[Dietary correction of metabolic disorders in patients with diabetic nephropathy].

One of the ways to optimize the complex treatment of patients with diabetic nephropathy (DN) is the use of therapeutic nutrition with the inclusion of foods for special dietary use (FSDU) that correct carbohydrate and lipid metabolism disorders and have antioxidant and anti-inflammatory, properties. The aim of the research was to study the effect of a low-protein diet with the inclusion of FSDU on some clinical and biochemical parameters in patients with DN. Material and methods. 30 patients with DN and concomitant obesity of I-III stages were examined, which were divided into two groups of 15 people each. Patients of the main group received a low-protein diet for 14 days (protein 62.4 g/day, energy value 1360 kcal/day) with the inclusion of FSDU (124 kcal per portion), modified by protein, fat and carbohydrate profile (dry instant mixture), and the comparison group - a low-protein diet without the inclusion of FSDU. In blood serum, the content of glucose, glycated hemoglobin (HbA1c), total cholesterol (CH), triglycerides, cholesterol of low and high density lipoproteins (LDL, HDL), urea, creatinine, total protein, albumin, total bilirubin, alanine and aspartate aminotransferase activity, levels of potassium, phosphorus, calcium. Glomerular filtration rate was calculated and body composition indicators were studied using the bioimpedancemetry. Results. Patients of the main group showed a statistically significant decrease in fat mass by an average of 5.5% (p=0.0001) and a tendency to increase muscle mass by 1.7% (p>0.05) from the initial level. Among the patients of the comparison group, the decrease in fat mass was 4.9% (p=0.0001) against the background of a decrease in lean body mass by 2.5% (p>0.05). When comparing biochemical parameters, positive dynamics of glycemic control indicators was noted in both groups: the level of glucose in blood serum decreased (p<0.005) by 10.9 and 9.3% from the initial level in the main group and the comparison group. A more pronounced decrease in LDL and triglycerides was noted in patients of the main group (29.4 and 26.2%, respectively, p=0.005), in the comparison group the decrease in these indicators was less pronounced and statistically insignificant. Conclusion. The results obtained indicate an increase in the effectiveness of therapeutic nutrition in patients with DN and concomitant obesity when an FSDU with a modified protein, fat and carbohydrate profile is included in a low-protein diet.

[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.

[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.

[Specialized products for dietary correction of the diet of patients with non-alcoholic steatohepatitis].

Non-alcoholic steatohepatitis (NASH) is a widespread disorder associated with a number of metabolic disorders. Lifestyle modification, including diet and physical activity are currently a first-line treatment for the disease. However, there is lack of specialized products (SP) with modified carbohydrate and fat composition, containing biologically active ingredients with proven physiological effects on the liver for this disorder. The aim of the paper is to summarize present knowledge on the biologically active ingredients with proven hepatoprotective effect and to describe the process of the development of two specialized products for clinical use in patients with NASH. Material and methods. Food ingredients containing soy and milk proteins, soluble dietary fiber, mono- and polyunsaturated fatty acids, vitamins, minerals, soy lecithin, L-carnitine, coenzyme Q10, α-lipoic acid, betaine, flavoring and aromatic additives were used in the development of SP formulations. The mass fraction of moisture in the SP was determined by the thermo-gravimetric method on a humidity analyzer, and the water activity was determined by measuring the dew point. The nutritional and energy value of the SP was calculated using data from chemical composition tables and information from manufacturers of food ingredients. Results and discussion. Taking into account the requirements for dietary therapy, the ingredient composition was scientifically justified and the formulations of two SP with a balanced amino acid composition were developed by using a combination of milk whey proteins, casein and soy protein isolate. The fat component included microencapsulated rapeseed oil, that is a source of mono- and polyunsaturated fatty acids (PUFAs) with the addition of ω-3 PUFAs. The carbohydrate composition was modified by eliminating mono- and disaccharides, traditionally used in sweet drinks, and adding maltodextrin in combination with sweeteners (polyols and natural sweeteners). Polydextrose, citrus pectin, inulin, and hydrolyzed guar gum are used as soluble dietary fibers. The SP included essential micronutrients (vitamins, mineral substances) and bioactive substances that have a proven physiological effect (coenzyme Q10, α-lipoic acid, L-carnitine, betaine hydrochloride, phospholipids). Technical documentation was developed and a pilot batch of SP-1 was developed for inclusion in the complex treatment of patients with NASH. Conclusion. The formulations and technology of SP (SP-1, SP-2) for therapeutic nutrition with a given chemical composition, designed to optimize the diet therapy of patients with NASH, have been developed. SP are sources of animal and vegetable proteins, soluble dietary fiber, mono- and polyunsaturated fatty acids, including ω-3 family, vitamins, minerals and trace elements, as well as bioactive substances with antioxidant, hepatoprotective and hypolipidemic effect. The technical documentation was developed and approved, according to which a pilot batch of SP-1 was produced to assess its effectiveness as a part of complex therapy of patients with NASH.

[Optimization of dietary support for patients with diabetic nephropathy].

The article presents modern approaches to dietary support for patients with diabetic nephropathy (DN). The possibility of using the developed specialized products (SP), modified by protein, fat and carbohydrate composition, containing food ingredients with hypoglycemic, hypolipidemic and antioxidant effects is presented. The aim - development of a formulation and technology for producing SP with modified chemical composition and energy value, intended for inclusion in a low-protein diet for patients with DN. Material and methods. When developing the SP formulation, soy protein isolate, monoand polyunsaturated fatty acids, soluble dietary fiber, fat- and water-soluble vitamins, tracelements, curcumin, taurine, flavoring and aromatic additives were used. Results. The chemical composition and organoleptic characteristics of two SPs have been determined. A technology has been developed for producing SP in the form of instant drinks, which consists in stage-by-stage mixing of prescription ingredients, which ensures uniform distribution of minor biologically active substances. The conducted studies of the organoleptic parameters of the developed SPs showed an average overall score of 4.8 and 4.9 on a 5-point scale. Conclusion. Taking into account the technological and organoleptic compatibility of the selected ingredients, formulations and technologies for preparing SP have been developed, which are powdery multicomponent mixtures for preparing drinks for use in the complex therapy of patients with DN.

[Dynamics of innovations in food technologies: from specialization to personalization].

Dynamically changing global trends in the field of innovative foods in recent years are aimed at the development of technologies that ensure the formation of segments of new types of products, positioned as healthy products. Scientific directions of research and development in this area, retrospectively related to the development of nutrition science, are focused on solving an interdisciplinary set of tasks to create new types of foods, the distinctive features of which are the specified compositions and properties that determine the health benefits (functional foods) and directed physiological effectiveness (specialized foods for preventive and therapeutic nutrition). Characteristics of the composition of a specific specialized food are formed in connection with its intended purpose on the basis of medico-biological requirements taking into account specific features of nutrition of the population in total, and its separate groups or individual. Depending on the mentioned specifics, the development of specialized foods provides for different levels of determining human needs: from energy consumption to the metabolome. Taking into account these features, the development tasks, methods of proving the effectiveness and conditions for using specialized foods in order to achieve maximum effect are determined. In studies of prophylactic or therapeutic foods, the subject of evaluating the effectiveness of a specialized product is the clinical effect, so innovative research in this category of products is associated with the creation of a universal approach to the development, use and evaluation of the effectiveness of biologically active substances and containing them specialized foods for the correction of metabolic disorders. The vector of innovative development of technologies for the production of specialized foods is focused today on the direction of personalized nutrition. The basis of scientific justification of the distinctive features of the compositions and properties, as well as technological know-how of the production of personalized foods, is the information about the metabolome directly related to the biological functions of the body.

[Effect of specialized product with modified carbohydrate profile on clinical and metabolic parameters in patients with type 2 diabetes].

The prevalence of type 2 diabetes mellitus (DM2) determines the need to develop evidence-based methods for preventing this disease, including personalized approaches to the dietary correction of metabolic disorders in DM2, including the use of specialized foods. Aim. To evaluate the effect of a low-calorie diet with the inclusion of a specialized product (SP) with a modified carbohydrate profile (dry instant mixture) on the glycemic and metabolic control indicators in patients with DM2. Material and methods. The study included 30 patients with DM2 with concomitant obesity, grade I-III, who were on oral sugar-lowering therapy. Within 2 weeks, patients of the main group received a low- calorie diet (1550 kcal/day) with the inclusion of SP with a modified carbohydrate profile (based on maltitol and with sweeteners) with strawberry flavor in the form of a drink (30 g dry mix per 150 ml of water) for the second breakfast instead of a carbohydrate-containing dish, which provided the intake of 7.8 g of protein, 6.1 g of fat, 1.8 g of carbohydrates, 5.6 g of maltitol. The comparison group received a low-calorie diet (1550 kcal/day) without the inclusion of SP. In all patients, on the background of complex therapy, anthropometric indices, body composition, parameters of carbohydrate, lipid and protein metabolism, liver function, and lipid peroxidation were assessed. Results and discussion. It was shown that SP inclusion into the hypocaloric diet was accompanied by a significant decrease in the level of basal glycemia by an average of 17.4% from the initial level (p<0.05), serum total cholesterol (TC) and low density lipoproteins cholesterol (LDL-C) on average by 26.9 and 36.2% of baseline, respectively, p<0.05, while in patients of the comparison group, the change in fasting blood glucose was not statistically significant (a decrease of 8.1%), and the decrease in TC and LDL-C was on average 22.1 and 21.0%, respectively (p<0.05). At the same time, against the background of complex therapy, positive dynamic in lipid peroxidation in the main group was observed: the level of blood serum malondialdehyde decreased on average by 25.3% from the baseline values (p<0.05). Conclusion. The inclusion of SP with a modified carbohydrate profile in a low-calorie diet is accompanied by an improvement in glycemic control, lipid metabolism and antioxidant status of patients with DM2, helping to reduce the risk of developing systemic vascular complications in this disease.

[Specialized food products with modified carbohydrate profile for dietary correction of diet of patients with type 2 diabetes].

In recent years, the incidence of diabetes mellitus (DM) in the world is growing steadily. According to the international diabetes Federation (IDF), the number of DM patients in the world in 2015 was 415 million, of them more than 90% - patients with type 2 diabetes. According to forecasts, in 2040 their number will increase to 642 million. Russia ranks fifth among the ten countries with the largest number of the adult population with diabetes. Dietary correction of the diet of patients with type 2 DM is carried out by the inclusion of specialized foods with a modified carbohydrate profile containing ingredients with hypoglycemic action. The purpose of the study - the development of composition and technology of specialized foods and assessment of the possibility of their use in the therapy of patients with type 2 diabetes. Taking into account the medical requirements for diet therapy for type 2 diabetes, composition and technology of two specialized foods in the form of beverage concentrates have been developed. The technology of step-bystep mixing contributed to the uniform distribution of biologically active substances in the mass of the product. The absence of sucrose and digestible polysaccharides in the composition of the developed products was established, the presence of about 1% lactose was due to its content in the protein component. Humidity didn't exceed the standard values for similar products, the values water activity were typical for products with low humidity, which justified the prediction of the microbiological stability of the developed products during storage. The osmolality of the beverages restored in accordance with the method of preparation was 310 and 258 mOsm/kg, which characterized them as isotonic. The products were balanced in amino acid composition, had a high score of essential amino acids due to the introduction of a combination of proteins. The consumption of one serving (30 g) of the product in the form of a drink (200 ml) provided an average daily requirement for essential amino acids by 15-22%, polyunsaturated fatty acids ω-3 - by 10%, ω-6 - by 15%, soluble dietary fibers - by 50-55%, vitamins groups B - by 14-81%, C - by 46%, A, D3, E, K1 - by 17-46%, minerals and trace elements - by 10- 33%. The content of polyphenols was about a half of its adequate level of consumption. The inclusion of specialized foods with a modified carbohydrate profile in the composition of the low-calorie diet lead to the stabilization of postprandial blood glucose levels in patients with type 2 DM.

[Standardization of the method of osmolality determination of specialized foods].

Binding requirements for the application and enforcement at the customs territory for specialized food products have been installed in the established documents of the Customs Union. The category of specialized foods consists of food products for babies, for pregnant and lactating women, dietary products (clinical and preventive nutrition), sport nutrition. In addition to the General safety requirements that must be met by specialized food products, the value of osmolality must be regulated in some kinds of such products. The specialists of Institute of Nutrition developed national standard "Specialized foods. Method of osmolality determination" for the purpose of standardization of a method of osmolality determining. Product samples for baby and sport nutrition which are realized on domestic market have been researched. Specialized products for baby food had osmolality from 290 to 327 mOsm/kg, that corresponded to the requirements of regulatory documents applicable to this product group. Osmolality of carbohydrate and mineral drink for athletes was in the range from 308 to 330 mOsm/kg, confirming their belonging to the isotonic drinks. The method can be used in researches for developing of the new products with specific predetermined chemical composition and in clinical practice for the osmolality control of products for enternal nutrition.

[Modification of carbohydrate composition of confectionery for diabetics type 2].

Confectionery products are not staple foods, however, are an integral part of the daily diet of almost all age groups of population, including children and the elderly. Traditional confectionery are high-calorie foods that contain significant amounts of carbohydrates, the bulk of which is sucrose. One of the main requirements to the diet of patients with diabetes mellitus type 2, is limiting of easily digestible carbohydrates in the diet. Modification of the ingredient composition of confectionery products by eliminating or replacing sugar by other functional food ingredients should help to reduce the glycemic index and calorie content of these products.