Nutritional Needs of Infants and Toddlers

    In most cases, breast milk or formula can provide the nutrients your baby needs in the first four to six months. After 4 to 6 months of age, as the baby's diet gradually changes from a full-liquid diet to a diet with more and more solid foods, he may or may not need additional nutritional supplements. It will depend on how balanced the baby’s diet of six categories (grains, roots, rhizomes, meat, fish, egg, milk, oils and fats, vegetables and fruits). But there are exceptions. For example, if the baby was born premature, at a low birth weight, or has a small gestational age at birth, extra vitamin supplements may be needed. Or, compared with other babies of the same age, if the baby has been drinking less breast milk or formula, yet there is no additional supplements from food to make up the insufficiency. Or, if the baby has poor appetite, poor food intake of the main meal, excessive partial eclipse, or do not like to eat fruits and vegetables, and thus cause imbalance of nutrition, then parents should consider nutritional supplements to help the baby to supplement moderately. The health of the mother will also affect the nutrition of breast milk. For example, mothers who have undergone gastric bypass surgery or take certain medications daily may have a poorer ability to absorb nutrients, which could reduce nutrients in breast milk. Or if the breastfeeding mothers are vegetarians, lacking vitamin B12, iron, zinc, calcium and omega-3 fatty acids are often occurred. Vegan mothers and babies may need extra effort to make up insufficient nutrients through food or multivitamin mineral supplements. The nutritional status of most infants and young children in Taiwan is either over-nutrition or deficiency. “Balanced Nutrition" is the key to make your baby grow up healthily. Nutritional unbalanced babies, their development may be slow. Therefore, it is important to develop a good eating habit when the baby is 1 to 3 years old. Get balanced nutrients from food, along with additional supplementations recommended by doctors, can help the baby build a good foundation in the key periods of growth and develop good intelligence and physical strength. For babies who need supplemental nutrition, here are two principles as guidelines for Daddy and Mommy to follow: First, in addition to carefully observing whether the baby really needs nutritional supplements, you can also consult doctors and get advised. Then aim at the missing nutrients, get the right amount supplements whether by food or nutritional supplements. However, do not try to supplement everything, that will only make the baby's nutrition more imbalanced. Second, when babies supplement the nutrition, the dose should be much less than adults. Because the baby's body organs are not yet fully developed, the amount of need is less than that of adults. Must be aware of the dosage on the label. The excessive amounts of vitamins may cause the baby's physical burden. Here are some nutritional supplements your baby’s doctor may recommend: Iron – Iron deficiency is a common syndrome in children, especially in infants from 6 months to 2 years old. A large number of studies have proven that iron deficiency in infants and young children might affect the growth and development. Both breast milk and formula contain iron, but when the baby starts to eat solid food, the demand for iron will gradually increase. The faster the baby grows and develops, the more iron is needed, and the more likely it is to have iron deficiency. Studies have shown that normal full-term babies have an iron storage of 280 mg at birth, but this only meets the iron the baby needs 4-6 months after birth. The baby's iron requirement in 6 months is 0.3 mg / day, and will increase directly to 10 mg / day after 6 months. It is important for your baby to get a good source of iron from food. Good sources include meat puree, iron fortified grains and lentils, lentils, kidney beans, black beans and pinto beans. If your baby does not eat enough iron-rich foods, your baby's doctor may suggest iron supplementation. In addition, for premature infants, twins, multiple births are more likely to have anemia and usually have more needs to supplement iron. Vitamin D –  Only a small amount of vitamin D will be transferred to breast milk. That's why the American Academy of Pediatrics (AAP) now recommends that you give your breast-fed baby supplement 400 IU of vitamin D daily from birth. Infants who are exclusively breastfed or partially formula-fed but drink less than 32 ounces of formula per day also need to replenish 400 IU of vitamin D daily. Our bodies produce vitamin D after the skin is exposed to sunshine. In general, babies within 6 months should not be exposed to sunlight directly. Because baby's skin is very delicate; when expose to the sun improperly, it is easy to cause skin burns. Meanwhile, if the sun directly hit baby's eyes, it is also easy to cause cataracts, the risk is high. Sunscreens could help keep your baby safe in the sun, but it also blocks the rays that enable the body to produce vitamin D. Vitamin D is essential in helping the body absorb and use calcium; in fact, the body cannot absorb calcium at all without some vitamin D. As a result, in order to make the child's bones growth, Vitamin D deficiency cannot be overlooked. Vitamin B12 – Vitamin B12 is critical for the development of the nervous system. This vitamin is naturally found in fish, meat, poultry, eggs, milk and dairy products. If you are breastfeeding and you don't eat much (or any) animal protein, it's important to have a regular and reliable source of vitamin B12 – whether it's from a supplement or fortified foods – so your baby's diet will contain adequate amounts of the vitamin B12. DHA – DHA is an omega-3s fatty acid that is important for babies. 6 months to 2 years old is the fastest growing age of your baby. DHA can help your baby's developmental needs. In addition, the baby's intake of appropriate amount of DHA can affect his ability to respond and observe, which can promote his hand-eye coordination ability. The content of DHA in the diet of the breastfeeding mothers is shown proportionally in her breast milk. In short, if your DHA intake is low, your breast milk levels will be low. Breastfeeding mothers who do not consume DHA from food sources – especially vegans and vegetarians – may need to consider taking DHA supplements. According to some researches, vegans and vegetarians’ moms and their babies have lower levels of DHA in their blood than those who eat meat.      

嬰兒的營養須知 – 寶寶需要吃營養品嗎?

    在大多數情況下,母乳或配方奶粉可以提供嬰兒在頭四到六個月內所需的營養。四到六個月後,隨著寶寶的飲食從全液體飲食逐漸變為含有越來越多固體食物的飲食,只要是均衡攝取六大類(五穀根莖類、魚肉豆蛋類、奶類、油脂類、蔬菜類、水果類)飲食的寶寶,一般而言並不需要額外的營養補充品。 但也有例外。例如,如果寶寶是早產兒,出生時體重不足或胎齡小,則可能需要再醫師建議下攝取補充品。或是與其他同齡嬰兒相比,一直飲用較少的母乳或配方奶,卻也沒有從食物中補充不足的營養素的寶寶。或是寶寶有食慾差、主餐攝食情況不佳、過度偏食、不愛吃蔬果等現象,進而造成營養不均衡的問題,爸媽也可考慮以營養品的方式幫寶寶適度補充。 媽媽的健康狀況也會影響母乳的營養。例如,進行過胃繞道手術或每天服用某些藥物的媽媽可能營養吸收的能力較差,這會減少母乳中的營養成分。或者哺乳媽媽為純素或素食者,維生素 B12,鐵,鋅,鈣和 Omega-3s 脂肪酸等就很有可能不足,純素食媽媽和嬰兒可能需要額外努力透過飲食或多種維生素礦物質補充劑來補足營養。 台灣多數嬰幼兒的營養狀況,不是營養過剩就是不足,「營養均衡」是讓寶寶健康成長的關鍵。營養不均衡的寶寶,可能發展受到影響。在寶寶 1~3歲時就要養成良好的飲食習慣,攝取均衡完整的營養素,輔以專業醫生推薦的專業配方,才能幫助寶寶在黃金關鍵成長期打好基礎,贏在起跑點。 對於需要補充營養品的寶寶,兩大原則提供爸比媽咪參考:第一,除了可以仔細觀察寶寶是否真正需要營養品的補充外,也可諮詢醫師、專業營養師的意見;針對寶寶缺乏的營養素去適量補充,不論由食物或補充品,但千萬不可有一網打盡的吃法,這樣只會讓寶寶的營養更失衡。第二,寶寶補充營養品時,食用量不用成人這麼多。因為寶寶的身體各部器官尚未發育完全,需要量較成人少,應特別注意標示上的劑量,補充過量反而造成寶寶的身體負擔,得不償失。以下是醫生建議寶寶可能需要的營養補充劑: 鐵:缺鐵兒童以 6 個月至 2 歲的嬰幼兒最為多見。研究證明,嬰幼兒鐵缺乏可能會影響嬰幼兒的生長等。母乳和配方奶都含有鐵,但從寶寶開始吃固體食物的時候,鐵的需求量會逐漸增加。有研究顯示,正常足月的寶寶出生時體內鐵儲存量為 280 毫克,但這僅能滿足寶寶出生後 4-6 個月的鐵需求。6 個月內的寶寶鐵需求量為 0.3 毫克/天,6 個月後會直接增加到 10 毫克/天。寶寶從食物中獲取良好的鐵來源非常重要,好的來源包括肉泥,鐵強化穀物和扁豆,扁豆,菜豆,黑豆和斑豆等。如果您的寶寶不吃富含鐵的食物,寶寶的醫生可能會建議補鐵。 維生素 D:只有少量的維生素 D 會轉移到母乳中。這就是為什麼美國兒科學會(AAP)現在建議您母乳餵養的嬰兒,從出生開始,每天補充 400 IU 的維生素 D。純母乳或部分配方奶餵養但每天飲用少於 32 盎司配方奶粉的嬰兒,也需要每日補充 400 IU 維生素 D。皮膚暴露在特定波長的陽光下後,我們的身體會產生維生素 D。一般來說,6 個月內的嬰兒不應直接暴露在陽光下,因為寶寶的皮膚非常嬌嫩;當不適當地暴露在陽光下時,很容易引起皮膚灼傷。同時,如果太陽直射寶寶的眼睛,也容易引起寶寶眼晶狀體白內障,風險很高。防曬乳有助於保持嬰兒在陽光下的安全,但它也阻擋了讓身體產生維生素 D 的光線。維生素 D 對幫助身體吸收和使用鈣質至關重要。事實上,維生素 D 增進鈣吸收,幫助骨骼與牙齒的生長發育。因此,為了讓孩子的骨骼生長發育,維生素 D 的缺乏不容忽視。 維生素 B12:維生素 B12 有助於紅血球的生成。增進神經系統的健康。這種維生素天然存在於魚類、肉類、家禽、蛋類、牛奶和奶製品中。如果您是母乳餵養並且您不太吃(或任何)動物蛋白,那麼補充維生素 B12 是很重要的 – 無論是來自營養補充品還是強化食品 – 這樣您的寶寶的飲食才會含有足夠的維生素 B12。 DHA:DHA 是一種對嬰兒發育很重要的 Omega-3s 脂肪酸。母乳媽媽飲食中 DHA 和必需脂肪酸的含量,成比例地顯示在母乳中。簡而言之,如果您的 DHA 攝入量很低,那麼您母乳中的含量也會很低。因此通常建議媽媽食用魚油補充品。據研究發現,素食和素食主義者母親及其嬰兒的血液中,其 DHA 含量低於吃肉的人。      

What to Eat While Breastfeeding

    Although formulas have been around for decades, the value of breast milk for babies is still irreplaceable. There are thousands of nutrients in the mother’s milk, many of which are beneficial to the development of the brain and nervous system, and are most effectively absorbed by the baby. Also, compared to formula, breast milk is relatively safe and non-polluting. After nine years of research on the growth patterns of young children in six very different countries (Brazil, Ghana, India, Norway, Oman and the United States), the United Nations World Health Organization (WHO) has set international standards for children under age of 5, which is applicable for children worldwide. WHO believes that beyond genetic and ethnic factors, the major differences in the growth for children under five years of age are influenced by nutrition, feeding methods, environment and health care, and WHO's conclusion is "Breastfeeding is recommended!" Breastfeeding has all sorts of benefits for both mother and baby. While breastfeeding, a healthy diet will provide a mother with the energy she needs to care for herself and her baby. More importantly, eating healthy foods could help mothers shed the pregnancy weight faster. Breast milk is very nutritious, it contains everything a baby requires for proper development during the first six months of life. The World Health Organization and UNICEF recommend that breastfeeding begin within one hour after delivery; exclusive breastfeeding should be carried out during the first six months of life; adequate nutrition and safe non-staple foods should be added at the age of six months, while continuing breastfeeding for two years or more. The composition of breast milk is dynamic. From the first day of birth to the last day of breastfeeding, the fat, carbohydrate and protein composition of breast milk will change with the growth and development of newborns to meet the special needs of individual infant’s demand. The ingredients of breast milk change along with the time of breastfeeding. The milk at the beginning of a feeding is more watery, and the milk that comes later is thicker, higher in fat and more nutritious. The pre-milk allows the baby to quench his thirst, while the high-fat post-milk is the food for the baby and gives the baby a message to stop sucking. Generally, an ounce (28 ml) of breast milk contains 19–23 calories, with 3.6–4.8% from protein, 28.8–32.4% from fat and 26.8–31.2% from carbs, mostly lactose. Moreover, breast milk also contains a variety of vitamins and minerals, such as vitamins A, D, E, K, beta carotene, calcium, potassium, chlorine, iron, zinc and so on. Breast milk can fully meet the nutritional needs of infants for the first 6 months. After 6 months, even if adding non-staple foods to the baby’s diet, breast milk can continue to provide important nutrients and growth factors for up to 2 years. Therefore, breast milk is considered to be the Godsent perfect food for the baby. Breastfeeding mothers require 500 more calories per day than non-breastfeeding mothers, but each mother is different and your energy needs change with the breastfeeding process. The number of calories you need will depend on your baby’s age, size and appetite, as well as your own body BMI, exercise volume, and other factors, such as whether your baby is exclusively breastfed, or whether you are feeding twins or multiple births. As the demand for calories increases, the nutritional needs of women during breastfeeding will also increase. In fact, many of the nutritional needs during lactation are actually higher than during pregnancy, and your breastmilk are a reflection of the nutrients in your diet, including fat-soluble vitamins and some B-vitamins (see Group 1 nutrients). This means that if your diet does not provide these nutrients, then your baby won’t get them either. For other nutrients, the levels in your breastmilk are not directly correlated to your diet, including important minerals such as folic acid, calcium, iron and zinc (see Group 2 nutrients). Even if they are not in your diet, these nutrients will be present in your breast milk. However, if these nutrients are low in your diet, your body will transfer these nutrients from your bones and tissues to your breast milk for delivery to your baby. Therefore, your baby will always get the nutrition she or he needs, but this may come at the cost of leaving you depleted. Group 1 Nutrients  Below are the group 1 nutrients and some common food sources : Vitamin B1 (Thiamin) : Fish, pork, seeds, nuts and bread. Vitamin B2 (Riboflavin) : Cheese, almonds, nuts, red meat, oily fish and eggs. Vitamin B6 : Seeds, nuts, fish, poultry, pork, bananas and dried fruit. Vitamin B12 : Shellfish, liver, oily fish, crab and shrimp. Choline : Eggs, beef liver, chicken liver, fish and peanuts. Vitamin A : Sweet potatoes, carrots, dark leafy greens, organ meats and eggs. Vitamin D : Cod liver oil, oily fish, some mushrooms and fortified foods. Selenium : Brazil nuts, seafood, fish, whole wheat and seeds. Iodine : Dried seaweed, cod, milk and iodized salt. If you are deficient or don’t get adequate amounts Group 1 nutrients in your diet, the amount of Group 1 nutrients in your breast milk will be substantially reduced. Therefore, it is important for you and your baby to get sufficient amounts of these nutrients from your diet or supplement. Group 2 Nutrients  Below are the group 2 nutrients and some common food sources : Folate : Beans, lentils, leafy greens, asparagus and avocados. Calcium : Milk, yogurt, cheese, leafy greens and legumes. Iron : Red meat, pork, poultry, seafood, beans, green vegetables and dried fruit. Copper : Shellfish, whole grains, nuts, beans, organ meats and potatoes. Zinc : Oysters, red meat, poultry, beans, nuts and dairy. The amounts of nutrients in Group 2 in breast milk are not affected by your dietary intake or body stores. If your intake is low, your body will take these nutrients from your own bones and tissue stores to secrete them into your breast milk. Therefore, your baby will always get the right amount of nutrients. However, if you don’t have enough from your diet, your body will be suffered and depleted. To avoid deficiency, these nutrients must come from your diet or supplements. For most women, while it may seem intuitive to stop taking prenatal vitamins after birth, continuing to take them postpartum can help ensure that you get the nutrients you need during lactation. In fact, taking a prenatal while nursing may be especially important given that many nutrient demands increase while breastfeeding. In other words, you should not rely on your prenatal vitamins to meet all your nutritional needs. Here are some of the specific nutrients that many breastfeeding women are lack, and you should know which nutrients to supplement to help you and your baby get the best nutrition. 1. Make sure you get enough Vitamin D while breastfeeding – The amount of vitamin D found in breast milk is directly related to the level of vitamin D in the mother. Unfortunately, common factors such as lack of sun exposure and limited fish intake may affect the adequate vitamin D stores of a new mother’s. As a result, the amount of vitamin D provided by breast milk is generally insufficient to meet the dietary needs of a developing infant. So what should breastfeeding mothers do to help solve this problem? In order to transfer enough vitamin D to breast milk, research reports that breastfed mothers need to take enough Vitamin D per day. Pediatricians also strongly recommend supplementing infants with vitamin D. However, even if you supplement your baby with vitamin D, it’s still important for you, a breastfeeding mother, to supplement yourself in order to prevent the depletion of your own vitamin D stores. 2. Obtaining a sufficient amount of Omega-3s fatty acids EPA and DHA during breastfeeding is critical – DHA is very important for both mother and baby during pregnancy, and in order to provide enough amount for her fetus, a mother’s DHA stores can easily become depleted. Unfortunately, this cycle continues when you are breastfeeding. In short, if your DHA intake is low, then the amount in your breast milk will be low. American Pregnancy Association recommended that pregnant and lactating women take at least 300 mg of DHA per day. Meanwhile, don’t forget other key omega-3s, EPA. More importantly, the consumption of sufficient amounts of EPA and DHA has also proven beneficial to body composition. Some studies have shown that supplementation with Omega-3s fatty acids can help women recover to pre-pregnancy weight more quickly, especially combine with breastfeeding.        


    儘管配方奶已經問世數十年,母乳的價值仍然是不可替代的。母乳中含有數千種營養素,其中許多有益胎兒的發育與生長,並且能最有效地被嬰兒吸收。此外,與配方奶相比,母乳相對安全無污染。經過九年對六個不同國家(巴西,加納,印度,挪威,阿曼和美國)幼兒生長方式的研究,聯合國世界衛生組織(WHO)訂出 5 歲以下幼童「兒童成長標準」的國際標準,而且是全球各地的兒童一體適用。世界衛生組織認為,超越遺傳和人種因素,五歲以下兒童成長的主要差異受到營養、餵養方法、環境和保健的影響,而且結論是推薦母乳餵養! 母乳餵養對媽媽和寶寶雙方都有好處。在母乳餵養期間,健康的飲食將為媽媽提供照顧自己和寶寶所需的能量。更重要的是,吃得健康可以幫助媽媽更快地減輕懷孕時的體重。母乳非常有營養價值,它可以提供嬰兒在前六個月內正常發育所需的一切營養。世界衛生組織以及聯合國兒童基金會建議:在分娩後一小時內即可開始母乳餵養; 在寶寶出生後頭六個月應進行純母乳餵養; 在寶寶六個月大時添加適當的營養和安全的副食品,同時持續母乳餵養兩年或更長時間。 母乳的成分是變動的,從寶寶出生的第一天到母乳餵養最後一天,母乳中的脂肪,碳水化合物和蛋白質成分將隨著新生兒的生長發育而變化,以滿足個體嬰兒的特殊需求。母乳成分會隨著哺乳時間而變化,在餵食開始時的前乳較富含水分,接近結束的後乳則較濃郁,脂肪更高,營養更豐富。前乳可讓嬰兒解渴,而高脂肪的後乳才是餵飽嬰兒的食物,並且向寶寶發出停止吸吮的訊息。一般來說,一盎司(28 毫升)母乳含有 19 – 23 卡路里,蛋白質含量為 3.6 – 4.8%,脂肪含量為 28.8 – 32.4%,碳水化合物含量為 26.8 – 31.2%,主要是乳糖。此外,母乳也含有多種維生素和礦物質,如維生素 A、D、E、K、β 胡蘿蔔素、鈣、鉀、鐵、鋅等。母乳可以滿足嬰幼兒前六個月的營養需求。六個月後,即使在飲食中加入副食品,母乳仍可持續提供長達兩年的重要營養物質和關鍵元素,母乳可說是上天賜與寶寶最完美的食物。 與非母乳餵養的媽媽相比,母乳餵養媽媽每天需要的卡路里數量要多出 500 卡,但每位媽媽都不一樣,您的能量需求隨著母乳餵養過程而變化。您需要的卡路里數量取決於寶寶的年齡、體型和食慾,以及您自己身體的 BMI 指數,運動量和其他因素,比如您的寶寶是否為純母乳餵養,或您是否餵養雙胞胎或多胞胎等。隨著卡路里需求的增加,女性在母乳餵養期間的營養需求也會增加。 事實上,哺乳期間對許多營養需求實際上高於懷孕期,您的乳汁可反映了您飲食中的營養成分,這些包括脂溶性維生素和一些 B 群維生素(見第 1 組營養素)。 這意味著,如果您的飲食不提供這些營養素,那麼您的寶寶也不會得到它們。至於部份與您的飲食沒有直接相關,不會反應在您母乳中的營養素,包括葉酸、鈣、鐵和鋅等重要礦物質(見第 2 組營養素),即使它們不在您的飲食中,這些營養素也會存在於您的母乳中。然而,如果您的飲食中當這些營養素含量低,您的身體將從您的體內和組織中提取這些營養素轉移至您的母乳中提供給寶寶。 因此,您的寶寶終將獲得他所需的營養,但這可能會以讓您耗盡自己為代價。 以下是第 1 組營養素和一些常見食物來源: 維生素 B1(硫胺):魚,豬肉,種子,堅果和麵包。 維生素 B2(核黃素):奶酪,杏仁,堅果,紅肉,油性魚和蛋。 維生素 B6:種子,堅果,魚類,家禽,豬肉,香蕉和乾果。 維生素 B12:貝類,肝臟,油性魚,蟹和蝦。 膽鹼:雞蛋,牛肝,雞肝,魚和花生。 維生素 A:紅薯,胡蘿蔔,深色綠葉蔬菜,器官肉和蛋。 維生素 D:鱈魚肝油,油性魚,一些蘑菇和強化食品。 硒:巴西堅果,海鮮,魚類,全麥和種子。 碘:乾海藻,鱈魚,牛奶和碘鹽。 以下是第 2 組營養素和一些常見食物來源: 葉酸:豆類,扁豆,綠葉蔬菜,蘆筍和鱷梨。 鈣:牛奶,酸奶,奶酪,綠葉蔬菜和豆類。 鐵:紅肉,豬肉,家禽,海鮮,豆類,綠色蔬菜和乾果。 銅:貝類,全穀物,堅果,豆類,器官肉和土豆。 鋅:牡蠣,紅肉,家禽,豆類,堅果和乳製品。 母乳中第 2 組營養素的含量不受您的飲食攝入量或身體儲存量的影響。如果您的攝入量很低,您的身體會從您自己的骨骼和組織儲存中攝取這些營養素,分泌到您的母乳中。因此,寶寶終將獲得適量的營養素。但是,如果您的飲食中沒有足夠的量,您的身體儲備將會耗盡。為避免缺乏,這些營養素必須來自您的飲食或營養補充品。 對大部分婦女而言,在生產後停止服用產前維生素似乎理所當然,但在產後繼續服用,可以幫助確保您在哺乳期間獲得所需的各種營養素。事實上,鑑於母乳餵養期間許多營養需求增加,在哺乳期間繼續服用產前維生素可能更為重要。 也就是說,您不應該依賴您的產前維生素來滿足您所有的營養需求。以下是許多母乳喂養女性缺乏的特定營養素,您應該瞭解該補充哪些營養素,以幫助您和寶寶獲得最佳的營養。 1. 確保在哺乳期間攝取足夠的維生素 D – 母乳中維生素 D 的含量與母親體內維生素 D 的含量直接相關。不幸的是,許多常見因素可能會影響新手媽媽攝入足夠的維生素 D。結果,通過母乳提供的維生素 D 的量通常不足以滿足發育中嬰兒的飲食需求。那麼母乳餵養的母親應該做些什麼來幫助解決這個問題呢?為了將足夠的維生素 D 轉移到母乳中,研究報告稱母乳餵養的媽媽每天需固定補充。兒科醫生也強烈建議嬰兒出生後即開始補充維生素 D,然而,即使您幫寶寶補充了維生素 D,您仍然需要補充自己,以防止自己的維生素 D 耗盡。 2. 在母乳餵養期間,獲得足夠量的 Omega-3s 脂肪酸 EPA 和 DHA 至關重要 – 懷孕期間 DHA 對媽媽和寶寶來說都非常重要,為了給胎兒提供足夠的量,母親的 DHA 存量很容易被耗盡。 不幸的是,當您母乳餵養時,這個循環仍舊繼續。 簡而言之,如果你的 DHA 攝入量很低,那麼你母乳中的含量也會很低,美國孕婦協會 (American Pregnancy Association) 建議孕婦和哺乳期婦女每日攝取最少 300 毫克的 DHA。同時不要忘記其他關鍵的 Omega-3,EPA。 大量研究表明,EPA + DHA 對產前與產後的媽媽有許多的益處。一些研究表明補充 Omega-3s 脂肪酸可以幫助婦女更快地恢復到孕前的體態,特別是與母乳餵養結合。      

Is It Safe To Take "EPA" In Pregnancy?

    Moms-to-be need to supplement DHA, which is well known. The American Pregnancy Association recommended that pregnant women should have a daily DHA intake of no less than 300 mg to meet their baby’s development needs. However, nowadays, due to too many sources of pollution, the accumulation of heavy metals, environmental toxins, animal drugs in fish has multiplied. If you eat fish every day, you might put yourself and your unborn baby’s health at risk. Another topic that is often debated on the Internet – “Should pregnant women take EPA or not?”. Rumor has it that taking EPA could lead to some negative effect. The fact is EPA itself is not risky for pregnant women at all. In Taiwan, some manufacturers used such information to manipulate, obfuscate and mislead consumers, EPA has been rumored to be a bad nutrient for pregnant women. The most correct theory is: 100% of pregnant women need EPA, but need to control the intake of EPA. Taking EPA has many positive effects on pregnant women and fetuses; this part has been confirmed by many clinical studies. Nowadays, many medical professionals, including well-known obstetricians and gynecologists, who have all recommended EPA could be taken during pregnancy until delivery, and proved it’s riskless to pregnant women. Here Are Our Recommendations For Pregnant Women : 1. Take fish oil containing a small amount of EPA, and the DHA content is recommended to be more than 300 mg. 2. Do not take only DHA-containing algae oil, because DHA is insufficient for pregnant women and fetuses. Only 4%-11% of DHA in the body can be converted to EPA, which is not enough to provide the daily needs for pregnant women. 3. Select fish oil wisely. Choose fish oil has fair inspection reports, especially for freshness, heavy metals, environmental toxins, and microbiological tests. 4. It is good to have a good third-party agency to recommend the brand; it’s another kind of quality assurance. 5. Small size capsules of fish oil are more suitable for pregnant women and women to swallow.    

Vitamin D May Be The Most Important Nutrient You Overlooked

    The innumerable effects of vitamin D on the human body have been confirmed by many studies over the past decades. However, the importance and demand of this important vitamin for the human body is still commonly misunderstood. MISUNDERSTANDING 1 : YOU CAN USE FOOD TO GET ENOUGH VITAMIN D Unfortunately, this is a misconception. Only a small amount of food contains vitamin D, and the content is not high. It is impossible to obtain sufficient vitamin D from the food source alone. Sources of vitamin D in the diet include oil-rich fish (such as salmon, mackerel, sardines, squid, etc.), egg yolk, beef liver, and mushroom mites. However, these foods usually contain low levels of vitamin D, less than 150 IU per serving. The two main ways to get vitamin D are by exposing your bare skin to sunlight and by taking vitamin D supplements. MISUNDERSTANDING 2 : IF YOU LIVE IN A SUNNY AREA, YOU SHOULD GET ENOUGH VITAMIN D Getting enough sunlight is very important for maintaining optimal vitamin D levels. The sun’s ultraviolet B (UVB) rays hit cholesterol in the skin cells, providing the energy for vitamin D synthesis to occur. However, where you live, the season, and the time of day affect how much ultraviolet B ( UVB) also influence your production of vitamin D. Even if you live in a sunny area, you still can’t get enough vitamin D from the sun. During the winter season, there is very little UVB in the form of UVB in the north latitudes – these amounts are not sufficient to produce vitamin D. The norther the place of residence ( the farther away from the equator), the less the UVB. For example, in North Atlanta, USA, from November to February, UVB ultraviolet rays that produce vitamin D are clearly insufficient. Some northern areas, such as New York City, the time lacking of UVB is even longer. FACT 1 : VITAMIN D IS ACTUALLY A HORMONE RATHER THAN A VITAMIN What makes vitamin D unique compared to other vitamins, is that when your body gets its vitamin D, it turns vitamin D into a hormone. This hormone is sometimes called “activated vitamin D” or “calcitriol.” It plays an important role in many parts of the human body. In recent studies, we have found more and more functionality that we did not know about vitamin D before. FACT 2 : FDA DOUBLES THE AMOUNT OF VITAMIN D DAILY INTAKE RECENTLY Vitamin D adequacy is best determined by measurement of the 25-hydroxyvitamin D concentration in the blood. In many recent vitamin D studies, there is a growing consensus among medical experts that the ideal concentration of vitamin D in the blood should be above 75–80 nmol/L. Even though people have gradually realized the importance of vitamin D to the human body, the testing result shows that most people still overlook the vitamin D deficiency. Many domestic and international inspection reports indicate that everyone must pay more attention to whether the body is adequate of vitamin D, and supplement it early. To help people increase their vitamin D intake, many health organizations have increased their daily recommended intake of vitamin D. In 2010, the US FDA doubled the daily recommended intake of vitamin D. In 2016, the FDA doubled again – for adults and children over the age of four, the recommended intake increased from 400 IU to 800 IU. Even though the FDA has significantly increased the daily recommendation of vitamin D, many experts and scholars still feel inadequate and worried. This is why the detection of vitamin D is very important, the adequacy of vitamin D content in your body can be confirmed after testing. The daily intake of high-quality vitamin D supplements could ensure that you get enough vitamin D content regardless of the weather or other environmental factors in your place of residence.    

Why Vitamin D Supplementation Matters For Babies?

    Vitamin D is critical for improving calcium absorption. It is involved in the growth and development of bones and teeth. In order for children to win at the starting point, vitamin D must not be ignored. 1. WHY VITAMIN D SUPPLEMENTATION MATTERS FOR BABIES? Newborns are rarely taken out to a sunbath, and his/her vitamin D supplementation can only be obtained from breast milk or formula. If the mother has higher vitamin D levels, her breastfed baby would receive higher vitamin D levels through the breast milk. Formula milk is also designed to take the lack of vitamin D into consideration. In order to prevent the baby from having vitamin D deficiency, there are two things to be aware of: first of all, the mother must supplement sufficient vitamin D herself. Secondly, if the mother’s vitamin D level is low or the breastfeeding time is longer, giving the baby extra vitamin D supplementation is considered. 2. DOES BREAST MILK CONTAIN VITAMIN D? WHAT IS THE RECOMMENDED AMOUNT OF VITAMIN D INTAKE? For babies, due to the diet limits, small amount of food intake, and lesser sun exposure, taking a supplement to achieve recommended levels of vitamin D intake is necessary. The average vitamin D content in breast milk is 22 IU/L (15-50 IU/L). Calculated by the average infant’s daily intake of 750 ml, the pure breastfeeding baby can only get about 11-38 IU/Day of vitamin D through the mother’s milk. It is far below the recommended intake of 400 IU/Day. Therefore, breastfed or semi-breastfed babies, and babies who are maladaptive to formula or complementary foods may generally have vitamin D deficiency. Taiwan Pediatrics Association recommended that exclusively breastfed or partially breastfed babies should be supplemented 400 IU of vitamin D daily. In addition, children who use formulas need to give 400 IU of vitamin D supplement per day if they consume less than 1,000 ml of vitamin D-rich formula or milk powder daily. In 2008, the American Academy of Pediatrics (AAP) recommended that all newborns to be supplemented with 400 IU per day right after birth, compared with the past, which is doubled the recommended dose to ensure that the daily needs of infants and young children are met. 3. WHEN SHOULD YOU STOP GIVING VITAMIN D TO YOUR BABY? The American Academy of Pediatrics (AAP) recommended that exclusively breastfed or partially breastfed babies should be supplemented 400 IU of vitamin D daily. 4. AFTER STARTING COMPLEMENTARY FEEDING, DO BABIES STILL NEED TO SUPPLEMENT VITAMIN D? After a baby reaches 6 months old, start try a variety of complementary foods, is adding vitamin D supplement still necessary? The answer is “YES”. Natural foods contain less vitamin D, in addition to liver, eggs and marine fish; however, the vitamin D content in liver, eggs and marine fish is actually not that high. One egg yolk is about 40 IU of vitamin D; eating 10 egg yolks would just reach the amount of 400 IU. Hence, having complementary food does not affect the baby to receive the supplemental vitamin D daily. 5. CAN YOU GET ENOUGH VITAMIN D FROM SUNLIGHT? Vitamin D can be synthesized in the bare skin upon exposure to UVB rays from the sun. However, there are several problems: First, the American Academy of Pediatrics (AAP) recommends that babies within 6 months should not be exposed to sunlight directly. Because baby’s skin is very delicate; when expose to the sun improperly, it is easy to cause skin burns. Meanwhile, if the sun directly hit baby’s eyes, it is also easy to cause harm, the risk is high. For age more than 6 months, you need to pay attention to sun protection, such as avoiding strong UV rays, applying sunscreen, wearing long-sleeve trousers, and wearing wide-brimmed hats. Secondly, it is difficult to control the amount of vitamin D obtained from the sun; plus, the sun protection measures, air pollution, the sunshine intensity and other factors would all affect the effect. Therefore, although it is necessary for the baby to have proper outdoor activities to obtain certain amounts of vitamin D, it is not suggested to rely on the sun to supplement the vitamin D, in case of vitamin D deficiency. 6. WHAT ARE THE COMMON VITAMIN D PRODUCTS ON THE MARKET? HOW TO CHOOSE? Liquid vitamin D products are best for infants and young children. Liquid products are easy to use and can be applied to mother’s nipples, pacifiers, spoons, or add into formulas and complementary foods. In terms of the formulas, it is essential to use oil that is easy to preserve, and use olive oil in some parts. However, in subtropical countries, the formulation of such base oil is easy to oxidized, produce bad oil odor and affect the product quality. The high viscosity characteristic of olive oil also tends to make it difficult to flow out of the dripper, not that ease-of-use. Another common base oil is coconut oil, which is more stable than olive oil and is widely used due to the low cost. However, more than 50% of the main component of coconut oil is lauric acid, which is a long-chain fatty acid and has lower absorption rate. The top base oil is medium chain triglyceride (MCT), a highly purified oil component of coconut oil that has been removed from lauric acid and other impure fats. Medium chain triglyceride (MCT) has the advantages of great stability, high absorption, good fluidity, not ease of oxidation and easy to preserve. It is the highest quality of oil formula for liquid vitamin D3.    

What Are The Advantages Of Capsules?

    Capsules generally refer to capsules made from special film-forming materials (such as gelatin, cellulose, polysaccharides, and pure natural plant starch, etc.), which is used to enclose ingredients in a relatively stable shell, allowing them to be taken orally. The two main types of capsules are hard-shelled capsules and soft-shelled capsules.  The hard-shelled capsules contain dry, powdered ingredients whereas the soft-shelled capsules primarily used for oils and for active ingredients that are dissolved or suspended in oil. The ingredients placed in the soft capsule are more restricted. In addition, the material of the capsule shell can also be made of plant material. The plant-based capsule shell is very commonly used in products for vegetarians. Generally speaking, the cost of the plant-based shell is higher than that of the animal-derived gelatin shell. The advantages of the capsule include the ability of being effective oxygen barrier and excellent chemical stability, which could improve product stability. For example, components are unstable, sensitive to temperature, light and heat can be made into capsule forms. Moreover, capsules are good in uniformity of dosage units, and capsules can be made into different types to meet the needs. Another common type used in dietary supplements is tablet format, which requires high pressure to help with molding. However, the pressure and temperature at the time of making could potentially damage the activity of the sensitive components. Moreover, the tablet form has to be coated with a film coat to increase moisture resistance; the composition of the coating contains a lot of chemical additives, including titanium dioxide and talcum powder. All of which have pointed out potential risks and harms. Some cheaper tablet products also used to add artificial colors on the coating, which burden our body in a big way. Aim at the multiple advantages of capsules, realpromise’s products chose the capsule format purposely. We also emphasize on using plant-based capsules, because it has better taste due to plant-derived ingredients and natural ingredients compared to animal-derived gelatin capsules. The plant-based capsule shell is stable at low humidity levels, has low moisture content and low static charge, and is more suitable for oxygen-sensitive and immediate-release drugs. These characteristics make the contents safer, better dissolution, and more remarkable impact on the users. realpromise is also extremely careful in the choice of capsule size. The sizes of the hard-shelled capsules for the human body are divided into six types, from 00 (maximum) to 4 (minimum). In general, the size of the hard shell affects the user acceptance and compliance. realpromise selects the smallest size of the capsules, our intention is to make the product easier to swallow, thus reducing the discomfort and rejection from the users. realpromise always think best for your health, we try to stand on the perspective of the consumers, and provide the best nutritional supplementations.    

Fish Oil 101 – How To Pick Your Fish Oil Supplement?

    Fish oil products have made them among the most popular dietary supplements on the market in Taiwan. How to choose right fish oil supplements is likely to be the choice customers often face. 1. WHAT IS THE MOST IMPORTANT INDICATOR IN PICKING FISH OIL SUPPLEMENTS – “FRESHNESS” The most important indicator of fish oil is freshness, which is also a key factor affecting the flavor of fish oil. All oils are susceptible to oxidation, but fish oil is highly susceptible due to its characteristic of fatty acid. Light, oxygen exposure, and heat can all contribute to oxidation. Once the fish oil begins to oxidize, it will start creating unpleasant fishy flavor and odors, which could also cause a risk to the human body. Therefore, it is necessary to make sure the quality assurance process from the source manufacturer! The easiest way to tell whether or not your fish oil supplement is fresh is to put it through the taste and smell test. The first step is to break a fish oil capsule open, if your nose gets a strong fishy smell, it means your fish oil supplement has been oxidized and you should just throw it away. Getting a third-party laboratory inspection report is a more accurate way to provide evidence. The first is the PV value, also known as the “Peroxide Value”. The second indicator is the AV value, the AV value refers to the “Anisidine Value”, and the third value is the AV + 2 (PV) = TOTOX value. These values will give you a clear picture of the freshness level of your fish oil supplement. Just remember, the lower these numbers are, the better. In short : PV (Peroxide Value) = The peroxide content contained now in fish oil is the PV value. AV (Anisidine Value) = Further oxidation of the peroxide will form an AV value. The AV value represents how the fish oil is treated at the front end of the manufacturing plant. When it is manufactured, if it encounters a poor high temperature and oxygen-containing process, and an initial oxide will be formed, which will further become the subsequent Anisidine Value. As a result, the most intact indicator is the TOTOX value = AV+2 (PV) As for the values, what are the qualifications? All third-party organizations such as the Global Organization for EPA and DHA Omega-3 (GOED) and the Council for Responsible Nutrition (CRN) have recommended: PV should be less than 5 mEq/kg, AV should be less than 20 mEq/kg, and TOTOX should be less than 26 mEq/kg. Therefore, you should purchase the fish oil products from the manufacturers who can provide you the report that meets the standard. 2. UNDERSTANDING THE TYPES OF FISH OIL SUPPLEMENTS There are many types of fish oil products on the market, including concentrated re-esterified triglyceride fish oil, natural triglyceride type fish oil, free fatty acid fish oil, and ethyl ester type concentrated fish oil. Which type has a higher absorption rate and best for the human body?
 Fish naturally contain the omega-3 fatty acids EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) as triglyceride esters. A general Natural TG fish oil capsule provides a maximum of 300 mg of combined EPA and DHA per 1,000 mg of oil. To reduce the intake amount of capsules, the manufacturer produces concentrated fish oil instead, and increase the EPA and DHA content. Usually A 1000 mg concentrated fish oil capsule can be raised to more than 500 mg of EPA + DHA. Before purifying fish oil and increasing EPA and DHA levels, individual EPA and DHA fatty acids must be removed from their triglyceride structure and excess fatty acids need to be removed as well. Once the expected concentration of EPA and DHA is reached, the manufacturer must choose between two different options. The first is to reconnect EPA and DHA fatty acids to reconstitute the natural triglyceride structure (a process known as “re-esterification”). The cost of the second option is much lower: let the fatty acid retain a concentrated esterification pattern (EE FORM), which is a “new state” fatty acid type with only 20 years of history in human diet. Many of the concentrated fish oil supplements on the market choose the Ester form (EE form), for the reason of lower cost. However, the TG molecular type of natural essential fatty acids ensures the higher rate of absorption and utilization, thereby achieving high quality results. A recent study in September 2010 has confirmed that the re-esterified triglyceride (rTG) has proven to be the most effective type. The results showed that that the unadjusted mean relative bioavailability EPA+DHA was 73% from EE, 91% from FFA and 124% from rTG. The re-esterified triglycerides was superior (124%) compared with natural fish oil.    


    魚油保健品是台灣營養補充品銷售排行榜單上最熱門的品項之一,但魚油產品該怎麼挑才適合,大概是消費者最常碰到的抉擇。 1. 魚油挑選首要指標 – 新鮮度 魚油最首重的指標就是新鮮度,這也是影響魚油風味的關鍵因子。這是因為魚油本身脂肪酸的特性,遇到 “熱”、“光” 和 “氧氣” 這三大因子,而容易氧化。一旦魚油開始氧化,就會開始惡性循環,而食用後對於人體會造成負面的風險,所以必須從源頭製造廠開始控管製程品質! 新鮮度最簡易測試方法就是剖開魚油膠囊,聞起來要是濃厚腥臭的魚味,代表已經氧化了。更準確者能有第三方實驗室檢驗報告提供實證。魚油新鮮度檢測指標可以分為三種,第一是 PV 值,又稱 “過氧化物值” ! 第二指標是 AV 值,AV 值是指“茴香胺值”;第三個數值呢,則是 AV+2(PV) = TOTOX 數值。 簡言之: PV 過氧化物值 = 檢測目前魚油裡面所含的過氧化物含量,就是 PV 值。AV 茴香胺值 = 過氧化物再進一步氧化會形成 AV 值。 AV 值代表的就是製造廠前端在製造時,製程溫度與環境的控管失調,都會形成初期的氧化物,進一步氧化後就會成為茴香胺指標。而最完整的判斷指標就是 TOTOX 數值 = AV+2(PV)。
 在 “全球 EPA 暨 DHA 組織”(GLOBAL ORGANIZATION FOR EPA AND DHA OMEGA-3;GOED)及 “可靠營養協會” (COUNCIL FOR RESPONSIBLE NUTRITION;CRN)等公正第三方機構都建議:PV 要小於 5 MEQ/KG,AV 要小於 20 MEQ/KG,TOTOX 要小於 26 MEQ/KG。所以選購魚油,必須選購可以提出新鮮度報告的廠商,並觀察其新鮮度指標有無符合標準。 2. 魚油型式 市面上魚油產品有很多種型式,包括濃縮的重新酯化型三酸甘油酯魚油,一般天然三酸甘油酯型式魚油,游離脂肪酸魚油,與乙酯型式濃縮魚油,哪一種型式吸收率對高,對人體最好?
 OMEGA-3 脂肪酸 EPA 和 DHA 以三酸甘油酯 (TG FORM) 的天然型式自然產生於魚體內。但一般大顆膠囊尺寸的魚油約 1000 毫克中,只含有 300 毫克的 EPA+DHA 。為降低食用顆數,製造商生產出濃縮魚油,但必須增加魚油內的 EPA 和 DHA 含量,濃縮後的魚油,通常一顆 1000 毫克的濃縮魚油膠囊中可以提升到 500 毫克以上的 EPA+DHA 。在淨化魚油及增加 EPA 和 DHA 含量之前,必須從其三酸甘油酯結構中去除個別的 EPA 和 DHA 脂肪酸,並排除多餘沒用的脂肪酸。一旦達到 EPA 和 DHA 的預期濃度,製造商就必須從兩個迥異的選項中做出選擇。 第一是重新連接 EPA 和 DHA 脂肪酸,以重新構建天然的三酸甘油酯結構(這過程稱為「重新酯化」)。第二個選擇的成本低得多:讓脂肪酸保留酯化型式 (EE FORM),這是人類飲食史上只有 20 年歷史的「新型態」脂肪酸型式。 市場上許多濃縮魚油產品都選擇第二種方式,原因無它,省了一個步驟,當然成本更為便宜。但天然必需脂肪酸的 TG 分子型式,能確保高度吸收率和利用度,進而達到優質的成效。在一篇 2010 年 9 月份的最新研究已獲得證實,重新酯化型三酸甘油酯(RTG)型式的濃縮 OMEGA-3 魚油在人體內的吸收與利用率最高,比一般天然魚油相比較高出 124%,而酯化(EE)型式只有 73%。至於游離脂肪酸(小分子魚油)只有 91%,與一般天然三酸甘油酯相比,並無顯著差異!