Fermented milk products for children under 1 year of age: what, when and how much?

• When is nutrition prescribed for high acidity?
• Foods for high acidity
• Nutrition menu for high acidity

A balanced and nutritious diet is the basis of our good health and well-being.
Today, more and more people adhere to a healthy lifestyle, thereby maintaining their health and avoiding many diseases. But what to do when the disease has already developed? When our body has a certain feature that forces us to follow a certain daily routine, diet, or take medications. Nutrition for high acidity is a specific direction in dietetics, created to meet the needs of people with dysfunction of the digestive tract. Who should eat for high acidity? What is this diet?

What foods should be excluded or limited?

Proper nutrition is the key to the normal functioning of the digestive tract. People suffering from stomach and intestinal disorders (heartburn, belching, diarrhea or constipation, increased formation of gases) should exclude or significantly limit the consumption of such foods and dishes as:

1. all confectionery products;
2. fatty fried foods;
3. smoked meats;
4. pickles;
5. onions, garlic and all vegetables with a strong taste;
6. tomatoes (especially pickled ones);
7. apples;
8. all citrus fruits, especially lemons;
9. coffee;
10. It is forbidden to add vinegar to food.

Important! The combination of such foods with high acidity is very dangerous for health, because it causes serious complications. Spices contribute to increased acidity, so they should be limited.

Description

The stomach always produces hydrochloric acid. If this organ functions normally, then it does not destroy its mucosa, the walls of the esophagus and the duodenum. Hydrochloric acid helps neutralize pathogenic microorganisms, so it is necessary for the normal functioning of the digestive tract.

But disruption of the processes of secretion and neutralization of hydrochloric acid leads to an increase in its content in gastric juice. An excess of this substance causes:

• stomach burn;
• pathological activity of Helicobacter;
• intoxication with chemicals;
• pathological disorders of pancreatic functioning;
• liver diseases.
• The most severe complications of this condition are oncological pathologies and the development of a perforated ulcer.

Fermented milk products: modern trends

Fermented milk products (FMP) have been an important component of nutrition for both children and adults for many centuries. For most Europeans, the era of their widest use began in the first half of the 20th century. after the discovery by I.I. Mechnikov of the positive role of fermented milk flora on the processes occurring in the gastrointestinal tract (GIT) and the human body as a whole. A new round of interest in them arose in the 1960s with the advent of the concept of functional nutrition. Yoghurts came to Russia much later; Today in our country they are popular along with traditional products (yogurt, Varents, fermented baked milk, kefir).

At the very beginning of the 20th century. I. I. Mechnikov and the staff of his laboratory focused on the question of whether fermented milk fermentation is really capable of preventing “intestinal putrefaction.” Of particular interest to them was a microorganism isolated from the KMPr yaurt, common in the Balkans - it was called “Bulgarian bacillus” (according to modern nomenclature - Lactobacillus bulgaricus). This interest was also due to the fact that L. bulgaricus produces a significant amount of lactic acid, but does not produce alcohol (unlike, for example, microorganisms that produce kefir). As a result of serious and painstaking research, the properties of this microorganism were studied, and a recipe for the prototype of modern yogurt was developed. I.I. Mechnikov himself, his colleagues and acquaintances, who have been drinking this drink for many years (sometimes called “Mechnikov’s curdled milk”), were convinced of its valuable qualities from their own experience.

The Codex Alimentarius in 1992 defined yogurt as “a product of curdled milk resulting from the activity of Lactobacillus bulgaricus and Streptococcus thermophilus” [1]. Currently, other lactic acid bacteria are introduced for the preparation of yoghurts, which have a synergistic effect with the two basic components.

The importance of yoghurts (as well as other CMPR) for human health is determined by their nutritional properties as a dairy product. However, their main advantage is the ability to deliver fermented milk flora and its metabolites into our body. The two sides are closely interconnected and complement each other. The fermented milk flora itself, having entered the human gastrointestinal tract as part of yogurt, primarily contributes to the restoration of intestinal microbiocenosis, providing an example of a probiotic effect.

In his work “Studies of Optimism” (1907), I. I. Mechnikov wrote: “In the fight against intestinal putrefaction, lactic acid bacteria should be introduced into the body. Since these bacteria are able to acclimatize in the human intestinal canal, finding substances containing sugar in it for nutrition, they can produce disinfectants and serve the benefit of the organism in which they live” [2].

Analyzing both his own data and information gleaned from contemporary literature, I. I. Mechnikov notes that the effect of lactic acid bacteria on the processes occurring in the gastrointestinal tract is due not only to their production of lactic acid, but also to unknown other metabolites and interaction with host organism. He draws attention to the fact that a similar effect is achieved not only by a live culture of lactic acid bacteria introduced into the intestines in an experiment, but also by a heat-treated culture in which the microorganisms themselves died, but the metabolic products were preserved.

Currently, living microorganisms that positively influence the composition of the intestinal microbiocenosis and support its functional activity are referred to as “probiotics,” and KMPr are one of the ways of their delivery to the body. Many mechanisms of their action, unknown in the time of I.I. Mechnikov, began to become clear only in recent years. It has become obvious that the importance of intestinal microorganisms is very diverse: it includes anti-infective protection, energy supply to the colon, regulation of the absorption of minerals and water, synthesis of vitamins B and K, participation in the regulation of lipid and nitrogen metabolism, regulation of intestinal motility and numerous immune functions. functions. In double-blind, placebo-controlled studies, it was proven that, in addition to L. bulgaricus and S. termophilus, L. acidophilus, L. rhamnosus, L. fermentum, S. faecium SF68, Bifidobacterium bifidum have a probiotic effect when administered externally. Yoghurts can be fully classified as products with probiotic properties, but their nutritional significance is quite high.

The nutritional value of yoghurts is determined, firstly, by the composition of the milk from which they are obtained. Cow's milk is an important source of high-quality protein, calcium, sodium, phosphorus, magnesium, zinc, and B vitamins [3]. The content of these ingredients in the final product is determined by many factors, including the nature of the microflora that can utilize them for their metabolism, as well as the production process, including heat treatment, pasteurization, ultrafiltration, shaking and oxidation.

The protein content in yoghurt is higher than in milk, which is due to the peculiarities of the production process, however, these proteins are easier to digest and assimilate due to their preliminary breakdown by bacteria [4, 5]. In particular, yoghurts contain significant quantities of the free amino acids proline and glycine. If the viability of bacterial cultures is maintained after the completion of the production cycle, the amount of free amino acids increases by 2 times during the first 24 hours and another 2 times over the next 21 days when stored at a temperature of +7°C [6]. At the same time, the proteolytic activity of S. thermophilus exceeds that of L. bulgaricus both at the stage of product production and during its storage. In general, the nutritional value of the protein component of milk does not decrease during the production of yoghurts, while the rate of digestion and the availability of amino acids for intestinal absorption when consuming yoghurts are significantly higher compared to the corresponding indicators of milk [7, 8].

L. bulgaricus and S. thermophilus actively break down lactose both during the production of yoghurt (lactose content is reduced by at least 20–30%) and in the human intestine if they reach it alive, which determines the high tolerance of yoghurts by persons with lactase deficiency [ 9, 10, 11].

The lipase activity of yoghurt cultures is minimal. At the same time, yoghurts contain a fairly large amount of linoleic acid and its derivatives, which are apparently formed during microbial fermentation [12].

Many lactic acid bacteria consume significant amounts of vitamin B12 for their needs, although some strains, on the contrary, actively synthesize it [13, 14, 15]. Some of the lactic acid bacteria synthesize folic acid: the folate content in yogurt can reach 4–19 μg/100 g [14], usually in the form of 5-methyl-tetrahydrofolate [16]. Folate producers, in particular, are S. thermophilus and bifidobacteria, while lactobacilli reduce their content to varying degrees [17]. The final folate content of yogurt is determined by the ratio of metabolic activities of the different strains of bacteria used to produce it.

Milk and dairy products are an important source of calcium, magnesium and phosphorus. Due to the relatively low pH values ​​in yogurt, calcium and magnesium are in an ionized state, which facilitates their absorption in the intestine and reduces the inhibitory effect of phytic acid on this process. Studies on rats have shown higher absorption of calcium and its incorporation into bone mineralization in animals fed yogurt compared to rats on a regular diet [18, 19].

One of the most important functions of normal intestinal microflora is its immunomodulatory effect as an important component of nonspecific anti-infective human defense. This effect is determined, in particular, by the influence of the elements of the cell wall of bacteria that make up the normal microbiocenosis of the gastrointestinal tract on the processes of differentiation of T-lymphocytes. As a result of this effect, the subpopulation of Th-1 lymphocytes, which provide an anti-infectious immune response, increases, while the number of the subpopulation of Th-2 lymphocytes, which determine atopic reactions, decreases. In addition, the subpopulation of Th-3 lymphocytes, which control the development of immunological tolerance, increases. Thus, the normal composition of the intestinal microflora contributes, on the one hand, to adequate resistance to infectious agents, and on the other hand, reduces the likelihood of allergic reactions. The described effect on the immune system is of great importance, in particular in the first months of a child’s life, when, in parallel with the formation of intestinal microbiocenosis, a change in subpopulations of T-lymphocytes occurs - from the predominance of Th-2 cells in a newborn to Th-1 cells in children of the second half of the year. Disruption of the intestinal microbiocenosis leads to a weakening of anti-infective protection and an increased risk of allergic reactions. In these cases, it is necessary to effectively restore the intestinal microbiocenosis, one of the ways of which is the use of probiotics. It has been proven that modern probiotic products - primarily complex ones containing bifidum and lactobacilli - not only help restore the qualitative and quantitative composition of the intestinal microflora, but also have a pronounced positive effect on the patient’s immune status. This effect can also be modulated by probiotic foods. Naturally, probiotic nutritional components are synergistic with probiotics. Thus, the use of probiotics not only has a local effect at the intestinal level, but increases the resistance of the child’s entire body to infectious agents and reduces the risk of allergic reactions.

A number of studies have shown that lactic acid bacteria modulate the intestinal production of many cytokines, including interleukins -1, -6, -10, -12, as well as tumor necrosis factor a [20, 21, 22, 23]. A stimulating effect of L. bulgaricus and S. thermophilus on the synthesis of γ-interferon by lymphocytes has also been noted [24, 22].

A meta-analysis of randomized controlled trials by CW van Neil et al. [25], showed the high effectiveness of various strains of lactobacilli in infectious diarrhea in children, and in a double-blind, placebo-controlled study, a significant positive effect of B. bifidum and S. thermophilus was proven in children with viral diarrhea [26]. The effect of lactic acid bacteria in antibiotic-associated diarrhea has been shown [27, 28, 29, 30, 31], associated with stimulation of the production of secretory immunoglobulin A (IgA) and a decrease in the adhesion of pathogenic microorganisms to epithelial cells. A dose-dependent effect of yoghurt consumption on the synthesis of secretory IgA in the intestine has also been shown. In addition, experimental work showed an increase in Salmonella typhimurium-induced IgA synthesis in mice fed yogurt for 4 weeks compared to mice fed unfermented milk, indicating a systemic effect of the studied products. And in the work of N. Bourrel et al. [23] showed that the introduction of L. bulgaricus into the culture of intestinal mucosal tissue obtained from a patient with Crohn’s disease reduces the yield of tumor necrosis factor α.

The normal functioning of the intestinal microflora has an important anti-carcinogenic value, which emphasizes the special role of factors contributing to its successful functioning. This anti-carcinogenic effect is due to a combination of processes that are provided by intestinal microorganisms, in particular the production of butyrate (regulation of apoptosis), the elimination of ammonia, a decrease in the activity of microbial enzymes such as azoreductase (formation of phenyl- and naphthylamines), 7-dehydroxylase (transformation of primary bile acids into secondary ), β-glucuronidase (hydrolysis of glucuronides with “retoxification” of a number of compounds previously neutralized by glucuronidation in the liver), nitroreductase (production of nitroso- and N-hydroxy compounds with mutagenic properties), urease (formation of ammonia). In addition, the immunomodulatory effect of normal intestinal microflora is aimed at stimulating the function of NK cells (“natural killers”), which play an important role in anticarcinogenesis. A number of studies have shown the anticarcinogenic effect of linoleic acid, present in fairly large quantities in yoghurts, associated with its direct effect on the cell cycle, as well as on the expression of the cell cycle regulator p53 [32, 33].

Wollowski et al. [34] studied the protective effect of a number of strains of lactic acid bacteria, traditionally used for the production of dairy products, on induced colon cancer in rats. Oral administration of L. bulgaricus for 4 days prevented damage to the colonic epithelium. LA Shackelford et al. [35] showed that milk fermented with L. bulgaricus increased the survival of mice with experimental colon cancer.

Finally, normalization of intestinal microflora contributes to the normalization of intestinal passage. Yogurts (fermented with L. bulgaricus and S. thermophilus) have been shown to reduce intestinal transit time and increase bowel movements [36]. And the lactase activity of yogurt cultures increases lactose tolerance in individuals with decreased lactase deficiency [10, 37].

Another approach to restoring and maintaining the normal composition of intestinal microflora is the use of prebiotics, partially or completely indigestible food components that selectively stimulate the growth and/or metabolism of one or more groups of microorganisms living in the large intestine, ensuring the normal composition of the intestinal microbiocenosis. Essentially, prebiotics provide nutrition to these microorganisms. All of them, from a chemical point of view, are carbohydrate compounds of various structures: disaccharides (lactose and lactulose), oligosaccharides, polysaccharides and dietary fiber. The mechanism of action of all prebiotics is the same: without being broken down by the enzyme systems of the human small intestine, they reach the large intestine, where they are utilized mainly by bifidobacteria and lactobacilli. The combined use of pro- and prebiotics for the prevention of disorders of intestinal microbiocenosis (and in some cases for its correction) seems quite justified, since prebiotic components provide energy not only to the intestinal microflora, but also to microorganisms introduced from the outside. In this regard, prebiotics can also be added to yoghurts. An example of such a product is Ermigurt Prebiotic, which contains inulin.

Chemically, inulin belongs to a group of compounds called fructans, which are oligo- and polymers of fructose. The individual monomers in these macromolecules are connected by β-bonds. The degree of polymerization (DP) of fructans varies widely. At DP = 2–10 they are called oligofructose (fructooligosaccharides), and at DP > 10 they are called inulin.

Inulin is found in many plants: in the tubers and roots of dahlias, artichokes and dandelions, in Jerusalem artichoke, garlic, onions, cereals, and fruits. A commercial source of inulin is chicory root, which also contains sucrose, fructose and oligosaccharides. The degree of polymerization of chicory fructans ranges from 2 to 60 with an average value (DPav) = 12. In the process of processing natural raw materials, oligofructose (DP = 2–7, DPav = 4) and inulin (DP = 10–60, DPav = 25) are obtained.

The β-bond of fructan molecules is not cleaved by intestinal a-glucosidases, and therefore they are not digested and reach the colon, where they are utilized by microorganisms [38]. Fructans are typical prebiotics and help increase the number of bifidobacteria. The so-called prebiotic index, which is the increase in the number of microorganisms per unit volume of colon contents (CFU/g) per unit (g) of the substance taken, is (4.00 ± 0.82) x 108 for inulin [39]. The combination of inulin with a probiotic leads to a significant increase in the effect, including in relation to the antagonistic effect on pathogenic microflora (E. coli, Campilobacter jejuni, Salmonella enteritidis).

The metabolic effects of inulin are diverse and are associated both with stimulation of normal intestinal microflora and with a direct effect on biochemical processes in the intestine. Inulin increases the absorption of calcium and magnesium in the colon, reduces triglyceride levels in the blood, and modulates insulin secretion.

The mechanisms responsible for both these and many other effects are increased production of butyrate by intestinal microflora, as well as stimulation of the secretion of glucagon-like peptide-1 and gastric inhibitory peptide by enteroendocrine cells and direct stimulation of glucose absorption.

The results of experimental work on rats are interesting: it was shown that the introduction of fructans into the diet of animals for 2 weeks leads to an increase in their general activity, interest in the environment, and learning ability [40].

Prebiotics (fructans) stimulate intestinal absorption of calcium, have a beneficial effect on osteogenesis of a growing organism and in osteoporosis of various origins. The effect depends on the period of life, initial calcium supply, hormonal profile (estrogens) and many others. etc. The exact mechanisms of this effect have not been established. Most likely, it is associated with stimulation of active and passive transport in the colon, caused, on the one hand, by a decrease in pH as a result of microbial metabolism, and on the other, by a direct effect on absorption. In addition, inulin promotes the destruction of phytates, increasing the proportion of free calcium in the intestinal lumen.

It should be noted that the consumption of prebiotics in Europe and the USA is significantly lower than the recommended norm. The same applies to inulin, the average consumption of which in Europe is 3–11 g per day, and in the USA - 1–4 g per day [41]. In this regard, the introduction of inulin into food products seems quite justified. Its inclusion in the KMPr is of particular importance. In this case, in addition to the probiotic effect, the product also acquires a prebiotic effect, becoming a synbiotic. Thus, Ermigurt Prebiotic yogurt contains 5 g of inulin per 200 ml of product (Inulin HP, Orafti, France), and S. thermophilus and L. bulgaricus as probiotic ingredients in an amount of at least 107 CFU/g of product. This combination is scientifically proven and promises to be an effective means of correcting intestinal microbiocenosis in children and adults (not to mention the nutritional properties of the product).

Yogurts, which have more than a century of scientifically proven use, are now firmly established in the diet of people in many countries around the world. The technology for the production of yoghurts and their recipes continue to be improved, but the yoghurts themselves, while acquiring new qualities, do not lose their main property - through ensuring the normal functional activity of the intestinal microflora, they contribute to the health of the entire body as a whole.

Literature

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S. V. Belmer , Doctor of Medical Sciences, Professor of Russian State Medical University, Moscow

Nutrition to normalize acid levels

All people suffering from disorders of the normal functioning of the gastrointestinal tract must adhere to a diet that does not cause hypersecretion of hydrochloric acid.

Note! Eating six meals a day is ideal: it will reduce the amount of food consumed at a time and reduce the risk of developing ulcers. Dishes should be boiled or stewed. You can steam them.

It is useful to consume the following products:

• baked fruits or vegetables;
• soups;
• pasta;
• fish (boiled);
• dried bakery products;
• porridge;
• lean meat.

Honey for high acidity of the stomach is not prohibited, but on the contrary, it is necessary. In combination with butter, it helps protect the mucous membrane and prevents damage to the stomach. It is recommended to include in the diet:

• whole milk;
• sea ​​buckthorn and pumpkin seed oil;
• salad;
• sea ​​buckthorn oil;
• oil obtained from pumpkin seeds.

If a person has high acidity, he is strictly prohibited from consuming foods that lead to increased formation of hydrochloric acid. It is necessary to monitor your diet, do not overeat, stop smoking and drinking alcoholic beverages. Treatment of hyperacidity of acidic juice should begin as early as possible.

It happens that after eating a person begins to experience heartburn. It can be caused by certain foods that increase stomach acidity. By adjusting your diet, you can get rid of heartburn and other problems with the gastrointestinal tract. However, if such problems occur more than 2 times a week, you should consult a doctor so as not to miss the onset of a more serious disease.

Fermented milk products in the diet of older people

Products obtained during the fermentation of milk: sour cream, cottage cheese, fermented baked milk, yogurt, acidophilus.

As a result of the content of lactobacilli and bifidobacteria in fermented milk products, the body of an elderly person most easily accepts these milk-containing products, unlike milk. At the same time, lactic acid promotes the growth of bacteria, which protect the intestines of an elderly person from infectious diseases and improve immunity.

When consumed regularly, fermented milk products:

• normalize metabolism;
• reduce gas formation in the intestines;
• are sources of vitamins A, B, D, E;
• are a supplier of calcium to the body;
• reduce the likelihood of osteoporosis.

Cottage cheese in the diet of older people

Cottage cheese must be present in the diet of an elderly person (unless prohibited by a doctor, which happens with some kidney diseases).

After 60 years, cottage cheese is especially useful. Bone density decreases, especially in women, calcium is washed out of the body, teeth fall out, hair and nails break, changes affect all the main life systems of the elderly body. Cottage cheese is one of those components of the diet that comes to the aid of an elderly person.

• Cottage cheese contains a large amount of protein (16.5 grams per 100 grams of product), which is necessary for elderly and older people to maintain muscle mass, which decreases with age.
• Cottage cheese is the leader in calcium content among other products, which is necessary to strengthen bone tissue and reduce the risk of osteoporosis in old age. Unlike whole milk, cottage cheese contains less phosphorus, which slows down the absorption of calcium. Therefore, cottage cheese is a more valuable product for older people than whole milk.
• Thanks to the enzymes that are used to make cottage cheese from milk, intestinal function improves. A healthy intestine means a strong immune system. Regular consumption of cottage cheese, rich in probiotics, is a step towards strengthening the immune system.
• Cottage cheese contains sodium salts, which is very useful for hypertensive patients. If you are a cheese lover, but have high blood pressure, switch to cottage cheese.
• Eating cottage cheese during menopause will stabilize hormonal levels in older women and reduce the risk of breast cancer. Selenium contained in cottage cheese will protect the cardiovascular system.
• Eating cottage cheese in the evening normalizes sleep and helps avoid anxiety and depression.

For an elderly person, it is enough to consume 200 grams of cottage cheese per day at least four times a week. Larger amounts can lead to complications in kidney disease and atherosclerosis.

Cottage cheese should be stored for no more than 3 days, and the higher the fat content of the cottage cheese, the less it can be stored. Storage temperature no more than +8⁰C. If the cottage cheese is frozen, it can be stored for up to two months.

Sour cream on an elderly person's menu

Fermented milk product is rich in vitamins C, E, PP, B vitamins, as well as microelements such as calcium, magnesium, iron.

— Sour cream has a beneficial effect on the hormonal levels of older women during menopause.

- Improves brain function.

- Helps improve vision.

— Improves the condition of hair, nails, teeth.

— Due to its iron content, sour cream is recommended for anemia.

- Normalizes digestion.

— Sour cream is useful for older men, increasing testosterone levels.

— Due to its high protein content, sour cream increases muscle mass.

— Contraindications for consuming sour cream: peptic ulcer, gastritis, liver disease, gall bladder, hypertension.

Elderly people are recommended to consume no more than 30 grams of sour cream per day.

In order for sour cream to benefit the body, you need to choose a natural product. The packaging of sour cream should contain the inscription “Sour cream”, and not “Smetanka”, “Smetanochka”, “Sour cream product”. Another indicator of the “naturalness” of sour cream is the content of microorganisms (CFU). The packaging must contain the inscription “microorganism content not less than 107 CFU/g”, GOST 31452-2012 is specified.

The shelf life of sour cream in sealed packaging is from 5 to 10 days at temperatures from +2⁰C to +6⁰C. Opened packages of sour cream should be stored for no more than five days. Homemade sour cream can be stored for one to two days. Sour cream can be frozen, but only once, before the first defrosting. Keep in mind that after defrosting the product loses most of its beneficial properties.

Products with alkaline-forming properties

The alkaline group of minerals that reduce acidity includes potassium, magnesium, calcium and sodium. However, their obvious excess can also negatively affect the condition of cells and even lead to their destruction. Therefore, products containing these minerals need to be rationed.

The daily human need for these substances has the following indicators:

• potassium - 1-1.5 g (for children - 16-30 mg);
• sodium - 4-6 g;
• calcium - 1000-1800 mg (for children - 210-1300 mg);
• magnesium - 400-500 mg (for children - 200 mg).

Liver, fish, cottage cheese, almost all nuts, grains, vegetables and fruits are rich in potassium. Sodium enters the body with regular salt, vegetables, and seafood. It is also found in legumes and cereals. Sources of calcium include cheese, cottage cheese, cereals, and legumes. Magnesium is found in nuts (walnuts and pine), seeds (sunflower, pumpkin, flax, sesame), chocolate, cocoa, seaweed.

Lean varieties of meat and fish and plant foods have alkali-forming properties: cereals, fruits, vegetables, melons, and herbs. Maple syrup, stevia and raw sugar also reduce acidity.

In case of increased acidity of gastric juice, it is recommended to consume the following foods:

• sour varieties of apples, sweet pears and bananas;
• lean meat and fish;
• boiled and stewed vegetables;
• porridge;
• non-acidic cottage cheese and cream.

Dishes should be boiled, stewed or steamed. It is necessary to avoid snacking on fast foods and sandwiches.

Citrus fruits, sour apples, tomatoes, onions and garlic are also prohibited. They increase acidity and lead to heartburn. Vinegar should not be added to food. Instead of black tea, it is recommended to drink green or herbal tea. You should limit your intake of herbs and spices.

Products containing synthetic preservatives, dyes and “E” additives should be prohibited. However, other people are recommended to eat them in very limited quantities.

Indications for use.

Therapeutic diet No. 1 according to Pevzner is recommended for people with peptic ulcers of the stomach and duodenum during the period of recovery after a sharp exacerbation, as well as during exacerbation of these diseases. The same diet is prescribed for exacerbation of chronic gastritis with preserved or increased secretion, as well as during the period of exacerbation after acute gastritis.

Nutritional features.

The main feature of treatment table No. 1 is the moderation of chemical, mechanical and thermal effects on the gastrointestinal tract. The diet limits foods that strongly stimulate the secretion of the stomach, irritate its mucous membrane, and are difficult or take a long time to digest. The main part of food is prepared in pureed, liquid or mushy form; it is boiled in water or steamed. Dishes can be baked, but without a crust. Fish and lean meats can be served in pieces. Too cold and very hot dishes are excluded from the diet. Salt is limited. Also limit foods containing a lot of fiber. It is recommended to take food in small portions, quite often - five to six times a day. By following such a diet, inflammation decreases, ulcers heal faster and easier, and the secretory and motor functions of the stomach return to normal.

Chemical composition and energy value.

Proteins – 90-100 g (60% animal), fats – 100 g (30% vegetable), carbohydrates – 400-420 g, table salt – 10-12 g, free liquid – 1.5 l.
The calorie content of the diet is 2800-3000 kcal. Product table

Two types of treatment table No. 1.

There are two types of treatment table No. 1, which are designated No. 1a and No. 1b, respectively. Table No. 1a is recommended in the very first days of exacerbation of the above diseases, that is, in the first three to eight days of treatment. When following this diet, even from the permitted foods listed above, it is advisable to exclude vegetables, snacks, dairy products, cheese and sour cream, as they can greatly irritate the digestive organs. After that. Once the acute stage of the disease has passed, table No. 1b is recommended, in which the prohibitions of diet No. 1a are lifted.

What to do if acidity is low?

People with low acidity are advised to drink a little dry wine daily. This is perhaps the best medicine in this case. You can quickly increase acidity with strong coffee or black tea. Horseradish and chili pepper have a similar effect, but they should not be abused: gastritis or ulcers may appear.

Sour fruits and jelly are also useful for increasing acidity. You need to eat little by little 6-7 times a day. Food should be as fresh and unsalted as possible.

Products whose consumption should be limited are the following:

• milk, kefir and yogurt (they promote fermentation);
• cheeses, cottage cheese, fatty meats (they are difficult for the stomach to digest).

If the diagnosis of “gastritis with low acidity” has already been established, it is recommended to drink honey water (dissolve ½ teaspoon of honey in 1/4 cup of warm water) before each meal (half an hour before). For this disease, drinks made from sea buckthorn or rose hips are useful.

Is it possible or not?

Gastritis with high acidity is accompanied by symptoms such as pain in the epigastric region, vomiting, nausea, belching with a sour taste, and burning in the chest. As a rule, the doctor prescribes treatment that is aimed not only at eliminating the inflammatory process, but also at reducing the concentration of hydrochloric acid in the gastric juice. When determining the method of therapy, special attention is paid to the patient’s diet. The specialist should give recommendations regarding nutrition.

Fermented milk products for gastritis with high acidity can be consumed in limited quantities. However, this must be done with extreme caution. Each fermented milk product has its own contraindications and indications. Therefore, when preparing a diet for a patient with gastritis, the individual characteristics of the body and the stage of the disease are taken into account.

When is nutrition prescribed for high acidity?

The acidity of gastric juice is one of the indicators of the health of the stomach, in which gastric juice is concentrated, which is involved in the processing of food that enters here. Secretion of gastric juice occurs in three stages:

• the first occurs at the stage of presentation and visualization of food products, their touch, smell and taste; such effects affect the central nervous system and only then through the nerve endings on the cells of the gastric mucosa;
• the second is called gastric because it occurs at the stage of penetration of food into the stomach; from this moment the hormone gastrin begins to be produced, which stimulates the production of hydrochloric acid;
• the third occurs at the final stage of the digestive process, when food ends up in the duodenum.

When too much hydrochloric acid is produced, the mechanism for regulating its secretion under the influence of somatostatin is triggered. This mechanism is often disrupted.

The content of hydrochloric acid in gastric juice of more than 0.5% provokes corrosion of the walls of the stomach, an inflammatory process easily forms here, and ulceration develops. Increased acidity of gastric juice is a frequent companion to gastritis and gastric ulcers.

Such conditions require timely correction followed by a review of lifestyle and diet. Otherwise, there is a risk of developing their chronic forms. Even if the treatment was successful, once detected increase in gastric acidity risks reoccurring. Since diseases affect the digestive tract directly, treatment cannot be effective without following a special diet. In such cases, eating with high acidity is nothing more than part of the healing process.

The acute period of gastritis and stomach ulcers, as well as exacerbations of chronic forms of these diseases, announces itself:

• heartburn,
• burning pain in the stomach area,
• feeling of heaviness after eating,
• belching with a bitter or sour taste,
• bloating,
• flatulence,
• intestinal constipation,
• partial loss of taste.

Usually the provocateurs of this feeling are:

• fast food and semi-finished products,
• canned and pickled foods, pickles,
• sour and bitter foods,
• fried and fatty foods,
• carbonated drinks and alcohol,
• combinations of products that cause fermentation and other unfavorable processes in the gastrointestinal tract.

It becomes clear that avoiding this problem requires the exclusion of obviously harmful foods, but this is not as simple as it seems. This becomes extremely difficult for a modern person, whose daily routine does not always include the opportunity for full, reusable (recommended up to 5 per day) meals of high-quality food.

Benefits of cottage cheese

It is often recommended to use cottage cheese for gastritis with high acidity. This product is quickly and easily absorbed. However, there are some limitations here too. For gastritis, you should eat low-fat fresh cottage cheese, without nuts, salt and various preservatives.

A homemade product is ideal. It is dietary, soft and tender. This cottage cheese can be consumed pureed. You can also use it to make soufflés or puddings, casseroles and dumplings.

This product should be used for gastritis three days after the onset of exacerbation. You should not use fatty, sour cottage cheese with all kinds of additives for cooking.

For gastritis, it is better to use this product in the form of a casserole. However, adding dried fruits and nuts to such a dish is not recommended. You can use a small amount of honey to add sweetness to the casserole.

Should you eat cheese?

What kind of fermented milk products can you use for gastritis? The list of them is not so long. Cheese with high acidity is allowed to be consumed. It must be of a solid variety without additives. You can introduce such a product into your diet only a week after the onset of an exacerbation of the disease.

What cheeses should you avoid? A list of fermented milk products of this type that are prohibited for gastritis is given below:

• processed cheeses;
• product with seasonings and pepper;
• cheese that is too salty or sour;
• spicy varieties;
• smoked, sausage cheese;
• goat cheese;
• feta cheese;
• Suluguni.

Dairy products and proper nutrition: to eat or not to eat?

Who can and who can't drink milk?

The source of rumors about the need to limit the consumption of milk and dairy products is lactose intolerance.
This is a genetic mutation that results in a deficiency of the enzyme that breaks down milk sugar (lactose). Consumption of milk in this case leads to abdominal pain, diarrhea and nausea.

In Africa, Southeast Asia and America, lactose intolerance is almost 100%; in Russia the percentage is lower, although some studies suggest that about half of Russians are lactose intolerant - 48%.

Overall, unless you're dairy intolerant, there's no reason to avoid it—research suggests that in adults, consuming dairy improves body composition and promotes weight loss.

In addition, milk consumption reduces the risk of developing type 2 diabetes, cardiovascular disease (especially stroke), and milk has a positive effect on bone mineral density, but is not associated with the risk of fractures.

What about fermented milk products?

Fermented dairy products - kefir, fermented baked milk, yogurt, yogurt, cottage cheese, hard cheeses - also contain lactose, but in negligible quantities, since fermentation processes have occurred in them.

Most often, even people prone to milk sugar intolerance have enough “strength” to cope with fermented milk products.

If you also have a reaction to fermented milk products in the form of nausea and digestive disorders, then try to find a source of calcium in other foods - legumes, broccoli, soy products, oranges. Consult your doctor - perhaps he will offer an effective solution to the problem.

They say that dairy products help the intestines and strengthen the immune system?

This is partly true. The intestines contain about 4-5 kg ​​of microflora, which really helps to cope with various diseases - microflora stimulates the differentiation of the body's immune cells, so it is important to maintain its condition in a normal state.

What types of cheese are good for gastritis?

Not all fermented milk products are allowed for gastritis. With this disease, you can eat unleavened fresh varieties of cheese. These include mozzarella, mascarpone, and ricotta. Blue cheeses are also not prohibited. However, when purchasing such a product, you should make sure that it is not expired. It is worth noting that the so-called blue cheese has an astringent property. It helps strengthen the protective layer of the stomach.

When introducing cheese into your diet, do not forget about the restrictions. You can consume only a few slices per day.

Yogurts for gastritis

Such fermented milk products are allowed for gastritis. However, when using them you should adhere to certain rules:

• The product should be consumed in small portions. Don't drink too much at one time. It is better to use two spoons, but often.
• Yogurt should be low-fat, approximately 2-2.5%.
• The product must be non-acidic and fresh.

The most useful is considered to be yogurt prepared at home and having a natural composition. The industrial product contains coloring and flavoring substances, stabilizers and preservatives that can cause harm to the body.

High-quality yogurt does not irritate the gastric mucosa. On the contrary, it reduces acidity and envelops.

Is it possible to have kefir for gastritis?

This is another common fermented milk product. However, many are afraid to use it for gastritis. For high acidity, kefir is recommended, the fat content of which is from 2 to 3%. The product must be fresh, maximum 2 days old. Only this kind of kefir has an enveloping effect and normalizes intestinal motility. The main criterion for choosing a product is freshness.

Is it possible to have kefir for gastritis? Certainly. However, this product should be consumed in moderation, drinking small portions throughout the day. If you do not follow the rules, you can provoke intestinal upset and diarrhea.

Mixed fermentation fermented milk products in the diet of older people

Mixed fermentation products: kefir, kumiss (fermented milk drink made from mare's milk), ayran, shubat (sour camel milk).

This type of fermentation, unlike conventional fermented milk fermentation, is characterized by the fact that in the process of mixed fermentation, in addition to lactic acid, carbon dioxide, alcohol, and volatile acids are formed.

Kefir in the diet of older people

The most common mixed fermentation fermented milk product. For older people, kefir is more preferable than milk due to its better digestibility. The benefits of kefir for older people are enormous:

• Kefir provides calcium and protein, which leads to increased bone density and increased muscle mass.
• The B vitamins contained in kefir have a beneficial effect on the nervous system.
• Lactic acid bacteria, as well as an acidic pH environment, normalize the intestinal microflora and improve the digestibility of food.
• Regular consumption of kefir improves the immunity of older people, which leads to a reduction in diseases, especially during the ARVI season.
• The risk of cancer cells is reduced.
• Kefir has a diuretic effect, which reduces swelling.
• Consuming kefir helps control weight. Number of kilocalories in 100 grams of kefir:

1% contains 40 kcal;

2.5% contains 53 kcal;

3.2% contains 59 kcal;

0% (low fat) contains 38 kcal;

2% contains 50 kcal.

• Kefir contains polyunsaturated acids omega 3 and omega 6.
• Kefir is used as a means of preventing stomach and duodenal ulcers.
• Kefir can be consumed by older people with lactose intolerance.
• Very useful for older people suffering from diabetes.

Despite the undeniable benefits of kefir for the body of an elderly person, there are also contraindications:
allergic reactions;

exacerbation of chronic gastritis and stomach ulcers;

intestinal disorder;

food poisoning.

You need to consume kefir on an empty stomach in the morning or in the evening before bed. Be sure to use kefir at room temperature. Kefir with a fat percentage of 2.5% -3.2% provides maximum benefit. In old age, it is enough to drink no more than 400 grams. kefir per day.

The shelf life of kefir in open packaging at a temperature not exceeding +10⁰C is 6-8 hours, then the process of accelerated fermentation begins. In a closed package, kefir can be stored for 72 hours at a temperature of +2⁰C +6⁰C. If the packaging says that kefir has a shelf life of 1 month, then it is not a natural product.

What should kefir be like?

During the period of exacerbation of gastritis, it is worth giving up fermented milk products for 4 days. This will avoid many problems.

For gastritis, patients with high acidity are not recommended to consume kefir that is too cold. The temperature of the drink should be room temperature. Do not heat it in the microwave or on the stove. As a result, it will become more acidic. It is better to place the cup of drink on the table and leave it for half an hour. This time will be enough.

To give kefir an original taste, you can add sweet fruits or natural honey to it.

Ryazhenka. Benefits in old age

Ryazhenka is a fermented milk product based on baked milk. Many doctors recommend fermented baked milk as a natural antibiotic. The benefits of fermented baked milk for older people are undeniable.

• Ryazhenka improves digestion. The probiotics contained in fermented baked milk normalize the functioning of the gastrointestinal tract. The B vitamins contained in fermented baked milk have a beneficial effect on the digestion process. If you had a large meal the night before, drink 100 ml of fermented baked milk in the morning to activate food digestion processes. If you regularly drink a small amount of fermented baked milk before meals, you can normalize the acid-base balance.

• Ryazhenka helps strengthen the immune system. Older people, especially during the off-season, suffer from exacerbation of chronic diseases, including those associated with decreased immunity. The bacteria and probiotics that make up fermented baked milk trigger the body's immune defense process, strengthening its resistance to various infections that originate in the intestines.

• Ryazhenka has a beneficial effect on the nervous system of older people. Magnesium, which is part of the chemical composition of fermented baked milk, strengthens the nervous system, reduces stress levels, which reduces the amount of depression in older people and normalizes sleep.

• Ryazhenka increases bone density due to a large amount of calcium, phosphorus and vitamin D, which is especially important for elderly and older people to prevent fractures. One glass of fermented baked milk contains 25% of the daily requirement of calcium and 20% of phosphorus.

• Ryazhenka helps prevent diabetes, thanks to probiotics that normalize the functioning of insulin receptors and control the processes of glucose modulation.

• Ryazhenka normalizes metabolism, which leads to the prevention of obesity, especially in old age, when fat deposits are increasingly difficult to control. Rich in protein, fermented baked milk can replace one full meal.

Ryazhenka can be consumed at any time of the day.
To choose the right product, you need to pay attention to the composition. It must be milk and sourdough. The composition should not contain any starch, sugar, or aromatic additives. The name should be “Ryazhenka”, and not “Ryazhenka product”, “Baked milk product”, etc. Next to the word “Ryazhenka” only the word “thermostat” can be used. Don't worry if the ingredients say "normalized milk", that's true. The shelf life of fermented baked milk in a closed package is 2-3 weeks, when opened, 2-3 days. And be sure to take fermented baked milk only from the refrigerated shelves in the store.

Acidophilus

This type of fermented milk product began to appear quite often on the shelves of hypermarkets. What is it?

Acidophilus is obtained from whole milk, starting the fermentation process with acidophilus, kefir fungi and milk yeast. The result is a thick fermented milk drink with a spicy aftertaste. Not for everyone, but very useful.

One glass of acidophilus contains a whole storehouse of vitamins and minerals. These are vitamins A, C, vitamins B, P, calcium, potassium, magnesium, iron, phosphorus, sodium.

Once in the body of an elderly person, the acidophilus bacillus begins to work as an antibiotic, suppressing pathogenic bacteria that multiply in the intestines.

Acidophilus, unlike some fermented milk products, has a beneficial effect on the functioning of the pancreas and the functioning of the stomach. As a result of these properties, acidophilus is actively used in various health and rehabilitation diets. It is recommended for diseases such as asthenia, anemia, after stress, and for depression. Very useful after a course of antibiotics to restore intestinal microflora. With a low calorie content of 80 kcal, acidophilus is recommended for people who are overweight.

When purchasing this fermented milk product, you need to pay attention to the expiration date. The shelf life of acidophilus is 72 hours from the date of manufacture at a temperature not exceeding +8⁰C.

Sour cream and gastritis

Industrially produced sour cream is not recommended for use for gastritis with high acidity, even if it is positioned as dietary. There are restrictions for the home product as well. Sour cream should not be greasy. When using such substances, there is an additional burden on the biliary system and the liver.

Homemade low-fat sour cream can be added to other dishes. It is not recommended to consume more than 15 grams of product at a time. For gastritis, sour cream is allowed only during the period of remission.

Characteristics of some lactic acid products

Curdled milk

help improve appetite and increase the separation of digestive juices. They have high biological value due to the content of B vitamins, choline, lecithin and antibiotic substances. The lactic acid bacteria contained in curdled milk contribute to the suppression of putrefactive microflora, and consequently, a decrease in putrefactive and fermentation processes in the intestines. All types of curdled milk have a laxative effect; they are indicated for diseases of the liver and biliary tract, because they increase the secretion of bile and its release into the duodenum, for pancreatitis, colitis and gastritis with secretory insufficiency.

Ordinary curdled milk is produced using pure cultures of lactic acid streptococci, Mechnikovskaya - using lactic acid streptococcus and Bulgarian bacillus (see). Curdled milk also includes fermented baked milk, Varenets, and the Yuzhny and Snezhok drinks. The Yuzhny drink has a consistency similar to liquid sour cream, but without separating the whey. The “Snowball” drink contains fillers in the form of sugar syrup or fruit and berry syrups (raspberry, lemon, blackcurrant, cherry).

Yogurt

prepared with sourdough containing lactic acid streptococcus (thermophilic) and Bulgarian bacillus. It has an increased amount of milk solids, which is achieved by preliminary condensation of milk in vacuum devices or by adding skim milk powder.

Acidophilus is prepared by fermenting milk with a mixed culture of lactic acid streptococcus and acidophilus bacillus.

Acidophilus products

(acidophilus milk, acidophilus paste and acidophilus yeast milk) are prepared using pure cultures of acidophilus bacillus. These products are medicinal in their properties.

Acidophilus milk is characterized by relatively high acidity and viscosity, has pronounced antibiotic properties, and therefore suppresses putrefactive microflora in the intestines more strongly than yogurt; in addition, acidophilus milk increases the phagocytic activity of leukocytes. The regulatory influence of acidophilus milk on the secretory and motor functions of the gastrointestinal tract was revealed. tract, and therefore it is indicated in the treatment of gastritis and enteritis in older children, as well as colitis in adults.

Acidophilus paste has the consistency of thick sour cream and is a concentrated culture of acidophilus bacillus. Due to the high content of antibiotic substances, acidophilus paste has a pronounced effect on putrefactive bacteria of the intestine and is used as a treatment. remedies for constipation, flatulence, gastritis with secretory insufficiency, ulcerative colitis. . The presence of antibiotic properties has allowed some doctors to use acidophilus paste for the treatment of purulent wounds as an external agent in combination with other drugs.

Acidophilus-yeast milk is obtained by fermenting milk with acidophilus bacillus and milk yeast. It is recommended for use in the treatment of tuberculosis, intestinal diseases, and furunculosis.

Sour cream

has high taste and is a good source of milk fat and energy (up to 384 kcal per 100 g).

Cottage cheese

is a protein lactic acid product obtained from pasteurized milk by fermenting it with pure cultures of lactic acid streptococcus, followed by removal of whey. Cottage cheese has a high biol value due to the content in it in sufficient quantities of all essential amino acids, especially such important ones as lysine, methionine and tryptophan. Cottage cheese helps improve the amino acid composition of food. The methionine and choline contained in cottage cheese determine the lipotropic effect of this product, which makes it possible to use it for the prevention of liver diseases. The high methionine content in cottage cheese helps remove cholesterol from the body, and therefore cottage cheese is considered as a means of preventing atherosclerosis. Cottage cheese has a diuretic effect and is included in diets for people with impaired nitrogen excretory function of the kidneys, hypertension, etc. Cottage cheese is a good source of easily digestible minerals, especially calcium and phosphorus. It is especially necessary for people who have an increased need for minerals - for children, adolescents, pregnant women and nursing mothers.

Kefir

prepared from pasteurized milk. In parallel with lactic acid fermentation, alcoholic fermentation occurs in it, caused by lactic yeast. Kefir increases gastric secretion, tones the nervous and cardiovascular systems, due to the presence of lactic acid bacteria, it reduces the processes of putrefaction and fermentation in the intestines, helps to increase diuresis, increases the excretion of urea and other products of nitrogen metabolism, as well as chlorides and phosphates; when consumed, the separation of pancreatic juice increases. Kefir is widely used in the nutrition of young children.

Kefir is available in 1%, 2.5% and 3.2% fat content.

The dairy industry produces low-fat and low-fat products of high biol, value (enriched with protein, fruit and berry fillers) - fruit kefir, Kolomensky and Moskovsky drinks.

Kumis

prepared from mare's milk by fermenting it with cultures of lactic acid bacteria and milk yeast. Mare's milk contains a lot of albumin, which, when fermented, falls out in the form of extremely small, delicate flakes. When kumis ripens, the proteins of mare's milk are broken down into simpler ones - peptones and albumoses. Mare's milk fats are in a finer suspension, so they are more easily absorbed in the intestines than cow's milk fats. According to the degree of maturity, kumiss is weak, medium and strong. Kumis contains almost all water-soluble vitamins, including ascorbic, folic and pantothenic vitamins. It has been established that kumiss has a stimulating effect on the hematopoietic organs, is a good stimulant of gastric secretion, increases the secretion of bile and pancreatic juice, enhances gastric tone and intestinal motility. It has found wide application in the treatment of many diseases, especially tuberculosis and diseases of gastrointestinal tract. tract.

Kumis is also made from cow's milk. In appearance and taste, it differs little from mare's.

Ayran

- a lactic acid drink common in the Caucasus, Central Asia, Kazakhstan, and Altai. It is prepared from boiled skim milk (cow, sheep or goat) by fermenting it with complex microflora (milk is usually fermented with old ayran).

Kurt

obtained by mixing ayran with milk, squeezing and drying. This concentrated M. p. is prepared in Kazakhstan. It keeps well for quite a long time and is used for making soups and sour, thirst-quenching drinks.

Chal

, a lactic acid product common in the Turkmen SSR, is prepared from raw camel milk fermented with ready-made chal. It has a complex composition of microflora (lactic acid bacillus, streptococci, yeast), contains up to 1.6% alcohol and up to 6.5 mg% ascorbic acid.

Cheeses

are a concentrate of nutrients contained in milk. They contain complete protein (15-30%), easily digestible milk fat (up to 30%), large amounts of calcium (600-1000 mg%) and phosphorus (400-700 mg%). The cheese also contains magnesium, potassium, sodium salts and trace elements, vitamins A (0.2 mg%), thiamine (0.14-0.65 mg%), riboflavin (0.34-0.6 mg%). Based on the production method, rennet and lactic acid cheeses are distinguished. Rennet cheeses are made by curdling milk with rennet or pepsin and then processing the curd. During the ripening process of cheeses, microbiological and physical-chemical processes occur. the breakdown of proteins into peptones, peptides, amino acids and ammonia, fat - into free fatty acids, milk sugar - into lactic acid. These transformations of nutrients contribute to their easier absorption.

Cheese proteins contain all the essential amino acids, and as the cheese matures, their quantity increases.

The cheese's high content of easily digestible proteins, calcium and phosphorus salts allows it to be recommended for feeding children, adolescents, pregnant women and nursing mothers.

The specific taste and aroma of cheeses depends on the presence of lactic acid, volatile fatty acids, carbonyl compounds and the products of deep protein breakdown. The pungent smell of cheeses is given by the volatile fatty acids they contain, which help increase appetite and improve the absorption of food.

Very sharp and salty cheeses (Roquefort and feta cheese) increase the secretion and acidity of gastric juice, irritate the kidneys and liver, and cause thirst. Therefore, they are contraindicated in gastritis with increased secretion, colitis, peptic ulcer, nephritis, cholecystitis, hepatitis, gout, obesity, as well as in patients with edema of cardiac and renal origin.

In case of gross violations of sanitary hygiene. conditions of cheese production (usually soft cheeses such as feta cheese) or when using heavily contaminated unpasteurized milk, cheeses can become factors in the transmission of pathogens of foodborne toxic infections, as well as brucellosis, tuberculosis, typhoid fever, dysentery, etc., the causative agents of these diseases can persist in cheeses for a long time. Violation of gig. storage conditions of cheese can cause damage to it by cheese mites or cheese flies.

What are the benefits of sour cream?

This fermented milk product ensures stable and proper functioning of the intestines. Sour cream contains many vitamins, including PP, E, A, B vitamins and ascorbic acid. The product is also rich in microelements: manganese, copper, iodine, fluorine, iron, zinc. In addition, it is saturated with fatty acids, β-carotene, natural carbohydrates, and animal proteins.

Sour cream helps improve brain performance, stabilize metabolic processes, and facilitate muscle function. You should not completely abandon this fermented milk product, as well as the others.

Lactic acid products in children's nutrition

Lactic acid products for baby food (Table 2) are also produced from pasteurized milk by fermenting it with starter cultures prepared from pure cultures of lactic acid bacteria with or without the addition of lactic yeast cultures. An exception is kefir, which is prepared primarily with natural fungal starter and rarely with pure cultures. In lactic acid products, under the influence of lactic acid bacteria enzymes, changes occur in the components of milk with the formation of components such as enzymes, bactericidal substances, free amino acids, vitamins, lactic acid bacteria, which have a beneficial effect on the digestive processes and intestinal microflora of the child.

Along with the advantages, lactic acid mixtures also have certain disadvantages, which should be especially taken into account when using them for feeding. In particular, the significant acidity of the product is combined with a relatively high content of protein and minerals in it compared to human milk and, at the same time, a deficiency of a number of essential nutritional factors. The use of milk products in the entire volume of daily nutrition can lead to compensatory changes in metabolic processes and in the function of the excretory organs of an infant, therefore it is usually recommended to use lactic acid products only in individual feedings.

For the first time in our country, adapted (close in composition to human milk) lactic acidophilic formulas “Malyutka” and “Malysh” have been created for feeding infants. They are recommended for feeding infants, newborns and premature babies in the absence or insufficiency of mother's milk. It is advisable to use mixtures in the treatment of gout. diseases and for the purpose of their prevention, especially in the hot season. In terms of composition and method of use, these mixtures are almost no different from similar sweet milk mixtures (see). In their production, an acidophilus starter is used, consisting of acidophilus rods. Acidophilus bacillus has a particularly beneficial effect on the child's intestinal microflora due to its high content of lactic acid, formed from lactose during the fermentation of milk, and a strong bactericidal effect on microorganisms that cause digestive disorders in children.

When feeding premature babies and children of the 1st month of life, it is recommended to combine acidophilus adapted formulas with sweet milk formulas.

There are a number of lactic acid products, which are used during feeding, but in composition they are not close to human milk and are classified into the group of incompletely adapted and non-adapted. These include kefir, which stimulates the secretion of digestive juices and the secretion of bile. The lactic acid contained in kefir hydrolyzes fat and ensures a more gentle curdling of the protein. The resulting enzymes are involved in the breakdown of carbohydrates. There is a beneficial effect of kefir on the intestinal microflora.

In the nutrition of children of the first 3 months. In life, dilutions of kefir are used - mixtures B and B. For their preparation, cereal decoctions are used - rice, oatmeal, buckwheat or flour from these cereals. Whole kefir is recommended when feeding children over 3 months.

The main representatives of kefir starter microorganisms are lactic acid bacteria, lactic acid streptococci, acetic acid bacteria and milk yeast. The best starter is the one in which the ratio between fungi and milk is 1:20. The best fermentation temperature is 20-22°. The duration of fermentation is 14-16 hours, the end of it is determined by the acidity of the curd, the edges should be approx. 80° but to Turner. To develop alcoholic fermentation, kefir after ripening is kept in a refrigerator at a temperature of 6-8°. Depending on the duration of aging, there are weak (one-day), medium (two-day) and strong (three-day) kefir. One- and two-day kefir is used in baby food.

In a number of republics of the Soviet Union, ready-made foods are used in the nutrition of both infants and older children. In Armenia, the “Narine” mixture is produced for the same purpose. The product is biologically active primarily due to the ability to produce antibiotic substances that suppress the development of pathogens, mainly the group of intestinal infections. In Georgia, a mixture of “Matsoni” was also developed, fermented with proteolytic enzymes of plant (ficia) and animal (pepsin) origin. The product is intended for feeding infants transferred to mixed and artificial feeding.

In Kyrgyzstan and other Central Asian republics, Biolact and Biolact-2 are widespread, which, unlike Biolact, are enriched with copper, iron, ascorbic and nicotinic acids. "Biolakt" and "Biolakt-2" are recommended for feeding healthy children, and are also used as a treatment. nutrition for dyspepsia, chronic eating disorders.

“Baldyrgan” (“Bogatyr”) is a lactic acid product produced in the Kazakh SSR, it is similar to “Biolakt”, prepared on the basis of cow’s milk, but with additional enrichment with a number of biologically active substances in order to be closer to human milk.

Lactic acid products, which are used to correct feeding and treat. nutrition are characterized by either a high concentration of lactic acid bacteria, which increases their biological activity, or an increased content of certain nutrients, in particular protein. These include acidophilus milk, acidophilus-yeast milk, propionic acidophilus milk, and buttermilk.

Propnonovic acidophilus milk is used in children's diets. The starter of propionic acidophilus milk consists of acidophilus bacillus and propionic acidophilus bacillus Sherman. Wedge, product tests have shown that among M. p. this milk has the most pronounced antimicrobial and antibiotic effect, is rich in ascorbic acid and B vitamins.

Buttermilk is a lactic acid product (low-fat) with a high content of protein and carbohydrates. The product is used for correction of feeding and treatment. target for eating disorders.

In children's nutrition, in addition to liquid fermented milk products, acidophilus paste, cottage cheese, and packaged sterilized cottage cheese are used. These products are used to correct feeding, as well as in the nutrition of children under 3 years of age. For healthy children of preschool and school age, dairy products used in the diet of adults are recommended.