Professional Documents
Culture Documents
Bin tp bi:
Nguyn Minh Thy
MC LC
1. Dinh dng ngi - Mi quan h gia lng thc - Thc phm, Nng nghip v sc
khe
1.1. nh ngha v dinh dng ngi
1.2. Vi nt v s pht trin ca khoa hc Dinh dng
1.3. Khi nim v cc cht dinh dng v thnh phn lng thc thc phm
1.4. Mi quan h gia dinh dng, lng thc - thc phm, nng nghip v sc kho
2. Cu trc c th v nhu cu dinh dng
2.1. Cu trc c th ngi
2.2. Nhu cu dinh dng
2.3. Nhu cu nng lng
2.4. Hnh thi nng lng
2.5. n v nng lng
2.6. Nng lng thc phm
2.7. Tiu hao nng lng
2.8. Lng cung cp nng lng
2.9. Cn bng nng lng
2.10. D tr nng lng
2.11. Cc bi ton v trao i vt cht
2.12. An ninh thc phm
3. Protein
3.1. M u
3.2. Cu trc v tnh cht l ho hc c bn ca protein
3.3. Thnh phn v hm lng protein trong cc nng sn phm chnh (ngun cung
cp protein trong thc phm)
3.4. Vai tr v chc nng ca protein trong dinh dng
3.5. Nhng thay i xy ra trong c th thiu protein
3.6. Cc acid amin v vai tr dinh dng ca chng
3.7. Nhng yu t nh hng n gi tr dinh dng ca protein
3.8. Cc phng php xc nh gi tr dinh dng ca protein
3.9. Nhu cu protein ca c th
4. Lipid
4.1. M u
4.2. Cu trc v cc tnh cht l ho c bn
4.3. Vai tr ca lipid trong dinh dng ngi
1/175
4.4. Cc acid bo
4.5. Phosphatide
4.6. Sterol v vitamin
4.7. Gi tr dinh dng ca cht bo
4.8. Hp thu v ng ho cht bo
4.9. Nhu cu cht bo
5. Carbohydrate
5.1. M u
5.2. Vai tr sinh l ca carbohydrate
5.3. Carbohydrate tinh ch v carbohydrate bo v
5.4. Cc carbohydrate n gin
5.5. Polysaccharide
5.6. Ngun carbohydrate trong thc n
5.7. Tiu ho v hp thu carbohydrate
5.8. Nhu cu carbohydrate
6. Vitamin
6.1. i cng
6.2. Cc vitamin tan trong cht bo
6.3. Cc vitamin tan trong nc
7. Cc cht khong
7.1. Cc cht khong
8. Khi lun v dinh dng cn i
8.1. Mi quan h tng h gia cc dinh dng trong c th
8.2. Quan nim v tnh cn i ca khu phn
8.3. Tiu chun dinh dng
9. Thc phm v nhu cu dinh dng cho cc i tng khc nhau
9.1. Thc phm v nhu cu dinh dng cho cc i tng khc nhau
10. Cc bnh lin quan n dinh dng
10.1. Cc bnh lin quan n dinh dng
Tham gia ng gp
2/175
3/175
5/175
Lipid
S xc nh hai cu t c bn c trong lipid l glycerin v acid bo l do cng ca
Chevreul, ngi Php vo nm 1828. Nm 1845, Boussingault chng minh c
rng, trong c th carbohydrate c th chuyn thnh lipid. V gi tr dinh dng trong
c th ngi:
Cht bo l ngun giu nng lng nht so vi cc hp cht khc nh protein,
carbohydrate.
Cht bo tham gia vo thnh phn nguyn sinh cht t bo
6/175
Carbohydrate
L cht dinh dng ch yu trong khu phn n ngi Vit Nam. Trong c th
carbohydrate v cc dn xut ca chng hon thnh cc nhim v sau:
Carbohydrate l ngun nng lng cho mi hot ng sng
Carbohydrate cn thit cho s oxy ho bnh thng cc cht bo v protein. Khi thiu
carbohydrate th s oxy ho cc cht trn khng th tin hnh n cng.
Carbohydrate l ngun dinh dng d tr, ng thi tham gia vo cu to cc protein
phc tp, mt s enzyme v hooc mon.
Carbohydrate cn ng vai tr bo v c th khi b nhim trng, khi b cc c t
thm nhp, n tham gia vo qu trnh th thai v qu trnh phc hi v iu ho phn
ng enzyme.
Cht khong
Nm 1713 ngi ta pht hin Fe trong mu, nm 1812 phn lp c iode tyrosine
ca tuyn gip trng. Tuy nhin vo sau na th k XIX, cc nh chn nui mi chng
minh c s cn thit ca cht khong trong khu phn, c bit l khi c ch ca
ton b qu trnh trao i cht trong c th ngi c lm sng t th ngi ta cng
chng minh cc c th ca cc ion calci, phosphor, magne, ng, coban, km.. trong
mi khu cng nh trong ton b qu trnh chuyn ho ca c th. Cc bnh thiu mu
dinh dng hoc thiu iode cn kh ph bin cc nc ang pht trin ngy nay cng
khng nh vai tr thit yu ca cht khong trong dinh dng ngi.
Vitamin
Nu nh Lind (1753) l ngi u tin pht hin v vai tr ca thc n i vi bnh tt
c lin quan vi vitamin (tc dng ca nc chanh i vi bnh hoi huyt) th Nicolai
Ivanovich Lunin l ngi sng lp ra hc thuyt vitamin. Tip cc cng trnh ca
Hopkin, Eijkman u chng minh vai tr thit yu ca vitamin trong vic chng li
mt s bnh tt, c bit l vic tch vitamin B1 t cm go ca Funk.
7/175
Cho n nay ngi ta pht hin khong 30 cht thuc vo nhm vitamin nhng trong
s ny ch c khong 20 cht c ngha trc tip i vi sc kho v dinh dng ngi.
Nc
Chim khong 55-75% trng lng c th. Nc s dng nh vt liu xy dng trong
tt c cc t bo ca c th. M m cha khong 20% nc, c cha khong 75%, huyt
tng mu cha 90%. Nc trong c th c s dng nh:
Cc dung mi
Mt phn cht bi trn
Cht gy phn ng ho hc
Cht gy iu ho nhit c th
Cht duy tr hnh dng v cu trc c th
Nc phn b trong v gia t bo, trong cc c quan. Nc c a vo c th nh
thc phm, ung v qua s trao i cht. N c thi ra khi c th bng nc tiu,
phn, m hi v h hp ca phi.
Cht x
C nhiu trong thnh t bo thc vt, n c tc dng lm cho phn o thi nhanh ra
khi c th, chng c cc bnh to bn, vim rut tha, tr.. Mt s cht x ho tan
c tc dng lm tng chuyn ho cholesterol, trnh c bnh x va ng mch.
8/175
9/175
Vng xoy trn c nguy him i vi tnh trng sn xut nng nghip km (Harper, 1984)
S biu th mi lin quan gia nng nghip, lng thc thc phm v dinh dng (FAO,
1984)
10/175
11/175
W
H2
12/175
Trong :
W: Cn nng tnh theo kg
H: Chiu cao tnh theo mt
Theo khuyn ngh ca t chc Y t th gii: ch s BMI ngi bnh thng nn vo
khong 18,5 24,99. C th thy s tng ng gia chiu cao v ch s BMI Hnh
2.1.
13/175
14/175
15/175
16/175
n v nng lng
n v nng lng
n v nng lng theo h SI l joule (J), l nng lng c s dng khi 1 kilogram
(kg) di chuyn qua mt metre (m) bng lc 1 Newton (N). Tuy nhin gi tr 1 joule l
rt b khi th hin n v nng lng, do trong hu ht khi nim trong dinh dng,
n v kJ (= 103 J) hoc MJ (= 106J) c s dng ph bin.
n v nng lng cn c th hin bng calorie, c xc dnh l nng lng cn
thit a 1 g nc t 14,5oC tng ln 15,5oC. Trong ng dng thc t ca dinh dng
hc, thng ly 1000 calo tc 1 kilo calo (Kcal) lm n v s dng ph bin. C th
chuyn ho gia Kcal v kJ nh sau:
1 Kcal = 4,184 kJ; 1 kJ = 0,239 Kcal hay 4,2 kJ = 1 Kcal.
17/175
18/175
19/175
C 3 loi cht dinh dng sinh nhit qua oxy ho trong c th u sinh ra nng lng,
v c 3 loi u c th chuyn hon c cho nhau trong qu trnh chuyn ho, nhng
khng th thay th nhau hon ton, trong cc ba n hp l cn phi c s phn b theo
mt t l tho ng. Tuy nhin khng phi hu ht nng lng ny hin hu trong c
th ngi v hai l do:
S tiu ho khng hon ton (ngi kho mnh n hn hp hp thu khong 99%
carbohydrate, 95% lipid v 92% protein).
Qu trnh t chy cc dinh dng khng hon ton (nht l m)
- Ur v cc sn phm cha nit khc ra theo ng nc tiu cha khong 1,25 Kcal
cho 1g protein.
- Acid hu c, cc sn phm thoi ho carbohydrate v lipid (vi g/ngy).
Bng 2.2 cho bit nng lng thi ra ca cc cht dinh dng chnh c tnh ton bi
Atwater. Gi tr Kcal/g c gi l h s Atwater v tng i ng cho phn ln cc
ch n ung thng gp tr khi cha qu nhiu cht khng tiu ho
Bng 2.2 Nng lng chuyn ho ca cc cht dinh dng chnh (Southgate v
Durnin, 1970)
Cht
dinh
dng
Nng
Phn
Nng
lng
trm
lng tiu
th (kJ/g) hp thu ho(kJ/g)
Mt theo
nc
tiu(kJ/g)
Nng lng
chuyn ho
(kJ/g)
H s
Atwater(Kcal/
g)
Tinh
bt
17,5
99
17,3
17,3
Glucose 15,6
99
15,4
15,4
Cht
bo
39,1
95
37,1
37,1
Protein
22,9
92
21,1
5,2
15,9
Ru
29,8
100
29,8
Vt
29,8
20/175
21/175
Ngoi ra ngi ta cn c th tnh CHCB theo nhiu phng php khc. Bng 2.4 biu
th cch tnh chuyn ho c bn da vo cn nng.
Bng 2.4 Cng thc tnh CHCB da theo cn nng (H Huy Khi, 1996)
23/175
Hnh 2.3. Ton tnh din tch da (Tver and Russell, 1989)
Hot ng th lc
Ngoi chuyn ho c bn ra, hot ng th lc l nhn t ch yu nht nh hng n s
tiu hao nng lng ca c th. Trong hot ng th lc, trng lng ca c th ngi
l mt loi ph ti. Hot ng ca c th i hi c bp v cc t chc khc sinh cng.
Qu trnh ny, ngoi vic tiu hao c nng ra, t bo v cc c quan t chc c lin quan
khi hp thnh nhiu cht mang nng lng nh protein, lipid, glycogen.. cng i hi
tiu hao nng lng. Hot ng c bp cng mnh v thi gian hot ng cng nhiu th
nng lng tiu hao cng ln. Trnh quen vic ca lao ng chn tay cng nh hng
n mc tiu hao nng lng. Phng php o chnh xc mc tiu hao nng lng l
tng i phc tp, v ch c th dng vo nghin cu khoa hc. Phng php tng
i n gin l dng phng php quan st sinh hot c biu th bng tiu hao nng
lng cho cc hot ng th lc Bng 2.5.
24/175
Bng 2.5 Tiu hao nng lng tnh theo Kcal/kg cn nng/gi ca ngi trng thnh
khi thc hin cc hot ng khc nhau v ngh ngi (Hong Tch Mnh v H Huy Khi,
1977)
Loi lao ng
Nm ngh ngi
0,10
1,10
Ngi yn
0,43
1,43
c to
0,50
1,50
ng thoi mi
0,50
1,50
May tay
0,50
1,50
Ng
0,57
1,57
ng nghim
0,63
1,63
an bng que an
0,66
1,66
Ht
0,74
1,74
n cm
0,84
1,84
May my
0,95
1,95
0,96
1,96
nh my ch
nhanh
1,00
2,00
i qun o (bn i
1,06
2,5 kg)
2,06
Ra chn a
1,06
2,06
Qut nh (138
ng tc/pht)
1,41
2,41
Bc ba ng gy
sch
1,43
2,43
Bi tp th dc
nh
1,43
2,43
Khu giy
1,57
2,57
25/175
Do chi thong th
1,86
(4km/gi)
2,86
Rn luyn th lc
kh nng
3,14
4,14
Th mc, c kh
2,43
3,43
i kh nhanh (6
km/gi)
3,28
4,28
Th
4,71
5,71
Lao ng nng
5,43
6,43
Cht cy
5,43
6,43
Bi
6,14
7,14
8,14
Lao ng rt nng
8,57
7,57
26/175
O2 tiu
th (l/g)
CO2 sinh
ra (l/g)
RQ+
Tinh bt
0,829
0,8324
0,994 17,49
21,10
Glucose
0,746
0,742
0,995 15,44
20,70
Cht bo
1,975
1,402
0,710 39,12
19,81
Protein
0,962
0,775
0,806 18,52
19,25
Ru
1,429
0,966
0,663 29,75
20,40
+ RQ: Thng s h hp
Nng lng tiu hao c th xc nh chnh xc t qu trnh oxy ho hn hp cc cht
dinh dng, Lng CO2 sinh ra cn c o v s nh gi hoc cn thit o lng ur
to thnh (t s bi tit nit theo ng tit niu). Cng thc ph bin s dng tnh ton
nng lng tiu hao ca ngi c pht trin bi Weir (1949) (Cng thc 6.1):
EE (kJ) = 16,489 VCO2 (l) + 4,628 VCO2 (l) 9,079 N (g) (6.1)
27/175
Trong VCO2 v VCO2 l th tch ca O2 tiu th v th tch CO2 sinh ra, tng ng
v N l lng bi tit theo ng tit niu. Nu lng nit bi tit ra theo ng tit
niu khng o c th cng thc tng t (cng thc 6.2) c th c s dng:
EE (kJ) = 16.318 VO2 (l) + 4.602 VCO2 (l) (6.2)
Trong : EE (Energy Expenditure): nng lng tiu hao
VO2 v VCO2 l th tch O2 tiu th v th tch CO2 sinh ra.
N l lng nit bi tit theo nc tiu
Cc cng thc tnh tng t cng c pht trin bi nhiu tc gi khc, vi s khc
bit nh t qu trnh tiu th cc cht dinh dng khc nhau nh carbohydrate hoc
protein hay lipid.. S khc bit ny dn n s khc bit trong cch tnh ton tiu hao
nng lng trong khong nh hn 3% di cc iu kin ch n ung thng thng
(Brockway 1987).
tnh ton s lng carbohydrate, protein v lipid b oxyho, cc gi tr th hin
Bng 2.6 v gi nh 6,25g protein cha 1 g nit c th s dng thit lp cng thc
sau:
Oxy ho carbohydrate (g) = 4,707 VCO2 (l) 3,340 VO2 (l) 2,714 N (g)
Oxy ho cht bo (g) = 1,786 VCO2 (l) 1,778 VO2 (l) 2,021 N (g)
Oxy ho protein (g) = 6,25 N (g)
Thit b o nng lng gin tip:
Thit b s dng o nng lng tiu hao bng phng php gin tip c th thay i t
thit b n gin c thit k hot ng trong iu kin iu khin t xa cho ti phng
thit k cho ngi phc tp hn.
28/175
H thng n gin nht l dng k thut ti Douglas. Vi k thut ny, cho php o
lng oxy s dng trong thi gian t 5 n 15 pht. Lng khng kh th ra c tch
a vo mt ti nh v mu khng kh ny c a i phn tch (Hnh 2.4)
Nhu cu nng lng ca nhm lao ng nam la tui 18 - 30, cn nng trung bnh 55kg,
loi lao ng nng c tnh nh sau:
Theo Bng 2.7
CHCB = (15,3 x 55) + 679 = 1520,5 Kcal
Nhu cu nng lng c ngy c tnh theo Bng 2.7
1520 x 2,10 = 3193,05 Kcal
b) Nhu cu nng lng c ngy da vo cch tnh gp: bao gm
+ Nhu cu nng lng cho chuyn ho c bn
+ Nhu cu nng lng cho tc dng ng lc c hiu ca thc n
+ Nhu cu nng lng cho hot ng th lc
29/175
Kh hu v vc dng
Do c s ci thin v iu kin n mc v , m thng kh hu nh hng khng ln
n nhu cu nng lng ca c th. Ch c trong iu kin kh hu nng bc hoc gi
lnh tng i lu th i hi phi c s iu chnh thch ng (Bng 2.8). Nhng ngi
c vc dng khc nhau, t l chuyn ho c bn cng khc nhau nn khi hot ng cn
tng hoc gim lng tiu hao nng lng mt cch tng ng. trnh bo ph hoc
qu gy, phi iu chnh hp l cho cn nng v chiu cao t c mc chun.
Bng 2.8 Nhu cu nng lng ca ngi ln theo nhit trung bnh hng nm cn
nng v tui (Hong Tch Mnh & H Huy Khi, 1977)
30/175
31/175
32/175
33/175
D tr nng lng
D tr nng lng
C th gm ba ngun d tr nng lng chnh, trong d tr ch yu l lipid nm
trong cc t chc m. Bnh thng lipid chim khong 10% trng lng nam v 25%
n. Cht bo d tr ch yu nhiu nht di da v trong cc bng. Trong cc t chc,
cht bo d tr vn thng c cc trao i ho hc. Khi i c th s dng khong 150
g/m/ngy, lng d tr c th trong khong 40 ngy. Lng carbohydrate d tr
di dng glycogen gan v c ch khong 100 - 200 g. Phn d tr ch cho c th
s dng trong 1 ngy. Trong c th c khong 300 g m dng d tr c ng. Chng
tp trung ch yu bo tng t bo v gan. D tr ny c th dng ht trong 4 - 6
ngy. Sau m ca cc t chc b phn hy.
34/175
180 gr glucose khi b t s dng ht (6 x 22,4 lit) = 134,4 lit Oxy = VCO2
C th t lipid
35/175
Mi lt oxy s sinh
ra (Kcal)
S % calo thuc
carbohydrate
S % calo
thuc lipid
0,70
4,88
0,0
98,9
0,75
4,739
15,6
84,4
0,80
4,801
33,4
66,6
0,85
4,862
50,7
49,3
0,90
4,924
67,5
32,5
0,95
4,985
84,0
16,0
1,00
5,047
100,0
0,0
36/175
Bi tp: Mt c th mi gi hp thu trung bnh 15 lit oxy, thi ra 13,5 lit kh CO2
1) Hi: trong gi , c th s dng bao nhiu nng lng?
Gii: Tnh thng s h hp = 13,5/15 = 0,90
Tra Bng 2.9, bit 1 lit oxy s to ra 4,924 Kcal, vy trong mt gi c th ny t
lng thc n c 73,86 Kcal nng lng,
1. Hi: trong s nng lng k trn, carbohydrate ng gp bao nhiu?
Gii: Carbohydrate ng gp 67,5%, tc l (73,86 x 67,5)/100 = 49,86 Kcal
Phn cn li l ca lipid = 24 Kcal
37/175
Yu cu
- Thc phm phi m bo s lng
- Cn i v mt cht lng
- Khng l ngun gy bnh
38/175
Tm, ln, cua c nhiu calci v yu t vi lng ng, selenium. Cua ng rang n b
do carbonate calci d tiu ho hp thu hn phosphate calci ca xng.
Trng l loi thc phm b dng nhng khng nn n trng sng v lng trng trng
cha avidin rt c (c th ph hy bng cch nh bng ln). Trng c th nhim k
sinh trng hoc vi sinh vt gy bnh. Trng vt ln cha nhiu ni tit t kch thch
chuyn ho c th ngi n.
Sa l loi thc n ton din, ch thiu vitamin C v st. i vi tr em, sa m
l tt nht. Sa cc loi ng vt khc tuy protein nhiu hn nhng cha nhiu
betalactoglobulin, mt loi protein c phn t lng cao, l i vi tr em, c th gy d
ng (chy mu rut, chm, hen..). Sa bt tch b cha nhiu lactose, tr em c th hp
thu d dng do c men lactase.
Ng cc: trong cc loi ng cc, cht lng protein ca go l tt hn c v t l cc acid
amin tng i cn i, sau l bt m v bp. Ng cc ni chung u thiu lysine
v methionin, bp cn thiu c tryptophan. Cc cht dinh dng qu u c lp ngoi
cng ca ht go v trong mm ht.
u c hm lng protein cao, cha nhiu lysine h tr tt cho ng cc. Ch loi u
nnh v u phng, m va giu protein va giu lipid.
Rau qu:
- l ngun vitamin
- l ngun cht khong
- l ngun khng sinh thc vt
- ngun tinh du hng liu kch thch n ngon ming
- ngun cht cht chng oxy ho (antioxydant) chng li cc gc t do ph hoi cc
mng t bo gy ri lon chuyn ho, gy ung th.
- ngun cht x phng to bn, qut sch cc cht c v cholesterol tha ra khi ng
tiu ho.
39/175
Protein
M u
M u
Protein ng vai tr c bit i quan trng i vi sc kho con ngi. Nh c cht
ng v phng x, n nay ngi ta xc nh l mt na cht protein ca c th c
i mi trong vng 80 ngy. Mt na protein gan, mu nhanh i mi trong vng 10
ngy. Trong mt i ngi, cht protein c th i mi ti 200 ln. Thng qua nhng
hu qu trc tip v gin tip, suy dinh dng do thiu protein l nguyn nhn ch yu
ca tnh trng sc kho km. Tnh trng thiu protein thng i km theo thiu nng
lng v cc yu t dinh dng khc cc mc khc nhau.
Suy dinh dng do thiu protein v nng lng c th gp bt k la tui no nhng
hay gp nht thi k sau thi b. Ngoi nh hng ti tc ln, thiu protein nh
hay trung bnh lm cho tr c bit nhy cm vi ng h hp v ng rut. Nhiu
nghin cu cn cho thy thiu protein trong hai nm u ca cuc i khng nhng a
ti tnh trng b nh tui trng thnh m cn lm chm pht trin tr tu.
Thiu protein cn nh hng r rt ti ph n c thai v cho con b. Ngi ta thy c
mi lin quan gia ch n thiu ca ngi m vi tnh trng non hay thiu cn ca
tr s sinh. Do bi tit sa nhu cu ca ngi m tng ln rt nhiu. khi n thiu m
protein trong c th m b s dng sn xut sa. Nhiu nh khoa hc cho rng suy
dinh dng do thiu protein l mt trong nhng vn sc kho hng u v cp thit
trong thi i hin nay.
40/175
Chng tham gia cu to nn phn t acid amin, trong c th sinh vt thng gp dng
acid - amin.
Cng thc tng qut:
trnh Krebs nh acid -cetoglutaric, acid oxaloacetic u chu s amin ho bng cch
kh to thnh cc acid amin.
T acid pyruvic s to c alanin, acid oxaloacetic s to c acid aspartic, acid
-cetoglutaric s to c acid glutamic
Cc phn t acid amin ny trng hp vi nhau thng qua lin kt peptid to thnh cc
polypeptid. Trong phn t protein c th c mt hay nhiu chui polypeptid.
Thnh phn ho hc
Protein c phn thnh hai loi:
- Protein n gin: trong thnh phn ch cha acid amin. V d prolamin, albumin,
globulin..
- Protein phc tp: ngoi acid amin ra, trong phn t ca chng cn cha cc hp cht
khc nh acid nucleic, glucid, lipid (Bng 3.2)..
Bng 3.2 Cc protein phc tp (L Don Din v V Th Th, 1996)
42/175
Bng 3.4 S phn loi thc phm da vo gi tr nng lng ca protein (L Don Din
v V Th Th, 1996)
43/175
44/175
45/175
46/175
peptidase ca rut non s b kh amin ho bng cch oxy ho, kt qu to thnh nhm
NH2 v -cetoacid.
Nhm amin phn ln c to thnh ur qua chu trnh ormithin, cn mt phn tn ti
di dng amoniac. Cc -cetoacid tip tc b bin i theo ng hng oxy ho
to thnh acetyl CoA v nng lng, acetyl CoA li tip tc i vo chu trnh Krebs
to ra CO2, H2O, nng lng v cc sn phm trung gian. Nh vy cc acid amin bin
i theo ng hng kh amin ho s cho ngun nng lng ln. Cc acid amin cng
c th b kh carboxyl ho to thnh cc amin hay diamin. Cc amin ny li b oxy
ho tip tc to thnh NH3, H2O, aldehyde tng ng, ng thi gii phng ngun
nng lng ng k. Nh vy khi thiu glucid, lipid th mt phn protein tha c th
chuyn ho thnh glucid hay acid bo tham gia vo qu trnh t chy v cung cp
nng lng. Khi t chy trong c th, 1 g protein cho 4 Kcal.
Protein iu ho chuyn ho nc v cn bng kim toan trong c th
Protein ng vai tr nh cht m, gi cho pH mu n nh do kh nng lin kt vi H+
v OH-. Cc hot ng ca c th rt nhy cm vi s thay i pH mu, v vy vai tr
duy tr cn bng pH l rt quan trng. Protein c nhim v ko nc t trong t bo vo
mch mu, khi lng protein trong mu thp, di p lc co bp ca tim, nc b y
vo khong gian bo gy hin tng ph n.
Protein bo v v gii c cho c th
C th con ngi chng li s nhim trng nh h thng min dch. H thng min dch
sn xut ra khng th c bn cht l cc protein bo v. Mi khng th gn vi mt phn
c hiu ca vi khun hoc yu t l nhm tiu dit hoc trung ho chng. C th c h
thng min dch tt khi c cung cp y acid amin cn thit tng hp nn khng
th. C th lun b e do bi cc cht c c hp th t thc phm qua h thng tiu
ho hoc trc tip t mi trng, cc cht c ny s c gan gii c. Khi qu trnh
tng hp protein b suy gim do thiu dinh dng th kh nng gii c ca c th gim.
Protein l cht kch thch ngon ming
Do chc nng ny m protein gi vai tr quan trng trong vic tip nhn cc ch n
khc nhau. Trong c th ngi protein l cht c nhiu nht sau nc. Gn 1/2 trng
lng kh ca ngi trng thnh l protein v phn phi nh sau: 1/3 c, 1/5 c
xng v sn, 1/10 da, phn cn li cc t chc v dch th khc, tr mt v nc
tiu bnh thng khng cha protein. Protein cn thit cho chuyn ha bnh thng cc
cht dinh dng khc, c bit l cc vitamin v cht khong. Khi thiu protein, nhiu
vitamin khng pht huy y chc nng ca chng mc d khng thiu v s lng.
47/175
48/175
49/175
50/175
Nhng acid amin khng cn thit c th tng hp c trong c th. Do khi thiu
chng trong c th, c th c th b tr s thiu ht nh cc qu trnh tng hp
bn trong. Mt s acid amin c v ngt kiu ng (alanin, valine). Mui natri ca acid
glutamic c v ngt kiu m c s dng lm gia v.
Gi tr dinh dng mt loi protein cao khi thnh phn acid amin cn thit trong cn
i v ngc li. Cc loi protein ngun gc ng vt (tht, c, trng, sa) c gi tr dinh
dng cao, cn cc loi protein thc vt c gi tr dinh dng thp hn, nu bit phi
51/175
h thp s lng hng cu v hemoglobin. Ngoi ra khi thiu lysine cn bng protein b
ri lon, c suy mn, qu trnh ct ho b ri lon v c hng lot cc bin i gan v
phi.
Lysine c ch yu trong fromage, tht, c, cha khong 1,5 g lysine/100 g thc phm
v c nhiu trong sa v cc ch phm ca sa, tht, nhiu nht trong m c-miosin v
m mu-hemoglobin. Lysine hin din rt t trong ng cc.
* L-methionine (acid -amino ? -methionine n-butyric)
Methionine thuc loi acid amin cha lu hunh. Lu hynh ca methionine bn
vng i vi kim hn cc acid amin c cha lu hunh khc (cystine v cysteine).
Methionine c vai tr quan trng trong chuyn ho vt cht, c bit l qu trnh gn
v trao i nhm methyl trong c th. Methionine l ngun cung cp chnh cc nhm
methyl d bin trong c th. Cc nhm methyl c s dng tng hp choline, mt
cht c hot tnh sinh hc cao. Choline cn l cht tng hp m mnh nht: ngn nga
m ho gan. Ngoi ra cn c nh hng c th vo chuyn ho lipid v phosphatid trong
gan v gi vai tr quan trng trong vic ngn nga v cha x va ng mch.. Ngun
methionine tt nht l sa, fromage, lng trng trng. Methionine cn hin din trong
u nnh, bt m, c thu, tht g, b, th..
* L-threonine (acid -amino -oxybutyric)
Thiu threonine sc vt ngng ln, xung cn v cht.
* L-tryptophan (acid -amino -indolepropionicic)
y l mt trong nhng acid amin quan trng nht m vai tr ca n lin quan cht ch
vi tng hp t chc, cc qu trnh chuyn ho v pht trin. Tryptophan c nhiu trong
tht, sa, trng, fromage..Ngoi ra cn c nhiu trong m la m, u nnh..
* L-phenylalanine (acid -amino -phenylpropionic)
Tham gia vo vic tng hp tyrosine (l cht tin thn ca adrenalin) v l loi acid amin
chnh trong vic to thnh m tuyn gip.
Nhu cu ca cc acid amin cn thit
Theo t chc FAO cho thy khi lng m y , cht lng m c quyt nh bi
tnh cn i ca cc acid amin trong hn l s lng tuyt i ca cc acid amin cn
thit khc nhau. Nhng tc dng qua li gia cc acid amin rt nhiu v phc tp. Mt
hn hp khng cn i c th nh hng xu v mt dinh dng ngay c khi lng acid
amin cn thit y cho mt c th bnh thng. Nhu cu ti thiu ca cc acid amin
cn thit c trnh by Bng 3.6.
53/175
Nhu cu ti thiu ca cc acid amin cn thit ca ngi (Hong Tch Mnh v H Huy Khi,
1977)
54/175
Phenylalanine Tyrosine
Methionine Cystine
Tuy nhin qu trnh ngc li khng th xy ra trong c th. 80 - 90% nhu cu ca
methionine c th tho mn bng cystine v 70 - 75% nhu cu ca phenylalanine c th
c tho mn bng tyrosine. Do cc acid amin khng cn thit c th c t tng hp
trong c th nn vic xc nh nhu cu ca chng rt kh khn.
55/175
56/175
57/175
B: 75 C: 75 Casein: 75 Sa: 93
Bp: 72 Go: 86 Trng: 100 Bt m: 44
c. H s s dng protein(net protein utilization NPU): l t l protein gi li so vi
protein n vo
58/175
Sp xp protein thc n
59/175
60/175
Nhu cu protein ca c th
Nhu cu protein ca c th
Cc t chc FAO/OMS thng nht dng phng php ton phn tnh nhu cu.
Phng php ny dng tnh gp li cc nhu cu khc nhau gm: lng mt nit
khng trnh khi duy tr v nhu cu cho pht trin, chng cc kch thch.
Lng mt nit khng trnh khi gm:
- Lng mt nit theo nc tiu Uk: tnh bng cch theo di lng nit ra theo nc tiu
ch calo nhng khng c protein, khong 3g nit/ngy tc l khong 46 mg/kg
cn nng ngi chun.
- Lng mt nit theo phn Fk: (cng o ch 1g nit/ngy - 20 mg/kg cn nng)
- Lng mt nit theo da P (m hi, mng, tc- khong 20 mg/kg cn nng)
- Nhu cu cho pht trin C: cng trnh ca Holt cho l lng N gi li bng 2.9% trng
lng tng thm trong qu trnh pht trin tr em trn mt tui.
nh hng ca cc kch thch
Nhu cu ton b: theo FAO/OMS nhu cu ny c tnh theo mg N/ kg cn nng bng
tng s nhu cu trn nhn vi h s 1,1 (tng thm 10% nhu cu) tnh n vic b tr
tiu ph do cc kch thch hng ngy.
K = (Uk + Fk + P + C) x 1,1
Trong , K: nhu cu N theo kg cn nng/ngy
Uk: lng mt nit khng trnh khi theo nc tiu (mg/kg cn nng/ngy)
Fk: lng mt nit khng trnh khi theo phn (mg/kg cn nng/ngy)
P: lng mt nit theo da (mg/kg cn nng/ngy)
C: lng tng nit trong thi gian pht trin/kg cn nng/ngy
1,1: s tng thm 10% b tr tiu ph do cc kch thch gp trong i sng hng ngy.
Nhu cu theo m chun = K x 6,25
61/175
Theo FAO:
- Cc nc pht trin: NPU = 70 - 80
- Cc nc ang pht trin: NPU = 60 - 70
- Cc nc c phn n c bn khng phi l ng cc (sn)
NPU = 50 - 60
62/175
Lipid
M u
M u
Lipid l hp phn quan trng ca khu phn n, c trnh by Hnh 4.1.
Lipid l thnh phn thay i mt cch ng k trong thnh phn v cu trc. Chng
c tm thy c hai loi thc phm thc vt v ng vt, v cng thay i rt rng
v tnh cht l ho hc. Hu ht cc loi du m t nhin u cha khong 98 - 99%
glyceride, phn cn li rt nh bao gm monoglyceride, acid bo t do, phospholipid v
cc cht khng x phng ho. Tnh cht l ho hc ca cc cht du m nh hng bi
kch thc ca ht phn t bo v bi s lng ca cc acid bo bo ho hoc cha bo
ho m chng cha. Thng thng vi cht bo bo ho nhiu v khi lng phn t
cao th chng dng rn. Glycolipid hoc cerebroside l nhng hp phn ca acid bo
vi carbohydrate v cha nitrogen nhng khng c acid phosphoric. Cerebroside c
tm thy trong mng ty (myelin) ca si thn kinh trong trng thi kt hp vi lecithin.
63/175
64/175
trng thi rn. Ngc li trong thnh phn c nhiu acid bo cha no th chng c nhit
nng chy thp, thng trng thi lng (Bng 4.1). a s du thc vt trng thi
lng trong iu kin nhit bnh thng.
66/175
67/175
Hm lng lipid tng s trong mt s loi thc n chnh (% khi lng kh)
68/175
69/175
70/175
Cc acid bo
Cc acid bo
Tnh cht ca cc acid bo c th hin Bng 4.3
Hm lng cc acid bo trong mt s thc n (Hong Tch Mnh v H Huy Khi, 1977)
Cc acid bo no
Ch yu nm trong thnh phn m ng vt, cc acid bo c trng lng phn t cao
(stearic, arachic, palmitic..) th rn. Cc acid bo c trng lng phn t thp (butyric,
caprinic..) th lng, trng lng phn t cng cao th nhit tan chy cng cao. Gi
tr sinh hc ca cc acid bo no km hn cc acid bo cha no do chng c tc dng
khng tt i vi chuyn ho m, chc phn v tnh trng gan v c vai tr ca chng
trong pht trin bnh x va ng mch. Nhiu cng trnh nghin cu cho thy tnh
trng cholesterol qu cao trong mu thng i km vi ch n nng lng cao v
nhiu m ng vt.
Cc acid bo cha no
Cc acid bo cha no hin din rng ri trong cht bo n, c bit l cc loi du thc
vt (Bng 4.4). Cc acid bo cha no mt, hai hoc ba ni i hay gp nhiu trong thnh
phn thc n. Nhng cht bo c hot tnh sinh hc cao l cc cht bo cha cc acid
be c t hai ni i tr ln trong thnh phn ca n. M c v ng vt sng bin
thng c nhiu acid bo nhiu ni i. Cc acid be cha no rt nhy vi phn ng oxy
ho v phn ng lin kt nn thng khng bn vng. ng thi thng qua cc phn
ng ny, cc acid bo cha no chuyn thnh cc acid bo no v tr nn rn.
71/175
72/175
73/175
Phosphatide
Phosphatide
Phosphatide l thnh phn cn thit ca t bo v t chc, tp trung nhiu nht cc t
chc thn kinh v t chc no, tim, gan, tuyn sinh dc.. Hm lng ca chng phn b
nh sau:
74/175
Sterol v vitamin
Sterol v vitamin
Sterol
L thnh phn thng xuyn i km theo m. y l cht c cu to phc tp v thuc
nhm cht khng x phng ho. Trong m ng vt c cholesterol, du thc vt c
sitosterol. Hm lng sterol trong m ng vt khong 0,2 0,5%, cht bo thc vt c
nhiu hn.
1. Sitosterol
1. Cholesterol
Vitamin
Cht bo l ngun vitamin A, D v E. Vi lng cht bo s dng y s lm cho
cc sinh t tan trong du c s dng hon ton v c hiu qu. Cht bo giu cc acid
bo cha no cn thit h tr hp thu vitamin A v caroten.
Cc cht bo giu tocopherol kch thch s dng vitamin A v D trong c th. Khi cht
bo c cht lng tt v bo qun hp l th lng vitamin trong cng c m bo.
Khi cht bo b h hng th cc vitamin trong cng b phn gii.
Vitamin A ch c trong m ng vt, cc loi du thc vt li cha carotene. M ng
vt cn cha vitamin nhm D, chng l dn xut ca ergosterol hay cholestetol. V vy
c th coi cholesterol l ngun vitamin D chnh trong c th.
Cht bo cng l ngun vitamin E (tocopherol). Mt lng y tocopherol trong ch
n gip tch cha vitamin A trong cc ni tng (gan, thn..)
V phng din v sinh, tnh cht chng oxy ho ca vitamin E c bit quan trng
trong vic ngn nga s h hng m. Tocopherol c nhiu trong du thc vt, m ng
vt cha t tocopherol nn rt kh bo qun.
Nhu cu vitamin E ph thuc vo lng cc acid bo cha no cn thit trong khu phn.
ngn nga biu hin thiu vitamin E, t l vitamin E (theo mg ?-tocopherol) v cc
acid bo cha no cn thit (theo gram) s tng ng 0,6.
Cc cht bo thc vt khc ngoi tocopherol cn cha cc cht chng oxy ho t nhin
nh sesamol (du m), gosipol (du bng). Tuy nhin gosipol (C30H30O8) l cht c
i vi c th vi hm lng khong 0,08 n 2% du bng. Qu trnh tinh ch cho
php loi tr cc cht c .
76/175
77/175
Hp thu v ng ho cht bo
Hp thu v ng ho cht bo
Cht bo trong c th l cht bo trung tnh triglyceride. Cc acid bo trong phn t ca
chng c cc lin kt khng no khc nhau v c cc chui lin kt vi cc di khc
nhau, v vy t l tiu ho hp thu ca chng cng khc nhau.
Cc cht bo d tan chy thng hp thu tt. Cc cht bo tan chy c nhit nng
chy trn 40oC u hp thu km.
V mt ng ho c th chia cht bo thnh ba nhm:
? Cc cht bo c tan chy thp hn thn nhit: ng ho 97 - 98%
? Cc cht bo c tan chy trn 37oC: ng ho khong 90%
? Cc cht bo c tan chy trn 50 - 60oC: ng ho 70 - 80%
Tnh cn i v c im cc acid bo trong khu phn nh hng ti hp thu cht bo.
Nu trong khu phn n c qu nhiu acid bo no hoc cha no, ng ho u gim
xung. Nu hm lng cc acid bo cha no c nhiu ni i cao qu 15%, chng s
khng ng ho.
78/175
79/175
Du u nnh: 97,5%
80/175
Nhu cu cht bo
Nhu cu cht bo
Lng cht bo n hng ngy c cc nc trn th gii rt khc nhau. Nhiu nc
Chu u, Bc M s dng hn 150 g cht bo hng ngy (theo u ngi). Trong khi
cc nc Phi lng cht bo khng qu 15 20 g/u ngi/ngy.
Nhu cu cht bo ph thuc theo tui, tnh cht lao ng, c im dn tc v kh hu
(Bng 4.7). x lnh, t l calo do cht bo nn khong 35% tng s calori ca khu
phn, vng n i, x nng 15 - 25%.
? ngi tr tui v trung nin, t l m: bo = 1/1
? ng tui: t l m: bo = 1/0,7
? Gi v bo ph: 1/0,5
81/175
Carbohydrate
M u
M u
Carbohydrate tn gi chung ca nhm phn t hu c v chng cung cp khong 48%
nhu cu nng lng ca khu phn. Carbohydrate c phn nhm ty thuc vo s
lng ca nguyn t carbon trong phn t, nh triose (3 n v carbon), pentose (5 n
v carbon), hexose (6 n v carbon). V mt dinh dng loi carbohydrate c tm quan
trng l hexose v trong D-glucose l loi quan trng nht. Lng carbohydrate cung
cp y s lm gim phn hy protid n mc ti thiu. Trong c th chuyn ho ca
cc carbohydrate c lin quan cht ch vi chuyn ho lipid v protid.
Cc thc n thc vt l ngun carbohydrate ca khu phn. Cc thc phm ng vt c
glycogen v lactose. Glycogen c mt t trong gan, c v cc t chc khc v c c
tnh ca tinh bt. Lactose c trong sa trn 5%.
Cc carbohydrate quan trng nht trong thc phm c trnh by Bng 5.1
Monosaccharides Glucose, Fructose
Disaccharides
Sucrose, Lactose
Sugar alcohols
82/175
cp, v khi lipid oxy ho khng hon ton th s sinh th cetone, y l cht mang tnh
acid, nu tch ng trong c th nhiu s dn n ng c acid. V vy c th xem
carbohydrate c tc dng chng to th cetone v phng nga ng c acid.
84/175
85/175
Cc carbohydrate n gin
Cc carbohydrate n gin
Thuc loi ny gm c mono v disaccharide. Chng c c tnh chung l d ho tan
trong nc, ng ho v s dng nhanh to glycogen. Cc carbohydrate n gin u
c v ngt, khi vo c th xut hin tng i nhanh trong mu.
Monosaccharide
Cc monosaccharide thng gp l fructose v glucose. V thnh phn ho hc chng
la nhng hexose ngha l trong phn t c 6 nguyn t carbon, ng vi 12 nguyn t H
v 6 nguyn t O (C6H12O6).
a. Glucose
Cu trc ca phn t glucose th hin Hnh 5.1. Glucose c kh nng ng ho nhanh
v c s dng nhanh nht trong c th to thnh glycogen. Cht ny cn thit cho
dinh dng cc c ang hot ng, k c c tim duy tr mc ng huyt v to thnh
d tr glycogen gan. Glucose l ngun cung cp nng lng chnh cho h thng thn
kinh trung ng. Phn ln carbohydrate a vo c th c chuyn thnh glucose
cung cp nng lng cho cc t chc. Glucose c xem l thc n tt nht cho ngi
sau khi m, m yu hoc b bnh nng.
Hnh 5.1
Glucose
Hnh 5.2
Fructose
Trong t nhin glucose c nhiu trong cc loi qu. Hm lng ca chng trong mt s
loi qu nh sau: chui 4,7%, to 2,5 5,5%, mn 1,4 4,1%.
b. Fructose
86/175
88/175
ngt ca cc loi ng
ngt ca cc loi ng khc nhau. Nu ly ngt ca saccharose (ma hay c ci
ng) l 100, th ngt ca cc loi ng c sp xp nh sau:
89/175
Polysaccharide
Polysaccharide
Tinh bt
L polysaccharide c cu trc ho hc phc tp. S phc tp ca cu trc phn t cc
polysaccharide l nguyn nhn ca tnh khng ho tan ca chng. Tinh bt c c tnh
ha tan dng keo. Cc dung dch keo ca tinh bt khng bao gm cc ht tinh bt ring
r m l cc mi-xen (micelle) bao gm mt lng ln phn t.
Tinh bt bao gm hai phn t, amylose (thng thng chim 20 - 30%) (Hnh 5.6) v
amylopectin (Hnh 5.7) (thng thng chim 70 - 80%). C hai cha hp cht cao phn
t ca cc n v -glucose trong cu trc.
Tinh bt l thnh phn dinh dng chnh ca thc phm thc vt, c bit l cc loi
ht v u cng nh khoai ty. S bin i tinh bt trong c th ng v thc vt khng
tch ri vi s to thnh ng. Do c th coi tinh bt l ngun ng quan trng,
cn thit cho hot ng ca c th. Nhiu nghin cu chng minh rng thc vt s to
tinh bt i trc s to thnh ng. Lng tinh bt trong to gim dn trong qu trnh
chn v bo qun, ng thi cc loi ng tng ln mt cch tng ng.
Trong c th ngi tinh bt l ngun cung cp glucose chnh. S bin i chm tinh
bt thnh glucose to iu kin thun li cho vic s dng chng hon ton nht
trong c th. Trong iu kin tiu hao nng lng trung bnh lng ng cn thit
90/175
91/175
92/175
93/175
Cht lng cellulose c ngha dinh dng quan trng v c chia thnh hai loi:
cellulose th v cellulose mn. Loi cng mn cng c kh nng phn gii v ng ho
cao. Chc nng ca cellulose v cc cht x thc n nh sau:
Phng nga ung th rut kt: Cc thc n c cha hm lng lipid cao s lm cho vi
khun k kh trong rut sinh si ny n nhiu khin cho cc steroid trung tnh hoc
c tnh acid, c bit l acid choleic, cholesterol cng cc cht chuyn ho ca chng
cng b thoi bin, cc cht chuyn ho acid choleic trong phn tng ln l cht gy ung
th.. Cht x trong thc n s c ch hot ng ca cc vi khun k kh, thc y vi
khun hiu kh sinh trng, lm cho lng hnh thnh acid choleic trong i trng gim
xung. Cellulose c tc dng kch thch nhu ng rut, v th dng iu ho bi tit.
Cellulose gi vai tr nht nh trong iu ho h vi khun c ch rut v to iu kin
tt nht cho chc phn tng hp ca chng.
Phng nga x va ng mch: gn y nhiu nghin cu cho thy cellulose to iu
kin bi xut cholesterol ra khi c th v nh vy c vai tr nht nh trong phng nga
x va ng mch.
Phng nga hnh thnh si mt, gim c hm lng m trong mu. Phn ln si mt
l do cholesterol trong dch mt bo ho qu mc gy nn. Khi acid mt v cholesterol
mt cn bng, th s chit xut ra cht kt tinh cholesterol nh v hnh thnh si mt.
Cht x thc n s lm gim c nng cholesterol trong mt v huyt thanh, t
lm bo ho ca cholesterol trong mt gim xung, t l mc bnh si mt theo
cng gim.
Gy nh hng n mc ng huyt, gim bt tc dng da vo insulin ca bnh nhn
tiu ng. Khi p dng cch n c cha nhiu cht x v carbohydrate nh lng thc
94/175
95/175
96/175
Ngun: Carbohydrates in human nutrition, (FAO Food and Nutrition Paper ) 1991
Dinh dng v v sinh an ton thc phm (H Huy Khi HYD H Ni-2004)
97/175
98/175
Nhu cu carbohydrate
Nhu cu carbohydrate
Nhu cu carbohydrate ph thuc vo tiu hao nng lng. Lao ng th lc cng tng,
nhu cu carbohydrate cng cao v ngc li. Ngy nay ngi ta thy glucid c mt s
chc nng m cc cht dinh dng khc khng th thay th c. V d hot ng ca
t bo no, t bo thn kinh th gic, m thn kinh c bit da vo glucose l ngun
nng lng chnh. Glucid cn ng vai tr quan trng khi lin kt vi nhng cht khc
to nn cu trc ca t bo, m v cc c quan. Khng nhng th, ch n m bo
glucid cn cung cp cho c nhng cht cn thit khc.
Mt s nghin cu v nhn chng hc v dinh dng mt s b lc ngi ch yu n
tht ng vt v cht bo, lng glucid ch di 20% (ngi Eskimos), cn phn ln mi
ngi u n ch hn hp vi lng carbohydrate c t 56-70% nng lng. Cho
n nay nhu cu v carbohydrate lun da vo vic tha mn nhu cu v nng lng v
lin quan vi cc vitamin nhm B c nhiu trong ng cc.
Tiu chun carbohydrate i vi ngi t lao ng chn tay phi thp hn ngi ng
tui v gi. Cn phi c s cn i gia carbohydrate, protid v lipid trong khu phn n
hng ngy. i vi ngi lao ng trung bnh, t l gia protid: lipid v carbohydrate
thch hp l 1:1:4. i vi ngi lao ng chn tay t l nn l 1:1:5. ngi
lao ng tr c ng tui v ngi gi, t l thch hp l: 1:0,8:3. Vi vn ng vin
trong thi k luyn tp, cn s dng t l 1:0,8:6. Nh vy trong vic tiu chun ho
carbohydrate cng nh cc thnh phn dinh dng khc cn ch n tnh cn i gia
chng vi nhau trong khu phn.
99/175
Vitamin
i cng
i cng
Vai tr thit yu ca cc vitamin c cng nhn trong 30 nm u ca th k XX
chng minh c th cha khi nhiu bnh khc nhau bng cch i khu phn n v ch
dinh dng hp l. Nm 1913 nh ho hc M Mc. Collum ngh gi vitamin
theo ch ci v cc vitamin A, B, C, D xut hin. Sau ny ngi ta pht hin thm
cc vitamin E v K.
Vai tr ca cc vitamin i vi c th rt ln, chng l nhng cht hu c phn t thp
cn thit cho cc chc phn chuyn ho bnh thng cu c th, trong c cc qu trnh
ng ho v s dng cc cht dinh dng cng nh cc qu trnh xy dng t bo v cc
t chc trong c th. Vitamin phn ln khng c t tng hp trong c th m vo c
th theo cc thc n ngun gc ng vt v thc vt. Khi vo c th nhiu vitamin nhm
B tham gia vo cc thnh phn cc men ca cc t chc v t bo di dng coenzyme.
Cc coenzyme tch cc tham gia vo nhiu phn ng sinh ha quan trng dn n cc
bnh gim vitamin (hypovitaminose) v thiu vitamin (avitaminose). Vitamin c chia
thnh hai nhm: vitamin tan trong cht bo v vitamin tan trong nc.
100/175
101/175
Vitamin A (Retinol)
Vitamin A tn ti trong t nhin di hai dng: vitamin A1 (retinol - ch yu c trong
gan c bin), vitamin A2 (3-dehydroretinol - c trong c nc ngt - c hot tnh khong
40% so vi vitamin A1) v vitamin A3 (Hnh 6.2)
Cc dng vitamin A
t nhin l hp cht tng i n nh, khng b phn hy khi gia cng ch bin thng
thng. Trong khng kh v nh sng, vitamin A b oxy ho v phn hy nhanh chng,
nhit cao li thc y qu trnh phn hy mnh m hn. Cc ester ca vitamin A bn
vng i vi cc qu trnh oxy ho hn l dng t do. V th chng thng c s
dng vitamin ho thc phm. C ch hot ng ca vitamin A trong c th c cc khu
chnh ng ch :
Vitamin A c quan h cht ch vi th gic bnh thng
T bo hnh que v t bo hnh nn trong vng mc nhn th l cc t bo tip nhn cm
quang, u c cha sc t th gic. Sc t th gic trong t bo hnh que l rhodopsin,
cn trong t bo hnh nn l iodopsin u do retinene (mt dng hot tnh ca vitamin
A) v opsin cu thnh. Khi nh sng kch thch vo t bo hnh que rhodopsin s b phn
gii thnh opsin v dehydroretinene, ng thi b mt i mt phn vitamin A. Trong
bng ti, vitamin A trong mu qua qu trnh chuyn ho s to thnh 11-synretinene, li
kt hp vi opsin thnh rhodopsin m phc hi li th gic. Nu tnh trng dinh dng
vitamin A tng i tt, hm lng c trong mu cao th lng hp thnh rodopsin
trong mt n v thi gian s cao, thi gian phc hi th gic trong bng m tng i
ngn. Ngc li s dn n chng bnh qung g.
Tc dng i vi vic hnh thnh pht trin bnh thng ca lp biu m v vic duy tr
s hon thin ca cc t chc biu m.
Khi vitamin A khng hoc thiu s dn n sng ho t bo biu m lm cho b mt
da th rp, kh, c dng vy, lp ni mc mi, hng, thanh qun, kh qun v h sinh
dc-tit niu b hy hoi nn d b vim nhim. ng tit niu b sng ho qu mc l
mt trong nhng nguyn nhn gy si.
Vitamin A cn thit cho s sinh trng bnh thng ca b xng, v gip ch cho s
pht trin v sinh trng ca t bo
Cc nghin cu gn y pht hin thy vitamin A acid (cht chuyn ho ca vitamin A)
c tc dng lm chm hoc ngn chn cc bin chng tin ung th, ngn nga ung th
biu b. Sau khi vitamin A v carotene trong thc n c hp thu vo trong c th b
nh ho cng vi mt v cc sn phm tiu ho lipid trong rut non, c nim mc
rut hp thu. V vy lng lipid v nc mt y trong rut non l iu kin quan
trng hp thu chng tt; cc cht chng oxy ho nh vitamin E v lecithin s ngn
khng cho chng b oxy ho v gip ch cho vic hp thu. T l hp thu vitamin A cao
hn carotene 2 - 4 ln.
Vitamin A c d tr ch yu gan, ph thuc vo lng n vo v cc nhn t khc.
Lng vitamin A trong c th ngi gi thp hn r rt so vi ngi tr tui. Khi khng
c vitamin A np vo th lng mt i trong gan mi ngy vo khong 0,5% tng lng
103/175
Trong qu trnh tng hp vitamin A, ngi ta cng c vitamin A acid (acid retinoic).
ngi dinh dng tt, d tr vitamin A tng i ln v cho c th trong thi gian
di. Cc triu chng thiu vitamin A thng gp tr em v hc sinh, d tr vitamin A
ca chng hn ch hn. V th phn ln cc nghin cu lm sng v thiu vitamin c
tin hnh tr cho b v tr ln hn.
Nguyn nhn thiu vitamin A
C th ly vitamin A t thc n v c d tr ch yu gan. Thiu vitamin A ch xy
ra khi lng vitamin A n vo khng v vitamin A d tr b ht. Cc nguyn nhn
gy thiu Vitamin A gm:
Do n ung thiu vitamin A: C th khng t tng hp c vitamin A m phi
ly t thc n, do vy nguyn nhn chnh gy thiu vitamin A l do ch n
ngho vitamin A v carotene (tin vitamin A). Nu ba n vitamin A nhng
li thiu m v du m cng lm gim kh nng hp thu v chuyn ho
vitamin A. tr ang b th ngun vitamin A l sa m, nu trong thi k ny
m n thiu vitamin A s nh hng trc tip n a tr.
Nhim trng: Tr b nhim trng c bit l ln si, vim ng h hp, tiu
chy v c nhim giun a cng gy thiu vitamin A.
Suy dinh dng thng ko theo thiu vitamin A v c th thiu m chuyn
ho vitamin A.
Cc bin i thiu vitamin A xut hin theo th t sau:
- Qung g
- Kh kt mc v gim tit cc tuyn nc mt
104/175
- Kt mc dy, , gp np
- c cng mc v th gic
- Ri lon th gic nh sng chi
- Ph, s nh sng, thm nhim bch cu v hoi t mm gic mc (nhuyn gic mc)
- Vim ton mt
- Gim st trng lng v kch thc tuyn c v tuyn lch (hai c quan to t bo
limpho). T bo limpho gim v c s lng v sinh lc trong vai tr to khng th.
- Gim hot tnh v mc hon ho cc hin tng thc bo gim cc qu trnh to
globulin min dch.
Nhu cu vitamin A (Bng 6.1) tnh theo retinol nh sau:
i vi ph n cho con b, c 100 ml sa cho thm 49 mcg. Trong c th c 2 mcg carotene cho 1 mcg retinol, s hp thu carotene rut non khng hon ton (1/3). Nh
vy cn c 6 mcg -carotene trong thc n c 1 mcg retinol.
Nhu cu vitamin A
Theo khi nim ng lng retinol (RE) vitamin A do FAO/WHO a ra, khi tnh ton
tng lng vitamin A np vo t ngun thc n, th quy i vitamin A c ngun gc
ng vt v carotene c ngun gc thc vt thnh quan h ng lng retinol nh sau:
1 n v quc t vitamin A = 0,3 g ng lng retinol kt tinh
1 RE = 3,3 I.U Retinol & = 10 I.U carotene
1 g vitamin A = 0,1 g ng lng retinol
105/175
106/175
Tocopherol (vitamin E)
Cc thc phm thc vt giu vitamin E l: u xanh ti 3 - 6 mg%, u kh 5 - 6 mg%,
c rt 1,5 mg%, salade 3 mg%, ng ht 10 mg%, mm ng 15 - 25 mg%, la m 6,5
7,5 mg%, u phng 9 mg%.
107/175
109/175
Hnh
6.7 Thiaminpyrophosphat
110/175
112/175
Sinh tng hp purin: vitamin B12 gi vai tr quan trng trong cu to v tng hp acid
nucleic.
Tng hp v vn chuyn cc nhm methyl: vitamin B12 tng sinh tng hp methyl t
tin thn ca n nh: -carbon ca glycin v -carbon ca serine.
Vitamin B12 cn nh hng ti chuyn ho lipid v glucid, c th l kch thch hot
tnh coenzyme A v tham gia vo qu trnh chuyn ho glucid thnh lipid.
S thiu cobalamin dn n nhng bnh thuc v dinh dng gi l bnh thiu mu c
tnh, l bnh rt him gp, nguyn nhn ca bnh l do thiu cht mucoprotein cn thit
cho s hp thu cobalamin. S thiu ht cobalamin cn km theo s thiu ht cc vitamin
khc.
Niacin
(a) Niacine
(b) Nicotinamide
Hnh
6.11 Niacine (a) v
Nicotinamide (b)
113/175
114/175
Acid folic tn ti trong t nhin ch yu di dng polyglutamic. Dng hot tnh sinh
hc ca acid folic l acid tetrahydrofolic. Acid folic tan t trong nc, khng tan trong
cn, te v cc dung dch hu c khc. Acid folic khng n nh trong dung dch acid,
v cng khng n nh vi nhit, gp nh sng d b phn hy. Acid folic khi c bo
qun v un nu thc n thng mt i 50 - 70%, c lc ln ti 90%.
Acid folic trong c th c hai phng php hp thu ch ng v hp thu th ng khuch
tn, v tr hp thu ch yu phn rut non. Glucose v acid ascorbic s xc tin vic hp
thu acid folic. Theo tnh ton, tng t l hp thu acid folic trong ba n l vo khong
70%, lng acid folic trong c th khong 5 - 6 mg, trong c khong mt na l
trong gan, phn thi ra ngoi c th s qua dch mt v nc tiu.
Acid folic sau khi c hp thu, vi s tham gia ca NADPH s c enzyme kh
(reductase) hon nguyn thnh acid tetrahydrofolic, acid tetrahydrofolic l dng c bn
ca formoxyl, formininodoyl methyl... coenzyme acid folic. Cc coenzyme acid folic
bit t nht c 5 loi, chng cn thit cho cc nhm carbon 1 (C1), bao gm di chuyn
n hp cht khc, ng vai tr quan trng trong s hp thnh purin v pirimidin, s
chuyn ho ln nhau gia cc acid amin v mt vi phn ng ho hc methyl. V vy
acid folic trong c qu trnh tng hp protein v qu trnh phn chia v sinh trng
ca t bo u rt quan trng. Thiu acid folic s dn n s gim st trong hnh thnh
hemoglobin ca hng cu, s sinh trng ca t bo gp tr ngi gy ra thiu mu
nguyn hng cu.
Mt chc phn sinh ho rt quan trng ca acid folic l tham gia vo cu to porphyrine
v hemin, iu ny xc nhn vai tr chng thiu mu ca n. Vai tr ln ca acid folic
vi chuyn ho v tng hp acid nucleic v acid amin ni ln tm quan trng ca n
trong cc qu trnh ln, sinh sn v pht trin ca bo thai.
115/175
116/175
kh hydro), loi cha c oxy ho gi l acid ascorbic hon nguyn. C hai loi hon
nguyn v loi kh hydro u c cng hot tnh sinh hc (Hnh 6.16).
117/175
118/175
119/175
Cc cht khong
Cc cht khong
i cng
Trong c th ngi c gn khong 40 nguyn t ho hc. Mt s trong c tng i
nhiu, tri li nhiu nguyn t ch c vi lng rt t. Lng tro ca mt ngi trng
thnh khong 3 kg, chim di 4% trng lng c th. Khong mt na lng cht
khong l yu t to hnh ca cc t chc xng v t chc mm. Phn cn li nm
trong cc dch th. Thnh phn tro c th hin Bng 7.1
Bng 7.1 Thnh phn tro
Calci
Phosphor 700 g
Clor
105 g
Kali
245 g
Magne 3,5 g
Natri
105 g
St
3,0 g
Ngoi cc cht trn, trong tro cn c mangan, ng, km, molipden, Bo v cc cht
khc. V hm lng ca chng thp nn thng gi l cc yu t vi lng. Hm lng
cc cht khong trong t chc khng ging nhau. xng, rng tp trung nhiu cht
khong, trong khi da v cc t chc m, lng tro khng qu 0.7%. Mt s cht
khong nm trong thnh phn lin kt hu c nh iod tyrosine, Fe hemoglobin hay S
thiamine nhng phn ln di dng mui khc nhau. Nhiu loi mui ny tan trong
nc nh clorur calci v natri. Nhiu loi khc t tan, quan trng nht l phosphate calci
v magne ca t chc xng. C th khng sn xut c cc cht khong. Cng vi
protein, vitamin v cc thnh phn khc ca thc n, chng tham gia vo tt c cc phn
ng sinh ho trong c th.
120/175
Cc yu t i lng
Calci (Ca)
Calci chim khong 1,4 - 2% tng khi lng c th. 90% calci tp trung xng v
rng di dng mui calci. Phn calci cn li hin din trong huyt tng v mang
nhim v trao i cht rt quan trng. Khong 10 - 30% calci khu phn n trung bnh
c hp thu rut. Nhim v sinh l hc ca 99% calci trong c th l xy dng v
duy tr m xng v c trong s hnh thnh rng. 1% cn li ca calci trong c th biu
hin kh nng sinh l khc. Trong s ng mu, ion calci cn thit cho lin kt gia
phn t fibrin to trng thi bn ca chui fibrin.
Calci l thnh phn cn thit cho s chuyn ho prothrombin thnh thrombin. Thrombin
l enzyme cn thit cho s ng mu, vitamin K cng tham gia vo phn ng ny.
Calci trong c th lun dng lin kt vi phosphor. 99% Ca v 99% P rng v xng.
Phn cn li cc vt cht sng khc. Ca v P cng vi cc cht khong khc ho vo
thc phm khi tiu ho v chng c hp thu d dy - rut v dn n mu. Mu
mang chng i khp cc phn khc nhau trong c th v c s dng cho qu trnh
tng trng.
Hp thu, bi tit v d tr
121/175
122/175
+ 13 - 15 tui: 1200 mg, t cho n khi thnh ngi ln li h xung cn 800 mg.
Ngun thc n c cha calci tt nht l sa v cc ch phm ca sa. Ngoi ra cc loi
rau xanh v u cc loi, c bit u nnh v ko m, ht da, rong bin, tm nn...
hm lng calci cng nhiu.
Phosphor (P)
Phosphor c nhiu trong xng, rng ca c th ngi bng mt na lng calci. Tng
lng phosphor trong c th trng thnh c khong 700 - 900 g, trong gn 3/4 tham
gia vo thnh phn xng v 1/4 c trong t chc v dch th.
Phosphor cn l thnh phn quan trng trong cc kt cu m mm, nh protein acid
ribonucleic (RNA), desoxyribonucleic acid (DNA) v lp m trn mng t bo u c
cha phosphor. Ngoi ra trong c th phosphor cn c nhiu chc nng nh:
Tn tr nng lng
Cht hot ho
Thnh phn to thnh enzyme phosphor l thnh phn to thnh ca rt nhiu
h enzyme hoc coenzyme nh thiamin pyrophosphate, flavine adenine
dinucleotide v niacinamide adenine dinucleotide...
iu tit s cn bng acid-kim
Chuyn ho v hp thu phosphor
Rut non c th hp thu phosphor trong thc n bng vic hp thu ngun nng lng
tiu hao khuch tn v vn chuyn ch ng. T l hp thu phosphor ty theo tui, theo
hm lng cc ion dng khc c trong thc n nh calci, nhm.. v theo ngun thc
n.
Ngun phosphor c trong thc n rt ph bin, do him gp trng hp c th thiu
phosphor. Phosphor tn ti trong cc t chc ng, thc vt, ch yu l kt hp vi
protein, lipid to thnh nucleoprotein, phosphoprotein v phospholipid... Cng c
mt lng t phosphor tn ti di dng cc hp cht phosphor hu c hoc v c khc.
Vic hp thu phosphor trong ng rut i hi phi c s tr gip ca vitamin D. Nu
thiu vitamin D th s lm cho mc phosphor v c trong huyt thanh b h thp. Mt s
hp cht ca phosphor kh hp thu, acid phytic thuc loi . Phosphor di dng cc
hp cht phytin c cc ht.
Magne (Mg)
Magne c hp thu rut nh s to thnh cc hp cht phc vi acid mt. Magne
cn tham gia vo cc qu trnh chuyn ho glucid v phosphor v gi vai tr quan trng
123/175
trong iu ho hng phn ca h thng thn kinh. Ngun magne chnh trong thc phm
l cc loi ng cc, u. Sa, trng, rau qu c t magne, c cha nhiu magne hn.
Kali (K)
Kali ch yu c bn trong t bo v gi vai tr quan trng trong cc qu trnh chuyn
ho. Kali tham gia vo cc qu trnh men, c bit l chuyn acid phosphopyruvic thnh
acid pyruvic. Kali c tm quan trng trong s to thnh cc h thng m (bicarbonate,
phosphate..) nhm ngn nga cc chuyn bin ca phn ng mi trng v m bo tnh
n nh ca n. Ngun kali quan trng trong khu phn n hng ngy l khoai. ch
n hn hp, nhu cu kali c tho mn hon ton. Hm lng kali v natri trong mt
s loi thc phm c cho Bng 7.2
Bng 7.2 Hm lng Kali, natri trong mt s thc n
Natri (Na)
Natri l thnh phn ph bin trong tt c cc c quan, t chc v dch sinh hc ca c
th ng vt. Trong huyt thanh c 335 mg% natri. Natri gi vai tr quan trng trong
cc chuyn ho bn trong t bo v gia cc t chc. Mui natri ch yu c trong cc
dch bn ngoi t bo-bch huyt v huyt thanh.Mui natri gi vai tr nht nh trong
vic duy tr tnh n nh ca p lc thm thu ca nguyn sinh cht v cc dch sinh hc
ca c th. Natri tham gia tch cc vo chuyn ho nc v tham gia vo vic trung ho
cc acid to thnh trong c th.
124/175
Clor trong thnh phn ca clorur natri tham gia vo iu ho p sut thm thu t chc
t bo, iu ho chuyn ho nc cng nh to acid chlohydric. Ngun clor trong thc
phm khng nhiu, rau qu rt ngho clor. Lng clor trong u, ng cc thng cao
hn cc loi thc phm khc. Cc thc phm ng vt cng c nhiu clor. Tuy nhin
ngun clor chnh ca c th nh vo clorur natri n vo hng ngy.
Cc yu t vi lng
St (Fe)
St tham gia vo qu trnh to mu. Tng lng st trong c th khong 3-5 gr, trong
57% hemoglobin, 7% myoglobin, 16% cc men v t chc, di 20% d tr
gan, lch, ty, thn. Thiu st thng dn ti thiu mu. Ngoi to mu, st cn gi vai
tr quan trng trong cc qu trnh oxy ho v kch thch chuyn ho bn trong t bo. St
cn l thnh phn cn thit ca cc nhn t bo v tham gia vo thnh phn nhiu men
oxy ho peroxydase, citocromase.. Nhu cu cung cp st hng ngy c cho Bng
7.3.
Ngun st (Bng 7.4) chnh l t cc thc phm ngun gc ng vt v thc vt: u,
ng cc, rau qu ... Gan, no, lng trng c cha nhiu st. 60% st cc ht di
dng khng th hp thu c. l do s c mt ca cc hp cht phytin gy cn tr
hp th st. St rau qu d hp th, v th tuy vi hm lng khng cao, chng l
ngun st quan trng. St rau qu hp th tt do s c mt ca vitamin C.
Bng 7.3 Nhu cu cung cp st hng ngy (mg)
125/175
Mangan (Mn)
Trong c th mangan c vi lng thp, hm lng mangan cao nht gan, thn, ty,
khong 2 - 4 g/g t chc ti.
Vai tr chnh ca mangan l tham gia tch cc vo cc qu trnh oxy ho kh. Trong
c th mangan l cht kch thch qu trnh oxy ho. Mangan c tnh hp m r rt, n
126/175
ngn nga m ho gan v tng s dng lipid trong c th. Mangan cn tham gia trong
qu trnh to xng. Mangan c nhiu trong thc phm thc vt hn thc phm ng
vt, tr c nhiu mangan nht. Gia mangan v hot ng mt s vitamin nhm B v
vitamin C c lin quan nht nh. Bnh thiu vitamin B tin trin nh v mau khi khi
cho thm mangan vo khu phn. Cc thc phm thc vt giu vitamin C thng c
nhiu mangan. Mangan cn tham gia vo qu trnh tng hp vitamin C trong c th.
Coban (Co)
Vai tr chnh ca coban l tham gia vo qu trnh to mu v chuyn ho vt cht. Coban
kch thch qu trnh to mu, tuy nhin liu lng cao c tc dng ngc li. Trong iu
tr thiu mu, coban c tc dng khi cho ng thi vi st. Ngi ta cn thy hot ng
to mu ca coban khi th hin mc ng (Cu) cao trong c th. Coban khi c mt
ca ng s tc dng ln s to thnh hng cu li v chuyn chng thnh hng cu
trng thnh.
Coban c kh nng lm chm pht trin t bo ung th, nh hng r rt n hot ng
mt s men thy phn. Coban l nguyn liu gc ni tng hp vitamin B12 trong c
th. Theo quan im hin nay nhu cu c th ch yu c tha mn nh lng vitamin
B12 do cc vi khun ng rut tng hp t coban ca thc n. Coban c nhiu nht
tuyn ty v tham gia vo qu trnh to thnh insulin.
Coban ph bin trong thc phm vi lng rt thp (trong thc vt bin, c v ng
vt khc..). Tuy nhin ch n hn hp cng tha mn nhu cu c th.
Iode ( I2)
Iode tham gia tch cc vo chc phn tuyn gip tng, thiu iode s dn n ri lon ca
tuyn ny, gy pht sinh bu c. Ngun thc phm cha iod thng thng c cho
Bng 7.5. Ngun d tr ln nht ch yu l nc bin, khng kh v t vng ven bin.
Tht, sa, trng c hm lng iode cao. Tuy nhin lng iode trong thc n thay i tu
theo iu kin a cht v theo loi thc phm. C bin v cc loi hi sn c nhiu iode.
S pht sinh bnh bu c, n n thng gp ch ngho iode.
Bng 7.5 Hm lng iode trong mt s thc n
127/175
Fluor (F)
Fluor tham gia vo qu trnh pht trin rng, to ng rng v men rng. Fluor cn gi vai
tr quan trng trong qu trnh to xng v c nh hng n iu ho calci - phosphor.
Lng fluor c nhiu xng v rng. Xng c 200 - 400 mg/kg trng lng, rng c
240 - 560 mg/kg trng lng, cc c khng qu 2 - 3 mg/kg trng lng. Tui cng cao
hm lng fluor trong c th cng tng. Qu trnh tch cha fluor men rng xy ra lc
cn b, trong thi k hnh thnh v pht trin rng vnh vin.
Lng fluor trung bnh trong thc phm t 0,02 - 0,05 mg%. Trong sa c 0,01 mg%
fluor, cm 0,1 mg%, tr c nhiu fluor 7,5 - 10 mg%.
ng (Cu)
ng tham gia tch cc vo qu trnh to mu v h hp t bo. Nhiu men oxy ho
(tyrosinase, lactase..) cha ng nh l thnh phn kim loi c hiu. ng tham gia
vo qu trnh tng hp hemoglobin v c nh hng ti chc phn cc tuyn ni tit,
insulin v adrenalin.. ng c nhiu trong gan, u v ng cc v hm lng khng
cao trong cc loi thc phm khc nh trng, g, sa..
Km (Zn)
Lng km trong c th khong 2 - 3 gr, trung bnh 30g/g trng lng ti. Vai tr
chnh ca km l tham gia vo cu to carbohydrase. Men ny gi vai tr quan trng
trong h hp v xc tin phn ng.
thit cho qu trnh tng hp tryptophan. Km c nh hng ti lng vitamin trong thc
phm. Lng km v thiamin trong thc phm thng song song vi nhau. Cng nh
nhiu kim loi khc, km c th phn hy v lm mt hot tnh vitamin A.
Km ph bin rng ri trong t nhin, lng km trong thc phm thc vt dao ng
t 1 - 10 mg/100 gr trng lng ti. Ng cc v u c nhiu km. Vi loi sn phm
ng vt nh lng trng, tht, trng, s, c rt, tiu mch, bnh m ch t bt th,
khoai tyc nhiu km.
129/175
130/175
131/175
Nhu cu ca vitamin lin quan ti lng glucid trong khu phn n. Ngi ta thng
tnh t l vitamin B1 (?)/calori khng do lipid. phng bnh Beri-beri t l cn
l 0.45
Protein v vitamin
Thiu vitamin gy cn tr tch ch riboflavin (B2) v lm gim d tr vitamin B2 trong
c th. Mi quan h gia s dng vitamin A v mc protein ca khu phn cng ang
c ch . Khi khu phn n c 18 - 20% protein, kh nng tch ly vitamin A gan
cao nht, nhng khi tng lng protein ln ti 30 - 40% th s dng vitamin A li tng
ln. Hm lng protein cao trong khu phn gy gim d tr vitamin A, do thng
xut hin sm cc biu hin thiu vitamin A. Ngc li khu phn ngho vitamin A th
biu hin thiu vitamin A s ko di.
Tnh trng thiu protein cng gi vai tr quan trng trong sinh hc bnh ci xng.
Nhiu nghin cu cho thy trong iu kin thiu protein vn c cc biu hin thiu
vitamin D.
Protein trong khu phn cn nh hng n vitamin C, vitamin PP v acid amin
tryptophan. Khi thiu protein cc vitamin ny d dng ra khi c th, khng tham gia
vo cc qu trnh chuyn ho. Ngoi ra thiu protein to iu kin pht sinh bnh
pellagre, bnh scorbut v bnh thiu a sinh t...
Quan h gia cc vitamin
Ngi ta chng minh c rng quan h khng kht ca hot ng nhiu loi vitamin
khin cho thiu mt vitamin ny c th gy thiu km theo mt loi khc. Thiu vitamin
B gy xut hin triu chng thiu acid pantothenic. i vi nhiu loi thiu vitamin
nhm B, Vitamin A c tc dng bo v r rt.
Vitamin v cht khong
Vai tr ca cht khong i vi hot ng ca cc vitamin rt cht ch v a dng.
Chng l nhng cht xc tc, hot ho hoc c ch cc phn ng ca h thng men c
cha vitamin. Mt s cht khong c th l thnh phn cn thit trong nhn hot ng
ca cc men, nh coban trong thnh phn vitamin B12.
132/175
Hnh 8.1 Khuynh hng s dng thc phm theo thu nhp
lipid, glucid, cc vitamin v cht khong ty theo tui, gii, tnh cht lao ng v cch
sng. Nng lng do protein cung cp trong khu phn cn t 10 - 15% mc d vai tr
sinh nng lng ca protein ch l ph.
Glucid v lipid l ngun nng lng chnh. Nng lng do lipid cung cp khng nn
qu 30%, nng lng do glucid cung cp nn t 40 - 60%. T l cn i sinh l v trng
lng gia protein, lipid v glucid trong khu phn n nn l 1:1:4. T l ny c thay
i theo tui, tnh trng sinh l v lao ng.
Cn i v protein
Cc protein c ngun gc ng vt c gi tr sinh hc cao nn chim t nht l 1/3 tng
s protein, tt nht l t s protein ng vt/protein thc vt 1.
Cn i v lipid
Hai ngun cht bo ng vt v thc vt nn cng c mt trong khu phn. Khuynh
hng thay th hon ton m ng vt bng cc loi du thc vt l khng hp l v
c khi nguy him do cc sn phm oxy ho (cc peroxyde) ca cc acid bo cha no l
nhng cht c hi i vi c th. Theo nhiu ti liu, trong khu phn nn c 30% tng
s lipid c ngun gc thc vt.
V t l gia cc acid bo, trong khu phn nn c 10% cc acid be cha no c nhiu
ni kp, 30% acid bo no v 60% acid bo cha no c mt ni kp (acid oleic).
Cn i v glucid
Khuynh hng cc nc pht trin l trong iu kin gim lao ng th lc th nn
hn ch glucid v t l nng lng do glucid trong khu phn nn khong 60%. Nng
lng do glucid nn vo khong 65 - 75% tng s nng lng.
Cn i v vitamin
Cn i v vitamin cng thng da trn tng quan vi nng lng.Cn hiu cn i
ny nh l cn i gia cc yu t sinh nng lng v khng sinh nng lng. Hay
ni cch khc gia ngun nng lng v cc yu t cn thit gii phng ngun nng
lng trong c th. Theo FAO/OMS, trong 1000 Kcal cn c:
0.4 mg vitamin B1
0.55 mg vitamin B2
0.6 ng lng niacine (1 ng lng niacine = 1 mg vitamin PP hay 60 mg
tryptophane).
134/175
Cn i v cht khong
T s Ca/P trong khu phn nn nm gia 0,5 1,5 v thay i theo tui, tr em
khong 2, tr ln hn nn l 1,25 v ngi ln t s nn l 0,7 - 1. T s Ca/Mg
trong khu phn nn l 1/0,6
Cn i v cc cht chng oxy ho
Mt s cht khong nh selen, km v vitamin cng c vai tr chng oxy ho. Vitamin
E chng oxy ho tt nht. Ngoi ra -caroten cng c tc dng chng oxy ho. Vitamin
C cng tham gia vo qu trnh ny.Tnh cn i trong thc n
Dinh dng hc phi tr li c nhng cu hi sau:
- Nhng thnh phn no ca thc n l cn thit i vi c th v nhu cu ca chng?
- Chng c mt trong nhng loi thc n no?
- Vai tr ca chng i vi c th?
Khi ni n gi tr dinh dng ngi ta thng ni n gi tr sinh nng lng, thnh
phn ho hc v gi tr s dng ca cc thnh phn trong c th. Gn y l lun v
dinh dng cn i c dng biu hin gi tr dinh dng. Gi tr dinh dng ca
mt thc phm cng cao khi n cng tho mn nhu cu c th v cc thnh phn dinh
dng hoc cc thnh phn ho hc ca n tho mn cng thc dinh dng cn i.
Ngi ta thng tnh theo 1000 Kcal hay 300 Kcal (coi nh tho mn 10% nng lng
c ngy). Cch tnh ny c gi l "cng thc v gi tr dinh dng ca thc phm"
(Bng 8.1).
T bng cho thy s khc nhau gia cc loi thc phm: ng, ru l ngun nng
lng rng, sa chnh l ngun calci, vitamin B2 c gi tr. Tht l ngun protein,
phosphor, st v vitamin PP.. i vi cc thnh phn sinh nng lng (protein, glucid,
lipid) thng tnh phn trm nng lng ca chng trong thc phm. i vi vitamin v
cht khong thng tnh hm lng ca chng c trong thc phm. Ngoi ra tnh thm
mt s t s cn thit nh t s Ca/P (Bng 8.2), Ca/Mg..
135/175
136/175
137/175
Nhu cu nng lng c ngy (NCNLCN) c tnh ton bng tng nhu cu nng lng
ca chuyn ho c bn (NL (CHCB)), nng lng cho tc dng ng lc c hiu ca
thc n (TDLHT) v nng lng cho cng lao ng (CL).
NCNLCN = NL [CHCB] + NL [TDLHT (10%CHCB)] + NL [CL]
138/175
Protein
Nhu cu ca protein khng nhng ch ph thuc vo tui v tnh trng sinh l m c vo
cht lng m. Do t l gia protein ngun ng vt v protein thc vt c
ngh t nht l 1:1. Cht lng protein c nh gi thng qua h s NPU (net protein
utilization). NPU th hin c mc tiu ho protein v c gi tr sinh hc ca hn hp
acid amin c hp thu qua ng tiu ho.
Lipid
Trong khu phn n ca tr em, thanh nin, thiu nin v ngi lao ng nng, t l
nng lng do lipid khng nn qu 30 - 35% tng s nng lng (cn cc nhm khc
th khng qu 25 - 30%). Cc lipid c ngun gc khc nhau cng tt v d to t l cn
i gia cc acid bo hn. m bo acid bo cha no cn thit nn s dng mt
lng nht nh du thc vt trong khu phn.
Glucid
cc khu phn hp l, glucid cung cp khong 50 - 60% nng lng. Do cc ngun
glucid thng r hn lipid v nht l protein nn cc nc ngho v tng lp ngho
mi nc, lng s dng cc thc phm giu glucid thng qu cao. Nh vy c kh
nng gy thiu tng i cc protein nht l khi khu phn ngho sa, fromage, rau v
qu..
Tiu chun v vitamin
Nhu cu v vitamin A, acid bo cha no, vitamin E tng ln cng vi lng lipid trong
khu phn. Nm 1965, FAO v OMS a ra cc tiu chun ngh v vitamin A,
thiamin, riboflavin v niacine..
Vitamin A
Vitamin A c th t vitamin A tht hay caroten, theo quy nh chung 1 n v quc
t (UI) vitamin A tng ng 0,3 g retinol (dng ru ca vitamin A) hay 0,34 g
acetate retinol hay 0,6 g caroten. Do c th ch hp thu khong 1/3 lng caroten v
sau ch 1/2 chuyn thnh vitamin A cho nn ngi t 1 g (alpha-carotene c th
ch nhn 0,167 g retinol. Nhu cu ngi trng thnh l 750 g retinol, ca ngi m
cho b l 1200 g retinol (2500 U.I).
Vitamin B1
Lng vitamin B1 nn t l vi lng calori ca khu phn v nn l 0,4 mg thiamin
cho 1000 Kcal.
139/175
Vitamin B2
Tiu chun ca vitamin B2 l 0,55 mg cho 1000 Kcal.
Vitamin C
Nhu cu thay i t 30 n 70 - 75 mg. Tiu chun ca FAO l 50 mg.
Vitamin D
Nhu cu l 400 UI cho tr em v 40 - 100 UI cho ngi trng thnh.
140/175
141/175
Protein trong sa bao gm: casein, albumin v globulin. Tuy tng lng protein trong
sa m t hn trong sa b nhng sa m c nhiu albumin v globulin thch hp vi
kh nng tiu ho ca tr. Di tc dng ca men tiu ho, protein ca sa m s vn
li thnh nhng ht nh rt d tiu. Ngc li, protein ca sa b a s l casein s vn
li thnh nhng cc sa c kh tiu ho hn.
Lipid trong sa m c nhiu acid bo khng no l nhng cht d tiu ho v cn thit
cho s pht trin ca tr. Kh nng thy phn cht bo ca men lipase c trong sa m
mnh hn sa b n 15 - 25 ln.
Sa m c nhiu lactose, ch yu l -lactose, l mi trng tt kch thch s hot ng
ca cc vi khun ln men chua lm tng s tiu ho sa, ng thi li c ch s hot
ng ca vi khun gy thi. Ngc li sa b c cha nhiu lactose l mi trng tt
cho vi khun c hi hot ng, v vy tr b sa b thng hay b ri lon tiu ho hn.
Sa m c nhiu vitamin A, C, D, B2 hn sa b. B m gip tr phng bnh kh mt
do thiu vitamin A, ci xng.. Lng calci, st trong sa m tuy t, nhng t l hp thu
cao nn b sa m tr t b ci xng v thiu mu.
Sa m cha nhiu men, hormone, khng th l nhng cht m sa b khng c. Mt
khc sa m cn cha cc globulin min dch bi tit (SIgA) cng vi cc i thc bo
c tc dng bo v, chng d ng. V vy tr b m t b cc bnh tiu chy, bnh v h
hp v t d ng, chm.. hn tr n sa b.
142/175
143/175
144/175
Nhu cu calci ca tr em
Nhu cu v phosphor thng tnh theo t l Ca/P trong khu phn. Natri v kali l cht
iu ho chnh ca chuyn ho nc trong c th. So vi ngi ln, tr em cn nhiu
kali hn natri. Theo mt s ti liu nhu cu ca kali l 5 mg/kg cn nng.
Thiu st trong c th cng c th gy thiu mu tr, ngun st thay i ty theo la
tui, vo khong 7 - 8 mg tr trc tui i hc v 10 - 15 mg tui hc sinh.
Iode v fluor gi vai tr ln trong pht sinh bnh bu c, su rng v nhim c fluor.
Ch n v nguyn tc xy dng thc n
T chc dinh dng hp l i hi chp hnh ch n nht nh: tr em trn 1,5 tui
nn n mi ngy 4 ln nhng khong thi gian nht nh. Khong cch gia cc ba
n thng vo khong 4 gi. Phn phi tng ba n thng b tr nh sau:
145/175
146/175
147/175
Ty theo cng lao ng, nhu cu nng lng ca cc loi lao ng nh sau:
148/175
thay th bi cc protein chc phn khng c kh nng . T chc thn kinh trung ng
chm gi nht nhng c nhng biu hin h thp kh nng lao ng tr c.
Nhng yu cu v dinh dng
Tnh trng dinh dng khng hp l ngi gi thng do:
- Kh nng chc phn ca c th gim st
- Nhai km
- Bin i tm l
Nhu cu nng lng
Tui cng cao, chuyn ho c bn cng gim, hot ng c th ni chung gim dn.
Nhu cu nng lng theo cch tnh ca FAO cho ngi trn 60 tui khong 1800 - 1900
Kcal/ngy (n) v 2300 Kcal/ngy (nam).
Nhu cu protein
Hn ch lng protein i vi ngi ln tui v lng tha ca chng d gy hnh thnh
v pht trin x va ng mch. Hn ch s dng ngun protein ng vt nh tht v
s dng ch yu cc ch n sa, protein thc vt. T l protein ng vt v thc vt
khng qu 1 ( 1).
Nhu cu lipid
Lng lipid trong khu phn ngi ng tui v gi cn hn ch v c th gy x va
ng mch v cng cn hn ch mt lng ln lipid gy kh tiu i vi ngi gi. Nn
s dng cht bo c ho lng thp, cc du thc vt giu cc acid bo cha no v cn
phi hp vi vitamin E phng cc bin i da v x va ng mch.
Nhu cu carbohydrate
T l gia protein, lipid v carbohydrate nn thay i v pha h thp lipid v
carbohydrate. T l c th chp nhn l 1:0.8:3. Mt lng tha carbohydrate d ng
ho gy tng cholesterol v tc dng khng tt ti tnh trng v chc phn ca h vi sinh
vt ng rut. Cc loi rau ti cn l ngun acid tartaric v fitonxit. Acid tartaric c
tc dng c ch cc qu trnh chuyn ho carbohydrate v lipid trong c th. Cc fitonxit
ngoi tc dng tit trng cn iu ho h vi khun ng rut, c bit n chc phn
tng hp ca chng v c ch cc vi khun gy thi.
150/175
Vitamin
Cc vitamin c tc dng c ch s pht trin ca qu trnh gi, duy tr hot ng bnh
thng ca h thng tim mch v thn kinh, c ch qu trnh x ho. Cc vitamin C v
vitamin PP c vai tr nht nh trong duy tr tnh trng bnh thng ca cc mch mu.
Vitamin C cn iu ho chuyn ho cholesterol, tng tnh phn ng ca c th v nh
hng tt n chc phn ca tuyn ni tit v c quan tiu ho. Cn cung cp y v
cn i cc vitamin cn thit B1, B2, B6 v vitamin A.
Cc cht khong
Magne l cht khong quan trng la tui ny v c tc dng kch thch nhu ng rut
v tng tit mt. Nhu cu mi ngy 300 - 400 mg. Kali cng l cht khong c tm quan
trng i vi tui gi. Kali tham gia vo cu to acetylcholine l cht chuyn cc kch
thch thn kinh cho cc t bo c. Khoai ty l ngun kali thch hp nht ngi trng
thnh v ngi ln tui.
151/175
152/175
153/175
Suy dinh dng th cm Marasmus l th thiu dinh dng nng hay gp nht. l
hu qu ca ch n thiu c nhit lng ln protein do cai sa sm hoc n b sung
khng hp l. Tnh trng v sinh km gy tiu chy, a tr n cng km v vng ln
qun bnh l bt u. Kwashiorkor t gp hn Marasmus thng l do ch n qu
ngho v protein m carbohydrate tm (ch n sam ch yu da vo khoai sn).
Ngoi ra cn c th phi hp MarasmusKwashiorkor (Bng 10.1).
Bng 10.1 c im cc th suy dinh dng
Th loi lm sng
Marasmus
Kwashiorkor
R rng
C th khng r do ph
Ph
Khng c
C cc chi di , mt
Rt thp
Thp, c th khng r do
ph
Bin i tm l
i khi lng l mt mi
Cc biu hin c th gp
Ngon ming
Kh
Km
Tiu chy
Thng gp
Thng gp
Bin i da
t gp
Bin i tc
t gp
Tc mng tha, d nh
Gan to
Khng
i khi do tch lu m
tng ng 75% - 90% ca cn nng chun. Thiu dinh dng 2 tng ng 60%-75%
ca cn nng chun. Cch phn loi ca Gomez F. n gin nhng khng phn bit
c thiu dinh dng mi xy ra hay lu.
khc phc nhc im , Waterlow J.C. ngh cch phn loi nh sau: Thiu
dinh dng th gy cm (tc l hin ang thiu dinh dng) biu hin bng cn nng
theo chiu cao thp so vi chun, thiu dinh dng th ci cc (tc l thiu dinh dng
trng din) da vo chiu cao theo tui thp so vi chun. Theo khuyn ngh ca T
chc Y t th gii, cc ch tiu thng dng nh gi tnh trng dinh dng l cn
nng theo tui v cn nng theo chiu cao (Bng 10.2).
Bng 10.2 Bng phn loi theo Waterlow
Di
Bnh thng
Di
Trong thi k 1980-1995, vin Dinh Dng tin hnh 3 cuc iu tra trong c nc
v tnh trng dinh dng ca tr em di 5 tui. Kt qu cho thy:
Vo nm 1995 t l suy dinh dng th nh cn gim khong 6% so vi nm
1985 nhng so vi nm 1990 khng c thay i.
T l thiu dinh dng th thp ci gim dn theo thi gian v so vi nm 1985
gim khong 10%.
T l thiu dinh dng th gy cm (cp tnh) hin nay cao hn so vi s liu
nm 1985 v 1990. Tuy vy nu tng hp c ba ch tiu chng ta c th nhn
thy xu th chung l c tin b c bit l qua ch tiu chiu cao th hin tnh
trng thiu dinh dng mn tnh gim i r rt. T l thiu dinh dng khc
nhau theo vng sinh thi. Nhng vng c t l suy dinh dng cao l: vng ni
pha Bc, Bc Trung b, Ty nguyn. Nhn chung Nam b t l thiu dinh
dng tr em thp hn cc vng khc.
155/175
T l cn nng s sinh c cn nng thp (di 2500g) l ch tiu c ngha v tnh trng
dinh dng ca ngi m, s chm sc ca ngi m trong thi k mang thai. Nhng
tr s sinh c cn nng thp thng c nguy c t vong cao, d b bnh v suy dinh
dng.
Thiu vitamin A v bnh kh mt
Cc ch tiu sau c t chc Y t th gii (1981) khuyn ngh s dng nhn nh
sc khe cng ng ca thiu vitamin A:
Cc nghin cu ca Vin Dinh Dng cho thy t l mc bnh chung l 0,72%, trong
t l tn thng gic mc l 0,075 v so gic mc l 0,12% cao hn nhiu so vi tiu
chun ngh ca OMS. Hu ht cc trng hp kh nhuyn gic mc hot tnh thy
nhm tui t 12 - 36 thng. Nhm tui 25 - 36 thng mc bnh nhiu nht vi cc biu
hin lm sng nng nht. Thiu Vitamin A lin quan cht ch vi suy dinh dng. Cc
tn thng hot tnh mt thng gp tr suy dinh dng nng. Ch tiu nh gi tnh
trng dinh dng vitamin A th hin Bng 10.3.
Tnh
trng
Vitamin A
Vitamin A trong Vitamin
trong khu phn
khu phn m g A gan
Biu hin lm sng
mg hay mcg/
hay mcg/ ngy (mg/kg)
ngy
Trn 400
Vng
sng
gii
hn
200-400
Gii
hn e
Di 200
do
bnh l
Trn 20 Trn 20
Khng c
10-20
10-20
Di 10 Di 10
156/175
Nng iode trong nc tiu rt quan trng, th hin lng iode thi ra hng ngy. Qua
c th nh gi c c th , thiu hay tha iode theo cc mc sau:
158/175
159/175
160/175
gia dinh dng vi tng huyt p c trnh by trn, cc nhn t sau cng nh
hng n nguy c gy bnh mch vnh.
a. Ht thuc l
Tt c cc Hi ng chuyn vin u xc nhn ht thuc l l yu t nguy c hng u
i vi bnh mch vnh. Ngi ta thy ht thuc l khng nhng gy tn thng mng
trong cc ng mch m cn sinh ra cht nicotin gy tng nhp tim v huyt p, tng nhu
cu oxy ca cc c tim. Cc oxyde cacbon do ht thuc l sinh ra lm gim kh nng
vn chuyn oxy ca mu. Hn th na, ht thuc l cn l ngun sn sinh ra cc gc
t do, tng kt dnh ca tiu cu v lm gim cc lipoprotein c t trng cao (HDL:
High Density Lipoprotein).
Yu t dinh dng c quan tm n khi ngi ta nhn thy nhiu vng a Trung
Hi nh: , Hy Lp l vng nghin thuc l nng nhng t l mc bnh mch vnh
khng tng. Nhiu tc gi cho rng l do lng rau v tri cy trong khu phn cc
nc ny thng cao.
b. Cholesterol mu
Mi lin quan gia bnh mch vnh vi lng cholesterol ton phn trong mu c
tha nhn rng ri. Cholesterol l mt cht sinh hc c nhiu chc phn quan trng, mt
phn c tng hp trong c th, mt phn do thc n cung cp.
Lng cholesterol trong khu phn c nh hng n cholesterol ton phn trong huyt
thanh, tuy nh hng ny t hn nh hng ca cc acid bo no. Do cholesterol trong
ch n gp phn to nn nguy c bnh mch vnh nn hu ht cc y ban chuyn
vin quc t u khuyn lng cholesterol trong ch n trung bnh nn di 300 mg/
ngy/ngi.
Cholesterol ch c trong cc thc n ngun gc ng vt, nht l no (2500 mg%),
bu dc (5000 mg%), tim (2100 mg%), lng trng (2000 mg%), do hn ch cc
thc n ny gp phn gim lng cholesterol trong khu phn. Lng trng c nhiu
cholesterol nhng ng thi c nhiu lecithin l cht iu ha chuyn ho cholesterol
trong c th. Do nhng ngi c cholesterol mu cao khng nht thit king hn
trng m ch nn n trng mi tun 1, 2 ln v nu c iu kin ung thm sa.
Thnh phn chnh trong ch n c nh hng n hm lng cholesterol huyt thanh
l cc acid bo no. Nghin cu ni ting ca Keys v cng s trn 7 nc sau chin tranh
th gii ln th hai cho thy mc cholesterol huyt thanh lin quan t vi tng s cht
bo m lin quan cht ch vi lng cc acid bo no. Qua 10 nm theo di thy t
l t vong do bnh mch vnh tng ln mt cch c ngha theo mc tng ca cc acid
bo no trong khu phn. Cc acid bo no c nhiu trong cc cht bo ng vt, cn cc
loi du thc vt ni chung giu cc acid bo cha no. Do mt ch n gim cht
161/175
162/175
tht chng nhim Clostridium. V vy vic gim st liu lng cho php cc cht ph
gia ny l rt cn thit.
Nhiu loi phm mu thc phm v cht gy ngt nh cyclamate cng c kh nng gy
ung th thc nghim, do cc quy nh v sinh v phm mu, cc cht ph gia cn
c tun th mt cch cht ch.
Mt s loi ung th c mi lin quan vi ch n ung r rng nht l:
a. Ung th d dy
Ngi ta thy t l mc ung th d dy khc nhau cc nc trn th gii v c lin
quan nhiu n ch n ung. Hin nay M t l ung th d dy thp nht trn th
gii trong khi vo nm 1930 l loi ung th gy t vong hng u nam gii v th
2 n gii. T l ung th d dy ang gim dn Nht Bn v t l ny gim dn trong
s nhng ngi di c t Nht n Hawaii. Vit Nam cn c theo s liu Bnh vin K,
ung th d dy thng gp nht trong cc loi ung th nam gii v ng hng th nh
trong cc loi ung th n gii, sau ung th t cung.
Vitamin C c nhiu trong rau v tri cy c tc dng bo v c th i vi ung th d
dy nh c ch s to thnh nitrit t nitrat.
b. Ung th i trng
Nhiu nghin cu cho thy l cc ch n t cht x v nhiu cht bo (c bit l loi
cht bo bo ha) lm tng nguy c ung th i trng. Tc dng bo v ca cht x (c
nhiu trong rau v tri cy) c th l do chng c kh nng chng to bn, pha long
cc cht c th gy ung th trong thc phm v gim thi gian tip xc ca nim mc
ng tiu ha vi cc cht ny.
c. Ung th v
Tm quan trng ca yu t mi trng i vi ung th v r rng v t l mc bnh
thay i khi nhng ngi di c t nc c nguy c thp ti nc c nguy c cao v
thay i ch n ung. Lng cht bo trong khu phn thng c coi l yu t
quan trng trong pht sinh ung th v. Nghin cu 23 nc Chu u tm thy c
mi lin quan cao gia t vong do ung th v v lng acid bo no trong khu phn,
mi lin quan ny cht ch hn trong thi k mn kinh. Trong mi lin quan ny c vai
tr trung gian ca cc ni tit t l prolactin v oestrogen. Prolactin c coi l yu t
bo v. nhng ph n n ch nhiu cht bo, lng prolactin thung cao, nhng
ngi n ch thc vt, lng prolactin thng thp v nhng i tng ny t l
mc bnh ung th v thp hn.
163/175
Phi
i trng
++
+/-
Khoang ming
D dy
Thc qun
++
++
164/175
165/175
Hm lng cht khong trong xng cao nht tui 25, sau gim xung n tui
mn kinh v nam khong 55 tui. T l khi lng xng gim i hng nm thay i t
0,5 - 2% ty theo tng ngi. Nhng ngi khi cn tr c c xng thp th khi v
gi d b long xng. Cc yu t sau y c nh hng ti c ca xng:
- Thiu oestrogen.
- Thiu hot ng.
- Ht thuc l.
- Ung ru v dng thuc.
- Ch dinh dng nht l calci
Tm li, cc hiu bit v mi quan h gia dinh dng v bnh tt tuy phong ph
nhng cha th coi l y , k c cc bnh do thiu dinh dng v tha dinh dng.
Tuy vy vi nhng hiu bit hin nay cho php xy dng mt ch dinh dng hp
l gi gn sc khe v phng bnh tt. Nhiu nc pht trin c cc khuyn
co v dinh dng trong tng giai on, chc rng vn cng s c quan tm
nc ta.
166/175
Tham gia ng gp
Ti liu: Dinh dng ngi
Bin tp bi: Nguyn Minh Thy
URL: http://voer.edu.vn/c/4c53c93b
Giy php: http://creativecommons.org/licenses/by/3.0/
Module: nh ngha v dinh dng ngi
Cc tc gi: unknown
URL: http://www.voer.edu.vn/m/1a158939
Giy php: http://creativecommons.org/licenses/by/3.0/
Module: Vi nt v s pht trin ca khoa hc Dinh dng
Cc tc gi: unknown
URL: http://www.voer.edu.vn/m/a045486c
Giy php: http://creativecommons.org/licenses/by/3.0/
Module: Khi nim v cc cht dinh dng v thnh phn lng thc thc phm
Cc tc gi: unknown
URL: http://www.voer.edu.vn/m/b6536f36
Giy php: http://creativecommons.org/licenses/by/3.0/
Module: Mi quan h gia dinh dng, lng thc - thc phm, nng nghip v sc
kho
Cc tc gi: unknown
URL: http://www.voer.edu.vn/m/111970b9
Giy php: http://creativecommons.org/licenses/by/3.0/
Module: Cu trc c th ngi
Cc tc gi: unknown
URL: http://www.voer.edu.vn/m/8a9fcaec
Giy php: http://creativecommons.org/licenses/by/3.0/
Module: Nhu cu dinh dng
Cc tc gi: unknown
167/175
URL: http://www.voer.edu.vn/m/692458d5
Giy php: http://creativecommons.org/licenses/by/3.0/
Module: Nhu cu nng lng
Cc tc gi: unknown
URL: http://www.voer.edu.vn/m/4efc1e80
Giy php: http://creativecommons.org/licenses/by/3.0/
Module: Hnh thi nng lng
Cc tc gi: unknown
URL: http://www.voer.edu.vn/m/137fb583
Giy php: http://creativecommons.org/licenses/by/3.0/
Module: n v nng lng
Cc tc gi: unknown
URL: http://www.voer.edu.vn/m/52136f01
Giy php: http://creativecommons.org/licenses/by/3.0/
Module: Nng lng thc phm
Cc tc gi: unknown
URL: http://www.voer.edu.vn/m/bce5bd3b
Giy php: http://creativecommons.org/licenses/by/3.0/
Module: Tiu hao nng lng
Cc tc gi: unknown
URL: http://www.voer.edu.vn/m/6031003d
Giy php: http://creativecommons.org/licenses/by/3.0/
Module: Lng cung cp nng lng
Cc tc gi: unknown
URL: http://www.voer.edu.vn/m/35f86b7c
Giy php: http://creativecommons.org/licenses/by/3.0/
Module: Cn bng nng lng
Cc tc gi: unknown
URL: http://www.voer.edu.vn/m/098797a0
168/175
170/175
Cc tc gi: unknown
URL: http://www.voer.edu.vn/m/76f1af4f
Giy php: http://creativecommons.org/licenses/by/3.0/
Module: Cc acid bo
Cc tc gi: unknown
URL: http://www.voer.edu.vn/m/e07af4d6
Giy php: http://creativecommons.org/licenses/by/3.0/
Module: Phosphatide
Cc tc gi: unknown
URL: http://www.voer.edu.vn/m/550e8776
Giy php: http://creativecommons.org/licenses/by/3.0/
Module: Sterol v vitamin
Cc tc gi: unknown
URL: http://www.voer.edu.vn/m/6f0ca260
Giy php: http://creativecommons.org/licenses/by/3.0/
Module: Gi tr dinh dng ca cht bo
Cc tc gi: unknown
URL: http://www.voer.edu.vn/m/139e4699
Giy php: http://creativecommons.org/licenses/by/3.0/
Module: Hp thu v ng ho cht bo
Cc tc gi: unknown
URL: http://www.voer.edu.vn/m/cc996de0
Giy php: http://creativecommons.org/licenses/by/3.0/
Module: Nhu cu cht bo
Cc tc gi: unknown
URL: http://www.voer.edu.vn/m/44a6749a
Giy php: http://creativecommons.org/licenses/by/3.0/
Module: M u
Cc tc gi: unknown
171/175
URL: http://www.voer.edu.vn/m/267b91aa
Giy php: http://creativecommons.org/licenses/by/3.0/
Module: Vai tr sinh l ca carbohydrate
Cc tc gi: unknown
URL: http://www.voer.edu.vn/m/67d859e3
Giy php: http://creativecommons.org/licenses/by/3.0/
Module: Carbohydrate tinh ch v carbohydrate bo v
Cc tc gi: unknown
URL: http://www.voer.edu.vn/m/e0012f57
Giy php: http://creativecommons.org/licenses/by/3.0/
Module: Cc carbohydrate n gin
Cc tc gi: unknown
URL: http://www.voer.edu.vn/m/f7c95091
Giy php: http://creativecommons.org/licenses/by/3.0/
Module: Polysaccharide
Cc tc gi: unknown
URL: http://www.voer.edu.vn/m/c05ad93f
Giy php: http://creativecommons.org/licenses/by/3.0/
Module: Ngun carbohydrate trong thc n
Cc tc gi: unknown
URL: http://www.voer.edu.vn/m/f5ec07fc
Giy php: http://creativecommons.org/licenses/by/3.0/
Module: Tiu ho v hp thu carbohydrate
Cc tc gi: unknown
URL: http://www.voer.edu.vn/m/6431e5b6
Giy php: http://creativecommons.org/licenses/by/3.0/
Module: Nhu cu carbohydrate
Cc tc gi: unknown
URL: http://www.voer.edu.vn/m/7e813bad
172/175
173/175
Module: Thc phm v nhu cu dinh dng cho cc i tng khc nhau
Cc tc gi: unknown
URL: http://www.voer.edu.vn/m/d068c6a1
Giy php: http://creativecommons.org/licenses/by/3.0/
Module: Cc bnh lin quan n dinh dng
Cc tc gi: unknown
URL: http://www.voer.edu.vn/m/144bad48
Giy php: http://creativecommons.org/licenses/by/3.0/
174/175
175/175