Antipova L V, Oboturova N P, Klimov L Ya, Stoyan M V, Masalova V V
Voronezh State University of Engineering Technologies.
North-Caucasian Federal University, Stavropol.
Vopr Pitan. 2018;87(2):85-93. doi: 10.24411/0042-8833-2018-10022. Epub 2018 Feb 26.
The purpose of the study is to evaluate the possibility and effectiveness of inclusion of specialized semi-finished meat products in the gluten-free diet of children and adolescents with celiac disease. In the article the authors present the recipe for a new type of specialized meat semi-finished products - gluten-free dumplings. As ingredients of semi-finished products rice flour, amaranth flour, flax flour, chickpea flour, corn starch, curd whey, beef, poultry, goose fat and other auxiliary ingredients were used. The results of studies of the main quality indicators (nutritional value) of a new specialized meat semi-finished product have been presented. The results of studies of the protein component of the product, related both to protein digestibility (evaluated in vitro) and to the degree of its amino acid balance, confirmed its high biological value. To substantiate the effectiveness of the inclusion of gluten-free dumplings in the diet of patients with celiac disease, clinical approbation has been carried out. In an open, prospective, nonrandomized study, 20 children with celiac disease consumed gluten-free diet for 6 months and more were included. Based on the results of the clinical and serological survey, a group of 13 children aged 7 to 15 years (mean age 9.4±0.8 years), strictly adherent to a gluten-free diet, was identified. Children received a portion of the cooked product (15-20 dumplings, which amounted to 180-250 g per day) within 1 month. Against the background of strict adherence to the gluten-free diet and a monthly course of dumplings intake, all children and adolescents were noted to have no elevation, and in some cases, a decrease in the level of specific autoantibodies, which is a proof of the absolute safety of the product for patients. The level of anti-tTG IgA decreased from 1.3 (0.5, 2.3) to 0.6 (0.1, 1.3) U/ml (p<0.05), a decrease in the level of anti-DPG IgA from 4.0 (1.1, 5.0) to 1.8 (1.3, 4.1) U/ml (p<0, 05) was also detected. Patients showed a tendency to improve anthropometric indices in the form of a decrease in the lag in the body mass from -0.22±0.3σ to 0.01±0.3σ and BMI from -0.64±0.4σ to -0.52±0.4σ (p>0.05). The hematological indices remained unchanged, while iron blood serum indexes on the background of the product intake improved: ferritin concentration increased from 27.4±3.6 to 37.7±6.0 μg/l (p<0.05), latent iron binding capacity decreased by 9.6% (p<0.05); total iron binding capacity tended to decrease by 6.4% (p=0.055) with a slight increase in iron transferrin saturation. The data obtained testify a positive effect of a new product intake on quality of a life and improvement of the general condition of patients that gives the basis to recommend the developed dumplings for inclusion in diets of patients with celiac disease.
本研究的目的是评估将特制肉类半成品纳入乳糜泻儿童和青少年无麸质饮食的可能性和有效性。在本文中,作者介绍了一种新型特制肉类半成品——无麸质饺子的配方。作为半成品的原料,使用了米粉、苋菜籽粉、亚麻籽粉、鹰嘴豆粉、玉米淀粉、凝乳清、牛肉、家禽、鹅油和其他辅助成分。本文展示了对新型特制肉类半成品主要质量指标(营养价值)的研究结果。对该产品蛋白质成分的研究结果,包括蛋白质消化率(体外评估)及其氨基酸平衡程度,证实了其较高的生物学价值。为了证实将无麸质饺子纳入乳糜泻患者饮食的有效性,已开展了临床验证。在一项开放、前瞻性、非随机研究中,纳入了20名食用无麸质饮食6个月及以上的乳糜泻儿童。根据临床和血清学调查结果,确定了一组13名7至15岁(平均年龄9.4±0.8岁)严格坚持无麸质饮食的儿童。儿童在1个月内每天食用一份煮熟的产品(15 - 20个饺子,相当于每天180 - 250克)。在严格坚持无麸质饮食和每月食用饺子疗程的背景下,所有儿童和青少年的特定自身抗体水平均未升高,在某些情况下反而下降,这证明了该产品对患者的绝对安全性。抗组织转谷氨酰胺酶IgA水平从1.3(0.5,2.3)降至0.6(0.1,1.3)U/ml(p<0.05),抗脱酰胺麦醇溶蛋白IgA水平也从4.0(1.1,5.0)降至1.8(1.3,4.1)U/ml(p<0.05)。患者的人体测量指标有改善趋势,体重滞后从 - 0.22±0.3σ降至0.01±0.3σ,身体质量指数从 - 0.64±0.4σ降至 - 0.52±0.4σ(p>0.05)。血液学指标保持不变,而在摄入该产品后血清铁指标有所改善:铁蛋白浓度从27.4±3.6升至37.7±6.0μg/l(p<0.05),潜在铁结合能力下降9.6%(p<0.05);总铁结合能力有下降6.4%的趋势(p = 0.055),转铁蛋白铁饱和度略有增加。所获得的数据证明了摄入新产品对患者生活质量和总体状况改善的积极作用,这为推荐所研制的饺子纳入乳糜泻患者饮食提供了依据。