perinatologyРоссийский вестник перинатологии и педиатрииRossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics)1027-40652500-2228Ltd. “The National Academy of Pediatric Science and Innovation”10.21508/1027-4065-2019-64-2-117-122perinatology-867Research ArticleВ ПОМОЩЬ ПРАКТИЧЕСКОМУ ВРАЧУFOR THE PRACTITIONERНовые тенденции в назначении прикорма: теория и практикаNew trends in complementary feeding: theory and practicehttps://orcid.org/0000-0002-9110-6753ПырьеваЕ. А.PyryevaE. A.

Пырьева Екатерина Анатольевна – к.м.н., зав. лабораторией возрастной нутрициологии.

109240 Москва, Устьинский проезд, д. 2/14.

https://orcid.org/0000-0002-6023-8737СафроноваА. И.SafronovaA. I.

Сафронова Адиля Ильгизовна – к.м.н., ст. науч. сотр. лаборатории возрастной нутрициологии.

109240 Москва, Устьинский проезд, д. 2/14.

Moscow

https://orcid.org/0000-0002-9932-4720ГмошинскаяМ. В.GmoshinskayaM. V.

Гмошинская Мария Владимировна – д.м.н., вед. науч. сотр. лабораториивозрастной нутрициологии.

109240 Москва, Устьинский проезд, д. 2/14.

Moscow

https://orcid.org/0000-0002-9523-6571ТоболеваМ. А.TobolevaM. A.

Тоболева Марина Александровна – мл. науч. сотр. лаборатории возрастной нутрициологии.

109240 Москва, Устьинский проезд, д. 2/14.

Moscow

Федеральный исследовательский центр питания, биотехнологии и безопасности пищиРоссияFederal Research Center for Nutrition, Biotechnology and Food SafetyRussian Federation201915052019642117122Copyright © Ltd. “The National Academy of Pediatric Science and Innovation”, 20192019Ltd. “The National Academy of Pediatric Science and Innovation”Ltd. “The National Academy of Pediatric Science and Innovation”https://www.ped-perinatology.ru/jour/about/submissions#copyrightNoticehttps://www.ped-perinatology.ru/jour/article/view/867

В статье обсуждаются вопросы, связанные с организацией прикорма, в свете новых представлений о его роли в сохранении здоровья и развития ребенка. К наиболее дискуссионным относится потребление белка и углеводов, существенно меняющееся на фоне введения прикорма, как в количественном, так и в качественном отношении. Представлены результаты зарубежных и отечественных исследований по анализу фактического питания у детей второго полугодия жизни, новые практические рекомендации по назначению прикорма. Выявлено, что фактическое содержание белка в рекомендуемых рационах для детей старше 6 мес жизни в США и странах ЕС существенно превышает установленные за рубежом нормы потребления (ФАО/ВОЗ; EFSA, 2017), но близко к рекомендуемому уровню потребления белка в отечественной практике. Рассматривается значение фруктовых соков в питании детей первого года жизни. Дано обоснование предложений по изменению тактики назначения прикорма в отечественной педиатрической практике.

The article discusses issues related to the introduction of complementary feeding in light of new ideas about its role in preserving child’s health and development. The most controversial topic is protein and carbohydrates consumption, which is significantly changing with the introduction of complementary feeding, both in quantitative and qualitative terms. The results of foreign and domestic studies on the analysis of actual nutrition of children over 6 month old as well as new practical recommendations for introducing complementary feeding are presented. It was found that the actual protein amounts in the recommended diets for children older than 6 months of age in the USA and EU countries significantly exceeds the consumption standards established abroad (FAO / WHO; EFSA, 2017), but is close to the recommended level of protein consumption in domestic practice. Article also reviews the importance of fruit juices in the nutrition of children in the first year of life and gives the rationale for changing tactics of introducing complementary feeding in the pediatric practice in Russia.

дети раннего возрастаприкормбелоксвободные углеводыinfantscomplementary feedingproteinfree carbohydratesНаучно-исследовательская работа по подготовке рукописи проведена за счет средств субсидии на выполнение государственного задания в рамках Программы фундаментальных научных исследований государственных академий наук на 2013–2020 гг. (тема № 529-2018-0111).This work was supported by the program of fundamental research of the Russian Academy of Sciences (№529-2018-0111).ReferencesPediatric Nutrition in Practice. 2nd, revised edition. B. Koletzko (ed.). II series: World review of nutrition and dietetics, 2015; 13: 334Pediatric Nutrition in Practice. 2nd, revised edition. B. Koletzko (ed.). II series: World review of nutrition and dietetics, 2015; 13: 334Koletzko B., Symonds M.E., Olsen S.F. Programming research: where are we and where do we go from here? Am J Clin Nutr 2011; 94: 2036–2043. DOI: 10.3945/ajcn.111.018903Koletzko B., Symonds M.E., Olsen S.F. Programming research: where are we and where do we go from here? Am J Clin Nutr 2011; 94: 2036–2043. DOI: 10.3945/ajcn.111.018903Michaelsen K.F., Greer F.R. Protein needs early in life and long-term health. Am J Clin Nutr 2014; 99(3): 718–722. DOI: 10.3945/ajcn.113.072603Michaelsen K.F., Greer F.R. Protein needs early in life and long-term health. Am J Clin Nutr 2014; 99(3): 718–722. DOI: 10.3945/ajcn.113.072603Haschke F., Grathwohl D., Detzel P., Steenhout P., Wagemans N., Erdmann P. Postnatal high protein intake can contribute to accelerated weight gain of infants and increased obesity risk. Nestle Nutr Inst Workshop Ser 2016; 85: 101–109. DOI: 10.1159/000439492Haschke F., Grathwohl D., Detzel P., Steenhout P., Wagemans N., Erdmann P. Postnatal high protein intake can contribute to accelerated weight gain of infants and increased obesity risk. Nestle Nutr Inst Workshop Ser 2016; 85: 101–109. DOI: 10.1159/000439492Hörnell A., Lagström H., Lande B., Thorsdottir I. Protein intake from 0 to 18 years of age and its relation to health: a systematic literature review for the 5th Nordic Nutrition Recommendations. Food Nutr Res 2013; 57. DOI: 10.3402/fnr.v57i0.21083Hörnell A., Lagström H., Lande B., Thorsdottir I. Protein intake from 0 to 18 years of age and its relation to health: a systematic literature review for the 5th Nordic Nutrition Recommendations. Food Nutr Res 2013; 57. DOI: 10.3402/fnr.v57i0.21083Национальная программа оптимизации вскармливания детей первого года жизни в Российской Федерации (Утв. на XVI Съезде педиатров России, февраль 2009 г). М., 2011; 68.The National Program for the Optimization of the Feeding of Children of the First Year of Life in the Russian Federation. Moscow, 2011; 68. (in Russ)]Нормы физиологических потребностей в энергии и пищевых веществах для различных групп населения Российской Федерации. Методические рекомендации. М.: Федеральный центр гигиены и эпидемиологии Роспотребнадзора, 2009; 36.Norms of physiological needs for energy and nutrients for various groups of the population of the Russian Federation. Methodical recommendations. Moscow: Federal Center for Hygiene and Epidemiology of Rospotrebnadzor, 2009; 36. (in Russ)Dietary Reference Values for nutrients Summary report. European Food Safety Authority (EFSA). Approved: 4 December 2017; DOI: 10.2903/sp.efsa.2017.e15121.Dietary Reference Values for nutrients Summary report. European Food Safety Authority (EFSA). Approved: 4 December 2017; DOI: 10.2903/sp.efsa.2017.e15121.Damianidi L. Gruszfeld D. Verduci E. et al. Protein intakes and their nutritional sources during the first 2 years of life: secondary data evaluation from the European Childhood Obesity Project. Eur J Clin Nutr 2016;70:1291-1297 . DOI: 10.1038/ejcn.2016.108Damianidi L. Gruszfeld D. Verduci E. et al. Protein intakes and their nutritional sources during the first 2 years of life: secondary data evaluation from the European Childhood Obesity Project. Eur J Clin Nutr 2016;70:1291-1297 . DOI: 10.1038/ejcn.2016.108Sidnell A., Long R. Protein intakes and sources in diet of infants and young children aged 6–18 months in the United Kingdom. Proc Nutr Soc 2017; 76(OCE4): E203. DOI: 10.1017/S0029665117003652Sidnell A., Long R. Protein intakes and sources in diet of infants and young children aged 6–18 months in the United Kingdom. Proc Nutr Soc 2017; 76(OCE4): E203. DOI: 10.1017/S0029665117003652Public Health England. National Child Measurement Programme. 2016; http://www.noo.org.uk/NCMP (accessed 3rd March 2017.Public Health England. National Child Measurement Programme. 2016; http://www.noo.org.uk/NCMP (accessed 3rd March 2017.Goldbohm R.A., Rubingh C.M., Lanting C.I., Joosten K.F. Food Consumption and Nutrient Intake by Children Aged 10 to 48 Months Attending Day Care in The Netherlands. Nutrients 2016; 8(7): 428. DOI: 10.3390/nu8070428Goldbohm R.A., Rubingh C.M., Lanting C.I., Joosten K.F. Food Consumption and Nutrient Intake by Children Aged 10 to 48 Months Attending Day Care in The Netherlands. Nutrients 2016; 8(7): 428. DOI: 10.3390/nu8070428Hauta-alus H.H., Korkalo L., Holmlund-Suila E.M. Rosendahl J., Valkama S.M., Enlund-Cerulloet M. et al. Food and Nutrient Intake and Nutrient Sources in 1-Year-Old Infants in Finland: A Cross-Sectional Analysis. Nutrients 2017; 9(12): 1309. DOI: 10.3390/nu9121309Hauta-alus H.H., Korkalo L., Holmlund-Suila E.M. Rosendahl J., Valkama S.M., Enlund-Cerulloet M. et al. Food and Nutrient Intake and Nutrient Sources in 1-Year-Old Infants in Finland: A Cross-Sectional Analysis. Nutrients 2017; 9(12): 1309. DOI: 10.3390/nu9121309Heyman M.B., Abrams S.A., Fruit Juice in Infants, Children, and Adolescents: Current Recommendations. Section on gastroenterology, hepatology, and nutrition, committee on nutrition. Pediatrics 2017; 139(6): e20170967. DOI: 10.1542/peds.2017-0967Heyman M.B., Abrams S.A., Fruit Juice in Infants, Children, and Adolescents: Current Recommendations. Section on gastroenterology, hepatology, and nutrition, committee on nutrition. Pediatrics 2017; 139(6): e20170967. DOI: 10.1542/peds.2017-0967Fewtrell M., Bronsky J., Campoy C., Domellöf M., Embleton N., Fidler Mis N. et al. Complementary Feeding: A Position Paper by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) Committee on Nutrition. J Pediatr Gastroenterol Nutr 2017; 64(1): 119–132. DOI: bit.ly/2j8cMPpFewtrell M., Bronsky J., Campoy C., Domellöf M., Embleton N., Fidler Mis N. et al. Complementary Feeding: A Position Paper by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) Committee on Nutrition. J Pediatr Gastroenterol Nutr 2017; 64(1): 119–132. DOI: bit.ly/2j8cMPpБоровик Т.Э., Скворцова В.А., Лукоянова О.Л., Яцык Г.В., Пырьева Е.А., Гмошинская М.В. и др. Консенсус по вопросам вскармливания детей первого года жизни, вошедшим в обновленную редакцию «Национальной программы оптимизации вскармливания детей первого года жизни в Российской Федерации» (2019). Педиатрия. Журнал имени Г.Н. Сперанского 2019; 98(1): 210–216. DOI: 10.24110/0031-403X-2019-98-1-210-216Borovik T.E., Skvortsova V.A., Lukoyanova O.L., Jatsyk G.V., Pyrieva E.A., Gmoshinskaya M.V., et al. The consensus on infant feeding in the first year of life, which was included in the updated version of the National Program for the Optimization of Feeding Children in the First Year of Life in the Russian Federation (2019). Pediatria. 2019; 98(1): 210–216. (in Russ) DOI: 10.24110/0031-403X-2019-98-1-210-216Пырьева Е.А., Сафронова А.И., Гмошинская М.В. Особенности формирования пищевого поведения у детей в РФ на первом году жизни по данным ретроспективного исследования. Фарматека 2019; 26(1): 8–15. DOI: 10.18565/pharmateca.2019.1.8–15Pyryeva E.A., Safronova A.I., Gmoshinskaya M.V. Features of the formation of food behavior in infants in the Russian Federation according to a retrospective study. Farmateka 2019; 26(1):8–15. (in Russ) DOI: 10.18565/pharmateca.2019.1.8–15Auerbach B.J., Wolf F.M., Hikida A., Vallila-Buchman P., Littman A., Thompson D. et al. Fruit Juice and Change in BMI: A Meta-analysis. Pediatrics 2017; 139(4): e20162454. DOI: 10.1186/s12937-018-0363-9Auerbach B.J., Wolf F.M., Hikida A., Vallila-Buchman P., Littman A., Thompson D. et al. Fruit Juice and Change in BMI: A Meta-analysis. Pediatrics 2017; 139(4): e20162454. DOI: 10.1186/s12937-018-0363-9Braegger C., Bronsky J., Campoy C., Domellöf M., Embleton N.D., Hojsak I. Sugar in infants, children and adolescents: A position paper of the ESPGHAN Committee on Nutrition Mis, NF. 2017; 54.Braegger C., Bronsky J., Campoy C., Domellöf M., Embleton N.D., Hojsak I. Sugar in infants, children and adolescents: A position paper of the ESPGHAN Committee on Nutrition Mis, NF. 2017; 54.Конь И.Я., Гмошинская М.В., Георгиева О.В., Абрамова Т.В., Куркова В.И., Шевякова Л.В. и др. Использование соков прямого отжима в питании детей первого года жизни. Российский вестник перинатологии и педиатрии 2015; 60(4): 125–130.Kon I.Yu., Gmoshinskaya M.V., Georgieva O.V., Abramova T.V., Kurkova V.I., Shevyakova L.V. et al. Use of fresh squeezed juices in the feeding of infants during the first year of life. Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics) 2015; 60(4): 125–130. (in Russ)Perez-Escamilla R., Segura-Perez S., Lott M. On behalf of the RWJF HER Expert Panel on Best Practices for Promoting Healthy Nutrition Feeding Patterns, and Weight Status for Infants and Toddlers from Birth to 24 Months. Feeding Guidelines for Infants and Young Toddlers: A Responsive Parenting Approach. Durham, NC, Healthy Eating Research, 2017; http://healthyeatingresearch.orgPerez-Escamilla R., Segura-Perez S., Lott M. On behalf of the RWJF HER Expert Panel on Best Practices for Promoting Healthy Nutrition Feeding Patterns, and Weight Status for Infants and Toddlers from Birth to 24 Months. Feeding Guidelines for Infants and Young Toddlers: A Responsive Parenting Approach. Durham, NC, Healthy Eating Research, 2017; http://healthyeatingresearch.orgNicklaus S. Complementary feeding strategies to facilitate acceptance of fruits and vegetables: A narrative review of the literature. Int J Envir Res Public Health 2016; 13(11): 1160. DOI: 10.3390/ijerph13111160Nicklaus S. Complementary feeding strategies to facilitate acceptance of fruits and vegetables: A narrative review of the literature. Int J Envir Res Public Health 2016; 13(11): 1160. DOI: 10.3390/ijerph13111160

The authors declare that there are no conflicts of interest present.