临床实践指南：加拿大女性营养共识（八）

前情提要

第七章　绝经期及之后的营养

概述

  1. 绝经期女性的健康、社会或家庭环境改变可能对营养产生不良影响（如饮食习惯改变、吃饭心不在焉、健康状态差、情绪低落、家庭压力）。（III）

推荐意见

  1. 女性常常担心围绝经期体重增加，建议可通过适度的能量限制和充足的蛋白质摄入（0.8～1.2g/kg，分3餐）来减少体重增加。（III-B）

  2. 胰岛素抵抗随着年龄的增长而增加，建议绝经后女性摄入低血糖指数的复合碳水化合物。（II-2B）

  3. 推荐定期负重锻炼来保持骨骼肌质量。（I-A）

  4. 为保持骨骼健康，建议绝经后女性每天摄入1200mg钙和800IU维生素D，同时定期中到高强度身体活动包括负重运动每周至少2.5个小时（对钙的补充更多细节详见第2章）。（I-A）

  5. 绝经后女性不易吸收天然的维生素B12（II-2），应通过强化食品（如非乳制品奶品、肉类替代品）或补充剂每天摄入2.4μg维生素B12，她们可能从维生素B12状态评估中受益。（I-A）

Chapter 7: Nutrition During Menopause and Beyond

Summary Statement

  1. Changes in women's health, social, or family circumstances at the time of menopause may adversely impact nutrition (e.g., changes in meal habits, distracted eating, ill health, mood, family stresses). (III)

Recommendations

  1. Women are often concerned with perimenopausal weight gain; advise that weight gain can be reduced by modest calorie restriction, along with adequate protein intake (0.8 to 1.2 g/kg divided over 3 meals). (III-B)

  2. Insulin resistance increases with age; recommend that menopausal women consume complex carbohydrates with a low glycemic index. (II-2B)

  3. Recommend regular, weight-bearing exercise to preserve skeletal muscle mass. (I-A)

  4. To preserve bone health, advise a daily intake of 1200 mg calcium and 800 IU vitamin D to menopausal women, along with regular moderate- to vigorous-intensity physical activity of at least 2.5 hours per week which includes weight-bearing activity (see Chapter 2 for more detail on calcium supplementation). (I-A)

  5. Menopausal women are less likely to absorb naturally occurring vitamin B12 (II-2) and should aim to consume 2.4 μg/day through fortified foods (e.g., non-dairy milks, meat substitutes) or supplements, and may benefit from having their B12 status assessed. (I-A)

翻译：肖慧娟（天津市第三中心医院营养科）

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