Empirical dietary patterns and their influence on health in epidemiological studies
The last two or three decades in the epidemiology of nutrition empirical approaches to assessing the diet of the population are increasingly being used. However, in Russian studies, these approaches are used extremely rarely, which may be due to insufficient knowledge of the essence, methodological aspects and the field of application of posterior dietary patterns.
In this regard, the aim of this review was to highlight the essence, methods and main results of using empirical approaches to assessing the diet of the population.
Results. This review discusses the main methodological features of multivariate analysis methods - factor analysis (principal component analysis) and cluster analysis. The main trends of dietary patterns characteristic of the epidemiology of nutrition, and various in different countries and regions are shown. The results of studies of the impact of dietary patterns on some indicators of health status (cardiovascular and oncological diseases, diseases of the musculoskeletal system, diabetes mellitus, metabolic syndrome and its components, mortality) are considered. A brief description of the few Russian studies that used the principal component method in identifying empirical dietary patterns of population is given. In general, this review indicates that the use of multidimensional statistics to highlight population dietary patterns as part of an empirical assessment is nowadays one of the most important components of nutrition epidemiology in different countries. An empirical assessment allows us to consider the diets of the population from a factual point of view and significantly supplements the scientific knowledge obtained using other epidemiological approaches. Currently, considerable experience in the development of methodological approaches to dietary patterns, as well as in the analysis of their associations with various indicators of health status has been accumulated.
Conclusion. All this testifies to the high relevance of the considered epidemiological approaches and the need for their testing in Russian conditions, which, perhaps, will give new knowledge about the dietary patterns formation and its impact on the health status of Russians.
The role of nutritional factors and food allergy in the development of psoriasis
Psoriasis is a chronic relapsing disease that affects about 2% of the world's population and leads to medical and social losses. There is evidence of the effect of nutritional factors on the course of psoriasis in modern literature.
The aim of the research was to analyze modern domestic and foreign literature on the role of nutritional factors, food allergies and the state of the gastrointestinal tract in the etiopathogenesis of psoriasis
Material and methods. The electronic resources were used in preparing the article: the PubMed/MEDLINE portal, “Scientific Electronic Library eLIBRARY.RU”. The following filters and keywords were requested: psoriasis and nutrition, food allergies and psoriasis, gastrointestinal manifestations and psoriasis, diet and psoriasis, obesity and psoriasis.
Results and discussion. The role of nutrition as a predictor of the development of psoriatic skin rashes and exacerbation of the disease has been discussed. The mechanisms of the positive influence of the correction of metabolic disorders on skin processes in patients with psoriasis have been analyzed. It has been noted that further studies are needed to study the effectiveness of a low-calorie diet for psoriasis treatment. Particular attention has been paid to the role of food allergy and pathology of the gastrointestinal tract in the etiopathogenesis of psoriatic disease. It is noted that in patients with psoriasis, structural and functional disorders in the gastrointestinal tract are observed, which lead to metabolic changes, endotoxinemia and autosensitization of the body. The role of intolerance to certain foods in the development of psoriasis has been discussed. Most of the available data indicate a high incidence of celiac disease and gluten intolerance in patients with psoriasis, however, information about the effectiveness of a gluten-free diet is controversial. Attention is drawn to the “non-celiac gluten sensitivity” associated with psoriasis, which represents a syndrome of neither allergic nor autoimmune genesis, which is manifested by gluten intolerance and characterized by symptoms similar to celiac disease. An increase in the frequency of occurrence of a high concentration of specific IgE to potato and carrot allergens in patients with psoriasis is noted, which most likely reflects cross-reactions with pollen allergens. An interesting hypothesis is the discussion of a lesion of the gastrointestinal tract in the presence of food allergies in patients with psoriasis, which may be a reflection of the systemic dermatogastrointestinal process and manifest psoriatic rashes on the skin. The mechanism of the anti-inflammatory effect associated with adhering to the Mediterranean diet for psoriasis is described in detail.
Conclusion. The data presented allow us to consider the role of nutrition in the etiopathogenesis of psoriasis as significant, both from the point of view of the influence of nutritional factors and food allergens, that must be taken into account when prescribing therapeutic nutrition and elimination diet in combination with standard systemic therapy.
Dietary intake of children with cystic fibrosis
The high incidence of nutritional deficiency in cystic fibrosis continues to be an urgent problem in pediatrics. This is due to the multifactorial nature of these violations, one of which is the lack of effectiveness of nutritional correction.
The aim of the research was to assess the actual diet of children and adolescents suffering from cystic fibrosis in order to develop an algorithm for individual approaches to correcting nutritional status.
Material and methods. 150 children (boys - 85, girls - 65) aged 1 year to 18 years (average age 6.4±5.2 years) with a confirmed diagnosis of cystic fibrosis have been examined. Depending on age, the children were divided into groups: the 1st group consisted of 40 children from 1 year to 2 years (average age 1.9±0.7 years); 2nd group - from 3 to 5 years (n=41, 4.4 ±1.0 years); 3rd group - from 6 to 9 years (n=43, 7.7±1.1 years); 4th group - from 10 to 18 years old (n=26, 13.1±2.5). The actual nutrition was evaluated by questionnaire for 3 days, including one day off. Body mass, height have been measured, and body mass index (BMI) have been calculated.
Results and discussion. Only children of the first three years of life had an optimal diet for this disease in terms of energy value. At the age of 3 years and older, the deficit of energy intake increased, reaching 32% of the individual requirement in adolescence (10-18 years). The structure of nutrition revealed an imbalance of the main nutrients in the direction of the predominance of the lipid component (more than 40% of the energy value) and increased intake of saturated fatty acids, with a reduced proportion of protein and carbohydrates. There was a lack of dietary intake of a number of vitamins (C, B1, B2, A, E, D) and mineral substances (iron, potassium).
Conclusion. The study showed the need for an individual approach to the correction of diet energy value and macronutrient intake in children with cystic fibrosis.
The study of biological effects of different geographical origin goji berries in rats with alimentary hypercholesterolemia
Food and medicinal plants as well as its’ fruits, used in traditional medicine, are now widely used as sources of bioactive phytochemical compounds to impart functional properties to products. Due to the significant variation in phytonutrient content depending on geoclimatic conditions, a comparative study of goji berries collected in different regions seems to be relevant.
The aim - comparative study of L. barbarum and L. chinense berries and its biological effects when inclusion in the diet of rats with experimental hyperlipidemia.
Material and methods. In the berries of L. barbarum (China) and L. chinense (Kazakhstan), the composition of monosaccharides, the content of vitamins (D, E, C), minerals (Mg, Ca, Se), phenolic compounds and steroid substances as well as catalase and superoxide dismutase activity and total antioxidant activity was determined. Biological experiment lasted 186 days, it was carried out on Wistar rats, divided into intact (n=10) and experimental animals (n=48), in which alimentary hyperlipidemia was reproduced for 100 days (diet containing animal fats 5.0-19.0% and cholesterol 0.5-2.0%), further animals were divided in control rats with hyperlipidemia, consuming a standard diet (group 1) and experimental rats, which were supplemented for 86 days with L. barbarum (group 2) and L. chinense (group 3) in an amount of 20% of the diet carbohydrate component. On the 128th and 186th days of the experiment, rats’ blood serum was analyzed for total protein, albumin, creatinine and urea, triacylglycerides, total cholesterol, high and low density lipoprotein cholesterol, malondialdehyde and the total antioxidant activity of blood serum was measured.
Results and discussion. L. chinense berries, which are characterized by a high content of phenolic compounds (20% higher than in L. barbarum berries), when administered to rats with alimentary hyperlipidemia on the 28th day, reduced the concentration of total cholesterol by 44.1% and low-density lipoproteins by 35.8% relative to control animals, on day 86 contributed to an increase in the concentration of high density lipoproteins to 79.6%. The effect of L. barbarum berries, characterized by an increase in high density lipoproteins in rat blood (by 62.3%), may be due to a higher content of vitamins C, E and selenium (35, 11 and 22% more than in L. chinense), the presence of phytosterols and phytostanols, in particular dodecanoic acid.
Conclusion. The data obtained indicate a pronounced antioxidant effect of L. barbarum and L. chinense berries and the possibility of their use in the diet to correct lipid metabolism disorders.
The effect of agar-pectin gels on the eating behaviour of fasted and fed mice
A diet rich in non-digestible plant polysaccharides (dietary fibers) leads to effective appetite suppression and reduces food intake. The mechanical properties of food contribute to the satiating effect of food. It is known that solid food satiates to a greater extent than liquid, as the duration of food processing in the oral cavity increases.
The aim of the study was to assess the effect of mechanical properties of agar-pectin gels on the feeding behaviour of mice.
Material and methods. The gels were prepared by dissolving the corresponding weights of agar, pectin and sucrose in 100 ml of water: gel 1 contained 6 g of agar, 3 g of pectin, gel 2 - 20 g of agar, 1 g of pectin and 0.03 M CaCl2, gel 3-20 g of agar, 1 g of pectin (without the addition of calcium ions). All gels contained an equal amount of sucrose (15 g per 100 ml of water). The mechanical properties of the gels (strength, Young’s modulus and elasticity) were determined on a texture analyzer. Mice with an initial body weight of 32.9±0.5 g (n=8 in each group) received gels once a day for four days. Each day, animals were individually placed in experimental cages for 60 minutes: in the first 30 min, they were given test gels and for the next 30 min standard rodent food. The first two days were training. Before the third gel presentation, the animals were previously completely restricted in food for 14 hr (fasted mice), and before the fourth gel presentation, the mice received food ad libitum (fed mice). The eating behaviour of the mice, the amount of gel eaten and standard feed eaten were determined. Mice that were not exposed to gels were used as control.
Results and discussion. Gel 3 was the hardest (251±3 kPa) in comparison with gel 1 (44±1 kPa) and 2 (141±3 kPa). Fasted mice that received gel 3 ate 36% less food (p<0.05), and the total energy intake was 19% lower (p<0.05) compared to the control. Fasted mice that received gels 1 and 2 ate the same amount of food as the control animals. Gel 3 significantly reduced feeding time by 19% (p<0.05) in fasted mice. Gels 1 and 2 did not alter the eating behaviour of fasted mice. Fed mice that received gels ate as much food as in the control. Gels failed to affect the eating behaviour of fed mice.
Conclusion. Overall, solid gel 3 reduced food intake and time spent on feeding after 14 h of complete food restriction. The effect of the gel on the feeding behaviour of animals and the amount of food eaten is determined by the hardness of the gel and does not depend on the ratio of the components of the gel and its resistance to in vitro simulated gastric and intestinal fluids.
The role of dietary diversity in the formation of syndrome intestinal bacterial overgrowth
Small intestinal bacterial overgrowth (SIBO) is a widespread disease characterized by a significant decrease of the quality of life. Antibiotic treatment of SIB O is usually effective, however, the recurrence rate is high. Microbiota is dependent on dietary pattern of the patient and specific nutrients, therefore the diversity of dietary patterns may be one of the major factor promoting SIB O or its relapses after treatment.
The aim of the study was to compare nutritional diversity in patients with SIBO-H2 and in healthy controls.
Material and methods. One thousand twenty three patients with suspected SIBO were examined. Hydrogen-methane breath test with lactulose was performed in 973 patients, the results of which identified groups with SIBO-H2 (n=522), with SIBO-CH4 (n=340) and without signs of SIBO (n=108). Data on food intake was collected with 24 h recall from all participants. Dietary diversity was assessed using method of calculation of unique values (count base diversity) for 11 groups of food: cereals, meat and eggs, fish and non-fish seafood, fat containing products, dairy products, nuts, vegetables, fruits and berries, confectionery, drinks, sauces and spices. The pattern of food diversity for each patient was obtained by counting the items in each of the studied food groups. Comparison of the mean values of the number of items in each of the studied food groups was used to compare food diversity in patients with and without SIBO-H2.
Results and discussion. A comparison of nutritional diversity in patients with SIBO-H2 revealed a lower count base diversity in the groups of dairy products (2.70±1.37 vs 3.19±1.34, p<0.001), vegetables (5.50±2.22 vs 6.29±1.90, p<0.001), fruits (154±1.38 vs 1.99±1.69, p=0.018) in compare with controls. Count base diversity in grains, meats, fishes, fat products, nuts and legumes and sweets did not demonstrate significant differences.
Conclusion. Significant differences in the diversity of dietary patterns in patients with SIBO were found in dairy products, vegetables and fruits and berries. The obtained data may be used to develop diet for SIBO patients additionally to the treatment and prevention of its relapses.
Enzymatic hydrolysates of whey protein and chicken egg protein: production, physical-chemical and immunochemical characteristics
Reducing the manifestations of food allergy by the inclusion of specialized foods in the nutrition of children and adults suffering from this disease is an important problem.
The aim was to obtain and characterize in vitro food protein hydrolysates to evaluate their use in specialized foods with reduced potential allergenicity.
Material and methods. Whey protein concentrate (WPC) and chicken egg protein (CEP) and enzymes such as pancreatin and alkalase have been used. Proteolysis of proteins was carried out in an FA-10 fermenter for 3 hours at an enzyme : substrate ratio of 1:50 in dry matter, at optimal pH and temperature for pancreatin and alkalase. Enzymes were inactivated at +75 °C and fermentolizate was ultrafiltered. The solutions were concentrated by reverse osmosis and freeze-dried. The molecular weight distribution of the peptide fractions was evaluated by HPLC. Residual antigenicity was determined by the method of indirect enzyme-linked immunosorbent assay and expressed as the fold of antigenicity reduction relative to the original protein.
Results and discussion. During WPC proteolysis with pancreatin the hydrolyzate was obtained with a fold reduction of antigenicity of 2.3x103 relative to the initial WPC. A decrease in antigenicity of 4.7x104 times was achieved with proteolysis of WPC by alkalase. The combination of WPC fermentolysis with pancreatin or alkalase followed by ultrafiltration reduced the content of high molecular weight peptides with a mass more than 8.7 kDa. The multiplicity of decrease in antigenicity with respect to the starting protein was 1.64x105 and 1.90x105, respectively. After repeated ultrafiltration the reduction in antigenicity of the obtained WPC alkalase or pancreatin hydrolysate was more than 1.0x106 and more than 5.0x105, respectively. The decrease in antigenicity of the CEP hydrolyzate obtained with proteolysis by alkalase and ultrafiltration compared to the initial CEP was 1.0x105 times, and 5.0x105 times when we used repeated ultrafiltration.
Conclusion. A significant decrease in the content of high molecular weight peptides and a decrease in the antigenicity of peptide mixtures based on WPC and CEP to the values that permit their use in hypoallergenic products is achieved by combining proteolysis and double ultrafiltration through a UF10 membrane.
Oral nutrition supplements: applied classification of formulas and basic rules of their prescribing in oncology
The analysis of current data concerning the use of oral nutrition supplements (ONS) in cancer patients has been performed.
The aim of the research is improving the effectiveness of medical nutrition in cancer patients by clarifying terms, definitions, developing an applied classification of ONS formulas and outlining the basic approaches for their use.
Material and methods. Using the keywords «cancer», «oral nutritional supplements», and «siping», the literature was searched in such databases as eLIBRARY (elibrary.ru) and MEDLINE (ncbi.nlm.nih.gov) in Russian and English.
Results and discussion. The definition of this type of nutritional support has been given. The applied classification of ONS formulas has been made. Depending on the energy and protein content, presence of some specific nutrients, osmolarity, nitrogen/non-protein kilocalories ratio and viscosity, they were divided into 3 groups. For the initial assessment of nutritional status of the cancer patient, the European society for medical oncology scale (ESMO, 2008) is the most appropriate. Emphasis is placed on the importance of maintaining physical activity.
Conclusion. An approximate algorithm of ONS prescribing in oncology has been formulated.
Modern approaches to the development of gluten-free bakery formulations
According to WHO, currently about 1% of the world's population suffers from celiac disease, a disease associated with a deficiency of enzymes that break down gluten and proteins close to it. In celiac disease, there is a malabsorption of disaccharides, fats, vitamins and amino acids, which imposes restrictions on food formulations that can be used in the diet of people with celiac disease. Analysis of the market of gluten-free bakery products showed a lack in this segment of products, including the complete absence of products with ω-3 polyunsaturated fatty acids (PUFAs), the total deficit of which is noted in the diet of Russians and around the world.
The aim of the study was to develop recipes for gluten-free bakery products enriched with ω-3 PUFAs, dietary fibers and protein.
Material and methods. The quality of the resulting bread was evaluated by conventional methods including the determination of the content of protein, dietary fiber, fat and its fatty acid composition.
Results and discussion. To achieve this goal, we used approaches that combined both traditional and non-traditional food raw materials, namely gluten-free flour of chia seeds (a source of PUFA and dietary fiber), lupin flour (a source of protein), as well as enzyme transesterificated milk fat substitute containing ω-3 PUFAs. A protein-polysaccharide mixture was used as a thickener and structure-forming agent. The developed formulations allowed to obtain finished products characterized by the content of ω-3 fatty acids - 0.4-0.6 g/100 g, while maintaining a balance between essential ω-6 and ω-3 fatty acids at the level (2.5-3.5):1, recommended for therapeutic nutrition, dietary fiber - 11.1-12.4 g/100 g, and protein content - 5.2-6.7 g/100 g, while maintaining good organoleptic properties. The achieved level of enrichment in accordance with the current legislation allows labeling the resulting products as «high in ω-3 fatty acids and dietary fibers». According to the available data on the biological effect of the components of the developed product, it can affect lipid metabolism, contributing to the reduction of atherogenic lipids in the blood.
Conclusion. The implementation of the results of this work in the industry will expand the range of gluten-free products through the production of specialized bakery products with the strengthening of their dietary therapeutic and preventive orientation due to the high content of ω-3 fatty PUFAs and dietary fibers.
Carrot juice nutritional profile
Carrot juice is one of the main products of carrot processing and the second most popular vegetable juice after tomato. Due to the presence of a complex of various nutritive and biologically active substances (BAS) carrot juice can make a significant contribution to maintaining human healthy diet.
The aim of the study was to establish the nutrient profile of carrot juice.
Material and methods. A study of parameters of carrot juice of industrial production, characterizing its nutritional and biological value was carried out. The results of these experiments were compared with the data of BAS profiles of carrot juice from reference books and scientific publications.
Results and discussion. The established nutrient profile includes data about content of more than 30 nutritients and BAS. The sucrose is the predominant carbohydrate in carrot juice; glucose and fructose concentrations are substantially lower. Among organic acids predominates L-malic acid whereas content of citric acid is usually 5-10 fold lower than that of L-malic acid. The total acidity of carrot juice is low, on average 0.25 mg of organic acids is present in 100 cm3 of juice. Carrot juice is a relatively rich source of a number of vitamins and minerals. A serving (200-250 cm3) of industrial carrot juice on average contains around 18% of the recommended daily intake (RDI) for potassium, 9% for magnesium, 8% for iron, 12% for copper and 14% for manganese. Vitamins are represented to a large extent by в-carotene and other carotenoids (more than 400% of the RDI in a serving), as well as niacin, biotin and pantothenic acid - about 7% of the RDI in a serving for each of these vitamins. The content of vitamins E and K in serving averages 17 and 10% of the RDI respectively. Not clarified carrot juice contains about 1.1 g of dietary fiber in 100 cm3, including pectins - about 0.2 g/100 cm3.
Conclusion. Based on the results of this investigation the carrot juice might be considered as a substantial source of minor BAS mostly carotenoids, vitamins E and K, group B vitamins: niacin, biotin, pantothenic acid, mineral substances: potassium, magnesium, iron, copper, manganese, as well as dietary fiber.
Lipid profile of the black sea shrimp Palaemon adspersus Rathke, 1837
Lipids play one of the leading roles in ensuring the physiological needs and quality of human life. Therefore, assessment of traditional and new types of aquatic organisms from the standpoint of nutritional value of lipids is an urgent task nowadays.
The aim of the work was to study the lipid profile of one of the most mass commercial species of crustaceans - the Black Sea grass shrimp Palaemon adspersus Rathke, 1837.
Material and methods. The collection of material was carried out in May in the Hadzhibey Lyman of Odessa region. Prawn catching was carried out by a trap net with a mesh size of 2.8 up to 8 mm. The total number of individuals analyzed was 250 specimens. In the average sample of prawn, the content of total lipids have been determined by the Soxhlet method, the fatty acid composition of lipids has been studied using gas chromatography, and the fractional composition - by a thin layer chromatography on silica gel plates method. All the studies have been performed in 3 replicates.
Results and discussion. Lipid profile of hepatopancreas of the Black Sea shrimp was represented by the content of total lipids 10±1.8, among them triglycerides - 35.2±5.3%, phospholipids - 16.8±3.6%, free fatty acids - 12.5±2.1%, sterols - 6.5±1.4%, sterol esters 6.5±1.3%, mono- and diglycerides - 1.5-2.7% of total lipids. The nutritive value of lipids was characterized both by a high content of phospholipids, and fatty acids such as oleic one belonging to the ω-9 family (18:1) - 15.7%, and eicosapentaenoic (20:5) -18.30% and docosahexaenoic (22:6) - 14.70% acids of the ω-3 family. The biological significance coefficient of lipids of the Black Sea grass prawn was 3.3, which was adjusted with the value of this indicator of other aquatic organisms. The ratio of fatty acids ω-6 to ω-3 was 1:19.5 which indicated a high nutritional value of hepatopancreas lipids of this prawn species.
Conclusion. The results of the study allow recommending the hepatopancreas lipids of the Black Sea grass shrimp for the enrichment of foods with ω-3 polyunsaturated fatty acids, the formation of multicomponent products with desired properties, as well as for the drug development.