Content
5 . 2019
Hygiene of nutrition

Anthropometric indicators of physical development and nutritional status employed in hygiene practice in Russia

Abstract

In the current review, we consider the main working methods of Russian hygienists to assess anthropometric indices using a) regional data on (populational) variability of the concerning measurements and b) unified reference data applicable in most regions.

An analysis showed that in most cases, the regional standards are based on average values and variabilities derived from a local sample, which can not serve as a working normative. As a result, these so called "standards" do not provide information on how healthy children should develop, and the assessments inferred are difficult to integrate to draw a picture for the whole country. In 2017, the Ministry of Health of the Russian Federation recommended the use of the WHO Child Growth Standards and the WHO Growth Reference for the purpose of medical screenings in children and adolescents. These data sets reflect the conditions, that healthy children should attain growing in supportive environment, with adequate nutrition and care. The single set of criteria will allow unifying the data collected in different regions, which is a necessity in communal hygiene and medical statistics. However, additional research is needed to check the validity of the WHO standards and reference to assess physical development and nutritional status in highly anthropologically specific populations, in particular in those indigenous and long-ago adapted to the sharply continental or Arctic climate.

The study of the raw milk contamination by bacteria of the genus Campylobacter using traditional microbiological methods and quantitative PCR assay

Abstract

Gastroenterocolitis caused by Campylobacter bacteria are the most common acute infectious zoonotic foodborne diseases. One of the important factors for the transmission of infection is contaminated dairy products, so the assessment of contamination of raw milk with Campylobacter is necessary to develop effective measures to suppress the growth of the pathogen and ensure the safety of products.

The aim of the study was to assess the microbial characteristics of raw milk samples and the nature of their contamination with thermophilic bacteria of the Campylobacter genus.

Material and methods. A total of 60 samples of raw milk from the central regions of the Russian Federation and 48 experimentally infected samples of raw milk were studied. To assess the microbial contamination of milk, the number of extraneous microflora was determined, including coliform bacteria (CFB). The identification and quantification of bacteria of the genus Campylobacter was carried out by cultural methods in comparison with quantitative PCR assay. For PCR, primers were used that detected the species-specific sequence of C. jejuni 16s rRNA, the presence of the cytotoxic toxin gene cdtB and the invasion gene ciaB.

Results and discussion. A significant part of the samples of raw milk (31.6%) was characterized by high levels of microbial contamination exceeding 106 CFU/cm3. Gram-negative bacteria were the dominant type of bacterial microflora, their levels were comparable with the detected values of the total number of microorganisms. Coliform bacteria were found in all studied samples, and their content in 90% of the samples reached 105 CFU/cm3, and in some samples - 107 CFU/cm3. Campylobacter spp. detection rate in raw milk was 8.3%, and their number ranged from 0.1 to 100 CFU/cm3 (average 2.0x10 CFU/cm3). The isolated strains of campylobacters were identified as a C. jejuni species. In the study of the microbial background of the examined samples of raw milk, a comparative analysis of their contamination by campylobacters by rti-PCR was simultaneously carried out. The majority of samples (over 60%) were positive for the presence of 16s rRNA genomic sequence, and they were characterized by the highest values of total bacterial contamination and the amount of coliforms. The use of a multi-primer approach (simultaneous testing for the presence of 16s rRNA and the gene of cytoletal toxin cdtB C. jejuni) reduced the number of positive cases of Campylobacter DNA detection to 16.6%, which suggests a greater informative value of the cdtB gene for the detection of viable, including uncultivated cells. An indicative assessment of the results in a quantitative format showed levels of 104-1065 genomic equivalents of the DNA in 1 cm3, suggesting the possible presence of viable Campylobacter cells in the tested probes with a significantly greater frequency than that established by cultural method.

Conclusion. At low levels of Campylobacter contamination the microbiological methods do not provide reliable detection of the pathogen due to massive contamination of raw milk by extraneous microflora. Campylobacter spp. were detected by the culture method in 8.3% of cases, while the use of multi-primer PCR assay with cdtB and ciaB genes can double the detection of C. jejuni in raw milk samples.

Characteristics of the macronutrient composition of diet and some somatometric indicators of patients with tuberculosis

Abstract

Relevance of the diet to the physiological needs of the organism is an important factor determining the incidence of tuberculosis in the world and effectiveness of its treatment. The need to study actual nutrition and nutritional status is determined by its significant changes in recent decades.

Aim: to study the actual nutrition and assess somatometric indicators of the nutritional status of patients with pulmonary tuberculosis in the acute stage.

Material and methods. 217 men and 83 women, the average age of 42.9±0.7years have been examined. Design: cross-sectional (simultaneous) epidemiological study. Research period: 2018. The method of analyzing the frequency of food consumption for the month preceding hospitalization has been applied. The somatometric indicators (height, body weight, waist, hip, shoulder girth) have been analysed, body mass index (BMI) have been determined.

Results and discussion. 77.7±2.4% showed non-compliance of the diet energy with the recommended values, an imbalance in diet according to the content of macronutrients was noted in 88.0%, insufficient amount of protein in the diet, taking into account the existing disease, in particular - animal protein was observed in 68.3% of the examined. Excessive intake of fats, including saturated fatty acids took place in 52.0%, cholesterol in 51.0%, as well as insufficient intake of dietary fiber was revealed in 38.7% of the examined. 19.3% had a malnutrition degree 1 (according to BMI), 11.7% had a 2nd degree, and 2% had a 3rd degree, respectively. BMI within normal limits (according to WHO criteria) was recorded in 57.7% of patients. The proportion of patients with overweight and obesity did not exceed 10% (7.3 and 2.0%, respectively).

Conclusion. The assessment of the nutritional status of patients suffering from tuberculosis and the identification of the macronutrient imbalance of their diet determine the need for their correction in the organization of therapeutic nutrition.

Features of nutrition pattern of patients with small intestinal bacterial overgrowth resistant to therapy

Abstract

Small intestinal bacterial overgrowth (SIBO) is a widespread disease characterized by a significant decrease in the quality of life. Antibiotic treatment with SIB O is not effective enough and the recurrence rate is high. Long-term dietary patterns can shift the composition of the microbiota.

The aim of the study was to compare the pattern of nutrition of patients with SIB О, resistant to therapy and cured patients.

Materials and methods. SIBO H2 has been identified in 458 patients using hydrogen-methane breath test with lactulose, and therapy with intestinal antiseptics and control breath test after 2 months was prescribed. 24 hour recalls or three-day food records were collected from all participants. The photographs were used to estimate the size of the portions eaten. According to food composition and portion all dishes in food diary were converted into constituent products by food groups, which were summed by weight per day and compared with the norms of consumption of the pyramid of healthy nutrition for a given caloric intake. The study compared dietary patterns of patients with resistance to the therapy of SIBO and those who had successful therapy.

Results and discussion. Control of the hydrogen content in the exhaled air was performed only in 79 re-appeared patients, 38 (48.9%) of them in 2 months after therapy revealed the presence of SIBO H2>20 ppm. A comparison of the nutrition of these patients showed that patients resistant to therapy had higher consumption of buckwheat (0.41±0.47 vs 0.14±0.35 relative to the rate of consumption of cereals, p<0.001) and millet (0.036±0.11 vs 0.007±0.021, p=0.047), poultry meat (0.80±0.64 vs 0.54±0.62, p=0.01) and butter (0.54±0.24 vs 0.39±0.22, p<0.01). The diet of patients with resistant to SIBO therapy was also сharacterized by a lower consumption of mono- and disaccharides (75.2±32.7 vs 95.5±41.5 g/day; p=0.015) and cottage cheese (0.07±0.08 vs 0.17±0.19, p=0.018). Consumption of fruits and vegetables did not have significant differences.

Conclusion. Treatment is ineffective in roughly half the patients with SIBO H2. According to the results of the study, significant differences in the nutrition pattern of patients resistant to SIBO therapy with respect to the consumption of cereals, poultry, butter, added sugars and cottage cheese were established. The obtained data may be used to develop dietetic maintenance of SIBO therapy and prevention of its relapses.

Physiology and biochemistry nutrition

The selection of optimal methods for determining the perfect body weight for the assessment of the nutritional status

Abstract

In everyday practice, for a personalized approach to assessing nutritional status it is necessary to determine the ideal body weight of a person, but bio-impedance analysis of body composition widespread in stationary conditions in an outpatient setting is not always available. Therefore, it is necessary to use other methods for determining the ideal body weight, the results of which would be most comparable with bio-impedance analysis results.

The aim of the work is a comparative analysis of various calculation methods for determining the ideal body weight and the results of bio-impedance testing.

Material and methods. 830 men aged 18 to 44 years were examined. The ideal body weight was calculated by 16 common methods. The obtained results were compared with bio-impedance analysis of body composition.

Results and discussion. To compare the accuracy of the coincidence of the results obtained by means of the used methods, the method of standard error of the model was used, as well as the correlation analysis was carried out, and regression models were constructed. A comparative analysis revealed the most informative methods for determining the ideal body weight, which are recommended for use in practice.

Conclusion. As a result of comparing several methods for determining the ideal body weight, we can conclude that the methods closest to the determination of ideal body weight obtained by bio-impedancemetry are the methods of Borgardt, Monnerot-Dumayn and the Insurance Company “Metropolitan Life”.

Micronutrients in nutrition

Assessment of the level of consumption of calcium and vitamin D with food in the adult population of Tyumen Region

Abstract

Calcium and vitamin D are essential micronutrients, whose deficiency adversely affects not only bone health, but also the functioning of the whole organism.

The aim of this study was to explore the level of calcium and vitamin D intake in the adult population of the Tyumen region, in order to optimize the nutritional program.

Material and methods. The study included 440 people living in Tyumen and Tyumen region. Inclusion in the study was conducted on the principle of random sampling using a random number program. The questionnaire was used to estimate the consumption of calcium and vitamin D with food. Serum level of 25(OH)D was determined in all participants of the study, the analysis was carried out by ELISA using Sunrise Euroimmin 25- OH Vitamin D ELISA test systems.

Results and discussion. The results of our own data led to the conclusion that there were a lack of consumption of foods rich in vitamin D among all ages and inadequate intake of calcium, especially in the older age groups. Approximately half of the respondents rarely ate sea fish, which was interrelated with plasma levels of 25(OH)D - vitamin D deficiency was detected in 70.7%, and its insufficiency was recorded in 22.0% of those examined. Only 45.5% of respondents consumed dairy products daily, while in general there was deficit of calcium intake in all age groups compared with the average age norm.

Conclusion. Adequate compensation of chronic calcium and vitamin D deficiency, which is widespread in both the Russian Federation and the Tyumen region, is an extremely important preventive direction of modern medicine.

Survey assesment of vitamin D and calcium dietary intake in children with somatic pathology

Abstract

Vitamin D and calcium play a key role not only in maintaining skeletal integrity, but are also important in the functioning of other systems of the human body.

The aim of the study is to evaluate the dietary intake of calcium and vitamin D in the children with different somatic pathologies (gastroenterological and endocrine) and its impact on somatic health indicators.

Material and methods. 114 children, aged 4-17 years old, were involved in the study. They underwent inpatient treatment for somatic pathology. The patients were divided into 4 groups: 36 children with chronic gastroduodenitis (the 1st group); 25 children with functional disorders of biliary tract (the 2nd group); 30 children with hypothalamic pubertal syndrome (the 3rd group); 23 patients with type 1 diabetes mellitus (the 4th group). Dietary intake of calcium and vitamin D was evaluated using a questionnaire. The sources of vitamin D and calcium intake were determined and the amount of these sources in the weekly diet of a child was evaluated. Then the total of vitamin D and calcium in the diet of each child and the average daily consumption of these nutrients with each food source were evaluated as well. All children underwent physical examination; a special attention was paid to the health of their teeth, nails, hair, skeletal system, as well as the presence of allergic reactions. Serum calcium concentration was determined by the colorimetric method with o-cresolphthalein in an alkaline medium and inorganic phosphorus by the phosphomolybdate method with aluminum molybdate in an acidic medium.

Results and discussion. It was established that the diet of the most children comprised baked goods (94.7%), meat (92.9%), dairy products (up to 90.4%), and eggs (90.4%). The children received most of their dietary vitamin D with fish (335.63±472.82 IU), butter (124.64±114.31 IU) and eggs (101.15±96.77 IU) per week. The dairy products, i.e. milk, yogurt, cheese, and cottage cheese, were the largest source of calcium. Calcium intake varied in different patient groups due to their food preferences and dietary recommendations related to their health. It was also proved that the average daily diet vitamin D intake at 123.98±53.52 IU was insufficient. The average daily intake of calcium with food was 524.53±248.38 mg. The insufficient intake of vitamin D and calcium with food correlated with clinical manifestations. Posture disorders were evidenced in 48.2% of children, tooth decay - in 40.4%, and hair illnesses - in 32.4%. These disorders were more significant in the children of the 1st group, who were proved to have the lowest vitamin D intake. The serum calcium level was lower than the reference values in 79.8% of children, the phosphorus level was lower than the reference values in 41.2% children.

Conclusion. The dietary intake of calcium and vitamin D in the children with different somatic pathologies (gastroenterological and endocrine) was insufficient, despite differences in children's diets under various pathologies, which led to the appearance of clinical signs of mineral metabolism disorders, among which posture disorders and tooth decay were most often observed.

Diet treatment

Evaluation of the nutritional value of products for enteral nutrition

Abstract

Optimal nutrition is especially important in the treatment and rehabilitation. In this regard, the use of special products of directed action - enteral nutrition is widespread. The market of these products is dynamically developing nowadays in Ukraine and worldwide. Basing on these statements, the development of enteral nutrition is an actual task.

The aim is the evaluation of the nutritional, in particular energy and biological, value of the developed dry soluble products for enteral feeding.

Material and methods. The developed dry soluble products for enteral nutrition “Reabilact” and “Reabilact-D ” were the objects for carrying out experimental studies, and dry enteral formula “Peptamen” (Nestle, Switzerland) was used as a reference sample. The content of macronutrients (protein - by Kjeldahl method, lipids - by Soxhlet extraction, carbohydrates - by Bertrand method) and micronutrients (vitamins A and C - by colorimetricalmethod, в-carotene - byphotometricalmethod, vitamins B1, B2, B3, B5, B6 -by capillary electrophoresis, mineral elements - by mass spectrometry with inductively coupled plasma) has been defined. Amino acid composition was determined by liquid column ion exchange chromatography. The energy value and glycemic index have been calculated.

Results and discussion. All studied samples were characterized by a high protein content (25-41%), the lipid content was 16.4-19.6%). The carbohydrate level in “Reabilact-D” (21.0%) was 2.6 fold lower, which was due to the physiological specificity of the target consumers (patients with diabetes mellitus). That is why sorbitol was used in this product (12.3%). The energy value of dry soluble products was 466 kcalper 100 g. Glycemic index of the dry mixture “Reabilact-D” (100 g) was 6.2 units. The results of the amino acid composition’s study of the products indicated that protein component was characterized by a high content and a balanced ratio of essential amino acids through the use of whey protein concentrate. The dominant amino acid was tryptophan (amino acid rate 145.0-175.0%), the limiting one was lysine (rate 102.9-123.9%). Studies of vitamin value indicated that the developed products contained a high content of vitamins, especially vitamins A and C, posessing antioxidant properties. It was found that the elemental composition of the proposed products was characterized by a balanced ratio of the basic chemical elements, which are essential for the human organism in the process of treatment and rehabilitation.

Conclusion. The researching results of the content of basic nutrients, vitamin and elemental composition of dry soluble products for enteral nutrition indicate their high nutritional (energy and biological) value. Basing on the established high content of proteins, vitamins (A, C, B1, B2, B6) and mineral elements, it can be stated that the consumption of the developed products will significantly improve the nutritional needs of the target category of victims during periods of treatment and rehabilitation.

Chemical composition of foodstuffs

The distinctive characteristics of the nutrient composition of reindeer meat from the Vorkuta district determined by the conditions of the region of origin

Abstract

Reindeer meat is an important source of crucial nutrients (protein, fat, minerals) in nutrition of Arctic indigenous people. The authentic meat properties are formed under the influence of many factors, the main of which are the lifetime factors including the region of production and peculiarities of keeping. The regional peculiarities of the reindeer meat composition are quite poorly reflected in the reference books on the chemical composition of food products and in the scientific publications.

The aim of the work was to evaluate nutritional value, the level of amino acids, fatty acids, minerals and trace elements of reindeer meat from the Vorkuta district.

Material and methods. The objects of the research were the samples of reindeer meat (m. longissimus dorsi) from the Vorkuta district obtained from the highly productive semi-domesticated young reindeers of the Nenets breed. The samples were taken from free-ranging male animals at the age of 8-10 month. The amino acid composition was analyzed by the chromatographic method, the mass fraction of tryptophan by the spectrofluorometrically method, oxyproline by the spectrophotometric method. The content of minerals and trace elements was detected by the flame atomic absorption method. The lipid extraction from the average sample was carried out by the extraction with chloroform/methanol by the Folch method, the purity of the extracted lipids was controlled by the method of thin layer chromatography. The fatty acid composition was determined the gas chromatographic method.

Results and discussions. The indicators of the chemical composition of reindeer meat from the Vorkuta district were established. The content of protein was 23.0%, the content of fat 1.2%. The high content of tryptophan (0.628 g/100 g of the product) was characteristic for this prodact. The ratio of tryptophan to oxyproline was 11.8, which exceeded the values in pork and chicken. The low level of polyunsaturated fatty acids (17.8% of total lipids), in particular linoleic acid (6.9%), was assigned to the special features of the composition of meat under investigation. With that, quite high content of saturated fatty acids (48.6% of total lipids) was observed, which explained increased meat stability to oxidative spoilage during long-term storage and processing. The content of calcium in the reindeer meat from the Vorkuta district was 72.25 mg/kg, potassium - 33.3 g/kg, magnesium - 310.25 mg/kg, iron - 55.54 mg/kg, zinc - 41.89 mg/kg, copper - 4.0 mg/kg. The level of iron, magnesium and copper in this type of meat was significantly higher than the data on reindeer meat presented in the reference literature.

Conclusion. The obtained data on the chemical composition of reindeer meat from the Vorkuta district can be a basis for the development of the indicators of its authenticity and in the future can be used for identification in case of the need to confirm species and a region of origin of meat, as well as for solving tasks of formation and promotion of regional brands.

Pomegranate juice nutritional profile

Abstract

Pomegranate juice is one of the main products of pomegranate processing with high content of a complex of polyphenolic compounds. It possesses high antioxidant activity.

The aim of the study is to establish the nutritional profile of pomegranate juice.

Material and methods. A research of nutrient composition of commercial pomegranate juice and analysis of the results in conjunction with the data of chemical composition present in reference books and scientific publications have been carried out.

Results and discussion. The nutrient profile of pomegranate juice has been defined. The nutrient profile shows the content of more than 30 nutrients and biologically active substances. Sugars of pomegranate juice are represented by glucose and fructose in approximately equal concentrations. Citric and L-malic acids prevail of the organic acids in pomegranate juice while the content of citric acid, as a rule, is several times higher than the content of L-malic. The total acidity of pomegranate juice is high, on average 1.1 g of organic acids is present in 100 cm3 of juice. A portion of pomegranate juice of industrial production on average contains 15% of the recommended daily allowance of potassium, 5% of magnesium, about 10% of copper. Pomegranate juice is rich in polyphenolic compounds - flavonoids and phenolic acids, as well as tannins, which are mainly represented by ellagotannins. The content of anthocyanins in pomegranate juice of industrial production on averages is 1 mg/100 cm3 (the majority is cyanidin-3,5- O-diglucoside - about 40% of the total content of anthocyanins), ellagic acid -on average 4 mg/100 cm3. The total concentration ellagotannins ( mostly punicalin andpuni-calagin ) is on average 40 mg/100 cm3.

Conclusion. Polyphenolic compounds (ellagotanins, anthocyanins, ellagic acid) and minerals -potassium, magnesium, copper are the most significant for pomegranate juice from the point of view of providing human body with micronutrients and minor biologically active substances.

Food quality control and safety

Comparative assessment of N-nitrosamines' contamination of baby's canned meat with vegetables and cereals by various methods in Russia and Vietnam

Abstract

The quality and safety of food, intended for baby in particular, is one of the global issues of our time. The group of carcinogenic N-nitrosamines is of especially dangerous. It is worth mentioning that currently there are no standards for their content in Vietnam. Therefore, to ensure the chemical safety of infant food, it is necessary to improve the control system, including the development of modern technical and methodological base.

The aim of the research is the comparative assessment of contamination with highly toxic, N-nitrosoamines of baby canned meat and vegetable products by the gas chromatography-mass spectrometry (GC/MS) using an automatic solid-phase extraction system and gas chromatography-tandem mass spectrometry (GC-MS/MS).

Material and methods. The objects of research were homogenized canned meat-vegetable products for baby nutrition - 21 samples taken from the distribution network of the Republic of Vietnam: vegetables and rice with chicken (sample No. 1); sweet corn with mashed potatoes and turkey (sample No. 2); potatoes with veal (sample No. 3); each species has 7 samples. Each food sample was analyzed thrice by two methods. At the Federal Center of Perm, the screening studies of canned foods were performed using GC/ MS with application of the automatic solid-phase extraction system (SPE) after distillation using alkaline catalysis at the sample preparation stage. At the National Institute of Food Control of Republic of Viеtnam, canned samples were studied using GC-MS/MS. The extraction method was developed on the base of QuEChERS-approach.

Results and discussion. During the research, the following chemical contaminants were found in the canned samples: N-nitrosodimethylamine, N-nitrosodiethylamine, N-methylethyl nitrosoamine, N-dipropylnitrosoamine, N-dibutyl nitrosoamine, N-piperidinitrozoamine, N-pyrrolidinin nitrosoamine, N-morpholinithrosamine and N-diphenyl nitrosoamine. It was demonstrated that the results of quantitative determination of the content of N-nitrosoamines in canned meat of Vietnam producers obtained in different laboratories are comparable and have good validation characteristics for the determination of N-nitrosoamines in baby food. Thus, N-nitrosodimethylamine was detected by both methods in all analyzed samples in the concentration range from 0.00045 to 0.00077 mg/kg. Values exceeding the maximum permissible level of N-nitrosoamines (N-nitrosodimethylamine and N-nitrosodiethylamine) in canned meat and vegetable samples (0.001 mg/kg according to Technical Regulations of the Customs Union TR TC 021/ 2011 “On Food Safety”) were not found. The application of low-resolution gas chromatography-mass spectrometry and the use of an automatic SPE system made it possible to achieve high comparability of the results in chemical analysis of N-nitrosoamines in canned products obtained in the laboratory of the Center and the National Institute for Food Control of Vietnam.

Conclusion. The executed studies indicate the need for further monitoring of the content of chemicals in baby products in order to justify methodological approaches to the analysis of the risk of the simultaneous effect of chemical contaminants on the health of children. In this regard, it seems extremely important and relevant issue of hygienic regulation of the content of the studied compounds in products for baby food.

In Memory of Igor Yakovlevich Kon'

Igor Yakovlevich Kon'

Abstract

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CHIEF EDITOR
CHIEF EDITOR
Viktor A. Tutelyan
Full Member of the Russian Academy of Sciences, Doctor of Medical Sciences, Professor, Scientific Director of the Federal Research Centre of Nutrition, Biotechnology and Food Safety (Moscow, Russia)

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