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TC.DD&TP 7(1)-2011 Dmh dudng va an toan vp sinh thuc phim cho tre liia tudi mIm non, Nxb KHKT, Ha Ndi. trl120 3. Nguyin Thi Hoa va CS (2010). Tmh trang dinh duong tre em tai benh vien... Tap chi Dinh dudng va thuc phim. Hdi dinh dudng Viet Nam. V6. No l.Tr 53 -59 4. Barbara A. Bowman (2001). Present knowledge in nutrition. ILSI, Washington, 760 pp. Summary THE NUTRITION COMMUNICATIONS EFFECT ON KAP OF MEDICAL STUDENTS AND TEACHERS OF 1 TO 5 YEARS OLD CHILDREN IN POOR AREAS OF THAINGUYEN With the aim of study about the nutrition communications effect on KAP of medical students and teachers of 1 to 5 years old children in poor areas of Thainguyen, an intervention study was carried out on 200 small childrens teachers and 500 students. The results showed that: After the intervention, the rates of good knowledge, attitude and practice have been significantly improved (p<0.05). It is recommended that: communication activities on the nutrition and primary health care should be continued and more often for the communities. Keyword: malnutrition, nutrition communication. rb^<^ THANH PHAN ACID AMIN VA MIEN DICH TRONG SUA CUA BA ME TAI THANH PHO H A NOI VA THANH PHO HO CHI MINH Traong TuyStMai', Ngayin Tbi Lanf, LS H^g DSnf, Bvi TbiMaiHtiOag*, SbinjiJixmcP, Takeshi TakahasbP 91 mlu siia me tii 91 ba me nudi con bii trong thdi gian tii 29 din 120 ngay da dupe thu thap tai ndi thanh thanh phd Ha Npi va thanh phd Ho Chi Minh. Cac mlu svta dugc phan tich 18 thanh phIn acid amm va 3 thanh phIn miln dich (lactoferrine, lysozym, IgA). Kit qua cho thay, co su dao dpng rlt Idn giiia cac ca thi vl nong dp cua cac thanh phIn acid amin va miln dich. Ham lugng trung binh cua valine, isoleusine, lysine, cystine, proline giam din theo thdi gian cho con bii, su khac biet cd y nghia thong ke khi so sanh giiia 3 nhom (nhdm nudi con 29 din 60 ngay, nhom 61 den 90 ngay va nhdm 91 din 120 ngay). Ndng dp trung bmh cua lactoferrine, lysozym va IgA trong siia me lln lugt la 233,6 mg/lOOg; 10,99 mg/lOOg va 55,72 mg/lOOg. Cd su khac biet c6 y nghia tiidng ke vl cac ham lugng thanh phIn miln dich Uong siia giCta 2 thanh phi Ha Npi va Hd Chi Minh: ham lugng thanh phIn lactoferrine trong siia me ciia cac ba me tai Ha Npi cao ban dang ke so vdi ba me H i Chi Minh, ngugc lai, ham lugng thanh phan lysozyme va IgA trong siia cua cac ba me tai Ho chi Mmh lai cao ban c6 y nghia thing ke so vdi cac ba me tai Ha Npi. Tu kh6a: thanh phan acid amin sira me. mien dich, bd me nuoi con bu ' TS, BS - Vipn Dinh dUdng 2 PGS, TS - Vi?n Dinh dUdng 3 Ths - Vi?n Dinh dudng * Ths - BS - Vien Dinh dUdng ' KS.Trung tam nghien cihi Meiji, Nh^t Ban 35. TC.DD&TP 7(1)-2011 LDATVANDE Siia me la thiic an tdt nhat cho tie dudi mgt tudi, nhat la tie tiong 6 thang dIu ddi. Siia me cung d p cho tre cac chit dinh duang hoan hao dl tieu hda, de hap thu va CO tac dung khang khuan, giiip tie phat tiiln vl the chat, tinh than va phdng chong cac benh nhiem khuan^ phdng chdng thiia can beo phi [1,2]. Td chiic Y tl Thi gidi va Qui Nhi ddng Lien hiep qudc da dua ra khuyen cao ve nudi con blng siia me hoan toan tiong 6 thang dIu, khang dinh viec nudi con bang siia me la mgt khau quan tigng trong cdng tac cham sdc siic khde ban dau [3]. Siia me la mdt thiic an hdn hgp vdi hang tiam cac thanh phIn dinh dudng va cac thanh phIn boat tinh sinh hgc khac nhau va cac thanh phan nay cting cd su thay ddi vl ndng do (ciing nhu su gin kit cac thanh phan) theo timg giai doan bai tilt siia [4]. Thanh phIn dinh dudng cua siia trudng thanh bao gdm cac protein, lipid, lactose, vitamin, mudi khoang, va cac thanh phan boat tinh nhu cac men, khang the va hormon. Protein va cac acid arnin la mdt thanh phan dinh dudng thiet ylu (dugc ggi la nIn tang cua cuoc sdng), hinh thanh nen protein co thi, tao nen cau tnic CO quan song va ca thanh phIn cac tac nhan cd boat tinh sinh hgc. Lonnerdal B [5], Kunz C va cdng su [6] da phan tich thanh phIn protein trong siia me cho thIy luong protein chilm tdi 75% trong thanh phIn cd chiia nitiogen. Bao gdm beta-casein, alpha-lactalbumin, lactoferrine, secretory IgA, va albumin [5], cung vdi su cd mat cua rat nhieu cac protein khac vdi lugng rat nhd. Hon niia, tiong siia me ciing cd day dii nhiing acid amin can thilt vdi ty le can ddi, va Martin va Williamson ciing da sdm xac dinh dugc 18 acid amin thilt yeu cd mat tiong siia me [7]. Lien quan din vai trd cua protein la cac nhdm globulin mien dich, cac enzyme khang khuan. Secretory IgA la mgt khang the ca ban nhat cd tiong sira me vdi vai tid boat ddng chdng lai mgt sd vi 36. khuan va virus, giup tre mdi de cd siic dl khang va miln dich [8, 9]. Ben canh do, cdn cd rlt nhieu protein vdi da dang chiic nang khac nhau, dien hinh nhu lactoferrin, cd chiic nang gan va tang hap thu sit, ddng thai la mgt khang khuIn ddi vdi nhieu td chiic, boat ddng nhu mgt protein dinh dudng, san sinh cac amino acid dl hap thu khi tieu hda. Ngoai ra, lysozyme la mgt enzyme cd tac dung diet khuIn ciing dugc tim thIy tiong siia me [8]. Trong nhiing nam qua, nen kinh te ciia Viet Nam da dan phat trien va miic sdng cua ngudi dan thanh thi tang len mgt each rd ret. KhIu phIn cua ngudi dan thanh thi da cai thien dang ke ve sd lugng ciing nhu ve chat lugng, dan din ca clu khau phSn ciia phu nii mang thai va phu nii nudi con bii ciing thay ddi. Van de dat ra la cung vdi su thay ddi ve dieu kien sdng, vl chat lugng biia an, thi chat lugng siia cua cac ba me nudi con nhd tai khu vuc thanh phd cd su thay ddi nhu the nao. Ben canh dd, can cd nhiing sd lieu co ban ve cac thanh phIn acid amin va thanh phan boat tinh sinh hgc trong siia me de giup cac nha khoa hgc cd dugc dii lieu tiong nghien ciiu, dong thdi giiip cac chuyen gia y tl va dinh dudng cd dinh hudng tiong viec phdng chdng thilu hut thanh phan cac chat dinh dudng trong siia me. Chinh vi vay, chiing tdi tiln hanh nghien cuu vdi muc tidu: Danh gia 18 thanh phIn acid amm va 3 thanh phIn miln dich tiong siia ciia ba me cho con bii tii 29 ngay din 120 ngay tai mgt sd phuong ngi thanh cua 2tiianhphd Ha Ngi va Hd Chi Minh. H. DOI TirONG VA PHlTONG PHAP NGHIEN C t r u 1. Ddi tuorng nghiSn cihi: Ba me cho con bii tii 1 din 4 th^g; tudi tii 22 den 35; sinh sdng tai mgt sd phuong ndi thanh ciia thanh phd Ha Ngi va thanh phd Hd Chi Minh. Tieu chuIn chgn lua ddi tugng: Ba me cd du va nhilu siia cho con bii; Ba me. TC.DD&TP 7(1)-2011 khde manh, khdng mic benh man tinh chuan, dilu tia tai nha ddi tugng: hdi ghi nhu benh tim mach, daitiiaodudng, benh chung, hdi ghi khIu phIn theo phuang than, benh gan, hoac khdng bi dilc, cam, phap hdi ghi 24 gid, hudng din each vit hoac rdi loan tam thin; Sinh con vdi tudi siia. Tdng sd lugng siia la 300 mL, thu tiiai tii 38-42 tuln tiioi; Tre cd can nang thap mlu siia tiong 3 ngay, trung binh so sinh tii 2.500 gram trd len; tie de mdi ngay la 100 mL, vit siia theo diing thudng hoac md de; tie khdng mic cac phuang phap vdi dung cu vd triing, tianh anh sang, bao quan lanh ngay sau khi lly. chiing benh bim sinh; Cac ba me ddng y tham gia chuong trinh va ky cam kit. - Xu: ly va phan tich mau: cac mlu siia 2. Thoi gian va dia dilm: dugc chia deu ra cac ong nghiem, ghi ma, luu mautiongtu da -20 oC tai Labo Hda An Dia dilm lly mlu: tai 6 phudng thudc toan v$ sinh thuc phim -\^en Dinh dudng quan ndi thanh Ha Ndi va 3 phudng thudc va Vien Kiem nghiemAn toan Ve sinh Thuc quan ndi thanh Thanh phd Hd Chi Minh. pham. Cac tharh phIn dugc phantichtheo Mlu dugc phan tich tai khoa Hda Ve sinh cac phuang phap chuan hda, 18 thanh phIn Thuc pham -Vien Dinh dudng Quoc gia. acid ainintiongsiia dugc xac dinh blng ky Thdi gian: tii tiiang 4 -12/2009 thuat sac 1^ Idng hieu nang cao vdi detector 3. Phuorng phap nghi§n cihi: huynh quang. Cac thanh phIn miln dich 3.1. Thiet ke nghien cuu: Nghien ciiu dugc xac dinh dua tien cac khang thi dac md ta, dieu tia cat ngang hieu bang phuang phap ELISA. 3.2. C&mau 4. Phan tich v^ xu ly so lieu Sd mlu cho nghien cuu la 90 ddi tugng. Sd Heu dugc nhap blng chuong trinh Chia thanh 3 nhdm theo sd ngay sau khi EPI DATA, phan tich sd Ueu bang chuong sinh con, 29 ngay din 60 ngay (nhdm A); tiinh SPSS 15.0 vdi test Mann-Whitiiey 61 ngay din 90 ngay (nhdm B) va 91 ng^y va test Kruskall-WalUs. Su khac biet cd y din 120 ngiy (nhdm C), mdi nhdm la 30. nghia thdng ke khi gia tri p<0.05. 3.3. Phutmgphdp thu thap HI. KET QUA NGHlfeN CUtJ Triln khai thu thap mlu: Sau khi lap 1. Dac diem chung danh sach, sang Igc ddi tugng dii tieu Bang 1. Daic dilm chungcua doi tatfng tham gia Nhdm A NhdmB NhdmC Tongsd (n=30) (n=30) (n=31) (n=^l) 28,7 ± 3,9 28,8 ± 3,9 28,6 ± 3,8 28,6 ±4.2 Tudi tmng binh cua me (nam) 43,2 ± 9,5 73,7 ± 8,4 75,1 + 27,9 107,3 ± 9,6 Tudi trung binh cua con (ngay) Can nang sd sinh cua con khi sinh. 3.216,6 ± 340,4. 3.188,3 ± 321,0. 3.270,3 ± 328,8. 3.225,6 ± 328,3. 2. H^m lugng acid amin trong sira me Bang 2 cho thIy hlu hit 18 acid amm tiong siia me dIu cd xu hudng thay ddi theo thdi gian, ham lugng cac thanh phIn nay giam xudng d nhdm B va C so vdi nhdm A. Tuy nhien, su thay d6i rd ret nhlt la ham lugng ciia thanh phIn glutamic, tii 117,02 xudng cdn 163, 35 va 150,71 mg/100 g siia me; ham lugng lysine tii 80,25 xudng 67,75 va 64,83 mg/lOOg; tuong tu ddi vdi histidine, valine, Isoleusine, cystine, va proline. Cac thanh phIn khac cd su thay ddi vl ham lugng, nhung khdng cd y nghia thdng ke. Ham lugng 18 acid amine cd s\r dao dgng tuong ddi Idn, vi du aspartic acid dao ddng tii 37,7-231,2 mg/1 OOg; glycine dao ddng tir 1,4-50,1 mg/IOOg, lysme dao ddng tii 28,3-141,3 mg/lOOg. 37. TC.DD&TP 7(1)-2011 Bang 2. Nong do cua 18 thanh phan acid amin trong sua m^ theo giai doan cho con bu Thanh phin (mg/lOOg). Nh6mA(n=30) Nh6mB(n=:30) Nh6mC(n=^l) TB±SD TB±SD TB±SD. Aspartic. 90,94 ± 28,49a. Glutamic. 177,02 ± 47,73a 163,35 ±4420a,b 150,71± 54,64b. Serine. 43,32 ± 12,18a. 42,12 ± 10,96a. 39,35 ± 11,75a. Histidine. 23,31 ± 9,21a. 18,72 ± 6,69b. 20,60 ± 9,77b. Glycine. 25,62 ± 10,57a. 19,80 ± 7,08b. 26,15 ± 8,84a. Threonine. 33,29 ± 16,58a. 27,92 ± 14,98a. 35,17 ± 16,18a. Arginine. 55,08 ± 23,84a. 57,24 ± 17,66a. 51,50 ± 20,36a. Alanine. 39,73 ± 16,35a. 35,22 ± 13,54a. 36,98 ± 15,39a. Tyrosine. 36,33 ± 10,06a. 32,04 ± 12,19a. 36,96 ± 17,95a. 13,48 ± 4,69a. 10,58 ± 3,29b. 10,70 ± 3,75b. Methionine. 53,30 ± 14,28a. 47,34 ± 13,80a. 49,40 ± 14,24a. Phenylalanine. 33,49 ± 9,27a. 30,09 ± 9,20a. 30,84 ± 9,26a. Isoleusine. 43,59 ± 14,88a. 36,87 ± 12,77b. 36,40 ± 12,91b. Leusine. 86,74 ± 23,60a. 76,78 ± 24,00a. 76,51 ± 23,74a. Lysine. 80,25 ± 25,59a. 67,75 ± 23,63b. 64,83 +24,22b. Cystine. 18,47 ± 5,32a. 15,73 ± 4,62b. 16,44 ± 4,95b. Proline. 79,72 ± 22,94a. 67,90 ± 19,92b. 70,96 ± 21,38b. Tryptophan. 16,53 ± 476a. 14,08 ± 4,42a. 14,71 ± 4,42a. Protein*. 1,08 ± 0,26a. 0,98 ± 0,27a. 1,00 ± 0,24a. VaUne. 86,68 ± 27,57a. 84,21 ± 33,94a. T^s6(n=91)'IB±SD (ph^m vi dao d$ng) 87,24 ±29,97 (37,7-23ia) 163,55 ±49,76 (2,4-326,8) 41,57 ±11,64 (14,7-66,9) 20,88 ±8,78 (7,8-45,6) 23,88 ± 9 3 0 (1,4-50,1) 32,16 ±16,05 (10,4-82,5) 54,57 ±20,67 (12,1-108,3) 37,31 ± 15,09 (10,1-73,4) 35,13 ± 13,88 (10,6-98,9) 11,57±4,13 (4,9-21) 50,01 ± 14,17 (22,2-95,9) 31,46 ±9,26 (11,0-55,6) 38,93 ±13,80 (16,3-75,9) 79,97 ±24,00 (35,1-148,3) 70,88 ±25,13 (28,3-141,3) 16,88 ±5,05 (7,9-29,2) 72,84 ±21,79 (340-125,9) 15,10 ±4,51 (7,1-26,1) 1,02 ±0,26 (0,48-1,63). Tren cung hang, cac ky tU (a, b) khac nhau bieu dien six khac biet co y nghia thong ke vdi p<0,05; Kms Wallis Test; *) tinh theo dan vi g/lOOg. 38. TC.DD&TP 7(1)-2011 Bang 3. Nong dp trung binh cua 3 thanh phIn miln d|ch theo giai doan cho con bu Tlwnhphan Nh6mA(n=30) NhdmB (mg/lOOg) TB±SD (n=30)TB±SD. NhdmC Tdngs6(n=91)TB±SD (n=31)TB±SD (ph?m vi dao dgng) 233,56 ±103,12 Lactoferrine 242,43 ± 96,55a 219,13 ± 109,96a 238,94 ± 104,32a (31-478) 10,99 ±4,44 Lysozyme 10,11 ±4,31a 11,31 ±4,40a 11,53 ±4,62a (2,1-24,7) 55,72 ±24,38 sIgA 56,13 ± 21,47a 50,83 ± 18,64a 60,05 ± 30,95a (19,4-167,5) Tren cung hang, cacky tif(a, b)khac nhau bieu dien sii khac biet coy nghia thong ke vdip<0,05; Knisk Wallis Test Bang 3 cho thay ham lugng cua 3 thanh phan mien dich lactoferrine, lysozym, si g A trong svta me cua ca 3 nhdm dat trung binh lan lugt la 233,56 mg/100 g (31-478); 10,99 mg/100 g (2,124,7); 55,72 mg/100 g (19,4-167,5). Khdng cd su khac biet cd y nghia thdng ke giiia 3 nhdm d ca 3 thanh phan nay. Hinh 1 cho thIy ham lugng thanh phan lactoferrine trong siia me ciia cac ba me tai mot so phudng Ha Ndi cao hon dang kl so vdi ba me tai mot sd phudng thanh phd Hd Chi Minh, ngugc lai, ham lugng thanh phIn lysozyme va IgA trong siia me ciia cac ba me tai tp. Hd chi Minh lai cao ban cd y nghia thdng ke so vdi cac ba. 300.0. DHiNfi BTp.HCM. 250.0. 200.0-. 3 •e.. 150.0-. 100.0-. so.o-. i ^. ^. 159.0. ^ ^ | < ; LactofTarrlne. 52.8 " • « *. 10.0. 12.9*. Lysozyme. IT. S. 7. IflA. (*)p<0,05, Mann- Whitney test Hinh J. Nong do trung binh cua cac thanh phan mien dich theo 2 thanh pho. me tai Ha Ndi. IV. BAN LUAN Phan tich 18 thanh phan acid amin va 3 thanh phan mien dich tren 91 mau siia ciia 91 ba me tai 2 thanh phd Ha Ndi va tp. Hd Chi Minh da cho thay cd su dao dong rat Idn ve ham lugng cac thanh phan trong siia ciia cac ba me trong nghien ciiu. Clemens Kuns va cong su [10] ciing da chi ra rang ham lugng cac thanh phan dinh dudng trong sura me cd mdt sir dao dong rlt Idn giiia ca the khac nhau. Trong mdt ca the, cac yeu td ve thdi gian tiet siia, mua, khau phan an.... ciing da gdp phIn lam cho ham lugng cac thanh phan siia me cd sir khac biet. Trong nghien ciiu nay, chiing tdi chgn 2 thanh phd Ha Ndi va tp. Hd Chi Minh lam 2 khu vuc nghien ciiu, vdi dieu kien sdng tuong ddi giong nhau. Tien hanh lay mau sua cua 91 ba me cd do tudi ddng deu, cd thdi gian nudi con bii tu 29 den 120 ngay vao mua he, thdi gian lay mau siia tii thang 4 den thang 6. Yeu td so sanh ve mua nhu mua he va mua ddng khdng dugc the hien tiong nghien ciiu, ma chi tap trung so sanh ve 3 cap dp thdi gian nudi con (nhdm A=29 den 60 ngay, nhdm B=61 den 90 ngay, nhdm C=91-120 ngay). Thanh phIn cac acid amin trong siia. 39. TC. DD & TP 7 ( l ) - 2 0 l l me ddng vai tid quan trgng trong hinh thanh va phat triln te bao. Trong 18 acid amin dugc phan tich trong nghien ciiu nay, cd 11 acid amin thiet ylu ma ca the khdng tu tdng hgp dugc. Ham lugng acid amin trong siia me phan anh chat lugng sira me. Ham lugng ciia 18 acid amin ciing cd su dao ddng khac nhau giiia 91 ba me, va cd su khac nhau giiia 3 nhdm thdi gian cho con bii, va cd su khac nhau giiia vung mien. Chiing tdi quan sat thay, cd ba me thi ndng do acid amin nay thap, cd ba me acid amin nay lai cao. Dieu nay ciing xay ra ddi vdi ket qua nghien ciiu cua tac gia Namiko Yamawaki [II] khi nghien cuu tien 1197 mau siia ciia cac ba me Nhat Ban. Cac yeu td vung mien, yeu td vl chi do an, ylu td ca thi ciing cd thi xem la cac yeu td anh hudng den ham lugng cac acid amin. Ham lugng ciia da sd cac acid amine tiong siia cua cac ba me Nhat Ban cao ban so vdi cac ba me Viet Nam, bao gdm Aspartic, Glutamic, Serine, Histidine, Threonine, Tyrosine, Valine, Phenylalanine, Isoleusine, Leusine, Cystine, Proline. Trong khi do ham lugng Arginin, Methionine ciia cac ba me Viet Nam cao hon cac ba me Nhat Ban. Ham lugng Glycine, Alanine, Lysine, Tryptophan tiong svra cua cac ba me Vi$t. Nam va Nhat Ban gin nhu blng nhau (bang 4). Cac thanh phIn miln dich hay cdn dugc ggi la cac protein khang khuan dugc phan tich tiong nghien ciiu nay la Lactoferrin, Lysozym, IgA. Ham lugng cua 3 thanh phan nay khdng dao dgng nhieu giiia cac thang cho con bii khac nhau, nhung ciing cd su dao dgng tuong ddi Idn giiia cac ca thi. Robert Jensen [12] da dua ra con sd so sanh ham lugng cac thanh phIn nay giiia ba me Gambia va cac ba me Anh theo thdi gian cho con bii tii 0 din 3 thang. Khi so sanh kit qua tiong nghien ciiu nay thi thIy ring ham lugng IgA va Lysozym ciia cac ba me Viet Nam la cao ban so vdi ba me Anh va ba me Gambia, nhung ngugc lai ham lugng Lactoferrin lai thIp ban. Kit qua nghi§n ciiu ciia Dao Nggc Diln [13] vl ham lugng IgA trong siia me cua 83 ba me trong 3 ngay dau sau khi sinh con tai Ha Ndi da cho thIy h^m lugng IgA ciing cd su dao dgng rlt Idn giiia cac ba me, va ndng do nay ciing thay ddi nhanh chdng theo thdi gian, giam din tii ngay thii nhat den ngay thii 3. BSn canh dd tac gia ciing da chi ra ylu td tudi cua cac ba me ciing anh hudng den su khac nhau ve ndng dO IgA siia me.. Bang 4. Bang so lifu vl nong do cac acid amin trong sua cua ba me Nhft Ban va ba me ViSt Nam. Thanh phSn (mg/lOOg). Vi^tNam. Nfa$tBan[ll]. 29-90 ngay (n=60). 91-120 ngay (n=31). 21-89 ngay (n=40). 90-180 ngay (n=40). Aspartic. 88,81 ± 27,88. 84,21 ± 33,94. 105,60 ± 9,00. 87,80 ± 5,20. Glutamic. 170,19 ±46,12. 150,71 ± 54,64. 214,60 ± 12,30. 189,00 ± 12,60. Serine. 42,72 ±11,51. 39,35 ±11,75. 51,70 ±5,70. 42,50 ± 3,30. Histidine. 21,02 ±8,31. 20,60 ± 9,77. 35,70 ± 3,80. 29,10 ± 3,50. Glycine. 22,71 ± 9,39. 26,15 ± 8,84. 27,20 ± 3,30. 22,80 ±1,50. Threonine. 30,61 ± 15,90. 35,7 ±16,18. 51,50 ±5,20. 42,80 ± 2,70. Arginine. 56,16 ±20,83. 51,50 ±20,36. 37,90 ±4,80. 32,00 ± 3,00. 40. TC. DD & TP 7 (1)-20I1 Alanine. 37,48 ± 15,05. 36,98 ± 15,39. 42,60 ±4,80. Tyrosine. 34,19 ±11,29. 36,96 ± 17,95. 90,20 ± 16,80. 35,90 ± 3,50 62,10 ±12,30. 12,03 ± 4,27. 10,70 ± 3,75. 61,70 ±5,90. 53,10 ±4,00. Methionine. 50,32 ± 14,24. 49,40 ± 14,24. 17,70 ±1,60. 14,60 ± 1,50. Phenylalanine. 31,79 ±9,32. 30,84 ± 9,26. 46,90 ±4,50. 38,90 ± 3,70. Isoleusine. 40,23 ± 14,16. 57,90 ±4,10. 48,60 ± 3,30. Leusine. 81,76 ±24,13. 36,40 ± 12,91 76,51 ±23,74. 96,10 ±9,60. Lysine. 74,00 ± 25,22. 114,60 ±9,80 79,30 ± 6,70. Cystine. 17,10 ±5,13 73,81 ±22,12. Vahne. Proline Tryptophan. 15,31 ± 4,59. 64,83 ± 24,22 16,44 ± 4,95. 66,40 ± 3,70 21,80 ±3,30. 70,96 ± 21,38. 25,80 ± 2,60 103,30 ± 17,80. 96,30 ± 6,80. 14,72 ± 4,43. 19,70 ±1,90. 16,70 + 1,50. Su khac biet ve mdt sd thanh phan miln dich tiong siia ciia ba me thanh phd Ha Ngi va thanh phd Hd Chi Minh cho thIy tinh chit vung miln va chi do dinh dudng, ylu td ca the ciia 2 thanh phd cd thi gdp phIn dan den su khac biet nay. Tuy nhien, dk cd thi ly giai su khac biet vl ham lugng cdc thanh phIn miln dich giiia 2 thanh phd can phai cd cac nghien ciiu chuyen sau dilu tia va phan tich cac ylu td, nguyen nhan, tiong dd phai kl din cac ylu td vl dia ly do nude, dit va cac ylu td tap quan an udng ciing cin dugc tinh din. Nghien ciiu ciia chiing tdi chi thuc hien dugc tien cd mau nhd va mdi chi dai dien cho 2 thanh pho Ha Ngi va thanh pho H I Chi Minh. Ngoai ra, njghien ciiu khdng dilu tia sd lugng bai tilt siia mdt ngay va sd lugng siia me ma mdi tie tieu thu trung binh mgt ngay. Ben canh do, ciing vi mat ban chi vl kinh phi nen de tai chua thu thap nhdm mlu siia ciia nhdm sa sinh, nhdm ba me cho con bu dudi 1 thang tiioi, nhdm 5-6 thang tiidi va sau 6 thang tudi. Dk cd thi phan anh dugc mdt each dai dien cho cac ba me Vi?t Nam, cin tilp die cd cac nghien ciiu phan tich thanh phIn siia tien cac ba me dai di?n cdc viing miln khac nhau va tren nhilu nhdm tudi khac nhau.. V. KET LUAN Ham lugng 18 thanh phIn dinh dudng va 3 thanh phSn miln dich tiong siia ciia 91 ba me nudi con bii tii 1 din 4 thang tai 2 thanh phd Ha Ndi vatiianhphd Hd Chi Minh: Cd su dao ddng rlt Idn giua cac ca thi vl ham lugng ciia hlu hit cac thanh phIn dinh dudng va miln dich. Cd su khac biet cd y nghia thong ke vl ham lugng trung binh ciia valine, isoleusuie, lysine, cystine, proline khi so sanh giiia 3 nhdm. - Cd su khac biet cd y nghia thdng kS vl cac ham lugng thanh phan miln dich trong siia me giiia 2 thanh phd Ha Ndi v^ thanh phd Hd Chi Minh. VL KHUYEN NGHI l.Cin cd cac nghien cuu ban niia vl cac thanh phIn cac chit boat tinh khac tiong siia cua cac ba me Viet Nam. 2.Cln cd cac nghien ciiu vl thanh phan siia me va ylu td lien quan tien pham vi rdng hon dk cd dugc con sd phan anh chung cho cac ba me Viet Nam, tii dd giiip cho cac nha khoa hgc cd them cac du lieu dl cd nghien cuu nhIm phdng chdng thieu hut thanh phan dinh dudng tiong siia me. 41. TC. DD & TP 7(1)-2011 TAI LIEU THAM KHAO 1 Statement of the Standing Committee on Nutrition of the British Paediatric Association (1994). Is breast feeding beneficial in tiie UK? Arch Dis Child;71:37680. 2. Dietz WH 2001. Breastfeeding may help prevent childhood overweight. JAMA. 16;285(19):2506-2507. 3. World Health Organisation/UNICEF (1989). WHO/UNICEF joint statement. Protecting, promoting and supporting breast feeding: the special role of maternity services. Geneva:World Health Organisation. 4. Filteau SM (2000). Role of breast-feeding in managing malnutrition and infectious disease. Proc Nutr Soc; 59(4):565-72. 5. Lonnerdal B (1985). Biochemistry and physiological fiinctions of human milk protems. Am J Clin Nutr; 42:1299-1317. 6. Kunz C, Rodriguez-Palmero M, Koletzko B, Jensen R (1999). Nutritional and biochemical properties of human milk. Part I: General aspects, proteins, and carbohydrates. Cim Perinatol; 26(2):307-33. 7. Martin B and Williamson (1944). The amino acid composition of human milk. proteins. Journal of Biological Chemistry; 47-52. 8. Buts JP (1998). Bioactive factors m milk. Arch Pediatr;5(3):298-306. 9. Prentice A, Ewing G. Roberts SB, Lucas A, MacCarthy A, Jarjou LMA, Whitehead RG (1987). The nutritional role of breastmilk IgA and lactoferrin. Acta Paediatr Scand;76:592-8. 1 O.Clemens Kunz, Maria Rodriguez-Pahnero (1999). Nutrition and biochemical properties of human milk, part I. Clinical Aspects of Human Milk and Lactation. Volume 26 No2. 11.Namiko Yamawaki, Mio Yamada, Akie Yonekubo (2005). Macronutrient, mineral and trace element composition of breast milk from Japanese women. Joumal of trace Elements in Medicine and Biology, 19: 171-181. 12.Robert G Jensen. Hanbook of Milk Composition. (1995). Academic Press. 237271. 13.Dao Ngpc Diln va cpng su (1991). Nong dp IgA bai tilt trong siia me. Ky ylu c6ng trinh dinh dudng. Nha xult ban Y hpc; 179-180.. Sununaiy ACID AMINES AND IMMUNOPROTEINS COMPOSITION IN BREAST-MILK OF MOTHERS IN HANOI AND HOCHIMINH CITIES A cross-sectional survey in 91 mothers to evaluate the breast-milk composition of Vietnamese mother from 29 to 120 days of lactation period was carried out in Hanoi and Hochiminh city. There are 18 acid amines and 3 immunoproteins were assessed in Food Science Laboratory of National Institute of Nutrition. Results showed that the level of these compositions varied in large by individual. The concentration of acid amines has a trend of decreasing by the lactating periods. The average concentrations of lactofferine, lysozyme and IgA in breast-milk are 233.6 mg/lOOg; 10.99 mg/lOOg and 55.72 mg/lOOg, respectively. There are significant differences in the some breast milk concentrations of immunoproteins between the mothers in Hanoi and mothers in Hochiminh: the levels of lysozyme and IgA in the breast milk of Hochiminhs mothers were higher markedly than that in the Hanois mothers; in contrast, the levels of lactoferrine in the breast milk of the Hanois mothers was higher than in that of the Hochiminhs mothers. Keywords: breast-milk composition, acid amines in breast milk, immunoproteins, lactating mothers in Vietnam. 42.