Characteristics of therapeutic nutrition. General characteristics of rational and therapeutic nutrition Describe the concept of nutrition

Therapeutic and preventive nutrition is intended to protect the internal environment of the human body from the harmful effects of chemical, physical and biological factors of production.

Purpose: to increase the protective functions of physiological barriers and prevent the entry of foreign substances.

The diet includes substances that help improve the condition of the stratum corneum and the function of the sebaceous and sweat glands;

Reduced permeability of the skin, mucous membranes of the upper respiratory tract and gastrointestinal tract;

Normalization of peristalsis and reduction of absorption of endotoxins and other harmful substances in the gastrointestinal tract.

Principles of therapeutic and preventive nutrition:

1. Influence on biotransformation processes by directing the formation of less toxic metabolites in the body

2. Activates the binding and removal of poisons from the body, as well as the products of their metabolism.

3. Helps normalize the function of those organs and systems that are affected by harmful substances.

4. Increase the antitoxic function of individual organs and systems

5. Contribute to compensation of nutritional deficiencies arising under the influence of harmful production factors.

6. Products that enhance the effects of production factors should not be used.

7. Therapeutic and preventive nutrition should have a beneficial effect on the body’s autoregulatory reactions.

There are three types of DILI:

1. Diets for LPP

2. Vitamin preparations

3. Milk and dairy products (usually given for breakfast or lunch)

BOB diets:

Diet No. 1

The ration is given when working with radioactive elements and sources ionizing radiation. The diet includes substances that have radioprotective and lipotropic effects. Radioprotectors (dietary fiber contained in legumes (especially soybeans), cabbage, carrots, fruits (especially apples), plums, berries and juices with pulp) bind radionuclides and remove them from the body. Lipotropic substances stimulate fat metabolism in the liver and increase its antitoxic function. In this regard, diet No. 1 is milk-egg-liver. The diet includes an increased amount of potatoes. Refractory fats are excluded from the diet (vegetable and butter oils are used to a limited extent in cooking technology). Meat and fish are boiled.

Diet No. 2

The diet is intended for those working in the production of inorganic acids, alkali metals, chlorine and fluorine compounds. The diet is enriched with complete proteins (due to the inclusion of meat, fish, dairy products), increased vegetable oil, calcium (dairy products) and other substances that inhibit the accumulation of harmful chemicals in the body. The diet contains a significant amount of vegetables and fruits, potatoes and herbs, which are rich in vitamin C and mineral elements, as a result of which the diet is alkaline.

Diet 2a

Designed for workers and employees who come into contact with chromium and chromium-containing compounds.
The diet affects the body's regulatory systems (nervous and endocrine). The diet should be hypoallergenic.
The diet should include proteins with increased content sulfur-containing amino acids: lecithins (rabbit meat, liver, unrefined vegetable oils, sour cream, cream); vitamins C, P, A, E; salts Ca, Mg, sulfur; alkaline products (milk, vegetables, fruits, berries).
Diet No. 3
Designed for workers in contact with inorganic and organic lead compounds.
The diet should contain dairy and fermented milk products, a large amount of vegetables, fruits and berries, fruit juices with pulp containing pectin. It is recommended to use vegetables and fruits without heat treatment. The diet contains increased protein, carbohydrates and limited fat.
Diet No. 4
Intended for workers and employees in contact with nitro- and amino compounds of benzene, chlorinated hydrocarbons, nitrogen dyes, arsenic, mercury, fiberglass, working at elevated atmospheric pressure.
The purpose of the diet is to protect the liver and hematopoietic organs.
The diet contains foods rich in lipotropic substances (dairy products - cottage cheese, vegetable oils), which have a beneficial effect on liver function and the hematopoietic apparatus. The amount of fat, strong broths, sauces and gravies, smoked meats and pickles is limited.
Diet No. 4a
Designed for workers in contact with phosphoric acid, phosphoric anhydrite, phosphorus and its derivatives.
The diet should contain a large amount of vegetables and animal proteins.
Fats in the diet are sharply reduced, lactic acid drinks are recommended instead of milk, which helps reduce phosphorus absorption.
Diet No. 46
Designed for workers exposed to hazardous chemicals such as animine and toluindine derivatives, dinitrochlorobenzene and dinitrotoluene.
The effect of this diet is associated with preventing the penetration of these toxic substances into the body of workers. The diet includes a variety of plant components and vitamins, as well as glutamic acid. All these substances have a detoxifying effect.

Ration No. 5 Ration is given to persons working with carbon disulfide, tetraethyl lead, manganese, beryllium, barium, mercury salts, pesticides, isoprene compounds, and heavy liquids. The listed substances have a toxic effect on nervous system(central and peripheral). The protective effect of the diet is based on the use of products rich in lecithin - egg products, sour cream, cream (in fat-containing dairy products, lecithin is part of the protein-lipid complex that forms the shell of fat globules), as well as on the inclusion of phosphatides and PUFAs in the diet.

Additional vitamins:

1. When exposed to fluoride, chromium, and cyanide compounds, vitamin A is prescribed.

2. When exposed to arsenic, tellurium, mercury, manganese, vitamin B1 is prescribed.

3. When exposed to carcinogenic substances, selenium, additional vitamin supplementation is NOT RECOMMENDED.

4. In conditions of a heating microclimate, A, B1, B2, C, PP are prescribed.

5. In tobacco and nicotine production, vitamin C and B1 are prescribed.

Rational (from lat. ratio- mind) nutrition is the most important factor healthy image life.

Nutrition balanced in energy terms and nutrient content depending on gender, age and type of activity.

Currently, for the majority of our population, nutrition does not correspond to this concept, not only due to insufficient material security, but also due to the lack or lack of knowledge on this issue. Before moving on to the dietary recommendations in everyday life, let us dwell on the role of nutrients in the body.

Nutrition is an integral part of life, as it maintains metabolic processes at a relatively constant level. in ensuring the vital functions of the body is well known: energy supply, enzyme synthesis, plastic role, etc. Metabolic disorders lead to the occurrence of nervous and mental diseases, vitamin deficiencies, liver diseases, blood diseases, etc. Improperly organized nutrition leads to decreased working capacity, increased susceptibility to disease and, ultimately, to reduced life expectancy. Energy in the body is released as a result of the oxidation of proteins, fats and carbohydrates.

The importance of basic nutrients, their energy value

- vital substances in the body. They are used as a source of energy (the oxidation of 1 g of protein in the body provides 4 kcal of energy), building material for the regeneration (restoration) of cells, the formation of enzymes and hormones. The body's need for protein depends on gender, age and energy consumption, amounting to 80-100 g per day, including 50 g of animal proteins. Proteins should provide approximately 15% of the calorie content of the daily diet. Proteins contain amino acids, which are divided into essential and non-essential. The more proteins contain essential amino acids, the more complete they are. Essential amino acids include: tryptophan, leucine, isoleucine, valine, lysine, methionine, phenylalanine, threonine.

They are the main source of energy in the body (oxidation of 1 g of fat gives 9 kcal). Fats contain substances valuable to the body: unsaturated fatty acids, phosphatides, fat-soluble vitamins A, E, K. The body's daily requirement for fats is on average 80-100 g, including 20-25 g of vegetable fats. Fats should provide approximately 35% daily caloric intake. The greatest value for the body are fats containing unsaturated fatty acids, i.e. fats of plant origin.

They are one of the main sources of energy (oxidation of 1 g of carbohydrates gives 3.75 kcal). The body's daily need for carbohydrates ranges from 400-500 g, including starch 400-450 g, sugar 50-100 g, pectin 25 g. Carbohydrates should provide approximately 50% of the calorie content of the daily diet. If there is an excess of carbohydrates in the body, then they turn into fats, i.e., an excess amount of carbohydrates contributes to obesity.

In addition to proteins, fats and carbohydrates, the most important component of a balanced diet are biologically active organic compounds necessary for normal life. Lack of vitamins leads to hypovitaminosis (lack of vitamins in the body) and vitamin deficiency (lack of vitamins in the body). Vitamins are not formed in the body, but enter it with foods. Distinguish water And fat-soluble vitamins.

In addition to proteins, fats, carbohydrates and vitamins, the body needs , which are used as plastic material and for the synthesis of enzymes. There are macroelements (Ca, P, Mg, Na, K, Fe) and microelements (Cu, Zn, Mn, Co, Cr, Ni, I, F, Si).

The ratio of proteins, fats and carbohydrates for middle-aged people should be (by weight) 1: 1: 4 (for heavy physical work 1: 1: 5), for young people - 1: 0.9: 3.2.

The body receives these substances only if a varied diet is consumed, including six main food groups: dairy; meat, poultry, fish; eggs; bakery, cereal, pasta and confectionery products; fats; vegetables and fruits.

The diet is of great importance: the frequency of meals, the distribution of daily calorie content, weight and composition of food in its individual meals.

For healthy person four meals a day are optimal, since less frequent meals lead to the accumulation of fat in the body, a decrease in the activity of the thyroid gland and tissue enzymes. Eating frequently at the same time helps improve the flow of bile. Poor diet is one of the main causes of chronic diseases stomach and intestines. The frequency of meals is determined by age, character labor activity, daily routine, functional state of the body. The regularity of eating contributes to the development of a conditioned reflex during eating and the rhythmic production of digestive juices.

With four meals a day, the ratio of the number of calories in food for individual meals should be 30, 15, 35, 20%.

Products rich in animal proteins (meat, fish) are healthier to consume in the morning and afternoon, as they increase performance. Second breakfast may include fermented milk products, vegetable dishes, sandwiches, fruit. Lunch should be the largest meal in terms of volume. Dinner should be small in volume and consist of easily digestible dishes. The last meal should be 2-3 hours before bedtime.

Principles of rational nutrition in everyday life

To give correct advice regarding diet and nutrition, we should talk not so much about chemical components, but about a set of products. Necessary for healthy eating American scientists present the ratio of products in the form of a pyramid (see Appendix 4), divided into four parts equal in height. The bottom, widest part of the pyramid is grain products (bread, cereals, etc.), the next is vegetables and fruits, then dairy products, meat and fish. The smallest part of the pyramid is sugar and fat. The diet of a modern person often contains too much animal fat and sugar, not enough vegetables and fruits, and not enough vegetable fats. In 1990, WHO presented its recommendations for a balanced diet. The daily diet (in calories), depending on energy costs, is usually presented in special tables.

To organize nutrition in everyday life, the following principles should be observed:

• do not overeat;
• the diet should be varied, that is, it is advisable to eat fish, meat, dairy products, vegetables and fruits, wholemeal bread, etc. every day;
• in cooking methods, preference should be given to boiled;
• know the calorie content and chemical composition of food.

Features of nutrition for the prevention of obesity

One of the negative consequences of poor nutrition is excess body weight, which increases the risk of many diseases. Obese people are 1.5-2 times more likely than people with normal body weight to develop diseases cardiovascular system, 3-4 times more often diabetes mellitus, 2-3 times more often cholelithiasis and liver diseases. Obesity is one of the most common reasons premature aging.

There are several ways to determine optimal body weight. The most common Brock's formula is: height (in cm) - 100. However, this calculation has a number of disadvantages. A more accurate indicator is the Quetelet index (weight (kg) / height 2 (m2), see Appendix 4). WHO offers the following gradation of the Quetelet index: 18.5-24.9 (normal values), 25-29.9 (overweight), 30 or more - obesity. The optimal levels are 22-25 kg/m2. It is at these values ​​that the risk of disease and death in each age group. Consequently, a person needs so many calories that his mass does not exceed the limits of the corresponding Quetelet index. You need to constantly monitor your weight, making the necessary adjustments to your diet and physical activity, including applying fasting days. To prevent obesity you need to:

• pay attention to information about the composition and calorie content of products on labels;
• do not get carried away with flour products, especially muffins containing fat and sugar;
• avoid excessive consumption of sugar and sweets, use sugar substitutes;
• avoid foods rich in fat (sausages, sausages, sausages, fatty dairy products);
• remember that alcoholic drinks, including beer, are high in calories;
• leave the table with a slight feeling of hunger, since the body has already received enough food, but the signal about this has not yet had time to reach the brain; chew food thoroughly, as this contributes to the extinction of appetite;
• increase physical activity as your body weight increases.

Features of nutrition of elderly people

Decrease in the intensity of metabolic processes in old age and decrease physical activity cause a decrease in the need for nutrients and a decrease in caloric intake in this population group. The diet of an elderly person should be varied and include a sufficient amount of vegetables and fruits. Food should be taken frequently, at least 5-6 times a day, in small portions. The diet should include sea fish, cottage cheese, lactic acid products, and lean meat. It is preferable to consume fish and meat boiled. You should limit the amount of animal fats, giving preference to vegetable fats containing unsaturated fatty acids, which is the prevention of atherosclerosis. You should limit your intake of salt, sugar (replace with honey or a sugar substitute), spices, smoked foods, strong tea and coffee. For regular bowel function, older people should include wholemeal bread in their diet.

Nutritional features of pregnant women

Rational nutrition of a pregnant woman is important not only for the proper development and maturation of the fetus, but also for the restructuring of the pregnant woman’s body in connection with future lactation. Therefore, the nutrition of a pregnant woman should provide the body with increased needs for all essential nutrients. In the first half of pregnancy, the need for proteins is 1.2-1.5 g per kilogram of weight, in the second half - 2 g per kilogram of weight. A pregnant woman should consume 120-200 g of lean beef or 150-200 g of fish daily. Fat should be consumed in the amount of 80-100 g per day (of which 30 g should be vegetable fats), carbohydrates - mainly in the form of raw vegetables and fruits up to 400-500 g per day. Particular attention should be paid to foods rich in iron, since anemia often develops in pregnant women. The daily requirement for iron is 15-20 mg. Iron is found in beef, beef liver, egg yolk, fruits and green vegetables (spinach, lettuce, apples). Pregnant women should limit their intake of salt, liquids, chocolate, citrus fruits, sweets, strong tea and coffee. With a rapid increase in body weight, on the recommendation of a doctor, so-called fasting days can be prescribed.

Medical nutrition

The patient’s diet, along with medications, plays a role big role in the treatment of the patient. A certain diet is the most important factor in the treatment of diseases of the digestive system, cardiovascular system, kidneys, endocrine system organs, etc.

Medical nutrition is organized according to the nomenclature of diets developed by the Institute of Nutrition of the Russian Academy of Medical Sciences. A social work specialist must have an idea about the features of a particular diet - a treatment table (there are 15 such treatment tables). Each number of the treatment table corresponds to a specific disease for which this table (diet) is used. A therapeutic diet can be prescribed not only in a hospital setting, but also at home. The diet is prescribed by the attending physician. In the hospital, along with the attending physician, the observance of therapeutic nutrition is monitored by the ward nurse, who checks the contents of the packages and controls the storage of products. At home, diet compliance is checked by a local doctor, a local nurse, and the patient’s relatives.

Radiation and nutrition

After the accident at the Chernobyl nuclear power plant, large areas were exposed to radioactive contamination. The remaining part of the population of these places receives up to 90% of radioactive substances from food, up to 10% from drinking water, and up to 1% from inhaled air. Plants absorb water-soluble isotopes of cesium-137 and strontium-90 from the soil. The concentration of radioactive substances in plants depends on the type of plant and soil composition. Since plants are eaten by domestic animals, radioactive substances accumulate in meat, milk and fish. Strontium accumulates most in carrots, beets, and grain crops. Thus, bread can also be contaminated with radionuclides (and rye bread 10 times more polluted than white). Cesium accumulates most in vegetables and meat, especially beef. Fewer radionuclides accumulate in fermented milk products than in milk. Eggs contain the least radionuclides in the yolk and the most in the shell. Freshwater fish accumulates more radionuclides than sea water. In order to reduce the level of radionuclides in the human body, it is necessary to subject foods to special processing, to use in the diet foods containing substances that promote the removal of radionuclides (minerals, vitamins, iodine, potassium, magnesium, dietary fiber). These products include: seaweed, legumes, garlic, nuts, seeds, wholemeal bread, oats, beans, pumpkin, cabbage.

Processing food products to reduce the level of radionuclides involves the following measures:

• thorough washing of food;
• peeling root vegetables, removing the top leaves of cabbage, removing seeds from fruits;
• soaking meat and root vegetables before cooking in frequently changed water (up to 12 hours);
• removal of bones, heads, internal organs animals and fish;
• exclusion (if possible) from the diet of lean fish and vegetable broths;
• use of fermented milk products (rather than whole milk);
• using eggs fried rather than boiled.

In order to reduce the intake of radionuclides into the human body, 2-2.5 liters of liquid should be consumed daily in the form of tea, juices, compotes, herbal decoctions with a weak diuretic effect (chamomile, St. John's wort, parsley, dill).

OPTIONS FOR APPETIZERS, SECOND COURSES, CANNED MEATS.

The “Hot breakfast/dinner NM (GP)” diet should, at a minimum, include:

· snack;

· second hot dish with side dish;

· individually packaged tea/coffee and sugar;

· confectionery;

· rye/wheat bread;

· jam/jelly in individual packaging;

· soft drinks;

· spices.

On flights without stopovers lasting more than 6 hours, the following must be additionally provided to the “GP” ration: a “Flight” type bun, toothpicks, butter in an amount of at least 20 g in individual packaging. The “hot meal” diet for business class passengers requires a choice of hot meals of at least 3 courses, and for economy class passengers - of at least two courses.

As a snack, diets may include:

The following may be included in the NM (GP) diet as second courses:

As side dishes for main courses, diets may include:

The “Hot Meal” ration for economy class passengers can be served on disposable tableware in a lunch box or on Dester tableware on a 2/3 tray or 1/2 tray in accordance with the airline’s Standard.

Diet "Cold breakfast/dinner SM (HP)".

The composition of the “Cold Breakfast/Dinner” diet is identical to the “Hot Breakfast/Dinner” diet, except for the main courses. Dishes that do not require heating on board the aircraft are served as second courses. The “Cold Breakfast/Dinner SM (HP)” food ration is served in the in-flight catering departments (except for additional orders) and is issued for a flight of more than 2 hours in the event of an aircraft type change to another aircraft without an oven.

As second courses, the diet may include:

· boiled or fried chickens;

· roast beef;

· beefsteak;

· fried stuffed meat;

· meat stuffed with vegetables;

· sausages, sliced ​​and vacuum packed.

As a side dish, pickled vegetables or fruits are served with a total yield of 100 g per serving.

Diet "Canned breakfast/dinner CF (KP)".

Canned food is provided on board aircraft during long flights as a second ration, or in the case where food is provided to passengers or crew not on the first flight, but on the subsequent or return flight, and therefore all ration products must have a long shelf life.

The composition of the diet is similar to the “Cold Breakfast/Dinner SM (CP)” diet, with the exception that canned meat with an appropriate side dish is served as second courses.

As a snack, the diet may include:

· Sprats, sardines, saury (canned) in oil or own juice;

· Fresh-cooked sausage;

· WITH melted holes.

Note. Sausage can be delivered on board the aircraft portioned in vacuum packaging or in whole loaves - portioning is carried out on board the aircraft.

Canned meats can be included in the diet as second courses:

minced sausage

· tourist breakfast,

· chicken fillet,

· fried meat,

· beef tongue in jelly,

· canned ham,

· canned sausages.

Note. Canned products are supplied in tin cans, free of grease and wiped clean.

The following may be included in the diet as side dishes:

· pickled fruits,

· pickled vegetables, green peas, greens,

· pickled fruits, pickled vegetables, herbs,

· pickled fruits, pickled vegetables, green peas, herbs.

Meal plan “Breakfast/dinner (NR No. 2)” released on board the aircraft for additional orders, without serving on trays.

Dispensing of rations for additional orders submitted by the airport in the prescribed manner (no later than 1 hour before departure) is carried out in pre-packaged packages (lunch boxes) for each passenger. The products may be different from the products that are issued according to the main order, but the food ration in packages (in lunch boxes) corresponds to the food ration provided for in the meal plan for a given flight.

Diet "Light breakfast/dinner SV (NR No. 1)" should include:

· snack;

· individually packaged tea/coffee;

· confectionery;

· individually packaged sugar;

· bun type “Flight”;

· fruit or fruit juice;

· soft drinks;

· spices.

Light snacks, sandwiches. Used as food on flights of short duration. The main requirements are ease of consumption without dishes and cutlery. Be sure to have meat or fish gastronomy (fillet of meat, poultry, fish), hard cheese with slices for sandwiches.

The Dessert PS diet should, at a minimum, include:

· individually packaged tea/coffee with lemon;

· confectionery;

· fruit or fruit juice;

· soft drinks.

The “Tea PS” diet, at a minimum, should include:

· sugar in ind. packaging;

· confectionery;

· soft drinks.

The following can be included in the diet as confectionery products:

· individually packaged cookies;

· individually packaged waffles;

· marshmallows or marshmallows in individual packaging;

· chocolate candies, pcs.;

· small slab chocolate;

· cake;

· sweet bun.

The following hot drinks may be included in the diet:

· individually packaged tea;

· natural instant coffee in ind. packaging;

· sugar in ind. packaging or granulated sugar in ind. packaging;

Note. Hot drinks must be provided in an assortment at the rate of no less than: coffee - 50%, black tea - 50%.

Taking into account the composition of passengers, airlines include hot drinks green tea. The percentage is determined by the airline.

Diet " Refreshments C (PN)”, at a minimum, should include:

fruit water

· mineral water (with gas, without gas).

Regardless of the diet, boiled chilled water is provided on board the aircraft in a boiler or a special container.

Meaning, principles, objectives.

Prevention of occupational and para-occupational diseases is one of the most important government and medical tasks. It is carried out by a complex of various hygienic measures of sanitary-technical and medical-biological content, among which an important place is given to therapeutic and preventive nutrition.

Therapeutic and preventive nutrition - These are specially selected diets aimed at preventing disorders in the body caused by exposure to harmful occupational factors. Therapeutic and preventive nutrition is based on a number of principles.

The use of antidote properties of food components, depending on the nature of the harmful factor and the nature of its action.

Accelerating the metabolism of poisons, slowing down the absorption of toxic substances in the gastrointestinal tract, accelerating their removal from the body.

Increasing the general resistance of the body and the functional abilities of the most affected organs.

Compensation for increased costs of biologically active substances due to the detoxification of poisons and the effects of harmful substances.

Organization of therapeutic and preventive nutrition.

The main principle of selecting a diet of a specific composition is pathogenetic validity, taking into account the mechanism of action of the professional factor.

Five therapeutic and preventive nutrition diets have been developed. Their compilation is based on the principle of compliance of the protective activity of the diet with the specific influence of harmful effects. Harmful substances are combined based on the homogeneity of their mechanism of action. For example, diet No. 4 is intended for those working with mercury, asbestos products, benzene and herbicides.

In addition to the indicated 5 numbers (6 options) of therapeutic and prophylactic nutrition rations, there are scientific developments in a number of individual industries, some of which have been introduced at the enterprises of the industries by the relevant trade unions.

The type and volume of preventive nutrition is determined by the nature of the active agent, the duration of contact with it, and the conditions of the working environment. A specific type of LPP is selected based on production conditions in accordance with the approved official “List of industries, professions and positions in which work gives the right to receive free LPP in connection with particularly harmful working conditions,” which includes more than 3,170 professions and positions.

Therapeutic and preventive nutrition is issued only to those employees for whom the provision of this food is provided for in this List, regardless of what sector of the economy these industries are located in, as well as the organizational, legal forms and forms of ownership of employers. Changes and additions to the above list are made by resolutions of the Government of the Russian Federation on the basis of proposals from federal bodies executive branch subjects Russian Federation in agreement with the Ministry of Health and Social Development of Russia.

Therapeutic and prophylactic nutrition is issued to employees on the days they actually perform work in production, provided that they are engaged in work in production, provided that they are employed at the specified job for at least half of the working day, as well as on days of illness with temporary loss of ability to work, if the nature of the disease is professional and the sick person was not hospitalized.

In accordance with the Labor Code of the Russian Federation, LPP provides for the free issuance of:

· hot breakfasts;

milk (or fermented milk products);

· vitamin preparations.

Hot breakfasts. Currently, eight hot breakfast diets have been developed and are used (in accordance with the main groups of industrial hazards). Hot breakfasts (LPP rations) are given out before the start of the work shift, with the exception of those working in high-pressure conditions (in caissons, pressure chambers, diving work) who receive the LPP ration after release. Hot breakfasts should contain at least 50% of the daily requirement for energy and nutrients.

Characteristics of diets

Diet No. 1

designed for LPP of workers in contact with radioactive substances and sources of ionizing radiation, including: 1) those directly involved in the mining, processing (including loading and storage) of uranium and thorium ores; production and processing of uranium, thorium, tritium, radium, thorium-228, radium-228, actinium-228, polonium, transuranic elements, fission products of uranium and thorium; 2) those employed in research, transport, pilot industrial nuclear reactors, their prototypes, critical assemblies and pulsed reactors, experimental thermonuclear installations and powerful isotope irradiation γ-irradiation installations.

Diet No. 1 contains 59 g of proteins, 51 g of fats, 159 g of carbohydrates, and additionally 150 mg of vitamin C is added to its composition. The diet should provide additional intake of antioxidant nutrients and lipotropic substrates into the body and protect the body from radio load, preventing lipid peroxidation and reducing the consequences of radiation mutagenesis.

Diet No. 2

intended for personal protective equipment for workers who come into contact with inorganic acids, alkali metals, chlorine and fluorine compounds, organophosphorus and cyanide compounds. It contains 63 g of protein, 50 g of fat, 185 g of carbohydrates, and additionally vitamin A and vitamin C are added to its composition in quantities of 2 and 100 mg, respectively.

Diet 2a

intended for personal protective equipment for workers in contact at work with chromium and chromium-containing compounds. The diet should provide a hypoallergenic diet for this category of workers. It is more strictly balanced in animal proteins and essential amino acids, vegetable oils (PUFAs), and vitamins. Diet 2a contains 52 g of protein, 63 g of fat, 156 g of carbohydrates, with the additional inclusion of vitamins C - 150 mg, as well as 100 ml of Narzan mineral water.

It is advisable to expand the range of fresh vegetables, fruits and berries in diet 2a with products such as cabbage, zucchini, pumpkin, cucumbers, rutabaga, turnips, lettuce, apples, pears, plums, grapes, chokeberry. In cases where fresh vegetables are unavailable, you can use well-soaked (to remove sodium chloride, hot spices and seasonings) salted, pickled and pickled vegetables when preparing dishes. When producing DPP provided for in this diet, it is recommended to prepare mainly boiled and steamed, as well as baked and stewed (without prior frying) dishes.

Diet No. 3

inorganic and organic lead compounds. It contains 64 g of protein, 52 g of fat, 198 g of carbohydrates and an additional 150 mg of ascorbic acid. When prescribing diet No. 3, it is imperative to provide daily meals from vegetables and fruits that have not been subjected to heat treatment (salads) to maximize the preservation of vitamins and indigestible dietary fiber in them. For the same purpose, it is necessary to use wholemeal bread and low-refined cereals (for example, oats instead of Hercules). Milk is not provided in its natural form; it is replaced with kefir and fermented milk products.

Diet No. 4

is intended for LPP of workers who come into contact at work with compounds of benzene and phenol, chlorinated hydrocarbons, azo dyes, arsenic, mercury, fiberglass, and also when working in conditions increased external pressure. This diet is one of the most widely used in DILI. It contains 65 g of protein, 45 g of fat, 181 g of carbohydrates with the additional inclusion of vitamins C - 150 mg and B1 - 4 mg (the latter when working with arsenic and mercury tellurium compounds). The purpose of diet No. 4 is to protect the liver and hematopoietic organs from compounds of both organic and inorganic nature that are tropic to them. It is lipotropic and low in fat.

Diet No. 4a

is intended for LPP of workers who come into contact at work with phosphoric acid, phosphoric anhydride, phosphorus and its other derivatives. It contains significant amounts of vegetables and animal protein sources. In this diet, fats should be reduced as much as possible: both due to a small amount of oils and as a result of the use low-fat varieties meat and dairy products. Whole milk is replaced with kefir. All this helps to reduce the absorption of phosphorus into gastrointestinal tract. Diet No. 4a contains 54 g of protein, 43 g of fat, 200 g of carbohydrates with the additional inclusion of vitamins C - 100 mg and B1 - 2 mg.

Ration No. 4b

is intended for LPP of workers who come into contact at work with very hazardous to health aniline and toluidine derivatives, dinitrochlorobenzene and dinitrotoluene. The effect of the diet is aimed at reducing the incorporation of these chemical compounds and increasing cellular protective and adaptive mechanisms. For this purpose, the diet includes a variety of plant components and is enriched with a wide range of vitamins and glutamic acid, which provides a general detoxification effect: vitamins C - 150 mg, B1 - 2 mg, B2 - 2 mg, B6 - 3 mg, PP - 20 mg, E – 10 mg, glutamic acid – 500 mg. Diet No. 4b contains 56 g of protein, 56 g of fat, 164 g of carbohydrates.

Diet No. 5

is intended for LPP of workers who come into contact at work with hydrocarbons, carbon disulfide, ethylene glycol, organophosphorus pesticides, polymeric and synthetic materials, manganese. The action of diet No. 5 is aimed at protecting the nervous system and liver. It contains lecithin, PUFAs, and complete animal proteins. Additionally, vitamin B1 (4 mg) and ascorbic acid (150 mg) are provided. This diet contains 58 g of protein, 53 g of fat, 172 g of carbohydrates.

Vitamins, intended for additional use as part of hot breakfasts, they are added in the form of an aqueous solution, as a rule, to the third course (C, group B, as well as glutamic acid) or in oil solutions to side dishes of second courses or salads (A, E).

Vitamin preparations. Workers engaged in industries associated with the adverse effects of high temperatures and nicotine-containing dust on the body are given free vitamin preparations as an independent type of DIE.

Standards for free distribution of vitamin preparations

Order of the Ministry of Health and Social Development of Russia No. 45n dated February 16, 2009“On approval of the norms and conditions for the free issuance of milk or other equivalent food products to employees engaged in work with hazardous working conditions, the Procedure for making compensation payments in an amount equivalent to the cost of milk or other equivalent food products, and the List of harmful production factors under the influence of which V for preventive purposes consumption of milk or other equivalent food products is recommended.”

According to this order, free distribution of milk or other equivalent food products is carried out to employees on days of actual employment in jobs with hazardous working conditions, caused by the presence in the workplace of harmful production factors, provided for in the List of harmful production factors, under the influence of which, for preventive purposes, it is recommended to consume milk or other equivalent food products and whose levels exceed established standards.

The rate of free milk distribution is 0.5 liters per shift, regardless of the duration of the shift.

Workers who come into contact with inorganic compounds of non-ferrous metals are given 2 g of pectin in addition to milk as part of food products enriched with it: drinks, jellies, jams, marmalades, juice products from fruits and (or) vegetables and canned food (the actual pectin content is indicated by the manufacturer).

It is allowed to replace these products with natural fruit and (or) vegetable juices with pulp in an amount of 300 ml.

If there is constant contact with inorganic compounds of non-ferrous metals, instead of milk, fermented milk products or products for dietary (therapeutic and preventive) nutrition under hazardous working conditions are given.

The distribution of pectin-enriched food products, drinks, jellies, jams, marmalades, juice products from fruits and (or) vegetables and canned food must be organized before starting work, and fermented milk products - during the working day.

Instead of fresh milk, workers involved in the production or processing of antibiotics are given fermented milk products enriched with probiotics (bifidobacteria, lactic acid bacteria) or colibacterin prepared from whole milk.

It is not allowed to replace milk with sour cream, butter, or other products (except for equivalent foodstuffs of equal value provided for by the standards for the free issuance of equivalent food products that can be issued to employees instead of milk), as well as the issuance of milk or other equivalent food products one or more shifts in advance, as well as for past shifts.

The standards for the free issuance of equivalent food products that can be given to employees instead of milk are given in the table.

Standards for the free issuance of equivalent food products that can be given to employees instead of milk

No.	Name of food product	Issue rate per shift
	Fermented milk liquid products, including fortified ones, with a fat content of up to 3.5% (different types of kefir, yogurt, acidophilus, fermented baked milk), yoghurts with a fat content of up to 2.5%.
	Cottage cheese no more than 9% fat
	Cheese no more than 24% fat content
	Products for dietary (therapeutic and preventive) nutrition under hazardous working conditions	Established in a conclusion authorizing their use

Replacing milk with equivalent food products is permitted with the consent of workers and taking into account the opinion of the primary trade union organization or other representative body of workers.

Workers who receive free therapeutic and preventive food due to particularly harmful working conditions, milk or other equivalent food products are not issued.

Responsibility for ensuring the free provision of milk and equivalent food products to employees, as well as for compliance with these standards and the conditions for their distribution rests with the employer.



The daily diet consists of products consumed in their natural form or after various culinary treatments. Depending on their nutritional and biological value, products are divided into six groups. Each food group contains one or more nutrients. Each product is special chemical composition and taste properties, which determines its effect on the body.

Bakery products, Grain products have a high energy value; they make up a significant share in the daily diet, covering more than 40% of daily energy costs.

Baking bread is one of the greatest discoveries of the human mind. Its technology was created over centuries and required invention, knowledge, work and perseverance from a person. The art of baking was well known to the ancient civilizations of Mesopotamia, Egypt, Harappa and Mohenjo-Daro. There are reports of bread baked in the Stone Age, i.e. 6 thousand years ago.

The diet of the world's population is dominated by wheat and rice (80% of the population). In many countries of Central and South America The main grain crop is maize.

Grain products contain a lot of carbohydrates, B vitamins, vegetable protein, and minerals, the content of which depends on the quality of grinding and cleaning of the grain. Dark flours are richer in nutrients and fiber compared to white flours. For healthy children and adults, a certain proportion in the consumption of rye and wheat bread is recommended.

Meat is one of the staple foods. It contains complete proteins, fats, minerals, retinol, calciferol, B vitamins and extractives. Meat is characterized by high digestibility (82 - 83%). The most valuable part of the meat carcass is muscle tissue containing proteins (myosin - about 50%, actin - 15%, globulin - 20%), which, in turn, contain all the essential amino acids. Meat is a significant source of potassium (212 - 259 mg/100 g), phosphorus (116 - 167 mg/100 g), iron (1.1 - 2 - 3 mg/100 g), as well as trace elements - copper, zinc, cobalt .

Connective tissue, unlike muscle tissue, contains incomplete proteins - collagen and elastin. The nutritional value of meat depends on the ratio of muscle and connective tissue in it, and fat content. The more muscle tissue and less connective tissue, the greater nutritional value it represents. A large amount of fat in meat leads to a decrease in the relative amount of proteins, which, from the standpoint of rational nutrition, reduces its nutritional value. Compared to mammalian meat, poultry meat contains significantly less connective tissue, therefore, less incomplete proteins and more complete proteins. The presence of mainly saturated fatty acids in meat determines the dense consistency of animal fats, which are well absorbed by the body (90 - 98%).

Blood is very valuable integral part meat, since its proteins contain all the essential amino acids. Meat contains nitrogenous and non-nitrogenous extractive substances, which give it a unique aroma, as well as purine bases (26 - 86 mg/100 g). When cooking meat, a significant part of the extractive substances goes into the broth.

IN eggs contains all the nutrients necessary for life (proteins, fats, vitamins, minerals), the entire complex of essential amino acids, phospholipids, retinol, calciferol, tocopherol, phylloquinone, B vitamins, biotin, choline. Easy and good digestibility allows them to be classified as valuable products.

Nutritional value fish due to the fact that it is one of the main sources of highly digestible, complete protein (16 - 18%) and fat (0.3 - 30.8%), rich in retinol, calciferol and containing a significant amount of unsaturated fatty acids, mineral salts and extractives . It also contains B vitamins. The amino acid composition of the proteins in fish muscle tissue is similar to the proteins in the meat of warm-blooded animals. The fat content is subject to large fluctuations, and therefore, according to fat content, fish are usually divided into lean (up to 4% ), medium fat content (4 − 8%) and fatty (over 8% ) fat Sea fish are generally low in fat. Many types of river fish (bream, carp, carp, etc.) are classified as medium-fat fish. According to fluctuations in fat content, the calorie content of fish also varies widely (from 288 to 1435 kJ per 100 g). Carbohydrates in fish, as in meat, are contained in small quantities (up to 1%) and are represented mainly by glycogen. There is less connective tissue in fish than in the meat of warm-blooded animals, and it is evenly distributed and contains almost no elastin. Skinny fish are low in purine and pyrimidine nitrogenous substances. Fish proteins are digested much faster by proteolytic enzymes compared to meat products. The digestibility of fresh fish protein is 2 - 3% higher than meat protein. Fish lipids are represented mainly by triglycerides of various fatty acids, of which up to 90% are biologically active unsaturated fatty acids.

Of the microelements, fish contains a lot of phosphorus and potassium, and sea fish contains a lot of iodine. Extractive substances from fish have a strong sap effect. There is especially a lot of retinol and calciferol in liver tissue.

Milk and dairy products. IN rational nutrition In children and adults, milk occupies an exceptional place, which is explained by the favorable ratio of essential amino acids included in milk protein, the good digestibility of fat, which is in a state of thin emulsion, and its vitamin composition. Milk proteins consist predominantly of caseinogen (2.5 - 3%), lactalbumin (0.5 - 1%) and lactoglobulin (0.1%); Casein accounts for 81% of all milk proteins. Due to the presence of methionine, lecithin, and phosphorus in milk protein, milk and dairy products have a pronounced lipotropic effect. The fat of milk and dairy products contains fat-soluble vitamins, most of all retnol. Milk is also a valuable source of B vitamins, mainly thiamine and riboflavin. The more carotene the feed of farm animals contains, the more retinol there is in the milk. Lactic acid products contain 20–30% more thiamine and riboflavin than original milk, due to their synthesis by lactic acid bacteria. The content of ascorbic acid in milk is small (5 - 35 mg/l). Due to technological processing, pasteurized and sterilized milk practically does not contain ascorbic acid. The mineral composition of milk is characterized by a high content of easily digestible calcium and its optimal ratio with phosphorus (1: 1.5).

Due to their high biological value, milk and dairy products must be included in the daily diet, especially for children and the elderly. Milk contains milk sugar (lactose), which, when hydrolyzed, breaks down into glucose and galactose. It plays an exceptional role in the technology of lactic acid products and cheeses. At the same time, the hydrolysis of lactose under the influence of the lactose enzyme with the formation of lactic acid is the cause of milk souring. Due to a deficiency of the lactose enzyme, some people cannot tolerate milk. In these cases, it is recommended to replace milk with fermented milk products.

Sugar and confectionery. Sugar contains 99.75% sucrose. Sugar and confectionery products have a high energy value and are easily digestible. Confectionery products are divided into sugary (all types of sweets, chocolate, halva, marmalade, marshmallows) and flour (cookies, pastries, pies, gingerbread, waffles). Sugary confectionery products contain mainly sugar and fats; flour confectionery products, in addition to sugar and fats, contain starch. Confectionery products, as a rule, do not contain vitamins and minerals.

Vegetables. Over many millennia, a wide range of products has been established in different parts of the Earth. edible plants. However, out of 500 thousand plant species, humanity uses only 5.5 - 6 thousand, and cultivates about 90 species.

Potatoes are one of the most important food products for everyday consumption. Mature potato tubers contain up to 24% starch, making potatoes a valuable energy source. When consuming 100 g of potatoes, 394 kJ (94 kcal) of thermal energy is generated in the body. Potatoes are an important source of ascorbic acid, which is especially important in winter. Potatoes are also valuable as a source of B vitamins. They are especially rich in folic acid, riboflavin and niacin, as well as various minerals. It contains especially a lot of potassium - 1.5 times more than in many other vegetables and fruits. The property of potassium to “unload” the body from excess water makes it useful for those suffering from edema, kidney and heart diseases. Raw potato juice is used in therapeutic nutrition for hypertension and peptic ulcers. There is little protein in potatoes (2 g per 100 g of product), but it is the most valuable of all vegetable proteins. It contains many essential amino acids.

Among all varieties of cabbage, white cabbage ranks first in terms of prevalence. Red cabbage has a milder taste and contains a lot of nitrogen, minerals and vitamins. Red cabbage contains anthocyanins, which give it not only its color, but also its beneficial properties.

Savoy cabbage contains slightly more protein, carbohydrates, carotene, ascorbic acid and niacin than white cabbage. She has high taste qualities. However, its production in our country is extremely low. Cauliflower has become more widespread. Kohlrabi is superior in the content of dry matter, nitrogen, carbohydrates and minerals. white cabbage. Brussels sprouts contain more protein (3.4 times), minerals (2.5 times), and ascorbic acid (4.4 times).

Green vegetables occupy a significant place in a balanced human diet. Among them there are several types of salads. Among green vegetables, spinach and sorrel are most common. Asparagus is a highly valuable perennial dessert vegetable. You can cook a lot with asparagus healthy dishes. It is boiled and consumed with butter, white sauce, mayonnaise, lightly fried or baked in oil, and prepared in soup, puree, canned food, and salads. Healthy green vegetables include the artichoke, which is common in many countries. Western Europe. Rhubarb is grown for its juicy, tender cuttings, which have a pleasant sour taste reminiscent of apple. Rhubarb is used for food in early spring, when the diet is poor in fresh herbs. Contains 10 mg ascorbic acid and 16 mg folic acid per 100 g of product.

Tomatoes and cucumbers are among the most common crops. Tomatoes, due to their pleasant taste and high content of vitamins and mineral salts, are widely used in a balanced diet. Some varieties of tomatoes are close to lemons and tangerines in ascorbic acid content. Canned tomatoes also contain ascorbic acid, which is of great importance when eating in the winter. Tomatoes contain large amounts of carotene and thioflavonoids, as well as many organic acids. Of the mineral salts in tomatoes, there are a lot of potassium and copper salts. Eggplants are much less widespread, and therefore their consumption does not exceed 1.8 kg per year per person, although they have a hypocholesterolemic effect.

Melons (watermelon, melon, pumpkin). These crops are distinguished by a significant content of glucose, potassium, and ascorbic acid (up to 20 mg per 100 g). In Ukraine, three types of pumpkins are grown: hard-boiled, nutmeg and large-fruited, as well as zucchini and squash.

Pumpkin is a valuable vegetable crop, contains a lot of potassium, carotene (1.5 mg per 100 g), ascorbic acid, and organic acids.

Legumes are high in complete protein, but their production is also insufficient (about 0.5 kg per person).

Onions and garlic have long been widely used in their natural form and in many preparations. national dishes. They contain a lot of phytoncides, ascorbic acid (10 - 55 mg per 100 g), folic acid.

Beetroot was brought from Byzantium to the territory Kievan Rus Prince Oleg (in 911). The characteristic color is due to the presence of anthocyanins (betaine). Has hypotensive properties.

Carrots are a source of carotene, which is converted into retinol in the body. In addition, carrots contain a lot of sugars and dietary fiber. It is advisable to consume carrots and their processed products daily. Excluding carrots from the diet can lead to retinol deficiency.

Leaf and root parsley has long been used as a means to help restore strength. Parsley leaves contain carotene. Celery improves the tone of the whole body and stimulates appetite. Celery greens have a significant carotene content (4.5 mg/100 g).

Radishes and radishes contain many essential oils, which determine their specific taste, as well as ascorbic acid (25 - 29 mg/100 g) and fiber.

Fruits and berries differ in a wide variety of taste and nutritional properties. Apples are the most common in the population's diet; they are a source of ascorbic acid, potassium, pectin, organic acids, iron and sugars. Citrus fruits contain 38 - 60 mg of ascorbic acid per 100 g. The maximum amount of ascorbic acid is found in black currants and sea buckthorn (200 mg per 100 g), as well as in rose hips (650 mg per 100 g). Apricots and rowan contain a lot of carotene (1.6 and 1.2 mg per 100 g). Grapes are valued as a good source of sugars and potassium.

Mushrooms can occupy a significant place in the diet of certain groups of the rural population (up to 1 kg per day in season). Dry mushrooms contain a lot of protein (white - 20.1% ). The energy value of 100 g of dried mushrooms reaches 628 - 1004 kJ (150 - 240 kcal). Mushrooms contain many extractive substances that give a specific taste and smell to dishes prepared from them.

Fat products. Dairy fat products are highly digestible and contain a significant amount of fat-soluble vitamins - retinol and calciferol, phosphatides. The fat content in butter is 82.5%, in cream - 10 - 20, sour cream - 20 - 40%. In other fatty products of animal origin, 100% fat content is achieved by rendering from adipose and bone tissue (beef, lamb and pork fats). These fats are characterized by a high content of saturated fatty acids (at least 50% of their total amount).

Sunflower seeds, soybeans, rapeseed, cotton, peanuts, and nuts contain a significant amount of fat (29 - 70%), so they are used to obtain vegetable fats. Most vegetable fat products contain a lot of PUFAs, which ensures their liquid state. Only cocoa butter and coconut oil contain predominantly (more than 50%) saturated fatty acids. Unrefined vegetable oils are a source of phosphatides, tocopherols, sterols and a number of other biologically valuable components, have better taste properties, and are biologically more valuable than refined ones. To eliminate this drawback, refined vegetable oils are enriched with phosphatides. At the same time, refining of some types of vegetable oils is necessary, as it allows you to get rid of impurities harmful to humans. Thus, raw cottonseed oil contains toxic gossypol (0.08 - 2%). By refining the oil, this pigment is completely removed. Vegetable oils are free of cholesterol.

A special group of fatty products consists of margarines (table and culinary), which are hydrogenated liquid fats from plants, marine animals and fish with various additives (rendered animal fats, vegetable oil, butter, milk, sugar, salt, aromatics, retinol and calciferol, dyes, emulsifiers, etc.).