孕产妇个体化一日膳食安排指导常规.doc

孕产妇个体化一日膳食安排指导常规孕产妇孕早期、孕中晚期、产褥期各期指导步骤与方法(1)计算孕前体重指数（BMI）孕前BMI=孕前体重（kg）/身高（m）2标准体重（kg）=身高cm-105(2)制订孕期合理体重增长计划孕前体重指数孕期体重增加(kg)孕早期(0-12周)孕中晚期(13-40周)18.5125-1822kg0.5 kg /W（0.4-0.6）18.5-23.9115-1615kg0.4 kg /W0.35-0.5 kg24.0-27.97-121kg0.3 kg/W(28.08-111kg(3) 计算每天食物总热量按不同劳动强度和孕前体重状况选择能量系数(kcal/kg)孕前体重指数劳动强度卧床极轻体力劳动轻(中)体力劳动重体力劳动举例办公室职员、教师、售货员、钟表修理工学生、司机、电工、外科医生、体育活动者农民、建筑工、搬运工、伐木工、冶炼工、舞蹈者18.520-25354045-5018.5-23.92030354024.0-27.915-2025303528.015202530孕早期一日热量=目前体重能量系数孕中期一日热量=基础热量(标准体重能量系数)+200kcal 孕晚期一日热量=基础热量(标准体重能量系数)+200kcal哺乳期一日热量=基础热量(是标准体重能量系数)+500kcal注: （1）孕中晚期需要增加的200kcal可在基础热量的基础上增加半份谷薯类,一份孕妇奶粉，一个鸡蛋或一份鱼、肉(50克),孕中期蛋白质较孕早期增15克/日,孕晚期蛋白质较孕早期增25克/日.（2）哺乳期需要增加的500kcal可在基础热量的基础上增加2份鱼、肉、蛋（100克）、2份奶、2份粮谷类。(3)制定一天膳食安排表（食物交换份法）孕早期方案：根据算出的热量在下表中选择一日食物交换份总量与各类分布：.各热量层次全日食物量表(基础热量)孕早期各热量层次全日各类食物量表热量KCAL一日食物交换份份数谷薯类肉蛋豆类奶类蔬菜类水果类油脂类碳水化合物蛋白质脂肪量两份量(两)份量ml份量斤份量两份量汤匙份克%克%克%12001436332501.51141221795652.51645.5321300153.57332501.51141221875554.51645.53014001648332501.51141222075756.515.645.5281500174.59332501.51141222275958.515.245.526160018510332501.51141222476060.51545.525170019510442501.51141222475769.51651.5271800205.511442501.51141222675971.51651.525190021612442501.51141222876073.515.551.5242000226124450031141222965975155324210023612445003114122296578115.65925220024612445003224122296588615.959242300256.513445003224122313598815.65923.62400266.513555003224122333579716.56525250027714555003224122353589916.365242600287.5155550032241223735810115.765222700297.5156650032241223735711016.871242800307.5156650032241223945811116.47123孕中期方案：孕中期孕妇在基础热量上增加200kcal的食物,蛋白质比孕早期增加15克/日，即在相应的热量上增加1份孕妇奶粉，1份蛋鱼肉豆类, 半份谷薯类，得下表：基础热量(KCAL)总热量粗略交换份总热量谷薯类谷薯类肉蛋豆类肉蛋豆类奶类奶类蔬菜类蔬菜类水果类水果类油脂类油脂类基础+200份数量(两)份量(两)份量(ml)份量(斤)份量(两)份量(汤匙)份120014001614403.573.53.5500311410.50.513001500171530483.53.5500311410.50.5140016001816204.593.53.5500311410.50.5150017001917104.594450031141111600180020180051044500311411117001900211890510555003114111180020002219805.51155500311411119002100232070612555003114111200022002421606.513555003114111210023002623407146650031141112200240027243071466500322411123002500282520714665003224122240026002926107.515665003224122250027003027007.51577500322412226002800312790816775003224122270029003228808.517775003224122280030003329708.517885003224122孕晚期方案：孕晚期孕妇在基础热量上增加200kcal的食物,蛋白质比孕早期增加25克/日，得下表：基础热量(KCAL)总热量粗略交换份总热量谷薯类谷薯类肉蛋豆类肉蛋豆类奶类奶类蔬菜类蔬菜类水果类水果类油脂类油脂类基础+200份数量(两)份量(两)份量(ml)份量(斤)份量(两)份量(汤匙)份120014001614404.59445001.50.50.520.50.50.5130015001715304.59555001.50.50.520.50.50.514001600181620510555001.50.50.520.50.50.5150017001917105105550020.50.520.511160018002018006.5115550020.50.520.511170019002219806126650020.50.520.511180020002219806126650020.50.520.51119002100242160612665003114111200022002522506.5136650031141112100230026234071466500311411122002400272430714775003114111230025002825207.515775003114111240026002926107.515775003224111250027003027007.51577500322412226002800322880816885003224122270029003329708.517885003224122280030003329708.517885003224122产褥期哺乳妇女方案：产褥期妇女在基础热量上增加500kcal的食物,即在相应的热量上增加1份蛋鱼肉豆类, 2份谷薯类，得下表：基础热量KCAL总热量基础+500交换份数总热量谷薯类肉蛋豆类奶类蔬菜类水果类油脂类碳水化合物蛋白质脂肪量两份量两份量ml份量斤份量两份量汤匙份克%克%克%120017001917104.594450031141112360.552750.175490.257130018002018004.595550031141112360.524840.186550.275140019002118905105550031141112560.541860.182550.261150020002219805105550031141222560.517860.173650.295160021002320705.5115550031141222760.533880.170650.282170022002421606125550031141222960.548900.166650.270180023002623406.5136650031141223160.5401010.172710.273190024002724307146650031141223360.5531030.169710.262200025002825207.5156650031141223560.5651050.166710.253210026002926107.5157750031141223560.5451140.174770.265220027003027008167750031141223760.5571160.171770.256230028003127908167750032241223930.5631210.173770.248240029003228808.5177750032241224130.5731230.170770.240250030003329708.5178850032241224130.5561320.177830.251260031003430609188850032241224330.5661340.175830.244270032003531509.5198850032241224530.5751360.172830.237280033003632409.5199950032241224530.5591450.179890.247（5） 孕中期一日六餐膳食安排表在上述选择好一日总热量与食物交换份份量的基础上，按早餐25%早点5%午餐40%晚餐25%晚点5%的原则进行一日饮食安排餐次基础热量(KCAL)总热量基础+200交换份数谷薯类肉蛋豆类奶类蔬菜类水果类油脂类油脂类量(两)份量(两)份量(ml)份量(斤)份量(两)份量(汤匙)份一日12001400163.573.53.5500311410.50.5早餐4211早点11午餐63205025午点晚餐4.521.5050.25晚点11一日1300150017483.53.55003114110.5早餐4211早点11午餐74205025午点晚餐421.5050.25晚点11一593.53.5500311410.50.5早餐421早点11午餐6.754205025025午点11晚餐4.2521.5050.250.25晚点11一59445003114111早餐4211早点11午餐7420505午点11晚餐4210505晚点211一日1600180020510445003114111早餐4211早点211午餐6320505午点11晚餐5310505晚点211一日1700190021510555003114111早餐5211早点211午餐6320505午点11晚餐6320505晚点211一511555003114111早餐5311早点211午餐6320505午点11晚餐6320505晚点211一日1900210023612555003114111早餐5311早点211午餐7420505午点11晚餐6320505晚点211一日20002200246.513555003114111早餐5311早点211午餐7420505午点1晚餐6320505晚点211一日2100230026714665003114111早餐5311早点211午餐8430505午点211晚餐7420505晚点211一日2200240027714665003224111早餐5311早点211午餐8543105午点211晚餐8552105晚点211一日2300250028714665003224122早餐6.5311051早点211午餐8430505午点211（干果类晚餐7.542105晚点211一日24002600297.515665003224122早餐6.5311051早点211午餐9530505午点211（干果类晚餐7.542105晚点211一日25002700307.515775003224122早餐6.5311051早点211午餐9530505午点211（干果类晚餐8.543105晚点211一日2600280031816775003224122早餐6.5311051早点211午餐10630505午点211（干果类晚餐8.543105晚点211一日27002900328.517775003224122早餐7.5411051早点211午餐10630505午点211（干果类晚餐8.543105晚点211一日28003000338.517885003224122早餐7.5411051早点211午餐10630505午点211（干果类晚餐8.543105晚点3111（5） 孕晚期一日六餐膳食安排表在上述选择好一日总热量与食物交换份份量的基础上，按早餐25%早点5%午餐40%晚餐25%晚点5%的原则进行一日饮食安排餐次基础热量(KCAL)总热量基础+200交换份数谷薯类肉蛋豆类奶类蔬菜类水果类油脂类油脂类量(两)份量(两)份量(ml)份量(斤)份量(两)份量(汤匙)份一日1200140016459445001505052050505早餐320505早点11午餐5532025025午点11晚餐4522025025晚点11一日1300150017459555001505052050505早餐4210505早点11午餐5532025025午点11晚餐5532025025晚点11一日1400160018510555001505052050505早餐4210505早点11午餐5532025025午点11晚餐5532025025晚点11一日15001700195105550020.50.520.511早餐3.5210.5早点11午餐6.754202505午点11晚餐5.753202505晚点11一日16001800206.5115550020.50.520.511早餐4.5310.5早点11午餐5.753202505午点11晚餐5.753202505晚点211一日17001900226126650020.50.520.511早餐4.5310.5早点211午餐6.753302505午点11晚餐5.753202505晚点211一5136650020.50.520.511早餐4.5310.5早点211午餐6.754202505午点11晚餐6.753302505晚点211一日19002100246.513665002114111早餐5311早点211午餐7330505午点11晚餐7420505晚点211一日20002200256.513665003114111早餐63111早点211午餐7420505午点11晚餐7330505晚点211一日2100230026714665003114111早餐63111早点211午餐8430505午点11晚餐7420505晚点211一日2200240027714775003114111早餐63111早点211午餐8430505午点11晚餐8430505晚点211一日23002500287.515775003114111早餐74111早点211午餐8430505午点11晚餐8430.505晚点211一日24002600297.515775003224111早餐6.5311051早点211午餐9530505午点22晚餐7.533105晚点211一日25002700307.515775003224122早餐6.5311051早点211午餐9530505午点211（干果类晚餐8.543105晚点211一日2600280032816885003224122早餐6.5311051早点211午餐10630505午点211（干果类晚餐9.544105晚点211一日27002900338.517885003224122早餐7.54110