vspВопросы современной педиатрииCurrent Pediatrics1682-55271682-5535Издательство «ПедиатрЪ»10.15690/vsp.v14i3.1375vsp-703Research ArticleОБМЕН ОПЫТОМEXCHANGE OF EXPERIENCEБелок в период введения прикорма: сколько нужно для здоровья?Proteins in Complementary Food: What Is the Healthiest Level?НетребенкоО. К.NetrebenkoО. K.

доктор медицинских наук, профессор кафедры госпитальной педиатрии No 1 РНИМУ им. Н.И. Пирогова 

Olga.Netrebenko@ru.nestle.comДубровскаяМ. И.DubrovskayaМ. I.Российский национальный исследовательский медицинский университет им. Н.И. Пирогова, Москва, Российская ФедерацияРоссияPirogov Russian National Research Medical University, Moscow, Russian FederationRussian Federation201525082015143Вопросы современной педиатрии387391Copyright © Нетребенко О.К., Дубровская М.И., 20152015Нетребенко О.К., Дубровская М.И.Netrebenko О.K., Dubrovskaya М.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vsp.spr-journal.ru/jour/article/view/703

Проблема адекватного потребления белка детьми грудного возраста вызывает многочисленные дискуссии. Это связано, во-первых, с развитием нового научного направления «Младенческие истоки здоровья и болезней человека», которое прямо указывает, что избыточное потребление белка в младенчестве имеет долговременные последствия и играет важную роль в развитии ожирения и хронических неинфекционных заболеваний у взрослых, а, во-вторых, с появлением новых технологий, позволяющих усовершенствовать белковый компонент смесей и приблизить его качество и количество к таковому белков грудного молока. Высокий уровень потребления белка связан с искусственным вскармливанием, т. к. количество белка в стартовых и последующих смесях выше по сравнению с грудным молоком. Высокое содержание белка в рационе стимулирует продукцию инсулиногенных аминокислот, инсулина и инсулиноподобного фактора роста (IGF-1). Сочетание высокого уровня IGF-1 и аминокислот с разветвленной цепью (лейцин, валин, изолейцин, треонин) активирует комплекс сигнальных молекул (mTOR), ответственных за интеграцию метаболического и иммунного ответа. Повторяющаяся активация mTOR при регулярном потреблении повышенного уровня молочного белка в младенчестве связана с нарушением здоровья во взрослом возрасте. Такие заболевания, как сахарный диабет 2-го типа, ожирение, артериальная гипертензия, рак (в особенности рак простаты), связаны с избыточной активацией сигнального комплекса mTOR. Активное потребление молока в современном мире является главным стимулом активации mTOR с увеличением риска развития болезней цивилизации и важным механизмом их развития. Развитие индустрии детского питания позволяет снизить уровень белка в стартовых и последующих смесях до 12 г/л и, соответственно, снизить риск развития неинфекционных заболеваний в старшем возрасте. 

Adequate protein consumption in infants is a heavily debated issue. First, it is related to the formation of a new scientific field — “Infant prerequisites of man’s wellness and illness,” which directly indicates that excessive intake of proteins during infancy has long-term consequences and greatly contributes to obesity and chronic infectious diseases in adults; second, it is related to new technologies, which improve the protein component of infant formulas and bring them at par with breast milk in terms of quality and quantity. High protein consumption is related to bottle feeding, because starter and further infant formulas are richer in protein than breast milk. Protein-rich menus trigger production of insulinogenic amino acids, insulin and the insulin-like growth factor (IGF-1). High IFTcombined with branched-chain amino acids (leucine, valine, isoleucine, threonine) activates a set of signalling molecules (mTOR), which are responsible for integrating metabolic and immune response. Repeated activation of mTOR coupled with regular intake of high-protein infant formulas causes health issues in adulthood. Diseases like diabetes type 2, obesity, arterial hypertension, cancer (particularly prostatic cancer), are related to overactivation of the mTOR signalling molecule complex. Intensive consumption of milk in today’s world is the key mTOR activator contributing to an increased risk of lifestyle diseases and triggering the mechanism of their development. The progressing infant formula industry allows to cut protein levels in starter and further infant formulas down to 12 g/l and, respectively, lower the risk of non-infectious diseases in adulthood. 

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