B CNG THNG TRNG I HC CNG NGHIP THC PHM

B CNG THNGTRNG I HC CNG NGHIP THC PHM

ti: KHO ST V NH GI CH DINH DNG CA TR 1-5 TUI CC HUYN VEN TP HCM

GVHD: H Th M HngNhm 3, th 2, tit 1-2Mn dinh dng

DANH SCH NHMNguyn Ngc Kha 2005120260Nguyn Th Diu Hin 2005120248Hunh Th Thu Nhiu 2005120274Nguyn Vn Tng Lm 2005120254Trn L Thi Ng 2005120335Nng Th Loan 2005120266

NI DUNG

1. TNG QUAN TI LIUSuy dinh dng tr em

Khi nim v cc hnh thi SDD tr emnguyn nhnNhng nguy c

1.1. Khi nim v cc hnh thi suy dinh dng tr emSDD l tnh trng thiu ht cc cht dinh dng cn thit lm nh hung n qu trnh sng, hot ng v tng trng bnh thng ca c th. SDD c 4 hnh thi chnh:SDD nng lng proteinthiu ht st & thiu muthiu ht vitamin Acc bnh do thiu ht Iode

NGUYN NHN

2. I TNG V PHNG PHP NGHIN CU2.1. i tng nghin cuTnh trng dinh dng ca tr em t 1-5 tui cc huyn ven TP H Ch Minh.2.2. Phng php nghin cu2.2.1. Chn mu:60 tr em t 1-5 tui gm 20 tr thuc x Trung Chnh huyn Hc Mn, 20 tr thuc x Vnh Lc A huyn Bnh Chnh v 20 tr thuc x Bnh M huyn C Chi.

2.2.2. Phng php thu thp s liuTnh hnh dinh dng- Nhn trc: nh gi cn nng, chiu cao.+ Phng php: khi tip xc vi b m xc nh tui, cn nng, chiu cao ca tr qua phiu kho st. +nh gi tnh trng suy dinh dng protein-nng lng ca c nhn:Ch yu da vo 3 ch tiu: cn nng theo tui (WAZ), chiu cao theo tui (HAZ), cn nng theo chiu cao (WHZ) da vo Z-Score (WHO-2006).

Z-score = kch thc o c- tr s trung bnh ca qun th chun lch chun ca qun th chun

Bng 2. 1: Phn loi SDD tr em di 5 tui theo cc ch s z-scoreZscoreWAZHAZWHZTrn 2Tha cn, bo ph-2 n +2Khng SDDKhng SDDKhng SDDDi -2Nh cnThp ciGy cmDi -3Nh cn nngThp ci nngGy cm nng

iu tra khu phn n* Bc 1: Chun b phiu iu tra.* Bc 2: Tin hnh phng vn b m ca tr.* Bc 3: i chiu vi Bng thnh phn thc n Vit Nam ca B y t v quy i ra n v trng lng cc thc phm mt cch hp l.* Bc 4 : nh gi khu phn n da vo bng nhu cu nng lng ca Vin dinh dng Vit Nam (2007).Tm hiu cc yu t nh hng n tnh hnh dinh dng tr: Dng phng php phng vn i vi cc b m, chh v quan st thc a.2.2.3. Phng php phn tch v x l s liuS dng tnh ton thng k tng hp v x l s liu.Da vo bng nhu cu nng lng v nhu cu cc nhm cht cho tng i tng nh gi khu phn n.

KT QUTrnh hc vnS b m (n)T l (%)Khng bit ch1220,00Cp I, II, III3456,67Trung cp tr ln1423,33Tng cng60100%

3.1. c im h gia nh3.1.1. Trnh hc vn ca mBng 3.1.1: Trnh hc vn ca m

Nhn xt: Trnh hc vn ca m ch yu l cc cp ph thng chim 56,67%. Bn cnh vn c nhng b m khng bit ch chim mt t l ng k 20%.

3.1.2. Thu nhp bnh qun u ngi trong thngBng 3.1.2: Thu nhp bnh qun u ngi trong thng

Phn loiS hT l (%)< 1.5 tr/ thng (thu nhp thp)3253,331.53tr/ thng (thu nhp trung bnh)1931,67 >3tr/ thng (thu nhp cao)915,00Tng cng60100%

Nhn xt: H gia nh ch yu thu nhp mc thp 53,33% v trung bnh 31,67.

3.2. Tnh hnh dinh dng ca tr em di 5 tui3.2.1. Tnh hnh SDD protein v nng lngBng 3.2.1.1: T l suy dinh dng tr em theo nhm tui

Nhn xt: T l suy dinh dng khng cao lm: nh cn 37,7%; t l ci cc 11,8%; gy mn 10,6%. Trong s ny, ch yu l suy dinh dng nh cn mc nh 32,8%; ch c 4,9% suy dinh dng nh cn mc nng. Thng tuiN% suy dinh dng nh cn(CN/T)% ci cc (CC/T)% gy mn (CN/CC) Nh cn mc nh Nh cn mc nngTng cng12 - 24 thng636,92,239,112,28,725 - 36 thng935,64,440,018,913,337 - 48 thng1431,55,236,713,612,149 - 60 thng3127,27,935,12,73,912 - 60 thng6032,84,937,711,810,6

3.2.2. Khu phn n thc t ca trTTTn thc phmTng s n< 3 ln3 - 5 ln> 5 lnKhng s dngN%n%n%N%1Tht cc loi603965,01423,3711,7002C cc loi602948,31016,72135,0003Trng cc loi604371,71525,023,3004Tm, cua,hi sn603355,02440,035,0005Khoai ty605083,358,311,746,76Khoai lang, sn60711,746,735,04676,77Rau xanh603253,32236,7610,0008Qu chin6024401931,71728,3009u cc loi604168,31016,735,0610,010Lc, vng6046,711,700,05591,711Bt dinh dng sa60711,735,000,05083,312Bnh cc loi604676,723,300,01220,013Ko604371,735,011,71321,714Nc ngt601626,735,011,74066,715Kem603558,323,300,02338,3

Nhn xt: Hu ht cc loi thc phm c s dng < 3 ln/ tun: ph bin l cc loi thc n protit nh: trng 71,7%; u cc loi: 68,3%; tht cc loi 65,0%; tm cua hi sn: 55,0%. Bnh ko cc loi thng c s dng < 3ln/tun. Rau xanh, qu chn c s dng t 3 - 5 ln/tun. Lc vng, khoai sn, bt dinh dng - sa thng t c s dng.

Bng 3.2.2.1: Tn sut tiu th LT - TP ca tr trong tun qua

12 - 24 thng25 - 36thng37 - 48thng49 - 60 thngNCKN (*)T l gia cc cht sinh nng lng P : L : G10,5:9,8:79,79,9:7,8:82,39,9:7,2:82,910,3:6,9:82,812:18:70 Protein ng vt/Protein Tng s16,914,512,414,225-30Lipit Thc vt /Lipit Tng s32,23636,142,525-30

Bng 3.2.2.2: Tnh cn i ca khu phn n theo nhm tuiNhn xt: - T l gia cc cht sinh nng lng: P:L:G tt c cc nhm tui u cha t so vi NCKN (Protit: Lipit: Gluxit =12:18:70).- T l: Protein ng vt/ Protein tng s thp hn NCKN (25-30).- T l Lipit thc vt/ Lipit tng s u t c v cao hn so vi NCKN.

T l tr ung vitamin A hoc vin vi cht khc: 51,7%T l tr s giun 6 thng/ln (tr >2tui): 58,3%T l gia nh s dng mui iot trong ba n: 95%

4. BN LUN4.1. c im h gia nh

Nhn chung tnh hnh kinh t, vn ha, x hi v mi trng ca qun th dn c sng cc huyn ven thnh ph H Ch Minh thp hn so vi cc ni khc trong thnh ph, iu ny s nh hng rt ln n tnh trng sc khe ca tr. Cc cp chnh quyn, cc ngnh cn quan tm nhiu hn na n vic ci thin i sng cho ngi dn, c bit l gip tr pht trin tt, gim t l tr suy dinh dng v y l nhng n v ca thnh ph H Ch Minh, trung tm kinh t,vn ha, du lch ln nht c nc.

4.2.1. Tnh hnh suy dinh dng tr em 1- 5 tuit l suy dinh dng rt cao: nh cn 37,7%; t l ci cc 11,8%; gy mn 10,6%. Trong s ny, ch yu l suy dinh dng nh cn mc nh 32,8%; ch c 4,9% suy dinh dng nh cn mc nng chnh lch qu xa t l suy dinh dng ca tr em di 5 tui ca thnh ph H Ch Minh: 4,1%do a im kho st thuc khu vc dn c c mc sng thp, trnh vn ha khng cao nn vn v chm sc sc khe dinh dng cho tr em cha c quan tm ng mc nn kt qu kho st nh vy l tng i hp l.

Khu phn n ca trNng lng v hm lng protein trong khu phn n ca tr cc la tui thp, t t 60 - 80% so vi nhu cu khuyn ngh (NCKN) ca Vin Dinh dng. C l do iu kin thu nhp thp, tr n chung cng vi gia nh, mi ngi trong gia nh n g th tr n theo y. Ngoi ra, do cc b m y thiu kin thc v dinh dng nn khng bit la chn cc loi thc n r tin, ph hp vi kinh t.Xt v tnh cn i ca khu phn n cha cn i so vi NCKN. T l gia cc cht sinh nng lng P:L:G cc nhm tui u cha t so vi NCKN (12:18:70). Cc t l Protein ng vt/Protein tng s thp hn NCKN ca Vin dinh dng. T l Lipit thc vt/ Lipit tng s t c so vi NCKN. Tuy nhin theo kho st phn ln cc b m u s dng mui iot nu n cho gia nh (95%), l mt iu ng mng khi khng phi quan tm nhiu n cc vn v thiu ht iot i vi s pht trin ca tr.Bn cnh khu phn n cha cn i, t l tr ung vitamin A hoc vin vi cht khc ch t 51,7% v t l tr s giun 6 thng/ln (tr >2tui) ch t 58,3% u mc khng cao, s nh hng n vic p ng c nhu cu khuyn ngh v mt s vi cht quan trng, c bit l vitamin A, st, km, canxi v vitamin D. iu ny cng tc ng khng nh n tnh trng dinh dng ca tr.

4.3 xut khu phn n cho tr 1-5 tui

Thc n ca tr t 1-2 tui: (ngy 3-4 ba)Cho trngGo t 40gamTrng g: 1 quRau xanh thi nh: 2 - 3 tha c phM (du n): 2 tha c phNc va Cho tht (tht ln, tht g, tht b)Go t 50gamTht g ta: 25gam (tng ng 5 tha c ph)Rau xanh thi nh: 2 - 3 tha c phM (du n): 2 tha c phNc va Cho lnGo t 40gamLn: 25gam (tng ng 5 tha c ph)Rau xanh thi nh: 2 - 3 tha c phM (du n): 1,5 tha c phNc va .

4.3.2 Khu phn n ca tr 2-3 tuiTr t 2-3 tui cn khu phn n bng 2/3 khu phn n ca ngi ln. Mi ngy nn n 4-5 ba v trong mt ngy mi ba n cn phi c s sp xp hp lTinh bt: 6 phn mi ngy, mi phn tinh bt bng:* 2/3 lt bnh m.* Tng ng 2 chic bnh quy vung.* Hoc 1/3 bt cm hoc m si.* Hoc 1/3 bt cho yn mch.Hoa qu v rau xanh: 5 phn mi ngy, mt phn hoa qu v rau xanh bng:* 1/3 nhnh bong ci xanh.* Hoc 1/3 cc sp c chua.* Hoc 1/3 cc qu vit qut.* Hoc 1/2 cc nc cam.* Hoc 2/3 qu chui

Sn phm t sa: 2 phn mi ngy mi phn sn phm t Sa bng:* 2/3 cc Sa ti.* Hoc 2/3 cc Sa chua.* Hoc 1 ming pho mt diTht: 2 phn mi ngy mi phn bng * 1,5 qu trng. * Hoc 3 tha b u phng. * Hoc 3/4 bt u nu chn

4.3.3 Khu phn cho tr 3-5 tuiv cht, tng t vi nhu cu v dinh dng ca cc thnh vin khc trong gia nh, ch khc v lng.Tinh bt: 6 phn mi ngy, mt phn tinh bt bng:* 1 lt bnh m.* Hoc 3 chic bnh quy vung.* Hoc 1/2 bt cm hoc m si.* Hoc 1/2 bt cho bt yn mch.Hoa qu v rau xanh: 5 phn mi ngy. Mt phn bng:* 2 nhnh bng ci xanh.* Hoc 1/2 cc sp c chua.* Hoc 1/2 cc qu vit qut.* Hoc 3/4 cc nc cam.* Hoc 1 qu chui nh.

Tht: 2 phn mi ngy, 1 phn thc phm giu m bng:* 2,5 qu trng.* Hoc 4 tha b u phng.* Hoc 1/4 bt u nu chnSn phm t sa: 2 phn mi ngy, mt phn sn phm t Sa bng:* 1 cc sa.* Hoc 1 cc Sa chua.* Hoc 1 1/3 ming pho mt di

TI LIU THAM KHOH Huy Khi. Tng quan tnh hnh dinh dng ti Vit Nam, Tnh hnh dinh dng v chin lc hnh ng Vit Nam, NXB Y hc H Ni, tr. 1-7 (1997).V Huy Chin. Khu phn n v mt s yu t lin quan n tnh trng dinh dng tr em 13-16 thng vng ng la Thi Bnh, Lun vn Thc s dinh dng cng ng (1996).H Huy Khi. Phng php Dch t hc Dinh dng, NXB Y hc H Ni, (1997) B Y t. Hng dn nh gi tnh hnh dinh dng v thc phm mt cng ng, NXB Y hc H Ni (1998) 13-33, 68-70.Phm Vn Hoan. Thng nht cch tnh tui v phn loi tnh trng dinh dng tr em, Bo co nghin cu khoa hc: 1987-1989, H Ni (1989) 88-93.http://www.nutrition.org.vn/news/vi/603/61/cach-phan-loai-va-danh-gia-tinh-trang-dinh-duong-dua-vao-z-score.aspx

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