B GIO DC V O TO TRNG I HC CN TH

GIO TRNH

DINH DNG NGI

M s: CB 320

Bin son: Ths. NGUYN MINH THY

NM 2005

CHNG I. DINH DNG NGI - MI QUAN H GIA

LNG THCTHC PHM, NNG NGHIP V SC KHO

I nh ngha v dinh dng ngi

Dinh dng l chc nng m cc c th s dng thc n duy tr s sng, ngha l thc hin cc hot ng sng nh: sinh trng, pht trin, vn ng. Khoa hc v dinh dng nghin cu mi quan h gia cc c th v thc n, ch n ung, sinh l nui dng, bin i bnh l... Thnh ng dinh dng v sc kho cng ng dng ch mi quan h gia ch n ung v sc kho hoc bnh tt trong mt phm vi cng ng dn s xc nh, vi mc ch u tranh chng cc bnh tt do n ung khng ng cch. Trong khi lun v dinh dng, mi lin quan gia dinh dng vi cc lnh vc khc c th hin: Dinh dng vi sc kho Dinh dng vi s sinh trng v pht trin Dinh dng vi suy lo Dinh dng vi min dch Dinh dng vi u sinh

II Vi nt v s pht trin ca khoa hc Dinh dng

Hypocrate-danh y thi c nu ln vai tr ca n ung trong vic bo v sc kho. Trong vic s dng n ung tr bnh, ng vit: thc n cho bnh nhn phi l mt phng tin iu tr v trong phng tin iu tr phi c cht dinh dng hoc hn ch v n thiu cht b rt nguy him i vi nhng ngi mc bnh mn tnh. Sidengai-nh y hc ngi Anh cho rng nhm mc ch iu tr cng nh phng bnh, trong nhiu bnh ch cn cho n nhng khu phn n (diet) thch hp v sng mt i sng c t chc hp l. A.L. Lavoisier l ngi u tin trong nhng nm 1770-1777 chng minh thc n i vo c th v sc vt s b t chy, s dng O2, gii phng CO2 v sinh nhit. Nm 1783 cng vi Laplace v Ramur chng minh trn thc nghim h hp l mt dng t chy trong c th v o lng c lng oxy tiu th v lng CO2 thi ra ngi khi lao ng, ngh ngi v sau khi n. Nghin cu ca ng t c s cho vn tiu hao nng lng, gi tr sinh nng lng ca thc phm v cc nghin cu v chuyn ho. 1

Giai on th hai bt u t s pht hin cc thnh phn c bn ca thc phm, t chc v dch th. Cng trnh ca nh bc hc c J. Liebig vo gia th k XIX v pht trin bi Voit, Rubner, Atwater v ch ra rng thc n cha ba nhm cht hu c c bn: protein, carbohydrate, lipid v cc cht v c l tro. Tip theo l thi k tm hiu vai tr ca m trong dinh dng pht trin v pht hin s khc nhau v gi tr sinh hc ca chng. Cui th k XIX v u th k XX, cng trnh ca nh bc hc Nga M. Lunin v nhiu ngi khc cho bit thm mt s yu t dinh dng m by gi cha bit: cc vitamin v pht hin ra hng lot cc vitamin. T cui th k 19 ti nay, nhng cng trnh nghin cu v vai tr ca cc axt amin cc vitamin, cc acid bo khng no, cc vi lng dinh dng phm vi t bo, t chc v ton c th gp phn hnh thnh, pht trin v a ngnh dinh dng ln thnh mt mn hc. Cng vi nhng nghin cu v bnh suy dinh dng protein nng lng ca nhiu tc gi nh Gomez (1956), Jelliffe (1959), Welcome (1970), Waterlow (1973). Nhng nghin cu v thiu vi cht nh thiu vitamin A v bnh kh mt (Bitot 1863, M. Collum 1913, Block 1920), thiu mu thiu st, thiu km. Ngoi ra cng c nhiu nghin cu gii thch mi quan h nhn qu v cc chng trnh can thip cng ng. Ngy nay bit khong 60 cht dinh dng m c th ngi c th s dng c, trong c khong 40 cht c th cn thit tuyt i: 8-10 acid amin, 1-2 ng n, 2-3 acid bo cha no, hn 13 nguyn t khong v hn 15 sinh t, v cng c tng i y c s khoa hc cho sn xut, bo qun, ch bin, dinh dng tp th v tit ch.

III Khi nim v cc cht dinh dng v thnh phn lng thc thc phm
Cc cht dinh dng l cc cht hu c c hnh thnh v tch ly trong nhng b phn nht nh ca c th ng vt v thc vt, n cn thit cho s tn ti v pht trin ca c th ngi v cc c th ng vt khc. Nm 1824, Prout (1785-1850) l thy thuc ngi Anh u tin chia cc hp cht hu c thnh 3 nhm: protein, lipid v carbohydrate.

3.1Protein
Nm 1816, Magendie chng minh cc thc phm cha nit cn thit cho s sng-albumin. Nm 1838 nh ho hc H Lan Mulden gi albumin l protein. Nm 1839 s cn bng nit c Boussingault thc hin Php v ng nhn thy cc loi ng vt khng th s dng trc tip dng nit v c hoc nit khng kh m phi n cc thc n cha cc hp cht c nit ca thc vt v ng vt duy tr s sng. Sau mi n th k 20, bng nhiu cng trnh nghin cu khc nhau ngi ta mi pht hin ra protein ca c th khng ch khc nhau v thnh phn, trnh t cc acid amin m cn khc nhau c v cu trc. Cng chnh v vy m n hon thnh cc chc nng c th cho tng loi c th. 2

Trong tt c cc t bo ng thc vt, s phn chia bt u t nhn, nhn li c to thnh t hai hp cht c lin quan mt thit vi nhau l protein v acid nucleic. Chnh v th m cc qu trnh sng khng th c c nu khng c protein. Ni c th qu trnh dinh dng khng th tin hnh c nu khng c protein hoc thiu vng mt trong cc acid amin khng thay th. Bnh thiu protein c ngi Php pht hin t nm 1929, gi tn l bouffissure dAnnam, ngi Anh pht hin Chu Phi nm 1932 gi l kwashiorkor. Sau nhng bnh suy dinh dng do thiu protein hoc cc acid amin khng thay th c pht hin vo nm 1959, Jelliffe gi bnh suy dinh dng nng lng, protein hay protein-energy-malnutrition (PEM). y l loi bnh cn tng i nhiu cc nc ang pht trin.

3.2 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 Bo v cho cc c quan khi b chn ng v bo v cho c th khi b lnh Cht bo cn l dung mi ho tan rt tt cc vitamin tan trong cht bo. Ngy nay vai tr ca cht bo trong dinh dng ngi c c bit quan tm khi c nhng nghin cu ch ra mi quan lin quan gia s lng v cht lng ca cht bo trong khu phn vi bnh tim mch.

3.3 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.

3.4 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 3

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.

3.5Vitamin
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. 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.

3.6 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.

3.7Cht 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.

IV Mi quan h gia dinh dng, lng thc - thc phm, nng nghip v sc kho
Qu trnh sinh ra, ln ln v tn ti ca mi ngi khng th tch ri s n ung hay l s dinh dng. S dinh dng c quyt nh bi ngun lng thc-thc phm do con ngi to ra. Ngun v nhng c tnh ca lng thc - thc phm 4

do nn sn xut nng nghip chi phi. Tt c nhng iu trn lin quan mt thit ti sc kho ca mi c nhn v ca c cng ng. Sc kho nh hng trc tip n ton b h thng sn xut nng nghip, quyt nh s lng, cht lng ca nng sn phm lm ra. iu ni ln rng cc yu t dinh dng, lng thc-thc phm, nng nghip v sc kho c lin quan hu c, gn b nhau trong mt h thng chung. 3 con ng chnh m thng qua n c chnh sch v chng trnh nng nghip nh hng n tnh trng dinh dng sc kho ca mi c nhn. l: S tng thu nhp ca mi c nhn v h gia nh s dn n vic tng tiu dng thc phm. Gi c lng thc-thc phm n nh v c phn h thp khi nn nng nghip pht trin v c cc chnh sch thch hp v ngc li. nh hng ti sc kho v v sinh mi trng mc c nhn v cng ng, iu ny c th lm tng hoc gim bnh tt. nh hng ti s phn b thi gian, c bit l ca cc b m, do c th lm tng hoc gim thi gian nui dng, chm sc tr. Thc t dinh dng cho thy cn nm c nhu cu dinh dng t da vo kh nng sn xut nng nghip, tp tc n ung ca a phng m tnh ra nhu cu thc phm. Cn c vo nhu cu thc phm t k hoch sn xut nng nghip cn i gia xut khu v nhp khu c li cho vic m bo cc nhu cu dinh dng. C th biu th bng s Hnh 1.1 v Hnh 1.2 nh sau:

V s pht trin ca vng xoy trn c

iu kin nng nghip km

Gim kh nng lm vic

Sn xut nng nghip thp km iu kin sng thp Thu nhp thp

Thiu dinh dng Tiu th thc phm thp

Hnh 1.1 Vng xoy trn c nguy him i vi tnh trng sn xut nng nghip km (Harper, 1984)

Hnh 1.2 S biu th mi lin quan gia nng nghip, lng thc thc phm v dinh dng (FAO, 1984)

CHNG II CU TRC C TH V NHU CU DINH DNG

I Cu trc c th ngi
1.1 Khi qut
Con ngi t khi s sinh n lc trng thnh, cn nng ca c th tng ln n 20 ln. c s pht trin v trng lng nh vy, c th ly cc nguyn liu t thc n, nc ung. Nhiu thc nghim chng minh ch n nh hng n cu trc c th. Cu trc ca c th thay i theo tng nhm tui (Bng 2.1) v gii tnh, gene v chng tc. Ngoi ra cc yu t nh dinh dng v tp luyn, lao ng th lc u c nh hng ti cu trc c th. Bng 2.1 nh hng ca qu trnh tng trng, trng thnh v mc bo ph n thnh phn ca c th v m khng cha cht bo (Garrow v cng s, 2000) Bo thai 2025 tun Cn nng (kg) Nc (%) Protein (%) Cht bo (%) Phn cn li (%) Trng lng khng cha bo (kg) Nc (%) Protein (%) Na (mmol/kg) K (mmol/kg) Ca (g/kg) Mg (g/kg) P (g/kg) 0,3 88 9,5 0,5 2 0,3 88 9,4 100 43 4,2 0,18 3,0 Tr trc khi sanh 1,5 83 11,5 3,5 2 1,45 85 11,9 100 50 7,0 0,24 3,8 Tr thng 3,5 69 12 16 3 2,94 82 14,4 82 53 9,6 0,26 5,6 Tr 1 tui 20 62 14 20 4 8,0 76 18 81 60 14,5 3,5 9,0 Ngi ln (Ngi trng thnh) 70 60 17 17 6 58 72 21 80 66 22,4 0,5 12,0 Tr Ngi suy bo dinh ph dng 5 74 14 10 2 4,5 82 15 88 48 9,0 0,25 5,0 100 47 13 35 5 65 73 21 82 64 20 0,5 12,0

1.2 Phng php xc nh cu trc c th S dng cc s o cu trc c th xc nh v nh gi tnh trng dinh dng tr thnh mt trong nhng phng php c p dng rng ri, c ngha thc tin cao trong nghin cu dinh dng v trong vic theo di sc kho. tr em, tng cn l mt biu hin ca pht trin bnh thng v dinh dng hp l. ngi trng thnh qu 25 tui cn nng thng duy tr mc n nh qu bo 7

hay qu gy u khng c li i vi sc khe. Ngi ta thy rng tui th trung bnh ca ngi bo thp hn v t l mc cc bnh tim mch cao hn ngi bnh thng. C nhiu cng thc tnh tnh cn nng "nn c" hoc cc ch s tng ng. Ch s c s dng nhiu v c T chc Y t th gii (1985) khuyn dng l ch s khi c th BMI (Body Mass Index):
BMI = W H2

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.

Hnh 2.1 Bng xc nh BMI theo chiu cao v cn nng (http://btc.montana.edu)

II Nhu cu dinh dng

Nhu cu dinh dng va l nhu cu cp bch hng ngy ca i sng, va l nhu cu thing ling bo tn, nhu cu c bn m bo s pht trin bnh thng th lc v tr lc ca con ngi, va m bo sc kho, kh nng hc tp sng to, 8

sc lao ng sn xut, s pht trin ca x hi. Nhu cu dinh dng gm hai phn: nhu cu nng lng v nhu cu cc cht dinh dng. xc nh nhu cu nng lng, theo t chc Y T th gii, cn bit cc nhu cu cho chuyn ho c bn v cho cc hot ng th lc khc trong ngy.

III Nhu cu nng lng Nghin cu v nhu cu nng lng l mt ngnh ca khoa dinh dng nhm tm hiu nh hng ca cc yu t khc nhau ti cng ca cc qu trnh chuyn ho vt cht trong cc iu kin sinh l.
C th ngi cn nng lng cung cp cho cc hot ng sau: Cc qu trnh chuyn ho Hot ng ca c Gi cn bng nhit ca c th Nng lng cho hot ng ca no, cc m thn kinh.

3.1 Hnh thi nng lng

Trong h thng sinh hc, c rt nhiu dng nng lng: Nng lng bc x Nng lng ho hc Nng lng c hc Nng lng in Nng lng nhit ng vt v thc vt khng loi tr kh nng tun theo nh lut th nht nhit ng hc, rng nng lng khng th t sinh ra v mt i m n ch thay i gia cc dng khc nhau. Tuy nhin khc vi ng vt, thc vt c th s dng ngun nng lng bc x tng hp cc phn t phc tp nh carbohydrate, protein, cht bo, trong khi ngun nng lng ca ng vt da ch yu vo ngun nng lng ho hc ca thc vt thng qua ngun thc phm (Hnh 2.2). Nng lng ho hc c s dng nh nng lng ca hot ng c (nh s co c), nng lng in (nh duy tr gradient ca ion qua mng) v nng lng ho hc (tng hp cc hp cht phn t lng ln). Tuy nhin, s chuyn ho nng lng thc phm khng phi l mt qu trnh hiu qu hon ton, khong 75% nng lng thc phm c th b hao ph nh l ngun nhit trong qu trnh chuyn ho. Nng lng sinh ra s l ngun duy tr nhit c th trong iu kin kh hu thng thng, c bit nu c th c cch nhit tt bng y phc.

3.2 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. 9

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.

Nng lng mt tri

Khng phc hi Quang hp

t lin
Nhin liu

i dng
Du kh, than , kh gas t trng trt

Phn bn, cy cy Vn chuyn

Vt nui

Bao gi Vn chuyn Lm lnh Nu nng Ph liu

Gia sc, cu, ln, gia cm Ch bin, lm lnh

ATP (nng lng ha hc)

Lm vic

CO2, H2O, nhit lng

Hnh 2.2 Ngun nng lng t mt tri n con ngi (http://en.wikipedia.org/wiki)

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3.3 Nng lng thc phm

Nng lng ho hc ca thc phm c th xc nh bng bom calori (Hnh 2.3). Nng lng o c bng cch ny gi l nng lng th (Gross energy) ca thc phm, v n biu th tng nng lng ho hc ca thc phm.
Nhit k Cnh khuy B phn nh la

H2O

Mi trng cha oxi Mu cha trong cc

Hnh 2.3 Bom calorie (http://wps.prenhall.com)

Ngun nng lng ch yu cn cho c th c bt ngun t carbohydrate (ng), lipid (m) v protein (m), 3 cht dinh dng ny qua oxy ho trong c th u c th sn sinh ra nng lng, c gi chung l cht dinh dng sinh nhit hoc ngun nhit. Gi tr sinh nng lng ca thc phm l nng lng ho hc ca carbohydrate, lipid, protein v ru chuyn sang nhit khi b t chy. Lng nhit thi ra o bng bom calorie.

Cc nh ng thc n c t trong khi hnh tr bng thp. Pha trn c dy in nh dng in chy qua. ng cht bom v cho oxy vo vi p sut cao. t bom vo thng nc c thnh lm bng cht cch nhit tt. Khi ni dng in, thc phm bt la. Lng nhit thi ra o bng tng nhit ca nc trong thng. Khi t bom calorie: 1g carbohydrate cho 4,1 Kcal (16,74 kJ) 1g lipid cho 9,1 Kcal (37,66 kJ) 1g protein cho 5,65 Kcal (23,64 kJ) 1g ru ethylic cho 7,1 Kcal (gan s dng ru 100 mg/kg cn nng/gi) 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 glucose 3,9 Kcal

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Bng 2.2 Nng lng chuyn ho ca cc cht dinh dng chnh (Southgate v Durnin, 1970) Cht dinh dng Nng lng th (kJ/g) 17,5 15,6 39,1 22,9 29,8 Phn trm hp thu 99 99 95 92 100 Nng lng tiu ho (kJ/g) Tinh bt Glucose Cht bo Protein Ru 17,3 15,4 37,1 21,1 29,8 5,2 Vt Mt theo nc tiu (kJ/g) Nng lng chuyn ho (kJ/g) 17,3 15,4 37,1 15,9 29,8 H s Atwater (Kcal/g) 4 4 9 4 7

3.4 Tiu hao nng lng

Mc nng lng m c th hp thu c cn phi tiu hao. S hp thu v tiu hao nng lng ngi ln kho mnh v c bn l cn bng, c th hin ch yu mc c nh tng i v trng lng c th. 3.4.1 Chuyn ho c bn (CHCB) CHCB l nng lng cn thit duy tr s sng con ngi trong iu kin nhn i, hon ton ngh ngi v nhit mi trng thch hp. chnh l nng lng ti thiu duy tr cc chc phn sinh l c bn nh: tun hon, h hp, hot ng cc tuyn ni tit, duy tr thn nhit... Cc yu t nh hng n CHCB: Tnh trng h thng thn kinh trung ng Cng hot ng cc h thng ni tit v men (chc phn mt s h thng ni tit lm tng CHCB (tuyn gip trng), trong khi hot ng mt s tuyn ni tit khc lm gim CHCB (tuyn yn). Tui v gii ( ph n thng thp hn nam gii 5 - 10%, CHCB ca tr em thng cao hn ngi ln tui, tui cng nh CHCB cng cao. ngi ng tui v gi, CHCB thp dn). Trong trng hp nhn i hay thiu n, CHCB gim. Tnh trng thiu n nng ko di, CHCB gim ti 50%. Trong nhng trng hp cn thit, ngi ta o CHCB. n gin nht l cch tnh CHCB bng 1 Kcal cho 1 Kg cn nng trong mt gi. Tuy nhin CHCB cn ph thuc vo nhiu yu t khc. Hp l hn l tnh ton CHCB theo tit din da. Tit din da ph thuc chiu cao v cn nng c th tnh ton theo cng thc n gin sau: 12

S = 0,0087 (W + H) 0,26 Trong : S: tit din da (m2) W: trng lng c th (kg) H: chiu cao (cm) Tit din da cn c tnh theo ton tnh din tch da (Hnh 2.3). T ton tnh din tch da, c th tnh c chuyn ho c bn ca mt ngi theo Bng 2.3 Bng 2.3 Chuyn ho c bn tnh theo kcal/m2 din tch da/gi (Hong Tch Mnh v H Huy Khi, 1977) Tui 6 7 8 9 10 11 12 13 14 15 Nam 53 52 51 50 49 48,5 47,5 47,0 46,0 45,0 N 50,5 49,5 48,0 46,5 45,5 44,5 43,0 42,0 41,0 39,5 Tui 16 17 18 19 20 - 30 30 - 40 40 - 50 50 - 60 60 - 70 70 - 80 Nam 44,0 43,5 42,5 42,0 39,5 39,5 38,5 37,5 36,5 35,5 N 38,5 37,5 37,0 37,0 37,0 36,5 35,5 35,0 31,0 33,5

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) Nhm tui Nm 03 3 - 10 10 - 18 18 - 30 30 - 60 Trn 60 Chuyn ho c bn (kcal/ngy) Nam 60,9 W 54 22,7 W + 495 17,5 W + 651 15,3 W + 679 11,6 W + 879 13,5 W + 487 N 61,0 W - 51 22,5 W + 499 12,2 W + 746 14,7 W + 496 8,7 W + 829 10,5 W + 596

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Hnh 2.3. Ton tnh din tch da (Tver and Russell, 1989) 3.4.2 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.

14

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 Nng lng tiu hao ngoi CHCB (Kcal/kg/gi) 0,10 0,43 0,50 0,50 0,50 0,57 0,63 0,66 0,74 0,84 0,95 0,96 1,00 1,06 1,06 1,41 1,43 1,43 1,57 1,86 3,14 2,43 3,28 4,71 5,43 5,43 6,14 7,14 7,57 15 Nng lng tiu hao gp c CHCB (Kcal/kg/gi) 1,10 1,43 1,50 1,50 1,50 1,57 1,63 1,66 1,74 1,84 1,95 1,96 2,00 2,06 2,06 2,41 2,43 2,43 2,57 2,86 4,14 3,43 4,28 5,71 6,43 6,43 7,14 8,14 8,57

Nm ngh ngi Ngi yn c to ng thoi mi May tay Ng ng nghim an bng que an Ht n cm May my Nghe ging, ghi bi nh my ch nhanh i qun o (bn i 2,5 kg) Ra chn a Qut nh (138 ng tc/pht) Bc ba ng gy sch Bi tp th dc nh Khu giy Do chi thong th (4km/gi) Rn luyn th lc kh nng Th mc, c kh i kh nhanh (6 km/gi) Th Lao ng nng Cht cy Bi Chy (gn 8,5 km/gi) Lao ng rt nng

3.4.3 o nng lng tiu hao a. Phng php o nng lng trc tip Phng php o nng lng trc tip gm qu trnh o lng nng lng tiu hao giai on nht nh bng cch o lng nhit mt i t c th ngi. V mt nguyn l, y l phng php o n gin, v s lng phng c thit k xy dng cho qu trnh o cho con ngi phi c bo v trnh s mt nhit. Dng c o ca Atwater c phng nh ngi c th lu trong vi ngy, c ging nm v xe p ti ch theo di cc ng tc lao ng. Thc n v cht thi ra qua l nh. Thnh ngoi cch nhit tt, lng nhit do c th pht ra s do nc chy theo cc ng chung quanh hp thu. Da vo nhit ca nc tng ln s tnh c lng nhit thi ra. Mt h thng lun chuyn khng kh khp kn m bo thong kh ca phng. Khng kh trong phng i qua cc bnh cha nc cht hp ph CO2, sau O2 c tng cng duy tr n mc bnh thng. Nguyn l ca my o ny n gin nhng thit k v s dng rt kh khn v tn km v thc hnh. Nhc im ca phng php o trc tip l ch c th thc hin trong vng vi gi hoc hn, do k thut gi nh rng khng c s tng hoc gim nhit ca c th ngi trong thi gian o nng lng. b. Phng php o nng lng gin tip Phng php ny da vo s oxy ho thc phm trong c th ngi, oxy c tiu th v CO2 c sinh ra. iu ny c th hin t phng trnh ho hc lng php din t s oxy ho 1 mol glucose: C6H12O6 (180 g) + 6 O2 (6 x 22,4 l) 6 CO2 (6 x 22,4 l) + 6 H2O (6 x 18 g) + nhit (2,78 MJ)

Nng lng to ra t s oxy ho 1 g glucose l 15,4 kJ (2780/180) v do mi lt oxy tiu th tng ng vi lng nhit sinh ra l 20,7 kJ (2780/6 x 22,4). V vy nu s lng oxygen tiu th c th c o lng th c th tnh ton c lng nhit sinh ra. Cc phng trnh tng t c th c vit cho qu trnh oxy ho protein, cht bo v alcohol, c biu din Bng 2.6, cho thy nng lng tiu hao cho 1 lit oxy s dng l 19,8, 19,3 v 20,4, tng ng. Thng s h hp RQ cho mi cht dinh dng c th hin ng thi Bng 2.6, xc nh t l th tch ca CO2 sinh ra v th tch O2 s dng cho qu trnh oxy ho s lng cc cht dinh dng c bit. Bng 2.6 Gi tr oxy ho ca cc cht dinh dng chnh (Brockway, 1987) Cht dinh dng Tinh bt Glucose Cht bo Protein Ru O2 tiu th (l/g) 0,829 0,746 1,975 0,962 1,429 CO2 sinh ra (l/g) 0,8324 0,742 1,402 0,775 0,966 16 RQ+ Nng lng sinh ra (kJ/g) 17,49 15,44 39,12 18,52 29,75 Nng lng sinh ra (kl/1O2) 21,10 20,70 19,81 19,25 20,40

0,994 0,995 0,710 0,806 0,663

+ 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) 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) 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) Oxy ho protein (g) = 1,786 VCO2 (l) 1,778 VO2 (l) 2,021 N (g) = 6,25 N (g) 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. 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) (6.2)

Thit b o nng lng gin tip:

Hnh 2.4 Ti Douglas o chuyn ho nng lng (http://www.nu.ac.za) 3.4.4 Nhu cu nng lng c ngy

Hai phng php c th c s dng tnh ton nhu cu nng lng c ngy: 17

a) Nhu cu nng lng ca ngi trng thnh da vo chuyn ho c bn (CHCB) v c tnh theo h s thuc loi lao ng c th hin Bng 2.7. Bng 2.7 H s nhu cu nng lng c ngy ca ngi trng thnh t CHCB Loi lao ng Lao ng nh Lao ng va Lao ng nng Nam 1,55 1,78 2,10 N 1,56 1,61 1,82

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

3.5 Lng cung cp nng lng

Vic quy nh lng cung cp nng lng ch yu l ly cng lao ng th lc lm c s. i vi tr em, thanh thiu nin, ph n mang thai, ph n nui con.. th phi m bo lng cung cp nng lng m nhu cu sinh l cn thit cho qu trnh sinh trng v pht trin. 3.5.1 Cng lao ng Lao ng cc nh: cng vic ngi lm l chnh, nh cng vic vn phng, cng vic lp t v sa cha my thu thanh, ng h.. c km theo cc hot ng vn th nghip d no .. Lao ng nh: Cng vic ng hoc i li t nh nhn vin bn hng, thao tc trong phng th nghim, gio vin ging bi.. Lao ng va: nh hot ng thng ngy ca hc sinh, li xe c ng, lp mc in, ct gt gia cng kim loi.. Lao ng nng: lao ng nng nghip phi c gii, luyn thp, nhy ma, vn ng th dc.. Lao ng cc nng: nh cc loi bc vc, cht g, khai thc khong sn v p .. phi c gii. 3.5.2 Tnh trng sinh l Tr em v thanh thiu nin trong thi k sinh trng pht trin, chiu cao, cn nng v lng lao ng tng ln tng ngy, v vy lng cung cp nng lng 18

cng tng ln tng ng, nhm p ng nhu cu v sinh trng v pht trin ca chng. Lng cung cp nng lng tng thm cho ngi m ang nui con l mc nng lng dng b p cho vic tit sa. 3.5.3 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) Nhit trung bnh hng nm (oC) -5 0 5 10 15 20 25 30 Phn trm ca chun (%) 104,5 103,0 101,5 100,0 97,5 95,0 92,5 90,0 3344 3296 3248 3200 3120 3040 2960 2880 2404 2369 2335 2300 2243 2185 2128 2070 Kcal/ngy Nam N

IV Cn bng nng lng

Trong qu trnh trao i cht, s cn bng nng lng theo sau nh lut nhit ng lc hc, xc nh rng di nhng iu kin l tng, nng lng lm vic bng vi nng lng sn sinh ra. y l ni dung ca lut d tr nng lng. Khi cn bng nng lng c hon ton th khi lng khng thay i. Khi ngun nng lng vt qu nng lng tiu dng th nng lng c d tr trong c th di dng m v lm tng trng lng. Khi ngun nng lng thc phm t hn nhu cu nng lng tiu dng th s dn n tnh trng gim trng lng c th. Trong khu phn n, khi nng lng nhn vo thp hn nng lng s dng th s khc bit c thnh lp bng cch t chy cc cht m trong c th v c s mt trng lng cn bng vi s trao i cht bo.

19

Khi tnh ton cn bng nng lng, nng lng thu nhn vo d dng xc nh bng cch o tng s calori trong thc phm tiu ho. Nng lng dng ht hoc tiu ph thng kh xc nh chnh xc. Cn bng nng lng = nng lng nhn vo - nng lng sn sinh (s sinh nhit). - Nng lng nhn vo = 1. nng lng thc phm 2. nhit trao i 3. nhit mi trng - Nng lng sn sinh = 1. nng lng t s bi tit 2. nhit mt mt ra mi trng xung quanh

V 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.

VI Cc bi ton v trao i vt cht

6.1C th t carbohydrate
C6H12O6 + 6 O2 6CO2 + 6H2O 180 gr glucose khi b t s dng ht (6 x 22,4 lit) = 134,4 lit Oxy = VCO2 Thng s h hp =
VCO2 VO2 =1

1 lit oxy t c 1,231 g carbohydrate v to ra 5,047 Kcal nhit lng Mt thanh nin nm ngh 15 pht hp thu 3 lt Oxy v thi 3 lit kh CO2, S oxy s dng mt gi l : 3 x 4 = 12 lit. S nng lng dng l : 12 x 5,047 Kcal = 60,56 Kcal trng thi ngh ngi, mi ngy c th cn: 60,56 x 24 = 1453 Kcal 20

6.2 C th t lipid
C18H36 O2 + 26 O2 18 CO2 + 18 H2O Thng s h hp = (18/26) = 0,7 1 g carbohydrate t chy cn 0,83 lit oxy 1 g lipid t chy cn 2,03 lit oxy 1 lit oxy dng t lipid s to ra 4,74 Kcal * Bi tp: Mt c th nhn i ko di hp thu trong 15 pht mt lng oxy l 3,164 lit v o thi 2,215 lit kh carbonic. Hi c th ny s dng ngun d tr no v trong 24 gi chi ph bao nhiu nng lng? 2,215 Gii: Tnh h s h hp = ---------- = 0,7 3,164 (S dng lng m d tr) Lng oxy s dng 24 gi c tnh l : 3,164 x 24 x 4 = 303,75 lit, Nu ch t lipid th oxy ny sinh c : 303,75 x 4,74 = 1440 Kcal

6.3C th dng nng lng t ngun protein

T s carbon (C) thi ra phi, lng oxy phi c to ra kh carbonic (CO2) nh sau: Lng kh carbonic to ra : 77,52 lit Lng oxy cn : 96,70 lit 77,52 Thng s h hp l = --------- = 0,8 96,7 Cch tnh n gin Bng 2.9 Quan h gia thng s h hp v % calo thuc carbohydrate hay lipid Thng s h hp (CO2/O2) 0,70 0,75 0,80 0,85 0,90 0,95 1,00 Mi lt oxy s sinh ra (Kcal) 4,88 4,739 4,801 4,862 4,924 4,985 5,047 21 S % calo thuc carbohydrate 0,0 15,6 33,4 50,7 67,5 84,0 100,0 S % calo thuc lipid 98,9 84,4 66,6 49,3 32,5 16,0 0,0

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, 2) 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

VII An ninh thc phm

7.1 nh ngha
- C lng thc thc phm (availability) - C lng thc mi ni, mi lc vi gi c n nh (stability) - C kh nng tip cn thc phm, c thu nhp, c tin mua thc phm (accessibility). Theo cng ng Chu u, an ninh thc phm khi vng bng nn i v nn suy dinh dng.

7.2 Yu cu
- Thc phm phi m bo s lng - Cn i v mt cht lng - Khng l ngun gy bnh

7.3 Cn ch i vi cc loi thc phm

Protein ng vt c 8 acid amin thay th t l cn i hoc c d 1 hoc nhiu acid amin. Protein thc vt thng thiu mt hoc nhiu acid amin cn thit hoc c nhng t l khng cn i. Do cn n cc mn n hn hp nhiu loi thc phm. Tht l protein ng vt c s dng ph bin, c gi tr dinh dng cao, nhng khng nn n nhiu nht l khi n khng c rau. i vi tht rang, nng do c p ng nn lm v hiu ho lysine do phn ng Maillard gn lysine vi carbohydrate thnh hp cht kh phn hy bi men tiu ho. Lysine l yu t cn thit cho qu trnh pht trin, do vy khng nn cho tr n cc mn tht nng, rang kh.. Tht heo c kh nng nhim giun xon (tht heo go), tht ch nhi thng hay b sn nn phi n chn. Trong da, ph tng ca trng cc c cha cht c buphotoxin gy cht ngi. Tht b h hng c histamin (gy d ng) hoc ptomain gy ng c c th cht ngi.

22

C c hm lng protein cao, cht lng tt, d tiu ho, n gi c sng khng nhng b ng c do vi khun, nhim c sn l gan m cn b thiu vitamin B1 do c sng c men thiaminase l men phn hy thiamin (B1). 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.

23

CHNG III.
I M u

PROTEIN

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.

II Cu trc v tnh cht l ho hc c bn ca protein

2.1 Cu trc
Cc thnh tu nghin cu v protein cho thy trong phn t protein ngoi cc nguyn t carbon, hydro, oxy ging nh glucid, lipid th cn c mt cc nguyn t nit v lu hunh. Mt s phn t protein cn cha cc nguyn t khc nh phosphor, st, km, ng.. Cc nguyn t k trn c trong phn t protein theo mt t l xc nh (Bng 3.1). Bng 3.1 T l cc nguyn t ch yu trong protein (L Don Din v V Th Th, 1996) Cc nguyn t C H O N S 24 T l (%) 50,6 54,5 6,5 7,3 21,5 23,5 15,0 17,6 0,3 1,5

Chng tham gia cu to nn phn t acid amin, trong c th sinh vt thng gp dng acid - amin. Cng thc tng qut: R CH NH2 C th ngi ch c th ng ho c acid -amin c trong protein v thc n thc vt, cc dng v khng c c th ng ho v hp thu. Acid amin l mt xch c bn to nn phn t protein, chng c lin kt vi nhau bng lin kt peptid ( CO NH ). C th thc vt c th tng hp c tt c cc acid amin t cc hp cht v c c cha nit, nhng ngi v ng vt th khng th tng hp c, cc acid amin u ly t thc vt; ngc li ch c th tng hp mt s acid amin t nhng hp cht hu c khc v c tin hnh gan nh enzyme aminotransferase m nhm ngoi l phosphopyridoxal. Cc -cetoacid c to thnh trong qu trnh chuyn ho trung gian glucid nh acid pyruvic, c to thnh trong chu 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. COOH

2.2 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) Protein phc tp Nhm ngoi Nucleoproteid Ribosome Lipoproteid Lipoproteid ca huyt thanh Glicoproteid -globulin Orozomocaid ca huyt thanh Phosphoproteid Casein (sa) Hemoproteid 25 Nhm phosphate Hexosamin, Galactose Galactose, Manose, N-acetyl galactosamine Phospholipid cholesteroid, lipid trung tnh ARN

Hemoglobin

Protoporphyrin Fe

III Thnh phn v hm lng protein trong cc nng sn phm chnh (ngun cung cp protein trong thc phm)
Thc n cung cp cho ngi gm hai nhm ln: ngun thc n ng vt (tht, c, trng, sa..), ngun thc n thc vt (go, khoai ty, bnh m, mt s loi rau, u ..). Cc thc n c ngun gc ng vt c cha hm lng protein nhiu hn thc n thc vt (Bng 3.3). Hm lng protein c trong thc n thng c biu hin bng s phn trm nng lng m protein ca thc n cung cp. Ch dinh dng tt l ch trong protein cung cp khong 10 - 15% nng lng. V th ngi ta phn loi thc phm d vo gi tr nng lng ca protein c trong thc phm (Bng 3.4). Bng 3.3. Hm lng protein trong mt s loi thc phm quan trng (Norton v cng s, 1978) Tn thc n Go np Go t Khoai lang Khoai ty Ng K Bnh m u H lan u nnh u xanh u phng M u c ve C rt Xp l Xu ho Rau mung Rau ngt Cn ty Hm lng protein (%) 8,2 7,6 0,8 2,0 8,0 - 10,0 12 7,8 - 8,0 21,6 36,8 22,0 24,3 20,1 22,1 1,0 1,5 2,0 2,5 2,0 2,8 2,6 3,2 4,7 5,3 3,0 3,7 Tn thc n Chui tiu u Cam To Tht heo Tht b Tht g Gan b Gan heo C Trng g ton phn Sa m Sa b ti Hm lng protein (%) 1,5 1,0 1,9 0,8 18 - 22 21 20 22 19,8 17 - 20 13 14,8 1,2 1,5 3,5 3,9

26

Bng 3.4 S phn loi thc phm da vo gi tr nng lng ca protein (L Don Din v V Th Th, 1996) Phn loi Ngho Ngun thc n cha protein Bt sn Da hu Khoai lang Khoai s Khoai ty Go Ng K Bt m trng Tt u phng Sa b (3.5% m) u H lan Tht b u nnh C c m C kh T l nng lng ca protein % 3,3 4,0 4,4 6,8 7,6 8,0 10,4 11,6 13,2 13,8 21,6 25,6 38,4 45,2 45,6 61,6

IV Vai tr v chc nng ca protein trong dinh dng

Thut ng protein c xut x t ting Hy Lp protos ngha l trc nht, quan trng nht. Protein l thnh phn c bn ca vt cht sng, n tham gia vo thnh phn ca mi mt t bo v l yu t to hnh chnh. Qu trnh sng l s thoi ha v tn to thng xuyn ca protein.

4.1 Protein l thnh phn nguyn sinh cht t bo

nguyn sinh cht t bo khng ngng xy ra qu trnh thoi ho protein cng vi s tng hp protein t thc n. Protein cng l thnh phn quan trng ca nhn t bo v cc cht gia t bo. Mt s protein c hiu c vai tr quan trng do s tham gia ca chng vo hot ng cc men, ni t, khng th v cc hp cht khc. V d globin tham gia vo thnh phn huyt sc t, miosin v actin m bo qu trnh co c, globulin tham gia vo s to thnh rodopsin ca vng mc mt, cht ny gip cho qu trnh cm th nh sng c bnh thng. 27

4.2 Protein cn thit cho s chuyn ho bnh thng ca cc cht dinh dng khc
Mi qu trnh chuyn ho ca glucid, lipid, acid nucleic, vitamin v cht khong u cn c s xc tc ca cc enzyme m bn cht ho hc ca enzyme l protein. Cc qu trnh chuyn ho ca cc cht d l phn gii hay tng hp u cn mt ngun nng lng ln, mt phn nng lng ng k do protein cung cp. Cc qu trnh chuyn ho ca cc cht u lin quan mt thit vi qu trnh chuyn ho protein, ni cch khc mi qu trnh chuyn ho trong c th u lin quan vi nhau, c th thy s Hnh 3.1.

Hnh 3.1 Qu trnh chuyn ho ca chui amino acid (http://cwx.prenhall.com) Glucid qua qu trnh ng phn s to thnh acid pyruvic (CH3CO.COOH). T acid pyruvic khi b kh carboxyl ho bng cch oxy ho, vi s tham gia ca enzyme pyruvate decarboxylase th sn phm thu c ca qu trnh ny l acetyl CoA. Acetyl CoA l nguyn liu tng hp nn cc acid bo no v cha no trong cht bo. ng hng bin i th hai ca acetyl CoA l i vo chu trnh Krebs. Trong qu trnh bin i ca chu trnh Krebs th ngoi nng lng c to thnh di dng cc nucleotide kh (NADH2, FADH2), CO2 v H2O, cn to ra hng lot cc sn phm trung gian, trong qua trng hn c l -Ketoglutarate, oxaloacetate, fumarate. y l cc ketoacid, nu chng b amin ho bng cch kh hoc amin ho trc tip th s to thnh cc acid amin. Cc acid amin thng gp trong trng hp ny l alanine, acid aspartic v acid glutamic. T cc acid amin ban u ny bng ng hng chuyn amin ho vi ketoacid vi s tham gia ca enzyme aminotranferase s to thnh hng lot cc acid amin khc-nguyn liu tng hp protein.

4.3 Protein tham gia vo cn bng nng lng ca c th

Protein l ngun nng lng quan trng cho c th, cung cp khong 10 - 15% nng 28

lng ca khu phn. Cc acid amin khng tham gia vo tng hp protein hoc c phn gii t protein, t cc on peptid nh enzyme carboxy peptidase hay amino 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.

4.4 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.

4.5 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.

4.6 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. Tm li nu khng c protein th khng c s sng. Ba chc phn chnh ca vt cht sng l pht trin, sinh sn v dinh dng u lin quan cht ch vi protein.

29

V Nhng thay i xy ra trong c th thiu protein

Thiu protein thng dn n tnh trng suy dinh dng. Nu tnh trng ny ko di s dn n tnh trng chung ca c th v pht trin ca n cng nh n s hnh thnh cc c im th cht ca con ngi. Nhng du hiu ca c th thiu protein: - Chm ln, t ln. y l biu hin ri lon chuyn ho nc v tch cha nc ca cc t chc ngho lipid. - Lon dinh dng, marasmus & kwashiorkor (Hnh 3.2) + Lon dinh dng v marasmus l nhng bnh suy dinh dng ni chung trong s thiu m, nng lng ng vai tr chnh km theo thiu tt c cc cht dinh dng khc. Tnh trng ny thng dn n suy mn m khng gy ph. + Kwashiorkor l bnh thiu protein n thun thng gp cc tng lp c i sng thp ca cc nc, nht l cc nc thuc a trc y. Bnh hay gp tr em di 5 tui n ch n ch yu l glucid v protein t ngun gc ng vt qu thp. Cc triu chng ca bnh thng gp l: * Chm ln v chm pht trin * Bin i mu da * Bin i tnh trng cc nim mc * Gim hot ng mi chc phn, c bit l h thng tiu ho dn n ri lon chc phn d dy, rut, kh tiu v tiu chy ko di. cc trng hp bnh nng c th gy ph v gim st kh nng hot ng tr tu.

Hnh 3.2 Cc biu hin bnh thiu protein (http://www.ennonline.net) - Gim chc nng bo v ca c th: + C th km chu ng khi thiu protein v nhy cm i vi cc tc nhn khng thun li ca mi trng bn ngoi, c bit i vi cm lnh v nhim trng. + Thiu protein v lng dn n cc bin i bnh l tuyn ni tit (tuyn sinh dc, tuyn yn, tuyn thng thn) v h thp chc phn ca chng. Hm lng adrenalin trong tuyn thng thn b h thp. - Ri lon s to thnh choline gan m hu qu l gan b xm nhim m cng ng c ch . S to m gan tng ln khi thiu methionin l mt acid amin cha lu hynh v nhm methyl (-CH3). Cht ny gip to thnh choline v do phng 30

gan b nhim m. Khi gan b tch m, gan khng hon thnh c nhim v tng hp albumin ca huyt thanh v gy ph. - nh hng n h thng thn kinh trung ng v ngoi bin - Thnh phn ho hc v cu trc xng cng b thay i. Cu trc c xng yu t, lng lo, gim hng cu, dn n hin tng thiu mu ca c th.

VI Cc acid amin v vai tr dinh dng ca chng

Acid amin l thnh phn chnh ca phn t protein. Do kt hp vi nhau trong nhng lin kt khc nhau, chng to thnh cc phn t khc nhau v thnh phn v tnh cht. Gi tr dinh dng ca protein c quyt nh bi mi lin quan v s lng v cht lng ca cc acid amin khc nhau trong protein . Nh qu trnh tiu ho protein thc n c phn gii thnh acid amin. Cc acid amin t rut vo mu v ti cc t chc, ti y chng c s dng tng hp protein c hiu cho c th. Cc acid amin cn thit v khng cn thit c trnh by Bng 3.5. Tiu chun xc nh gi tr sinh hc v vai tr sinh l ca cc acid amin l kh nng duy tr s pht trin sc vt ca chng. Mt vi acid amin khi thiu s lm cho sc vt ngng ln, xung cn mc d cc thnh phn khc ca khu phn u y . Cc acid amin ny c gi l cc acid amin cn thit hay khng th thay th c v chng khng th t tng hp trong c th hoc tng hp vi tc khng th p ng c nhu cu ca c th m chng phi c a vo y trong m thc n. Bng 3.5 Cc acid amin cn thit v khng cn thit (http://en.wikipedia.org) Acid amin khng cn thit Alanine Asparagine Aspartate Cysteine Glutamate Glutamine Glycine Prolin Serine Tyrosine Acid amin cn thit Arginine Histidine Isoleucine Leucine Lysine Methionine Phenylalanine Threonine Tryptophan Valine

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 31

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 hp cc ngun protein thc n hp l s to nn gi tr dinh dng cao ca khu phn. V d go, ng, m ngho lysine cn u tng, lc, vng hm lng lysine cao, khi phi hp go hoc m hoc ng vi u tng, vng, lc s to nn protein khu phn c gi tr dinh dng cao hn cc protein n l.

6.1 Gi tr sinh hc ca cc acid amin cn thit

Ngoi 8 acid amin cn thit ph bin, arginine v histidine cng l acid amin cn thit i vi s pht trin ca tr em. Nu thiu mt trong nhng acid amin cn thit s dn n ri lon cn bng m v ri lon s dng tt c cc acid amin cn li. m thc vt nhn chung km gi tr hn m ng vt do thiu hay hon ton khng c mt s cc acid amin cn thit. Vai tr ca cc acid amin khng ch gii hn s tham gia ca chng vo tng hp m c th m chng cn c nhiu chc phn phc tp v quan trng khc. * L-histidine (acid -amino -imidasolyl propionic) C nhiu trong hemoglobin. Khi thiu histidine mc hemoglobin trong mu h thp. Histidine c vai tr quan trng trong s to thnh hemoglobin. Khi cn thit hemoglobin c th b phn gii gii phng histidine. Kh carboxyl Hemoglobin Histidine Histamin Histamin l cht gi vai tr quan trng trong vic lm gin mch mu. Thiu hay tha histidine lm gim st cc hot ng c iu kin. * L-valine (acid -amino isovalerianic) Vai tr sinh l ca valine cha c bit r rng nhng cc th nghim trn chut cho thy khi thiu valine, chut t n, ri lon vn ng, tng cm gic v cht. Khi b sung valine vo, cc ri lon trn s khi. * L-leucine (acid -amino isocapric) Nhng th nghim trn chut cho thy nu thiu leucine chut ngng ln, xung cn, c cc bin i thn v gip trng. * L-lysine (acid , diamino propionic) Lysine l mt trong cc acid amin quan trng nht. y l mt trong b ba acid amin c c bit ch khi nh gi cht lng dinh dng ca khu phn (lysine, tryptophan, methionine). Thiu lysine trong thc n dn n ri lon qu trnh to mu, 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 32

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.

6.2 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. Bng 3.6 Nhu cu ti thiu ca cc acid amin cn thit ca ngi (Hong Tch Mnh v H Huy Khi, 1977) Acid amin Tr em (mg/kg) N trng thnh (g/ngy) 0,45 0,62 0,50 0,35 0,55 0,22 1,12 0,30 0,15 33 Nam trng thnh (g/ngy) 0,70 1,1 0,80 - 0,2 (a) 1,1 - 1,01 1,1 - 0,3 (b) 1,1 - 1,4 0,5 0,25

Isoleucine Leucine Lysine Methionine Tng s acid amin cha S Phenylalanine Tng s acid amin thm Threonine Tryptophan

126 150 103 45 90 87 22

Valine a. Khi lng cystine y

105

0,65

0,80

b. Khi lng tyrosine y T l cn i gia cc acid amin cn thit theo F.A.O l: Tryptophane-1, phenylalanine v threonine-2, methionine + cystine, valine-3, isoleucin v leucine-3,4. Theo Leverton (1959) khi nh gi t l cn i ca cc acid amin cn thit th ch cn tnh theo b ba: tryptophane, lysine v acid amin cha lu hynh (methionine + cystine) v t s gia chng nn l 1: 3: 3.

6.3 Cc acid amin khng cn thit

Cc acid amin khng cn thit (c th thay th c) chim t l ln trong thnh phn m thc n. C th c th tng hp c nhng qu trnh tng hp bn trong ch p ng c nhu cu ti thiu ca c th. Do cn a hp l cc acid amin ny vo thnh phn m ca thc n. Cc acid amin c th thay th bao gm: alanine, asparagine, acid asparaginic, glycine, glutamin, acid glutamic, oxyprolin, proline, serine, tyrosine, cystine, cysteine.. Acid glutamic tham gia tch cc vo qu trnh chuyn ho m. Mt trong nhng tnh cht ca n l gp phn bi xut cc sn phm c hi ca qu trnh chuyn ho m ra khi c th. Vai tr ca cystine v tyrosine cng khng km phn quan trng. Tyrosine v cystine c th c tng hp trong c th: Phenylalanine Methionine Tyrosine 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.

VII Nhng yu t nh hng n gi tr dinh dng ca protein

Gi tr dinh dng ca protein thc n ph thuc vo cht lng v s lng protein trong . Cht lng ca protein c quyt nh ch yu bi thnh phn acid amin v mc s dng ca chng trong c th. Nhng yu t sau y nh hng n gi tr dinh dng ca protein

7.1 nh hng ca nng lng cung cp

Khi nng lng cung cp khng y th hiu qu s dng protein b gim st, triu chng thiu m xut hin nhanh chng khi nng lng cung cp di nhu cu.

7.2 nh hng ca vitamin v mui khong

Cc vitamin v mui khong cn thit cho chuyn ho v pht trin, ng thi gi vai 34

tr nht nh trong s dng protein thc n. iu tr tnh trng thiu protein, mt s vitamin v cht khong c tm quan trng nh: niacine, kali v phosphor.

7.3 Kh nng s dng cc acid amin

C th khng hon ton s dng acid amin c trong thc n. Lng thng gim v nhng l do sau: - S tiu ho v hp thu khng hon ton - S c mt ca mt s cht c ch cc men tiu ho mt s thc n - S bin cht protein v cc acid amin do nhit hoc cc tc dng khc T l hp thu cc acid amin rt cao phn ln cc protein ng vt nhng protein thc vt thng km hn. ch n hon ton ngun gc thc vt, lng nit ca phn ln ti 20% lng nit n vo hoc hn. Khi cha b nhit lm gim hot tnh, cc cht c ch c hiu cc men tiu ho cng lm gim tiu ho v hp thu protein. Tc dng nhit qu mnh cng lm gim mc s dng v hp thu protein. Tc dng ny hay gp nht l thc n giu glucid. Lysine v cc acid amin cha lu hynh chu nh hng nhiu nht.

7.4 Tnh cn i ca cc acid amin trong khu phn - Yu t hn ch

Tt c cc acid amin cn thit phi c mt y , ng lc vi t l thch hp tham gia vo qu trnh tng hp protein. Nu mt trong cc acid amin c vi lng khng y , n to thnh "yu t hn ch", ngha l c th ch s dng tt c cc acid amin khc mc cn i vi "yu t hn ch" ny, phn cn li s b tiu ph i. "Protein chun" l protein trong cc acid amin t l cn i nht, thch hp nht cho tng hp t bo, thng chn protein trng lm chun.

VIII Cc phng php xc nh gi tr dinh dng ca protein

8.1 Phng php sinh vt hc
a. H s tng trng lng (Protein efficiency ratio PER) L trng lng tng thm ca mt con vt ang pht trin chia cho lng Protein n vo. Trng lng sc vt tng theo g PER = ---------------------------------------------------Lng protein s dng tnh theo g H s tng trng cng cao chng t m cng tt. Thng thng ng cc = 1 - 2, sa = 2.8, trng g ton phn = 3.8. b. Gi tr sinh vt hc (biological value BV): l t l protein gi li so vi protein hp thu. N gi li BV = ------------------35 * 100

N hp thu B: 75 Bp: 72 C: 75 Go: 86 Casein: 75 Trng: 100 Sa: 93 Bt m: 44

c. H s s dng protein (net protein utilization NPU): l t l protein gi li so vi protein n vo N gi li NPU = BV * D = ------------N n vo Cc xt nghim trn ch nh gi v mt cht lng protein. Nhiu tc gi tnh "phn trm nng lng protein s dng" (Net dietary Protein Calories Percent NDpCals%) th hin c v cht v lng protein trong khu phn. NDpCal% = NPU x % nng lng do protein * 100

8.2 Ch s ho hc (Chemical score CS)

Do c mi lin quan v gi tr sinh vt hc v yu t hn ch ca protein thc n. Do ch s ho hc c tnh l t s gia cc acid amin trong protein nghin cu so vi thnh phn tng ng ca chng protein trng trong cng mt lng protein ngang nhau. a x 100 CS = -----------------b Acid amin c ch s ho hc thp nht s l "yu t hn ch". Cc gi tr dinh dng ca protein v sp xp gi tr dinh dng ca protein trong thc n c trnh by Bng 3.7 v Bng 3.8. Bng 3.7 Cc loi protein thc n (Hong Tch Mnh v H Huy Khi, 1977) Protein Trng Tht b Sa b Go Bp La m CS 100 67 60 53 49 53 NPU 94 80 75 59 52 48 BV 100 75 95 86 72 44 a: % hm lng acid amin trong m nghin cu b: % hm lng acid amin trong m trng

Bng 3.8 Sp xp protein thc n

36

Loi thc n Trng ton phn Tht b C Sa b Go Bt m Bt u phng Bt bp

Yu t hn ch Cystine + methionine Tryptophan Cystine + methionine Lysine Cystine + methionine Tryptophane

NPU 100 80 83 75 57 52 48 55

CS 100 80 75 60 75 50 70 45

8.3 Tiu ho v hp thu protein

Protein cao phn t c hp thu trong rut, di tc dng ca nhiu loi enzyme tiu ho (nh pepsin, trypsin ..) phn gii thnh peptide ngn v acid amin trong rut d dy. Sau c hp thu trong rut non, theo tnh mch ch gan, vo trong gan. Mt b phn acid amin trong gan s tin hnh phn gii hoc tng hp protein; mt b phn acid amin khc tip tc theo tun ho mu, phn b n cc t chc c quan, tng hp nn cc loi protein m ring bit. Protein khng th c tiu ho hp thu hon ton trong ng tiu ho, phn cha c tiu ho di tc dng ca cc vi khun trong rut gi s sinh thi ra, sn sinh ra cc cht c nh amoniac, phenol, benzpyrol... Trong , i b phn theo phn thi ra ngoi c th, mt s t c nim mc rut hp thu, theo tun hon mu chuyn vo gan, tin hnh gii c sinh l, sau theo nc tiu thi ra, nh vy mi c th lm c th khng b c.

IX 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.

9.1 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. nng) - Lng mt nit theo phn Fk: (cng o ch 1g nit/ngy - 20 mg/kg cn - 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.

9.2 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 37

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 , nng/ngy) K: nhu cu N theo kg cn nng/ngy Uk: lng mt nit khng trnh khi theo nc tiu (mg/kg cn 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 Tnh theo cng thc trn cho ngi trng thnh: (46 + 20 + 20) x 1,1 = 95 mg N/kg cn nng Nhu cu theo m chun = 95 mg x 6.25 = 0,59 g/kg Thm 20% cho cc thay i c bit 0,71 g/kg cn nng Phng php tnh trn th hin nhu cu i vi protein chun, ngha l vi protein hon ton cn i. V th phi iu chnh nhu cu trn khi bit cht lng protein n vo. Nhu cu theo protein chun Nhu cu thc t = ------------------------------------------NPU ca protein n vo Theo FAO: - Cc nc pht trin: - Cc nc ang pht trin: NPU = 70 - 80 NPU = 60 - 70 NPU = 50 - 60

- Cc nc c phn n c bn khng phi l ng cc (sn)

38

CHNG IV. LIPID

I M u
Lipid l hp phn quan trng ca khu phn n, c trnh by Hnh 4.1.

(a) Triacylglycerols

(b) Phosphatidyl choline Hnh 4.1 Cu trc ca cc lipid ca c th v vi loi thc phm quan trng (a) Triacylglycerols (hay triglycerides) l cht bo d tr ch yu. (b) Phosphoglycerides: l nhm c phn loi chung cho cc lipid c cha phosphor, hay c gi l phospholipid. R biu th chui hydrocarbon ca cc acid bo

(c) Cholesterol

(c) Cholesterol: l sterol ch yu ca m ng vt (Garrow, 2000)

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. Phospholipid hoc phosphatide cha c hai nitrogen v phosphorus. Cht c bit l lecithin rt phong ph trong lng trng. Ngoi ra cn c tm thy trong c, m thn kinh v trong tt c cc t bo ca c th. Sterol l nhng hp cht monohydroxyalcohol phc c khi lng phn t cao, c tm thy di dng t nhin kt hp vi acid bo. Chng cha carbon, hydrogen v 39

oxy. c bit nhiu nht l cholesterol, phn phi rt rng trong c th, thng hin din trong ty sng bao bc m thn kinh, trong mu v trong tt c cc t bo ca c th. Cht bo dng lipid n gin hay phc tp u b hydro ho hoc enzyme phn hy thnh dng lipid dn xut. Ba thnh phn quan trng ca nhm ny l: acid bo, glyceride v steroid. Hu ht s tiu ho lipid xy ra ng rut. Mt nh tng ho cht bo v chuyn chng thnh dng c th cho php cc qu trnh thy phn bi ng rut v enzyme ca dch ty. Trong qu trnh ny cht bo c th b thy phn thnh acid bo, glycerol v monoglyceride. Mui mt v choline gip cho s nh tng ho cc hp cht thy phn ny, sinh ra hp cht hp thu c. Sut qu trnh hp thu cht bo, glycerol v monoglyceride tng hp li thnh cht bo.

II Cu trc v cc tnh cht l ho c bn

2.1 Cu trc
Du m l hn hp cc ester ca glycerin v cc acid bo (Hnh 4.2). Ty theo mt, hai hay ba nhm OH ca glycerin to ester vi cc acid bo m ta c mono, di v triglyceride. Cc acid bo c trong du m lun c s nguyn t carbon chn v chng c tng hp t hp cht 2C (Acetyl CoA). C 2 loi: Acid bo no (bo ho): acid caproic, acid caprylic, acid lauric, acid myristic, acid palmitic, acid stearic, acid arachidic.. Hnh 4.2 Triglyceride (http://bioweb.wku.edu) Acid be cha no (cha bo ho): acid oleic (C18H34O2), acid linoleic (C18H32O2), acid acid arachidonic linolenic (C18H30O2), (C20H32O2).

Phopholipid l diacilglycerin lin kt vi H3PO4 bng lin kt ester v tr nhm OH th 3 ca glycerin, sau gc phosphate b ester ho bi ru cha nhm amin (cholin, etanolamin), acid hydroxyamin (serin).. Phospholipid c mt bt k t bo thc vt no v n l cu t bt buc ca mng t bo, c bit l cc cy ly du v cc cy h u. Trong quan trng v nhiu hn c l phosphotidinetanolamin (hp cht ph l ethanolamin NH2-CH2-CH2OH) v phosphatidincholin (hp cht ph l cholin: (CH3)3 - N+ - CH2 - CH2OH). Cc hp cht ny l thnh phn cu trc ca t bo thn kinh, no, tim, gan, tuyn sinh dc, c bit ng vai tr quan trng trong tnh thm mng t bo.

2.2 Cc tnh cht ca lipid

Cc ch s c bn phn nh tnh cht ca du v m l: - Nhit nng chy: ph thuc vo thnh phn ca acid bo. Nu trong thnh phn du v m c nhiu acid bo no th chng c nhit nng chy cao hn v thng trng thi rn. Ngc li trong thnh phn c nhiu acid bo cha no th chng c 40

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.

Bng 4.1 Tnh cht ca mt s loi du m (L Don Din & V Th Th, 1996) Loi m M b M ln M cu Nhit nng chy + 35 - 38oC + 35 - 45oC + 44 - 50oC Loi du Du bng Du olive Du hng dng Nhit nng chy 1 - 6oC 2 - 6oC 16 - 18oC

Khi lng ring ca du thc vt 15oC l 90-98 Kg/m3, ch s chit quang: 1,44 1,48. Nhit ng c ca du thc vt thng l m, cn m c nhit ng c gn 40oC. Do khi lng triglyceride cao nn du thc vt khng bay hi ngay c iu kin chn khng cao. nhit 204 - 250oC, triglyceride s b phn gii thnh cc sn phm bay hi ca s phn hy ho hc. Trong ht c du khi ny mm hoc trong cc c quan tiu ho ca ngi v ng vt xy ra qu trnh phn gii du v m di tc dng ca enzyme lipase, vi s tham gia ca H2O. CH2OCO R1 CHOCO R2 + CH2OCOR3 Du m (triglyceride) H2O CH2OH CHOH CH2OH Glycerin + R1COOH R2 COOH R3COOH Acid bo

Glycerin v acid bo s c chuyn ho tip tc, to ra mt ngun nng lng kh ln cung cp cho mi hot ng sng. Glycerin c th c dng tng hp nn cc ng 6C hoc b phosphoryl ho ri c phn gii nh glucid. Cc acid bo s c chuyn ho theo ng hng oxy ho to ra acetyl CoA v cc nucleotide kh (NADH2, FADH2). Acetyl CoA li tip tc i su vo chu trnh Krebs cung cp cho c th mt ngun nng lng ln. Chng hn mt phn t acid bo no b oxy ho qua 1 vng oxy ho gii phng ra 1 FADH2, 1 NADH2 v 1 phn t Acetyl CoA, 1 phn t CoA i vo chu trnh Krebs cho ta 12 ATP. Tng nng lng ca mt vng oxy ho l 17 ATP, tr i 1 ATP dng hot ha ban u cn 16 ATP. Nu acid bo c mch Carbon l 16 th phi quay 8 vng oxy ho, nh vy ta c: 8 x 16 ATP = 128 ATP x 12 Kcal = 1536 kcal. l nguyn nhn d tr v cung cp nng lng ca cht bo.

41

2.3 Thnh phn v hm lng lipid trong mt s nng sn phm chnh

Thnh phn v hm lng lipid hon ton khc nhau cc ngun thc n c ngun gc ng vt v thc vt. Trong thc n thc vt: nhm ly tinh bt nh cc loi go, cc loi khoai, ng, sn th ng c hm lng cao hn c khong 3 - 8% v tp trung phn phi ht. Trong la m, i mch v lu go thng c khong 1,6 - 3,2%; khoai lang, khoai ty, sn ti hm lng lipid khng ng k 0,1 - 0,3%. Cc loi rau hu nh cha rt t lipid, tr cc loi rau u: u H lan, u c-ve, hm lng lipid khong 1 - 2%. Cc loi qu chn, tr gc c hm lng lipid cao, cn li cha khong 0,1 - 0,5% lipid. Ch ring ht v qu cc loi cy ly du l c hm lng lipid rt cao, cao hn bt k loi thc n no, trong phi k n ci da, u phng, m, u nnh, u rng, c du (Bng 4.2). C th ni nhng thc phm ny l ngun lipid v cng qu gi c th dng lm thc n trc tip, c th l nguyn liu sn xut du thc vt.
Bng 4.2 Hm lng lipid tng s trong mt s loi thc n chnh (% khi lng kh)

STT 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32

Tn thc phm (*) Go np Go t Khoai lang Khoai ty Sn ti (khoai m ti) Ng * u nnh Ht u phng Ci da Nhn c du u rng Vng (m) Thu du Hng dng ** u H lan u xanh u c ve C chua Ci bp Rau mung Rau ngt Nm hng kh Gc Chui tiu u chn Tht b Tht heo Gan heo C chp Trng g Sa m Sa b ti 42

Hm lng lipid tng s (%) 2,0 1,5 0,3 0,1 0,2 4,6 23,5 40,2 60,7 62,9 74,0 47,5 53,8 17,0 46,4 66,0 68,2 64,3 66,5 1,3 1,0 1,7 0,0 0,0 0,0 0,0 4,0 7,9 0,4 0,1 3,8 21,5 7,5 3,6 11,6 3,0 4,4

(*) Theo FAO, 1972

* Theo Norton v cng s, 1978 ** Theo bng TPTAVN, 1995

III Vai tr ca lipid trong dinh dng ngi

3.1 Cung cp nng lng
Lipid l mt trong ba thnh phn ho hc chnh trong khu phn hng ngy, nhng khc vi protein v glucid, lipid cung cp nng lng nhiu hn (1g lipid cung cp khong 9 kcal), gp i so vi mc nng lng do carbohydrate v protein sn sinh ra. Trong khu phn n hp l, nhu cu nng lng do lipid cung cp khong t 15 -20%. Thc n giu lipid l ngun nng lng m c cn thit cho ngi lao ng nng, cn thit cho s phc hi sc kho i vi ph n sau khi sinh v cc c th mi m dy, cht bo d tr nm di da v m lin kt.

3.2 Cu thnh cc t chc

Nh mng t bo l lp m do lipoid, glucolipid v cholesterol.. hp thnh; ty no v cc m thn kinh c cha lipid v glucolipid. Cholesterol l nguyn liu cn thit ch to ra steroit hormoon.

3.3 Duy tr nhit c th, bo v cc c quan trong c th

Lipid l cht dn nhit khng tt ngn nga s mt nhit di da, c tc dng gi nhit, gip ch cho vic chng rt, ng thi cn lm cho lng nhit bn ngoi c hp thu khng truyn dn vo bn trong c th, c tc dng cch nhit. Lipid phn b khng u trong c th ngi vi tng hm lng khong 10%. Lng cht bo ch yu tp trung cc t chc di da to thnh lng m d tr c th s dng khi cn thit. Mt phn cht bo cn bao quanh ph tng nh l t chc bo v, ngn nga cc va chm v gip chng v tr ng n. N cn gip c th trnh khi cc tc ng bt li ca mi trng ngoi nh nng, lnh. Ngi gy th lp m di da mng, do vy m c th km chu ng vi s thay i ca thi tit.

3.4 Thc y vic hp thu cc vitamin tan trong cht bo

Vitamin A, D, E, K khng tan trong nc m tan trong cht bo hoc dung mi ho tan cht bo. Lipid c trong thc n s lm dung mi thc y s hp thu chng. Nu hm lng lipid trong ba n thp th s nh hng n vic hp thu caroten trong rau xanh (trong c th caroten chuyn thnh vitamin A).

3.5 Lm tng cm gic no bng

Lipid ngng d dy vi thi gian tng i lu, cho nn khi n nhng thc n c hm lng lipid cao s lu b i.

3.6 Nng cao gi tr cm quan ca thc n

Thc n c nhiu cht bo s c mi thm v ngon, do vy lm tng s thm n.

43

IV Cc acid bo
Tnh cht ca cc acid bo c th hin Bng 4.3

Bng 4.3 Hm lng cc acid bo trong mt s thc n (Hong Tch Mnh v H Huy Khi, 1977) Hm lng cc acid bo theo % M Miristic Cu B Heo Nga 2 - 4,6 2 - 2,5 Acid bo no Palmitic 24,6-27,2 27-29 24-32,2 29,5 Stearic 25-30,5 24-25 7,8-15 6,8 Acid bo cha no Oleic 33-43,1 43-45 50-60 55,2 Linoleic 2,7-4,3 0-2,6 0-10 6,7 Linolen -ic 1,7 Nhit nng chy (oC) 44-55 43-51 36-48 29,5-43,2

4.1 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.

4.2 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. Cc acid bo cha no thng gp nht l acid oleic. Acid bo ny c hu nh tt c cc cht bo ng v thc vt, do d dng tho mn nhu cu ca c th. Ngoi ra 44

cc acid bo cha no khc nh: acid linoleic, acid linolenic, acid arachidonic l nhng acid bo c nhiu ni kp v l nhng cht c hot tnh sinh hc r rng nht. Vai tr sinh hc ca cc acid bo cha no cn thit rt quan trng v a dng. Mt s t chc nh tim, gan, no, tuyn sinh dc c nhu cu rt cao v cc acid . Khi thiu chng trong thc n, cc ri lon thng xut hin trc ht cc c quan ny. Vai tr sinh hc ca cc acid bo cha no cn thit c th c tm tt nh sau: Kt hp vi cholesterol to thnh cc ester c ng, khng bn vng v d dng bi xut ra khi c th. iu ny c ngha trong vic ngn nga bnh x va ng mch. Trong trng hp thiu chng, cholesterol s ester ho vi cc acid bo no v tch li thnh mch. Cc acid bo cha no cn thit s to iu kin chuyn cholesterol thnh acid cholic v bi xut chng ra khi c th. C tc dng iu ho thnh mch mu phng nhi mu c tim v cc ri lon ca h thng tim mch Chng ung th Cn thit cho chuyn ho cc vitamin nhm B, nht l pyridoxin v thiamin phng cc tn thng da (do hot tnh ca men citocromosidase gim). Trong c th acid arachidonic l loi c hot tnh sinh hc cao nht, 2 - 3 ln hn acid linoleic. C th c th chuyn acid linoleic thnh acid arachidonic khi c s hin din ca pyridoxin. Bng 4.4 Hm lng cc acid bo cha no trong mt s du m n (Hong Tch Mnh v H Huy Khi, 1977) M ng vt B M heo M b M ngng M g Hm lng acid bo theo % Linole -ic 4,0 5,3 15,6 19,3 21,3 Linolenic 1,2 Arachid -onic 0,2 0,6 2,1 0,6 Du thc vt H.dng Du u nnh Du bp Du liu Linoleic 68,0 58,8 50-60 15 Linolenic 8,1 0,10,7 Arachid - onic Hm lng acid bo theo %

Xt v hot tnh sinh hc v hm lng cc acid bo cha no cn thit, c th chia cht bo thnh ba nhm: Nhm c hot tnh sinh hc cao: hm lng cc acid bo cha no cn thit khong 50 - 80% v vi s lng 15 30 g/ngy c th tho mn nhu cu c th. Thuc nhm ny c: du hng dng, u nnh, bp .. Nhm c hot tnh sinh hc trung bnh: hm lng acid bo cha no cn thit khong 15 - 22% v c th cn 50 60 g/ngy m bo nhu cu. Thuc nhm ny c: m ln, m ngng, g v du olive.. 45

 Nhm c hot tnh sinh hc thp: hm lng acid bo cha no cn thit khng qu 5 - 6% v v thc t khng p ng c nhu cu c th v cc acid ny, thng gm cc loi: m cu, m b v margarine.

V 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: Tht b: 1,8 - 1.9% Gan: 3,5 3,6% Tim: 2 2,1% No: 6.0 6,1%

Phosphatide tham gia tch cc vo qu trnh chuyn ho t bo v chuyn ho m, nh hng ti cng hp thu v s dng cht bo trong c th. Ngun phosphatide ch yu l lng trng, gan, no.. nhiu cht bo nht l cc loi du thc vt l ngun phosphatide quan trng. Phosphatide hay gp trong thc phm l lecithin (Hnh 4.3) v phn t ph bin hn l cephalin (Hnh 4.4). Lecithin c tc dng iu ho lng cholesterol trong mu, ngn nga tch ly cholesterol, thc y cc qu trnh phn tch v bi xut chng ra khi c th. Duy tr cn bng sinh hc gia lecithin v cholesterol l yu t quan trng phng v ngn nga x va ng mch. Bnh thng ngi kho t l lecithin/cholesterol = 1/1. B l ngun lecithin qu. Do cc vai tr trn, c th cn cung cp phosphatide y theo thc n. Ngoi cc loi du thc vt cng cn ch b sung cc loi thc phm khc giu lecithin nh trng g ton phn.

Hnh 4.3 Lecithin

Hnh 4.4 Cephalin

VI Sterol v vitamin
6.1 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. a. Sitosterol 46

Sitosterol (Hnh 4.5) c hot tnh sinh hc cao v gi vai tr quan trng trong iu ho chuyn ho m v cholesterol. Sitosterol kt hp vi cholesterol to thnh nhng hp cht khng tan v khng c c th hp thu. Do ngn nga c s tng cholesterol trong mu.

Hnh 4.5 Sitosterol b. Cholesterol

L cht c hot tnh sinh hc rt quan trng. Cholesterol c trong cc t bo v t chc, no 4%, gan 0,3%, c 0,2 0,25%, mu 0,12 - 0,16%. Cholesterol (Hnh 4.6) tham gia vo cc qu trnh thm thu v khuch tn trong t bo. ng thi tham gia vn chuyn cc acid bo d tr n gan c t chy cho c th s dng khi cn thit.

Hnh 4.6 Cholesterol

Cholesterol b oxy ho gan cho cc acid mt. Cc acid mt c vai tr nh tng ho rut. Cholesterol tham gia vo vic tng hp cc ni tit t v thng thn (testosterol, vitamin D3, ni tit t sinh dc..). Cholesterol l yu t chnh tham gia vo s hnh thnh v pht trin x va ng mch, v vi ch n nhiu cholesterol th cholesterol trong mu tng. Theo nhiu nghin cu cho thy cholesterol huyt gy ng cholesterol thnh mch mu v gy ra cc bin i x va ng mch. Trong nhng nm gn y ngi ta cng nu ln mi quan h gia cholesterol vi s pht trin ca khi u c tnh. cc t bo ung th, lng cholesterol gp 4 ln cao hn cc t chc bnh thng. Tuy nhin vn cn ang nghin cu tip tc.

6.2 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. 47

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 .

VII Gi tr dinh dng ca cht bo

nh gi gi tr dinh dng ca cht bo, cc tiu chun sau y c s dng: Hm lng vitamin A, D v tocopherol Hm lng cc phosphatide (lecithin) Hm lng cc acid bo cha no (acid linoleic) Hm lng cc sterol, nht l -sitosterin D tiu ho v tnh cht cm quan tt Cht bo ng vt v cht bo thc vt cng khng hon ton p ng c cc nhu cu trn. Cc loi m ng vt c vitamin A, D nhng li khng c hoc c rt t cc acid bo cha no cn thit. Cht bo ca sa tuy c c tnh sinh hc cao do trong thnh phn c cha acid arachidonic nhng li rt ngho cc acid bo cha no cn thit khc. Ngc li du thc vt khng c vitamin A, D hay acid arachidonic nhng li c nhiu acid linoleic, phosphatid, tocopherol v sitosterin. Vic s dng phi hp cc cht bo ng vt v thc vt mi c th to nn ngun cht bo c gi tr sinh hc cao. V mt gi tr sinh hc, t l cht bo ngun gc ng vt nn khong 60 - 70% v ngun gc thc vt 30 - 40%. ngi ng tui, t l du thc vt s dng nn tng. Tnh cn i ca cc acid bo trong m n cng rt quan trng. T l trong khu phn nn l 10% cc acid bo cha no c nhiu mch kp, 30% cc acid bo no v 60% acid oleic.

VIII 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% 48

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.

Gan Cholesterol ca.0.5g/ngy Cht bo

Mui mt

Ho lng Mt
Acid mt to phc vi albumin huyt thanh T trng Nh tng du/nc

Ti mt

D dy

Tnh mch ca gan

Hnh thnh mixen

Lipase tuyn ty Tuyn tu Rut chay

Hp thu bo
99%

Rut hi

1% ca. 0,5g/ ngy

phn

Hnh 4.7 Vai tr ca mui mt v s tiu ho cht bo ng (- - - -) biu din s tun hon ca mui mt TG: triacyl glycerol 49 MG: monoacylglycerol

FA: chui acid bo Ngun: Harper's Review of Biochemistry, 19th ed., Long Medical Publications, Los Altos, Calif. (1983) Qu trnh hp thu cht bo c biu din Hnh 4.7. Cht bo c hp thu rut non. Trong d dy cht bo s c nh tng ho s b v i vo t trng, tc v nhp iu i vo s khc nhau ty thuc vo hm lng ca cht bo trong thc n, t l cng nhiu th thi gian dng li trong d dy cng lu. Khi cht bo vo n t trng, gp mt v enzyme lipase ca tuyn ty s phn gii cc phn t triglyceride, u tin hnh thnh 1-diglyceride v 2-diglyceride v tch 1 phn t acid bo ra, sau tip tc phn gii hnh thnh 2 n glyceride v 1 phn t acid bo khc. Tc tc dng phn gii do enzyme cng khc nhau ty theo di ca lin kt cht bo, tc phn gii ca acid bo khng no nhanh hn acid bo no. ng ho ca mt s cht bo nh sau: B: 93 - 98% M cu: 80 - 90% M heo: 96 - 98% Du m: 98% M b: 80 - 96% Du u nnh: 97,5%

IX 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 Bng 4.7 Nhu cu cht bo theo g/kg cn nng i tng Ngi cn tr v trung nin Lao ng tr c + c gii Lao ng chn tay Ngi lung tui Khng lao ng chn tay C lao ng chn tay 0,7 1,2 0,5 0,7 1,5 2,0 1,2 1,5 Nam N

50

51

CHNG V. CARBOHYDRATE
I 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 Bng 5.1 Cc carbohydrate Monosaccharides Glucose, Fructose Disaccharides Oligosaccharides Polysaccharides Sugar alcohols Sucrose, Lactose Raffinose, Stachyose, Fructo-oligosaccharides Cellulose, Hemicelluloses, Pectins, -Glucans, Fructans, Gums, Mucilages, Algal polysaccharides Sorbitol, Mannitol, Xylitol, Lactitol, Maltitol

II Vai tr sinh l ca carbohydrate

2.1 Cung cp nng lng
L vai tr sinh l ch yu ca carbohydrate. Carbohydrate c trong c bp l ngun nng lng hu hiu nht ca hot ng c. Carbohydrate c oxy ho trong c th c theo con ng hiu kh v k kh. Carbohydrate v cc ng phn lp th ca chng tham gia vo thnh phn t chc ca c th, c chc phn v tnh c hiu cao. Trong dinh dng ngi vai tr chnh ca carbohydrate l sinh nng lng. Hn 1/2 nng lng ca khu phn n l do carbohydrate cung cp, 1 g carbohydrate t chy trong c th cho 4 Kcal. Hot ng ca tim cng ch yu da vo nng lng ca phosphoric acid, glucose v glycogen oxy ho. H thn kinh ngoi glucose ra, khng th s dng c nng lng do 51

cc cht dinh dng khc cung cp. Glucose trong mu l nng lng duy nht ca h thn kinh, khi lng ng huyt thp s xut hin hn m, ngt, thm ch t vong..

2.2 Thnh phn cu to nn cc t chc thn kinh

Ngoi vai tr sinh nng lng mc nht nh, carbohydrate cn c vai tr to hnh. Mc d c th lun phn hy carbohydrate cung cp nng lng, mc carbohydrate trong c th vn n nh nu n vo y . Tt c cc t chc v t bo thn kinh u c cha carbohydrate. Desoxyribonucleic acid (DNA) l c s vt cht ca di truyn sinh hc c cha ng ribose l loi pentose.

2.3 Bo v gan, gii c

Khi glycogen gan c d tr tng i y , gan s c kh nng gii c tng i mnh i vi chng c huyt do mt vi loi ho cht c (nh carbon tetra-chloride, cn, thch tn) v do b nhim cc loi vi sinh vt gy bnh gy nn. V th m bo vic cung cp ng, duy tr trong gan lng glycogen vi mc no s bo v gan trnh c nhng tn hi ca cc tc ng c hi; ng thi s duy tr c chc nng gii c bnh thng ca gan.

2.4 Chng to th cetone

Lipid oxy ho trong c th s da vo nng lng do carbohydrate cung cp. Khi carbohydrate cung cp khng , c th do b bnh (nh bnh tiu ng) khng th tn dng c ngun carbohydrate, ngun nng lng phn ln cn thit do lipid cung 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.

III Carbohydrate tinh ch v carbohydrate bo v

3.1 Carbohydrate tinh ch
Carbohydrate tinh ch ch nhng thc phm giu carbohydrate thng qua nhiu mc ch bin lm sch, mt ti a cc cht km theo carbohydrate trong thc phm. Mc tinh ch cng cao, lng mt cc thnh phn cu to cng ln, cht x b loi tr cng nhiu, hm lng carbohydrate cng tng v thc phm tr nn d tiu hn. Carbohydrate tinh ch l nguyn nhn chnh trong vn gy bo ph, ri lon chuyn ha m v cholesterol ngi nhiu tui, ngi gi t lao ng chn tay. Thuc loi carbohydrate tinh ch cao c: - Cc loi ngt, trong lng ng qu 70% nng lng hoc tuy c hm lng ng thp (40 - 50%) nhng m cao (30% v hn). - Bt ng cc t l xay xt cao, hm lng cellulose mc 0,3% hoc thp hn cng thuc loi carbohydrate tinh ch v chng d to m tch cha trong c th. 52

Ngi nhiu tui, ngi gi, ngi t vn ng th lc nn hn ch lng carbohydrate tinh ch di 1/3 tng s carbohydrate khu phn.

3.2 Carbohydrate bo v
Gm nhng carbohydrate thc vt ch yu dng tinh bt vi hm lng cellulose cao hn 0,4%. Carbohydrate loi ny thng c bo v bi cellulose trc men tiu ho v vy chm tiu, ng ho chm v rt t c s dng to m. Thay th carbohydrate tinh ch bng carbohydrate bo v m khng lm thay i cc thnh phn khc trong khu phn lm tng cm gic no bng.

IV 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.

4.1 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 Cu trc phn t ca fructose th hin Hnh 5.2. Fructose c coi l loi carbohydrate thch hp nht cho ngi lao ng tr c ng tui v ngi gi. y cng l loi 53

carbohydrate tt cho cc bnh nhn x va ng mch, cc trng hp ri lon chuyn ho lipid v cholesterol. Fructose nh hng tt n hot ng ca cc vi khun c ch trong rut, c bit ti chc phn ca chng. ngt cao ca fructose cho php s dng vi lng nh t mc cn thit. Ngoi ra cn hn ch c hm lng ng s dng. Do s lng ca chng bng vi s lng ca glucose t s thy phn ng ma nn fructose hot ng nh glucose trong vic sn sinh ra glycogen. Glucose v fructose chuyn ho ho hc di tc dng ca dung dch kim v mt cch sinh ho hc bi enzyme trong qu trnh chuyn ho qua li cc cht dn xut phosphate, glucose-6phosphate thnh fructose-6-phosphate. Cc loi qu l ngun fructose chnh. Ngun fructose t nhin quan trng l mt ong, trong lng fructose ln ti 37,1%. Hm lng fructose trong mt s loi qu nh sau: chui 8,6%, to 6,5 11,8%, mn 0,9 2,7%, m 0,1 - 3%, nho 7,2%. 4.2 Disaccharide Saccharose (ng ma hay c ci ng) v lactose (ng sa) l cc disaccharide chnh c vai tr quan trng trong dinh dng ngi. Tnh cht ca chng l d tan trong nc, d ng ho v s dng to glycogen. Cc disaccharide rt gn vi monosaccharide. a. Saccharose

Hnh 5.3 Saccharose

Hnh 5.4 Lactose

Saccharose (Hnh 5.3) l dng disaccharide ca glucose v fructose. Saccharose di dng ng ma hay c ci ng c s dng nhiu nht trong dinh dng ngi. Tuy nhin cn gii hn lng ng s dng i vi ngi ln tui lao ng tr c, nhng ngi c khuynh hng bo... do cc l do sau: * Mc s dng ng cao thng khng tch ri vi s tng nng lng chung ca khu phn, y l vic khng tt i vi ngi khng lao ng chn tay. * Khi tha, saccharose d dng bin thnh m * Nhiu nghin cu cn cho thy ngi ng tui v gi, tha saccharose c tc dng tng cholesterol trong mu, trong khi tinh bt khng c tnh cht ny. Ngun saccharose ch yu trong dinh dng ngi l ng ma (10 - 15%) v ng c ci (14 - 18%). Ngoi ra saccharose cn hin din trong mt s loi thc phm khc nh sau: chui 13,7%, m 2,8 - 10%, mn 4,0 9,3%, da hu 5%, c rt 6,4%, to 1,5 5,3%. 54

b. Lactose (ng sa) Lactose l mt disaccharide gm 2 monosaccharide to thnh carbohydrate (cu trc phn t c cho Hnh 5.4) trong sa cc loi ng vt c v. Lactose km ngt v km ho tan hn sucrose, ho tan khong mt phn trong 6 phn nc. Khi hydro ho bng nhit vi acid hoc bi enzyme nh lactose ca nc qu ng rut, mi phn t lactose cho mt phn t glucose v mt phn t galactose. Do lactose n vo c hp thu. Enzyme thy phn lactose l lactase. Lactase thng mt trong cc c th thanh thiu nin v lm cho cc c th ny khng chu c sa. Qu trnh thy phn lactose ng rut xy ra chm, iu c mt tt v khng tt. * Mt tt ca vic thy phn chm lactose l nh c th hn ch c cc qu trnh ln men rut v bnh thng ho cc hot ng ca vi khun ng rut c ch. S c mt ca lactose kch thch pht trin ca vi sinh vt lm chua sa, c ch cc vi khun gy thi. Saccharose khng c tnh cht ca lactose nn khng c tc dng no i vi vi khun rut. * Mt khng tt ca vic thy phn chm lactose l hn ch s dng n to glycogen nhanh, do mt ny m khi lao ng nng dng glucose hay saccharose tt hn. Lactose rt t s dng trong c th to m v cng khng c tc dng lm tng cholesterol trong mu. Ngun lactose l sa v cc ch phm ca sa. c. Maltose (ng mch nha) Maltose do hai phn t glucose ngng kt hp thnh (Hnh 5.5). Trong mm ca cc loi ng cc mi ny mm c hm lng tng i nhiu, c bit l trong mch nha c hm lng cao nht. Thc n c cha tinh bt trong ming di tc dng ca amylase trong nc bt, mt phn s c phn gii thnh ng maltose.

Hnh 5.5 Maltose

4.3 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: Saccharose Fructose ng nghch chuyn Glucose 100 173 130 74 Maltose Ramnose Galactose Lactose 32,5 32,5 32,1 16,0

T s liu cho thy ngt nht l ng fructose, t ngt nht l ng lactose. ng ch cc loi ng t lactose phn gii ra, glucose v galactose li ngt hn nhiu (74 v 32) so vi lactose (16).

55

V Polysaccharide
5.1 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.

Hnh 5.6 Cu trc mt phn ca amylose

Hnh 5.7 Cu trc mt phn ca amylose pectin

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 ch yu da vo tinh bt. S bin i tinh bt thnh glucose i qua nhiu giai on trung gian. Do nh hng ca cc men (amylase, diastase) v acid, tinh bt b thy phn to thnh dextrin (bt u l amylodextrin, sau l erytrodextrin, acrodextrin v maltodextrin). Trong qu trnh , mc ho tan trong nc ca cc dextrin to thnh tng ln. Amylodextrin ch ho tan trong nc nng, cn erytrodextrin c th ho tan trong nc lnh. Acrodextrin v maltodextrin tan d dng trong bt k trng hp no. Phn ng c hiu cho tinh bt cng mt i theo qu trnh trn. Amylodextrin cho mu xanh nht, acrodextrin v maltodextrin khng cho phn ng vi iode. Sn phm cui cng ca bin i cc dextrin l ng maltose. y l mt loi ng c y tnh cht ca disaccharide, k c tnh cht d ho tan trong nc. Do nh hng ca cc men, maltose chuyn thnh glucose, cht ny c s dng to glycogen. C th thy qu trnh chuyn ho ca cc disaccharide v polysaccharide theo s Hnh 5.8 56

5.2 Glycogen
ch tn ti trong c th ng vt, l hnh thc carbohydrate tn tr. Glycogen c tng i nhiu gan (ti 20% trng lng ti) v c. Trong c th glycogen c s dng dinh dng cc c, c quan v h thng ang hot ng di dng cht sinh nng lng. S phc hi glycogen xy ra khi ngh ngi nh s ti tng hp glycogen t glucose ca mu. H thng thn kinh trung ng iu ho vic to thnh v phn gii glycogen trong c th. H thng ni tit t cng tham gia vo iu ho chuyn ho glycogen gan. Khi glucose trong mu cao, insulin ca tuyn ty kch thch tng hp glycogen gan v gy h ng huyt. Khi glucose trong mu thp, adrenalin ca tuyn thng thn gip phn gii glycogen gan. Tinh bt Amylase (nc bt) 20 - 40% Amylase (ty) 50 - 80% Amylase (rut) Maltose Saccharose Saccharase (rut) Maltase (rut) (rut) Lactose Lactase

Fructose

Glucose

Galactose

Hnh 5.8 Qu trnh chuyn ho ca cc disaccharide v polysaccharide

5.3 Cc cht pectin

Cc pectin (Hnh 5.9) thuc loi polysaccharide keo hoc glucopolysaccharide. Chng c mt ch yu trong cc sn phm thc phm. Cc cht pectin c th coi nh cc hemicellulose va c cc chc phn c hc chng , chc phn ca cc cht bo v, va c gi tr dinh dng nht nh. Phn t pectin thng gm mt phn t polysaccharide no v mt acid pectinic. Hnh 5.9 Pectin V cu trc ho hc, acid pectinic c cc chui di gm cc anhydric ca acid galacturonic ni bi cc dy ni glucoside d b phn hy. Do nh hng ca cc tc nhn 57

ho hc (acid, kim) v un nng, cc cht pectin d dng b thy phn. Cc cht pectin cng d dng b phn gii bi cc men c mt trong vi khun, nm v cc t chc thc vt cao cp. Pectin gm hai dng: Protopectin * L nhng pectin nguyn thy ca thc vt khng tan trong nc * C mt trong cc thc phm thc vt nh: qu, c to thnh cc lp trung gian gia cc t bo v cht liu lin kt v cng c thnh t bo. * Protopectin c nhiu trong cc qu xanh, do qu xanh thng cng. Trong qu trnh protopectin b phn gii, qu dn tr nn mm. Lng pectin rau qu un chn cao hn rau qu cn ti v mt phn c to thnh t protopectin. Pectin * Thuc nhm cht ho tan, ng ho c trong c th. V thnh phn ho hc l cc polygalacturonic phn t cao (trong nguyn t H trong cc nhm carboxyl c thay th bi cc nhm methyl v ion kim loi theo mc khc nhau). * Pectin l esther methylic ca acid pectinic. Di nh hng ca enzyme pectinase, pectin b thy phn ti cc thnh phn n gin hn l ng v acid tetragalacturonic. Do tc dng ca cc enzyme ny nhm methoxyl (OCH3) tch khi pectin. Nh vy pectin l acid polygalacturonic c cha cc nhm methoxyl. Tnh cht ca cc pectin quyt nh vai tr ca chng trong k ngh thc phm l khi c mt ca acid v ng chng to thnh vi nc cc khi ng keo. Ngi ta thy lng ru methylic trong pectin cng cao th c tnh ng keo cng tt. Nhiu nghin cu cho thy pectin c vai tr trong dinh dng ngi kho v ngi m. Cc cht pectin c ch cc vi khun gy thi trong rut v iu ho h vi khun ng rut, ci thin cc qu trnh tiu ho. Pectin c cng hiu cao trong cc trng hp ng c ngh nghip do ch. nhng ni sn xut c nguy him do ch, ch n iu tr, d phng giu pectin c tc dng tt. Nhiu nghin cu ch ra rng vic s dng pectin vo ch n iu tr, d phng giu pectin c th p dng cho cc ngh nghip tip xc vi cc cht c khc. Pectin cn thc y qu trnh lin so v c tc dng tt trong iu tr bng lot. Hiu qu iu tr ca cc thc n thc vt (to, c rt, chui..) trong iu tr cc bnh d dy-rut l do cc cht pectin c nhiu trong . Cc tc dng ny ca pectin cha c gii thch y mt cch khoa hc. Ngi ta cho rng tc dng trn c c l do cc c tnh keo ca pectin v kh nng hp ph cao ca chng. Pectin c nhiu trong cc loi qu, c nh cam 12,4%, m 4 7,1%, mn 3,1 - 8%, to 1,6 5,6%, c rt 2,4 4,8%.

5.4 Cellulose
Cellulose l thnh phn cu to ca thc vt, v cu trc ho hc rt gn vi polysaccharide (Hnh 5.10). 58

Hnh 5.10 Cellulose

Cellulose trong rut c th c phn gii v ng ho do mt s vi khun ng rut c cc loi men phn gii cellulose. Do mc nht nh n c gi tr dinh dng. Cc loi ht c hm lng cellulose cao, tuy vy hm lng ny gim nhiu trong qu trnh xay xt. Lng cellulose trong rau qu khong 0,7 - 2,8 %, trong qu 0,5 - 1,3 %, khoai ty 0,7 - 1 %.

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 cc loi, u cc loi v rau xanh th lng ng-niu v lng yu cu insuline bnh nhn tiu ng u gim xung Ngn nga s tha nng lng v bo ph. Ba n c nhiu cht x s lm tng dung tch cha thc n trong rut, to cm gic no bng, t c th gim c lng thc n v nng lng np vo, kim sot c cn nng v ngn nga c bo ph.

59

VI Ngun carbohydrate trong thc n

Ngun carbohydrate trong thc n c th hin cc Bng 5.2, Bng 5.3, Bng 5.4 Bng 5.2 Hm lng cellulose v carbohydrate tng s trong mt vi thc n chnh (%) Tn thc n Go np Go t Khoai lang Khoai ty Sn ti Ng u H Lan u tng u xanh u c ve C chua Ci bp Rau mung Rau ngt Nm hng kh Gc Chui tiu u chn Tht b Tht ln Tht g Gan ln C chp Trng g Sa m Sa b ti Cellulose 0,6 0,4 1,3 1,0 1,5 2,1 5,4 5,0 4,5 4,0 0,8 1,6 1,0 2,5 17,0 1,8 0,8 0,6 0,0 0,0 0,0 2,7 0,0 0,0 0,0 0,0 Carbohydrate tng s 74,9 76,2 28,5 21,0 36,4 70,0 50,0 23,5 35,6 45,0 4,2 5,4 2,5 3,4 23,5 10,5 22,4 7,7 0,0 0,0 0,0 2,0 0,0 0,5 7,0 4,8

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Bng 5.3 Hm lng cc loi ng trong mt s loi thc phm (%) Tn sn phm La go La m Ng K Tinh bt 63 65 70 60 ng tan 3,6 4,3 3,0 3,8 Carbohydrate khc 2 8 7 2

Bng 5.4 Hm lng ng trong b phn n c ca mt s loi rau qu (% so vi trng lng ti) ng tng s Tn sn phm Cam Nho L Chanh o Hng Da b Da hu Da chut Bp ci C chua t ngt C rt C ci ng Gii hn giao ng 4,3 - 11,5 14,0 - 35,0 7,3 - 21,0 0,5 - 3,1 6 - 15,3 9 - 20,0 6 - 11 6 - 18 1,2 - 3,1 1,6 - 4,0 1,6 - 4,1 2,0 - 4,9 6-8 16 - 26 Tr s thng gp 7-8 15 - 23 10 - 12 10 - 11 6 - 11 8 - 11 2,5 - 3 2,0 - 3,0 16 - 23 Saccharose Gii hn giao ng 1,0 - 6,0 0 - 0,5 0 - 5,1 0 - 0,8 2,7 - 12,0 0-5 1,2 - 3,2 1,3 - 11,0 0 - 0,3 0 - 0,8 0,3 - 0,8 0 - 0,5 2-6 16 23 Tr s thng gp 4 0 - 0,3 4 - 7,0 7 - 10 0 2 3-7 0,3 - 0,4 16 - 20 Loi ng ch yu Saccharose ng n Fructose ng n Saccharose ng n Fructose Saccharose ng n ng n Saccharose

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) 61

VII Tiu ho v hp thu carbohydrate

S tiu ho tinh bt c bt u t tc ng ca -amylase trong nc bt, nhng ch yu tin hnh on trn rut non. Trong on khoang rut ny, -amylase s thy phn -1,4 glucoside thnh dextrin v maltose. Trong t bo biu b nim mc rut cng c loi enzyme tng t nh vy, ri li tin hnh thy phn tip lin kt 1,6 glucoside v lin kt 1,4 glucoside trong phn t -dextrin cui cng thy phn dextrin v maltose thnh glucose. Ngoi ra cc enzyme sucrase, lactase cng thy phn ng sucrose v lactose thnh ng fructose, galactose v glucose. vng rut non v c bn l do nim mc rut hon thnh vic hp thu ch ng i vi cc monosaccharide, trong mt loi cht truyn ti ca t bo biu b nim mc rut s chn lc glucose v galactose chuyn n t bo, a vo trong mu. Trong s cc loi ng monosaccharide, hesose c hp thu tng i nhanh, cn pentose th c hp thu tng i chm. Vi cc loi hesose th hp thu nhanh nht l glucose v galactose, tip n l fructose. Nu cho tc hp thu glucose l 100 th galactose l 110, fructose l 43, pentose l 9. V vy dng monosaccharide b sung nng lng s c hiu qu nhanh hn tinh bt. Carbohydrate s dng qu nhiu, vt qu nhu cu ca c th s chuyn ho thnh lipid, ng thi tn tr li trong m m. Ngoi ra tnh trng bnh thng, ngoi mt phn ng chuyn ho thnh glycogen, cn c mt b phn acid bo s l ngun nng lng cung cp cho c th. Carbohydrate sau khi c hp thu trong c th s c ba hng i: - Vo trong mu - Tn tr di dng glycogen - Chuyn ho thnh lipid T l ca 3 hng i ny c s khc nhau ty thuc vo tnh trng ca c th. Trong tnh trng c th bnh thng, ngoi vic lm ngun nng lng s dng, hu ht s chuyn thnh lipid, 1/5 chuyn ho c bn c th ngi c dng cho t chc no. ng l ngun nng lng ch yu m cc t chc thn kinh da vo duy tr hot ng bnh thng. No rt nhy cm vi phn ng gim glucose-huyt.

VIII 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 62

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.

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CHNG VI.
I i cng

VITAMIN

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.

II Cc vitamin tan trong cht bo

Trong iu kin c cht bo, cc vitamin tan trong cht bo s c hp thu ng rut. Sau khi c hp thu phn ln s c d tr trong c th, ch yu cc m m. Chng thi ra khi c th qua ng mt, nhng v thi t t nn triu chng xut hin cng tng i chm. Nu ung vo vi liu lng ln (gp 6 - 10 ln so vi chun lng cung cp) thng dn n ng c.

2.1 Retinol (vitamin A) v cc carotene

2.1.1 Cc carotene Cc carotene ph bin rng ri trong t nhin, chng c nhiu trong cc phn xanh ca thc vt. Thuc cc carotenoid c , , -carotene v cryptoxantin. -carotene c hot tnh sinh hc cao nht, khong gp hai ln cc carotene khc. i vi ngi v ng vt n c, cc caroteneoid thc t l ngun vitamin quan trng. Khi vo c th, mt b phn ln ca chng chuyn thnh vitamin A. -carotene hay gp nht trong t nhin, thng hin din trong phn xanh ca thc vt v cc loi rau qu c mu da cam. N cng cn c nhiu trong cc thc vt h ng: rong, to, nm v vi khun. Bp l ngun cryptoxantin chnh, du c cng cha mt lng provitamin A. Trong t bo thc vt cc carotenoid lin kt vi protid v lipid. Carotene v vitamin A cng c trong ph tng v t chc ca cc ng vt v ngi. , , carotene l nhng ng phn c cng thc th l C40H56. Cc carotene rt nhy cm vi 63

oxy ho trong khng kh v nh sng. Chng tan trong lipid v cc cht ho tan lipid, khng tan trong nc. Qu trnh chuyn ho cc carotene thnh vitamin A trong c th (Hnh 6.1) xy ra ch yu thnh rut non v l mt qu trnh phc tp. Carotene khng chuyn thnh vitamin A hon ton m ch khong 70 - 80%.

Hnh 6.1 Qu trnh chuyn ho -carotenee thnh vitamin A 2.1.2 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)

64

Hnh 6.2 Cc dng vitamin A Vitamin A c trong cc t chc ng vt, c bit c nhiu trong gan ca cc loi c khc nhau. Trong t chc ng vt nh m, gan c vitamin A thng dng ester, trong lng trng 70 - 90% vitamin A dng t do. Vitamin A cn c nhiu trong sa v cc sn phm sa, trng, gan, thn, tim, tht. Vitamin A tan trong cht bo v trong phn ln cc dung mi hu c, khng tan trong nc. Vitamin A tn ti trong thc n 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. 65

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 dctit 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 vitamin A. Kh nng d tr ca tr em rt km, do rt d b thiu. C th tm tt chuyn ho vitamin A nh sau:

Carotenee oxydase -carotene + protid (Mi trng nc) Retinaldehyde

Alcohol dehydrogenase Vitamin A (Ester vitamin A)

Vitamin A t do (th ru) 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. 66

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 - 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. Bng 6.1 Nhu cu vitamin A Tui (g retinol/ngy) 6 - 12 thng 1 nm 2 tui 3 tui 4 6 tui 300 250 250 250 300 Tui 7 - 9 tui 10 - 12 tui 13 - 15 tui 16 - 19 tui Ngi trng thnh (g retinol/ngy) 400 575 725 750 750

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 67

1 g carotene = 0,167 g ng lng retinol.

2.2 Ergoscalcipherol, cholescalcipherol (vitamin D)

Vitamin D (Hnh 6.3) ch yu gp thc phm ng vt. Trong 100g thc phm ti c (n v quc t): sa m 2 - 4, sa b 4, trng 50 - 200, lng trng 300, gan b 100, gan ln 90, gan c thu 500 - 1500. cc thc phm thc vt rt t gp hoc vi lng rt b. Trong thc phm thc vt thng gp provitamin D, ch yu di dng ergosterol. Ngun vitamin D ca cc ng vt cao cp l thc n nh trng, c, tht cc con vt c lng mao hoc cc cy c chiu nng v lng vitamin D to thnh da hay trong da. Hnh 6.3 Cc vitamin D Hu ht cc cht bo c trong tht v c bit gan c cha nhiu vitamin D.

Tuy nhin hm lng ca n dao ng ty theo loi c v nhiu yu t khc. Phn ln m c cha nhiu vitamin D3. Trong c th ngi, provitamin D3 (7-dehydrocholesterol) c da hoc cc lp trn ca n s chuyn thnh vitamin D3 nh chiu nng mt tri. Vitamin D tp trung nhiu nht gan v huyt tng. Cng vi tc dng chng ci xng, vitamin D cn l yu t pht trin quan trng. C ch hot ng ca vitamin D l chuyn ho calci, phosphor trong c th. Vitamin D to iu kin s dng calci ca thc n nh to thnh lin kt calci-phosphor cn thit cho qu trnh ct ho. Vitamin D cn gip lm tng ng ho v hp thu calci. Khi thiu calci trong ba n, vitamin D huy ng calci t t chc xng duy tr hm lng n trong mu. in hnh cho thiu vitamin D l bnh ci xng thng gp tr em t 2 - 4 thng cho ti 1,5 - 2 nm. Nhng ri lon in hnh: d b kch thch, suy yu chung, ra m hi v nht l mc rng chm, d b co git v vim ph qun. Nhu cu ca vitamin D cho tr l 300 - 400 UI, ngi trng thnh 50 - 100 UI, ph n c thai v cho con b 500 UI.

2.3 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%.

68

Trong s cc thc phm ngun gc ng vt, sa b cha 0,1 0,2 mg%, trng g 1 - 3 mg%, lng 3,5 mg%, tht b 2 mg%, ln 0,6 mg%, c m 1,5 mg%. Sa m cha 0,05% vitamin E. dng tinh khit, tocopherol c dng du nhn, mu vng sng khng tan trong nc v phn ln cc dung mi hu c, bn vng vi acid v kim khi un nng ti 40oC, chu nhit tt. Cc tia t ngoi c th ph hy vitamin E.

Hnh 6.4 Cc tocopherol

Trong cc tocopherol (Hnh 6.4), -tocopherol l cht hot ng nht. N l i biu chnh ca vitamin E v chim 90% tt c tocopherol trong mu v t chc. Tc dng ch yu ca vitamin E trong c th l: Tc dng chng oxy ho. Vitamin E l cht chng oxy ho mnh, c th bo v cho t bo trnh khi cc nguy hi do cc gc t do gy nn, c ch s oxy ho ca cht dng m trn mng t bo v trong t bo, ngoi ra c th phn ng vi peroxyde lm cho chng chuyn ho thnh cc cht khng gy c hi i vi t bo. Vitamin E c tc dng phng nga s oxy ho ca vitamin A, vitamin C, m bo chc nng dinh dng ca chng trong c th. Duy tr tnh hon chnh ca hng cu. Hm lng viatmin E trong thc n thp s dn n lng hng cu gim v rt ngn thi gian sinh tn ca hng cu. iu tit s tng hp nn mt s cht trong c th. Vitamin E bng s iu tit cc baz pyridine m tham d vo cc qu trnh tng hp sinh hc ca DNA. Vitamin E l nhn t ph tr tng hp nn vitamin C v coenzyme Q, ng thi c kh nng lin quan n s tng hp nn hemoglobin. Vitamin E c th c ch s oxy ho cc cht khng phi l hemoglobin nh protein st, bo v gc SH trong dehydrogenase khng b oxy ho hoc khng xy ra phn ng ho hc vi cc ion kim loi nng m mt tc dng. Vitamin E cng c kh nng to thnh v pht trin ca tinh trng. Tocopherol khng t tng hp trong c th. Sau khi vo c th theo thc n, vitamin E tch ly cc t chc, ch yu m 10 - 50 mg%, gan 1,3 2,5 mg%, c 1,2 1,6 mg%. Thiu vitamin E xy ra khi ri lon hp thu lipid. Thiu vitamin E thng xy ra tnh trng teo c, cc bin i su sc i no v ty. Nhu cu vitamin E i vi tr em 0,5 mg/kg cn nng, ngi trng thnh 20 - 30 mg/ngy, nhu cu cao hn i vi ph n c thai v cho con b. Tuy nhin nhu cu v vitamin E cha c xc nh chc chn m ch gn ng da vo hm lng ca n trong khu phn, mc hp thu lipid, s tch ly trong cc m v s bi xut. Do hot tnh sinh hc ca cc ng phn (isomer) ca vitamin E trong c th khc nhau, v vy khi tnh ton lng vitamin E a vo, nn da vo t l tng ng vi lng tocopherol: 69

ng lng vitamin E = (1 x -tocopherol mg) + (0,5 x -tocopherol mg) + (0,1 x tocopherol mg) + (0,3 x -tocopheroltriene mg).

2.4 Vitamin K

Hnh 6.5 Cc dng vitamin K Hm lng vitamin K trong mt s loi thc phm theo mg% nh sau: c rt 0,1, u nnh 0,2, c chua 0,4, khoai 0,12, ng 0,04, khoai ty 0,08, sa 0,002, tht b 0,1, tht heo 0,15, c m 0,1. Ni chung vitamin K c nhiu hn trong thc phm ngun gc ng vt. Vitamin K thng gp trong t nhin di dng vitamin K1 v K2 (Hnh 6.5). Vitamin K1 do phn xanh ca l to thnh thng lin kt vi chlorophyll, vitamin K2 do vi khun to thnh. Vitamin K1 v K2 khng ho tan trong nc, d tan trong cht bo v dung mi ca chng, nhy cm vi nh sng, kim v nhit. Vitamin K cn thit cho mi t bo sng. V vy c mt trong hu ht mi c th, t cc vi khun cho n cc ng vt. Cc vi khun ng rut tng hp mt lng ln vitamin K2 khong 1,5 mg mi ngy (Glavine-1942) p ng nhu cu c th. hp thu vitamin K cn phi c acid mt. Khi ri lon dn mt vo t trng, hp thu vitamin b ri lon dn n hin tng thiu vitamin K. Triu chng thiu vitamin K chnh l h thp lng prothrombin mu, ko di thi gian ng mu, chy mu di da v trong c. Bnh thiu vitamin thng rt t gp ngi ln v tng hp vitamin K ng rut tng i ln, ngay c khi lng ca n trong thc n khng y . Tr s sinh b sa m thng b thiu vitamin K v trong sa m c t loi vitamin ny hn trong sa nhn to, cng vi tp qun n king du, m v cc loi thc phm giu vitamin K ca cc b m sau sinh nn s thiu ht cng trm trng. Hng nm, Vit Nam c t 2.000 n 3.000 tr b chy mu no, mng no v thiu vitamin K, gn 1/5 s t vong v 40 - 50% tr nu c cu sng th mang cc di chng thn kinh v tinh thn. Tr cc ri loi v bnh l, lng vitamin K n vo v c tng hp rut p ng nhu cu ngi trng thnh. Nhu cu vitamin K tr em cao hn.

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III Cc vitamin tan trong nc

3.1 Cc vitamin nhm B
3.1.1 Thiamin (vitamin B1) Vitamin B1 (Hnh 6.6) ph bin rng ri trong th gii thc vt. Tuy nhin tr mt s loi c bit c nhiu (men, mm lu m, cm go), cc loi thc phm khc hm lng ca chng khng ng k. Phn ln cc thiamin thc phm thc vt nm di dng thiamin t do. Trong sn phm ng vt thng gp di dng lin kt phosphate hay pyrophosphate nh diphosphothiamin. Ht la m cha tng i nhiu thiamin, hm lng ca n ph thuc vo loi la m v iu kin trng trt, dao ng t 500 - 800 g/100g. u cng l ngun thiamin quan trng. u nnh c 540 g/100g, u xanh 720, u phng 440 g/100g. Cc loi khoai c ngho thiamin. Thiamin cn hin din trong cc ph tng ng vt, c bit gan, thn, c. 100g tht b c 100 g, 100g gan b c 400 g. Tht heo tng i giu thiamin, 100g tht ba ri ch 530 g. c hm lng ny thp hn, trng g th hm lng thiamin tp trung lng trng (300 g/100g). Thiamin gi vai tr quan trng trong chuyn ho acid pyruvic. N l thnh phn ca men carboxylase, men ny kh carboxyl ca acid pyruvic cho acetaldehyde. Trong c th thiamin xut hin di dng thiamin-diphosphate (thiamin pyrophosphate T.P.P Hnh 6.7) v khi theo thc n vo c th chng d dng b phosphoryl ho bi cc men cha adenosin-triphosphate (ch yu gan), b kh phosphorin thn nh men phosphatase v ra ngoi theo nc tiu dng t do. Nguyn nhn thiu thiamin l do s tng tiu th cc loi go hoc bt b xay gi trng v cng do thiamin l mt trong nhng cht dinh dng d tr vi lng khng ln v nhanh chng cn nhng tnh trng sinh l khc nhau. Cc du hiu lm sng thng gp: nhc u, mt mi, mt ng, ri lon tr nh, d b kch thch, ra m hi, thn nhit gim, tim p nhanh, h huyt p, kh th.. Do ri lon chuyn ho nc c th gy ph nhng cn phn bit vi dng ph do thiu protid. Nhu cu ti thiu phng bnh beriberi khng di 0,7 mg thiamin/ngy.

Hnh 6.6 Thiamine

Hnh 6.7 Thiaminpyrophosphat

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3.1.2 Riboflavin (vitamin B2) Riboflavin (Hnh 6.8) c rng ri trong t nhin, trong cc l xanh ca cy. Trong cc ht c t, khoai ty v cc loi c ngho riboflavin. Tri li, c chua v cc loi rau c l tng i nhiu. Cc loi men cha nhiu riboflavin nht: men bnh m 6mg%, men bia 4 mg%. Cc loi u nh u nnh 0.3 mg%. Vi cc loi thc phm ng vt, riboflavin c nhiu trong ph tng: gan 0,2 mg%, tim 0,5 mg%. Tht cng l ngun B2 rt tt, khong 0,2 mg%, trng khong 0,3 mg%, c ngho riboflavin. Riboflavin tng i bn vng nhit un nu bnh thng v t b ph hy. Riboflavin c th mt nhiu do nh hng ca nh sng, tia t ngoi hoc khi un nu trong ni kn. Phn ln cc loi men, thc vt, nm cng nh mt s vi khun c kh nng tng hp c riboflavin.

Hnh 6.8 Riboflavin

Vai tr sinh hc chnh cu riboflavin l tham gia vo thnh phn cu to cc flavoproteid v hot ng nh l nhng enzyme. Riboflavin cn thit cho chuyn ho protein, khi thiu B2, mt phn acid amin ca thc n khng c s dng v ra ngoi theo nc tiu. Riboflavin c nh hng ti cu trc t bo, lm tng tnh thm ca mng t bo i vi mt s cht nh glucose. Cng nh vitamin A, riboflavin c nh hng ti kh nng cm th nh sng ca mt, nht l i vi s nhn mu. C ch tc dng ca riboflavin i vi th gic cha hon ton r rng. Khi thiu vitamin B2 xy ra nhng tn thng ca gic mc mt. Cc triu chng thiu riboflavin thng gp nht l cc tn thng nim mc li, mt li tr nn xm , b mt c nhng ht nh, gai li tr nn phng, sau teo li. Ngoi ra thiu riboflavin cn gy ra cc bin i mu, qu trnh tng hp hemoglobin b ri lon, ng thi cn xut hin cc bnh khc nh vim gan, x gan, vim mng phi, thp khp... Nhu cu riboflavin l 0,55 mg/1000 kcal. 3.1.3 Pyridoxine, pyridoxan (cc vitamin nhm B6) Vitamin B6 (Hnh 6.9)c trong t nhin thng di dng phc hp vi protid: men, go trng, mm nhiu loi ht. Cc phng php ch bin thng thng khng lm ph hy vitamin B6. Trong t nhin, vitamin B6 thng gp di cc dng: pyridoxine, pyridoxan v pyridoxamin. Pyridoxan l sn phm oxy ho ca pyridoxine, thng gp di dng ester ca acid phosphoric (pyridoxanphosphate). C 3 dng vitamin B6 trong thc phm phn ln dng lin kt vi protid ca cc men. Khi vo rut sau khi phn gii v hp thu, chng li lin kt vi cc protid v di dng tch ly trong cc t chc.

Hnh 6.9 Pyridoxine

Pyridoxine khi vo c th chuyn ho thnh pyridoxan v pyridoxamin. Tt c cc dng ny u b oxy ho thnh 4-pyridoxalic v ra theo nc tiu cng vi lng nh pyridoxan v pyridoxamin. Vitamin B6 cn cho tng hp porfirin v tham gia vo chuyn ho cc lipid, c th trong qu trnh chuyn ho acid linoleic thnh acid arachidonic. 72

Vitamin B6 c tc dng lm gim lng cholesterol trong huyt thanh, do c kh nng ngn nga c bnh x va ng mch. Theo tiu chun ca B Y T Lin X (1960) nhu cu vitamin B6 l 0,7 mg/100 Kcal khu phn vi s tng hp l cho ph n c thai v cho con b. 3.1.4 Cobalamin (vitamin B12) Trong cc loi thc vt cao cp hu nh khng c vitamin B12. Trong c th ng vt, vitamin B12 (Hnh 6.10) c tng hp bi h vi khun ng rut, sau c hp thu. Vitamin B12 d tan trong nc v cn, n nh v nhit , nhng khng n nh trong mi trng acid mnh, kim mnh v b chiu sng, d b phn hy khi chu tc dng ca cc kim loi nng, cc cht oxy ho mnh hoc chu tc dng ca cc cht kh, nhng khi lm nng cao p (120oC) trong thi gian ngn th s phn hy khng r rng. Vitamin B12 trong thc n khi vo c th di tc dng ca acid gastric v cc enzyme trong rut, s c phn ly t trong cc lin kt polypeptide v kt hp vi cc cht trong d dy (mt loi glucoprotein) hnh thnh nn hp cht dimer chuyn n rut hi th c hp thu. T l hp thu tnh trng c th bnh thng l khong 30 - 70%, trong s khuch tn gin n ch l 1 - 3%. V vy khi chc nng d dy khc thng th vitamin B12 hu nh khng th hp thu. Thiu st v vitamin B6 cng lm gim t l hp thu vitamin B12. Vitamin B12 ch yu c t tht trai, c, cm gia cm v trng cc loi, hm lng trong gan phong ph, hm lng trong sa tng i thp. Trong cc thc n t thc vt nh cy ht cc, rau xanh, hoa qu.. hu nh khng cha vitamin B12, nhng vi sinh vt sng k sinh nt sn r u cc loi li c th to ra vitamin B12, cc ch phm t u ln men c hm lng vitamin B12 rt cao. Hm lng vitamin B12 trong mt s thc phm ng vt nh sau: (tnh theo g/100g trng lng ti) Tht b 2 - 8, gan b 30 - 130, tht heo 0,1 - 5, Sa b 0,2 0,6, lng trng 1,2. Hnh 6.10 Cobalamine Vai tr chnh ca cobalamin c th c tm tt nh sau:

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. 73

3.1.5 Niacin (a) Niacine Niacine l yu t quan trng trong vic phng bnh pellagre, l bnh vim da c hiu do dinh dng v bnh thng xut hin nhng vng hay dng thc phm ch yu l bp, Nam M v a Trung Hi. Trong cc m ng vt, niacin di dng nicotinamid. Trong cc m thc vt n li di dng acid nicotinic. Niacin c th c to thnh t thc phm hoc c chuyn ho t tryptophan trong c th ngi. Sau c th thc hin cc phn ng khc nhau l bin i niacin thnh nicotinamide. y l dng vitamin bn vng nht i vi nhit, oxy ho v kim. Cc phng php un nu thng thng ch lm mt t 15 - 20%. hp bo qun trong 2 nm mt khng qu 15% vitamin ny. Niacine v cc amid ca n c vai tr ct yu trong cc qu trnh oxy ho gii phng nng lng ca cc phn t glucid, lipid v protid. Niacin l thnh phn ch yu ca 2 coenzyme quan trng trong

(b) Nicotinamide

Hnh 6.11 Niacine (a) v Nicotinamide (b)

chuyn ho glucid v h hp t bo l nicotiamide adenin dinucleotid (NAD, coenzyme I) v nicotiamid adenin dinucleotid phosphate (NADP, coenzyme II). Vai tr chnh ca NAD v NADP l ly hydrogen t mt s c cht v chuyn n sang 1 coenzyme hay c cht khc trong dy chuyn vn chuyn hydrogen. Thiu niacin cn gy bnh li en (Hnh 6.12) vi triu chng chnh l li au, nhy cm vi nng, mui v thc n acid. Trong c th 60 mg tryptophan to thnh 1mg niacin v gi l 1 ng lng niacin. Nhu cu 6,6 mg ng lng/ngy cho 1000 Kcal.

Hnh 6.12 Triu chng bnh pellagre Cc thc phm giu vitamin ny l: Men: 30 - 100 mg% Mm la m: 17 mg% u phng: 16 mg% Cm go: 30 - 100 mg% u: 2 - 3 mg% M: 4,5 mg% C chua: 0,5 mg%

Cc thc phm ng vt (tr trng v sa) u cha nhiu niacin. Cc loi thc phm nh: Tht gia cm: 8 - 10 mg% Tht b: 6 mg% Ph tng: 15 - 16 mg% Thn: 12 - 15 mg% Cc loi c ngho niacin hn tht. Tht heo: 3 mg%

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3.1.6 Acid folic (vitamin B9) Cn gi l acid pteroyl glutamic hay vitamin B9. Acid folic c vi dng tn ti trong t nhin, cht mu ca n c hp thnh t ba thnh phn lin tip l pterin, acid Paminobenzoic v acid glutamic (Hnh 6.13).

Hnh 6.13 Acid folic (Vitamin B9) Cc dng dn xut ca acid folic c th hin Hnh 6.14

Hnh 6.14 Cc dng dn xut ca acid folic 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 75

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. Rt nhiu qu trnh chuyn ho ca acid folic u cn s tham gia ca acid ascorbic, vitamin B12 v vitamin B6. Nhiu nghin cu cho thy, nu lng acid folic hp thu mi ngy ca c th khi duy tr mc 3,1 g/kg cn nng th c th s c lng d tr acid folic tho ng. Trn c s ny, trong thi k mang thai, nu b sung 100 g/ngy/ngi th s duy tr c mc acid folic bt bin trong mu thi k mang thai; nu>200 g/ngy/ngi th hm lng acid folic bnh qun trong hng cu s tng ln rt nhiu. V vy p ng c nhu cu acid folic trong thi k mang thai, ngi m nn b sung 200 - 300 g, tng lng hp thu mi ngy phi ln hn 350 g/ngi. Lng an ton cho tr em tnh theo kilogram cn nng gn ging ngi ln, tc l khong 3,6 g/kg/ngy th c th p ng c nhu cu sinh trng v duy tr c huyt bnh thng ca chng. Nhng a tr mi sinh c cn nng thp thng c lng d tr acid folic thp, mi ngy cn 65 g duy tr mc acid folic trong mu ca chng. Acid folic c ph bin trong cc thc n t ng thc vt, cc loi thc n c cha hm lng ln acid folic l: gan, trng, c, u, c ci ng, sup l, rau cn, rau dip, cam ng, chui tiu v cc loi qu cng, cc loi u khc.. 3.1.7 Acid pantothenic Acid pantothenic (Hnh 6.15) c nhiu trong cc loi thc phm thc vt v ng vt nh: men, u phng, ng cc, tht, c, ph tng.. Trong thc phm acid pantothenic phn ln di dng lin kt, ch yu di dng coenzyme A (l nucleotid cha adenosin monophosphate, acid pantothenic, systeamin v phosphate). Cc triu chng bnh xy ra khi thiu acid pantothenic l li en, beriberi, pellagre... Nhu cu acid pantothenic c th c tho mn bi ch n bnh thng. Nhu cu 10-15 mg/ngy (i vi ngi trng thnh) hay 4-5 mg/1000 kcal. Cc qu trnh ch bin thng thng lm mt 25% acid pantothenic.

Hnh 6.15 Acid pantothenic

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3.2 Acid ascorbic (Vitamin C)

L loi c lng cung cp ln nht trong cc loi vitamin. Bnh thiu vitamin C c bit t nm 1550 trc Cng nguyn, nhng mi n nm 1928 mi tch ra c cht mang tnh acid ca bnh scorbut, nm 1933 tng hp c acid ascorbic. Acid ascorbic tn ti trong thin nhin di hai dng l dng L v dng D. Dng D khng c hot tnh sinh hc. Dng L khi oxy ho s to thnh dehydro-ascorbic acid (acid ascorbic 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).

Ascorbic acid

Dehydro-ascorbic acid Hnh 6.16 Vitamin C

Vai tr ca vitamin C trong c th l duy tr m lin kt. Trong s thiu vitamin C, cu trc ca m lin kt b yu i, thnh mch mu cng nh mng bao bc ca cc m lin kt tr nn yu i, v s chy mu xy ra. Acid ascorbic c dng trong vi h thng trao i cht, gm s hydro ho prolin thnh hydroxyprolin, l giai on quan trng trong s tng hp collagen, hp phn ca m lin kt. V th nu acid ascorbic khng s nh hng n s tng hp collagen lm cho vt thng lu lnh, thnh mao mch yu m dn n xut huyt cc mc khc nhau. Acid ascorbic c nh hng n s to thnh hemoglobin, s hp thu st t rut v s s dng st trong m gan. Acid ascorbic hin din trong nhiu b phn ca c th. Do tnh cht tan trong nc nn acid ascorbic nhanh chng c hp thu t d dyrut v vo mu trong vi gi sau khi tiu ho v c mang n cc m. Acid ascorbic ch yu thi ra ngoi qua h tit niu, trong m hi v phn cng thi ra mt t. Cht d ho ca acid ascorbic l oxalate (Hnh 6.17) v mt t lng cht chuyn ho cng c thi ra t nc tiu. V vy thng xuyn a mt lng ln acid ascorbic th s lm cho oxalate trong h tit niu thi ra tng ln, cng l mt trong nhng nguyn nhn gy si trong ng tit niu. Nhiu nghin cu cho thy acid ascorbic c ly t huyt thanh v chuyn n tuyn thng thn, gan v thn. Cc m c hot tnh trao i 77

Hnh 6.17 Qu trnh d ho ca acid cao thng cha acid ascorbic nhiu nht. ascorbic acid Acid ascorbic km hm chuyn ho cholesterol v ngn nga pht trin x va ng mch. Chuyn ho vitamin C lin quan n chuyn ho nhiu vitamin khc. Acid ascorbic cn tham gia vo nhiu qu trnh chuyn ho quan trng trong c th. Vitamin C gi vai tr quan trng trong vic duy tr sc khng ca c th i vi cc bnh nhim trng. Khi thiu vitamin C nhiu phn ng min dch sinh hc ca c th gim xung. Mt s bnh nhim lnh thng thng v cc bnh nhim trng nh cm thng pht sinh vo ma t cc thc phm giu vitamin C, vitamin A v riboflavin. Cc t chc Y t v Dinh dng th gii cho rng hm lng acid ascorbic cn dng mi ngy cho n ng l 60 mg v 55 mg. Thc t hu ht vitamin C c t cc loi rau qu. Thc phm giu vitamin C l loi qu citrus, gan, c chua v hu ht cc loi rau khc. Cc loi qu khc c hm lng vitamin C thp hn rau. Vitamin C khng b ph hy bi nhit nhng s oxy ho thng xy ra khi nhit tng. Vic nu chn cc loi rau (hp, luc hoc dng p sut) c kh nng lm mt khong 50% acid ascorbic. Cc loi qu citrus v nc qu, nc c chua l ngun acid ascorbic quan trng. Tm tt vai tr quan trng ca cc vitamin i vi qu trnh dinh dng ngi c cho Bng 6.2 Bng 6.2 Cc vitamin v vai tr quan trng i vi dinh dng ngi Vitamin Danh Php ho hc Vai tr sinh l vi ngi Nhu cu ca c th ngi (mg/ngy)

VITAMIN TAN TRONG NC B1 Thiamine B2 Riboflavin B3 Acid pantothenic B5 (PP) Acid nicotinic B6 Pyridoxin, pyridoxal v pyridoxamin B12 Cyancobalamin B15 Gluconodimetilamino acetat C Acid ascorbic H Biotin P Rutin VITAMIN TAN TRONG CHT BO A Retinol D Calcipherol E Tocopherol

Chng bnh vim thn kinh Vitamin ca s sinh trng Yu t chng vim, l da Chng bnh da sn si Chng bnh vim, l da Chng bnh thiu mu Chng s i oxy Chng bnh hoi huyt Chng s tit m di da Lm bn mao qun Chng bnh kh gic mc Chng bnh ci xng Tng cng sinh sn 78

12 - 18 20 - 40 12 12 - 18 15 - 20 0,001 20 50 - 100 0,01 10 - 25 0,025 5

K Q F

Filoquinol Ubiquinol Phc hp ca cc acid bo cha no khng th thay th

Chng bng huyt Vn chuyn H+, e- trong h hp

0,015 0,015 1000

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CHNG VII.
I i cng

CC CHT KHONG

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 Kali Natri 1050 g 700 g 245 g 105 g Sulfur Clor Magne St 175 g 105 g 3,5 g 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.

II Ngun cht khong trong thc phm

Cc nguyn t khong rt phong ph trong cc loi thc n, tuy nhin s phn phi trong cc thc phm thng khng ging nhau. Cc thc phm trong c cc cation nh K+, Na+, Ca2+, Mg2+ .. chim u th c coi l thc phm ngun yu t kim. Phn ln cc thc n thc vt nh rau l, rau c, qu ti, v c sa.. u thuc loi ny. Ngc li cc loi thc phm c cc anion nh S2-, P5- .. chim u th dn n qu trnh to acid ca c th sau qu trnh chuyn ho c gi l thc phm ngun cc yu t acid.. Thuc loi ny c tht, c, trng, u , ng cc..

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III Vai tr ca cht khong i vi c th

Gi vai tr quan trng trong cc qu trnh to hnh, c bit l t chc xng.. Duy tr cn bng acid - kim trong c th, duy tr tnh n nh thnh phn cc dch th v iu ho p lc thm thu. Tham gia vo qu trnh to protid Tham gia vo chc phn tuyn ni tit (nh iod tuyn gip trng) v nhiu qu trnh ln men Tham gia trung ho cc acid ngn nga chng nhim acid. iu ho chuyn ho nc trong c th

IV Cc yu t i lng
4.1 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 Calci trong thc n ch c hp thu 20 - 30% trong ng rut, ch yu do cc ion calci cng vi acid oxalic, acid thc vt, acid bo phn ly c trong thc n to thnh mui calci khng ho tan dn n. Cn ngng t aldehyde trong x thc n cng s kt hp vi calci v lm gim hp thu calci trong thc n. Cc acid bo phn ly do lipid phn gii trong ng rut, nu cha kp thi hp thu, s gp calci rt d tr thnh x phng vi calci v thi ra theo phn, cng lm gim hp thu calci. Trong c th cc yu t nh hng n hp thu calci gm: Vitamin D:Vitamin D s cng vi lipid trong rut non hnh thnh nn cc vi th, qua hp thu i vo huyt tng, sau li kt hp c vi -globulin, c hydroxyl ho trong gan, thn v thc y vic hp thu v tn dng calci, phosphor. Vtamin D cn thit cho s hp thu calci t ng rut. T l Ca/P trong khu phn nh hng n s hp thu calci. 80

T l 1:1 c coi l l tng cho s pht trin ca b m mang thai v giai on cho con b. Mt khc t l 1:1,5 ca Ca:P c s dng cho tui thanh thiu nin. Lactose: Lactose s cng vi calci hnh thnh nn phc cht ho tan vi lng phn t thp, do nng cao c t l s dng calci. Protein: Cc acid amin do protein phn gii cng vi calci hnh thnh cc loi mui ho tan, thc y hp thu calci. Tnh trng c th: Ngi ln c th hp thu 20% calci thc n, t l hp thu tr em ang trong giai on sinh trng pht trin, ph n mang thai v b m cho con b s ln ti khong 50%. i b phn calci c hp thu vo c th (khong 400 mg) s qua cc t bo biu m nim mc rut v s bi tit ca dch tiu ho m i vo rut, trong ch c mt s b phn c ti hp thu, phn cn li (mi ngy khong 100 - 350 mg) s c thi ra qua nc tiu. Nu protein trong ba n qu nhiu th lng calci thi ra qua nc tiu cng tng ln. Lng cung cp v ngun thc n Ngi ln: 800 mg/ngy Ph n mang thai: 1000 - 1500 mg/ngy B m cho b: 1500 mg/ngy Tr em: + Di 2 tui: 600 mg + 3 - 9 tui: 800 mg + 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.

4.2 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 81

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.

4.3 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 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.

4.4Kali (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 Tn thc n Trng ton phn Sa m Sa b Tht b nc Tht ba ri Gan C ti C kh (TB) Nc mm (TB) Go t Bp ht Bt m u cc loi Khoai ty K mg% 153,6 83,9 157,8 241,8 326,3 205,1 215,9 560,5 310,6 186,0 816,3 553,9 Na mg % Tn thc n 146,9 Khoai lang 18,5 ng ct 45,3 Mui n 77,9 Bp ci 35,6 C chua 78,6 Carotte 39,3 Da chut 6000 - 12000 Rau dn 10000 Su ho 158,0 Cam 10,4 Chanh 2,5 Chui 17,1 Da 17,1 M 82 K mg% 480,8 264,9 565,0 560,5 318,8 207,6 173,6 742,4 337,9 460,9 456,7 361,2 160,9 215,1 Na mg% 55,6 79,4 34000 48,2 125,4 115,7 12,6 70,5 55,6 4,4 3,0 54,2 26,7 14,1

4.5Natri (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. Ngun t nhin ca natri khng nhiu, ch yu da vo mui n. Cc loi khoai, qu c t natri. Mt s loi rau (cart, c chua), go, tht c nhiu natri hn. Lng trng trng cha lng natri ln.

4.6 Clorur (Cl)

Trong c th clorur to thnh mui vi hu ht cation. Ngun clorur chnh trong c th l clorur natri. Chuyn ho clorur c cc c im ng ch nh sau: Clorur c kh nng tch ly nhiu da, to thnh nhng ch cha clorur. C th c kh nng gi clor li 12 - 14 gi sau khi n vo mt lng clor tha. Clor c th ra nhiu theo m hi. Cc hp cht ca clor d ho tan v d hp thu rut Clor ch yu c bi xut theo nc tiu.

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.

V Cc yu t vi lng
5.1 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 83

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) Nhm tui + Tr em 0.25 - 1 1 - 2 2 - 6 6 - 12 + Nam thiu nin 12 - 16 + N thiu nin 12 - 16 + Trng thnh (nam) + Trng thnh (n ) Tui hnh kinh Mn kinh Cho b Cn nng (kg) 8 11 16 29 53 51 65 55 55 55 Nhu cu 0,96 0,61 0,70 1,17 1,82 2,02 1,14 2,38 0,96 1,31

Bng 7.4 Hm lng st trong mt s thc phm Tn thc phm Go t Ng vng kh M si Khoai lang Khoai ty C sn u tng u phng ht M C chua C rt Rau mung Su ho Bp ci Hm lng st theo mg% 1,3 2,3 1,5 1,0 1,2 1,2 11,0 2,2 10,0 1,4 0,8 1,4 0,6 1,1 Tn thc phm Bi Cam Chanh Chui tiu Tht b loi I Gan b Tht ba ch Gan heo Tht g C chp Trng g Trng vt Sa m Sa b Hm lng st theo mg% 0,5 0,4 0,6 0,6 2,7 9,0 1,5 12,0 1,5 0,9 2,7 3,2 0,1 0,1

5.2 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 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 84

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.

5.3 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.

5.4 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 Tn thc n Trng ton phn Sa b Tht b nc Tht ba ri C ti C kh (trung bnh) Nc mm (trung bnh) Go t Iode (g %) 6,0 5,0 5,3 7,6 7 - 240 1360 950 1-8 Tn thc n u cc loi Mui n Bp ci Ci soong Rau gin Cam Chanh Iode (g %) 6,4 555 2 45 50 2 1,5 - 14

5.5 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. 85

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%.

5.6 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..

5.7 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. Carbohydrase H2CO3 CO2 + H2O Km cn tham gia vo chc phn to mu, iu ho chuyn ho lipid v ngn nga m ho gan. Thiu km nh hng xu n tc hp th cc acid amin. Km cn cn 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.

86

CHNG VIII. KHI LUN V DINH DNG CN I

Theo quan nim hin nay, mt khu phn hp l l: - Cung cp y nng lng theo nhu cu ca c th - C cc cht dinh dng cn thit - Cc cht dinh dng t l cn i thch hp c nhiu nghin cu v xc nh nhu cu cc cht dinh dng mt cch ring r nhng cng ngy cng c nhiu cng trnh nhn mnh v mi tng quan gia chng vi nhau v ra cc yu cu v tnh cn i ca khu phn. hiu l lun v dinh dng cn i, trc ht cn tm hiu mi quan h tng h mt cch cht ch gia cc thnh phn dinh dng trong c th.

I Mi quan h tng h gia cc dinh dng trong c th

Trong c th chuyn ho cc thnh phn dinh dng lin quan cht ch vi nhau v ch tin hnh bnh thng khi khu phn m bo cn i. S thiu mt thnh phn dinh dng ny c th hn ch s hot ng ca thnh phn dinh dng kia v ngc li s tha mt thnh phn dinh dng no c khi gy cn tr s dng ca mt hay nhiu thnh phn dinh dng khc.

1.1 Thiu dinh dng v ngon ming

Tt c cc loi thiu dinh dng c hiu (acid amin, vitamin, cht khong..) ni chung thng dn n hin tng km n, ngha l n khng ngon ming. S thiu cn i v cht ca khu phn dn n s gii hn v lng thc n lm cho nhu cu nng lng khng c tha mn. Glucid, lipid, protein l ngun nng lng nhng qu trnh thoi ho ca chng xy ra bnh thng i hi nhiu h thng men m trong thnh phn cc men ny c protein, cc vitamin nhm B v cht khong.

1.2 Nng lng v protein

Nhu cu nng lng v nhu cu protein c mi lin h cht ch vi nhau. Nng lng n vo lin quan cht ch vi cht v lng ca protein trong khu phn hay ni cch khc khi nhu cu protein khng m bo th nng lng cng thiu ht. Ngc li nng lng c th tit kim protein. Khi lng protein ca khu phn khng thay i, cn bng nit dng hay m ty theo nng lng n vo. 87

1.3 Tnh cn i ca cc acid amin

Nhu cu protein ph thuc vo cht lng ca n, ngha l tu theo s cn i ca cc acid amin trong khu phn ch khng phi s lng tuyt i ca chng. Nhu cu mi acid amin cn thit khng th tnh theo s lng tuyt i m trong s lng tng i lin quan vi cc acid amin khc. Tha mt acid amin ny h thp s dng cc acid amin khc v to nn s thiu ht th pht ngay c khi s lng ca chng y . "Protein" chun l protein c tng quan acid amin cn i nht v do c hiu qu sinh hc cao nht.

1.4 Phosphor, calci v vitamin D

S tho mn nhu cu phosphor, calci ph thuc nhiu vo t s Ca/P hn l s lng tuyt i ca calci v phosphor n vo. Hm lng phosphor v calci trong khu phn n l yu t nh gi hiu qu ca vitamin D. Nhu cu ca vitamin D ty theo t l Ca/P trong khu phn v n trc tip tham gia vo iu ho chuyn ho phosphor, calci trong c th.

1.5 Lipid v vitamin

Nhiu th nghim cho thy khi tng lng lipid trong khu phn thc hin ch n c nng lng cao th i hi phi xt li nhu cu nhiu vitamin. Trong c th vitamin E c tc dng bo v cc lipid ca ty th v vi th khi b oxy ho. S oxy ho lipid trong cc t chc to thnh cc peroxyde, cc aldehyde.. nhng cht ny gy c i vi c th v lm mt hot tnh ca mt s men v vitamin.

1.6 Glucid v vitamin

Qu trnh s dng glucid trong c th gii phng nng lng cn c s tham gia ca nhiu men m trong thnh phn ca chng c cha vitamin: men dehydrogenase v coenzyme l nicotiamid adenin dinucleotid (NAD) trong c amid ca acid nicotinic (PP), men decarboxylase m coenzyme l thiamin pyrophosphate (B 1 ). Nhu cu ca vitamin lin quan ti lng glucid trong khu phn n. Ngi ta thng tnh t l vitamin B 1 ()/calori khng do lipid. phng bnh Beri-beri t l cn l 0.45

1.7 Protein v vitamin

Thiu vitamin gy cn tr tch ch riboflavin (B 2 ) v lm gim d tr vitamin B 2 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 88

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...

1.8 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.

1.9 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 B 12 .

II Quan nim v tnh cn i ca khu phn

2.1 Tnh hnh thc t
Cc ti liu ca t chc Thc phm & Nng nghip, t chc Y t th gii (FAO/OMS) v c cu khu phn (tnh theo % nng lng) cc nc trn th gii xp theo mc thu nhp quc dn tnh theo u ngi c trnh by nh sau: - V protein: t l nng lng do protein ca khu phn khng khc nhau nhiu (chung quanh 12%) nhng nng lng do protein ngun gc ng vt tng dn khi thu nhp cng cao. - V lipid: mc thu nhp cng cao th t l nng lng do lipid (nht l lipid ngun gc ng vt) cng cao. - V glucid: mc thu nhp cng cao th nng lng do glucid ni chung v tinh bt ni ring gim dn, nhng nng lng do cc loi ng ngt (saccharose) tng ln (Hnh 8.1)

89

Du m
Thu nhp quc dn theo u ngi Lipid trong thc n thc vt Lipid trong thc n ng vt

ng

Tinh bt

Hnh 8.1 Khuynh hng s dng thc phm theo thu nhp

2.2 Nhng yu cu v dinh dng cn i

2.2.1 Cn i v nng lng Yu cu u tin v quan trng nht ca dinh dng cn i l xc nh c mi tng quan hp l gia cc thnh phn dinh dng c hot tnh sinh hc ch yu: protein, 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. 2.2.2 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. 2.2.3 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). 2.2.4 Cn i v glucid Khuynh hng cc nc pht trin l trong iu kin gim lao ng th lc th 90

Protein ng vt Protein thc vt

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. 2.2.5 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 B 1 0.55 mg vitamin B 2 0.6 ng lng niacine (1 ng lng niacine = 1 mg vitamin PP hay 60 mg tryptophane). 2.2.6 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 2.2.7 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.

2.3 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 B 2 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 91

thc phm. Ngoi ra tnh thm mt s t s cn thit nh t s Ca/P (Bng 8.2), Ca/Mg..

Bng 8.1 Cng thc gi tr dinh dng ca mt s thc phm Ch s Mc tho mn cng thc dinh dng cn i ca mt s thc phm Tht b Protein Ngun ng vt Lipid Ngun thc vt Cht khong: Ca P K Fe Vitamin: C B1 B2 PP 33 60 21 0 2 30 10 35 0 11 14 41 7 15 28 19 0 64 37 17 3 6 14 41 2 14 28 42 26 0 11 35 7 33 0 19 72 2 81 9 0 2 9 5 21 7 21 0 20 7 22 0 7 0 0 0 4 14 53 28 41 18 8 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Sa Trng Bnh m Khoai ty ng Ru

92

A Nng lng 10 10 10 10 10 10 10

Bng 8.2 c im cn i trong mt s thc phm Tn thc n Phn trm nng lng do Protein Go t Bp ht M si Khoai lang Khoai ty Khoai m ti u ph u phng ht Tht heo m Tht g C chp Trng g Sa m Sa b Rau mung Ci bp 9 10 12 3 8,5 3,0 46 19 14,0 40,5 60 35 11,5 20 57 24 Lipid 3 12 3 1,5 0 1,0 52 70 85,4 59,5 34 63 43 53 0 0 Glucid 87 78 85 95,5 91,5 96,0 2 11 0 2 45,5 26,4 43 70 T s B 1 /1000 Kcal 0,29 0,77 0,28 0,40 1,1 0,2 0,3 0,7 0,7 1,8 0,9 0,16 0,65 4,4 2,0 T s Ca/P 0,30 0,16 0,36 0,70 0,20 0,80 0,26 0,16 0,05 0,00 0,09 0,26 2,2 1,2 2,9 1,5

III Tiu chun dinh dng

C ba ngun ti liu thng c s dng khi xy dng tiu chun: - iu tra khu phn: kt qu thc t ca cc iu tra ny gip ch rt nhiu, nht l xy dng nhu cu nng lng v protein. - Cc kt qu nghin cu trn nhng ngi tnh nguyn cho n nhng ch n khc nhau. - Cc kt qu nghin cu trn sc vt th nghim Trn phm vi quc t, cc tiu ban chuyn vin ca cc t chc dinh dng v Y 93

t quc t (FAO/OMS) a ra cc tiu chun v mt s thnh phn dinh dng cn thit. Cc tiu chun dinh dng ca OMS nh sau:

3.1 Nng lng

Da vo kt qu rt nhiu nghin cu ngi ta xc nh nng lng tiu hao cho mi loi hot ng, trong cng ca lao ng th lc l yu t quan trng nht nh hng ti nhu cu nng lng trong ngy. Nng lng thm vo ngoi chuyn ho c bn ty theo cng lao ng c sp xp nh sau: Lao ng tnh ti Vic nh Lao ng va Lao ng nng Lao ng rt nng Lao ng cc k nng 0,5 Kcal/pht 1,1 Kcal/pht 1,7 Kcal/pht 3,3 Kcal/pht 5,0 Kcal/pht 7,5 Kcal/pht

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]

3.2 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.

3.3 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.

3.4 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..

94

3.5 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.. 3.5.1 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). 3.5.2 Vitamin B1 Lng vitamin B 1 nn t l vi lng calori ca khu phn v nn l 0,4 mg thiamin cho 1000 Kcal. 3.5.3 Vitamin B2 Tiu chun ca vitamin B 2 l 0,55 mg cho 1000 Kcal. 3.5.4 Vitamin C Nhu cu thay i t 30 n 70 - 75 mg. Tiu chun ca FAO l 50 mg. 3.5.5 Vitamin D Nhu cu l 400 UI cho tr em v 40 - 100 UI cho ngi trng thnh.

IV p dng thc hnh cc tiu chun dinh dng

Nhu cu cc cht dinh dng c tho mn bi thc phm. Ty theo iu kin sn xut v tp qun dinh dng, cch n ca nhiu ni trn th gii khc nhau. Cc cht dinh dng c trong thc phm vi s lng rt khc nhau. Tr sa m i vi tr s sinh, khng c loi thc phm no mt mnh c th p ng nhu cu c th v mi cht dinh dng cn thit. Trong qu trnh lm sch v tinh ch, hm lng ca mt s cht dinh dng gim i nhiu nh i vi cc loi bt c t l xay xt cao. V th dinh dng hp l v cn i cn phi bit s dng phi hp cc loi thc phm chng b sung ln nhau. Sp xp cc thc phm theo nhm da vo s ging nhau v thnh phn ho hc v vai tr dinh dng.

4.1 Phn chia thc phm theo nhm

4.1.1 Chia thc phm ra hai nhm - Nhm bo v: cc thc phm cha nhiu m c gi tr sinh hc cao, calci v vitamin, nht l vitamin A, C, B 1 , B 2 .... Thuc nhm ny c tht, c, trng, sa, ng cc, mt s loi rau qu. 95

- Nhm cung cp nng lng: gm tt c cc loi thc phm khc nh bt trng, cht bo, ng v ngt, khoai v cc loi rau ngho vitamin. 4.1.2 Chia thc phm ra 4 nhm Bn nhm thc phm c xem l c bn trong s cn thit tp trung cc cht dinh dng bao gm: Sa v cc sn phm sa Tht v cc sn phm tht Rau qu Ht (bnh m v ng cc) C 4 nhm thc phm ny to nn s ng gp cht dinh dng c bit cho khu phn n. im ni bt ca cc nhm thc phm hng ngy bao gm nh sau: - Nhm c th p dng cho tr em - 4 nhm u tin cha thc phm cn thit, nhng dng khc cha thc phm ph. - Mi dng bao gm cc loi thc phm cha cht dinh dng quan trng v cn thit. - Khng c nhm thc phm no c y cc cht dinh dng, t nht mt cht dinh dng b thiu trong mi nhm thc phm. Vic b sung cho 4 nhm thc phm c bn c pht trin bi Trung tm Khoa hc v Sc kho, Washington D.C, b sung khu phn n trong vic nh hng gim m, cholesterol, mui v thm cht ng bt, cc vitamin t nhin v cht khong, cho php c y cc loi thc phm s dng. 4.1.3 Chia thc phm ra su nhm Cch chia A Nhm I: Tht C Trng u kh Nhm II: Nhm III: Nhm IV: Nhm V: Nhm VI: Sa Fromage B Cc cht bo khc Bnh m Ng cc Qu Rau ti Nhm V: Nhm VI: 96 Rau qu ng v ngt Nhm IV: Nhm III: Cc cht bo (b, cc cht bo ng v thc vt) Ng cc (k c ch phm) Nhm II: Sa v fromage Cch chia B Nhm I: Tht, c, trng v ch phm

Khoai ty Nhm ph: Cc thc n ngt: ng Chocolate Ko ngt im khc nhau gia cch chia A v B: - cch chia A ng v cc sn phm c ngt c xp thnh nhm ph ngoi 6 nhm. - Trong cch chia A, nhm I c thm u kh - Trong cch chia B, rau qu chung mt nhm, cch chia A c c nhm qu v rau. Gi tr dinh dng ca nhng nhm trn: Nhm I: l ngun protein c gi tr cao gm P, St v mt lng vitamin B ng k. Ngc li thc phm ny ngho glucid, calci, vitamin A v C. Cc thc phm ny gy tnh acid ( protein, vitamin B, Fe). Nhm II: sa l mt trong cc nhm thc n ton din nht v thnh phn ho hc v gi tr dinh dng. Fromage giu protein qu. Chng l ngun calci d ng ho nht. Sa cn c riboflavin v vitamin A. Sa cha t st v vitamin C protein, calci, vitamin A, vitamin B 2 . Nhm III: cc cht bo l loi thc phm tng i phin din v phng din thnh phn v gi tr dinh dng. Chng khng c protein, glucid v cht khong, ngc li cha lipid l ngun nng lng cao. Nhm IV: nhm ng cc. y l ngun nng lng cao do c ch nhiu tinh bt. Hm lng lipid, calci trong cc thc phm nhm ny thp v hu nh khng c cc vitamin A, C, D (glucid, vitamin B) Nhm V: qu l ngun cht khong qu, nht l cc yu t vi lng, cc vitamin ch yu l vitamin C, provitamin A v mt s vitamin nhm B. y l cc thc n gy kim. ng ch l lng vitamin C trong qu khng b mt mt do qu trnh nu nng. Nhm VI: rau, khoai ty l nhm ngho nng lng. Khi la chn thch hp chng cung cp vitamin A (dng carotene), vitamin C, nhiu cellulose v cc yu t gy kim. Trong cc loi rau nn ch ngun vitamin C quan trng (c chua, cn ty, rau ngt, su ho, rau dn, rau mung), mt s khc l ngun caroten qu (c rt, hnh l, h, rau mung, rau dip, x lch). Hin nay, mt s m hnh phn chia thc phm c thc hin trn quy m ton th gii nhm ch n loi thc phm quan trng v lng s dng hp l cc ngun thc phm trong khu phn n hng ngy. c bit cc m hnh ang p dng ph bin Chu (Hnh 8.4) v trong nc (Hnh 8.5) da trn cc m 97

hnh kim t thp s dng thc phm trn th gii (Hnh 8.2) v cc m hnh pht trin t m hnh Hnh 8.2 (Hnh 8.3).

98

Du, m v ngt S d t

Nhm sa, yaourt v ph mai

Nhm tht, gia cm, u, trng v

Nhm rau

Nhm qu

Nhm bnh m, ng cc, go, v cc sn phm ch bin t bt m a) (www.fldoe.org/nutrition/ images/pyramid.gif)

99

KIM T THP HNG DN S DNG THC PHM (M HNH MI)

Hn ch s dng tht v b Cc loi vitamin Sa t bo v sa u nnh Nc Trng, c, gia cm v protein thc vt Rau u Ht nguyn Ht Du thc vt Qu

Rau

b) M hnh mi (www.makinghealthychoices.info/Nutr/images/new_foo...)

Hnh 8.2 Cc m hnh kim t thp hng dn s dng thc phm (a v b)

100

n t

n nhiu

Hnh 8.3 M hnh kim t thp hng dn s dng thc phm tt cho sc kho (www.nutrition.com.sg/ he/img/pyr)

4.2 Nguyn tc xy dng thc n hp l

- Xy dng thc n trong thi gian di t nht 7-10 ngy hay hn - S ba n v gi tr nng lng: da vo yu cu ca tui, loi lao ng, tnh trng sinh l v cc iu kin sng phn chia v p dng cho ba n hp l. - Khong cch gia cc ba n ( ch n ba ba) khng nn ngn qu 4 gi v di qu 6 gi (tr khong cch t ba n ti n ba n sng). Nng lng ca cc ba n nn chia nh sau (Bng 8.3)

101

Trng , tht v ngt Du thc vt Sn phm C v Gia cm thy sn

Qu

u, cc loi ht, khoai c

Rau

Hnh 8.4 M hnh hng dn s dng thc phm cho cc nc Chu (www.kroger.com/Food Guide Pyramid Asian.jpg)

102

Hnh 8.5 M hnh hng dn s dng thc phm Vit nam (nature.berkeley.edu) Bng 8.3 Phn chia nng lng ba n Ba n n ba ba Ba sng Ba sng II Ba tra Ba chiu Ba ti 30 - 35% 35 - 40% 25 - 30% 103

% tng s nng lng n bn ba 25 - 30% 5 - 10% 35 - 40% 25 30% n nm ba 25 - 30% 5 - 10% 30 - 35% 5 - 10% 15 - 20%

- Th tch, mc d tiu, gi tr nng lng ca tng ba n

- Tnh a dng v gi tr dinh dng ca mi ba n - Cc mn n cng cn phong ph v mu sc, mi v, nu nng ngon v nhit thch hp.

4.3 nh hng ca ch bin nng n thnh phn dinh dng

4.3.1 Lipid nhit qu 100oC khng nhiu, lipid khng c nhng bin i ng k ngoi ha lng. nhit cao hn c th to thnh glycerol v cc acid bo. Sau khi mt nc, glycerol tro thnh acrolein. Acrolein c mi c hiu v gy kch thch nim mc mi, hng v kt mc. un nng nhiu cng lm gim v phn hy vitamin A c trong cc lipid cha vitamin A nh b. 4.3.2 Glucid nhit 100 oC khng nhiu, glucid khng c nhng bin i ng k. ng un kh n 180 o C chuyn sang mu nu c mi c hiu gi l caramel. l hn hp ca nhiu cht khc na do ng phn gii. Qu trnh ch bin nng lm cho tinh bt d tiu hn, cellulose khng b phn hu nhng nt v tr nn mm hn, cho php dch tiu ho tip xc vi cc cht dinh dng trong t bo thc vt. 4.3.3 Protein Khi un nng mt s loi protein c th vo trong nc nh albumin, protein cc t chc lin kt (gelatin). Phn ln protein un nng quanh nhit 70 o C s ng vn li, ri b thoi ho. Khi c acid qu trnh ny xy ra nhit thp hn. Qu trnh ng vn va phi lm cho protein d tiu. Khi un nng nhiu, gi tr dinh dng ca protein gim i v to thnh cc lin kt kh tiu. Qu trnh ny thng xy ra khi un kh, hp bnh. un nng qu mnh gy phn hu mt s cc acid amin nh lysine, methionine 4.3.4 Cc loi khong Trong qu trnh nu nng khng c bin i v cht lng. Cc bin i v s lng l do chng ho tan mt phnvo trong nc. V vy nn s dng c nc luc. 4.3.5Vitamin Cc vitamin chu nhiu thay i quan trng nht v l nhng cht tng i bn vng. Cc vitamin tan trong cht bo nh A, D, E, K tng i bn vng vpi nhit nn mt va phi trong qu trnh nu nng bnh thng (10 20 %). Cc vitamin tan trong nc mt nhiu hn. C hai nguyn nhn c bn, mt l khi ngm ra, cc vitamin nyb ho tan, hai l cc vitamin ny d b phn gii, nht l trong mi trng kim. Trong mt s cc vitamin nhm B, thiamin t bn vng nht. Riboflavin v niacine hu nh khng b phn hu. Khi luc tht v c, mt lng tng i 104

vitamin nhm B ra theo nc luc. Tr vitamin B 1 , cc qu trnh ch bin nng khng lm mtqu 20% cc vitamin nhm B khc. Vitamin C t bn vng vi cc qu trnh k thut do cht ny khng nhng d ho tan trong nc m cn b oxy ho nhanh nhit cao. Trong qu trnh ny c s tham gia ca men oxydase ca vitamin C, men ny hot ng nht nhit 40 45 o C, trong mi trng acid s phn hu xy ra chm hn. Lng cc vitamin mt do nu nng: Vitamin C: 50% Vitamin B 1 : 30% Vitamin B 2 : 20% Caroten: 20 30%

105

CHNG IX. THC PHM V NHU CU DINH DNG CHO CC I TNG KHC NHAU
I Dinh dng cho tr em
Dinh dng l mt trong nhng yu t quan trng nht ca mi trng bn ngoi c nh hng n s pht trin ca tr. Dinh dng khng hp l k c thiu hoc tha cng c th c hi n sc kho v s pht trin ca tr. S pht trin ni chung ph thuc vo cc yu t: di truyn, ni tit, thn kinh thc vt v dinh dng, trong ba yu t u m bo th pht trin nht nh. Khi thiu n tm thi, c th c th pht trin chm nhng tnh trng c th hi phc khi lng thc n n vo y . Trong trng hp dinh dng khng hp l ko di c th cn tr s hi phc , do vy cn quan tm c bit n dinh dng.

1.1Dinh dng cho tr em di mt tui

C rt nhiu yu t nh hng n qu trnh ln v pht trin ca mt a tr, song dinh

dng l yu t quan trng nht. Tnh trng dinh dng ca tr ph thuc vo ch n ca ngi m trong sut thi k mang thai, vo vic ngi m c sa v ch n b sung c hp l vi tr hay khng (Hofvander v Margaret, 1983). Sa m l thc n hon chnh nht cho tr trong thng u. Sa m cha y cc cht dinh dng v an ton cho tr s sinh (Motarjemi v cng s, 1983). Lng sa m s gim i vo thng th 6. Theo Hofvander v cng s (1983), tr s c n b sung vo thng th 6, khi sa m khng cn p ng nhu cu ca tr. Lc ny mt ch n b sung hp l cho tr l v cng cn thit. Tuy nhin, cc nc ang pht trin th vn t ra li l thc n b sung cho tr thng khng p ng nhu cu dinh dng ca tr c v mt s lng, cht lng v v sinh an ton thc phm. 1.1.1 Phng php dinh dng i vi tr em c sa m Sa m c nng lng v cc cht d tr cn thit cho s pht trin c th tr em di mt tui (Bng 9.1). Sa non tit ra trong tun u sau khi sanh thng c cha nhiu khng th (IgA), cc t bo bch cu hn sa thng, cho tr b sm s tn dng c ngun sa non, gip tr tng sc khng, chng li bnh tt. Bng 9.1 So snh sa m v sa b, thnh phn c trong 100 ml sa Cc cht Nng lng (calo) Protein (gr) 105 Sa m 62 1,5 Sa b 53 3,1

Casein/t l hp thu ti u Cht bo (g) St (mg) Calci (mg) Vitamin A (g) Vitamin B1 (mg) Vitamin B2 (mg) Vitamin C (mg) Vitamin D (g)

0,67/1 3,2 0,2 34,0 45,0 0,02 0,07 4,0 0,01

4,7/1 3,5 0,1 114,0 38,0 0,04 0,04 1,0 0,06

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. 1.1.2 Phng php cho tr n thm thc n b sung (n sam) Khi c 5 thng, sa m khng tho mn nhu cu cho a tr ang ln, v vy phi cho tr n thc n b sung. Nguyn tc cho tr n b sung - Tp cho tr n t t n nhiu, t long n c, cho tr quen dn vi thc n l, mi ln mt t, mt loi thc n mi. - Ch bin ph hp vi la tui, m bo v sinh - n nhiu ba, phi hp nhiu loi thc n ba n cht v hp l. Ch n b sung cho tr di 1 tui 106

S ba n b sung trong ngy cho tr: + 5 thng: B m + 1 ba bt long + 6 thng: B m + 1 ba bt c + 7 - 8 thng: B m + 2 ba bt c + 9 - 12 thng: B m + 3 - 4 ba bt c + Khi tr trn mt tui c th cho n cho nghin Cc loi thc n b sung Mt ba n ca tr cn phi hp nhiu loi thc n c trong vung sau: Thc n giu carbohydrate: - Go t, go np, ng, khoai.... - ng Thc n giu protein: - Sa, trng, tht, c, tm, cua - u ..
SA ME

Thc n giu vitamin v mui khong: - Cc loi rau, c, qu ..

Thc n giu lipid: - Du, m .. - u phng, m ..

1.2 Dinh dng cho tr em trn mt tui v thanh thiu nin

1.2.1 Nhu cu cc cht dinh dng a. Nhu cu carbohydrate Carbohydrate l ngun nng lng chnh trong khu phn ca tr em. Tha carbohydrate trong khu phn gy h thp s dng cc cht dinh dng khc, nh hng khng c li n sc kho ca tr. Mt s tc gi cho rng nhu cu tr em hng ngy v carbohydrate nn khong 10 15 g/kg cn nng. tr em 13-15 tui hot ng chn tay nhiu nn c khong 16 g/kg cn nng. Nng lng do carbohydrate a vo khu phn nn t nht vo khong 50% tng s nng lng ca khu phn. b. Nhu cu protein Protein thc n l thnh phn to hnh chnh. Nhu cu protein thay i theo tui, tr cng b nhu cu protein tnh theo cn nng cng cao. Theo FAO, nhu cu protein cho tr em t 1 - 3 tui l 4 g/kg cn nng. cc la tui khc cng c s khc nhau tng t, nguyn nhn l do: Thiu protein nh hng ti sc ln, pht trin, sc khng ca c th, gy tnh trng suy dinh dng do thiu protein. Ngc li mt lng tha protein li c nh hng khng c li i vi cu trc v chc phn t bo v xc tin qu trnh lo ho. 107

V cht lng protein ni chung cc tc gi u cho rng nu phi hp thch ng gia protein ng vt v thc vt th nhu cu cc acid amin cn thit s c tho mn y . c. Nhu cu lipid Nhu cu lipid c tnh theo tui, tui cng b nhu cu lipid tnh theo trng lng c th cng cao. Theo tiu chun ca Vin Dinh Dng Lin X, hm lng lipid v protein nn ngang nhau trong khu phn tr em v thanh thiu nin. d. Nhu cu vitamin Vitamin l thnh phn chnh trong khu phn ca tr. Do nhu cu pht trin v chuyn ho vt cht cao nn nhu cu vitamin tr em tnh theo trng lng cao hn i vi ngi ln. ch n ca tr, cn cung cp y vitamin A v C. Nu cc ngun thc n khng y cc thnh phn ny, c th cho cc vitamin di dng ch phm tng hp hoc thng qua vitamin ho thc phm. Cn cung cp thm vitamin D cho tr v khu phn n bnh thng khng tho mn nhu cu tr em v vitamin ny. e. Nhu cu cht khong Cc cht khong gi vai tr quan trng i vi c th ang pht trin. Tuy nhin yu cu chung v chng vn cn cha y . Calci tham gia vo qu trnh ct ho, khi thiu calci tr em ngng ln, rng pht trin khng bnh thng. Theo FAO, nhu cu calci tr em th hin Bng 9.2 Bng 9.2 Nhu cu calci ca tr em Nhu cu calci (mg/ngy) Tr 0 - 1 tui 1 - 9 tui 10 - 12 tui Nam N 1 3 - 15 tui 16 - 20 tui 13 - 15 tui 16 - 20 tui 500 - 600 400 - 500 600 - 700 600 - 700 500 - 600 600 - 700 500 - 600

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.

108

1.2.2 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: Ba sng Ba tra Ba chiu Ba ti 25% tng s nng lng 40% 15% 25% -

Vi nhu cu nng lng tr em n mt tui l 800 - 900 kcal. cc tr em do c quan tiu ho cha tht hon chnh, do thc n cn d tiu, giu protein c gi tr cao, calci v vitamin. Nhu cu nng lng cn thit cho tr em c cho Bng 9.3 v thc phm s dng c phn chia theo m hnh kim t thp (Hnh 9.1) Bng 9.3 Nhu cu nng lng ca tr em Tui (nm) 1 2 3 4 5 6 7 8 9 10 11 12 Nam 13 14 15 2950 3100 3250 Nhu cu 1150 1300 1450 1550 1700 1850 1950 2100 2250 2350 2500 2650 N 2650 2600 2550 Gp 13 -15 tui 3100 2600 Nam N Gp 10-12 tui 2500 Gp 7 9 tui 2100 Gp 4 6 tui 1700 Gp 1 3 tui 1300 Nhm tui Kcal/ ngy

109

Du, m, ngt

Sa

Tht

Rau

Qu

Bnh m, ng cc, go v cc loi ht khc

Ngun
Hnh 9.1 M hnh p dng cho tr em (www.intelihealth.com)

II Dinh dng cho cc i tng lao ng

2.1 Dinh dng cho cng nhn
Lng protein trong khu phn ngi lao ng lun lun cao hn ngi nhn ri. Nhiu nghin cu v sinh l cho thy khu phn ngho protein, lc ca c nht l kh nng lao ng nng gim st r rt. 2.1.1 Nhu cu nng lng Tiu hao nng lng Tiu hao nng lng ca ngi lao ng ty theo cng lao ng, thi gian lao ng, tnh cht c gii ho v t ng ho qu trnh sn xut. 110

Phn loi lao ng Ty theo cng lao ng, nhu cu nng lng ca cc loi lao ng nh sau: Lao ng nh Lao ng nng va Lao ng nng loi B Lao ng nng loi A Lao ng nng c bit 2.1.2 Nhu cu cc cht dinh dng - Protein: khu phn ngi lao ng cn c t l t 10 - 15% nng lng do protein. Lng protein n vo cng cao khi lao ng cng nng. Lng protein ng vt nn chim 60% tng s protein. - Lipid v carbohydrate: khi lao ng nng, lipid b phn hy nhiu v qu trnh hnh thnh lipid t carbohydrate trong c th b hn ch. Cc biu hin r rt ca tch cha lipid tha thng khng c nhng ngi lao ng chn tay. - Vitamin v cht khong: cc vitamin tan trong cht bo khng thay i theo cng lao ng, tiu chun nh ngi trng thnh. Cc vitamin tan trong nc thay i ty theo cu trc ba n. Lng tha vitamin khng nh hng g n nng sut lao ng ca ngi cng nhn. Cc nhu cu v cht khong ni chung ging nhau cho cc i tng lao ng (nh ngi trng thnh). Thc hin ch n ba ba hoc bn ba. 2200 - 2400 Kcal 2600 - 2800 Kcal 3000 - 3200 Kcal 3400 - 3600 Kcal 3800 - 4000 Kcal

2.2 Dinh dng cho nng dn

2.2.1 Tiu hao nng lng Cc nghin cu v tiu hao nng lng trong nng nghip cho thy: - Cng tiu hao nng lng ca cng qu trnh lao ng thay i nhiu ty theo mc c gii ho. - Tiu hao nng lng trung bnh ca nng dn x vin, cng nhn cc nng trng cao hn cng nhn cng nghip loi nh v gn vi tiu hao nng lng ca cng nhn xy dng v giao thng. - Tnh cht cng vic ca nng dn phn ln thuc loi lao ng nng trung bnh. Theo cc ti liu nghin cu, tiu hao nng lng ca x vin nng nghip l 2700 Kcal/ngy (c nam v n). 2.2.2 Nhu cu cc cht dinh dng Lao ng nng nghip khng ra nhng i hi v nhu cu dinh dng c bit. Nhng yu cu v dinh dng i vi ngi lao ng ni chung tng t vi lao ng cng nghip.

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III Dinh dng cho ngi lao ng tr c

3.1 Nhu cu nng lng
Sng v hot ng ca con ngi km theo tiu hao nng lng khng ngng. Lao ng tr c d cng thng nhiu hay t, khng km theo tiu hao nng lng cao. ngi lao ng tr c trong iu kin lao ng chn tay khng qu 90 - 110 Kcal/gi. Nhu cu nng lng thuc loi lao ng nh, lao ng vn phng, khong 2200 - 2400 Kcal/ngy.

3.2 Tiu chun dinh dng

Nguyn tc chnh ca dinh dng hp l i vi ngi lao ng tr c l duy tr nng lng ca khu phn ngang vi nng lng tiu hao. Trong khu phn ngi lao ng tr c v tnh ti nn hn ch lipid v carbohydrate. Nhiu ti liu khng nh nh hng ca lng lipid tha i vi hnh thnh x va ng mch sm i vi ngi lao ng chn tay. Carbohydrate, c bit cc loi c phn t thp l thnh phn th hai nn hn ch ngi t lao ng. Nhiu ti liu cho rng nn hn ch carbohydrate ti s lng 350 400 g/ngy, ch yu l hn ch cc loi bt c t l xay xt cao, ng v cc loi thc phm giu ng. Nhu cu protein cn cao v lng protein ng vt khng di 60% tng s protein, m bo tnh cn i b ba: methionine + cystine, tryptophane v lysine. Cung cp y vitamin cho ngi lao ng tr c l vn quan trng. Vitamin c xem l thnh phn cn thit bt buc ca khu phn, m bo chuyn ho v cc hot ng chc phn bnh thng ca c th, nht l h thng thn kinh trung ng, tim mch, tiu ho v ni tit.

IV Dinh dng tui gi

4.1 Nhng bin i tui gi
S chm tr cc phn ng oxy ho kh, s h thp chuyn ho vt cht v kh nng hot ng ca cc c quan v h thng trong c th. Trong giai on ny cn l s pht trin ca qu trnh teo t v thoi ho. Qu trnh ti to nguyn sinh cht b gim c v cng ln cht lng. Cc loi protein sinh sn (nucleoproteid) c kh nng ti sinh, tng hp v hi phc dn dn b 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.

4.2 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 112

4.2.1 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). 4.2.2 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). 4.2.3 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. 4.2.4 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. 4.2.5 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. 4.2.6 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.

V Nhu cu i vi ph n c thai v cho con b

Cht dinh dng cn thit trong giai on ngi ph n mang thai cng c v xy dng mi cc c quan cho ngi m, ng thi cn cho s pht trin ca bo thai. Cc nghin cu nc ta cho thy lao ng ca ph n cn nng, nng lng tiu hao cao v 113

tnh trng thiu nng lng lu di cn ph bin. Mt vi cht dinh dng rt cn thit trong giai on mang thai nh acid folic, st.. thng b thiu ht. V vy nhu cu ngh lao ng n cao hn 300 Kcal so vi kt qu tnh ton t khuyn ngh ca WHO. Vi ph n c thai (3 thng cui), nhu cu b sung l 350 Kcal v 15 g protein, v ph n cho con b (6 thng u) nhu cu b sung l 550 Kcal v 28 g protein. Nhu cu st cho b m cho con b l 1,31 mg/ngy. Nhu cu calci trong giai on mang thai 3 thng cui v cho con b: 1000 - 1200 mg/ngy. Nhu cu vitamin A trong thi gian mang thai l 600 mcg (ng lng retinol/ngy) v trong thi gian cho b l 850 mcg/ngy (ng lng retinol/ngy). Nhu cu acid folic l 200 mcg/ngy.

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CHNG X. CC BNH LIN QUAN N DINH DNG

I Cc bnh thiu dinh dng c ngha sc kho cng ng
Nhng kt qu nghin cu ca khoa hc dinh dng ch ra trong thc n c cha cc thnh phn dinh dng cn thit i vi c th, l cc cht protein, lipid, cc vitamin, cc cht khong v nc. S thiu mt trong cc cht ny c th gy ra nhiu bnh tt nh bnh scobut do thiu vitamin C ly i sinh mng 100 trong s 160 thy th theo Vasco de Gama tm ng sang phng ng, vim da pellagre hay gp cc vng n ton ng do thiu vitamin PP, bnh t ph do thiu vitamin B1... Ngi ta gi l cc bnh thiu dinh dng c hiu, ngha l nguyn nhn ch yu l do thiu mt thnh phn dinh dng no . Nh p dng kin thc dinh dng vo chm sc sc khe; nhiu loi bnh ny c y lui v qu kh. Tuy vy cc nc ngho vn cn ni tri ln cc vn sc khe do thiu dinh dng, cc bnh thiu dinh dng quan trng nht hin nay l thiu proteinnng lng, thiu vitamin A v bnh kh mt, thiu mu dinh dng, thiu iot v bnh bu c. Cc c im v tnh trng dinh dng l nhng ch tiu quan trng nh gi tnh trng sc kho v pht trin ca mt cng ng. Dinh dng l mt trong nhng nhn t c nh hng rt ln n cc dng ri lon thng gp. Do vy s pht hin vai tr cn thit ca cc cht dinh dng trong thc n m khi thiu c th gy ra cc bnh c hiu nh cc bnh thiu vitamin, bu c, kh mt, kwashiorkor... Ngi ta gi l cc bnh thiu dinh dng c hiu, nguyn nhn ch yu l do thiu mt thnh phn dinh dng no . i v cc bnh thiu dinh dng hin nhin l c im ca cc nc ngho nhng liu cc nc no, d tha v thc phm th vn v dinh dng c g ng quan tm na khng? Cc thng k v dch t hc so snh tng nc trong cc thi k khc nhau v so snh cc qun th di c t vng ny sang vng khc cho thy m hnh bnh tt thay i theo li sng v cch n ung. cc nc giu, t l t vong do cc bnh tim mch, ung th, tiu ng tng ln. Bnh bo ph chim 20 - 40% s dn trng thnh nhiu nc pht trin l nguy c quan trng ca nhiu bnh khc. Nh vy c thiu n ln tha n (tha v s lng v thiu v cht lng) u c th gy bnh. Mt ch n cn i, hp l l cn thit cho con ngi sng lu v khe mnh. Mi lin quan gia dinh dng v bnh tt c th hin Hnh 10.1

115

Thiu dinh dng K, Ca Vitamin A Fluor Iode Acid bo cn thit Protein/Nng lng Vitamin C

Bnh Tng huyt p Kh mt Su rng Bu c Tim mch, K v PEM Gan K d dy Si mt Tiu ng

Tha dinh dng Mui, cht bo ng ngt Cht bo Cht bo no Ru Mui Tht, cht bo Bia Bo ph Nng lng ng Cht bo, ru

Cht x

K i trng K trc trng

Ca, Fluor Vitamin D Fe, acid folic

Long xng Mm xng Vim khp Thiu mu

Hnh 10.1 Mi quan h gia dinh dng v bnh tt

1.1 Thiu dinh dng protein-nng lng (Protein Energy Malnutrition PEM)
Thiu dinh dng protein nng lng l loi thiu dinh dng quan trng nht tr em, vi biu hin lm sng bng tnh trng chm ln v hay i km vi cc bnh nhim khun. Thiu dinh dng protein nng lng tr em thng xy ra do: 116

- Ch n thiu v s lng v cht lng - Tnh trng nhim khun, c bit l cc bnh ng rut, si, v vim cp ng h hp dn n gim ngon ming v gim hp thu. 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

Cc biu hin thng gp C teo t Ph Cn nng/ chiu cao R rng Khng c Rt thp C th khng r do ph C cc chi di , mt Thp, c th khng r do ph Hay quy khc, mt mi

Bin i tm l

i khi lng l mt mi

Cc biu hin c th gp Ngon ming Tiu chy Bin i da Kh Thng gp t gp Km Thng gp Thng c vim da, bong da Tc mng tha, d nh i khi do tch lu m

Bin i tc Gan to

t gp Khng

Ho sinh (albumin Bnh thng hoc hi Thp (di 3g/100ml) huyt thanh) thp 117

Suy dinh dng bt u t biu hin chm ln cho n cc th nng l Marasmus v Kwashiorkor. Trong hot ng chm sc sc khe ban u, vic nhn bit cc th nh v va c ngha quan trng c bit. Trong iu kin thc a, ngi ta ch yu da vo cc ch tiu nhn trc (cn nng theo tui, chiu cao theo tui, cn nng theo chiu cao, vng cnh tay) phn loi tnh trng suy dinh dng. Khi o vng cnh tay cn s nn nh gi tnh trng lp m di da. cng ng, cch phn loi thng dng nht trc y do Gomez F. a ra t nm 1956 da vo cn nng theo tui quy ra phn trm ca cn nng chun. Thiu dinh dng 1 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 Cn nng theo chiu cao (80 % hay -2SD) Trn Chiu cao theo tui (90% hay-2SD ) Trn Bnh thng Di Thiu dinh dng gy cm Thiu dinh dng nng ko di

Di

Thiu dinh dng ci cc

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 118

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. 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.

1.2 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: Qung g (tr 24 - 71 thng) Vt Bitot Kh/lot/nhn gic mc So gic mc Hm lng vitamin A trong huyt thanh di 10 mcg/ml : trn 5% 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. : : : : trn 1% trn 0,5% trn 0,01% trn 0,05%

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Bng 10.3 Ch tiu nh gi tnh trng dinh dng vitamin A tr em Tnh trng Vitamin A trong khu phn m g hay mcg/ ngy Trn 400 200-400 Vitamin A gan (mg/kg) Vitamin A trong khu phn mg hay mcg/ ngy Biu hin lm sng

Vng sng gii hn

Trn 20 10-20

Trn 20 10-20

Khng c C th c biu hin chm ln, n km ngon, gim sc khng vi nhim khun Xut hin cc biu hin lm sng (qung g, kh gic mc, lot v nhn gic mc)

Gii hn e do bnh l

Di 200

Di 10

Di 10

1.3 Thiu mu dinh dng

Thiu mu dinh dng l mt vn sc khe cng ng quan trng Vit nam nhng cc s liu v t l mc bnh v cc nhn t nguy c vn cn cha y . Trong cc iu tra dch t hc cng ng, t chc Y t th gii khuyn ngh ly cc mc hemoglobin (Hb) sau y l thiu mu: Tr em 6 thng - 6 tui Tr em 7 tui - 14 tui Nam gii trng thnh N trng thnh B m mang thai 110 g/l 120 g/l 130 g/l 120 g/l 110 g/l

Cc kt qu nghin cu cho thy t l thiu mu cao nht tr em 6 - 24 thng v ph n c thai. Cc nghin cu cho thy t l thiu mu tng i thp ng bng Bc B, cao 120

nht Ty Nguyn. ng ch l thiu mu tr em di 5 tui rt cao Ty Nguyn v Nam B. T l thiu mu nng thn, vng su cao hn th.

1.4 Thiu iode v bnh bu c

Khi thiu iode trong khu phn, s to thnh hoormone tyrosin b gim st. b tr vo thiu ht tuyn gip trng di s kch thch ca hoormone tuyn yn phi s dng c hiu qu hn ngun iode ang c v ph to dn. Trong phn ln trng hp, s ph to tuyn gip trng biu hin mt c ch b tr nn chc phn ca n vn duy tr c bnh thng. Tuy vy nu tnh trng thiu iode qu trm trng th c th xut hin thiu nng tuyn gip. Vn nghim trng nht ca thiu iode l nh hng n s pht trin ca bo thai. Nu ch n thi k c thai, ngho iode c th nh hng n nng lc tr tu ca a tr sau ny. iu nh hng rt ln n c cng ng sau ny. trnh tnh trng thiu iode, ngi ta da vo hai ch s c bn theo khuyn ngh ca T chc Y t th gii v T chc phng chng cc ri lon do thiu iode l: T l bu c la tui hc sinh 6 - 12 tui trn 5% theo cc mc nh sau: - Thiu nh: t 5 19,9 % - Thiu va: 20 29,9% Mc iode trong nc tiu di 10 mcg/dl 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: - Trn 10 mcg/dl: iode - 5 9,9 mcg/dl: thiu iode nh - 2 4,9 mcg/dl: thiu iode trung bnh - < 2 mcg/dl: thiu iode nng Cc iu tra cc nc cho thy t l mc bnh bu c trung bnh trong dn c min ni l 34,7 %, mc iode trong nc tiu thp hn 5 mcg/dl. c bit nhng vng giao thng kh khn t l bu c ln ti 50 - 80%, t l n n 1 - 8%. Tnh hnh thiu iode nc ta l nghim trng v ph bin, v vy chng trnh s dng mui iode c thc hin t thng 1- 1995.

II Dinh dng trong mt s bnh mn tnh

Cc bnh mn tnh khng ly l m hnh bnh tt chnh cc nc c nn kinh t pht trin. Trong my thp k gn y mi quan h gia dinh dng, ch n v cc bnh mn tnh c quan tm nhiu. Tuy nhiu iu cn cha sng t nhng cc tc gi hu nh u cho rng dinh dng l mt trong nhng nhn t nguy c quan trng.

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2.1 Bo ph
Bo ph l mt tnh trng sc khe c nguyn nhn dinh dng. Thng thng ngi trng thnh kho mnh, dinh dng hp l, cn nng ca h ng yn hoc dao ng trong gii hn nht nh. "Cn nng nn c" ca mi ngi thng vo tui 25 - 30. Hin nay, T chc y t th gii thng dng Ch s khi c th (Body Mass Index, BMI ) nhn nh tnh trng gy bo. Ch s khi c th l mt ch tiu c t chc Y t th gii khuyn ngh nh gi tnh trng dinh dng ca ngi trng thnh. l t s ca cn nng trn bnh phng chiu cao ( cp Chng II) Cc ngng nh gi tnh trng dinh dng da vo ch s khi c th (BMI) l: Di 16: thiu nng lng trng din III 16 16,9: thiu nng lng trng din II 17 18,4: thiu nng lng trng din I 18,5 24,9: bnh thng 25 29,9: bo ph - I Trn 30: bo ph - II C th gi c cn nng n nh l nh trng thi cn bng gia nng lng do thc n cung cp v nng lng tiu hao cho lao ng v cc hot ng khc ca c th. Cn nng tng ln c th do ch n d tha vt qu nhu cu hoc do np sng lm vic tnh ti t tiu hao nng lng. Khong 60 - 80% trng hp bo ph l do nguyn nhn dinh dng, bn cnh cn c th do cc ri lon chuyn ha trong c th thng qua vai tr ca h thng thn kinh v cc tuyn ni tit nh tuyn yn, tuyn thng thn, tuyn gip trng v tuyn ty. Vo trong c th, cc cht protein, lipid, carbohydrate u c th chuyn thnh cht bo d tr. V vy khng nn coi n nhiu tht, nhiu m mi gy bo m n qu tha cht bt, ng, ngt u c th gy bo. V tr phn b cht bo d tr trong c th cng c ngha sc khe quan trng. Cht bo tp trung nhiu bng (bo bng) khng tt i vi sc kho. V vy bn cnh theo di ch s BMI nn theo di thm t s vng bng/vng mng, khi t s ny cao hn 0,8 th cc nguy c tng ln. Bo ph khng tt i vi sc khe, ngi cng bo cc nguy c cng nhiu. Trc ht, ngi bo ph d mc cc bnh tng huyt p, bnh tim do mch vnh, tiu ng, hay b cc ri lon d dy rut, si mt... Nhiu nghin cu cho thy hm lng cholesterol trong mu v huyt p tng ln theo mc bo v khi cn nng gim s ko theo gim huyt p v cholesrol. ph n mn kinh, cc nguy c ung th ti mt, ung th v v t cung tng ln nhng ngi bo ph, cn nam gii bo ph bnh ung th thn v tuyn tin lit hay gp hn. Thc hin mt ch n ung hp l v hot ng th lc ng mc duy tr cn nng n nh ngi trng thnh, l nguyn tc cn thit trnh bo ph. nhiu nc pht trin, t l ngi bo ln ti 30 - 40%, nht l tui trung nin v chng bo ph tr thnh mt mc tiu sc khe cng ng quan trng. 122

2.2 Dinh dng v cc bnh tim mch Ch dinh dng l mt nhn t quan trng trong phng nga v x tr mt s bnh tim mch, trc ht l bnh tng huyt p v bnh mch vnh. 2.2.1 Tng huyt p v bnh mch no Yu t nguy c chnh ca tai bin mch mu no l tng huyt p. Cc nghin cu u thy mc huyt p tng ln song song vi nguy c cc bnh tim do mch vnh v tai bin mch no. Trong cc nguyn nhn gy tng huyt p, trc ht ngi ta thng k n lng mui trong khu phn. Cc thng k dch t cho thy cc qun th dn c n t mui th bnh tng huyt p khng ng k v khng thy c tng huyt p theo tui. Tuy nhin, phn ng ca tng c th i vi mui n cng khng ging nhau. Hin nay t chc Y t th gii khuyn co ch n mui 6 g/ngy l gii hn hp l phng tng huyt p. Bn cnh mui n cn c mt s mui khc cng c vai tr i vi tng huyt p. Theo mt s tc gi, tng lng calci trong khu phn c nh hng lm gim huyt p. Mt s cng trnh khc cho rng ch n giu kali c li cho ngi tng huyt p. Sa v cc ch phm t sa l ngun calci tt, cc thc n ngun gc thc vt nh lng thc, khoai c, u v cc loi rau qu c nhiu kali. Thm vo mt lng cao cc acid bo bo ha trong khu phn cng dn n tng huyt p. Nh vy bn cnh mui natri, nhiu thnh phn khc trong ch n cng c nh hng n tng huyt p, l cha k n mt s yu t khc c cp ti l bo ph v ru. Mt ch n hn ch mui, gim nng lng v ru c th lm gim huyt p phn ln i tng c tng huyt p nh. nhng ngi tng huyt p nng ch n ung ni trn gip gim bt s dng cc thuc h p. Bn cnh ch n nn giu canxi, kali, vitamin C, thay th cc cht bo ca tht bng c. Vit Nam, vo nhng nm 60, t l tng huyt p ch vo khong 1% dn s, nhng hin nay theo s liu ca Vin tim mch t l ny cao hn 10%, nh vy tng huyt p tr thnh mt vn sc khe cng ng quan trng. Cc cuc iu tra do Vin Dinh dng tin hnh cho thy cc vng c nhiu ngi tng huyt p mc tiu th mui n thng cao hn cc ni khc, do trnh thi quen n mn l mt ni dung gio dc dinh dng quan trng phng tng huyt p nc ta. 2.2.2 Bnh mch vnh Bnh tim do mch vnh (Coronary Heart Disease CHD) l vn sc khe cng ng quan trng cc nc pht trin, chim hng u trong cc nguyn nhn gy t vong. Nh cc chng trnh gio dc sc khe tch cc, bnh c khuynh hng gim dn trong cc thp k gn y nhiu nc Ty u, c, M, nhng mt s nc ng u bnh vn c xu hng tng. T l mc bnh khc nhau cc nc cng nh trong cng mt nc nhng khc nhau v iu kin kinh t x hi lm cho ngi ta ch n cc nhn t nguy c mc bnh l mi trng v dinh dng. Theo s hiu bit hin nay ba yu t nguy c c xc nh, l ht thuc l, tng huyt p v hm lng cholesterol trong mu cao. Cc nguy c tng dn theo tui n (trc khi mn kinh) thp hn nam. Cc nguy c do tng huyt p v mi lin quan 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 123

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 bo ng vt, tng du thc vt, bt n tht, tng n c l c li cho ngi c ri lon chuyn ha cholesterol. Ngi ta nhn thy cc acid bo no lm tng cc lipoprotein c t trng thp (LDL) vn chuyn cholesterol t mu ti cc t chc v c th tch ly thnh ng mch. Ngc li cc acid bo cha no lm tng cc lipoprotein c t trng cao (High Density Lipoprotein HDL) vn chuyn cholesterol t cc m n gan thoi ha. Ch n nhiu rau v tri cy t ra c tc dng bo v c th vi bnh mch vnh tuy th cn cha r rng. C th l do tc dng ca cht x c nhiu trong rau qu, cng c th l mt ch n thc vt s lm gim huyt p, mt nhn t nguy c ca cc bnh mch vnh. 124

Trong cc thp k va qua, nhiu nc nh Thy in, Phn Lan, c, Hoa K... thc hin nhiu bin php phng nga bnh mch vnh v h t c mt s kt qu kh quan. Ni chung cc bin php ny bao gm cc li khuyn v ch dinh dng, cai thuc l, hot ng th lc v duy tr cn nng n nh. Trong cc khuyn co v n ung, ngi ta khuyn nng lng do cht bo cung cp khng c vt qu 30% tng s nng lng, s dng du thc vt, tng s dng khoai, rau v tri cy. Cc loi ng ngt khng cung cp qu 10% tng s nng lng cn nng lng do protein nn t t 10 - 15%. Cc bi hc trn rt b ch cho nc ta khi bnh mch vnh ang c khuynh hng tng. Nghin cu tn thng gii phu bnh l cc trng hp va x ng mch vo thp k 60, bnh vin Bch Mai cho thy, 95% c tn thng ng mch no, 5% c tn thng ng mch vnh, cn u thp k 80, 85% c tn thng ng mch no v 15% c tn thng ng mch vnh.

2.3 Dinh dng v ung th

Mc d nguyn nhn ca nhiu loi ung th cn cha bit r nhng ngi ta cng ngy cng quan tm n mi lin quan gia ch n ung vi ung th. Theo thng k dch t hc, c 30% ung th lin quan ti ht thuc l, 35% lin quan n n ung, do ru 3% v do cc cht cho thm vo thc phm 1%. Trc ht, nhiu cht gy ung th c mt trong thc phm, ng ch nht l cc aflatoxin v nitrosamin. Aflatoxin l c t do mc Aspergillus Flavus to ra, thng gp u phng v mt s thc phm khc do iu kin bo qun khng hp l sau thu hoch. Aflatoxin l c t gy ung th gan mnh trn thc nghim v s dng thc phm nhim aflatoxin l mt nguy c gy ung th gan ngi. Mt s cc nitrosamin cng l cht gy ung th trn thc nghim. Nitrosamin c hnh thnh rut non do s kt hp gia nitrit v cc acid amin. Cc nitrat thng c mt lng nh trong thc phm, mt khc ngi ta cn dng nitrat v cc nitrit bo qun 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. 125

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. Mi quan h gia ch n v ung th v ang cn c tip tc nghin cu, tuy nhin cu hp lin tch gia t chc Chu u v phng chng ung th vi Hip hi dinh dng th gii vo thng 6/1985 khuyn co rng ch n phng bnh tng huyt p v mch vnh cng c coi l c th hn ch nguy c gy ung th. d. Tm tt cc mi lin quan ch yu gia ch n v ung th Mi lin quan gia ch n vi ung th cn t c nghin cu hn so vi cc bnh tim mch, mt khc l nhng nghin cu khng d dng. Theo s hiu bit hin nay, ngi ta cho rng ch n c lng cht bo cao l yu t nguy c i vi ung th i trng, tuyn tin lit v ung th v. Cc ch n giu thc n thc vt, c bit l cc loi rau xanh, qu chn lm gim nguy c cc ung th phi, i trng, thc qun v d dy. C ch ca cc yu t ny cn cha r rng nhng ngi ta cho rng c th l do cc ch n ny c t cht bo bo ha, nhiu tinh bt, cht x, cc vitamin v cht khong, c bit l -caroten. Bng 10.4 tng hp cc mi lin quan . Trng lng c th cng c vai tr nht nh, ngi bo d mc bnh ung th v v ni mc hn. Bng 10.4 Mi lin quan gia thnh phn dinh dng v ung th V tr ung th Phi V i trng + ++ Cht bo Cht x Rau qu Ru Thc n p mui, hun khi +/-

Tuyn tin lit ++ 126

Bng quang Trc trng Khoang ming D dy Thc qun +

+ +

++

++

Ch thch: +: n nhiu c nguy c cao -: n nhiu lm gim nguy c

2.4 Tiu ng khng ph thuc insulin

C hai th tiu ng chnh: - Th tiu ng ph thuc insulin. - Th tiu ng khng ph thuc insulin. Tiu ng ph thuc insulin ch yu gp tr em, thiu nin v ngi di 30 tui do tuyn ty b tn thng gy thiu insulin. Loi tiu ng ph thuc insulin chim khong 10% trng hp tiu ng. Phn ln bnh nhn tiu ng thuc th tiu ng khng ph thuc insulin, thng hay gp ngi trung nin tr ln. Bo ph l nguy c chnh ca bnh tiu ng khng ph thuc insulin, nguy c ny cng tng ln theo thi gian v mc bo. C n 80% bn nhn mc bnh ny l nhng ngi bo. T l ny tng gp i nhng ngi bo va phi v tng gp 3 nhng ngi qu bo. Chng bo l bin php d phng c trin vng nht d phng bnh tiu ng khng ph thuc insulin. Ch n thc vt nhiu rau c lin quan n h thp t l mc tiu ng.

2.5 Si mt
Trong 30 nm li y, sinh bnh hc ca si mt tr nn r rng hn. Cc ri lon ca ti mt lm hnh thnh si mt (ch yu l si cholesterol). Si mt thng ph bin hn cc nc ang pht trin. cc nc pht trin, bnh si mt thng gp nhng ngi n ch n t rau hn nhng ngi n nhiu rau.

2.6 X gan
Mi lin quan gia s dng ru v x gan c tha nhn rng ri. Php trong thi gian chin tranh th gii th hai, t l cht do x gan gim 80% do hn ch s dng ru. Kt qu mt s nghin cu Php cho thy nu gim mc tiu th ru t 160g xung 80g/ngy c th gim t l mc bnh x gan 58% v ung th thc qun 28%. Nh vy, gim tiu th ru r rng l c li. Tuy nhin mc nhy cm i vi ru khc nhau gia cc c th, n gii c phn nhy cm hn so vi nam gii.

127

2.7 Bnh long xng

T l ngi gi cng tng ln trong cng ng th cng tr thnh mt vn ln i vi vic chm sc sc khe. Ngi gi d b gy xng, thng l xng i v xng chu c khi ch sau mt chn thng nh. Xng d b gy thng do long xng gy nn, l hin tng mt i mt s lng ln t chc xng trong ton b th tch xng, lm c ca xng gim i. 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.

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TI LIU THAM KHO 1. Cc Bnh Thiu Dinh Dng v Sc Kho Cng ng Vit Nam (1994). H Huy Khi & T Giy. Nh Xut Bn Y Hc H Ni. 2. Conducting Small Scale Nutrition Surveys - A field manual. FAO (1985) 3. Dinh Dng Ngi (1996). L Don Din & V Th Th. Nh Xut Bn Gio Dc. 4. Dinh dng Hp L v Sc Kho (1994). H Huy Khi v T Giy. Nh Xut Bn Y Hc H Ni 5. Dinh Dng Tr Em (1998). Nh Xut Bn Gio Dc 6. Food: Nutrition and Agriculture - Text Book, Teacher's manual and Student Worbook Food and Agriculture Organization of The United Nations. Rome 1984 7. Handbook of Human Nutritional Requirements - FAO (1974). FAO Nutritional studies No. 28. 8. Human Nutrition and Dietetics (2000). Tenth Edition. J S Garrow, WPT James, A Ralph - Churchill Livingstone. 9. My vn v Dinh Dng Trong Thi K Chuyn Tip (1996). H Huy Khi. Nh Xut Bn Y Hc H Ni. 10. Nutrition: Chemistry and Biology (1988). Julian E. Spallholz. Prentice Hall. Engleword Cliffs. New Jersey 07632. 11. Planning and Evaluation of Applied Nutrition Programmes (1972). Food and Agriculture Organisation of The United Nations. 12. Present Knowledge in Nutrition (1990). Myrtle L. Brown. Nutrition Foundation, Washington, D. C 13. The care intiative assessment, analysis an action to improve care for nutrition (1997). NICEFU. New York, 1997. 14. The Science of Nutrition (1972). Marian Thompson Arlin. Macmillan Publishing Co., Inc - Newyork 15. The Nutrition and Health Encyclopedia (1989). David F. Tver and Percy Russell, Van Nostrand Reinhoil. Newyork. 16. Thc trng v gii php phng chng suy dinh dng tr em. Mt s cng trnh nghin cu v dinh dng v v sinh an ton thc phm (2000). H Huy Khi. NXB Y hc, H Ni. 17. V Sinh Dinh Dng v V Sinh Thc Phm (1977). Hong Tch Mnh v H Huy Khi 18. Xy dng C Cu Ba n (1984). T Giy, Bi Th Nhu Thun, H Huy Khi. Nh Xut Bn Y Hc. Cc trang web tham kho: http://btc.montana.edu http://en.wikipedia.org/wiki http://www.nal.usda.gov/fnic/foodcomp/Data/SR15/reports/sr15page.htm http://www.nutritionexplorations.org/kids/nutrition-pyramid.asp http://www.womensheartfoundation.org/content/Nutrition/nutrition_heart_disease_good_ health.asp http://www.sciencemaster.com/jump/life/food_guide.php http://www.youngwomenshealth.org/nutrition-sports.html http://www.fda.gov/diabetes/food.html

http://www.veggie-mon.org/students7_8/VM_nutrition/food_pyramid/pyramid.htm http://www.childrenscentralcal.org/content.asp?id=966&parent=1&groupid=G0044 http://www.vitacost.com/science/hn/Healthy_Eating/Food_Guide_Pyramid.htm http://www.ext.vt.edu/pubs/nutrition/348-020/348-020.html http://healthtranslations.vic.gov.au/bhcv2/bhcht.nsf/PresentDetail?open&s=The_healthy_ diet_pyramid_(Vietnamese)

MC LC Chng Ta Trang I Dinh dng ngi - Mi quan h gia lng thc-thc 1 phm, nng nghip v sc kho 1 I. nh ngha v dinh dng ngi 1 II. Vi nt v s pht trin ca khoa hc Dinh dng 2 III. Khi nim v cc cht dinh dng v thnh phn lng thc thc phm 2 3.1 Protein 3 3.2 Lipid 3 3.3 Glucid 3 3.4 Cht khong 4 3.5 Vitamin 4 3.6 Nc 4 3.7 Cht x 4 IV. Mi quan h gia dinh dng, lng thc thc phm, nng nghip v sc kho II Cu trc c th v nhu cu dinh dng 7 7 I. Cu trc c th ngi 7 1.1 Khi qut 7 1.2 Phng php xc nh cu trc c th 8 II. Nhu cu dinh dng 8 III. Nhu cu nng lng 9 3.1 Hnh thi nng lng 9 3.2 n v nng lng 10 3.3 Nng lng thc phm 12 3.4 Tiu hao nng lng 18 3.5 Lng cung cp nng lng. IV. Cn bng nng lng. 19 V. D tr nng lng 20 VI. Cc bi ton v trao i vt cht 20 VII. An ninh thc phm 22 7.1 nh ngha 22 7.2 Yu cu 22 7.3. Cn ch n cc loi thc phm 22 III Protein 24 24 I. M u 24 II. Cu trc v tnh cht l hc c bn ca protein 24 2.1 Cu trc 25 2.2 Thnh phn ho hc 26 III. Thnh phn v hm lng protein trong cc nng sn phm chnh. 27 IV. Vai tr v chc nng ca protein trong dinh dng 4.1 Protein l thnh phn nguyn sinh cht t bo 27 4.2 Protein cn thit cho s chuyn ho bnh thng ca cc 27
i

IV

cht dinh dng khc 4.3 Protein tham gia vo cn bng nng lng ca c th 4.4 Protein iu ho chuyn ho nc v cn bng kim toan trong c th 4.5 Protein bo v v gii c cho c th 4.6 Protein l cht kch thch ngon ming V. Nhng thay i xy ra trong c th thiu protid VI. Cc acid amin v vai tr dinh dng ca chng 6.1 Gi tr sinh hc ca cc acid amin cn thit 6.2 Nhu cu ca cc acid amin cn thit 6.3 Cc acid amin khng cn thit VII. Nhng yu t nh hng n gi tr dinh dng ca protein 7.1 nh hng ca nng lng cung cp 7.2 nh hng ca vitamin v mui khong 7.3 Kh nng s dng cc acid amin 7.4 Tnh cn i ca acid amin trong khu phn - Yu t hn ch VIII. Cc phng php xc nh gi tr dinh dng ca protein 8.1 Phng php sinh vt hc 8.2 Ch s ho hc 8.3 Tiu ho v hp thu protein IX Nhu cu protein ca c th 9.1 Lng mt Nit khng trnh khi 9.2 nh hng ca cc cht kch thch Lipid I. M u II. Cu trc v tnh cht l hc c bn 2.1 Cu trc 2.2 Cc tnh cht ca lipid 2.3 Thnh phn v hm lng lipid trong mt s nng sn phm chnh III. Vai tr ca lipid trong dinh dng ngi 3.1 Cung cp nng lng 3.2 Cu thnh cc t chc 3.3 Duy tr nhit , bo v c quan trong c th 3.4 Thc y vic hp thu cc vitamin tan trong cht bo 3.5 Lm tng cm gic no bng 3.6 Nng cao gi tr cm quan ca thc n IV Cc acid bo 4.1 Cc acid bo no 4.2 Cc acid bo cha no V. Phosphatide VI. Sterol v vitamin 6.1 Sterol 6.2 Vitamin
ii

28 29 29 29 29 30 31 33 33 34 34 34 34 34 35 35 35 36 37 37 37 39 39 40 40 40 41 43 43 43 43 43 43 43 43 44 44 45 46 46 47

VI

VII

VII. Gi tr dinh dng ca cht bo VIII. Hp thu v ng ho cht bo IX. Nhu cu cht bo Carbohydrate I. M u II. Vai tr sinh l ca carbohydrate 2.1 Cung cp nng lng 2.2 Thnh phn cu to nn t chc thn kinh 2.3 Bo v gan, gii c 2.4 Chng to th ceton III. Carbohydrate tinh ch v carbohydrate bo v 3.1 Carbohydrate tinh ch 3.2 Carbohydrate bo v IV. Cc carbohydrate n gin 4.1 Monosaccharide 4.2 Disaccharide 4.3 ngt ca cc loi ng V. Polysaccharide 5.1 Tinh bt 5.2 Glycogen 5.3 Cc cht pectin 5.4 Cellulose VI. Ngun carbohydrate trong thc n VII. Tiu ha v hp thu carbohydrate VIII. Nhu cu carbohydrate Vitamin I. i cng II. Cc vitamin tan trong cht bo 2.1 Retinol (vitamin A) v cc caroten 2.2 Ergoscalcipherol, cholescalcipherol (Vitamin D) 2.3 Tocopherol (Vitamin E) 2.4 Vitamin K III. Cc vitamin tan trong nc 3.1 Cc Vitamin nhm B 3.2 Acid Ascorbic (Vitamin C) Cc cht khong I. i cng II. Ngun cht khong trong thc phm III. Vai tr ca cht khong i vi c th IV. Cc yu t i lng 4.1 Calci 4.2 Phosphor 4.3 Magne 4.4 Kali 4.5 Natri 4.6 Clorur
iii

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VIII

IX

V. Cc yu t vi lng 5.1 St 5.2 Mangan 5.3 Coban 5.4 Iode 5.5 Fluor 5.6 ng 5.7 Km Khi lun v dinh dng cn i I. Mi quan h tng h gia cc dinh dng trong c th. 1.1 Thiu dinh dng v ngon ming 1.2 Nng lng v protid 1.3 Tnh cn i ca cc acid amin 1.4 Phosphor, calci v vitamin D 1.5 Lipid v vitamin 1.6 Glucid v vitamin 1.7 Protein v vitamin 1.8 Quan h gia cc vitamin 1.9 Vitamin v cht khong II. Quan nim v tnh cn i ca khu phn 2.1 Tnh hnh thc t 2.2 Nhng yu cu v dinh dng cn i 2.3 Tnh cn i trong thc n III. Tiu chun dinh dng 3.1 Nng lng 3.2 Protein 3.3 Lipid 3.4 Glucid 3.5 Tiu chun v vitamin IV. p dng thc hnh cc tiu chun dinh dng. 4.1 Phn chia thc phm theo nhm 4.2 Nguyn tc xy dng thc n hp l 4.3 nh hng ca ch bin nng n thnh phn dinh dng Thc phm v nhu cu dinh dng cho cc i tng khc nhau I. Dinh dng cho tr em 1.1 Dinh dng cho tr em di mt tui 1.2 Dinh dng cho tr em trn mt tui v thanh thiu nin II. Dinh dng cho cc i tng lao ng 2.1 Dinh dng cho cng nhn 2.2 Dinh dng cho nng dn III. Dinh dng cho ngi lao ng tr c 3.1 Nhu cu nng lng 3.2 Tiu chun dinh dng
iv

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IV. Dinh dng tui gi 4.1 Nhng bin i tui gi 4.2 Nhng yu cu v dinh dng V. Nhu cu dinh dng cho ph n c thai v cho con b Cc bnh lin quan n dinh dng I. Cc bnh thiu dinh dng c ngha sc kho cng ng 1.1 Thiu dinh dng protein-nng lng 1.2 Thiu vitamin A v bnh kh mt 1.3 Thiu mu dinh dng 1.4 Thiu iod v bnh bu c II. Dinh dng trong mt s bnh mn tnh 2.1 Bo ph 2.2 Dinh dng v bnh tim mch 2.3 Dinh dng v ung th 2.4 Tiu ng khng ph thuc insulin 2.5 Si mt 2.6 X gan 2.7 Bnh long xng Ti liu tham kho

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