Prophylactic aspects of baby food

The essential problem of modern dietology is the preventive aspects of nutrition. Elements of preventive nutrition can be represented by enriching water, flour or table salt with such nutrients as iodine, fluorine or selenium, in geochemical zones depleted of these substances.

Preventive measures in the regions with the most "soft" drinking water require supplementation of the diet with magnesium and calcium salts. Monitoring food supplies with iron, copper, folic acid and ascorbic acid is necessary to prevent anemia. A wide preventive value is confirmed for a combination of food antioxidants, dietary fiber, probiotics and prebiotics. However, prevention of chronic diseases of the cardiovascular system - hypertension and atherosclerosis - is especially important in children's years of life for children from families where cardiovascular "disasters" (strokes or infarcts) at a relatively young age were observed in parents or other close relatives.

Inclusion in the prevention programs of cardiovascular diseases obliges to change the attitude to the fat component of the diet. An example would be recommendations on such a limitation of the American Academy of Pediatrics.

Fats in the diet of children older than two years

• Fat content up to 3 years - 35%, after - 30%.
• The ratio of fatty acids is polyunsaturated: monounsaturated: saturated = 1: 1: 1.
• The total amount of cholesterol per day - up to 200 mg.
• Energy due to protein - 12-15%.
• Energy due to carbohydrates is 55-58%.

With this mode of fat maintenance, constant and careful monitoring of the growth of children is necessary, since for many, the above scheme can create difficulties in energy supply. Along with fat restrictions, such children need to increase the proportion of polyunsaturated fatty acids in the group of oZZ, form the supply of calcium, magnesium, folic acid and pyridoxine.

[1], [2], [3], [4], [5], [6], [7], [8],

Principles of approaching a balanced diet for children older than a year

Ensuring multicomponent balance of the diet after a year is no less responsible than in feeding the children of the first year of life or feeding pregnant women. This creates specific difficulties inherent in the increasing independence of behavior and decision-making by a child or adolescent. At the same time, the possibilities for expanding the assortment of animal and vegetable products are gradually increasing, allowing some approximation to the multi-balanced diet. In ordinary life, the frequent use of complex forms of registration and computer analysis of the diet is unrealistic, therefore, various pediatric schools develop simple rules for grouping food products in connection with their role as carriers of a certain group of nutrients. As an example, there are several variants of such grouping.

Principles for the formation of a universal diet for children ("prudent" meals)

• Milk - 600-800 ml.
• Meat, fish, poultry - 1 portion per day (5-6 per week).
• The liver is 1 serving a week.
• Egg - 1-4 times a week.
• Vegetables raw - 1 serving per day.
• Vegetables, painted - 1 serving per day.
• Fruits fresh (juices) - 2-3 servings per day.
• Bread and cereals. Appetite and fatness.

Within the framework of this approach, the use of our recommendations is also legitimate. According to them, the total daily energy of the "medium-normal" diet is 1000 + 100n (kcal), the volume of products of the daily table is about 1200 + 100n (g or ml, not counting tea and drinks, n is the number of years of the child). The volume of products of daily consumption for children over 2 years can be calculated.

Protein group:

• lean meat, poultry, offal (liver, kidney) from 3 years - 1-2 times a week, eggs, legumes in combinations and with alternation. The total amount is 100 + 10n.

Fish and fats of fish origin:

• trout, mackerel, lake salmon, sardines, salted herring for 20-70 g, depending on age, 3-4 times a week and (or) (on the advice of the pediatrician) fish oil from 2 g (after a year) to 5-7 g at school age.

Vegetable fats:

• sunflower, olive, linseed, rapeseed oil, etc., preferably in salads and in combinations. In total up to 1-2 g for a year of life.

Dairy:

• milk, kefir, yoghurts 600-700 ml / day at any age, of which 50-200 ml of the product with probiotics + cottage cheese 50-100 g + cheese 15-25 g.

Different vegetables and fruits (except potatoes) 4-5 different colors:

• part of vegetables and fruits in raw form, part of unsweetened natural juices. Total amount of vegetables, fruits and juices up to 40p.

Energy group:

• potatoes, various cereals, pasta, bread and bakery - the main energy "ration", dosed depending on the physical activity and nutritional status of the child in the range from 150-200 g to children of early age to 1000-1500 g of ready meals for the "sports" teenager .

"Ration of deliciousness" or "reward":

• It is used to encourage the child only at the end of the basic 3-4 meals and in minimum quantities. It is desirable to minimize the use of sweets and more often to attract fresh fruits and juices (group 5 of the main products), black (bitter chocolate), honey (in the absence of allergy to them), homemade preparations with a minimum amount of sugar based on berries, especially cranberries, cranberries, blueberry, black currant. Occasionally - ice cream.

Beverages:

• In addition to milk and juices, children can drink different teas (green and black) cooked on purified tap water or bottled non-carbonated water authorized for baby food.

On the advice of a doctor:

• "Insured" multivitamin or combined multivitamin and multimineral supplements in dragees or syrups for children.

Discussing different aspects of dairy nutrition for children over the age of the year, one should keep in mind that, as in the first year of life, in subsequent periods, the availability of milk and dairy products is especially critical due to the very high need of children and adolescents in assimilated calcium. This issue is discussed in the chapter on the physiology of bone tissue. However, it seems very advisable to apply, in addition to whole milk or in part, instead of it, baby food produced by the industry "cow milk substitutes". This can provide both additional intake of micronutrients, and restriction of sodium salts. Leading British nutritionist Brian Wharton compares the composition and even the cost of different types of milk. Particularly promising is the replacement of a part of whole cow milk (1-2 cups) with a mixture of baby food such as Follow-up, Enfamil-Unior, etc.

Different forms of milk in baby food. Ingredients in 100 ml of milk (according to W. Wharton, 1990)

Indicators	Mixtures	Follow-up	Cow's milk whole	Cow milk semi-degreased	Cow milk degreased
Energy, kcal	67-70	65-67	67	48	34
Protein, g	1.5-1.9	2.0-2.9	3.4	3.4	3.4
Vitamin P, μg	1.0	1.1-1.2	0.02	0.02	0.02
Iron, mg	0.4-0.7	0.7-1.2	0.05	0.05	0.05 -
Saturated fat, g	1.0-1.9	1.2	2.5	1.1	-
Sodium, mmol	0.6-1.1	1.3-1.5	2.2	2.2	2.2
Price (pence)	7th	7th	6th	6th	5
Age of application	Since birth	From 6 months	From 1 year	From 2 years old	From the age of 5

The widespread occurrence of nutritional disorders in children in Russia, and mainly qualitative disorders with deficiency of salts, vitamins and microelements, makes all approaches to improving the balance of the diet extremely important. In all cases where the range and quality of the foodstuffs used can not solve this problem, that is, for a very large part of children, it is necessary to use artificial products such as the already mentioned milk mixtures of nutraceuticals or supplements with a wide range of micronutrients. There are real opportunities for combining dairy nutrition with separately manufactured supplements. An example is the enrichment of whole milk recommended by the Institute of Nutrition with the domestic vitamin complex "Golden Ball". To enrich the products with micronutrients, vitamin-mineral mixtures (premixes) of industrial production are used (Valetek, Elevit, Viten, Komivit, etc.). Sapplements can be tableted, presented in the form of solutions, bubbles, etc. A pediatrician who solves the problem of choosing one or the other means of correcting the diet should behave like a dietopharmacologist who visualizes the tasks and directions of the required supplementation and the amount of supplements or nutraceuticals necessary for the child or a group of children. It is necessary to be afraid of multiple overdoses of any vitamin, mineral or trace element, do not forget about the toxicity of some of them (vitamins A and D, large doses of iron, copper, manganese, iodine, etc.).

Adaptation of the child to regular intake of large doses of certain vitamins (ascorbic acid) can lead to the formation of dependence and severe hypovitaminosis in the transition to normal maintenance with this vitamin. Nevertheless, the requirement of modern dietetics for multi-component balancing should be fulfilled. This is one of the real ways to improve the health and quality of children's development, and therefore, ways to a brighter future for them. Confirmation of this came unexpectedly in one of the latest reports of the World Bank (1998). Financiers taking part in the investment in nutrition programs came to the conclusion that "no other technology provides such opportunities for improving people's health at such a low price and for such a short time."