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[Current issues of regulation of contaminants in food]. [食品中污染物监管的最新问题]。
Q2 Medicine Pub Date : 2025-01-01 Epub Date: 2025-01-21 DOI: 10.33029/0042-8833-2025-94-1-50-63
Kh Kh Khamidulina, E V Tarasova, A S Proskurina, A K Nazarenko, E V Dorofeeva

In the Russian Federation, ensuring food security is one of the main tasks of state policy, which is reflected in the national Food Security Doctrine, which declares the need not only to control products for compliance with the mandatory requirements of the technical regulations of the Eurasian Economic Union, but also to harmonize food quality and safety standards with international ones. The purpose of the work was to identify priorities for the development or revision of characteristics and parameters of food safety and quality in the Russian Federation, taking into account global trends. Material and methods. The comparative analysis of the normative legal acts of the Russian Federation and the Eurasian Economic Union, documents of the Food and Agriculture Organization of the United Nations and the World Health Organization, Codex Alimentarius, national and international databases on the toxicity and danger of chemicals has been carried out. As part of the study, a search of literature for the last 8 years was performed using Elsevier, eLIBRARY, PubMed bibliographic platforms. Results. Traditionally, Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor) is most concerned about the regulation of heavy metals, pesticides, mycotoxins, veterinary drugs and chemicals entering food as a result of technological processes. The management of the danger and risk of exposure to contaminants in food is based on the establishment and updating of hygienic standards, including the maximum permissible levels of residual content, (temporary) permissible daily doses of consumption, permissible levels of migration from containers and packaging, prohibition and (or) restriction of the use of highly hazardous chemicals, their replacement with safer alternatives, changing technological processes. Conclusion. A comparative analysis showed that despite the active actions of Rospotrebnadzor to develop new standards, hygienic regulations and guidelines for the control of contaminants, harmonization with international requirements is needed in a number of areas based on fundamental research in the field of hygiene and nutrition science. The standards for the permissible lead content in food and the maximum permissible levels of residual amounts of a number of pesticides in agricultural crops require updating. In addition, activities under the Rotterdam Convention's prior informed consent procedure indicate the need for timely and relevant decisions on the prohibition or restriction of particularly hazardous chemicals and pesticides.

在俄罗斯联邦,确保食品安全是国家政策的主要任务之一,这体现在国家食品安全原则中,该原则宣布不仅需要控制产品以符合欧亚经济联盟技术法规的强制性要求,而且需要协调食品质量和安全标准与国际标准。这项工作的目的是在考虑到全球趋势的情况下,确定发展或修订俄罗斯联邦食品安全和质量特征和参数的优先事项。材料和方法。对俄罗斯联邦和欧亚经济联盟的规范性法律行为、联合国粮食及农业组织和世界卫生组织的文件、食品法典、关于化学品毒性和危险性的国家和国际数据库进行了比较分析。作为研究的一部分,使用Elsevier、eLIBRARY、PubMed等书目平台对过去8年的文献进行了检索。结果。传统上,联邦消费者权利保护和人类福利监督局(Rospotrebnadzor)最关心的是对由于技术过程而进入食品的重金属、农药、真菌毒素、兽药和化学品的监管。管理食品中接触污染物的危险和风险的基础是建立和更新卫生标准,包括最大允许残留量、(临时)允许每日消费剂量、从容器和包装迁移的允许水平、禁止和(或)限制使用高度危险化学品、用更安全的替代品替代它们、改变技术过程。结论。一项比较分析表明,尽管Rospotrebnadzor积极采取行动,为控制污染物制定新的标准、卫生条例和准则,但在卫生和营养科学领域的基础研究的基础上,许多领域需要与国际要求协调一致。食品中容许铅含量的标准和农作物中若干农药的最大容许残留量的标准需要更新。此外,根据《鹿特丹公约》事先知情同意程序开展的活动表明,有必要就禁止或限制特别危险的化学品和农药作出及时和相关的决定。
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引用次数: 0
[The influence of vitamin D status on anxiety and depression in students in different seasons of the year]. [不同季节学生维生素D水平对焦虑、抑郁的影响]。
Q2 Medicine Pub Date : 2025-01-01 Epub Date: 2025-09-15 DOI: 10.33029/0042-8833-2025-94-5-151-158
A V Tarasov, R S Rakhmanov, N A Skoblina, E S Bogomolova

The academic demands and lifestyle of university students contribute to the development of stress, anxiety, and depression, with micronutrient deficiencies, including vitamin D insufficiency, among the contributing risk factors. The aim of the research was to evaluate the impact of vitamin D status on anxiety and depression in students by season.

Material and methods: A study was conducted in September-October (n=100, including 64 girls and 36 boys) and April-May (n=94, including 70 girls and 24 boys) among students of 1st-5th years. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS), with scores ≤7 indicating no clinically significant symptoms, 8-10 - subclinical symptoms, and ≥11 - clinically significant symptoms. Plasma 25-hydroxyvitamin D [25(OH)D] levels were measured using ELISA.

Results: Anxiety and depression were recorded in 25.0 and 11.0% of students in autumn, increasing to 50.0 and 29.8% in spring, respectively. In spring, the prevalence of clinically significant anxiety (from 6.0±2.5 to 25.5±4.5%, p=0.001) and subclinical depression (from 9.0±3.0 to 24.5±4.3%, p=0.001) rose. Median 25(OH)D level was 1.9-fold lower in spring than in autumn (10.16 [8.02; 13.85] vs 19.16 [16.41; 22.90] ng/ml, р<0.001) with no significant gender differences. The prevalence of severe deficiency increased 9.6-fold in spring, while insufficiency decreased 4.9-fold. In spring, the proportion of students with severe vitamin D deficiency increased from 8.4±3.5 to 54.2±6.7% among males and from 3.1±1.8 to 45.7±7.4% among females, while the prevalence of insufficiency decreased from 33.3±8.1 to 8.4±4.5% and from 37.5±7.9 to 7.1±3.6%, respectively. The correlation between vitamin D status and anxiety scores increased from weak to moderate (r =-0.39 to -0.56), and between vitamin D status and depression scores from very weak to moderate (r =-0.22 to -0.52); all correlations were statistically significant, supporting the role of vitamin D status in the development of these conditions.

Conclusion: These findings support the implementation of biochemical screening to identify students with low vitamin D status and the initiation of supplementation at the beginning of the academic year.

大学生的学业需求和生活方式导致了压力、焦虑和抑郁的发展,而维生素D不足等微量营养素缺乏是造成压力、焦虑和抑郁的危险因素之一。这项研究的目的是评估维生素D水平对不同季节学生焦虑和抑郁的影响。材料与方法:选取1 -5年级学生,于9 - 10月(n=100,其中女生64名,男生36名)和4 -5月(n=94,其中女生70名,男生24名)进行研究。采用医院焦虑抑郁量表(HADS)对焦虑和抑郁进行评估,得分≤7表示无临床显著症状,8-10表示亚临床症状,≥11表示临床显著症状。ELISA法测定血浆25-羟基维生素D [25(OH)D]水平。结果:秋季学生中有焦虑和抑郁的比例分别为25.0%和11.0%,春季分别为50.0%和29.8%。春季有临床意义的焦虑(从6.0±2.5上升到25.5±4.5%,p=0.001)和亚临床抑郁(从9.0±3.0上升到24.5±4.3%,p=0.001)的患病率上升。春季25(OH)D水平中位数比秋季低1.9倍(10.16 [8.02;13.85]vs 19.16 [16.41; 22.90] ng/ml),结论:这些发现支持实施生化筛查来识别维生素D水平低的学生,并在学年开始时开始补充。
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引用次数: 0
[Study of frequency and levels of mycotoxin contamination of fruit juices]. [果汁霉菌毒素污染的频率和水平的研究]。
Q2 Medicine Pub Date : 2025-01-01 Epub Date: 2025-09-15 DOI: 10.33029/0042-8833-2025-94-5-110-119
I B Sedova, Z A Chalyy, A L Spiridonova, D M Kompaintseva, E E Keshabyants, V A Tutelyan

Fruit juices and nectars are an integral part of the diet of the Russian population, especially children. Being a source of antioxidants, vitamins, minerals, trace elements and dietary fibers, at the same time fruit and berries are a good substrate for the development of mold fungi capable of producing secondary metabolites with toxic and even carcinogenic properties - mycotoxins, which pose a real danger to human health. The aim of the research was studying of the nature of mycotoxins' contamination of fruit juices based on apples and grapes sold in the Russian market.

Material and methods: The content of 31 mycotoxins in 49 samples of fruit juices marketed in Moscow and Moscow region was studied using high-performance liquid chromatography combined with tandem mass spectrometric detection.

Results: Screening studies of fruit juices based on apples and grapes for mycotoxin content were carried out. The results obtained by multidetection method indicate the detection of at least one mycotoxin at relatively low levels in 39 samples; two or more mycotoxins - in 26 out of 49 tested samples. The spectrum of toxins found differed depending on the type of juice. Tenuazonic acid, mycophenolic acid, toxins T-2, HT-2 and alternariol were found more frequently. The detection of toxins (fumonisins, ochratoxin A, aflatoxin B1, sterigmatocystin, deoxynivalenol and patulin) at low levels of contamination, including in juice samples intended for children's nutrition, indicates the relatively low quality of fruit and berry raw materials used.

Conclusion: The results of the study indicate the need to revise the technical requirements for fruit and berry raw materials in juice production industry. This is primarily necessary to prevent the inclusion of moldy and spoilage-prone fruit and berries, as well as to strengthen simultaneously control over product quality and safety, especially during storage and transportation intended for juice manufacturing.

果汁和花蜜是俄罗斯人饮食中不可或缺的一部分,尤其是儿童。水果和浆果是抗氧化剂、维生素、矿物质、微量元素和膳食纤维的来源,同时也是霉菌真菌生长的良好基质,霉菌真菌能够产生具有毒性甚至致癌性的次级代谢物——真菌毒素,这对人类健康构成了真正的威胁。该研究的目的是研究在俄罗斯市场上销售的苹果和葡萄果汁中霉菌毒素污染的性质。材料与方法:采用高效液相色谱-串联质谱法对莫斯科及莫斯科地区销售的49份果汁样品中31种真菌毒素的含量进行了研究。结果:对以苹果和葡萄为原料的果汁进行了霉菌毒素含量筛选研究。多重检测结果表明,在39份样品中至少检出一种相对较低水平的霉菌毒素;49个检测样本中有26个含有两种或更多真菌毒素。毒素的种类因果汁的种类而异。Tenuazonic acid、mycophenolic acid、毒素T-2、HT-2和alternarol的检出率较高。毒素(伏马毒素、赭曲霉毒素A、黄曲霉毒素B1、sterigmatocystin、脱氧雪腐毒素和棒曲霉素)在低污染水平下的检测,包括用于儿童营养的果汁样品,表明所使用的水果和浆果原料质量相对较低。结论:研究结果表明,果汁生产行业对水果和浆果原料的技术要求有必要进行修订。这主要是为了防止包含发霉和容易变质的水果和浆果,以及同时加强对产品质量和安全的控制,特别是在用于果汁制造的储存和运输过程中。
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引用次数: 0
[On digitalizing the analysis of food chemistry composition data]. 食品化学成分数据分析的数字化研究
Q2 Medicine Pub Date : 2025-01-01 Epub Date: 2025-11-17 DOI: 10.33029/0042-8833-2025-94-6-69-79
E A Smirnova, V V Bessonov, E S-A Shakhvalieva, G D Shcherbakov, E E Keshabyants, M S Andronova, V A Tutelyan
<p><p>The development of digital nutrition science, based on the application of artificial intelligence algorithms for the personalization of dietary recommendations, is hindered in the Russian Federation by the absence of a unified verified database of the chemical composition of foods. Such a resource should representatively reflect the current state of the agro-industrial complex and include products that form the basis of the diet of various demographic groups of the population. The objective of the research was to develop a software-analytical complex for creating and verifying a national database of the chemical composition of food. The system being created will ensure the consolidation of data from heterogeneous sources on food raw materials, industrially produced products, and culinary dishes, forming a representative resource that reflects the structure of the actual nutrition of the population and the current product range.</p><p><strong>Material and methods: </strong>The development of a three-tier software-analytical complex (MySQL 8.0, Python 3.13.3/Flask 2.0, HTML5/CSS3/JavaScript) involved the implementation and refinement of the following approaches: data collection (via web interface and REST API), data verification (using algorithms for missing value imputation, outlier detection, and k-means clustering), and the creation of algorithms to calculate the nutritional value of foods and dishes, accounting for technological losses. The system was validated against retrospective data from nutritional epidemiology studies.</p><p><strong>Results: </strong>A software-analytical complex has been created, including three interconnected databases: the chemical composition of food raw materials and industrially produced foods, dishes and culinary products, as well as coefficients of losses during technological processing. Data verification algorithms were developed and implemented, including methods for processing missing values, detecting statistical outliers, and clustering. A module for calculating the nutritional value of ready-made dishes, taking into account technological losses, was created. Criteria for classifying data as verified were developed, including requirements for completeness of filling (≥95%), compliance with permissible value ranges, and consistency with reference values. Tools for calculating the nutritional value of ready-made dishes, taking into account technological losses, were created, including a methodology for selecting recipes considering regional dietary characteristics.</p><p><strong>Conclusion: </strong>The developed software-analytical complex with a web interface is designed for managing data on the chemical composition of food. The system supports the full data lifecycle. Further development of the complex involves expanding the list of analyzed nutrients and integration with software for various purposes, including for dietitians, public catering specialists, diet calculations for organized groups, as we
在俄罗斯联邦,由于缺乏统一的食品化学成分验证数据库,基于应用人工智能算法实现个性化饮食建议的数字营养科学的发展受到阻碍。这种资源应具有代表性地反映农工综合体的现状,并包括构成人口各人口群体饮食基础的产品。这项研究的目的是开发一种软件分析综合体,用于创建和验证食品化学成分的国家数据库。正在建立的系统将确保整合来自食品原料、工业生产产品和烹饪菜肴等不同来源的数据,形成反映人口实际营养结构和当前产品范围的代表性资源。材料和方法:开发一个三层软件分析复合体(MySQL 8.0, Python 3.13.3/Flask 2.0, HTML5/CSS3/JavaScript)涉及以下方法的实现和完善:数据收集(通过web界面和REST API),数据验证(使用缺失值插入算法,异常值检测和k-means聚类),以及创建计算食物和菜肴营养价值的算法,计算技术损失。该系统通过营养流行病学研究的回顾性数据进行验证。结果:建立了一个软件分析综合体,包括三个相互关联的数据库:食品原料和工业生产的食品、菜肴和烹饪产品的化学成分,以及工艺加工过程中的损失系数。开发并实现了数据验证算法,包括处理缺失值、检测统计异常值和聚类的方法。一个计算现成菜肴营养价值的模块,考虑到技术损失,被创建。制定了数据验证分类标准,包括填充完整性(≥95%)、符合允准值范围以及与参考值一致的要求。在考虑到技术损失的情况下,创造了计算现成菜肴营养价值的工具,包括考虑区域饮食特征选择食谱的方法。结论:所开发的具有web界面的软件分析系统可用于食品化学成分数据的管理。系统支持完整的数据生命周期。该综合系统的进一步发展包括扩大分析营养素的清单,并与各种用途的软件集成,包括营养师、公共餐饮专家、有组织团体的饮食计算,以及个人营养评估应用程序,并向人们通报饮食的能量和营养价值。该项目的实施将为流行病学研究、制定与饮食有关的疾病的预防措施以及在健康营养领域形成科学的国家政策提供证据基础。
{"title":"[On digitalizing the analysis of food chemistry composition data].","authors":"E A Smirnova, V V Bessonov, E S-A Shakhvalieva, G D Shcherbakov, E E Keshabyants, M S Andronova, V A Tutelyan","doi":"10.33029/0042-8833-2025-94-6-69-79","DOIUrl":"https://doi.org/10.33029/0042-8833-2025-94-6-69-79","url":null,"abstract":"&lt;p&gt;&lt;p&gt;The development of digital nutrition science, based on the application of artificial intelligence algorithms for the personalization of dietary recommendations, is hindered in the Russian Federation by the absence of a unified verified database of the chemical composition of foods. Such a resource should representatively reflect the current state of the agro-industrial complex and include products that form the basis of the diet of various demographic groups of the population. The objective of the research was to develop a software-analytical complex for creating and verifying a national database of the chemical composition of food. The system being created will ensure the consolidation of data from heterogeneous sources on food raw materials, industrially produced products, and culinary dishes, forming a representative resource that reflects the structure of the actual nutrition of the population and the current product range.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Material and methods: &lt;/strong&gt;The development of a three-tier software-analytical complex (MySQL 8.0, Python 3.13.3/Flask 2.0, HTML5/CSS3/JavaScript) involved the implementation and refinement of the following approaches: data collection (via web interface and REST API), data verification (using algorithms for missing value imputation, outlier detection, and k-means clustering), and the creation of algorithms to calculate the nutritional value of foods and dishes, accounting for technological losses. The system was validated against retrospective data from nutritional epidemiology studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A software-analytical complex has been created, including three interconnected databases: the chemical composition of food raw materials and industrially produced foods, dishes and culinary products, as well as coefficients of losses during technological processing. Data verification algorithms were developed and implemented, including methods for processing missing values, detecting statistical outliers, and clustering. A module for calculating the nutritional value of ready-made dishes, taking into account technological losses, was created. Criteria for classifying data as verified were developed, including requirements for completeness of filling (≥95%), compliance with permissible value ranges, and consistency with reference values. Tools for calculating the nutritional value of ready-made dishes, taking into account technological losses, were created, including a methodology for selecting recipes considering regional dietary characteristics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The developed software-analytical complex with a web interface is designed for managing data on the chemical composition of food. The system supports the full data lifecycle. Further development of the complex involves expanding the list of analyzed nutrients and integration with software for various purposes, including for dietitians, public catering specialists, diet calculations for organized groups, as we","PeriodicalId":23652,"journal":{"name":"Voprosy pitaniia","volume":"94 6","pages":"69-79"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145991011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[The role of nutrition in the prevention of bone metabolism disturbances in high performance sports]. [营养在预防高性能运动中骨代谢紊乱中的作用]。
Q2 Medicine Pub Date : 2025-01-01 Epub Date: 2025-01-15 DOI: 10.33029/0042-8833-2025-94-1-21-36
K I Nikitina, T V Strelnikova, I T Vykhodets, T F Abramova, T M Nikitina

Modern professional sports activities are characterized by high training and competitive loads, which are a factor affecting bone metabolism and leading to an increase in injuries, including due to osteoporotic disorders. Nutrition can be classified as a modifiable factor that determines the development and maintenance of bone mass and quality. Correction of athlete's nutrition is an important mechanism aimed at preventing disorders of bone metabolism in elite sports in order to reduce the risk of injuries of the musculoskeletal system. The aim of the research was to analyze modern scientific publications devoted to the influence of the diet of adult athletes over 18 years of age on the maintenance of bone metabolism. Material and methods. The review is based on publications from the PubMed, Google Scholar, Cyberleninka, eLIBRARY databases. Preference was given to international recommendations published over the past 10 years in refereed sources. Results. The review presents current data on the role of nutrition in maintaining the quantity and quality of bone mass, given that the process of skeletal formation requires an adequate and constant supply of macro- and micronutrients: protein, calcium, magnesium, phosphorus, vitamin D, zinc, iron, vitamins A, C, K, E, B vitamins, ω-3 polyunsaturated fatty acids. An important place is given to nutrition balanced in macronutrient composition, designed taking into account energy needs that increase with intense physical activity, which is especially important given the negative impact of limited energy intake on bone metabolism, up to the development of osteoporosis. It is recommended to evaluate the athlete's diet to determine whether he or she is consuming sufficient amounts of essential nutrients that have a positive effect on bone metabolism, taking into account systematic physical activity. If necessary, it is recommended to introduce fortified foods and dietary supplements into the athletes' diet to increase its nutritional value. Conclusion. A balanced diet rich in vitamins, minerals and trace elements, aimed at preventing a de crease in bone mineral density, is necessary for an athlete throughout the entire period of professional activity, in some cases in combination with vitamin D, magnesium, calcium and phosphorus intake.

现代职业体育活动的特点是高训练和竞技负荷,这是影响骨代谢的一个因素,导致损伤的增加,包括由于骨质疏松症。营养可以被归类为一个可改变的因素,它决定了骨量和质量的发展和维持。纠正运动员的营养是精英运动中预防骨代谢紊乱以降低肌肉骨骼系统损伤风险的重要机制。这项研究的目的是分析现代科学出版物中关于18岁以上成年运动员饮食对维持骨骼代谢的影响的研究。材料和方法。该综述基于PubMed、b谷歌Scholar、Cyberleninka、eLIBRARY数据库的出版物。优先考虑过去10年在参考来源中发表的国际建议。结果。鉴于骨骼形成过程需要充足和持续的宏量和微量营养素供应:蛋白质、钙、镁、磷、维生素D、锌、铁、维生素A、C、K、E、B族维生素、ω-3多不饱和脂肪酸,本综述介绍了目前关于营养在维持骨量的数量和质量方面的作用的数据。营养平衡在宏量营养素组成中占有重要地位,其设计考虑到随着剧烈体育活动而增加的能量需求,考虑到有限的能量摄入对骨骼代谢的负面影响,直至骨质疏松症的发展,这一点尤为重要。建议对运动员的饮食进行评估,以确定他或她是否摄入了足量的对骨骼代谢有积极影响的必需营养素,同时考虑到系统性的身体活动。如有必要,建议在运动员的饮食中加入强化食品和膳食补充剂,以增加其营养价值。结论。富含维生素、矿物质和微量元素的均衡饮食,旨在防止骨密度下降,对运动员在整个职业活动期间都是必要的,在某些情况下,还需要摄入维生素D、镁、钙和磷。
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引用次数: 0
[Iodine and vitamin status, body composition in older persons living in Republic of Sakha (Yakutia)]. [居住在萨哈共和国(雅库特)的老年人的碘和维生素状况、身体成分]。
Q2 Medicine Pub Date : 2025-01-01 Epub Date: 2025-10-06 DOI: 10.33029/0042-8833-2025-94-5-159-170
N A Beketova, O A Vrzhesinskaya, O V Kosheleva, U M Lebedeva, N V Zhilinskaya
<p><p>Optimizing the micronutrient status of older adults is an important component of maintaining healthy longevity. The objective was to study gender and age characteristics of iodine, vitamin A, E, B2 and β-carotene status, as well as indicators of body component composition associated with aging in elderly indigenous people of the Republic of Sakha (Yakutia).</p><p><strong>Material and methods: </strong>In the autumn, a one-time examination of the micronutrient status of 53 women and 8 men aged 61-95 years (median - 75 years, indigenous residents of Yakutia) was conducted. The concentration of iodine in daily urine was determined by stripping voltammetry, in blood serum the level of riboflavin (vitamin B2) was determined by the fluorimetric titration with riboflavin-binding apoprotein, retinol (vitamin A), α- and γ-tocopherols (vitamin E), carotenoids (β-carotene) - by reversed-phase HPLC. Bioelectrical impedance analysis (BIA) of body composition was performed using the InBody S10 analyzer.</p><p><strong>Results: </strong>Reduced iodine status (excretion <100 μg/l) was observed in the majority of elderly individuals - 92.5%, vitamin B2 (riboflavin <5 ng/ml) - in 31.9%, vitamin E (α + γ-tocopherols <0.8 mg/dl) - 6.1% and carotenoids (β-carotene <10 μg/dl) - 22.4%. All subjects were provided with vitamin A (retinol >30 μg/dl). Combined deficiency of 3 micronutrients (most often iodine, vitamin B2 and β-carotene) was detected in 14.9% of citizens. In a subgroup of elderly women aged ≥75 years moderate (not mild) iodine deficiency was detected more often than in women 60-74 years old, while vitamin B2 deficiency was detected less often (p<0.05). There was a positive relationship (p<0.05) between the age of women and serum β-carotene level, as well as between the concentration of α-tocopherol, on the one hand, and the levels of γ-tocopherol and β-carotene, on the other. A negative correlation was found between the serum retinol level and some BIA body composition indices: extracellular water component (ECW; -0.466, p=0.002), minerals component (-0.420, p=0.006), bone mineral component (BMC; -0.405, p=0.009), soft lean mass (SLM; -0.408, p=0.008), fat free mass (FFM; -0.433, p=0.005), and skeletal muscle mass (SMM; -0.398, p=0.010). In women with 76.3-110.9 μg/dL serum retinol level (quartile IV), the mass of the ECW, minerals and BMC, SLM, FFM and SMM were significantly lower (p<0.05) than in those examined with retinol levels in the range of 30-63 μg/dL (quartiles I and II).</p><p><strong>Conclusion: </strong>Iodine and vitamin B2 deficiency are most common in elderly indigenous people of Yakutia; iodine deficiency worsens with age. In women aged ≥60 years, elevated serum retinol level (>80 μg/dl) was associated with negative changes in body composition parameters associated with aging. In elderly individuals, serum retinol levels above the upper norm limit should probably be considered as a diagnostically significant marker of increased risk of
优化老年人微量营养素状况是保持健康长寿的重要组成部分。目的是研究萨哈共和国(雅库特)土著老年人碘、维生素A、E、B2和β-胡萝卜素状况的性别和年龄特征,以及与衰老有关的身体成分组成指标。材料和方法:在秋季,对53名61-95岁(中位数- 75岁,雅库特土著居民)的妇女和8名男子的微量营养素状况进行了一次性检查。每日尿碘浓度采用溶出伏安法测定,血清中核黄素(维生素B2)含量采用核黄素结合载脂蛋白、视黄醇(维生素A)、α-和γ-生育酚(维生素E)、类胡萝卜素(β-胡萝卜素)反相高效液相色谱荧光滴定法测定。采用InBody S10分析仪进行体成分生物阻抗分析(BIA)。结果:碘含量降低(排泄量30 μg/dl)。14.9%的公民同时缺乏3种微量营养素(最常见的是碘、维生素B2和β-胡萝卜素)。在≥75岁的老年妇女亚组中,发现中度(非轻度)碘缺乏症的频率高于60-74岁的妇女,而发现维生素B2缺乏症的频率较低(结论:碘和维生素B2缺乏症在雅库特老年土著居民中最常见,碘缺乏症随着年龄的增长而恶化。在年龄≥60岁的女性中,血清视黄醇水平升高(bbb80 μg/dl)与衰老相关的身体成分参数的负变化相关。在老年人中,血清视黄醇水平高于标准上限可能被视为肌少症风险增加的诊断显著标志。扩大消除碘和B族维生素缺乏症和纠正过量维生素A摄入量以预防雅库特老年人与年龄有关的消化系统疾病的措施的理由得到证实。
{"title":"[Iodine and vitamin status, body composition in older persons living in Republic of Sakha (Yakutia)].","authors":"N A Beketova, O A Vrzhesinskaya, O V Kosheleva, U M Lebedeva, N V Zhilinskaya","doi":"10.33029/0042-8833-2025-94-5-159-170","DOIUrl":"10.33029/0042-8833-2025-94-5-159-170","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Optimizing the micronutrient status of older adults is an important component of maintaining healthy longevity. The objective was to study gender and age characteristics of iodine, vitamin A, E, B2 and β-carotene status, as well as indicators of body component composition associated with aging in elderly indigenous people of the Republic of Sakha (Yakutia).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Material and methods: &lt;/strong&gt;In the autumn, a one-time examination of the micronutrient status of 53 women and 8 men aged 61-95 years (median - 75 years, indigenous residents of Yakutia) was conducted. The concentration of iodine in daily urine was determined by stripping voltammetry, in blood serum the level of riboflavin (vitamin B2) was determined by the fluorimetric titration with riboflavin-binding apoprotein, retinol (vitamin A), α- and γ-tocopherols (vitamin E), carotenoids (β-carotene) - by reversed-phase HPLC. Bioelectrical impedance analysis (BIA) of body composition was performed using the InBody S10 analyzer.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Reduced iodine status (excretion &lt;100 μg/l) was observed in the majority of elderly individuals - 92.5%, vitamin B2 (riboflavin &lt;5 ng/ml) - in 31.9%, vitamin E (α + γ-tocopherols &lt;0.8 mg/dl) - 6.1% and carotenoids (β-carotene &lt;10 μg/dl) - 22.4%. All subjects were provided with vitamin A (retinol &gt;30 μg/dl). Combined deficiency of 3 micronutrients (most often iodine, vitamin B2 and β-carotene) was detected in 14.9% of citizens. In a subgroup of elderly women aged ≥75 years moderate (not mild) iodine deficiency was detected more often than in women 60-74 years old, while vitamin B2 deficiency was detected less often (p&lt;0.05). There was a positive relationship (p&lt;0.05) between the age of women and serum β-carotene level, as well as between the concentration of α-tocopherol, on the one hand, and the levels of γ-tocopherol and β-carotene, on the other. A negative correlation was found between the serum retinol level and some BIA body composition indices: extracellular water component (ECW; -0.466, p=0.002), minerals component (-0.420, p=0.006), bone mineral component (BMC; -0.405, p=0.009), soft lean mass (SLM; -0.408, p=0.008), fat free mass (FFM; -0.433, p=0.005), and skeletal muscle mass (SMM; -0.398, p=0.010). In women with 76.3-110.9 μg/dL serum retinol level (quartile IV), the mass of the ECW, minerals and BMC, SLM, FFM and SMM were significantly lower (p&lt;0.05) than in those examined with retinol levels in the range of 30-63 μg/dL (quartiles I and II).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Iodine and vitamin B2 deficiency are most common in elderly indigenous people of Yakutia; iodine deficiency worsens with age. In women aged ≥60 years, elevated serum retinol level (&gt;80 μg/dl) was associated with negative changes in body composition parameters associated with aging. In elderly individuals, serum retinol levels above the upper norm limit should probably be considered as a diagnostically significant marker of increased risk of","PeriodicalId":23652,"journal":{"name":"Voprosy pitaniia","volume":"94 5","pages":"159-170"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145565667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Hypoglycemic and hypocholesterolemic activities in vivo of polyphenols - popular components of dietary supplements]. [多酚在体内的降血糖和降胆固醇活性-膳食补充剂的常用成分]。
Q2 Medicine Pub Date : 2025-01-01 Epub Date: 2025-07-15 DOI: 10.33029/0042-8833-2025-94-4-56-67
A S Frolova, A D Vesnina, A M Fedorova, I S Milentyeva, A Yu Prosekov, A V Zaushintsena

Polyphenols such as rutin (RUT), quercetin (KVC) and tras-cinnamic acid (TKR-k) are sought-after components of dietary supplements and functional foods for the prevention of metabolic diseases due to their bioactivity. Studies devoted to the evaluation of the complex effect of mixtures of these polyphenols are very few. The aim of this research was to evaluate mixtures consisting of different amounts of RUT, KVC and TKR-k isolated from plant cells in vitro, to exhibit hypoglycemic and hypocholesterolemic potential in vivo.

Material and methods: The objects of the study were mixtures of bioactive compounds (mixture No. 1 - RUT : KVC : TKR-k in a weight ratio of 1:1:1; mixture No. 2 - in a weight ratio of 2:1:1; mixture No. 3 - in a weight ratio of 1:2:1; mixture No. 4 - in a weight ratio of 1:1:2). To determine hypoglycemic activity, Wistar rats weighing 250±15 g were used as a model organism. After 12 hours of fasting, they were orally administered a mixture of bioactive compounds (100 mg/kg body weight), and then, 1 hour later, they were orally given glucose at a dose of 2000 mg/kg. Then, after 30 min, 1, 1.5, 2, 4 and 6 hours, blood plasma glucose and total cholesterol (TC) levels were estimated. To determine hypocholesterolemic activity, C57Bl/6 mice were used, which were orally administered a mixture of bioactive compounds (100 mg/kg body weight) daily for 14 days, and hypocholesterolemia was created using poloxamer P407 (three times a week intraperitoneally at a dose of 400 mg/kg). At the end of the experiment, blood plasma levels of glucose, TC, low-density lipoproteins (LDL) and triglycerides were estimated.

Results: In the hypoglycemic load experiment, mixture No. 3 reduced blood glucose level (р<0.05). In the hypocholesterolemic load experiment, all mixtures reduced blood glucose levels (р<0.10). Only mixture No. 4 caused a reliable decrease in the level of TC (2 fold lower compared to the control group, р<0.01) and LDL (1.72 times lower compared to the control group, р<0.10).

Conclusion: The relationship between the ratio of bioactive compounds in mixtures and their activity has not been established. According to in vivo experiments, it is advisable to use mixture No. 3 to normalize glucose levels, and mixture No. 4 to normalize glucose and cholesterol levels.

芦丁(RUT)、槲皮素(KVC)和反式肉桂酸(TKR-k)等多酚类物质由于其生物活性,是膳食补充剂和功能食品中广受欢迎的成分,用于预防代谢性疾病。专门评价这些多酚混合物的复杂作用的研究很少。本研究的目的是评估从植物细胞中分离的由不同量的RUT、KVC和TKR-k组成的混合物在体内表现出的降血糖和降胆固醇的潜力。材料与方法:研究对象为生物活性化合物混合物(1号混合物- RUT: KVC: TKR-k,重量比为1:1:1;2号混合物-重量比为2:1:1;3号混合物-重量比为1:2:1;4号混合物-重量比为1:1:2)。以体重为250±15 g的Wistar大鼠为模型生物测定降糖活性。禁食12小时后,他们口服生物活性化合物的混合物(100 mg/kg体重),然后,1小时后,他们口服葡萄糖剂量为2000 mg/kg。然后,在30分钟、1、1.5、2、4和6小时后,测定血浆葡萄糖和总胆固醇(TC)水平。为了确定降低胆固醇的活性,C57Bl/6小鼠每天口服生物活性化合物(100 mg/kg体重)混合物,持续14天,并使用波洛沙姆P407(每周3次,剂量为400 mg/kg)腹腔注射造成低胆固醇血症。实验结束时,测定大鼠血浆葡萄糖、TC、低密度脂蛋白(LDL)和甘油三酯水平。结果:在降糖负荷实验中,3号合剂可降低血糖水平(结论:合剂中生物活性成分的比例与其活性之间的关系尚未建立。根据体内实验,建议使用3号合剂使血糖水平正常化,4号合剂使血糖和胆固醇水平正常化。
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引用次数: 0
[The assessment of the consumption of food packaged in plastic containers]. [对塑料容器包装食品的消费评估]。
Q2 Medicine Pub Date : 2025-01-01 Epub Date: 2025-09-15 DOI: 10.33029/0042-8833-2025-94-5-85-93
K V Kudryavtseva, A N Martinchik, V A Shipelin, D A Kraskevich, D O Gorbachev, Yu Yu Eliseev, O V Mitrokhin, S A Khotimchenko
<p><p>Microplastics (MP) contamination of food has become a serious problem due to its increasing accumulation in ecosystems, including terrestrial and aquatic, as well as in organisms of living creatures, including humans. MP can enter food such as water, milk, fish and seafood, which contributes to their entry into the human body and creates health risks. The main sources of contamination of food include the raw materials used and packaging or materials in contact with food during its transportation, cooking and storage. MP can be added or removed from food during processing and cooking. However, it is difficult to assess the total oral exposure to MP due to the lack of data on MP contamination in many other food groups. In addition, there is no data in the Russian Federation on the amounts of actual consumption of food packaged in plastic containers that may be contaminated with MP, which makes it relevant to study the scale of consumption of food groups in which microparticles are found most frequently. The purpose of the research was to assess the actual consumption of liquid products by the population of the Russian Federation, including dairy products, carbonated drinks, juices, mineral and drinking waters packaged in plastic containers as well as products in which, according to scientific data, the largest amounts of MP particles have been identified.</p><p><strong>Material and methods: </strong>The assessment of food consumption was carried out using data obtained by analyzing the frequency of food consumption applying an online survey, which was based on a specially designed questionnaire. The survey was conducted on a voluntary basis among 494 respondents aged over 18 who lived in various regions. The data from the electronic survey was automatically stored in an Excel database.</p><p><strong>Results: </strong>The obtained primary data on the frequency and volume of portions of consumed products, which were recalculated into average daily values - per capita and per consumer, and statistically processed. The average per capita consumption of water in plastic bottles was 411 ml/day, and per consumer - 497 ml/day. The average daily per capita consumption of milk in plastic bottles was 114 ml, in a tetrapack package - 68 ml. Milk consumption per consumer was 179 ml/day in a plastic bottle and 129 ml/day in a tetrapack package. There was also a high frequency of tea bag consumption. The average daily consumption of sugary carbonated and non-carbonated beverages was 81 and 55 ml, respectively. Among the products obtained from the aquatic ecosystem, boiled/ fried fish was the most consumed product - 16.9 g/day. However, the consumption of oysters (68.8 g/day) and mussels (29.9 g/day) per consumer was higher (this is due to the small number of consumers, n=30 and n=118, respectively). In general, the consumption of products packaged in plastic containers varied depending on the product category.</p><p><strong>Conclusion: </strong>The develope
由于微塑料在陆地和水生生态系统以及包括人类在内的生物有机体中的积累越来越多,食品污染已成为一个严重问题。MP可以进入食物,如水、牛奶、鱼和海鲜,这有助于它们进入人体并造成健康风险。食品污染的主要来源包括食品在运输、烹饪和储存过程中所使用的原料和包装,以及与食品接触的材料。MP可以在加工和烹饪过程中从食物中添加或去除。然而,由于缺乏许多其他食品中多聚氰胺污染的数据,很难评估口服多聚氰胺的总暴露量。此外,俄罗斯联邦没有关于可能被多聚甲基磺酸污染的塑料容器包装食品的实际消费量的数据,因此,研究最常发现微粒的食品类别的消费规模是有意义的。这项研究的目的是评估俄罗斯联邦人口对液体产品的实际消费情况,包括用塑料容器包装的乳制品、碳酸饮料、果汁、矿泉水和饮用水,以及根据科学数据已查明其中含有最多多氯丙烷颗粒的产品。材料与方法:食品消费评估采用专门设计的在线调查问卷,通过对食品消费频率的分析获得数据。该调查是在自愿的基础上对居住在不同地区的494名18岁以上的受访者进行的。电子调查的数据自动存储在Excel数据库中。结果:获得了食用产品的频率和分量的原始数据,将其重新计算为人均日平均摄入量和人均日平均摄入量,并进行统计处理。人均塑料瓶水的消费量为411毫升/天,人均消费量为497毫升/天。每人每天平均消费114ml装在塑料瓶里的牛奶,68 ml装在四环袋里。每人每天消费179 ml装在塑料瓶里的牛奶,129 ml装在四环袋里的牛奶。茶包消费的频率也很高。含糖碳酸饮料和非碳酸饮料的平均每日消费量分别为81毫升和55毫升。在水生生态系统中获得的产品中,水煮/煎鱼是消费量最大的产品,为16.9 g/d。然而,每个消费者对牡蛎(68.8克/天)和贻贝(29.9克/天)的消费量更高(这是由于消费者数量较少,分别为n=30和n=118)。一般来说,用塑料容器包装的产品的消费量因产品类别而异。结论:所开发的在线问卷可以评估塑料容器包装的液体食品的消费情况,以及MP颗粒检测量最高的产品。在塑料容器中包装的液体产品中,体积最大的是水和包装茶。同时,在消费量上也存在显著差异,这与受访者的个人偏好和习惯有关。乳制品和含糖饮料的消费量较小,但它们仍然很重要。能量饮料虽然消费频率较低,但在消费者中需求量很大。通过对食品中多聚体含量进行量化后获得的数据,将使我们更接近于计算俄罗斯联邦城市人口口服多聚体暴露总量。迫切需要扩大居住在其他区域的答复者群体。
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引用次数: 0
[Effectiveness evaluation of the implementation of educational programs in the field of healthy nutrition in the Omsk Irtysh region adult population (2018-2023)]. [鄂木斯克额尔齐斯州成人健康营养教育项目实施效果评价(2018-2023)]。
Q2 Medicine Pub Date : 2025-01-01 Epub Date: 2025-09-15 DOI: 10.33029/0042-8833-2025-94-5-120-130
O V Kozubenko, Yu V Menshchikova, M S Turchaninova, E A Vilms, A V Brusentsova, D V Turchaninov

The federal project «Strengthening public Health» of the national project «Demography» was implemented in 2018-2024, an essential part of which was the organization and implementation of educational training (enlightenment) programs on healthy nutrition for various population groups. Omsk region has become one of the first five pilot Russian regions in this area, thanks to which some experience has been accumulated to solve an urgent scientific and practical task - assessing the effectiveness of educational measures, changes in the level of knowledge and skills in the field of healthy nutrition. The purpose of the study was to evaluate the effectiveness of educational programs on healthy nutrition in the Omsk region in 2018-2023.

Material and methods: The study was conducted in the design of an epidemiological study of the «before-after» type on representative samples formed in 2018 (n=241) and in 2023 (n=506) from the general adult population. The level of knowledge and skills of applying the principles of healthy eating was assessed based on the results of data analysis obtained by a sociological survey.

Results: The positive changes that indicate the effectiveness of educational programs among the population of the region include an increase in knowledge about the structure of a healthy diet and the formation of practices in the field of healthy nutrition. The majority of respondents believe that vegetables, fruits and grain products should prevail in the diet structure (an increase from 46.9±3.1% of respondents in 2018 to 57.7±2.1% in 2023, p>0.05), it is necessary to reduce salt consumption (an increase from 57.3±2.5% to 65.2±2.0%, p=0.045), and the predominant use of iodized salt is noted (from 46.1±3.1% in 2018 to 58.1±2.1% in 2023, p<0.001). The leading criterion for choosing food in 2023 was its quality, taste habits were in second place, nutritional value was in third, and knowledge of the product usefulness was in fourth place.

Conclusion: Against the background of activities within the framework of the implementation of training programs on healthy nutrition, the adult population of the region is developing ideas about the structure of a healthy diet. Although the media are the leading source of information for the general population, it should be noted that medical professionals have a significant influence on the formation of knowledge and ideas about healthy nutrition and their increasing role in this issue.

2018-2024年实施了国家“人口”项目的“加强公共卫生”联邦项目,其中一个重要组成部分是组织和实施针对不同人口群体的健康营养教育培训(启蒙)方案。鄂木斯克州已成为俄罗斯在这一领域的首批五个试点地区之一,因此积累了一些经验,以解决一项紧迫的科学和实际任务,即评估教育措施的有效性、健康营养领域知识和技能水平的变化。该研究的目的是评估2018-2023年鄂木斯克地区健康营养教育计划的有效性。材料和方法:该研究是在2018年(n=241)和2023年(n=506)从普通成年人群中形成的代表性样本的“前后”型流行病学研究设计中进行的。根据社会学调查获得的数据分析结果,评估了应用健康饮食原则的知识和技能水平。结果:积极的变化表明该地区人口中教育计划的有效性,包括健康饮食结构知识的增加和健康营养领域实践的形成。大多数受访者认为饮食结构应以蔬菜、水果和谷物为主(从2018年的46.9±3.1%增加到2023年的57.7±2.1%,p b> 0.05),有必要减少盐的消费(从57.3±2.5%增加到65.2±2.0%,p=0.045),并注意到碘盐的主要使用(从2018年的46.1±3.1%增加到2023年的58.1±2.1%,p。在实施健康营养培训方案框架内开展活动的背景下,该地区的成年人口正在形成关于健康饮食结构的想法。虽然媒体是普通民众的主要信息来源,但应该指出的是,医疗专业人员对形成关于健康营养的知识和观念具有重大影响,并在这一问题上发挥越来越大的作用。
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引用次数: 0
[External factors contributing to the development of constitutional exogenous obesity in children]. [导致儿童体质外源性肥胖的外部因素]。
Q2 Medicine Pub Date : 2025-01-01 Epub Date: 2025-02-10 DOI: 10.33029/0042-8833-2025-94-1-37-49
A A Dzhumagaziev, N M Shilina, D A Bezrukova, N Yu Otto, E V Sosinovskaya, A V Filipchuk

Obesity is a multifactorial disease associated with excessive deposition of adipose tissue, accompanied by impaired organism metabolic functions and changes in the function of organs and systems. Childhood obesity is of particular concern, which in many cases turns into obesity in adults. The most common is simple (constitutionally exogenous, polygenic, idiopathic) obesity associated with excessive intake of calories in conditions of physical inactivity and hereditary predisposition. The purpose of the research was to analyze the literature data on the influence of external factors on the development of constitutionally exogenous obesity in children. Material and methods. 84 literature sources were analyzed, keyword (children, obesity, risk factors) searches were conducted using PubMed, Scopus, Elsevier, eLibrary, and Google Scholar databases. The preference was given to the sources compiled from the standpoint of evidence-based medicine with a high level of reliability and evidence (meta-analyses of cohort studies). Results. External risk factors for obesity development include 3 groups of factors: family and home environment factors (parents' attitude to breastfeeding, responsive, positiveemotion feeding while responding sensitively to the child's signals of hunger and satiety, fostering children's skills and culture of optimal, balanced nutrition, family traditions associated with sweet and salty foods and juices, portion sizes, fast or slow eating style, duration of screen time and sleep, sedentary lifestyle, exposure to secondhand smoke, psychosocial stress, depression, adverse childhood experiences, the use of medications associated with an increase in body weight, unfavorably altered intestinal microbiota), environmental factors (fast food outlets, an unfavorable school environment, lack of conditions for safe physical activity) and systemic and political factors (inequality of individual social groups regarding access to quality health services, education, safe food and water, which can lead to differences in health status, ranging from maternal pregnancy planning and outcomes to children's adolescence, marketing of high-calorie foods high in saturated fat, simple carbohydrates and table salt, and sugar-containing beverages aimed at children). Conclusion. Obesity is a disease characteristic of modern society, the occurrence and development of which can be influenced by all the listed external risk factors. However most of these factors are manageable. Therefore, knowledge and understanding of the role of these external risk factors is necessary to develop adequate methods for obesity prevention and use them in clinical practice.

肥胖是一种多因素疾病,与脂肪组织过度沉积有关,并伴有机体代谢功能受损和器官系统功能改变。儿童肥胖尤其令人担忧,在许多情况下,儿童肥胖会演变成成人肥胖。最常见的是单纯性(体质外源性、多基因、特发性)肥胖,与缺乏运动和遗传易感性条件下摄入过多卡路里有关。本研究的目的是分析外界因素对儿童本构性外源性肥胖发展影响的文献资料。材料和方法。分析84篇文献来源,使用PubMed、Scopus、Elsevier、library和谷歌Scholar数据库进行关键词(儿童、肥胖、危险因素)搜索。优先考虑从循证医学的角度编制的来源,具有高水平的可靠性和证据(队列研究的meta分析)。结果。肥胖发展的外部危险因素包括3组因素:家庭和家庭环境因素(父母对母乳喂养的态度,对儿童饥饿和饱腹感敏感的反应性积极情绪喂养,培养儿童最佳均衡营养的技能和文化,与甜咸食物和果汁相关的家庭传统,份量大小,快或慢的饮食方式,屏幕时间和睡眠时间,久坐的生活方式,二手烟暴露,心理社会压力,抑郁症,不良的童年经历、使用与体重增加有关的药物、肠道微生物群的不利改变、环境因素(快餐店、不利的学校环境、缺乏安全体育活动的条件)以及系统和政治因素(个别社会群体在获得优质保健服务、教育、安全食品和水方面的不平等,这可能导致健康状况的差异)。从孕产妇怀孕计划和结果到儿童青春期,高热量食品(高饱和脂肪,简单碳水化合物和食盐)的营销,以及针对儿童的含糖饮料。结论。肥胖是现代社会的一种特征性疾病,其发生和发展受到上述所有外部危险因素的影响。然而,这些因素中的大多数都是可控的。因此,认识和理解这些外部危险因素的作用对于制定适当的肥胖预防方法并将其应用于临床实践是必要的。
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