Вопросы питания № 4 2022

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.

4 . 2022

Basic principles of dietary therapy in type 2 diabetes mellitus: focus on antioxidant protection and endothelial dysfunction


Oxidative stress and endothelial dysfunction have been identified as the most important pathogenetic pathways for the development and progression of vascular complications in type 2 diabetes (T2DM).

Objective. To evaluate the effect of individual dietary components on oxidative stress and endothelial dysfunction in patients with T2DM.

Material and methods. The search and analysis of publications was carried out using the PubMed, MEDLINE, Web of Science databases, mainly for the last 10 years, using the keywords “type 2 diabetes mellitus”, “endothelial dysfunction”, “polyphenols”, “antioxidants”, “diet”.

Results. It has been shown that despite the progress in the development of drugs for the correction of clinical and metabolic disorders in T2DM, diet therapy is an important therapeutic factor influencing the main mechanisms of development and progression of cardiovascular complications in T2DM, including hyperglycemia, dyslipidemia, arterial hypertension, subclinical inflammation, endothelial dysfunction. Properly organized and built on modern scientific principles, clinical nutrition improves glycemic control, correction of arterial hypertension, dyslipidemia and overweight/obesity. Influencing the mechanisms of development of oxidative stress, therapeutic nutrition can serve as a preventive approach to protect against the occurrence of endothelial dysfunction and subsequent complications, primarily atherosclerotic origin.

Conclusion. The review presents current data on the effect of diet therapy on the main clinical and metabolic parameters in T2DM, endothelial function and oxidative stress, as the most significant factors in the development of systemic vascular complications.

Arthrospira platensis: antioxidant, hypoglycemic and hypolipidemic effects in vitro and in vivo (brief review)


The cyanobacterium Arthrospira platensis biomass is a promising food source of biologically active substances with pharmacological activity.

The aim of this research was a brief review and analysis of experimental in vitro and in vivo studies of the antioxidant, hypoglycemic and hypolipidemic properties of A. platensis biomass, phycocyanins, and their chromophore – phycocyanobilin.

Material and methods. For the main search of the literature, the PubMed Internet resource was used, the key component of which is the Medline article database, covering about 75% of the world’s medical publications. In addition, Scopus and Web of Science databases were used. Search depth – 20 years. Search keywords: Arthrospira platensis, phycobiliprotein, C-phycocyanin, allophycocyanin, hypoglycemic effect, hypolipidemic effect, antioxidant activity, in vitro and in vivo studies.

Results. A brief description of the composition of the cyanobacterium Arthrospira platensis biomass, methods of its cultivation, phycocyanins extraction methods is presented. The results of experimental studies indicate the presence of pronounced antioxidant properties of A. platensis biomass, mainly due to phycocyanins in its composition. The hypoglycemic and hypolipidemic effects of A. platensis biomass and extracted phycocyanins intake have been established in vivo when modeling carbohydrate and/or lipid metabolism disorders. The results of in vitro and in vivo studies indicate the presence of pronounced antioxidant properties of phycocyanins. Hypoglycemic effects are shown in particular in experiments on rats with hyperlipidemia and alloxan diabetes fed a diet enriched with A. platensis biomass and on KKAy mice, treated with C-phycocyanin extract.

Conclusion. The analysis of the results of in vitro and in vivo studies of the antioxidant, hypoglycemic and hypolipidemic properties of A. platensis biomass and extracts with a high content of phycocyanins, presented in a brief review, suggests that their use in the diet of people with impaired carbohydrate and lipid metabolism is promising. Accordingly, from the standpoint of evidence-based medicine, clinical studies on the use of spirulina biomass and/or its extracts with a high content of phycocyanins as part of specialized foods intended for the prevention and/or dietary correction of carbohydrate and lipid metabolism disorders should be preceded by additional experimental physical-chemical, physiological and biochemical research.

Physiology and biochemistry nutrition

Relationship between vitamin D level and lipid profile in young adults


Vitamin D deficiency, like cardiovascular disease, is widespread throughout the world. Researches indicate a number of potential mechanisms for the relationship between vitamin D deficiency and cardiometabolic risk factors. The results of studying the relationship between 25-hydroxyvitamin D [25(OH)D] in blood serum and lipid profile indicators are contradictory, studies were mainly carried out among the adult and elderly population.

The aim of the research was to study the relationship between the level of 25(OH)D and lipid spectrum indicators in young people.

Material and methods. The cross-sectional study included 278 young adults (aged from 18 to 24 years), of which 64 (23%) were boys, 214 (77%) were girls. The assessment of lipid spectrum indicators included total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, calculation of the atherogenic index; vitamin D status was evaluated by 25(OH)D blood serum level determination.

Results. The levels of 25(OH)D below the criterion of insufficiency (30 ng/ml) were found in 81% of participants. A weak positive correlation was found between the level of triglycerides and 25(OH)D concentration (ρ=0.181, p=0.003). Gender differences were found in the association of 25(OH)D level with lipid profile parameters. In young men, a negative correlation was found between 25(OH)D level and indicators of total cholesterol (ρ=-0.316, p=0.014) and LDL cholesterol (ρ=-0.348, p=0.007), as well as significantly lower concentrations of 25(OH)D in the group with elevated LDL cholesterol levels.

Conclusion. The results of the study indicate the existence of the relationships between 25(OH)D concentration and various parameters of the lipid spectrum of blood serum. Vitamin D deficiency may be associated with an increased risk of dyslipidemia, especially in males. The relationship between 25(OH)D level and lipid profile scores may differ depending on gender.

The structure of blood gut microbiota markers in athletes and their relationship with the diet


It is known that under conditions of ultra-high physical activity and a specific diet, the state of the microbiota plays a significant role in maintaining the health, metabolic and energy status of athletes.

The purpose of the study was to evaluate the composition of blood microbial markers in professional football players and physically active people and their correlation with diets in order to substantiate recommendations for their optimization.

Material and methods. In a cross-sectional study a group of football players (n=24, 28±3 years old, body mass index – 22.5±1.0 kg/m2) who received a diet according to the training regimen, and a comparison group of physically active individuals (n=25, 34±5 years old, body mass index – 21.8±2.8 kg/m2) have been examined. The method of gas chromatography-mass spectrometry was used to analyze microbial markers of microbiome, mycobiome, virome and blood metabolome populations. Data on actual dietary intake were collected using food diaries for 3 days, followed by data processing with the Nutrium 2.13.0 nutritional computer program. For analysis, individual daily requirements for energy and macronutrients have been calculated based on the basal metabolic rate (according to the Mifflin–San Geor formula, taking into account anthropometric data), the coefficient of physical activity (groups IV and II, respectively).

Results. The analysis of the athletes’ diet, compared with individual requirements and with the recommendations of the International Society for Sports Nutrition (ISSN), revealed a lack of complex carbohydrates (5±1 instead of 6.1±0.3 g/kg body weight day), an excess of sugars (23±4 instead of <10% of kcal). These figures are significantly higher than the intake of similar nutrients in physically active people in the comparison group. In football players, compared with the comparison group, significant changes in microbial markers were found for Alcaligenes spp., Clostridium ramosum, Coryneform CDC-group XX, Staphylococcus epidermidis (p<0.001), known for their pro-inflammatory activity in the intestine, as well as for Lactobacillus spp. (p<0.001) performing a protective function. In addition, mycobiome markers were increased in athletes: Candida spp. (p<0.001), Aspergillus spp. (p<0.001), among which there are potential pathogens of mycoses. This was not observed in the comparison group. At the same time, an increase in the microbial markers of Alcaligenes spp., Coryneform CDC-group XX, Lactobacillus spp., Streptomyces spp., Candida spp. Micromycetes spp., containing campesterol in the cell wall, in football players positively correlated with a high calorie diet (p<0.001). A similar correlation of mycobiome markers (Micromycetes spp., containing sitosterol in the cell wall, ρ=0.346, p=0.015) was observed with an excess of easily digestible carbohydrates. Taking into account the data obtained, a correction of the diet have been proposed: increasing the consumption of carbohydrates to 7.3–7.5 g/kg of body weight/day by including bakery products from whole grain flour and cereals in the diet (up to 300–370 g/day), limiting simple sugars (up to 90–95 g/day).

Conclusion. High physical activity leads to changes in the structure of blood microbial markers, including a shift towards an increase in potentially pathogenic fungi. Wherein, a predictive role is played by an imbalance of macronutrients in terms of quantitative and qualitative composition, an excess of simple sugars, and a lack of slowly digestible carbohydrates. To correct the diet, an additional inclusion in the diet of their main sources – products from cereals (cereals and bakery products) is proposed.

Protective effect of anthocyanins on apoptosis of gastrocnemius muscle myocytes of rats after intense exercise


Currently, in sports medicine, much attention is paid to the prevention and treatment of delayed muscle soreness syndrome (DOMS), which occurs several hours or days after unusual or intense physical activity, as well as the state of athlete overtraining. One of the main pathogenetic factors in the development of this syndrome is myocyte ultrastructural damage with apoptosis activation. Therefore, using natural antioxidants in sports nutrition for the relief of this pathology is of particular relevance.

The aim of the study was to study the effect of an anthocyanin-enriched diet on apoptosis of gastrocnemius muscle myocytes of rats after intense exercise.

Material and methods. The experiment was carried out for 4 weeks on 4 groups of male Wistar rats (12 animals in each, initial body weight ≈300 g). Animals were divided into groups of rats (groups 1 and 2), whose motor activity was limited by standard conditions for keeping animals in vivarium, and groups of physically active rats (groups 3 and 4), which received additional physical activity – treadmill training. Before the end of the experiment, the animals of groups 3 and 4 were given debilitating (until the rats refused to continue the exercise) physical activity on a treadmill. Rats of all four groups received a standard semi-synthetic diet, water ad libitum. Animals in groups 2 and 4 were additionally given blueberry and blackcurrant extract (30% anthocyanins) as part of the diet at a daily dose of 15 mg anthocyanins/kg body weight. The intensity of apoptosis of gastrocnemius muscle myocytes was studied by flow cytometry. Cells were stained with fluorochrome-conjugated annexin V and vital dye 7-aminoactinomycin. The results are presented as the percentage of intact cells and cells at different stages of apoptosis per 100 000 counted objects in each sample.

Results. The enrichment of the diet of control group rats with blueberry and black currant extract did not have a significant effect on the relative content of intact cells and the studied parameters of apoptosis of gastrocnemius muscle myocytes of rats of the 2nd group. Intense physical activity in rats of the 3rd group led to a statistically significant (p<0.05) decrease in the relative content of intact (live) cells compared with this indicator in rats of other groups (85.32±1.44 vs 90.87±0.66% – in the 1st group; 90.16±0.79% – in the 2nd group; 89.01±0.81% – in the 4th group, р<0.05). After intense physical activity in rats of the 3rd group, activation of apoptosis of gastrocnemius muscle myocytes was found, as evidenced by an increase in the relative content of objects in apoptosis compared with other groups (11.61±1.45 vs 7.88±0.60% – in the 1st group, р<0.05; 8.01±0.70% – in the 2nd group, p<0.10; 7.93±0.59% – in the 4th group р<0.05). Enrichment of the diet of exercise rats with blueberry and blackcurrant extract (4th group) had a protective effect on the intensity of the apoptosis process, the studied parameters did not differ significantly from those in rats of the control and the 2nd groups.

Conclusion. The results of the study indicate the activation of the process of apoptosis of gastrocnemius muscle myocytes of rats after intense physical activity. Enrichment of rats’ diet with anthocyanins from blueberry and black currant extracts ensures the restoration of the studied apoptosis parameters to the level of control group rats. In the control group of rats with normal physical activity, the addition of anthocyanins to the diet does not have a significant effect on the physiological process of apoptosis of gastrocnemius muscle myocytes. In this way, an evidence base for the effectiveness of the use of biologically active substances – anthocyanins – in sports nutrition for the restoration of skeletal muscles has been obtained.

Hygiene of nutrition

Analysis of the diet and food structure of the daily diet of children aged 3–17 years in the Russian Federation


A healthy diet is a necessary condition for the normal physical and mental development of children, which has a significant impact on the ability to withstand the effects of adverse environmental factors and determines the health of future generations.

Healthy nutrition of children and adolescents is important not only for the normal physical and mental development of the child, but also as a factor determining the health of future generations. It is important for the preservation of the child’s health to have a proper diet, that is, the distribution of the amount of food during the day (the multiplicity of meals), its energy value, chemical composition, food set for individual meals, a certain time of intake and the duration of intervals between meals.

The aim of the study – to analyze the diet, nutrient and energy consumption and the structure of the food set of various meals in children aged 3–17 years.

Material and methods. Analysis of the actual nutrition of about 18 000 children on the basis of primary materials obtained by the Federal State Statistics Service during the Selective observation of the diets of the population.

Results. An analysis of nutrition of children aged 3–17 showed that the majority of children (67.9%) had three main meals with a hot meal (breakfast, lunch, dinner), while they accounted for the largest amounts of energy consumption in all age groups. Supplementary meals (evening snack and second breakfast) were characterized by the lowest calorie value, the afternoon snack occupied an intermediate position in terms of energy consumption. At the same time, energy consumption with the main meals as a % of the daily calorie intake did not correspond to the recommended values. A shift in energy consumption to the second half of the day, including just before bedtime, was revealed, especially in older children, which is a bad eating habit that can contribute to weight gain in a child. Bread products, cereals and cereal dishes made the greatest contribution to the daily calorie intake of children of all ages (32.4–33.0%). Meat products occupied the second position in the share of daily calorie content (12.8–21.2%), dairy products provided 9.5–14.0% of daily energy, and among preschoolers their consumption, in contrast to meat products, was the highest, and among older schoolchildren – the lowest. An additional 8.3 to 14.9% of energy came from sugars found in non-dairy drinks, confectionery, chocolate, jams, and other sweets.

Conclusion. An analysis of the diet and food structure of the daily ration of children aged 3–17 revealed deviations from the principles of healthy eating, especially in schoolchildren: energy consumption with the main meals did not meet the recommended norms, a significant proportion of the calorie intake fell on the second half of the day. Differences in the contribution of meals, as well as individual foods and dishes, to the total daily calorie value of diets in children, depending on age, have been established.

Calcium supply of adolescent girls and sucrose-lactose imbalance in nutrition


Ensuring calcium homeostasis is a complex metabolic process. Its impairment, especially in childhood and adolescence, is manifested by numerous changes in the functioning of most organism systems, which are difficult to restore in later periods of life.

The goal of this research was to study the characteristics of calcium and disaccharide consumption by adolescent girls and to identify the physiological and biochemical mechanisms of the influence of sucrose-lactose imbalance on calcium supply.

Material and methods. A multicenter cross-sectional study was conducted. In this study, teen girls aged 11–14 years without an established diagnosis of lactase insufficiency, living in urban areas, took part on a voluntary basis in the autumn period (n=136, of which 40 were Adyghes, 45 Chechens, other nationalities, mainly Russian – 51). Three-day diets were analyzed, physiological manifestations of calcium deficiency and taste sensitivity to sucrose were evaluated, the CFRt indices (sum of carious, filled and removed permanent teeth) were calculated, and calciuria was studied according to the Sulkovich test in the morning portion of urine.

Results. It has been established that the consumption of milk and dairy products by adolescents does not meet physiological standards, which leads to the 2.2 fold decrease in their contribution to calcium provision and to the risk of insufficient milk calcium consumption (RIC Camilk). In the nutrient status of adolescents, regardless of nationality and region of residence, the syndrome of sucrose-lactose imbalance (SLI) was revealed: the 1.4 fold excess of sucrose consumption and 2.1 fold decrease in lactose consumption compared with optimal values. For further analysis, the children were divided into groups, variable in the combination of RIC Camilk and SLI of varying severity: group 1LL – low RIC Camilk and low SLI; group 2LM – low RIC Camilk and moderate SLI, group 3MM – moderate RIC Camilk and moderate SLI; group 4MH – moderate RIC Camilk and high SLI, and group 5HH – high RIC Camilk and high SLI. The analysis of the data showed that higher levels of SLI (groups 2LM and 4MH) at the same levels of RIC Camilk (groups 1LL and 3MM) reduce calcium bioavailability, impair calcium metabolism and increase the prevalence and severity of physiological manifestations of calcium insufficiency by 1.5 and 1.4 fold, and dental diseases estimated using the CFRt index – by 1.2 and 1.6 fold. The prevalence of low taste sensitivity to sucrose in 5HH group was 1.4 fold higher compared to 4MH group. Against the background of excessive consumption of added sugars, calciuria didn’t significantly differ in groups with different levels of calcium intake.

Conclusion. Based on the assessment of nutrition, teen girls showed SLI syndrome and high RIC Camilk. SLI reduces calcium availability, increasing the prevalence of calcium insufficiency symptoms in adolescent girls with moderate and high RIC Camilk.

Characteristic of eating behavior in functional dispepsy


Functional dyspepsia is the actual problem of modern gastroenterology, its manifestations contribute to the lifting of lifestyle and nutrition. However, a comprehensive assessment of the effect of violations of food behavior, the distribution of adipose tissue and the level of gosters regulating appetite on the severity of gastroenterological symptoms in individuals with various types of functional dyspepsia hasn’t been carried out yet.

Aim – to clarify the effect of food behavior, ghrelin and leptin blood concentrations on clinical symptoms in patients with different types of functional dyspepsia.

Material and methods. A prospective study with the participation of 90 people aged 22.3±0.2, divided into 3 groups was carried out: patients with postprandial distress syndrome (PDS), patients with epigastric pain syndrome (EPS), and practically healthy. All respondents were interviewed using the GSRS, DEBQ questionnaires, their anthropometric data have been defined, body composition indicators were calculated based on the measurement of body circumference measurements, leptin and ghrelin concentration in blood serum was measured by the enzyme immunoassay method.

Results and discussion. EPS was characterized by more pronounced symptoms (10.10±0.32 points on the GSRS questionnaire) due to abdominal pain syndrome (4.33±0.51 points) compared with patients with PDS and healthy individuals. In both variants of the functional dyspepsia, all three types of food behavior disorders were revealed, however, the external type was more characteristic for PDS. Patients with PDS had a larger volume of visceral adipose tissue (42.84% of the total fat tissue in the body) than those with EPS (34.02%) and healthy ones (35.55%). Blood leptin concentration in patients with both variants of the functional dyspepsia was lower (especially in patients with EPS – 0.17±0.03 ng/ml, p=0.039) than in healthy (0.32±0.08 ng/ml). Ghrelin level in patients with EPS (14.91±0.17 ng/ml) was significantly higher than in healthy (11.55±0.44 ng/ml, p=0.022). Factor analysis made it possible to identify the stress factor showing the connection of emotional disorders of food behavior with increasing gastrointestinal symptoms and blood leptin concentration and decreasing blood ghrelin level.

Conclusion. Different variants of functional dyspepsia are characterized by their own peculiarities of eating behavior, the distribution of fat in the body, the degree of changes in leptin and ghrelin levels, which determine their clinical symptoms. The identification and accounting of these factors will make it possible to individualize the approach to the curation of patients with functional dyspepsia.

Intensity of processes of oxidative modification of proteins in women’s and cow’s milk


Breast milk is a source of all the essential nutritional components necessary for the full growth and development of the child, therefore, it is necessary to study its composition and physical and chemical properties in order to adapt human milk substitutes. Adapted infant milk formulas are produced mainly from cow’s milk, bringing formula nutrient composition closer to the composition of women’s milk, adapting it in accordance with the requirements of the infant body. However, technological processes for the production of dairy products contribute to the activation of oxidative reactions, the violation of protein conformation.

The purpose of the study was to compare the intensity of formation of carbonyl derivatives of human and cow’s milk proteins during spontaneous and metal-catalyzed oxidation.

Material and methods. The object of the study were samples of mature milk of healthy nursing mothers (n=12), and samples of drinking ultra-pasteurized milk for baby nutrition (n=8) which were used as a comparison material. The intensity of oxidative modification of milk proteins was determined spectrophotometrically by the interaction of carbonyl derivatives of amino acid residues with 2.4-dinitrophenylhydrazine to form 2.4-dinitrophenylhydrazone derivatives in a native sample of biological material and under induction of protein oxidation in vitro by the Fenton reaction by adding FeSO4 and hydrogen peroxide solutions. The content of non-protein sulfhydryl groups was determined after protein precipitation spectrophotometrically with 5.5’-dithio-bis-2-nitrobenzoic acid.

Results. The intensity of spontaneous (basic) oxidation doesn’t have significant differences between the indicators of breast and cow’s milk. Significant differences were established in the content of carbonyl derivatives of amino acid residues of human and cow’s milk proteins during metal-catalyzed oxidation. Incubation with iron ions caused 1.5–2.5 fold more formation of both aldehyde and ketone derivatives of cow’s milk proteins, recorded in the visible and ultraviolet spectrum. In cow’s milk during spontaneous oxidation and induction of oxidation by a metal, the percentage of aldehyde-dinitrophenylhydrazones was lower than in breast milk and, conversely, the proportion of ketone-dinitrophenylhydrazones, late markers of oxidative degradation of proteins, was significantly higher. The content of non-protein sulfhydryl groups in cow’s milk was 2 times less than in fresh human milk. A significant excessive content of aldehyde-dinitrophenylhydrazones (2 times) and ketone-dinitrophenylhydrazones (2.6 times) undet metal-catalyzed protein oxidation of cow’s milk in comparison with breast milk indicates a lower level of antioxidant reserves of cow’s milk. This is confirmed by the reduced level of non-protein sulfhydryl groups. The results obtained indicate the need to improve the antioxidant status of dairy products for infant nutrition.

Diet treatment

Effect of the elimination diet in psoriasis: a clinical case


Psoriasis (PS) is a multifactorial disease with a dominant role of genetic predisposition, but the questions of PS etiology and pathogenesis still remain open. The development of PS can be facilitated by environmental factors, as well as a violation of the skin barrier and immune imbalance. In the literature of recent years, an association in clinical practice between PS and atopic diseases (atopic dermatitis, bronchial asthma, allergic rhinitis) has been increasingly reported. As a result of the increase in the prevalence of allergic diseases in the world, a special role is given to the study of nutrition, in particular food allergy in the development of PS. An elimination diet under food allergy is the main type of etiotropic therapy that prevents the launch of immunopathological inflammatory reactions. However, the literature does not provide data on the positive effect of the elimination effect in food allergy in patients with psoriasis.

The purpose of this work was to present a clinical case of the effectiveness of the elimination diet for food allergy in a patient with PS.

Methods. A specific allergological examination of a 65-year old patient with widespread PS (suffering from the age of 25) was carried out: determination of the concentration of total immunoglobulin E (IgE), eosinophilic cationic protein and allergen-specific IgE to food, pollen, fungal allergens in the blood serum by enzyme-linked immunosorbent assay, skin prick testing with food and pollen allergens. Taking into account the specific allergological examination, the patient was prescribed a diet with the elimination of causally significant allergens, including cross-reacting ones, for a period of 1–3 months (with the exception of chicken eggs, cereals, buckwheat, baker’s yeast and products based on yeast fermentation, cereal products (bread, bakery, rolled oats, bran, oatmeal cookies, cereals, pasta); as well as peanuts, smoked sausages, coffee, cocoa, ice cream, sherbet, sesame, sorghum, honey and bee products, strawberries, wild strawberries, citrus, legumes, soybeans, sorrel, herbal teas, tree fruits (raw apples, peaches, cherries; nuts, exotic fruits), celery, raw carrots, tomatoes).

Results. The demonstrated clinical case indicates that the appointment of an elimination diet in patients with PS with concomitant food allergies contributes to the rapid regression of the skin process. The increased concentration of total IgE in blood serum revealed during patient examination, the presence of positive reactions to food and pollen allergens according to the results of skin prick testing and the determination of allergen-specific IgE, the positive food elimination effect demonstrate the important role of allergic reactions in the development of skin lesions in PS. The presented observation demonstrates the importance of conducting a specific allergic examination in patients with PS, including an allergic history, determining the concentration of total and allergen-specific IgE, and eosinophilic cationic protein in blood serum, studying the spectrum of sensitization to food, pollen and fungal allergens by skin prick testing.

Conclusion. Thus, as a result of the study, it was found that the appointment of an individual elimination diet, taking into account the results of a specific allergological examination, can contribute not only to the effective resolution of foci of psoriatic skin lesions, but also to the prevention of the progression of the systemic inflammatory process, reducing the risk of comorbid conditions and, therefore, improving the life quality of patients with psoriasis.

The effectiveness of BIFIFORM KIDS in the prevention of the incidence of acute respiratory infections in children


Probiotics are widely used as a means of dietary correction of the intestinal microbiota in patients not only with alimentary, but also with allergic and inflammatory diseases. They have systemic effects on the human organism. However, the diversity of the composition of probiotic complexes complicates the determination of the beneficial effects of specific microorganisms on the human body. These circumstances call for more research. Investigation of the effect of probiotic intake on the levels of various cytokines may explain the mechanisms of the beneficial effect of probiotic intake on the functioning of the immune system.

Objective – to study the effectiveness of the probiotic Bifiform Kids for the prevention of respiratory infections in children with recurrent respiratory infections with gastrointestinal allergy symptoms.

Material and methods. The prospective randomized controlled trial included 92 children aged from 4 to 5 years who suffers from more than 5 episodes of respiratory infections per year with gastrointestinal allergy symptoms. Patients from the main group (n=46) were prescribed 2 chewable tablets Bifiform Kids (Lactobacillus rhamnosus GG not less than 1×109 CFU, Bifidobacterium animalis spp. lactis not less than 1×109 CFU, thiamine mononitrate 0.40 mg, pyridoxine hydrochloride 0.50 mg in each) twice per day within 21 days. Patients from the control group (n=46) were prescribed no probiotics during the study period. The study included the measurement of blood serum levels of immunoglobulins A, M, G (by immunoturbodimetry) and E, as well as the concentration of cytokines IL-17, IL-10 (by enzyme immunoassay). Measurements were performed at the 1st day of the study, at the 21st day of the study, and 6 months after the study initiation. The microbiota composition was determined by sequencing the bacterial 16S rRNA genes in DNA preparations isolated from stool samples collected at the start of the study and after 21 days. The Shannon index was calculated for the species of detected bacteria to determine the diversity of the microbiome. The effectiveness of disease prevention was measured by calculating the prevention index and the efficiency coefficient based on the incidence of respiratory infections in both groups during the observation period (6 months).

Results. In the main group, the volume of the commensal flora decreased 3 weeks after the study initiation: Enterobacter from 18.3±19.3 to 10.5±18.1%; Enterococcus from 8.7±16.1 to 3.1±10.0%; Clostridium from 3.1±8.1 to 0.5±2.2%. There was a statistically significant increase in the proportion of representatives of the genus Bifidobacterium by 2.2 times (from 16.9±26.4 to 36.5±31.5%, p=0.0017) and a decrease in the Shannon index from 1.1±2.1 up to 0.4±1.1 (p<0.05). In the control group, there were no statistically significant changes in the microbiota content. In the main group, after 21 days, the blood IL-10 level increased from 11.3±15.4 to 15.7±13.4 pg/ml, and the IL-17 concentration decreased from 8.9±7.7 to 6.5±7.1 pg/ml (p≤0.05) while maintaining this trend by the 6th month of observation. There were no changes in these indicators in children from the control group. The main group demonstrated a significant (р≤0.05) decrease in the level of IgE from 184±121 to 104±67 and 114±54 kU/l, and a significant increase in IgA from 0.73±0.45 to 1.33±0.65 and 1.21±0.57 g/l after 3 weeks and at the end of the probiotic intake, respectively. The level of IgA in the main group remained higher during the study compared to the control group. The main group demonstrated a 3-fold decrease in the incidence of respiratory infections in comparison with the control group. The efficiency index was 3.21, the therapeutic response was 69%.

Conclusion. The results of the study show the effectiveness of the complex probiotic for the respiratory infections prevention in children with gastrointestinal allergy symptoms.

Prophylactic nutrition

Instant drinks based on extracts of Japan sea brown algae and fruit and berry juices as functional products


Nowadays, there is a need to create functional drinks that not only normalize the water-electrolyte balance, but also correct and optimize the chemical structure of the diet. The basis for the production of dry drinks can be fruit and berry juices, extracts of herbal raw materials, including algae, etc.

The aim of the study was to develop dry drinks based on dry extracts of brown algae (Costaria costata and Undaria pinnatifida) and concentrated fruit and berry juices and to evaluate the content of biologically active substances in them, as well as the antioxidant properties of the resulting drinks.

Material and methods. Brown algae of the Far Eastern region Costaria costata and Undaria pinnatifida were used as objects, from which dry hydrothermal extracts were obtained, as well as dry drinks based on these extracts (21–26%) and concentrated fruit and berry juices of black currant and blueberry (31–37%). The content of iodine was determined by titrimetric method, fucoidan, the sum of phenolic compounds, flavonoids, catechins – by spectrophotometric method, vitamin C – titrimetrically, anthocyanins – by pH-differential spectrophotometry. Identification of phenolic compounds was carried out by HPLC. The antiradical properties of beverages were evaluated by the ability to interact with the stable 2.2-diphenyl-1-picrylhydrazyl free radical in vitro spectrophotometrically.

Results. Dry hydrothermal extracts of C. costata and U. pinnatifida brown algae are characterized by a high content of bioactive substances, the main of which are fucoidan and iodine. The fucoidan content in C. costata extract was 1.7 g/100 g, in U. pinnatifida extract – 0.5 g/100 g; the iodine content was 0.0036 and 0.0028 g/100 g, respectively. The content of phenolic compounds was at least 205 mg of tannic acid per 1 g, the main compounds were syringic acid and epicatechin, salicylic and coumaric acids, as well as chlorogenic, caffeic, 2.5-dihydroxybenzoic, ferulic acid and gallates of epigallocatechin and epicatechin. The developed drinks based on dry extracts of C. costata and U. pinnatifida brown algae (21–26%) and concentrated blueberry and blackcurrant juices (31–37%) (the rest is powdered sugar) are a food system enriched with bioactive substances. The content per 1 serving of drinks (10 g per 200 ml) of iodine was high and amounted to 70–75 mcg, phenolic compounds – about 250 mg, vitamin C level was maximum in a drink with black currant (41–44 mg), fucoidan content ranged from 79 to 84 mg. The resulting dry drinks satisfy the daily physiological requirement in iodine by at least 40%, in vitamin C – by at least 30% when consuming 1 serving. The radical binding activity of all the studied beverages was quite high and amounted to 91.1–96.5%. The drink with blueberry juice and C. costata extract showed maximum antiradical properties.

Conclusion. The developed dry soft drinks based on dry extracts of C. costata and U. pinnatifida brown algae and concentrated juices of black currant or blueberry contain a wide range of bioactive compounds. They can be attributed to functional products due to the high degree of satisfaction of the daily physiological requirement of the human body in vitamin C and iodine and are characterized by high antiradical properties.

Brief reports

Technological features of fermented beverages production using kombucha


Kombucha is a beverage made by fermenting sweetened brewed tea (substrate) by symbiotic culture of yeast and bacteria. Numerous researches on optimization of fermentation process, determination of the influence of technological factors on physical and chemical properties, formation of taste and flavor profile of the beverages, prevention of industrial product risks are due to the growing popularity of kombucha in Europe and the USA. Technological features of kombucha production are to optimize conditions for the growth of symbiotic culture and substrate fermentation. The duration of the process depends on the composition of the substrate, the ratio of tea mushroom and substrate, temperature, size and shape of fermentation vessel.

The aim of the work was to generalize the results of studying the technological features of the production of fermented kombucha type beverages and to identify the factors that affect the chemical composition and safety of the finished beverages.

Material and methods. Analytical research was carried out on the main databases for the keyword “kombucha”. The criteria for inclusion of articles in the analysis were research articles with open access and presenting detailed technology of kombucha.

Results. The technology of kombucha production is based on fermentation of the substrate and obtaining the base of the beverage with high content of organic acids, mainly acetic acid. In order to ensure microbiological safety the acetic acid concentration in the beverage base must be at least 1.2%. The high organic acid content necessitates the use of only glass or stainless steel fermentation equipment approved for food contact. The fermentation temperature ranges from 18 to 32 °C. The fermentation process is monitored according to basic criteria: temperature, pH value, acidity, acetic acid content, ethyl alcohol content, and residual sugar content. Kombucha production process is connected with microbiological, chemical and physical risks which could appear in case of using low quality raw materials, equipment and consumer packaging made of materials which do not correspond to sanitary norms, violating technological regimes, storage conditions of raw materials and ready production. To prevent hazards affecting the quality and safety of the finished product, it is necessary to control the technological process at all stages of production.

Conclusion. Following sanitary-hygienic norms and technological regimes allows producing kombucha with a balanced taste and aroma, which meets the safety requirements for fermented beverages.

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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)
Medicine today

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