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ید و سلامتی

ید و سلامتی. دکتر حسن مظفری، استاد گروه تغذیه دانشکده بهداشت، دانشگاه علوم پزشکی شهید صدوقی یزد Mozaffari.kh@gmail.com. ید. ید بطور عمده بصورت یون و بیشتر در غده تیروئید و مقدار کمتری نیز در غدد بزاقی و معده وجود دارد. تمام سلول ها دارای مقدار جزئی ید هستند. اعمال ید در بدن.

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ید و سلامتی

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  1. ید و سلامتی دکتر حسن مظفری، استاد گروه تغذیه دانشکده بهداشت، دانشگاه علوم پزشکی شهید صدوقی یزد Mozaffari.kh@gmail.com mozaffari.kh@gmail.com

  2. ید ید بطور عمده بصورت یون و بیشتر در غده تیروئید و مقدار کمتری نیز در غدد بزاقی و معده وجود دارد. تمام سلول ها دارای مقدار جزئی ید هستند. Mozaffari_h@hotmail.com

  3. اعمال ید در بدن عمل اصلی ید حضور در دو هورمون تری یدوتیرونین و تیروکسین است که بر بیشتر اندام ها اثر می گذارد و برای تکامل و عملکرد طبیعی : • کل بدن • مغز و دستگاه عصبی • حفظ گرمای بدن و • متابولیسم انرژی ضروری می باشد. Mozaffari_h@hotmail.com

  4. Thyroid Hormones Contain 3-4 Atoms of Iodine Mozaffari_h@hotmail.com

  5. Mozaffari_h@hotmail.com

  6. منابع ید • مهمترین منبع طبیعی مواد غذایی دریایی • ید موجود در مواد غذایی بستگی به ید خاک دارد • بعضی از مواد غذایی گواتروژن هستند ولی در اثر حرارت از بین می روند. Mozaffari_h@hotmail.com

  7. Reference intakes for iodine • infants,0-59 months 90 μg/day • Schoolchildren, 6-12 years 120 • Children >12 years and adults 150 • pregnant and lactating women 200 Public health nutrition, Michel JG, et al, chap 13 2004 mozaffari.kh@gmail.com

  8. عوارض ناشی از کمبود • نازایی • سقط جنین • تولد نوزاد مرده • آنومالی های مادرزادی • عقب ماندگی های ذهنی • گواتر • کرتینیسم Mozaffari_h@hotmail.com

  9. World Iodine Deficiency Distribution Mozaffari_h@hotmail.com

  10. Mozaffari_h@hotmail.com

  11. Iodine Deficiency Disorder (IDD) mozaffari.kh@gmail.com

  12. Frequency distribution of students by goiter grading and cities of Yazd province. Mozaffari_h@hotmail.com

  13. Frequency distribution of students by age groups and goiter grading)(Yazd province). Mozaffari_h@hotmail.com

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  15. Goiter Mozaffari_h@hotmail.com

  16. Assessment of IDD AccordingWHO, UNCF, ICCIDD • Urinary iodine excretion • thyriod size • by palpation • ultrasonography • TSH and thyroglobolin • other indicators mozaffari.kh@gmail.com

  17. Assessment of IDD AccordingWHO, UNCF, ICCIDD Public health nutrition, Michel JG, et al, chap 12 2004 • Urinary iodine excretion mozaffari.kh@gmail.com

  18. Assessment of IDD AccordingWHO, UNCF, ICCIDD • Grade 0: no palpable or no Visible • Grade 1: palpable but not Visible • Grade 2: Visible when the neck is in a normal position. thyriod size: by palpation Public health nutrition, Michel JG, et al, chap 13 2004 mozaffari.kh@gmail.com

  19. Assessment of IDD AccordingWHO, UNCF, ICCIDD • Cretinism frequency • T4 and T3 Others Public health nutrition, Michel JG, et al, chap 13 2004 mozaffari.kh@gmail.com

  20. Management of ID • Strategies decided upon dependent on: • The severity of IDD • the accessibility of the population • The resources available mozaffari.kh@gmail.com

  21. Management of IDD Strategies • Use of iodized salt • Iodination of drinking water • Fortification of infants formulas • Fortification of other foods • Fortification of foods consumed by farm animals mozaffari.kh@gmail.com

  22. پیشگیری از کمبود ید • یددار کردن نمک: باصرفه ترین، مطمئن ترین و سهل الوصول ترین • وضع اقتصادی خانواده اثری در میزان مصرف نمک ندارد • نظارت بر میزان ید نمک در سطح کارخانه ها و مراکز توزیع به راحتی امکان پذیر است • نوع ید، یدات پتاسیم است که هم پایدار تر و هم مقاوم تر است • میزان ید اضافه شده به نمک 40 پی پی ام است • اکنون 95 درصد مردم تحت پوشش هستند • نمک یددار را باید دور از نور و در ظرف دربسته نگهداری و در پایان پخت به غذا استفاده کرد. • نباید نمک یددار را به مدت طولانی(بیش از یک سال) نگهداری نمود Mozaffari_h@hotmail.com

  23. Mozaffari_h@hotmail.com

  24. پیشگیری از کمبود ید(ادامه) • محلول روغنی یددار(خوراکی یا تزریقی) • جایی که تصحیح فوری کمبود ید نیاز باشد(شیوع گواتر بیش از 70 درصد) • جایی که نمک یددار در دسترس نیست • یک تزریق داخل عضلانی 5/0 تا یک میلی لیتر به مدت 3 تا 5 سال محافظت میکند • تجویز یک دوزخوراکی ، ذخیره 1 تا 2 سال تامین می کند Mozaffari_h@hotmail.com

  25. Assessment and elimination of IDD • Process indicators • Iodine content of iodized salt at three levels: at the production site, at the retail level and at the household level. • Coverage of iodized salt • Outcome indicators • urinary iodine secretion • thyroid size, TSH and thyroglobulin • cretinism • T4 and T3 levels mozaffari.kh@gmail.com

  26. ویتامین دی و سلامتی دکتر حسن مظفری، استاد گروه تغذیه دانشکده بهداشت، دانشگاه علوم پزشکی شهید صدوقی یزد Mozaffari.kh@gmail.com mozaffari.kh@gmail.com

  27. Vitamin ِِِِD ِH. Mozaffari-Khosravi, PhD mozaffari.kh@gmail.com Mozaffari_h@hotmail.com

  28. Vitamin D chemistry • Ergocalciferol (D2), obtained by irradiating the plant sterol ergosterol, was the major form of vitamin D used for the prevention and treatment of rickets. • Vitamin D3 is the form of vitamin D in nature, but it can be irradiating 7-dehydrocholesterol and is more effective in preventing and curing rickets than vitamin D2. Mozaffari_h@hotmail.com

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  32. Vitamin D function • Intestinal calcium absorption • Bone resorption and formation • Has Role in body immunity • Reproduction • Insulin secretion • Differentiation of keratocytes • Stimulates the active phosphate transport system in the intestine • In conjunction with parathyroid hormone, it mobilizes calcium from bone and increases renal tubular reabsorption of calcium and phosphate Mozaffari_h@hotmail.com

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  35. Vitamin D contents of selected food Mozaffari_h@hotmail.com

  36. Dietary sources Vitamin D3 exists naturally in animal products, and the richest sources are fish-liver oils. It is found in only small and highly variable amounts in butter, cream, egg yolk, and liver. Human milk and unfortified cow's milk tend to be poor sources of vitamin D, providing only 0.4 to 1 Mg/L. However, approximately 98% of all fluid milk sold in the United States is fortified with vitamin D2 (usually 10 Mg [400 IUl/qt), as are most dried whole milk and evaporated milk and some margarines, butters, soy milks, certain cereals, and all infant formula products. Mozaffari_h@hotmail.com

  37. Deficiency Vitamin D deficiency manifests as rickets in children and growing animals and as osteomalacia in adults. Mozaffari_h@hotmail.com

  38. Etiology of vitamin D deficiency • Primary • Low intake of dietary food sources • Inadequate sunlight exposure • Skin pigmentation • Secondary • Liver diseases • Renal diseases • GI diseases • Malabsorption syndrome Mozaffari_h@hotmail.com

  39. Rickets • Rickets is a disease involving impaired mineralization of growing bones. It can not only result from deprivation of vitamin D but also from deficiencies of calcium and phosphorus. • Rickets is characterized by structural abnormalities of the weight-bearing bones(e.g., tibia, ribs, humerus, radius, ulna) and is associated with accompanying bone pain, muscular tenderness, and hypocalcemic tetany, bowed legs, ''knock knees," beaded ribs (the rachitic rosary), pigeon breast, and frontal bossing of the skull. Radiography reveals enlarged epiphyseal growth plates manifested as enlarged wrists and ankles resulting from their failure to mineralize and continue growth. Patients have increased plasma and serum levels of alkaline phosphatase. Mozaffari_h@hotmail.com

  40. Bowed legs Mozaffari_h@hotmail.com

  41. osteomalacia • Patients experience muscular weakness and bone tenderness and have a greater risk of fractures, particularly of the wrist and pelvis. • Prevention of osteomalacia is usually possible with an adequate consumption of vitamin D, calcium, and phosphorus in the diet. • It has been estimated that as little as 10 to 15 minutes of sun exposure on a clear summer day, two or three times a week, is sufficient to prevent osteomalacia among most older adults. • Osteomalacia can be treated effectively with vitamin D3 in doses of 25 to 125 Mg/day; Mozaffari_h@hotmail.com

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  43. سپاسگزارم Mozaffari_h@hotmail.com

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