vspВопросы современной педиатрииCurrent Pediatrics1682-55271682-5535Издательство «ПедиатрЪ»10.15690/vsp.v14i1.1271vsp-87Research ArticleОБМЕН ОПЫТОМEXCHANGE OF EXPERIENCEАЛИМЕНТАРНЫЕ ФАКТОРЫ ФОРМИРОВАНИЯ КОСТНОЙ ТКАНИ У ДЕТЕЙ И ПОДРОСТКОВ. ПУТИ ПРОФИЛАКТИКИ ВОЗМОЖНЫХ НАРУШЕНИЙALIMENTARY FACTORS OF BONE TISSUE DEVELOPMENT IN CHILDREN AND ADOLESCENTS. PREVENTIVE MEASURES AGAINST POTENTIAL DISORDERSВолковаЛ. Ю.VolkovaL. Yu.

кандидат медицинских наук, ассистент кафедры диетологии и нутрициологии РМАПО

volkova2912@gmail.comРоссийская медицинская академия последипломного образования, Москва, Российская ФедерацияРоссияRussian Medical Academy for Postgraduate Education, Moscow, Russian FederationRussian Federation201514022015141Вопросы современной педиатрии124131Copyright © Волкова Л.Ю., 20152015Волкова Л.Ю.Volkova L.Y.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/87

Современное питание детей и подростков характеризуется сниженным потреблением кальция, количество которого в рационе питания составляет в среднем около 500 мг/сут. Дефицит потребления кальция в основном обусловлен недостаточным потреблением молока и кисломолочных продуктов. Дети ежесуточно потребляют 150–250 мл молочных продуктов, что втрое ниже рекомендуемого объема. Во многом это обусловлено изменением пищевых предпочтений детей и подростков: увеличением потребления продуктов-источников «простых» углеводов и насыщенных жиров. Недостаток молочных продуктов в рационе детей и подростков повышает риск повреждений опорно-двигательного аппарата и развития остеопении и остеопороза. Эффективным способом профилактики нарушений формирования костной ткани и процессов ее минерализации в детском возрасте является включение в ежедневный рацион молока и молочных продуктов в количестве 450–500 мл, которые обеспечивают поступление 1200–1300 мг кальция в сутки. Данные меры доступны широкому кругу населения и позволяют охватить профилактическими мероприятиями максимальное число детей и подростков.

The nutrition of children and adolescents nowadays often consists of the reduced calcium amount, which daily measure in a food intake averages about 500 mg. The calcium intake deficiency is mainly caused by underconsumption of milk and fermented milk products. Children eat 150–250 ml of dairy products per day that is three times less than recommended dose. This situation arises due to changing of children and adolescents’ eating preferences: increased consumption of simple carbohydrates and saturated fat. Dairy product deficiency increases the risk of orthopaedic injuries, osteopenia and osteoporosis development in children and adolescents. Milk and dairy products included in the daily food intake in the amount of 450–500 ml are effective preventive measures against bone tissue development and bone mineralization disorders in children. The said amount assures a daily supply of 1200–1300 mg of calcium. These measures are available to general public, and allow to apply preventive measures to most children and adolescents.

 

детиподросткипитаниекальциймолочные продуктыостеопорозпрофилактикаchildrenadolescentsnutritioncalciummilk productsosteoporosispreventionReferencesVolkova L.Yu. Alimentarnye faktory formirovaniya kostnoy tkani u detey [Dietary Factors of the Bone Tissue Formation in Children]. Meditsinskoe obsluzhivanie i organizatsiya pitaniya v DOU = Medical Care and Nutrition in Preschool Educational Institutions. 2013;10:66–72.Volkova L.Yu. Alimentarnye faktory formirovaniya kostnoy tkani u detey [Dietary Factors of the Bone Tissue Formation in Children]. Meditsinskoe obsluzhivanie i organizatsiya pitaniya v DOU = Medical Care and Nutrition in Preschool Educational Institutions. 2013; 10: 66–72.Stennikova O.V., Levchuk L.V. Fiziologicheskaya rol' kal'tsiya i vitamina D: vozmozhnosti pishchevoy korrektsii defitsita u detey doshkol'nogo i mladshego shkol'nogo vozrasta [Physiological Role of Calcium and Vitamin D: Possible Food Deficiency Correction in Preschool and Primary School-Aged Children]. Voprosy sovremennoi pediatrii = Current Pediatrics. 2010;9(2):141–145.Stennikova O.V., Levchuk L.V. Fiziologicheskaya rol' kal'tsiya i vitamina D: vozmozhnosti pishchevoy korrektsii defitsita u detey doshkol'nogo i mladshego shkol'nogo vozrasta [Physiological Role of Calcium and Vitamin D: Possible Food Deficiency Correction in Preschool and Primary School-Aged Children]. Voprosy sovremennoi pediatrii = Current Pediatrics. 2010; 9 (2): 141–145.Shcheplyagina L.A., Rimarchuk G.V., Samokhina Ye.O., Tyurina T.K., Chibrina Ye.V., Kruglova I.V. Kostnaya prochnost' u detey: izvestnye i neizvestnye fakty. Uch. pos. [Bone Strength in Children: Well-Known and Unknown Facts. Manual] Мoscow, 2010. 16 p.Shcheplyagina L.A., Rimarchuk G.V., Samokhina Ye.O., Tyurina T.K., Chibrina Ye.V., Kruglova I.V. Kostnaya prochnost' u detey: izvestnye i neizvestnye fakty. Uch. pos. [Bone Strength in Children: Well-Known and Unknown Facts. Manual] М. 2010. 16 p.Kon' I.Ya., Tutel'yan V.A. Uglitskikh A.K., Volkova L.Yu. Ratsional'noe pitanie rossiyskikh shkol'nikov: problemy i puti ikh preodoleniya [Rational Nutrition of School Children in Russia: Problems and Ways to Solve Them]. Zdorov’e naseleniya i sreda obitaniya = Public health and environment. 2008;7(184):4–5.Kon' I.Ya., Tutel'yan V.A. Uglitskikh A.K., Volkova L.Yu. Ratsional'noe pitanie rossiyskikh shkol'nikov: problemy i puti ikh preodoleniya [Rational Nutrition of School Children in Russia: Problems and Ways to Solve Them]. Zdorov’e naseleniya i sreda obitaniya = Public health and environment. 2008; 7 (184): 4–5.Baturin A.K., Ogloblin N.A., Volkova L.Yu. Rezul'taty izucheniya potrebleniya kal'tsiya v Rossiyskoy Federatsii [Results from the Study of Calcium Intake in the Russian Federation]. Voprosy detskoi dietologii = Problems of Pediatric Nutritiology. 2006;4(5):12–16.Baturin A.K., Ogloblin N.A., Volkova L.Yu. Rezul'taty izucheniya potrebleniya kal'tsiya v Rossiyskoy Federatsii [Results from the Study of Calcium Intake in the Russian Federation]. Voprosy detskoi dietologii = Problems of Pediatric Nutritiology. 2006; 4 (5): 12–16.Kon' I.Ya., Volkova L.Yu., Ivanovskaya G.V., Davudi Kh. Pishchevye predpochteniya detey shkol'nogo vozrasta v otnoshenii moloka i molochnykh produktov [Food Preferences of School Children in Relation to Milk and Dairy Products]. Voprosy detskoi dietologii = Problems of Pediatric Nutritiology. 2006;4(2):47–49.Kon' I.Ya., Volkova L.Yu., Ivanovskaya G.V., Davudi Kh. Pishchevye predpochteniya detey shkol'nogo vozrasta v otnoshenii moloka i molochnykh produktov [Food Preferences of School Children in Relation to Milk and Dairy Products]. Voprosy detskoi dietologii = Problems of Pediatric Nutritiology. 2006; 4 (2): 47–49.Kon' I.Ya., Volkova L.Yu., Sannikova N.Ye, Dzhumagaziev A.A., Alyoshina I.V., Toboleva M.A., Korosteleva M.M. Svyaz' mezhdu izbytochnoy massoy tela i fakticheskoe potreblenie konditerskikh izdeliy, produktov bystrogo prigotovleniya (fastfood) i sladkikh gazirovannykh napitkov. Mul'titsentrovoe issledovanie rossiyskikh shkol'nikov [Relationship between Overweight and Actual Consumption of Confectionery Products, Fast Food and Carbonated Soft Drinks. Multicenter Study of Russian School Children]. Voprosy pitaniya = Problems of Nutrition. 2010;79(1):52–55.Kon' I.Ya., Volkova L.Yu., Sannikova N.Ye, Dzhumagaziev A.A., Alyoshina I.V., Toboleva M.A., Korosteleva M.M. Svyaz' mezhdu izbytochnoy massoy tela i fakticheskoe potreblenie konditerskikh izdeliy, produktov bystrogo prigotovleniya (fastfood) i sladkikh gazirovannykh napitkov. Mul'titsentrovoe issledovanie rossiyskikh shkol'nikov [Relationship between Overweight and Actual Consumption of Confectionery Products, Fast Food and Carbonated Soft Drinks. Multicenter Study of Russian School Children]. Voprosy pitaniya = Problems of Nutrition. 2010; 79 (1): 52–55.Saigitov R.T. Regulyarnoe upotreblenie moloka i molochnykh produktov i ikh vliyanie na mineral'nuyu plotnost' kostnoy tkani u detey: sistematicheskiy obzor [Regular Consumption of Milk and Dairy Products and their Effect on the Bone Mineral Density in Children: Systematic Review]. Voprosi sovremennoi pediatrii = Current Pediatrics. 2008;7(6):72–77.Saigitov R.T. Regulyarnoe upotreblenie moloka i molochnykh produktov i ikh vliyanie na mineral'nuyu plotnost' kostnoy tkani u detey: sistematicheskiy obzor [Regular Consumption of Milk and Dairy Products and their Effect on the Bone Mineral Density in Children: Systematic Review]. Voprosi sovremennoi pediatrii = Current Pediatrics. 2008; 7 (6): 72–77.Shilin D.Ye. Kal'tsiy, vitamin D i formirovanie zdorovogo skeleta. Uch.pos. dlya vrachey, klinicheskikh ordinatorov, internov, studentov [Calcium, Vitamin D and Development of a Healthy Skeleton. Textbook for Doctors, Residents, Interns, Students]. Moscow, 2008. 60 p.Shilin D.Ye. Kal'tsiy, vitamin D i formirovanie zdorovogo skeleta. Uch.pos. dlya vrachey, klinicheskikh ordinatorov, internov, studentov [Calcium, Vitamin D and Development of a Healthy Skeleton. Textbook for Doctors, Residents, Interns, Students]. Moscow, 2008. 60 p.Shcheplyagina L.A., Moiseeva T.Yu., Kovalenko M.V., Kruglova I.V., Arsen'yeva Ye.N., Bakanov M.I., Volkov I.K. Osteopenii u detey: diagnostika, profilaktika i korrektsiya. Pos. dlya vrachey [Osteopenia in Children: Diagnosis, Prevention and Correction. Manual for Doctors]. Moscow, 2005. 40 p.Shcheplyagina L.A., Moiseeva T.Yu., Kovalenko M.V., Kruglova I.V., Arsen'yeva Ye.N., Bakanov M.I., Volkov I.K. Osteopenii u detey: diagnostika, profilaktika i korrektsiya. Pos. dlya vrachey [Osteopenia in Children: Diagnosis, Prevention and Correction. Manual for Doctors]. Moscow, 2005. 40 p.Mal'tsev S.V., Arkhipova N.N. Osteoporoz — «pediatricheskaya problema s geriatricheskimi posledstviyami» [Osteoporosis – ‘Pediatric Problem with Geriatric Consequences’]. Prakticheskaya meditsina = Practical medicine. 2008;7(31):14–17.Mal'tsev S.V., Arkhipova N.N. Osteoporoz — «pediatricheskaya problema s geriatricheskimi posledstviyami» [Osteoporosis – ‘Pediatric Problem with Geriatric Consequences’]. Prakticheskaya meditsina = Practical medicine. 2008; 7 (31): 14–17.Khimicheskiy sostav rossiyskikh pishchevykh produktov. Spravochnik [Chemical Composition of Russian Food. Reference Book]. Ed. by Skurikhin I.M., Tutel’yan V.A. Moscow, DeLiprint, 2002, 12 p.Khimicheskiy sostav rossiyskikh pishchevykh produktov. Spravochnik [Chemical Composition of Russian Food. Reference Book]. Ed. by Skurikhin I.M., Tutel’yan V.A. Moscow, DeLiprint, 2002, 12 p.Nikolaeva S.V. Znachenie kal'tsiya i vitamina D dlya detey [Value of Calcium and Vitamin D for Children]. Pediatriya = Pediatrics. Consilium medicum. 2012;3:33–36.Nikolaeva S.V. Znachenie kal'tsiya i vitamina D dlya detey [Value of Calcium and Vitamin D for Children]. Pediatriya = Pediatrics. Consilium medicum. 2012; 3: 33–36.Pilat T.L., Kuz'mina L.P., Izmerova N.I. Detoksikatsionnoe pitanie [Detoxification Nutrition]. Moscow, GEOTAR-Media, 2012.Pilat T.L., Kuz'mina L.P., Izmerova N.I. Detoksikatsionnoe pitanie [Detoxification Nutrition]. Moscow, GEOTAR-Media, 2012.Normy fiziologicheskikh potrebnostey v energii i pishchevykh veshchestvakh dlya razlichnykh grupp naseleniya Rossiyskoy Federatsii. Metodicheskie rekomendatsii. MR 2.3.1.2432-08», utv. Rospotrebnadzorom 18.12.2008 g [Standard Physiological Needs for Energy and Nutrients for Different Groups of Population in the Russian Federation. Recommended Practices RP 2.3.1.2432-08 approved by the Federal Service for Supervision of Consumer Rights Protection and Human Welfare 18.12.2008].Normy fiziologicheskikh potrebnostey v energii i pishchevykh veshchestvakh dlya razlichnykh grupp naseleniya Rossiyskoy Federatsii. Metodicheskie rekomendatsii. MR 2.3.1.2432-08», utv. Rospotrebnadzorom 18.12.2008 g [Standard Physiological Needs for Energy and Nutrients for Different Groups of Population in the Russian Federation. Recommended Practices RP 2.3.1.2432-08 approved by the Federal Service for Supervision of Consumer Rights Protection and Human Welfare 18.12.2008].Sheplyagina L.A., Petrova I.N., Moiseeva T.Yu. and etc. Istoki osteoporoza vzroslykh lezhat v detskom vozraste [Adult Osteoporosis Has its Origins in Childhood]. Lechenie i profilaktika = Treatment and Prevention. 2003;1(5):5–12.Sheplyagina L.A., Petrova I.N., Moiseeva T.Yu. and etc. Istoki osteoporoza vzroslykh lezhat v detskom vozraste [Adult Osteoporosis Has its Origins in Childhood]. Lechenie i profilaktika = Treatment and Prevention. 2003; 1 (5): 5–12.Korolev A.A., Perelygina O.V., Kon' I.Ya., Nikitenko Ye.I., Shilina N.M. Izmenenie sostoyaniya pitaniya detey v period godichnogo nablyudeniya pri perekhode iz doshkol'nogo obrazovatel'nogo uchrezhdeniya v shkolu [Change in the Nutritional Status of Children over One-Year Period under the Observation When Going from the Preschool Educational Institution to the School]. Rossiyskiy mediko-biologicheskiy vestnik = Russian Medical and Biological Gazette. 2011;3:23–29.Korolev A.A., Perelygina O.V., Kon' I.Ya., Nikitenko Ye.I., Shilina N.M. Izmenenie sostoyaniya pitaniya detey v period godichnogo nablyudeniya pri perekhode iz doshkol'nogo obrazovatel'nogo uchrezhdeniya v shkolu [Change in the Nutritional Status of Children over One-Year Period under the Observation When Going from the Preschool Educational Institution to the School]. Rossiyskiy mediko-biologicheskiy vestnik = Russian Medical and Biological Gazette. 2011; 3: 23–29.Khosla S., Melton L.J., 3rd, Dekutoski M.B., Achenbach S.J., Oberg A.L., Riggs B.L. Incidence of childhood distal forearm fractures over 30 years: a populationbased study. JAMA. 2003;290(11):1479–1485.Khosla S., Melton L.J., 3rd, Dekutoski M.B., Achenbach S.J., Oberg A.L., Riggs B.L. Incidence of childhood distal forearm fractures over 30 years: a populationbased study. JAMA. 2003; 290 (11): 1479–1485.Konstantynowicz J., Nguyen T.V., Kaczmarski M., Jamiolkowski J., Piotrowska-Jastrzebska J., Seeman E. Fractures during growth: potential role of a milk-free diet. Osteoporos Int. 2007;18(12):1601–1607.Konstantynowicz J., Nguyen T.V., Kaczmarski M., Jamiolkowski J., Piotrowska-Jastrzebska J., Seeman E. Fractures during growth: potential role of a milk-free diet. Osteoporos Int. 2007; 18 (12): 1601–1607.Pires L.A., Souza A.C., Laitano O., Meyer F. Bone mineral density, milk intake and physical activity in boys who suffered forearm fractures. J. Pediatr. (Rio J.). 2005;81(4):332–336.Pires L.A., Souza A.C., Laitano O., Meyer F. Bone mineral density, milk intake and physical activity in boys who suffered forearm fractures. J. Pediatr. (Rio J.). 2005; 81 (4): 332–336.Cadogan J., Eastell R., Jones N., Barker M.E. Milk intake and bone mineral acquisition in adolescent girls: randomised, controlled intervention trial. BMJ. 1997;315(7118):1255–1260.Cadogan J., Eastell R., Jones N., Barker M.E. Milk intake and bone mineral acquisition in adolescent girls: randomised, controlled intervention trial. BMJ. 1997; 315 (7118): 1255–1260.Merrilees M.J., Smart E.J., Gilchrist N.L., Frampton C., Turner J.G., Hooke E., March R.L., Maguire P. Effects of diary food supplements on bone mineral density in teenage girls. Eur. J. Nutr. 2000;39(6):256–262.Merrilees M.J., Smart E.J., Gilchrist N.L., Frampton C., Turner J.G., Hooke E., March R.L., Maguire P. Effects of diary food supplements on bone mineral density in teenage girls. Eur. J. Nutr. 2000; 39 (6): 256–262.He M., Yang Y.X., Han H., Men J.H., Bian LH., Wang G.D. Effects of yogurt supplementation on the growth of preschool children in Beijing suburbs. Biomed. Environ. Sci. 2005;18(3):192–197.He M., Yang Y.X., Han H., Men J.H., Bian LH., Wang G.D. Effects of yogurt supplementation on the growth of preschool children in Beijing suburbs. Biomed. Environ. Sci. 2005; 18 (3): 192–197.Chan G.M., Hoffman K., McMurry M. Effects of dairy products on bone and body composition in pubertal girls. J. Pediatr. 1995;126(4):551–556.Chan G.M., Hoffman K., McMurry M. Effects of dairy products on bone and body composition in pubertal girls. J. Pediatr. 1995;126 (4): 551–556.Renner E., Hermes M., Stracke H. Bone mineral density of adolescents as affected by calcium intake through milk and milk products. Int. Dairy J. 1998;8(9):759–764.Renner E., Hermes M., Stracke H. Bone mineral density of adolescents as affected by calcium intake through milk and milk products. Int. Dairy J. 1998; 8 (9): 759–764.Lau E.M., Lynn H., Chan Y.H., Lau W., Woo J. Benefits of milk powder supplementation on bone accretion in Chinese children. Osteoporos Int. 2004;15(8):654–658.Lau E.M., Lynn H., Chan Y.H., Lau W., Woo J. Benefits of milk powder supplementation on bone accretion in Chinese children. Osteoporos Int. 2004; 15 (8): 654–658.Shcheplyagina L.A., Moiseeva T.Yu., Marchenko T.K., Bakanov M.I., Botvin'yeva V.V. Effektivnost' pishchevoy korrektsii defitsita kal'tsiya u detey doshkol'nogo vozrasta [Effectiveness of Nutritional Correction of Calcium Deficiency in Preschool Children]. Voprosy sovremennoi pediatrii = Current Pediatrics. 2004;3(6):87–92.Shcheplyagina L.A., Moiseeva T.Yu., Marchenko T.K., Bakanov M.I., Botvin'yeva V.V. Effektivnost' pishchevoy korrektsii defitsita kal'tsiya u detey doshkol'nogo vozrasta [Effectiveness of Nutritional Correction of Calcium Deficiency in Preschool Children]. Voprosy sovremennoi pediatrii = Current Pediatrics. 2004; 3 (6): 87–92.Izvlechenie iz «Sanitarno-epidemiologicheskie trebovaniya k ustroystvu, soderzhaniyu i organizatsii rezhima raboty doshkol'nykh obrazovatel'nykh organizatsiy». SanPiN 2.4.1.3049-13 [Extract from the Sanitary and Epidemiological Requirements for Arrangement, Content and Organization Mode of Preschool Educational Institutions. Sanitary Regulations and Standards 2.4.1.3049-13].Izvlechenie iz «Sanitarno-epidemiologicheskie trebovaniya k ustroystvu, soderzhaniyu i organizatsii rezhima raboty doshkol'nykh obrazovatel'nykh organizatsiy». SanPiN 2.4.1.3049-13 [Extract from the Sanitary and Epidemiological Requirements for Arrangement, Content and Organization Mode of Preschool Educational Institutions. Sanitary Regulations and Standards 2.4.1.3049-13].Izvlechenie iz «Sanitarno-epidemiologicheskie trebovaniya k organizatsii pitaniya obuchayushchikhsya v obshcheobrazovatel'nykh uchrezhdeniyakh, uchrezhdeniyakh nachal'nogo i srednego professional'nogo obrazovaniya».SanPiN 2.4.5.2409–08 [Extract from the Sanitary and Epidemiological Requirements for Pupils’ Nutrition Organization in General Education Institutions, Institutions of Primary and Secondary Vocational Education. Sanitary Regulations and Standards 2.4.5.2409–08].Izvlechenie iz «Sanitarno-epidemiologicheskie trebovaniya k organizatsii pitaniya obuchayushchikhsya v obshcheobrazovatel'nykh uchrezhdeniyakh, uchrezhdeniyakh nachal'nogo i srednego professional'nogo obrazovaniya».SanPiN 2.4.5.2409–08 [Extract from the Sanitary and Epidemiological Requirements for Pupils’ Nutrition Organization in General Education Institutions, Institutions of Primary and Secondary Vocational Education. Sanitary Regulations and Standards 2.4.5.2409–08].

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