The first thousand days of a child's life have important role in their future health. The adequacy of nutrition during this period critically affects the growth of the child, the development of his functional abilities, the full formation of all body systems. A well-planned mother's diet is important during pre-conception, during pregnancy and lactation. The choice of a vegetarian or vegan diet often occurs even in the pre-conception period, and at the onset of pregnancy, vegetarian women most often do not change their type of diet. Due to the risk of a number of nutrient deficiencies, the use of plant-based diets during pregnancy and lactation requires high awareness of mothers regarding diet planning, as well as special attention from pediatricians and nutritionists due to the increased nutritional risks.

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Адекватное питание является важнейшим фактором здоровья ребенка, влияющим не только на его самочувствие, но и на показатели физической активности. Дети-спортсмены для компенсации затрат энергии, активации анаболических процессов, восстановления работоспособности нуждаются в оптимальном рационе с достаточным содержанием белков, жиров, углеводов, минеральных веществ и витаминов для покрытия потребностей в развитии и росте, а также с целью восстановления после физической и нервно-психической нагрузки. Определенные требования предъявляются также к питанию и питьевому режиму, особенно в периоды интенсивных тренировок и на этапах соревнований. Рекомендации по составу рационов для детей-спортсменов разработаны и отражены в ряде руководств, однако, как показывают исследования, фактическое питание почти половины учащихся специализированных детско-юношеских школ олимпийского резерва не соответствует рекомендуемым нормам. В статье представлен обзор современных подходов к организации питания юных спортсменов и даны рекомендации по персонифицированной коррекции рациона и нутритивной поддержке в зависимости от спортивной специализации, характера физической нагрузки, этапа тренировочного процесса, индивидуальных особенностей ребенка.

Background. The growing popularity of vegetarianism in the world also affects the growth of the number of families choosing this type of diet. Adherence to a vegetarian diet in children is a concern due to the high risks of macro- and micronutrient deficiencies. Increasing interest in vegetarian diets is also relevant for our country, but there is currently no data on the prevalence of vegetarianism among children in Russia. Materials and methods. We conducted a cross-sectional controlled study of indices of physical development, body component composition, and macronutrient composition of diets in vegetarian and non-vegetarian children. The physical development of vegetarian children was assessed using the «Anthro Plus», the macronutrient composition of diets was assessed using the special computer software, body composition was assessed using the bioelectrical impedance analysis. Results. 24% of vegetarian children had physical deviations: reduced body weight (6.3%), reduced body length (1.9%), mild malnutrition (13.3%), moderate malnutrition (1.3%), severe malnutrition (0.6%), overweight (5.1%). The assessment of the body composition showed statistically lower values of % ACM (p = 0.004) and phase angle (p = 0.005) in vegetarian children. 95% of the vegetarian children had an inadequate composition of the diet: both insufficient and excessive consumption of protein, fat, and carbohydrates. Low consumption of all macronutrients was found in 15% of vegetarian children. Children who received a vegan diet consumed protein with food statistically significantly lower, compared with lacto-and lacto-ovo-vegetarians (p < 0.005), but statistically more often consumed a high level of carbohydrates. High fat intake was found in most vegetarian children, especially children under 12 years. Conclusion. The results of the study showed the need to raise awareness of vegetarian parents about the nutritional risks associated with a vegetarian diet, and to make an adequate diet for their children.

Background and aimsEpidermolysis Bullosa (EB) refers to a group of rare inherited disorders characterised by skin and/or mucous blistering even after minor injuries. Nutritional deficiency in EB, especially in dystrophic form, is the result of associated states such as: dental/gum diseases, oral, pharyngealandoesophageal blistering, microstomia, fixed tongue, dysphagia, oesophageal stricture, gastro-oesophageal reflux.Study ObjectiveTo assess the nutritional status of children suffering from different forms of EB.Materials and methodsThe study included 60 children aged 1–16 years suffering from Epidermolysis Bullosa Simplex (EBS) (n=17) and Dystrophic Epidermolysis Bullosa (DEB) (n=43). The assessment of physical development indices was carried out using WHO ANTRO+ computer program. Z-score values (weight index (WAZ), height index (HAZ), body mass index (BAZ)) within > −2 /<+1 are a normal. BAZ indices > −3/<-2 represent a moderate degree of nutritional deficiency, < −3 – a severe one. Comprehensive assessment of the factors affecting the nutritional status in EB was performed using the THINC validated scale (Tool to Help Identify Nutritional Compromise).ResultsWAZ, HAZ and BAZ in children with EBS were in normal limits in most of patients (82.3%), 2 children had undernutrition (BAZ > −3/< −2), 1 had BAZ >+1.WAZ in patients with DEB was within normal limits only in 16 children (37.2%), increased (>+1) – in 1 child (2.3%). Other children had a decreased WAZ: within > −3/< −2 in 11 children (25.5%), and below −3 in 15 children (34.8%). HAZ was within normal limits in 26 children (60.5%), increased (>+1) – in 3 children (7.0%), decreased within > −3/< −2 – in 9 children (20.9%), below −3 – in 5 children (11.6%). BAZ was within normal limits in 13 children (30.2%). The moderate nutritional deficiency (BAZ >-3/<-2) was detected in 11 (25.5%), and severe nutritional deficiency (BAZ below −3) – in 18 children (41.8%).THINC scale values ranged from 10 to 55 (Me 30±10.47) in children with EBS; from 25 to 95 (Me 60±17.63) in patients with DEB.ConclusionsThe performed analysis shows evident disorders of the nutritional status in children with a dystrophic form of EB. The THINC tool should be used for a comprehensive assessment of nutritional status and nutritional compromise, effectiveness of the administered treatment, including dietary therapy, over time.

Nutritive support of young sportsmen using a specialized Russian product Author affiliation: Svetlana Gennad'evna Makarova, PhD, leading research fellow at the pediatric nutrition department of the SCCH Address: 2, Lomonosovskii Ave., Moscow, 119991, tel.: +7 (499) The issue of adequate nutrition for children going in for sports is rather urgent. Despite the developed dietary recommendations for children sportsmen [1][2][3], literature data and evaluation of real diet of such children showed that the real consumption of macro-and micronutrients is considerably different from the recommended norms [4][5][6][7]. The main reasons of insufficient consumption of certain nutrients are intensive training regimen, which impedes compliance with the necessary dietary pattern (in almost all children), selective appetite, food allergy or intolerance, whereas diet of a child or an adolescent actively going in for sports ought to provide the body with the necessary amount of calories and nutrients, such as proteins, fats, carbohydrates (macronutrients), mineral substances, vitamins and other vital bioactive food factors (micronutrients) and ensure natural processes of its growth and development. Moreover, it ought to cover the additional caloric and plastic needs in order to compensate for physical stress, muscle bulk upbuilding, psychoemotional stress and strain. Unfortunately, the analysis we conducted previously showed that the most unsatisfactory diet is observed among adolescent sportsmen, i.e. in the most difficult body development periodpuberty, which is even further complicated by considerably training and competitive stress. A child's growing body reacts especially rapidly to shortage or excess of certain nutrients in a diet with physical or emotional developmental disability, malfunction of the organs vital for homeostasis and decrease in immunity. Imbalanced nutrition in such a situation is a real threat to a child's health and, without any doubt, affects sports results [5][6][7]. We developed a complex personified approach aimed at correcting a child's diet in the course of individual consultations based on evaluation of the real diet, its chemical composition and individual preferences: body weight composition parameters (bioimpedance analysis) and the malfunctions of a child's body organs and systems revealed in the course of examination. Threpsological approach is based on the formation of an adequate diet out of regular wholesome products. However, one of the dietary issues of young sportsmen to be resolved is to provide a child with all the necessary macro-and micronutrients in a compact form. This issue is especially critical for high-level sportsmen in the process of intensive physical training, when demand of proteins, vitamins and mineral substances considerably increases in the setting of reduced ability to observe an adequate diet due to intensive training regimen. This creates a demand of using special products enriched with a certain set of nutrients. At the same time, there is a deficit of trials em...

Обоснование. Врожденный буллезный эпидермолиз (ВБЭ) относится к группе редких наследственных заболеваний с тяжелым поражением кожи. Для дистрофической формы ВБЭ характерна полиорганная патология, сопровождающаяся нарушением нутритивного статуса. Для более точной оценки нутритивного статуса, планирования и контроля эффективности нутритивной поддержки помимо антропометрических индексов важно оценивать показатели состава тела. Цель исследования-изучить возможность и целесообразность использования методов оценки состава тела у детей с дистрофической формой ВБЭ. Методы. В исследование включены 43 ребенка с дистрофической формой ВБЭ в возрасте от 2 мес жизни до 16 лет 2 мес. Антропометрические индексы Z-scores масса тела/возраст (WAZ), длина тела/ возраст (HAZ) и индекс массы тела/возраст (BAZ) оценивались с помощью компьютерной программы WHO AnthroPlus. Воздушная бодиплетизмография проводилась на аппарате PEA POD (LMi, США), предназначенном для использования у детей первых месяцев жизни. Биоимпедансометрия выполнена детям старше 6 лет по стандартной тетраполярной схеме. Результаты. Для детей с дистрофической формой ВБЭ характерно снижение индексов WAZ (-2,24±1,46) и BAZ (-2,5±1,74). Индекс BAZ ниже-3 (тяжелая недостаточность питания) зарегистрирован у 21 ребенка. Биоимпедансометрия имела существенные ограничения (поражение кожи и/или наличие рубцов в местах стандартного наложения электродов), была проведена 5 участникам исследования и дала искаженные результаты (процентное содержание жира и активной клеточной массы оказались нормальными даже у детей с умеренной и тяжелой нутритивной недостаточностью). Воздушная бодиплетизмография продемонстрировала корректные результаты, однако данный метод имел ограничения по весу ребенка и состоянию кожных покровов. Заключение. Методы оценки состава тела нецелесообразно применять в клинической практике для оценки нутритивного статуса и его динамического контроля у детей с дистрофической формой ВБЭ.

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