Вопросы питания № 4 2024

Problems of Nutrition

scientific and practical journal

Included in the List of the leading peer-reviewed journals and publications recommended by the Higher Attestation Commission (HAC) of the Ministry of Education and Science of the Russian Federation for publication of the results of theses for the degree of candidate or doctor of science.


Content
4 . 2024
Lead article

Medicine of the future: the role of artificial intelligence in optimizing nutrition for the health of the Russian population

Abstract

One of the most pressing medical, social and government tasks is to ensure health saving, improve the quality of life and increase the life expectancy of the Russian population. The most important lever to ensure the solution of these issues is the optimization of nutrition and the use of methods of artificial intelligence (AI) and new information technologies to support decision-making in this area.

The purpose of the study was to familiarize specialists with the Scientific Instrument for Nutrition Analysis (SINA), created on the basis of AI technologies to optimize nutrition and prevent alimentary diseases in order to preserve the health of the population of the Russian Federation.

Results. A patent was created and received for a scientific web tool (SINA) based on AI technologies for actual nutrition analyzing with subsequent assessment of health status and generation of recommendations, including a personalized diet, which is formed based on individual human needs for energy, nutrients and bioactive compounds, taking into account genome, gender characteristics, age, food preferences, profession, diseases, medication treatment, clinical blood parameters, individual morphological and constitutional characteristics, his physical activity, etc.

Conclusion. The results of using SINA can reduce the labor costs of doctors; personalize diets as much as possible taking into account many factors; increase patient adherence to the prescribed diet and recommendations; increase public awareness of nutrition issues, reduce morbidity rates and improve public health. The high-tech approach using AI is advanced and is capable of solving many key challenges in the field of health care, prevention and medicine in general, and improve the quality of life of the population.

Review

The importance of amaranth products in the diet of children with gluten intolerance

Abstract

The study of gluten intolerance is a modern area of medical science. With the advent of new diagnostic capabilities and data on the forms of the disease, wide opportunities have opened up in optimizing the timing and invasiveness reducing of intervention during diagnosis and further monitoring of the child’s health. However, despite all efforts, the basic method of treating all forms of gluten intolerance remains strict adherence to a gluten-free diet (GFD). It is known that GFD itself, as well as low adherence to its observance can lead to nutritional disorders. Therefore, the expansion of the diet at the expense of foods with high nutritional value will greatly contribute to the optimization of diet therapy and compensation for food restrictions.

The purpose of the review was to evaluate the possibility of using amaranth products in a GFD to fill the need for nutrients in children with gluten intolerance.

Material and methods. The search for literature data was carried out using PubMed, eLIBRARY, scholar.google platforms mainly over the last 5 years, using the keywords: gluten intolerance, children, amaranth, gluten-free diet.

Results. An analysis of modern literary sources has shown that amaranth is a product of choice in diet therapy when following a GFD, since it is a pseudo-grain crop. The article presents data confirming the high nutritional value of amaranth due to the protein component and the features of the lipid fraction. The features of the amino acid composition and squalene content in comparison with other plant crops are discussed. The article contains information on the preservation of the beneficial properties of amaranth in finished foods, in particular, the addition of amaranth flour instead of corn starch increases the protein content by 32% and fiber by 152% in gluten-free bread without affecting the taste. The advantages of the chemical composition of amaranth are shown in comparison with other pseudo-cereals. The research results prove the effectiveness of using amaranth products in GFD to eliminate deficiency states in patients, normalize physical development in children with gluten intolerance, and increase patient adherence to the diet.

Conclusion. The composition of amaranth and the available studies on the effectiveness of amaranth products consumption convincingly prove the advisability of using it in nutrition, especially under dietary restrictions or increased need for nutrients in childhood.

Physiology and biochemistry nutrition

Biochemical disorders in mild protein-energy deficiency in children: gender peculiarities

Abstract

The growth of protein-energy malnutrition (PEM) in children with prevalence of endogenous factors of the causes of development has not been decreasing in the Russian Federation and all over the world for the last decades. This determines the relevance of multifaceted study of this pathology. Consequences of PEM suffered in early childhood can have a remote character of realization and influence on human health during the whole life. A separate problem of PEM is the identification of mild forms of pathology, which are often missed. The pathogenesis of PEM is insufficiently studied, in particular, the variability of pathology development depending on gender.

The aim of the research was to characterize the peculiarities of the blood metabolic profile of infants at the initial stage of PEM with regard to gender.

Material and methods. 38 children (20 boys, 18 girls) aged from 1 to 12 months with the degree I of PEM were examined; the comparison group consisted of 30 children (18 boys, 12 girls) aged from 2 to 12 months. Laboratory monitoring included general and biochemical blood tests with evaluation of such parameters as the content of total protein, albumin, hemoglobin, transferrin, urea, creatinine, glucose, lactate, pyruvate, triglycerides, the activity of lactate dehydrogenase, alanine aminotransferase, aspartate aminotransferase, creatine phosphokinase, using hematological analyzer (MEDONIC, Boule Diagnostics AB, Japan) and biochemical analyzer (Cobas Integra 400plus, Roche Diagnostics, Switzerland).

Results. In children with a mild degree of PEM the blood levels of total protein, albumin, hemoglobin, transferrin didn’t differ from that in the comparison group. Against this background, there is an increase in blood serum urea level in all children and a significant increase in creatinine level, which is most pronounced in girls, in whom this indicator is 2.5 fold higher than in the comparison group and by 79% higher than in boys (p≤0.05). In combination with body weight deficiency, this characterizes the development of catabolic stress. A decrease in blood glucose level was detected in all children of the main group; a decrease in triglycerides was revealed in boys (-33%; p≤0.05) with stability of the index in girls. The increase in pyruvate blood serum level in boys (+21%; p≤0.05) with a tendency to decrease in girls is accompanied by a significant elevation in the lactate/pyruvate ratio (by 75% in boys and 3 fold in girls, p≤0.05).

Conclusion. There are gender peculiarities of metabolic in children of the first year of life with a mild degree of PEM. In male children there is a decrease in the levels of glucose and triglycerides as energy substrates with the orientation to the ketosis formation. In girls, a more intense character of catabolic stress is observed with stable blood levels of triglycerides with a tendency to develop lactacidosis.

The effect of ω-3 polyunsaturated fatty acids on carbohydrate metabolism in northern men

Abstract

Omega-3 polyunsaturated fatty acids (PUFA) are known for being one of the most important classes of bioactive lipids; of them, the long-chain ones, namely eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids, have many positive effects on the human body.

The aim of this study was to assess the carbohydrate metabolism in northern men living in the Magadan Region before and after the administration of a dietary supplement with PUFA.

Material and methods. The study included 45 men (mean age 40.0±0.8 years), of whom 2 groups comparable in age and analyzed parameters were formed by random sampling. The participants of the main group (n=30) consumed PUFA (2 capsules containing 1200 mg, including 660 mg EPA and 440 mg DHA), and the control group (n=15) had no impact on the diet. Fasting venous blood was collected using a vacuum system to determine glycated hemoglobin (HbA1c) using the turbidimetric immunoinhibition, glucose by the hexokinase method, insulin by the immune chemiluminescence using paramagnetic particles at the beginning (late October, 2023) and the end (mid-December, 2023) of the study, and HOMA-IR index was calculated. The daily diet was assessed using the ASPON-nutrition program (St. Petersburg) based on the results of the food diary keeping for 3 days (weekdays).

Results. In men of the main group, positive changes in the carbohydrate profile were noted, associated with the intake of ω-3 PUFAs, manifested in HbA1c decrease (from 5.5±0.1 to 5.2±0.1%, p<0.05) while maintaining blood concentration of glucose and insulin and HOMA-IR at the same level. Unlike the main group, the control group experienced disadaptation in their carbohydrate metabolism as they exhibited the signs of hyperinsulinemia (increased basal fasting insulin level from 8.8±1.2 to 11.4±1.1 mIU/l, p<0.05) and insulin resistance (the increase in the HOMA-IR from 2.0±0.2 to 2.6±0.3, p<0.05), which was apparently due to the autumn-winter period of the study.

Conclusion. Resulting from the data obtained, this study showed the presence of a leveling function and even an optimizing role of additional ω-3 PUFAs intake with respect to seasonal changes in the biochemical parameters of the northern residents during the crucial period of the year with its temperature curve transition through 0 °C.

Contractive function of mesenteric lymph nodes in obese rats

Abstract

Over the past 50 years, the prevalence of obesity around the world has increased several times and has become a pandemic. The effect of obesity on the lymphatic system, which plays a key role in the regulation of fluid homeostasis, immune cell migration, antigen presentation, and resolution of inflammatory responses, is poorly understood, and there is no data on the contractile activity of the lymph nodes in obesity.

The purpose of the research was to investigate the parameters and mechanisms of dysfunction of the contractile function of the mesenteric lymph nodes of rats in obesity caused by the feeding with the high-fat diet (HFD).

Material and methods. The study was conducted on 50 male Sprague-Dawley rats. Rats aged 6 weeks were randomly divided into groups: a control group (n=10) fed a standard diet and a group of rats (n=40) kept on HFD (60% fat content by calorie value). Rats received food and water ad libitum for 16 weeks. Before the end of the experiment, four groups of HFD rats were formed: obesity resistant animals (HFD-OR, n=11), without additional interventions (HFD, n=10), rats which were administered dexamethasone three days before the study (HFD+Dexa, n=9), HFD followed by 8-week diet restriction (HFD+DR, n=9). At the end of the experiment, mesenteric lymph nodes (LNs) were taken from rats under anesthesia and their contractile function was studied in a myograph using 1400W, dynastat and Tempol.

Results. LNs of control rats had a high level of tone and generated spontaneous high-amplitude phasic contractions. The LNs of HFD rats had a low initial tone, and rare low-amplitude phasic contractions were recorded in them. The parameters of contractile activity of the LNs of rats in HFD-OR and HFD+Dexa groups differed slightly from the corresponding parameters of the LNs of rats in the control group. Calorie restriction for 8 weeks in obese rats (HFD+DR) resulted in an increase in tone, frequency and amplitude of phasic contractions of the LNs compared to those in HFD rats. iNOS inhibition caused a significant increase in the tone, amplitude and frequency of phasic contractions of the LNs in the HFD group. An increase in the frequency of phasic contractions was observed only in the LNs of HFD+Dex and HFD+DR rats. Inhibition of cyclooxygenase 2 did not affect the contractile function of the LNs of rats of all groups, with the exception of animals from the HFD group (increase in the amplitude and frequency of phasic contractions). Tempol significantly increased the tone, frequency and amplitude of phasic contractions of the LNs in rats of the HFD group and increased the frequency of phasic contractions of the LNs of the HFD+DR rats.

Conclusion. A high-fat diet leads to impaired contractile function of rat LNs and can create additional obstacles to the movement of lymph, promoting its leakage into surrounding tissues. Obesity is accompanied by the development of inflammation in the LNs and perinodal adipose tissue, which induces the expression of inducible NO synthase, cyclooxygenase-2 and the accumulation of reactive oxygen species (ROS). NO, prostaglandins and ROS have an inhibitory effect on the SMC capsules of the LNs, leading to a decrease in tonic tension and a weakening of spontaneous phasic contractions. The reason for inhibition of LN contractile function is obesity, but not consumption of food high in fat. Transferring obese rats to a calorie-restricted diet results in a decrease in body weight and visceral fat mass and an improvement in LN contractile function.

Hygiene of nutrition

Effect of low doses of active chlorine on commensal populations of intestinal bacteria in rats by oral ingestion

Abstract

Chlorine-containing substances are widely used as disinfectants for treating equipment surfaces and technological aids for antimicrobial treatment of a number of foodstuff in the food industry. The toxic and bactericidal effects of the active (free) chlorine they contain are well understood for the concentrations used in practice, whereas little is known about the effect of its residual (subinhibitory) amounts on the organism and on the microbiota, including the ability to induce antimicrobial resistance.

The aim of the study was to investigate the effect of different doses of active chlorine at oral administration on the commensal bacteria of intestinal microbiota, body weight gain and micromorphological features of the liver in rats.

Material and methods. The study was carried out on male Wistar rats, with an initial body weight of 90–100 g, which for 4 weeks received doses of active chlorine together with drinking water ad libitum, with the given concentration: subinhibitory (10 mg/L), threshold (50 mg/L) and aggravated (100 mg/L). Chloramine was used as a chlorine-containing agent stable in aqueous solution. Body weight gain was monitored daily. After decapitation, the caecum was taken for microbiota examination as well as the liver. The phenotypic antimicrobial resistance characteristics of Enterobacteriaceae and Enterococci were studied by the disk diffusion method. Additionally, a micromorphologic study of liver slices was performed.

Results. Insignificant negative deviations in the body weight gain of rats in the experimental groups receiving subinhibitory doses of active chlorine, combined with a reduced level of Enterococci and Enterobacteriaceae representatives, were revealed. No significant effect of chlorine on the levels of resistant Escherichia coli populations was found, but a tendency to exhibit antimicrobial resistance of Enterococci isolated from rats receiving low doses of active chlorine (10 and 50 mg/l) was detected. No signs of toxic effect on the liver tissue most sensitive to chlorine were detected, but some accumulations of inflammatory cells in the liver slice were revealed.

Conclusion. Low doses of chlorine-containing substances at their oral consumption are not indifferent for rats’ organism, causing negative phenomena in intestinal bacteria and in liver tissues at the level of tendency. It is expedient to continue studies in this direction.

Assessment of the radiation risk to health caused by the intake of Cs-137 and Sr-90 radionuclides from food in the able-bodied population of the Samara region

Abstract

Monitoring of the content of technogenic radionuclides (Cs-137 and Sr-90) in foods is one of the key areas in ensuring radiation safety of the population, taking into account the current radiation situation. The greatest risk to health is food produced or imported from the territories that have been subjected to man-made radiation accidents.

The purpose of the research was to assess the radiation risk caused by oral intake of radionuclides based on the study of the actual nutrition of the adult population and contamination of food with Cs-137 and Sr-90 radionuclides.

Material and methods. The specific activity of Cs-137 and Sr-90 radionuclides (median and 90 percentile) was assessed by gamma spectrometric method in 1235 samples of food produced in the Samara region and imported from outside. Data on the actual nutrition of 894 respondents aged 18 to 68 years (in the autumn-winter period) were obtained by the 24-hour dietary recall using the automated software package Nutri-prof (version 2.9). Based on the data obtained, effective annual doses of internal radiation were calculated, information was obtained on the risks of malignant neoplasms, including in the long-term period under various scenarios of internal radiation.

Results. Radiometric studies of food samples did not reveal deviations from hygienic standards. The highest median values of Cs-137 specific activity were observed in samples of forest mushrooms (1.23 Bq/kg), wild berries (0.97 Bq/kg), fish and fish products (0.96 Bq/kg). The highest median values of Sr-90 specific activity were also observed in samples of forest mushrooms (3.86 Bq/kg), fish and fish products (2.71 Bq/kg). The radiation risk under various scenarios of Cs-137 intake was regarded as «negligible», while the risk was regarded as «small» when consuming food contaminated with Sr-90. The number of additional cases of malignant neoplasms at the admission of Cs-137 in the median values of specific activity is 0.38 per year, at maximum values – 0.57 per year, at the admission of Sr-90 – 2.04 per year and 3.30 cases per year, respectively.

Conclusion. The implementation of radiation monitoring of food, especially those imported from areas of high radiation risk, is a necessary condition for ensuring radiation safety of the population. It is also necessary to take into account the stochastic effect of the influence of small doses of internal exposure on the organism when consuming food, which make a significant contribution to the formation of the dose of internal radiation.

Analysis of the properties of Komagataella phaffii CF-st401, a genetically modified producer of the sweet protein brazzeinby using in silico methods

Abstract

Currently, in order to reduce the consumption of mono- and disaccharides in diets, sweeteners are widely used. At the same time, none of the sweeteners approved for food industry usage matches the organoleptic properties of natural sugars. This circumstance was the basis for the development of technology for producing a new type of food ingredient with a sweet taste – brazzein using the producer strain Komagataella phaffii CF-st401.

The purpose of the study was the application of in silico methods to assess the safety of K. phaffii CF-st401 genetically modified (GM) microorganism, which is the producer of the “Sweet protein Brazzein”.

Material and methods. The research object was the map of K. phaffii CF-st401 plasmid obtained by Biryuch LLC as a result of sequencing the plasmid of GM strain K. phaffii CF-st401, including: a synthetic nucleotide sequence similar to the sequence encoding the brazzein protein in the plant (Pentadiplandra brazzeana) and optimized for expression in the DNA of the recipient strain; the nucleotide sequence of plasmid M4794 from Saccharomyces cerevisiae and a linear fragment of the flanking DNA regions from K. phaffii used for integration into the genome of the recipient strain K. phaffii YIB Δleu2 VKPM Y-476, as well as amino acid sequence data of recombinant brazzein. By using bioinformatics methods (in silico), we investigated the DNA structure of the vector sequence of K. phaffii CF-st401, including the presence of operons responsible for toxin production, antibiotic resistance, and allergenicity.

Results. As a result of the studies of K. phaffii CF-st401 vector plasmid, introduced into K. phaffii YIB Δleu2 VKPM Y-4761, it was shown that its regions responsible for the structure of the “Sweet protein Brazzein” coincide by more than 70% with elements of the brazzein P56552 reference protein from the plant P. brazzeana. The absence of selective markers and allergenicity in the vector plasmid was confirmed.

Conclusion. The analysis of the structure of the DNA vector sequence of the K. phaffii CF-st401 GM strain confirmed the feasibility of using bioinformatics methods to predict the properties of technological microorganisms when assessing their safety for consumers.

Vitamin D status in connection with VDR and GC genes polymorphism in coal mining workers

Abstract

Vitamin D is a unique compound that can enter the human body not only with food, but also be synthesized in the skin under the influence of ultraviolet radiation. Individual differences in the need for this vitamin may be associated with the carriage of polymorphic variants of genes that implement its biological effects, which include VDR BsmI C>T (rs1544410), VDR TaqI A>G (rs731236) and GC rs2282679 T>G. At risk for vitamin D deficiency are workers in the coal mining industry, whose working conditions combine limited insolation and a pronounced deficiency of vitamins in the diet.

The purpose of the study was to assess vitamin D plasma level in coal mining workers depending on the carriage of polymorphic variants of the VDR BsmI C>T (rs1544410), VDR TaqI A>G (rs731236) and GC rs2282679 T>G genes and professional working conditions.

Material and methods. The study included 154 coal mining workers. The main group consisted of 100 workers associated with the underground nature of work, the comparison group – 54 ground workers of the enterprise. In all individuals, the level of 25-hydroxyvitamin D in blood plasma was determined by enzyme-linked immunosorbent assay and genotyping was performed for three polymorphic loci: VDR rs1544410, rs731236, GC rs2282679 by real-time PCR.

Results. A statistically significant decrease in the concentration of plasma vitamin D in the underground workers was revealed, compared with the level of this vitamin in ground workers of the enterprise (p=0.037). Underground workers – carriers of the CT genotype of the VDR rs1544410 gene, AG of the VDR rs731236 gene and TT of the GC rs2282679 gene had a lower 25(OH)D level in blood plasma compared to owners of similar genotype variants in the comparison group (p<0.05). Among ground workers, carriers of the TT genotype of the GC rs2282679 gene had a significantly higher vitamin D plasma level compared to carriers of the TG and GG genotypes (p=0.02). An association of the GC gene with vitamin D level in blood plasma was revealed according to a dominant model of inheritance (OR=0.47, 95% CI 0.23–0.97; p=0.037, for owners of the TT genotype, compared with carriers of the TG+GG genotypes).

Conclusion. The development of personalized diets based on individual genetic status may be of great importance for the prevention of diseases associated with vitamin D deficiency in individuals at risk.

Vitamin D and childhood disability: diseases of the musculoskeletal system and connective tissue in the Khanty-Mansi Autonomous Okrug – Ugra

Abstract

Vitamin D deficiency is more prevalent among children with musculoskeletal and connective tissue disorders (MSCTD), which plays a significant role in childhood disability, which ranks sixth in the structure of childhood disability in the Russian Federation.

The aim of the research was to study of the relationship between the incidence of childhood disability associated with MSCTD and the state of vitamin D status of the population living in the territory of the Khanty-Mansiysk Autonomous Okrug – Ugra.

Material and methods. A correlation analysis was carried out between the level of childhood disability (that arose in connection with MSCTD in children aged 0–17 years in the Khanty-Mansi Autonomous Okrug – Ugra in 2021) and the prevalence of severe vitamin D deficit [serum 25(OH)D <10 ng/ml] among the population (12 city and 5 district municipalities), using the INVITRO-Ural LLC database (31 595 anonymized measurements of vitamin D level in Ugra residents). In addition, a correlation analysis was conducted between the total incidence of certain types of MSCTD in the constituent entities of the Russian Federation and the geographical latitude of the administrative center of the subjects of the Federation.

Results. In the Khanty-Mansi Autonomous Okrug – Ugra, the frequency of childhood disability resulting from MSCTD is associated with a statistically stable (p=0.01) directly proportional relationship with the prevalence of severe vitamin D deficit in the residents of the municipality territory. In the Russian Federation, the dependence of the general morbidity of MSCTD in children (arthropathy, juvenile arthritis, and damage to the tendon synovial membranes) is very stable (p<0.0001) directly proportional associated with the geographical latitude of the territory. This indicates the impact of reduced levels of ultraviolet radiation and, accordingly, the average blood level of vitamin D in the population high in latitudes, along with other reasons, on human health.

Conclusion. Low levels of vitamin D have a negative impact on the activity of MSCTD in children and the associated disability. To justify the recommended daily dose and duration of vitamin D intake, which in some cases can reduce the activity of MSCTD, it is necessary to measure its initial level in the blood serum of patients at risk.

CHEMICAL COMPOSITION OF FOODSTUFFS

Comparative analysis of dietary patterns in patients with non-alcoholic fatty liver disease with and without type 2 diabetes mellitus

Abstract

Non-alcoholic fatty liver disease (NAFLD) is considered to be metabolically determined and alimentary condition, one of the components of metabolic syndrome. Therefore, dietary patterns of patients with different clinical types of the disease are worth to be studied.

The aim of the research was to study the dietary patterns in patients with NAFLD and with type 2 diabetes mellitus (T2DM) (group T2DM+) compared to the control group without T2DM (T2DM-).

Material and methods. A retrospective analysis of the database (n=316) of patients with NAFLD, formed in the period from 2021 to 2023, was carried out. A total of 79 sex- and age-matched pairs of T2D+ and T2D- patients were selected for the case-control study. Hepatic steatosis and fibrosis stage assessment was performed using vibration-controlled transient elastography (VCTE) with controlled attenuation parameter (CAP). Actual nutrition was evaluated using a semi-quantitative method of assessing consumption frequency during a personal interview. Consumption of 100 grouped food items was assessed. Blood parameters characterizing lipid and carbohydrate metabolism were assessed.

Results. Among patients with T2DM+, patients with NASH (24.1 vs 8.9%, p=0.005) and patients with severe liver fibrosis F3–F4 (32.9 vs 10.1%, p<0.0001) were significantly more common. There were no differences between the T2DM+ and T2DM- groups in energy consumption (1969 [1492; 3098] vs 1870 [1380; 2593] kcal/day; p=0.4), proteins (90.5 [71.5; 130.3] vs 81.0 [59.4; 116.0] g/day; p=0.1), fats (83.0 [66.7; 144.9] vs 78.8 [59.2; 116.4] g/day; p=0.3), carbohydrates (220 [156; 312] vs 209 [155; 282] g/day; p=0.9). The study of dietary patterns revealed greater consumption of meat and meat products (1.23 [0.84; 1.73] vs 0.96 [0.71; 1.37] times a day, p=0.03), fish and seafood (0.37 [0.17; 0.89] vs 0.27 [0.13; 0.51] times a day, p=0.01) in T2DM+ group. It was found that in patients with T2DM the intake of calories and the following nutrients from meat and meat products was more, then without: energy (289.6 [174.9; 420.3] vs 191.9 [148.2; 336.5] kcal/day, p=0.006), proteins (25.8 [17.2; 36.5] vs 18.6 [12.6; 29.6] g/day, p=0.008) and fats (18.9 [10.8; 31.4] g/day vs 13.7 [10.3; 23.6] g/day, p=0.01). Similar data was obtained for fish and seafood, with energy (59.7 [28.3; 117.3] vs 45.2 [20.5; 70.1] kcal/day, p=0.03), proteins (8.1 [6.9; 16.8] vs 6.3 [6.7; 10.2] g/day, p=0.02) and fats (3.0 [1.5; 6.4] vs 1.9 [0.9; 3.8] g/day, p=0.01) consumed more in T2DM+ group.

Conclusion. In the traditional analysis of actual nutrition in NAFLD patients with and without T2DM, no significant differences were found. However, the structure of the patients’ diet differs significantly due to meat and meat products, fish and seafood. The identified differences may indicate the need to change dietary recommendations for patients with T2DM, and may also become the basis for the development of innovative food for special dietary uses aimed at improving the quality of nutrition of patients and, as a result, remission of the underlying disease.

Assessment of tolerance of a new product (gluten-free grain snack) in children with food allergy to gluten

Abstract

The development of a technological scheme for the production of cereal snacks based on the extrusion process with preliminary enzymatic treatment of wheat flour and the use of hydrolysate as a partial replacement for gluten-free raw materials is an urgent task. The use of gluten-free cereal snacks in the diet opens up new possibilities for dietary therapy in patients suffering from various manifestations of food allergy to gluten, making their diet more diverse and meeting their individual needs.

The purpose of the research was to clinically evaluate the tolerance of gluten-free cereal snacks in children with PA to gluten.

Material and methods. The study included 21 patients (male and female) aged 3 to 17 years with a diagnosed food allergy, including gluten. All children received gluten-free cereal snacks according to their age: children from 3 to 7 years old (n=11) received 50 g (176 kcal) daily, and children aged 8 to 17 years old (n=10) received 100 g (352 kcal) daily for 14 days, in addition to a non-specific hypoallergenic diet excluding highly allergenic foods. On the first day of the study, the patients or one of their parents evaluated the organoleptic properties of the presented product (taste, color, smell) using a 5-point scale (1 – very bad, 5 – excellent), according to a specially designed questionnaire. The assessment of clinical symptoms over time related to skin, gastrointestinal tract, and nervous system was conducted using a second questionnaire, where parents kept a daily «observation log» reflecting the child’s well-being and condition, as well as adverse events associated with taking the product. Clinical safety parameters were assessed based on the dynamics of complete blood count and blood immunological parameters (total IgE, specific IgE, and IgG4 antibodies to the studied allergens) at the beginning and end of the consumption period.

Results. Daily examinations and patient questionnaires revealed no adverse reactions to the product. No significant differences in body weight were observed at the end of the study (p>0.05). In the results of clinical and immunological blood analysis before and after consuming gluten-free cereal snacks, no significant deviations were observed in the form of an increase in eosinophil count, total IgE, allergen-specific IgE and IgG4 antibodies in peripheral blood. This suggests a favorable clinical safety profile of the proposed product.

Conclusion. The study found that consumption of the new product (gluten-free cereal snacks) was well-tolerated by children aged 3 to 17 years with various manifestations of food allergy: no adverse effects of the product or exacerbations of the underlying disease were observed during the 14-day period of gluten-free cereal snack consumption. Therefore, the studied gluten-free cereal snacks can be recommended for children aged 3 to 17 years with various manifestations of gluten FA, in combination with a gluten free diet.

Chemical composition of foodstuffs

Determination of carbohydrate content in soft drinks. Methodological aspects and results of research using various methods

Abstract

An important component of the programs to prevent type 2 diabetes mellitus, obesity, and other chronic noncommunicable diseases is limiting the intake of added sugars. Information about the composition of the product and its nutritional value contained in the labeling contributes to the informed choice of consumers when forming a diet. On July 1, 2023, new provisions of the Tax Code of the Russian Federation came into force, providing for the imposition of an excise tax on “sugar-containing drinks” – soft drinks made with added sugar and containing carbohydrates in quantities of more than 5 g/100 ml. The stated goal of the new excise regulation is to reduce sugar consumption by the population. Currently, information on the carbohydrate content in soft drinks is provided by manufacturers based on calculated values according to the recipe, which makes it possible to take into account as much as possible all the carbohydrate components of the product. There is no standardized method for analytically assessing the carbohydrate content of soft drinks (including “sugar-sweetened beverages” for excise tax purposes).

The purpose of the work was the comparative analysis of existing analytical methods for determining the content of sugars and carbohydrates in general in foods, including beverages; and determination of the most correct analytical approach to assessing the content of carbohydrates in soft drinks.

Material and methods. The existing methods for determining sugars and carbohydrates in foods, including beverages, have been analyzed. The objects of research were samples of model aqueous solutions with different sugar concentrations (30 samples) and 17 samples of industrially produced soft drinks (including tonic and tonic energy drinks) made using sugar or sugars (glucose-fructose syrup), sweeteners, and a mixture of sugar and sweeteners. The total content of sugars/carbohydrates in beverages was determined: in accordance with MU 10-05031531-372-93 as the difference between the total dry matter content and the dry matter from acids; by the Bertrand method; by the Bertrand–Schorl method. The obtained values were compared with the calculated data specified in the labeling of consumer packaging of the products.

Results. The determination of sugars in model solutions showed sufficient accuracy of the Bertrand–Schorl method: deviations of the obtained values from the amount of sugars added to the model solution were observed only at their high concentration (over 10 g/100 ml) and amounted to ±0.1 g/100 ml. The carbohydrate content in industrial soft drinks estimated by various methods differed slightly from that indicated in the labeling (obtained by calculation). The differences were at the level from -0.2 to +0.4 g/100 ml when using the method from MU 10-05031531-372-93, at the level from -2.6 to +0.8 g/100 ml when using the Bertrand method and at the level from -2.7 to +0.1 g/100 ml when using the Bertrand–Schorl method. The greatest differences were observed for tonic drinks (including energy drinks) – from -2.7 to +0.3 g /100 ml, depending on the method.

Conclusion. The research data showed that the Bertrand–Schorl method can be used as a basis for developing a state standard for determining the total sugar content in soft drinks and for assessing their carbohydrate content in general. At the same time, the method needs to be refined for tonic drinks. At present, the most acceptable method is to assess the carbohydrate content using the analytical method given in MU 10-05031531-372-93, but it should be taken into account that deviations from the carbohydrate content values determined by this method from the values obtained by calculation can be up to +10%. At the same time, the calculation method for determining the carbohydrate content in drinks remains a priority, including for the purposes of excise regulation.

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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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