On the new (2021) Norms of physiological requirements in energy and nutrients of various groups of the population of the Russian Federation
The article presents the main provisions of the new “Norms of physiological requirements in energy and nutrients for various groups of the population of the Russian Federation” developed and approved in accordance with the established procedure, accumulating the latest fundamental knowledge and world and domestic experience, that determine the values of physiological requirements in nutrients and energy sources, adequate levels of consumption of micronutrients and biologically active substances with an established physiological effect. In the Norms the conceptual apparatus has been expanded and updated, several terms and definitions to them (nutriome, intestinal microbiome, trans-isomers of fatty acids, critical nutrients, edible salt, glycemic index of food products, etc.) have been introduced. Changes have been made to the age periodization of the child and adult population of the Russian Federation, as well as adjustments in the differentiation of the population by the level of physical activity (4 groups for men and women). Taking into account these data, the recommendations on the proportion of macronutrients in the calorie content of the daily diet have been adjusted. The levels of physiological requirements in energy and nutrients have been clarified, depending on the physical activity of the population, including vitamins and mineral substances for both men and women, including period of pregnancy and lactation, as well as for children of different ages. For the first time, recommendations are included to reduce the intake of critical nutrients for health (dietary salt, added sugars, trans-isomeric fatty acids), based on data from modern meta-analyzes on the negative health effects of their excessive intake. Recommendations on the consumption of a-3 and a-6 polyunsaturated fatty acids by children and adults, including pregnant and lactating women, have been significantly expanded; adequate dietary intake of plant sterols have been introduced for the first time; while adequate dietary intake of certain phenolic compounds (phenolic acids, flavonoids, polymeric phenolic compounds and stilbenes) were specified. For the first time, the Norms include recommended levels of water (drinks) consumption to maintain the body’s water balance under optimal environmental conditions for adult men and women at different levels of physical activity, for children, as well as pregnant and lactating women. For the first time in world practice, a complex of qualitative and quantitative indicators of the reference intestinal microbiome is presented, including modern taxonomic and functional characteristics that give an conception of microbiota phenotype in adults with a normal body mass index.
Dietary fiber as modulators of gastrointestinal hormonal peptide secretion
The review provides information on the effect of dietary fibers on the production of key gastrointestinal hormonal peptides that affect eating behavior and the formation of feelings of hunger and satiety. The mechanisms of action of dietary fiber on the production of appetite-regulating peptides are discussed. Modulation of gastrointestinal hormonal peptide secretion by dietary fibers is involved in the regulation of the balance of energy, appetite, and body weight.
The aim of the research was to expand the understanding about the effects of dietary fiber on the secretion of major gastrointestinal hormonal peptides involved in appetite control, the formation of feelings of hunger, satiety and satiation.
Results. Gastrointestinal hormones, as physiological regulators of food intake, play an essential role in the formation of feelings of hunger, satiety and satiation, helping to reduce appetite and maintain normal body weight. Various dietary fibers, depending on the physic-chemical properties, the amount and duration of the consumption period, can have a modulating effect on the secretion of the hunger hormone ghrelin and the hormones of satiety: leptin and intestinal peptides (glucagon-like peptide-1, cholecystokinin and YY peptide). Conclusion. Dietary fiber influence on processes of energy intake, food ingestion and nutrient absorption in gastrointestinal tract, enhance neuroendocrine responses, modulate release of appetite-regulating hormones involved in energy balance and regulation of feelings of hunger and satiety. The possibility to promote a favorable profile of the endogenic gastrointestinal hormones by inclusion of dietary fiber in food ration both in the form of the natural food and additionally as dietary supplements is of interest as one from strategies of over appetite control and normal body weight maintenance.
Intestinal microbiote of athletes
The intestinal microbiota, due to new data on its functions obtained in the last decade, has become a new target point of influence on the organism. However, nowadays knowledge about the possible impact of physical activity and sports on the composition of the gut microbiota and, as a result, on the organism is limited.
The aim of this review was to summarize current knowledge about the gut microbiota of healthy people with different levels of physical activity (from athletes to physically inactive people), and to identify patterns in the composition of the microbiota of various surveyed groups.
Material and methods. A systematic search was carried out in electronic databases including EMBASE, MEDLINE, Web of Science, Google Scholar and eLIBRA RY. The search process was carried out using keywords and logical operators. We included the following studies in our review: a) crossover studies comparing the gut microbiome of subjects with different physical activity; b) studies involving healthy adult women and men (18-45 years old); c) studies written in English and Russian. We excluded studies containing dietary changes, consumption of probiotics or prebiotics, and studies of physical activity in sick people.
Results and discussion. Total 743 articles were received, of which 14 articles fully met the search criteria, and 101 articles partially corresponded. An analysis of the data from these studies indicated noticeable differences in the microbiota between athletes and people leading an sedentary lifestyle: the athletes had a greater α-diversity of the microbiota, while the level of microorganisms of the phylum Bacteroidetes was reduced; Akkermansiaceae and Faecalibacterium bacteria are elevated in athletes and people with active lifestyles. Different levels of physical activity in physically active people according to the levels of cardiorespiratory endurance did not affect the level of α- and β-diversity. When analyzing the effect of loads on the microbiota in various sports disciplines and skill levels, a connection was found with an increase in α-diversity in professionals and highly qualified athletes, with the relative content of series of bacteria (Methanobrevibacter smithii in professional cyclists; Parabacteroides, Phascolarctobacterium, Oscillibacter, Bilophila, Megasphaera in athletes of high martial arts qualifications of wushu; Eubacterium rectale, Polynucleobacter needarius, Faecalibacterium prausnitzii, Bacteroides vulgatus, Gordonibacter massiliensis in athletes of international level of various sports), and certain genera of bacteria have been identified (Parabacteroides, Phascolarctobacterium, Besilibacterium).
Conclusion. The data obtained indicate a higher relative proportion of microbiota effective members, which are involved in the fermentation of complex polysaccharides and the production of short-chain fatty acids such as Faecalibacterium prausnitzii, Eubacterium hallii, Phascolarctobacterium, Eubacterium rectale, and Methanobrevibacter smithii, which increases the fermentation efficiency of many bacterial taxa in the gut by using hydrogen gas (H2) and formate to reduce carbon dioxide (CO2) to methane. There is a need to study other members of the microecological community, leading to a better understanding of the adaptation of the gut microbiota to levels of physical activity and its potentially positive effects on metabolism and endurance.
Iatrogenic deficits of micronutrients
Long-term use of certain drugs causes subclinical and clinically significant micronutrient deficiencies, which can affect the course of the disease, its prognosis, quality of life, and patient compliance with therapy.
The aim of the study was to single out groups of drugs, which long-term use leads to micronutrient deficiency, and to determine vitamins, minerals and trace elements, which supply can be reduced as a result of pharmacotherapy, basing on the analysis of data published in the scientific literature.
Material and methods. This review analyzes articles on medical sciences from MEDLINE and PubMed-NCBI bibliographic databases.
Results. Combined oral contraceptives reduce woman’s supply with B vitamins (B6, B12, B9), can cause hypomagnesemia, affect the calcium/magnesium blood ratio, reduce the amount of vitamin E circulating in blood. Proton pump inhibitors reduce the absorption of vitamin B12, calcium, magnesium, iron, zinc. Aspirin increases ascorbic acid metabolism. Loop diuretics increase urinary excretion of calcium, magnesium, thiamine, thiazide ones elevate zinc and vitamin B9 excretion. Loss of taste when taking captopril is associated with a decrease in zinc supply. The use of calcium channel blockers interfere with the absorption of folic acid by gingival fibroblasts.
Conclusion. Given the growing prevalence of long-term drug use, it is necessary to be able to predict and prevent potential consequences of interactions with micronutrients. It is advisable, along with a varied and healthy diet, to provide patients with supplementation in order to prevent micronutrient deficiencies. Optimization of vitamin status of the population in terms of its significance for public health is comparable to drug therapy and is one of the technologies for reducing losses from chronic diseases.
Oleogels as prospective nutritional ingredients of lipid nature
The composition of the lipid component of consumed foods affects the consumers’ health. Fats are not only a source of essential fatty acids, but also participate in the formation of the organoleptic and rheological properties of foodstuffs. At the same time, fats are sources of saturated and trans-isomeric fatty acids, which excessive consumption is associated with the risk of cardiovascular diseases, and therefore, it is relevant to search for promising ways to replace such fats.
The aim of this review is to summarize data from studies of oleogels as an alternative to such fats.
Results. It has been shown that the prevalence of obesity in many countries, including Russia, remains an acute problem. At the same time, as a rule, in persons with obesity and cardiovascular diseases, the consumption of fat including saturated and trans-isomeric fatty acids is excessive. To reduce the content of saturated and trans-isomeric fatty acids in foodstuffs, such systems as oleogels have recently been considered. The interest in these systems is related to the fact that they can act not only as substitutes for solid fats -sources of trans- and saturated fats but also as carriers of biologically active substances.
Conclusion. The results of the analytical study indicate that active research is currently underway concerning the properties of oleogels, their use in foodstuffs, and modeling the effect of consumption of oleogels and containing them foodstuffs on the general metabolic health of humans. These studies are currently in their initial stages, but their results already indicate the great potential of oleogels as a food ingredient.
Prospects for the correction of intestinal microbiota in the prevention and treatment of asthma in children
The issues of therapy and prevention of asthma in children do not lose their relevance. The increase in the prevalence of allergic diseases and asthma is associated, among other things, with a relative deficit in the microbial load and changes in the microbiota due to improved hygiene and living conditions. The microbiota plays an important role in the formation and functioning of the immune system. Contact with microorganisms contributes to the normal maturation of T-regulatory cells, preventing an inadequate immune response in both the Th1- and Th2-pathways.
Aim - literature review on the possibilities of gut microbiota correction for prevention and treatment of asthma in children.
Results. In children with an increased risk of asthma, abnormalities in the intestinal microbiota are observed in the first year of life: there is a relative deficiency of Lachnospira, Veillonella, Faecalibacterium and Rothia. The imbalance of the intestinal microbiota is accompanied by a decrease in the synthesis of short-chain fatty acids (butyrate, acetate, propionate), which, among other things, play the role of signaling molecules. Gut microbiota maturation is delayed in children at risk of asthma. It is not clear whether the diversity of the gut microbiota is associated with the risk of developing asthma. Maintenance of normal gut microbiota or correction of its disturbances in early life is a possible approach to the prevention and treatment of asthma. Breastfeeding, vaginal delivery, constant contact with farm animals or dogs since an early age, limiting antibiotic use in the first year of life, a varied diet with the inclusion of fiber-rich foods, and the use of pre-and probiotics can help. However, the implementation of these recommendations in practice is difficult. Further research is required to identify specific prophylactic stimuli reproducible in the urban environment. The conflicting results of studies in this area, in particular, the effectiveness of probiotics in the prevention of asthma, require large-scale prospective cohort studies with a long follow-up period and careful selection of probiotic strains and their combinations. Now, there are no definitive recommendations on the use of probiotics for the prevention of allergic diseases.
Conclusion. The possibilities of correcting the gut microbiota for the prevention and treatment of asthma are actively studied, but at present, there are many contradictions and unresolved issues.
Identification of factors influencing the texture sensitivity of young healthy volunteers based on a model for distinguishing the hardness of an agar-gelatin gel
Elucidating the causes of variability in food texture sensitivity is important for understanding the mechanisms underlying food choice and portion size, eating rates, and enjoyment of food. Since texture perception significantly affects eating behavior, it is assumed that ability to recognize food texture, in turn, may depend on eating behavior.
The aim of the study was to elucidate the relationship between the ability to recognize the hardness of an agar-gelatin gel, on the one hand, and the nutritional value of the diet, the type of eating behavior and the level of hunger and satiety feelings, on the other hand.
Material and methods. In 38 healthy residents of Syktyvkar (15 men, 23 women aged 21 to 31 years) food textural sensitivity was determined by pairwise comparison of the hardness of model agar-gelatin gels and the level of the feeling of stomach fullness at the time of testing. All participants completed a food diary, the Dutch Eating Behavior Questionnaire, the Yale Food Addiction Scale, and assessed the standard organoleptic and hedonic properties of commercial fruit jelly. Statistical processing of the data was performed using non-parametric statistics: the Mann-Whitney U-test, Fisher’s exact test, and calculating the Spearman’s correlation coefficient.
Results. The ability to recognize the hardness of food gel was found to vary significantly among the participants. The percentage of correct answers given by participants with high food textural sensitivity (n=20) was equal to 92 and 82% when comparing agar-gelatin gels with hardness in the range of 40-300 and 800-1000 kPa, respectively. Participants with low food texture sensitivity (n=18) gave the correct answer in 74 and 31% of cases when tasting soft and hard gels, respectively. Participants with high and low sensitivity to food gel texture did not differ in the type of eating behavior, as well as in the average daily intake of energy, macronutrients and dietary fiber. Correlation analysis revealed a negative relationship (rs=-0.37, p=0.020) between the percentage of correct answers when determining the hardness of the agar-gelatin gel and the level of the stomach fullness among all participants (n=38). In the sensory evaluation of fruit jelly, it was found that the descriptor «hard» was chosen by 60 and 22% (p=0.025) of the participants from the groups with high and low textural sensitivity, respectively.
Conclusion. The ability to discriminate the hardness of an agar-gelatin gel is higher in people with a low level of stomach fullness feeling. Sensitivity to the texture of food gel is not related to energy value and macronutrient content in the daily diet and does not depend on the type of eating behavior. Participants with high food textural sensitivity are more likely to use the characteristic “hard” when evaluating fruit jelly.
Urinary miRNA expression in cynomolgus macaques (Macaca fascicularis) fed high salt rations
High food intake of sodium chloride is associated with damage not only the cardiovascular system, but also the kidneys. The mechanisms of the potential negative effects of high-salt diets on the kidneys have not been established.
The aim of the study was to trace the changes in relative expression of miRNA-21, 203 and 133 in urine of cynomolgus macaques (Macaca fascicularis) fed high-salt diet with and without isolated soy proteins.
Material and methods. The object of the study was 18 male cynomolgus macaques (Macaca fascicularis) aged 6-8 years with a body weight of 5.1-9.7 kg. The animals were divided in 3 groups (6 individuals each). The animals of the first (control) group received a standard diet (2 g NaCl/kg feed). The animals of the second group were fed high-salt diet (8 g NaCl/kg feed), of the third - high-salt diet combined with SUPRO 760 isolated soy protein (200 g/kg feed; instead of milk and egg proteins, corn gluten). Access to water was free. The follow-up period in this study was 4 months. In animals blood pressure (BP) and relative level of microRNA (miRNA) expression in urine were measured.
Results and discussion. Keeping monkeys on the studied diets for 4 months did not lead to significant changes in systolic or diastolic BP compared with the initial level. In the control group, there were no distinct changes in the expression of miRNA-21 in urine during observation. In the other two groups, there was a significant increase (approximately equally) of this parameter in comparison with the initial values. Both high-salt diets resulted in a significant increase in the relative level of expression of miRNA-133 and miRNA-203 in urine compared to basal values. However, the increase in these parameters in the group of animals fed a high-salt diet in combination with soy isolate was significantly less than in monkeys fed only a high-salt diet.
Conclusion. Possible, potentially negative effects of high-salt diets on kidney may be mediated by epigenomic mechanisms and partially modulated by the inclusion of isolated soy proteins in the diet.
Metabolic disorders of chronically critically ill patients caused by consequences of traumatic brain injury
The problem of chronic critical illness therapy is relevant all over the world. Revealing the metabolic function in patients in chronic critical condition is an important link in the development of adequate treatment and rehabilitation tactics.
The aim - identification of metabolic features in chronic critical patients after brain injury in the first 3 days from the moment of admission to the rehabilitation center.
Material and methods. Single-center observational study included a group of 25 patients with chronic critical illness, aged 38.7±14.0 years with body mass index 20.8±4.3 kg/m2 (min 14.5; max 29.7), who were on independent breathing through a tracheostomy tube, and who have pronounced neurological disorders in the form of depression of minimally conscious state, FOUR scale from 12 to 16 points, as well as bedsores 1-2 stage and polysegmental pneumonia. The patients underwent indirect calorimetry and analysis of biochemical parameters of protein, carbohydrate, fat and mineral metabolism, as well as the level of nitrogen excretion with urine.
Results and discussion. The data obtained indicate that chronic critical ill patients with the consequences of traumatic brain injury had pronounced metabolic disorders, mainly of a protein component. Total protein level decreased up to 61.0±9.4 g/l (min 39.1; max 83.1), albumin up to 30.2±6.0g/l (min 17.4; max37.8), prealbumin up to 0.13± 0.06 g/l (min 0.04; max 0.23) and transferrin up to 147.7±37.7 mg/dl (min 84.0; max 209.0). The patients’ requirement in protein was 106.4±38.5 g/day (min 57.1; max 160.5) or 1.55±0.46 g/kg/day (min 0.75; max 2.22). The level of resting energy expenditure measured by indirect calorimetry was 1549.1±421.8 kcal/day (min 673.0; max 2430.0) or in terms of body weight 24.8±7.6 kcal/kg/day (min 12.4; max 45.8).
Conclusion. The data obtained indicate a continuing catabolic phase in patients more than 30 days after the primary injury, which led to their chronic critical condition.
Assessment of relationship of lipid and carbon profile indicators with vitamin D supply in children depending on body mass index
Overweight children represent a particularly vulnerable group for hypovitaminosis D. Clinical studies on the relationship between vitamin D (VD) deficiency and metabolic risk factors for cardiovascular disorders are controversial, and for children of primary school age who have overweight and obesity are insufficient.
The aim of the research was to study the relationship between lipid and carbohydrate metabolism indicators and VD status in children, depending on the body mass index.
Material and methods. A cross-sectional (one-step) study was carried out on a sample of 154 children with different weight of 8-10 years old (74 girls, 80 boys). Three groups of research participants were identified: group 1 - 44 obese, group 2 - 58 overweight, group 3 - 52 children with normal body weight. For all children, the serum level of 25(OH)D, parathyroid hormone (PTH), calcium (Ca), phosphorus (P), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol (TC), triglycerides (TG), β-lipoproteins, glucose, insulin was determined, and Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) was also calculated.
Results. VD deficiency in obese children was found almost 2.3 fold more often than in overweight (p=0.002) and 2.8 fold more often than in children with normal body weight (p=0.001). Indicators of lipid and carbohydrate metabolism were within physiological limits. However, in obese children they significantly exceeded the indicator of healthy children (p<0.05). When comparing the results of biochemical studies, it was revealed that children with VD deficiency [25(OH)D <20 ng/ml] had statistically significantly higher medians of PTH, TC, TG, ALT, AST, glucose, insulin, HOMA-IR and lower P and Ca level compared with children with normal micronutrient blood content (p<0.05). The medians of ALT, AST, TC, β-lipoproteins, TG, glucose, insulin and HOMA-IR levels in obese children with VD deficiency were statistically significantly higher than in children with normal body weight and VD deficiency and in healthy children with an optimal concentration of 25(OH)D. At the same time, there was no statistically significant difference between the indicators of lipid and carbohydrate metabolism in the group of healthy children with normal VD status and its deficiency.
Conclusion. VD deficiency is an important predictor of obesity complications and it exacerbates the risk of cardiometabolic disorders in children who are obese in the early school years.
Influence of chemosensional disorders on taste preferences in cancer patients who are receiving oral nutrition supplements
Chemosensory disorders (CSD) such as disorders of taste and smell are one of the causes of malnutrition in cancer patients.
The aim of the research was to evaluate the influence of CSD on taste preferences in cancer patients receiving oral nutritional supplements (ONS).
Material and methods. The procedure involves 100 oncological patients (26 men, 74 women; 57.0+1.2 years old). The taste preferences in these patients were assessed using a digital rating scale during ONS. All patients had cancer outside the head and neck area and underwent specific treatment. The functional status on the ECOG scale was 0-II. All patients had indications for DPP (ESMO scale >2 points). Patients were offered a mixture of sweet (banana, coffee, vanilla) and unsweetened (vegetable, chicken soup) tastes in a disposable 30 ml container. The patient was asked to take a sip and evaluate the smell, taste, strength of taste and density (consistency) of the sample on a digital rating scale from 0 to 5 points, where 0 -1 do not feel, 5 -1 feel excellent. The maximum possible number of points for each sample was 20.
Results. Signs of CSD (score <10) were detected in 69% of patients [95% confidence interval (CI) 59.5-77.7]. In this group, the frequency of choosing unsweetened tastes for ONS was 59.4% (95% CI 47.5-70.8), sweet - 40.6% (95% CI 29.2-52.5). In the group of patients without signs of CSD, the frequency of choosing savory tastes was 29.0% (95% CI 14.1-46.7), sweet - 71.0% (95% CI 53.3-85.9) (р=0.0049).
Conclusion. The presence of CSD significantly affects the taste preferences of cancer patients and significantly increases the likelihood of choosing products for ONS with unsweetened taste (unsweetened foods).
Role of tomatoes and products thereof in human healthy diet
Tomatoes are an essential part of the diet. Epidemiological studies have established a link between the consumption of tomatoes, which contain carotenoids, and a reduction in the risk of diseases such as cancer and cardiovascular diseases. Ripe tomato fruits are dark red in color due to the carotenoid lycopene, which is synthesized during fruit ripening. The aim of this review was to summarize and analyze modern data on the role of tomatoes and their processed products in healthy human nutrition.
Results. The beneficial effects of this vegetable on bone health, cognitive function, and the cardiovascular system have been studied. However, large intervention studies are needed to confirm a real causal relationship between tomato consumption and the risk of these diseases. Given the presence of various useful bioactive components in tomatoes, the results of most studies provide a reason to include more tomatoes and their processed products in the diet. However, both excessive and regular consumption of this vegetable can cause some side effects in the human body. Conclusion. Recent studies highlight the relationship between tomato consumption and a reduced risk of various diseases such as obesity, hypercholesterolemia, cardiovascular disease and cancer. Tomatoes, thanks to the bioactive substances they contain, with an adequate level of consumption, can become effective component of a healthy diet.
Pre-clinical studies of cold exposure to evaluate the efficiency and functionality of a specialized product
Strengthening the adaptive capabilities of the human body during cold exposure is one of the conceptual elements of solving the problem of the well-being of the population of the northern regions of Russia.
The aim of the work was to determine the dynamic performance, endurance and to study the morphological parameters of the rat tracheal mucosa against the background of the consumption of functional confectionery products containing the juice of Chinese lemongrass berries (Schisandra chinensis) and dry extract of eleutherococcus (Eleutherococcus) in regular exposure to cold.
Material and methods. The study was carried out on albino rats weighing 190±10 g. Functional confectionery were not introduced into the diet of rats of the 1st group. Rats of the 2nd and 3rd experimental groups were fed 1 g of marmalade and 1 g of caramel three times a day. Rats of the 3rd group were additionally regularly exposed to cold in the Memmert climate chamber (Germany) for an hour three times a day for 30 days. The groups were formed according to the principle of analogs, using body weight as a criterion (the difference in average weight did not exceed 10%), while each group had the same number of males and females. The physical performance was evaluated by the swimming time of the albino rats until complete exhaustion. The endurance to static load was determined by the retention time on a vertical metal grid. To study the morphological parameters of the rat tracheal mucosa after removal from the experiment, the isolated lung tissue, carefully treated without crushing, was fixed in 9% formaldehyde, then added to paraffin and stained with a hematoxylin-eosin solution.
Results. The studied indices of physical performance and static endurance indicate that the cold exposure statistically significantly increased the swimming time and the hanging time of rats on the grid after thirty days of consumption of functional confectionery. The morphological parameters of the tracheal mucosa of the 2nd experimental group did not differ significantly from those of the 1st experimental group. The content of ciliated and goblet cells in the 3rd experimental group was higher than in the 2nd and 1st groups of laboratory animals (p<0.05). The ratio of goblet cells to ciliated cells in rats of the 3rd group was 1:3.1, in the 2nd group - 1:3.5 vs 1:4.6 in the 1st group (p<0.05). This indicates an important role of secretion in the functioning of the epithelium when consuming functional confectionery products against the background of regular cold exposure. In this regard, it can be assumed that functional confectionery products can serve as a mean of protecting the mucociliary apparatus of rats during prolonged exposure to cold.
Conclusion. The inclusion of sugary confectionery products, containing Schisandra chinensis berries juice and dry Eleutherococcus extract, in the diet of albino rats increased physical performance and endurance and the regeneration of the epithelial layer of the tracheal mucosa during cooling.