Physiological norms of baby food

There is no doubt that nutrition as a form of providing the building material and energy for the entire process of growth and development of the child is of great importance for the health of children and the final results of growth and development. At the same time, even to the present day, it can not be said that in the nutrition of the child, as in the nutrition of an adult, all scientific truths and practical solutions are available to us today. We have to state that the extremely conservative human genome that has survived in our cells up to the present time bears in itself both food orientations and dependencies conditioned by the long-standing past, including information on the habitat for which it was adapted at the time of the person's appearance or his nearest ancestors. It is possible that these were the orientations to those food products with which the world's ocean was rich and the land on which our ancestors crawled from the ocean.

Fortunately, for pediatricians, the main food product of an infant - mother's milk - has changed relatively little and mainly in the part in which its composition is determined by the nutrition of the nursing woman. Therefore, women's milk remains an unshakable "gold standard" for children's dietetics. As for human nutrition in the period after his excommunication from the maternal breast, we have to discover a whole new and unexpected.

[1], [2], [3], [4]

Physiological nutrition

By the term "physiological nutrition" is meant the provision of a normal diet for a given age, the growth and development of a child with the help of a food ration. The principal difference between the physiological nutrition of children and the physiological nutrition of adults is, first of all, its focus on growth and development. Dietology, or nutritiology, childhood is primarily a "dietology (nutritiology) development." The concept of "physiological nutrition" includes some more narrow or special concepts and their inherent definitions.

One of the most complex and key theoretical aspects of dietetics development is the study of the mechanism of the emergence of persistent, often lifelong, influences of nutrition characteristics. Naturally, most of the latter are peculiar to the nutrition of the fetus during pregnancy, closely related to the nutrition of the pregnant woman herself. Such influences are very convincing for the nutrition of young children, but they are also present in all subsequent childhood periods until the growth and development of the organism is complete.

In early childhood, the issues of dietetic provision of fine differentiations of the nervous tissue and brain, the development of bone tissue, vessels, skeletal muscles and myocardium, and the endocrine apparatus of reproduction are more acute than in subsequent age periods. Suboptimal provision of children of junior and even senior school age with iron, selenium, iodine, zinc, calcium, etc. Can be a sufficient basis for the non-optimal or more significant violations in the formation of the intellect, musculoskeletal system or connective tissue in general, the reproductive sphere, The decrease in physical working capacity and the timing of the upcoming life in connection with the diseases already in the adult period.

All this is largely different from the dietary views of the recent past. Previously existing child nutrition concepts have been oriented more toward analyzing the relationships between nutrition and health in the near future. The clinician, as well as the nutritionist, is easier to navigate in such immediate phenomena as hunger or satiety, tolerability or intolerance of foods, the presence of reactions to food intake, the characteristics of the dynamics of body weight and growth in the period of feeding by a given diet, etc. From the standpoint of dietetics of development, this also important characteristics, but the presence of even the most positive immediate assessments is not enough to recognize a diet adequate for use or optimal.

When discussing the mechanisms of the long-term effects of nutrition on development, the role of the following processes must be taken into account.

1. Direct influence of environmental factors, first of all - nutrients, on the expression of genes and, first of all, on gene regulators of development, and the resulting correction of the genetic program and the intensification of growth and differentiation processes.
2. Often there are "adaptations" to nutritional insufficiency by substituting for a deficient nutrient with chemical substances (chemical) or compounds that are similar in chemical properties or structure. The result of this substitution is the formation of tissue or cellular structures, in particular membranes and receptors with non-optimal functional characteristics. Examples include the replacement of deficient long chain polyunsaturated ω3 and ω6 fatty acids with oleic acid, the formation of brain glucocerebrosides instead of galactoacerebrosides in the absence of lactose (galactose) in the diet, the use of strontium, aluminum or other elements in osteogenesis in the absence of sufficient calcium intake, etc. Even the development of lead intoxication is largely due to a lack of iron in the diet and its pseudocompensation - a substitution for lead.
3. The introduction of elements of chaos and heterochronies into nutrient-dependent sequences of growth and differentiation processes with the resulting mismatch between interstructural and intersystem connections and finite non-optically formed structures and chains of their integration.
4. Induction under the influence of nutrients of metabolic and neuroendocrine chains of development regulation that do not correspond to this period of ontogenesis, or "switching" of the biological clock of development. An example is the effect of early glucose administration in feeding a newborn, followed by activation of insulinogenesis, a decrease in oxidation and the use of fatty acids, and other metabolic changes characteristic of older childhoods - the physiological basis and prerequisites for the formation of "syndrome X," or "cancrophilia syndrome" ( by VM Dilman).

Balanced diet

The term "balanced nutrition" characterizes not only the adequacy of nutrients, but also the observance of certain interrelationships among numerous interchangeable and irreplaceable nutritional factors. Thus, the concept of balance and imbalance refers primarily to the expanded biochemical characteristics of diets.

[5], [6], [7],

Adequacy of nutrition

The term "nutritional adequacy" as applied to physiological nutrition includes not only the idea of sufficiency and balance of the diet, but also the observance of a wide range of additional conditions that often change for children of different age groups. The choice of products, the recipe for their cooking, the final volume or consistency, the taste, osmotic or immunoallergological characteristics may or may not correspond to the age or individual characteristics of the child, thus representing a greater or lesser degree of inadequate nutrition, even with its highest nutritional value and nutritional balance .

Within the framework of adequate nutrition, it is possible, but with great conventionality, to consider the problems of natural, mixed and artificial feeding of children of the first year of life. Strictly adequate for children of the first year of life can be considered only natural feeding. This is determined by the extremely complex integrated effect of the nutritional and biological regulatory role of both the mother's breast milk and the feeding process.

Taking into account the very significant influence of the quantitative characteristics, in particular the energy value of the diet and the protein content in it, on the growth rate of the child, especially in the first months and years of life, within its boundaries, adequate levels can be distinguished.

The maximum nutrition is appropriate to call such an adequate diet, at which the rate of physical development is above average (above 75 centiles by the speed standards); average - adequate nutrition at an average growth rate (from 25 to 75 centiles); minimum - at a low growth rate (from 3 to 25 centiles by increments of length or body weight). Close to the above concepts can be put and such as "forced nutrition", occupying the middle position between the physiological and therapeutic. Forced nutrition is physiological in nature, as it is designed to ensure life, growth and development, but it is used exclusively in the recovery period after diseases that lead to inhibition or arrest of growth and body mass dynamics. To ensure "catch-up" growth and recovery processes, these children use an increase in protein and energy load while observing a balanced diet relative to this already increased load.

To the category of concepts intermediate in the range between physiological and therapeutic nutrition, one can include the notion of "preventive" nutrition. Most often this term denotes adequate nutrition, but with features that provide a specific effect on the compensation of a child's identified constitutional or hereditary predisposition to a particular group of diseases or pathological conditions. In recent years, the term "functional" nutrition, used for long-term modifications of physiological nutrition of a very wide preventive orientation, began to spread. The range of functional nutrients that allow you to reach higher levels of health is constantly expanding.

The most common recommendations for a healthy person's diet include the use of 3-5 servings of vegetables (except potatoes), fruits or juices of different colors during the day, which is a guarantee of sufficient supply of functional nutrition substances.

One of the sections of functional nutrition is the doctrine of biocurrents and prebiotics, which considers the aspect of synergy between the human body and saprophytic bacteria.

Phytochemicals
Carotene idae (β-carotene, lutein, lycopene, ziaksanthin)	Flavonoids (resveratrols, anthrocyanins, quercetins, hesperidins, tenserites)	Sulforaphanes, indoles, elagic acid
Vegetables
Broccoli	Broccoli	Broccoli
Carrot	Garlic	Cabbage asparagus
Cabbage leaves	Lettuce	Cabbage Brussels
Pumpkin		Cabbage head
Red pepper		Cauliflower
Spinach		Cabbage leaves
Tomatoes		Turnip
Turnip		Beetroot leaf
Fruit and berries
Apricot	Cherry	Currant
Kiwi	Pears	Raspberries
Mango	Apples	Blackberry
Papaya	Blueberry	Blueberry
Grapefruit pink	Grapefruit	Grapefruit
Watermelon	Kiwi	Kiwi
	Liletta	Liletta
	Orange	Orange
	Grapefruit pink	Grapefruit pink
	Red grapes	Red grapes
	Strawberry	Strawberry
	Strawberries	Strawberries
	Tangerine	Tangerine
	Mandarin	Mandarin

Phytochemicals - nutrients with high antioxidant activity

Substances	Media
Capsaicins	Peppers
Flavonoids	Citrus, tomatoes, carrots, apples, cherries, peppers, berries
Indoles	White cabbage and asparagus (broccoli)
Isothiocyanates	Broccoli cabbage, horseradish, mustard
Lycopene	Tomatoes, red grapefruits
β-allylcysteine	Garlic, cucumber
Triterpenoids	Lacrimal root, citrus fruits

[8], [9], [10], [11],

Probiotics

The concept of biota is very close to the problems of health and nutrition. The biota is a collection of all living organisms that accompany human life in the spaces of its intestines, skin and mucous membranes.

What is our biota - the "third world of man", occupying an intermediate position between its external and internal world?

Of the total number of cells in the human body, 10 times larger than the stars in the Milky Way, 10% belong to the human body proper and 90% belong to its biota, that is, the sum of bacteria, fungi, protozoa and life forms such as Arctaea . Only in the intestine their number varies from 10 to 100 trillion. Currently, the biota of the gastrointestinal tract is represented mainly by the following groups of bacteria or bacterial cultures.

Probiotics - 1014 cells, more than 500 species.

Basic bacterial cultures:

Lactic Acid Bacteria (56 species)	Bifidobacteria (32 species)
L. Rhamnosis GG	B. Bifidum
L. Acidophilus	V. Longum
L. Casei	V. Breve
L. Bulgaricus	V. Infantis
	V. Animales

Basic functions of biota:

• participation in the formation of the capillary network of the intestinal wall;
• stimulation of nonspecific immunity;
• suppression of the FIAF protein limiting fat formation in the body;
• participation in the metabolism of cholesterol and bile acids;
• synthesis of vitamins, especially vitamins B |, B6 and K;
• digestion of plant fiber;
• extraction of energy from food;
• formation of short-chain fatty acids for feeding the wall of the colon;
• together with the protein of female milk (factor HAMLET *) - stabilization of DNA structures.

* HAMLET is a multimeric α-lactalbumin of breast milk that induces selective apoptosis of cells with potentially probable oncological transformation, mainly in the gastrointestinal tract and in lymphoid tissue.

Finally, one can agree with the validity of the existence of such a concept and term as "optimal" nutrition. This is still a purely theoretical representation or abstraction, in which, with respect to pediatric nutrition, the achievement of such an ideal level of nutrition is laid, in which it will not only be adequate or highly prophylactic, but also provide the most positive impact for the entire subsequent period of life - will become a factor in the formation of long-term health and active longevity. The definition of "optimal breastfeeding" is clearly described.

Therapeutic nourishment in pediatrics

Therapeutic diet in pediatrics, in contrast to the therapeutic diet of adults, should necessarily be oriented toward the simultaneous solution of two fundamental tasks - maintaining adequate physiological nutrition sufficient to ensure normal development of the child, and the proper therapeutic function, with respect to specific morbid manifestations and metabolic disorders . Thus, we can say that therapeutic nutrition in pediatrics is a special adaptation to the disease or to the conditions set by the disease, all laws and principles of dietetics development.

Where these conditions are met, you can talk about adequate nutrition. With a moderate violation of adequacy, we can talk about sub-adequate therapeutic nutrition. Finally, in the most dramatic situations of the clinic, therapeutic nutrition for a certain period can certainly take an inadequate character. In these situations, there is a complete analogy between the use of inadequate nutrition and the use of highly toxic drugs, radiation or surgical methods that are traumatic, but which contribute to the salvation or prolongation of life. By analogy with these methods, a characteristic such as "aggressive nutrition" is often used to feed a sick child. Typically, this includes such options for the supply of therapeutic nutrition, as enteral probing or parenteral nutrition. Some logical paradox is the fact that the most serious reason for the use of aggressive nutrition is not so much the drama of the clinical situation and the need to protect the patient's life, but the indications aimed at maintaining its adequate development, i.e., indications of a physiological plan.

"Sufficiency", "insufficiency" or "redundancy" of nutrition - the terms are clinical and related not to the diet, but to the nutritional status of the child. Qualitative malnutrition is determined through the identification of clinical or laboratory signs (symptoms) of a lack of one or more vitamins, salts or trace elements. Quantitative insufficiency or redundancy is usually attributed to manifestations of impaired supply with protein or energy nutrients, which include fats and carbohydrates. The main manifestations of this predominantly quantitative deficiency are lag in growth, weight loss, partial or complete loss of the subcutaneous fat layer, a decrease in muscle mass in far-reaching cases. It is to the dominance of signs of quantitative malnutrition that the widely used term "protein-energy malnutrition" applies.