6 . 2018

Modern approaches to dietary support for patients with diabetic nephropathy


The article presents modern approaches to dietary support of patients with diabetic nephropathy (DN) characterized by gradual sclerosis of the renal tissue, leading to a loss of filtration and nitrogen excretory function of the kidneys. An analysis of publications of domestic and foreign authors indicates a slowdown in the progression of chronic kidney disease against the background of low-protein diets. However, the role of protein restriction and its qualitative composition in the diet of patients with DN is the subject of comprehensive discussion. KDOQI (2007) Clinical Practice Guidelines and Clinical Practice Guidelines for Kidney Disease determine the target level of protein intake in individuals with diabetes and chronic kidney disease 1-4 stages at the level of 0.8 g/kg of body weight per day. In the recommendations on nutrition for patients with DN, along with a controlled reduction in protein content, great importance is attached to reducing sodium intake from food to 1.5-2.3 g per day. In recent years, close attention has been paid to the use of highly active natural antioxidants for the treatment and prevention of type 2 diabetes, including DN, which was determined by the results of studies demonstrating their beneficial effects on DN patterns. It has been shown that one of the ways to optimize the nutrition of patients with DN is the use of specialized foods modified by protein, fat and carbohydrate composition, including food ingredients with hypoglycemic, hypolipidemic and antioxidant effects.
Physiology and biochemistry nutrition

Effect of quercetin on morphological changes in nonalcoholic fatty liver disease in high fructose-fed rats


The aim of this study was to examine the effect of polyphenol quercetin on morphological changes in nonalcoholic fatty liver disease (NAFLD) in rats fed high-fructose diet.

Material and methods. For 20 weeks animals (n=8 in each group) of the 1st group were given standard diet and water; the 2nd group - standard diet and 20% fructose solution; the 3rd group - standard diet with quercetin supplementation (0.1%) and 20% fructose solution. Formalin-fixed and paraffin-embedded liver samples were sectioned, stained (hematoxilin and eosin, Van Gieson’s stain), evaluated with the use of the SAF and NAS scales.

Results and discussion. Histological assessment did not reveal pathology in the structure of the liver of the 1st group rats (S0A0F0; NAS - 0, fibrosis - 0). The 2nd group rat livers disclosed micro-, mid- and macrovesicular steatosis, inflammation without ballooning, pericellular and periportal fibrosis (S2A1F2; NAS - 3, fibrosis - 2). Quercetin-treated rats exhibited in liver significantly less steatosis without significant changes in inflammation and fibrosis features (S1A1F2; NAS - 2, fibrosis - 2) compared with rats of the 2nd group.

Conclusion. The data obtained demonstrate the ability of quercetin to inhibit the development of NAFLD in rats fed a diet with a high content of fructose, by reducing the severity of hepatostatosis.

Hygiene of nutrition

Hygienic assessment of indoles in the diet of medical students


A number of studies have shown the relationship between the regular consumption of cruciferous vegetables and the risk of malignant tumors in certain localizations, the activation of mechanisms of alimentary adaptation of the organism under conditions of alien loads, by inducing enzymes of the biotransformation system of xenobiotics. The cruciferous vegetables are distinguished by the presence of minor components, such as indole-3-carbinol, formed during the hydrolysis of glucosinolates.
The aim of the investigation was a retrospective study of the content of indoles in students’ diet with subsequent quantitative analysis in different comparison groups. The study involved 250 students from a medical university aged 21 to 27 years. To assess the actual nutrition, the developed questionnaires were used, which included the most common products in the Moscow region, sources of indole glucosinolates. It was found that 44% of the respondents didn’t include cruciferous vegetables in the diet, and of those who consumed sources of indoles (56% of respondents), only about half received them in the recommended amount. It should also be noted that as in men, in women the most commonly used in the diet product as a source of indoles was cabbage, it was included in the diet of 68% of the respondents who used cruciferous vegetables, rarely pekin cabbage was used (16.3%) and broccoli (16.3%). Cauliflower, radishes, Kale and horseradish was included in the diet of 7.8-14.9% of the students. Less often turnip was consumed - only by 2.1% of the students. No significant differences in the consumption of indoles in the student with deficient, normal or overweight was revealed. Also, there was no correlation between excess weight and the consumption of various indoles sources. The obtained results testify to the extremely low level of alimentary intake of indole-3-carbinol.

A comparative analysis of actual nutrition of children aged 9-10 years


Aim of the study is to carry out a comparative analysis of actual nutrition of children aged 9-10 years with different nutritional status, to asses relationships between Energy Value (EV) of diet, BMI and diet composition.

Material and methods. The study covers two groups of children residing in Almaty - 80 children aged 9-10 years with obesity (40 boys and 40 girls) and 80 normal-weight children (40 boys and 40 girls). To determine the nutritional status of the children, diagnostic criteria such as BMI-for-Age Z-score tables of WHO growth standards have been used. The nutrition was studied using the 24-hour recall method.

Results. The level of consumption across the entire range of food products, with the exception of cheese, cottage cheese, fish and eggs, turned out to be higher for the obese children with a difference range of 20-151% as compared to normal-weight children. Irrespectively of the nutritional status, all groups of children failed to achieve the recommended level of consumption of vegetables (1.7-fold less than recommended on average), potato (1.4-fold), milk and/or liquid fermented milk products (2.6-fold), fish (4.9-fold), eggs (3.1-fold), and consumed refined foods significantly higher than its limit level (confectionary items - 5.6-fold, flour - 2.9-fold). The contribution of sugar, pasta and sausages to EV of the diet was higher in diet of obese children as compared to normal-weight children. The daily Energy Intake (EI) for the obese children was significantly higher than for the normal-weight children. The obese boys consumed 2174±564 kcal whereas normal-weight boys - 1625±343 kcal, obese girls - 2059±530 kcal, normal-weight girls - 1532±293 kcal. The macronutrient composition of the diet for obese children differed from that of normal-weight children by increased proportions across all nutrients; however it didn’t differ from the normal-weight children’s diet in terms of the percentage content of macronutrients and the nature of imbalance. The imbalance took the form of a reduced quota of carbohydrates, excessive intake of simple carbohydrates (2-fold), saturated fats (1.5-fold), and a deficiency of dietary fibers, vitamins A, D, B group (thiamine, niacin, pantothenic acid, biotin, folic acid), zinc and calcium. The relative content of dietary fibers in the diet of obese children was lower than that in the diet of normal-weight counterparts. In obese children the percentage of carbohydrates contribution to EV of the diet served as a predictor of EI (β=0.5, р=0.00). Elevated BMI was predicted by EI (β=0.7, р=0.00), Carbohydrate to Fiber Ratio (β=0.2, р=0.05), Carbohydrate to Fat Ratio (β=0.3, р=0.01), Carbohydrate to Protein Ratio (β=0.3, р=0.01), percentage of carbohydrate contribution to EV of the diet (β=0.3, р=0.01). Thereby elevated BMI was predicted by EI, carbohydrate intake and by deficiency of the dietary fiber.

Assessment of the risk of malnutrition in the older age group of the Voronezh Region


Modern scientific data indicate the widespread use in European countries of questioning in assessing the nutritional status of patients. The use of questionnaires in medicalpractice allows the doctor to reduce the time to collect anamnesis, to place emphasis on building a further algorithm of diagnosis and treatment. The article is devoted to the study of the nutritional status of elderly people in the city of Voronezh and the Region; determining the risk of malnutrition syndrome. The work involved 166 people aged 60 to 89 years. The average age of the respondents was 69.4±7.2 years. The main part of the participants consisted of urban population, the predominance of urban population over rural was more than 2 fold (67.5 to 32.5% respectively). 72.3% of respondents were female, 27.7% - male. At the same time, the share of urban population among female participants was almost 2 fold more than in rural areas (64.2 to 35.8%). For men, the urban population was more than 3 fold than the rural population (76.1 to 23.9%). Methods of registration of anthropometric data, collection of anamnesis and data from the outpatient card, questioning have been used in the work. A questionnaire «Mini Nutritional Assessment» (MNA) have been used for the evaluation of nutrition. Study design: a retrospective study. In the course of the work it was determined that only 1.8% of the surveyed patients have the syndrome of malnutrition. However, the risk of its development was revealed in 46.6% of patients. Older people living in the city had a statistically significantly higher risk of developing malnutrition (p<0.05) than the villagers.

Organization of nutrition of children and adolescents at the regional level


The article presents the results of 13-year monitoring epidemiological studies on the actual nutrition and eating habits among children and adolescents studying in educational institutions of the Republic of Sakha (Yakutia). The study used standardized questionnaires, adapted by the Nutrition Center of the Health Institute M.K. Ammosov North-Eastern Federal University, in accordance with national traditions and food culture of the peoples of the North and the Arctic. Methods of frequency analysis of consumption of individual products and daily reproduction of food from memory have been used to study the main parameters of consumption of individual foods, including those from local animal and vegetable raw materials, and national dishes. Three monitoring epidemiological studies of 2001 (1st study), 2008 (2nd study), 2013 (3rd study) studied the energy value of diets and nutrients (proteins, fats, carbohydrates, vitamins and minerals), the contribution of macronutrients in energy value. Schoolchildren’s awareness of healthy nutrition was assessed. Dietary habits and addictions of children to particular foods and dishes have been identified. A comprehensive assessment of the actual nutrition and health status of 130 adolescents aged 15-18 years is given to study the effect of actual nutrition on the health of children, their anthropometric indices and body composition. Based on the results obtained, recommendations on how to optimize the nutrition of children of school age were scientifically substantiated, measures were taken to improve it, and conclusions were drawn on the need to improve the legal regulation of school feeding.
Prophylactic nutrition

The prospective of using plant polyphenols as functional food ingredients


In this review we briefly discuss the publications dedicated to experimental evaluation of hypoglycemic, hypolipidemic and antioxidant properties of different plant polyphenols. The stages of preclinical studies of their efficacy are presented: in silico studies with molecular docking methods and in vivo studies with the use of genetic and medicamental models of type 2 diabetes. The results of own studies present the substantiation of prospects of using the plant polyphenol extracts as functional food ingredients for diet therapy and treatment of patients with type 2 diabetes. It was shown using genetic fatty Zucker rats model that extract consumption led to lower blood glucose level, had beneficial effect on glucose sensitivity and also improved the reaction of insulin-sensitive tissues on exogenous injection of glucose and insulin. Hypoglycemic and hypolipidemic properties of bilberry leaves extract were characterized on male Wistar rats model of carbohydrate metabolism disorder (streptozotocin injection accompanied with consumption of 10% fructose solution). The results of previous studies showed the beneficial effects of bilberry leaves extract on carbohydrate metabolism and determined the task to enhance the efficacy of developed polyphenol ingredient by the way of sorption on protein food matrix - brown buckwheat flour. Thus, a brief review of presented in this article results of foreign and domestic experimental studies shows the prospect of using the individual plant polyphenols and polyphenol plant extracts as phytonutrients for diet therapy and treatment of diseases associated with disorders of carbohydrate and lipid metabolism.

Biodegradation of proteins of grain raw materials for the production of new bakery products


The effect of enzyme systems on the degree of protein destruction of grain crops to obtain new types of bakery products has been studied. Protein and amino acid composition of triticale grain crop in comparison with wheat and rye one has been studied. The high biological value of triticale proteins containing 38.75% of essential amino acids while in wheat - 34.93% has been shown. The influence of different enzyme systems (ES) with proteolytic action on the efficiency of catalytic modification of triticale proteins has been investigated. It was found that the highest activity was shown by the enzymatic system ES-1, synthesized by the mycelial fungus Aspergillus oryzae, as a result of which at a concentration of 5 u/g, the level of accumulation of amine nitrogen in triticale enzymatic hydrolysates was 125 mg%; the degree of hydrolysis of proteins was 90%. Enzyme preparations of bacterial origin, as well as alkalase and papain had a lower ability to hydrolyze triticale proteins. The fractional composition of modified proteins obtained by ES-1 showed a decrease in their molecular weight (to 35 kDa). Analysis of amino acid composition in grain enzymatic hydrolysates showed that as a result of exposure to FS-1, about 50% of the total number of amino acids passed into the free state, of which 38.8 to 43.6% were essential amino acids. The recipes of breads, containing composition of wheat flour and fermentolizates of the whole-grain triticale flour in the ratio 1:1 have been tested. The amino acid composition of the bread showed that the test samples contained 6.2 fold more free amino acids than the control. The use of fermented triticale in the recipes of bread allowed to increase the content of essential amino acids such as methionine, valine, isoleucine, leucine, phenylalanine, threonine, tryptophan and lysine in 2.0-5.0 times. It was shown that the developed technology allowed baking bread containing peptides with reduced molecular weight and free amino acids, which by its organoleptic and physic-chemical parameters corresponded to classic bakery products.
Diet treatment

Specialized food products with modified carbohydrate profile for dietary correction of diet of patients with type 2 diabetes


In recent years, the incidence of diabetes mellitus (DM) in the world is growing steadily. According to the international diabetes Federation (IDF), the number of DM patients in the world in 2015 was 415 million, of them more than 90% - patients with type 2 diabetes. According to forecasts, in 2040 their number will increase to 642 million. Russia ranks fifth among the ten countries with the largest number of the adult population with diabetes. Dietary correction of the diet of patients with type 2 DM is carried out by the inclusion of specialized foods with a modified carbohydrate profile containing ingredients with hypoglycemic action. The purpose of the study - the development of composition and technology of specialized foods and assessment of the possibility of their use in the therapy of patients with type 2 diabetes. Taking into account the medical requirements for diet therapy for type 2 diabetes, composition and technology of two specialized foods in the form of beverage concentrates have been developed. The technology of step-bystep mixing contributed to the uniform distribution of biologically active substances in the mass of the product. The absence of sucrose and digestible polysaccharides in the composition of the developed products was established, the presence of about 1% lactose was due to its content in the protein component. Humidity didn’t exceed the standard values for similar products, the values water activity were typical for products with low humidity, which justified the prediction of the microbiological stability of the developed products during storage. The osmolality of the beverages restored in accordance with the method of preparation was 310 and 258 mOsm/kg, which characterized them as isotonic. The products were balanced in amino acid composition, had a high score of essential amino acids due to the introduction of a combination of proteins. The consumption of one serving (30 g) of the product in the form of a drink (200 ml) provided an average daily requirement for essential amino acids by 15-22%, polyunsaturated fatty acids ω-3 - by 10%, ω-6 - by 15%, soluble dietary fibers - by 50-55%, vitamins groups B - by 14-81%, C - by 46%, A, D3, E, K1 - by 17-46%, minerals and trace elements - by 1033%. The content of polyphenols was about a half of its adequate level of consumption. The inclusion of specialized foods with a modified carbohydrate profile in the composition of the low-calorie diet lead to the stabilization of postprandial blood glucose levels in patients with type 2 DM.

Chemical composition of foodstuffs

Monitoring of selenium content in some food of residents of the Khabarovsk


The development of about 40 diseases, including cancer and cardiovascular diseases, is associated with a lack of selenium (Se) consumption. According to the previously obtained data, Khabarovsk Krai is characterized by low human selenium status in various age groups and low content in most foods, that is the main reason for the population Se deficit in Khabarovsk territory.

Aim: to study the content of Se in some foods in Khabarovsk in the comparative aspect. Study design: prospective.

Material and methods. The content of Se in the basic products collected in the commercial network of Khabarovsk [wheat, rye-wheat bread (48 samples), chicken eggs -24 samples] was determined, the choice of these products was justified by their maximum availability for all segments of the population. The Se level was determined by fluorimetric method.

Results and discussion. According to previous studies, we have found low Se content in donors’ blood serum and basic food products in the Khabarovsk territory, which indicated the need to for monitoring and correcting Se status. Eating exclusively local products and the influence of geochemical specificity of the area were the main reasons for the development of Se deficit, because the status of a person completely depended on the inflow of nutrient from the diet. According to the monitoring data for 10 years, Se content in wheat bread decreased more than 3 fold, in rye bread - more than twice. There was 2-fold decrease in Se content in a chicken egg. On average, residents of Khabarovsk with 1 chicken egg received only 3.7-22.6% of the adequate level of Se consumption. The selenium content in an egg enriched with this trace element was 15.85±4.3 gg (or 25.5±6.4 gg/100 g), which is twice as high as the average Se content in a standard egg.

Conclusion. The dynamic assessment of Se content in products of daily demand of residents of the Khabarovsk territory indicates a critically low content of the element in bread and chicken eggs; the established level of Se in foods does not contribute to the accumulation of the element in the human body. The obtained data should become one of the main components of the regional program of optimization of Se status of Khabarovsk population.

Grape juice nutritional profile


The nutrient profile of grape juice is presented on the basis of reference books data analysis, scientific publications and research results. The profile contains more than 30 food and biologically active substances (BAS). Grape juice does not have high acidity, it contains on average 0.4 g of organic acids per 100 cm3. Tartaric acid and L-malic acid are major acids in grape juice. The presence of tartaric acid is a distinctive feature of grape juice, in other juices it presents extremely rare and only in traces. Potassium, magnesium, iron, manganese, as well as flavonoids and hydroxycinnamic acids are the most important for grape juice from the point of view of providing humans with micronutrients and minor BAS. Juices from red/purple grapes varieties contain anthocyanins (on average 3 mg/100 cm3), the color of grapes and grape juices are associated with them, about 50% of the anthocyanins are malvidin glycosides. Resveratrol (an average of 0.01 mg/ 100 cm3), a stilbenoid, is also found in grape juices, this substance is widely studied recently due to its high antioxidant activity. Caftaric acid prevails among hydroxycinnamic acids presented in grape juice (on average 5 mg/100 cm3). A portion of industrial grape juice contains, on average, 6-10% of human daily need for potassium, about 5-8% for magnesium, iron and manganese. The content of flavonoids per serving is about 25% of the adequate level of daily consumption, and the content of hydroxycinnamic acids exceeds it. Studies of fresh grapes purchased in commercial networks show that the content of magnesium, iron and manganese in grape juices of industrial production is comparable to the content of these micronutriens in fresh fruit.
Food quality control and safety

Development of a modern methodological base for monitoring the content of vitamins in food and food supplements


The determination of vitamins in various food matrices is necessary for monitoring the quality and safety indicators of food, including the control of the use of vitamins as foodadditives - food colorings and antioxidants. As well it is necessary to evaluate the level of consumption of vitamins by different age and sex categories of the population. The analysis of the regulatory and methodical basis in the field of determining the content of vitamins in food, including food supplements, has been held. It is shown that the sample preparation process plays an important role in the procedure of determination of vitamins. The modern problems of sample preparation of foods depending on their matrix are considered. The tasks to improve the methodological base, including the harmonization of interstate and national standards of the Russian Federation with international regulatory documents, are marked. It is emphasized that the most promising methods of vitamins ’ determination for further development are mass-spectrometry and capillary electrophoresis. The selected methods are characterized by high authenticity of the results. Mass-spectrometric detection is characterized by identification reliability. Capillary electrophoresis is characterized of simplicity of analysis.

Determination of phthalates in juice product by high-performance liquid chromatography/mass spectrometry


The paper presents the research results obtained after determination of the persistent organic pollutants of the environment - phthalates in domestic juice products with the use of high-performance liquid chromatography/ mass spectrometry (HPLC/MS/MS) with application of solid-phase extraction as a method of sample preparation. Selective determination of phthalates in fruit and vegetable juices by HPLC/MS/MS method has been provided through parent and child ions’ monitoring that are formed during ionization of the molecules of the studied compounds in the electrostatic spray of isomers on a reversed-phase column. The analysis of the samples of juice product revealed the presence of 11 phthalates out of 13 studied in concentration range from 0.4 up to 59.26 mg/dm3. The maximum amount of phthalates was found in juices with pulp 31.9-59.26 mg/dm3 (tetrahedral package), the minimum content of phthalates 0.4 mg/dm3 was detected in flavoured beverages (polyethylene terephthalate packing) and 1 mg/dm3 in the fruit-and-vegetable nectar (glass packing). The most samples contained from 3 to 8 phthalates with total content of 0.4-5.82 mg/dm3. The most prevailing pollutants of the analyzed samples were di-n-octylphthalate found in 100% of samples, dinonyl phthalate and di (2-ethylhexyl) phthalate, presented in 70-80% of samples. The maximum pollution density of the juice samples was noted for di-n-octyl phthalate, di (2-ethylhexyl) phthalate, diisononyl phthalate and diisobutyl phthalate.

Secondary lipid oxidation products. Human health risks evaluation (Article 1)


The first article of the series describes possible applications of both proton nuclear magnetic resonance spectroscopy (1Н NMR) and Fourier transform infrared spectroscopy (FTIR) in food lipid thermo-oxidation analysis. Thermo-oxidation process is a source of various oxidation products. Some of them are known to be toxic, such as oxidized α,β-unsaturated aldehydes and epoxidized linoleic acid derivatives. Today we know that routine nonspecific methods in lipid oxidation analysis are not informative, may provide incorrect results and procedures are long and laborious. Therefore it might be useful to find more reliable, accurate and informative physic-chemical methods measuring food lipid oxidation status. This paper is devoted to the most widely used in lipid analysis spectroscopic methods such as 1Н NMR and FTIR. It has been shown that 1Н NMR and FTIR provide more information on the types, formation and degradation time of compounds formed than wet chemistry methods. 1Н NMR gives qualitative and quantitative information on degraded and newly formed compounds and FTIR is able to measure a lot of standard oxidation indices with high accuracy. Both of them allow us to trace any compounds’ evolution in lipid matrices in real time. Mention is made of their advantages for routine laboratory analysis.
In Memory of Vladimir Borisovich Spirichev

Vladimir Borisovich Spirichev

Index of articles

Index of Articles Published in the Journal «Problems of Nutrition» for 2018

SCImago Journal & Country Rank
Scopus CiteScore
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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