meat, garlic
