慢性肾病膳食营养素干预研究进展

营养不良已成为慢性肾病发病和死亡的一个重要原因,营养治疗通过调整膳食营养素改善患者营养状况、提高患者生活质量,对慢性肾病的发展具有重要意义。本文结合相关指南及近期发表的研究论文,综述了膳食营养素对慢性肾脏疾病的影响,旨在为肾病患者膳食营养的合理配制和临床上的具体实施提供参考。     

各国推荐的膳食营养素供给量的比较

制定膳食营养素供给量(以下简称膳食供给量)并不容易。精确的人体观察数据不多,有些年龄组人群的材料根本没有。个体的营养需要不同,对于一般疾病的反应也不同。制定标准时首先要听取各方面的意见,然后决定采用估计的平均最低生理需要量加上个体变化的上限以保安全,还是采用想象中的理想适宜供给量。     

植物性膳食营养素调节焦虑抑郁行为的研究进展

研究表明,膳食营养素与焦虑抑郁关系密切,本文综述植物性膳食营养素与焦虑抑郁调节的研究进展。     

武威市结核病患者膳食多样化水平及营养素摄入状况调查

目的：了解武威市结核病（TB）患者膳食多样化水平及各类营养素摄入情况。方法：选取武威市结核患者826名,由统一培训的结核病防治科医生,进行面对面的问卷调查,应用食物频率表收集调查对象消费的食物种类;24小时膳食回顾法收集调查对象膳食营养素摄入情况。采用9大类食物评价膳食多样化,每周食用一种食物计1分,最多为9种食物计9分。结果：膳食多样化评分（DDS）结果显示,分值为7分及以上的人群达到了51．5％,其中得分7分的人群达到总人数的33.3％,有48．5％不足7分,即没有达到膳食多样化。鱼虾类和豆类消费率最低,分别仅为6．7％和44．3％。能量及营养素分析结果显示：结核病患者每日能量和蛋白质摄入量分别为1563．9kcal和60．6g,仅达到推荐摄入量（RNI）的65．16％和80．67％,除了铁、锰、磷元素的摄入量达到了RNI之外,其余维生素及矿物质每日摄入量均不足,尤以视黄醇（122．2μg）和钙（224．7mg）最低,分别为RNI的15．28％和28．09％。膳食纤维、抗坏血酸和核黄素的摄入水平均不足RNI的50％。结论：武威市结核病患者膳食结构不均衡。建议积极改善营养、调整膳食结构,加强膳食营养相关知识的健康宣教,有效防治结核病。     

每日膳食中营养素供给量

每日膳食中营养素供给量标准,是作为保证正常人身体健康而提出的膳食质量指标,供计划膳食工作的参考。营养素供给量的含义,与营养素需要量不同。需要量是指维持身体正常生理功能所需要的数量,低于这个数量将对身体产生不利影响。供给量是在满足身体正常生理需要的基础上,按食物生产和饮食习惯的情况而规定的“适宜”数量;因而,它比需要量充裕。当摄入的营养素量稍低于供给量时,不一定就是不足。本表所列各种类型人群的膳食营养素供给量是适用于大多数人的适中数值。在应用于个人时,应考虑个体的差异,作适当的增减。一、能量影响能量需要的因素有:体力劳动、年龄、气候和体型等。其中以体力劳动,即劳动强度及劳动时间为     

南京市不同养老模式下老年人膳食营养素摄入特点分析

摘要：目的：比较南京市居家与机构养老老年人膳食营养素摄入特点。方法：随机选择南京市181名60岁以上居家养老与机构养老老年人作为被调查对象,采用24h膳食回顾法对其连续3d的食物摄取情况进行调查,分析比较其膳食营养素摄入状况。结果：与机构养老者相比,居家养老者谷类、豆类、根茎类外的蔬菜、水果、禽肉、奶类、坚果、酒的摄取量明显较高,而蛋类、油类、糕点、盐的摄取量明显较低。能量、蛋白质、脂肪、碳水化合物、膳食纤维、维生素A、维生素E、维生素B1、维生素B2、烟酸、维生素C、钙、铁、锌、硒的摄入量明显较高,胆固醇摄取量较低。食物摄取出现中高度失衡的较低,出现中高度过量的比例较高。结论：机构养老者易出现膳食营养素摄入不足,而居家养老者则易出现膳食营养素摄入偏高的倾向。     

营养基本知识讲座（六）：——合理膳食

营养基本知识讲座（六）──合理膳食刘绣云（北京医科大学营养教研组１０００８３）（续１９９５年第３０卷第７期第２３页）我们人体需要的营养素有蛋白质、脂肪、碳水化物、维生素、矿物质和水六大类，有些类中还有很多种。一般情况下营养素来源于食物，任何一种天然食...     

北京某高校大学生膳食调查与评价

目的：了解高校大学生的膳食营养情况,为有针对性地开展营养改善工作提供依据。方法：采用连续3d 24h膳食回顾法,调查首都医科大学166名本科生日常膳食摄入情况。分析膳食能量、营养素摄入情况,与《中国居民膳食营养素参考摄入量》进行比较分析。结果：能量及多种营养素摄入不足,甚至有严重缺乏的情况。男生食物净重、能量、蛋白质、脂肪、碳水化合物、硫胺素、尼克酸、磷和铁的摄入量均明显高于女生,差异有统计学意义（P＜0.05）。各年级比较,食物净重、能量、脂肪、维生素C和钙的摄入量有统计学差异。脂肪（男生27.78%、女生29.05%）、蛋白质（男生17.10%、女生15.66%）提供能量比例偏高,碳水化合物（男生55.12%、女生55.29%）提供能量比例偏低。三餐能量分配基本合理,男女生间差别较小。结论：大学生营养素的摄入不够合理,应提高奶、蛋、瘦肉、蔬菜、水果的摄入量,加强对大学生的营养知识的教育。     

Are the recommended allowances for dietary antioxidants adequate?

Recommended dietary allowances are standards for maintaining health. Claims that intakes substantially above the allowances may provide protection from xenobiotics and prevent diseases, including cancer, are examined critically for five nutrients that have antioxidant potential. Major criticism is directed at the failure of epidemiologists to recognize that for many of these nutrients, metabolic differences among individuals preclude a direct relationship between dietary intake and plasma or tissue concentration. Also, the fact that no differences in disease incidence have been described within various species of animals that have markedly different metabolic patterns for some of these nutrients has not been considered. It is concluded that the experimental and epidemiological evidence to data that increased intakes of certain nutrients will have beneficial effects on human health are tenuous.     

Response of hepatic proteins to the lowering of habitual dietary protein to the recommended safe level of intake

The plasma concentrations of albumin, HDL apolipoprotein A1 (apoA1), retinol-binding protein (RBP), transthyretin (TTR), haptoglobulin, and fibrinogen were measured, and a stable isotope infusion protocol was used to determine the fractional and absolute synthesis rates of RBP, TTR, and fibrinogen in 12 young adults on three occasions during a reduction of their habitual protein intake from 1.13 to 0.75 g x kg(-1) x day(-1) for 10 days. This study was performed to determine whether healthy adults could maintain the rates of synthesis of selected nutrient transport and positive acute-phase proteins when consuming a protein intake of 0.75 g x kg(-1) x day(-1). During the lower protein intake, the plasma concentration of all the proteins, other than HDL-apoA1, remained unchanged. HDL-apoA1 concentration was significantly reduced (P < 0.05) after 3 days of the lower protein intake, but not at 10 days. The rates of synthesis of RBP and TTR declined significantly (P < 0.05), whereas the rate of synthesis of fibrinogen remained unchanged. The results indicate that, when normal adults consume the recommended safe level of protein, 0.75 g x kg(-1) x day(-1), there is a slower rate of turnover of nutrient transport proteins than on their habitual diet. Hence, healthy individuals consuming this amount of protein may be less able to mount an adequate metabolic response to a stressful stimulus.     

Commentary on the workshop statement. Essentiality of and recommended dietary intakes for Omega-6 and Omega-3 fatty acids

The Workshop document is welcome and important in its content and objectives. My comments deal with three topics, and are intended to set the historical perspective and take the discussion further as regards attitudes to infant nutrition. 1. ADVERSE ARACHIDONIC EFFECTS. I have some difficulty with the statement on the need to reduce LA (linoleic acid) content of the diet because 'This is necessary to reduce adverse effects of excesses of arachidonic acid and its eicosanoid products.'I have no problem with suggesting a reduction in the present level of LA in the USA but consider the expression 'adverse effects of arachidonic acid ...' to be misleading. Linking LA and AA in this way also implies a direct conversion of LA to AA, which is not the case. In fact, a very high dietary LA will reduce membrane AA. 2. EFA RATIOS. I suspect that their choice of omega 3/omega 6 ratio of 5.7 for early life may be high. Their recommendation for adults gives the much lower ratio of about 1.4. In view of the high requirement for DHA during neural development, I would have thought the ratios would have been the other way round or the same for infants as adults but with AA included in the omega 6. Also, I have some difficulty with the concept of a unitary ratio when there is clear disunity in the biological activities of the different parent and LCP EFAs. Hence the concept of omega 6/omega 3 ratio based on activity equality does not reflect the biological reality. 3. FDA RECOMMENDATIONS ON INFANT FORMULA. The Workshop essentially disagrees with the recent FDA recommendations on inclusion of LCPs in infant formula. There is, in addition, a need to re-think the requirements of the preterm infant beyond their recommendation.