乳母膳食模式与乳汁脂肪酸构成谱的分析
发布时间：2018-08-04 15:22
【摘要】：目的:哺乳期妇女处在一个特殊的生理状态并且对于营养的需求较高,母亲分泌的乳汁对于婴儿的生长发育起至关重要的作用。母乳中的脂肪酸对婴儿的身心健康具有重要意义而脂肪酸水平受乳母膳食的影响。因此,本研究旨在分析长春市201例乳母膳食营养素摄入情况并将其摄入的食物种类利用因子分析法分成4种膳食模式,研究膳食模式与乳汁脂肪酸构成谱的关系。方法:研究对象来自长春市某产后护理中心、吉林省妇幼保健院以及本小组通过网络平台宣传招募的志愿者。纳入标准:健康乳母且为纯母乳喂养或混合喂养婴儿,婴儿足月分娩,无出生缺陷或疾病。母亲无吸烟、饮酒等不良嗜好。排除标准:孕期37周或42周,婴儿出生体重2500g或4000g。乳母患有高血压、糖尿病、冠心病、肥胖症、肝肾疾病和其他脏器合并疾病病史以及素食的乳母。孕期、哺乳期摄入多不饱和脂肪酸补充剂的乳母。研究对象均签署知情同意书,研究设计得到吉林大学公共卫生学院医学伦理委员会批准。采用面对面调查问卷的形式收集研究对象的基本信息以及膳食信息,采用3d24h膳食回顾问卷调查乳母膳食摄入情况,应用金钥匙营养专家系统软件—孕产妇版(上海营康)对乳母膳食能量及营养素摄入情况进行分析,同时利用乳母食物频率问卷以及《2009中国食物成分表》分析其膳食脂肪酸摄入情况。乳汁收集于乳母产后第22天~3个月,并置于-80℃冰箱保存。提取乳汁中脂肪酸并进行甲酯化,用气相色谱仪检测母乳中脂肪酸甲酯水平,根据内标物C17:0的保留时间找到各脂肪酸色谱峰再利用甲酯转换系数算出36种脂肪酸水平,根据脂肪酸水平计算出各脂肪酸所占比例。采用SPSS16.0统计软件分析乳母基本信息,膳食5种脂肪酸、能量、各营养素摄入量,利用因子分析法的主成分分析将膳食种类分为4种膳食模式,利用4种膳食模式与乳汁脂肪酸进行多因素秩和检验。将有意义的膳食模式与母乳脂肪酸水平进一步做两独立样本非参数检验,分析不同膳食模式间脂肪酸水平的差异。所有统计检验均为双侧检验,P0.05为差异具有显著性。结果:1、201例乳母平均年龄30.00岁,孕周为39.29周,孕期平均增重16.00kg。大部分产妇孕前BMI在正常范围(58.71%),文化程度以大学本科为主,占54.73%,研究生及以上学历和高中及以下学历人数分别占25.87%和16.42%。月家庭收入分为低收入(2000-5000元/月)、中等收入(5000-10000元/月)以及高收入(10000元/月以上)家庭,分别占16.42%、44.29%和27.86%。有92个产妇为自然生产,占45.77%。2、乳母平均每天能量摄入为1829.42kcal,低于膳食营养素参考摄入量(Dietary Reference Intakes,DRIs),由三大产能营养素碳水化合物、蛋白质和脂类提供的能量分别为52.51%、14.42%和33.07%。三类产能营养素的供能比接近于推荐范围,碳水化合物供能比在宏量营养素可接受范围(Acceptable Macronutrient Distribution Range,AMDR)内,而蛋白质和脂类供能比都稍高于推荐摄入量(Recommended Nutrient Intake,RNI)。3、乳母膳食中摄入的必需脂肪酸亚油酸(Linoleic acid,LA)和α-亚麻酸(Linolenic acid,ALA)的量分别为19.14g/d、2.40g/d,均超过适宜摄入量(Adequate Intake,AI)。二十碳五烯酸(Eicosapentaenoic acid,EPA)和二十二碳六烯酸(Docosahexenoic acid,DHA)平均摄入量分别为18.24mg/d和11.45mg/d,远远低于适宜摄入量。4、乳母膳食维生素摄入量偏低,其中维生素A、维生素B1、维生素B2、维生素C和叶酸摄入量均低于RNI,分别占RNI的46.49%、61.33%、66.67%、47.19%、32.89%。维生素E和烟酸超过RNI,达到推荐摄入量的178.82%和101.93%。乳母膳食中矿物质摄入的钙、钠严重不足,仅占RNI的43.86%和43.93%。铁、镁、钾、硒摄入量也低于RNI,分别占RNI的78.50%、75.65%、67.66%和61.44%。只有铜的摄入量超过RNI,达到119.29%,锌的摄入量接近RNI,占RNI的90.25%。5、通过因子分析的主成分分析将乳母膳食分成4种膳食模式,分别为以菌藻类、肉类、蛋类、水产品为主的模式1;以水果、蔬菜为主的模式2;以豆制品和坚果为主的模式3;以谷薯类为主的模式4。6、本研究共检测母乳中36种脂肪酸,饱和脂肪酸(Saturated fatty acid,SFA)16种,其水平占总脂肪酸的45.41%。其中以棕榈酸(C16:0)为主,占19.62%;其次是硬脂酸(C18:0),占6.18%;月桂酸(C12:0)占5.27%;肉豆蔻酸(C14:0)占4.88%。单不饱和脂肪酸(Monounsaturated fatty acid,MUFA)9种,其水平占总脂肪酸的29.59%。以油酸(C18:1n9c)为主,占24.25%,其次是十六碳一烯酸(C16:1)占2.83%。多不饱和脂肪酸(Polyunsaturated fatty acids,PUFA)有11种,其水平占总脂肪酸的21.09%。其中n-6PUFA有7种,其水平占总脂肪酸的17.02%,n-3PUFA有4种,其水平占总脂肪酸的3.79%,两个通路的脂肪酸含量均以其前体为主,LA和ALA,分别占总脂肪酸的13.70%和2.25%。n-6 PUFA和n-3 PUFA的主要产物花生四烯酸(Arachidonic acid,AA)和DHA分别占总脂肪酸的0.04%和0.94%。SFA:MUFA:PUFA为2.2:1.4:1,其中n-6PUFA:n-3PUFA为4.4:1。7、秩和检验结果表明,SFA、PUFA、n-6 PUFA水平在四种膳食模式之间存在差异(P0.05)。两两模式间的非参数检验结果显示,对于母乳中SFA的水平,模式2乳母乳汁低于模式4乳母乳汁水平(P=0.009),母乳中n-6 PUFA水平,模式1的母乳低于模式2母乳水平(P=0.007),模式2母乳中PUFA、n-6PUFA水平均高于模式4的母乳水平(P=0.003,P=0.004)。结论:1、本研究对象中乳母膳食能量摄入低于推荐的能量需要量(Estimated Energy Requirement,EER),碳水化合物供能比在推荐范围内,而蛋白质、脂类供能比高于DRIs。膳食中摄入的LA和ALA水平均高于DRIs推荐的乳母适宜摄入量,而EPA和DHA水平低于适宜摄入量。2、本研究对象中乳母膳食微量营养素,只有维生素E、烟酸、铜高于推荐摄入量,其他维生素、矿物质摄入量均低于推荐摄入量。3、本研究对象乳母乳汁中SFA水平,模式2低于模式4;母乳中PUFA水平,模式2高于模式4。
[Abstract]:Objective: breast-feeding women are in a special physiological state and have a high demand for nutrition. The milk secreted by mothers plays a vital role in the growth and development of infants. The fatty acids in the breast milk are important to the physical and mental health of the baby and the fatty acid level is influenced by the lactating diet. Therefore, this study aims to analyze the length of the milk. The intake of dietary nutrients from 201 cases of milk mother in spring city was divided into 4 dietary patterns by means of factor analysis, and the relationship between the dietary pattern and the composition of milk fatty acid was studied. Methods: the research object was from a postpartum nursing center in Changchun, the maternal and child health care hospital in Jilin province and the group through the network platform. Volunteers. Included in the standard: healthy breast mother and pure breastfeeding or mixed feeding infants, baby full moon delivery, no birth defects or diseases. Mother no smoking, drinking and other bad habits. Exclusion criteria: 37 or 42 weeks of pregnancy, 37 or 42 weeks of pregnancy, baby birth weight 2500g or 4000g. milk mother blood pressure, diabetes, coronary heart disease, obesity, liver and kidney disease and its His organs combined with the history of disease and the mother of vegetarian diet, pregnant, and lactating with polyunsaturated fatty acid supplements. All the subjects signed informed consent and the research and design were approved by the medical ethics committee of the school of public health of Jilin University. The dietary information was investigated by the 3d24h dietary review questionnaire. The dietary energy and nutrient intake of the milk mother were analyzed by using the golden key nutrition expert system software, the maternal version of the maternal Version (Shanghai camp Kang), and the dietary fatty acid intake of the milk mother and the 2009 Chinese food composition table. The milk was collected at ~3 months after twenty-second days after the milk mother and stored in the refrigerator at -80 C. The fatty acids in milk were extracted and methyl ester was extracted. The level of fatty acid methyl esters in breast milk was detected by gas chromatograph. According to the retention time of the internal standard C17:0, the fatty acid chromatographic peaks were found and the 36 fatty acid levels were calculated by the conversion coefficient of methyl ester. The proportion of fatty acids was calculated. The basic information of milk mother, 5 kinds of fatty acids, energy and nutrient intake were analyzed by SPSS16.0 software. The dietary types were divided into 4 dietary patterns by the principal component analysis of factor analysis. The multifactor rank and test of 4 dietary patterns and milk fatty acids were used. The significant dietary pattern and the milk fatty acid level were further tested by two independent samples, and the difference of fatty acid levels between different dietary patterns was analyzed. All the statistical tests were both bilateral tests. The difference in P0.05 was significant. Results: the average age of 1201 cases was 30 years, the pregnancy week was 39.29 weeks, and the average weight increased by 16.00kg. in pregnancy. In some parturients, BMI was in the normal range (58.71%), and the degree of education was mainly university, accounting for 54.73%. The number of graduate students and above and high school and below were 25.87% and 16.42%., respectively, and the family income was divided into low income (2000-5000 yuan / month), middle income (5000-10000 yuan / month) and high income (10000 yuan / month), respectively. 16.42%, 44.29% and 27.86%. have 92 mothers for natural production, accounting for 45.77%.2, and the average daily energy intake of the milk mother is 1829.42kcal, lower than the dietary nutrient reference intake (Dietary Reference Intakes, DRIs), and the energy supplied by three large capacity nutrients, carbohydrates, proteins and lipids is 52.51%, 14.42%, and 33.07%. three capacity battalions, respectively. The energy supply ratio of the nutrient is close to the recommended range, and the carbohydrate energy supply is within the acceptable range of Acceptable Macronutrient Distribution Range (AMDR), while the protein and lipid feed energy ratio is slightly higher than the recommended intake (Recommended Nutrient Intake, RNI).3, and the essential fatty acid linoleic acid (Linole) in the diet of the milk mother (Linole) The amount of ic acid, LA) and alpha linolenic acid (Linolenic acid, ALA) are 19.14g/d, 2.40g/d, which are higher than the appropriate intake (Adequate Intake, AI). The average intake of twenty carbon five enoic acids and twenty-two carbon six enoic acids, respectively, is far below the appropriate intake, milk mother. The intake of vitamin A, vitamin B1, vitamin B2, vitamin C and folic acid were lower than RNI, which accounted for 46.49%, 61.33%, 66.67%, 47.19%, 32.89%. vitamin E and nicotinic acid more than RNI, respectively, to the recommended intake of 178.82% and 101.93%. lactate diet calcium of mineral intake, severe deficiency of sodium, only RNI. 43.86% and 43.93%. iron, magnesium, potassium, selenium intake is also lower than RNI, accounting for 78.50% of RNI, 75.65%, 67.66% and 61.44%., only copper intake exceeds RNI, 119.29%, zinc intake is close to RNI, accounting for 90.25%.5 of RNI. By the principal component analysis of factor analysis, milk mother food is divided into 4 dietary patterns, respectively, bacteria algae, meats, eggs, water, respectively. The main product model 1; the model 2 with fruit and vegetable mainly; the model 3 with bean product and nut mainly; the model 4.6 with grain and potato mainly, this study detected 36 kinds of fatty acids in breast milk, saturated fatty acid (Saturated fatty acid, SFA), which accounted for the 45.41%. of total fatty acid (C16:0) mainly, accounting for 19.62%; secondly, Stearic acid (C18:0) accounted for 6.18%, lauric acid (C12:0) accounted for 5.27%, myristic acid (C14:0) accounted for 9 kinds of 4.88%. monounsaturated fatty acids (Monounsaturated fatty acid, MUFA), and the level of the total fatty acids accounted for oleic acid (C18:1n9c) mainly, accounting for 24.25%, followed by sixteen carbon enoic acid (C16:1) accounted for 2.83%. polyunsaturated fatty acids. S, PUFA) had 11 species, which accounted for 7 of the 21.09%. of total fatty acids, which accounted for 17.02% of the total fatty acids, 4 of n-3PUFA, and 3.79% of the total fatty acids. The two pathways of fatty acids were dominated by their precursors, LA and ALA, accounting for 13.70% of total fatty acids and the main product of 2.25%.n-6 PUFA and n-3 PUFA, peanut four ene. The acid (Arachidonic acid, AA) and DHA accounted for 0.04% of the total fatty acids and 2.2:1.4:1 respectively, and n-6PUFA:n-3PUFA was 4.4:1.7. The rank sum test results showed that SFA, PUFA, n-6 PUFA levels were different between the four dietary patterns. The non parametric test between the 22 patterns showed that the level of the breast milk was the norm. The milk level of type 2 was lower than that of model 4 (P=0.009), the level of n-6 PUFA in breast milk, breast milk in mode 1 was lower than that of mode 2 (P=0.007), and in model 2 breast milk, PUFA, n-6PUFA level was higher than that in mode 4 (P=0.003, P=0.004). Conclusion: 1, dietary energy intake of milk mother was lower than that of recommended energy requirement (Es). Timated Energy Requirement, EER), carbohydrate supply energy ratio is within the recommended range, while protein, lipid feed energy ratio is higher than DRIs. diet LA and ALA levels are higher than the recommended intake of DRIs recommended lactate, and EPA and DHA levels are lower than the appropriate intake.2, the dairy cow dietary micronutrients, only vitamin E, tobacco. Acid, copper was higher than recommended intake, other vitamins and mineral intake were lower than recommended intake.3. SFA level in milk mother milk was lower than model 4 in this study. PUFA level in breast milk was 2, pattern 2 was higher than model 4..
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R153.1
[Abstract]:Objective: breast-feeding women are in a special physiological state and have a high demand for nutrition. The milk secreted by mothers plays a vital role in the growth and development of infants. The fatty acids in the breast milk are important to the physical and mental health of the baby and the fatty acid level is influenced by the lactating diet. Therefore, this study aims to analyze the length of the milk. The intake of dietary nutrients from 201 cases of milk mother in spring city was divided into 4 dietary patterns by means of factor analysis, and the relationship between the dietary pattern and the composition of milk fatty acid was studied. Methods: the research object was from a postpartum nursing center in Changchun, the maternal and child health care hospital in Jilin province and the group through the network platform. Volunteers. Included in the standard: healthy breast mother and pure breastfeeding or mixed feeding infants, baby full moon delivery, no birth defects or diseases. Mother no smoking, drinking and other bad habits. Exclusion criteria: 37 or 42 weeks of pregnancy, 37 or 42 weeks of pregnancy, baby birth weight 2500g or 4000g. milk mother blood pressure, diabetes, coronary heart disease, obesity, liver and kidney disease and its His organs combined with the history of disease and the mother of vegetarian diet, pregnant, and lactating with polyunsaturated fatty acid supplements. All the subjects signed informed consent and the research and design were approved by the medical ethics committee of the school of public health of Jilin University. The dietary information was investigated by the 3d24h dietary review questionnaire. The dietary energy and nutrient intake of the milk mother were analyzed by using the golden key nutrition expert system software, the maternal version of the maternal Version (Shanghai camp Kang), and the dietary fatty acid intake of the milk mother and the 2009 Chinese food composition table. The milk was collected at ~3 months after twenty-second days after the milk mother and stored in the refrigerator at -80 C. The fatty acids in milk were extracted and methyl ester was extracted. The level of fatty acid methyl esters in breast milk was detected by gas chromatograph. According to the retention time of the internal standard C17:0, the fatty acid chromatographic peaks were found and the 36 fatty acid levels were calculated by the conversion coefficient of methyl ester. The proportion of fatty acids was calculated. The basic information of milk mother, 5 kinds of fatty acids, energy and nutrient intake were analyzed by SPSS16.0 software. The dietary types were divided into 4 dietary patterns by the principal component analysis of factor analysis. The multifactor rank and test of 4 dietary patterns and milk fatty acids were used. The significant dietary pattern and the milk fatty acid level were further tested by two independent samples, and the difference of fatty acid levels between different dietary patterns was analyzed. All the statistical tests were both bilateral tests. The difference in P0.05 was significant. Results: the average age of 1201 cases was 30 years, the pregnancy week was 39.29 weeks, and the average weight increased by 16.00kg. in pregnancy. In some parturients, BMI was in the normal range (58.71%), and the degree of education was mainly university, accounting for 54.73%. The number of graduate students and above and high school and below were 25.87% and 16.42%., respectively, and the family income was divided into low income (2000-5000 yuan / month), middle income (5000-10000 yuan / month) and high income (10000 yuan / month), respectively. 16.42%, 44.29% and 27.86%. have 92 mothers for natural production, accounting for 45.77%.2, and the average daily energy intake of the milk mother is 1829.42kcal, lower than the dietary nutrient reference intake (Dietary Reference Intakes, DRIs), and the energy supplied by three large capacity nutrients, carbohydrates, proteins and lipids is 52.51%, 14.42%, and 33.07%. three capacity battalions, respectively. The energy supply ratio of the nutrient is close to the recommended range, and the carbohydrate energy supply is within the acceptable range of Acceptable Macronutrient Distribution Range (AMDR), while the protein and lipid feed energy ratio is slightly higher than the recommended intake (Recommended Nutrient Intake, RNI).3, and the essential fatty acid linoleic acid (Linole) in the diet of the milk mother (Linole) The amount of ic acid, LA) and alpha linolenic acid (Linolenic acid, ALA) are 19.14g/d, 2.40g/d, which are higher than the appropriate intake (Adequate Intake, AI). The average intake of twenty carbon five enoic acids and twenty-two carbon six enoic acids, respectively, is far below the appropriate intake, milk mother. The intake of vitamin A, vitamin B1, vitamin B2, vitamin C and folic acid were lower than RNI, which accounted for 46.49%, 61.33%, 66.67%, 47.19%, 32.89%. vitamin E and nicotinic acid more than RNI, respectively, to the recommended intake of 178.82% and 101.93%. lactate diet calcium of mineral intake, severe deficiency of sodium, only RNI. 43.86% and 43.93%. iron, magnesium, potassium, selenium intake is also lower than RNI, accounting for 78.50% of RNI, 75.65%, 67.66% and 61.44%., only copper intake exceeds RNI, 119.29%, zinc intake is close to RNI, accounting for 90.25%.5 of RNI. By the principal component analysis of factor analysis, milk mother food is divided into 4 dietary patterns, respectively, bacteria algae, meats, eggs, water, respectively. The main product model 1; the model 2 with fruit and vegetable mainly; the model 3 with bean product and nut mainly; the model 4.6 with grain and potato mainly, this study detected 36 kinds of fatty acids in breast milk, saturated fatty acid (Saturated fatty acid, SFA), which accounted for the 45.41%. of total fatty acid (C16:0) mainly, accounting for 19.62%; secondly, Stearic acid (C18:0) accounted for 6.18%, lauric acid (C12:0) accounted for 5.27%, myristic acid (C14:0) accounted for 9 kinds of 4.88%. monounsaturated fatty acids (Monounsaturated fatty acid, MUFA), and the level of the total fatty acids accounted for oleic acid (C18:1n9c) mainly, accounting for 24.25%, followed by sixteen carbon enoic acid (C16:1) accounted for 2.83%. polyunsaturated fatty acids. S, PUFA) had 11 species, which accounted for 7 of the 21.09%. of total fatty acids, which accounted for 17.02% of the total fatty acids, 4 of n-3PUFA, and 3.79% of the total fatty acids. The two pathways of fatty acids were dominated by their precursors, LA and ALA, accounting for 13.70% of total fatty acids and the main product of 2.25%.n-6 PUFA and n-3 PUFA, peanut four ene. The acid (Arachidonic acid, AA) and DHA accounted for 0.04% of the total fatty acids and 2.2:1.4:1 respectively, and n-6PUFA:n-3PUFA was 4.4:1.7. The rank sum test results showed that SFA, PUFA, n-6 PUFA levels were different between the four dietary patterns. The non parametric test between the 22 patterns showed that the level of the breast milk was the norm. The milk level of type 2 was lower than that of model 4 (P=0.009), the level of n-6 PUFA in breast milk, breast milk in mode 1 was lower than that of mode 2 (P=0.007), and in model 2 breast milk, PUFA, n-6PUFA level was higher than that in mode 4 (P=0.003, P=0.004). Conclusion: 1, dietary energy intake of milk mother was lower than that of recommended energy requirement (Es). Timated Energy Requirement, EER), carbohydrate supply energy ratio is within the recommended range, while protein, lipid feed energy ratio is higher than DRIs. diet LA and ALA levels are higher than the recommended intake of DRIs recommended lactate, and EPA and DHA levels are lower than the appropriate intake.2, the dairy cow dietary micronutrients, only vitamin E, tobacco. Acid, copper was higher than recommended intake, other vitamins and mineral intake were lower than recommended intake.3. SFA level in milk mother milk was lower than model 4 in this study. PUFA level in breast milk was 2, pattern 2 was higher than model 4..
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R153.1
【参考文献】
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1 郭齐雅;于冬梅;俞丹;王寻;许晓丽;房sリ，
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