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[用于非酒精性脂肪性肝炎患者饮食调整的专用产品]

[Specialized products for dietary correction of the diet of patients with non-alcoholic steatohepatitis].

作者信息

Vorobyeva V M, Vorobyeva I S, Morozov S V, Sasunova A N, Kochetkova A A, Isakov V A

机构信息

Federal Research Centre of Nutrition, Biotechnology and Food Safety, 109240, Moscow, Russian Federation.

出版信息

Vopr Pitan. 2021;90(2):100-109. doi: 10.33029/0042-8833-2021-90-2-100-109. Epub 2021 Mar 11.

Abstract

Non-alcoholic steatohepatitis (NASH) is a widespread disorder associated with a number of metabolic disorders. Lifestyle modification, including diet and physical activity are currently a first-line treatment for the disease. However, there is lack of specialized products (SP) with modified carbohydrate and fat composition, containing biologically active ingredients with proven physiological effects on the liver for this disorder. of the paper is to summarize present knowledge on the biologically active ingredients with proven hepatoprotective effect and to describe the process of the development of two specialized products for clinical use in patients with NASH. . Food ingredients containing soy and milk proteins, soluble dietary fiber, mono- and polyunsaturated fatty acids, vitamins, minerals, soy lecithin, L-carnitine, coenzyme Q10, α-lipoic acid, betaine, flavoring and aromatic additives were used in the development of SP formulations. The mass fraction of moisture in the SP was determined by the thermo-gravimetric method on a humidity analyzer, and the water activity was determined by measuring the dew point. The nutritional and energy value of the SP was calculated using data from chemical composition tables and information from manufacturers of food ingredients. . Taking into account the requirements for dietary therapy, the ingredient composition was scientifically justified and the formulations of two SP with a balanced amino acid composition were developed by using a combination of milk whey proteins, casein and soy protein isolate. The fat component included microencapsulated rapeseed oil, that is a source of mono- and polyunsaturated fatty acids (PUFAs) with the addition of ω-3 PUFAs. The carbohydrate composition was modified by eliminating mono- and disaccharides, traditionally used in sweet drinks, and adding maltodextrin in combination with sweeteners (polyols and natural sweeteners). Polydextrose, citrus pectin, inulin, and hydrolyzed guar gum are used as soluble dietary fibers. The SP included essential micronutrients (vitamins, mineral substances) and bioactive substances that have a proven physiological effect (coenzyme Q10, α-lipoic acid, L-carnitine, betaine hydrochloride, phospholipids). Technical documentation was developed and a pilot batch of SP-1 was developed for inclusion in the complex treatment of patients with NASH. . The formulations and technology of SP (SP-1, SP-2) for therapeutic nutrition with a given chemical composition, designed to optimize the diet therapy of patients with NASH, have been developed. SP are sources of animal and vegetable proteins, soluble dietary fiber, mono- and polyunsaturated fatty acids, including ω-3 family, vitamins, minerals and trace elements, as well as bioactive substances with antioxidant, hepatoprotective and hypolipidemic effect. The technical documentation was developed and approved, according to which a pilot batch of SP-1 was produced to assess its effectiveness as a part of complex therapy of patients with NASH.

摘要

非酒精性脂肪性肝炎(NASH)是一种与多种代谢紊乱相关的广泛疾病。生活方式的改变,包括饮食和体育活动,目前是该疾病的一线治疗方法。然而,缺乏碳水化合物和脂肪成分经过改良、含有对该疾病肝脏具有已证实生理作用的生物活性成分的特殊产品(SP)。本文的目的是总结关于具有已证实肝脏保护作用的生物活性成分的现有知识,并描述两种用于NASH患者临床使用的特殊产品的开发过程。在SP配方的开发中使用了含有大豆和牛奶蛋白、可溶性膳食纤维、单不饱和脂肪酸和多不饱和脂肪酸、维生素、矿物质、大豆卵磷脂、L-肉碱、辅酶Q10、α-硫辛酸以及甜菜碱、调味剂和芳香添加剂的食品成分。通过在湿度分析仪上采用热重法测定SP中的水分质量分数,并通过测量露点来测定水分活度。利用化学成分表中的数据和食品成分制造商提供的信息计算SP的营养和能量值。考虑到饮食疗法的要求,对成分组成进行了科学论证,并通过将乳清蛋白、酪蛋白和大豆分离蛋白组合使用,开发了两种氨基酸组成平衡的SP配方。脂肪成分包括微胶囊化菜籽油,它是单不饱和脂肪酸和多不饱和脂肪酸(PUFA)的来源,并添加了ω-3多不饱和脂肪酸。通过去除传统用于甜味饮料中的单糖和双糖,并添加麦芽糊精与甜味剂(多元醇和天然甜味剂)组合来改良碳水化合物组成。聚葡萄糖、柑橘果胶、菊粉和水解瓜尔胶用作可溶性膳食纤维。SP包含必需的微量营养素(维生素、矿物质)和具有已证实生理作用的生物活性物质(辅酶Q10、α-硫辛酸、L-肉碱、盐酸甜菜碱、磷脂)。制定了技术文件,并开发了一批SP-1试验批次,用于纳入NASH患者的综合治疗。已经开发出具有给定化学成分的用于治疗营养的SP(SP-1、SP-2)的配方和技术,旨在优化NASH患者的饮食疗法。SP是动物和植物蛋白、可溶性膳食纤维、单不饱和脂肪酸和多不饱和脂肪酸(包括ω-3族)、维生素、矿物质和微量元素以及具有抗氧化、肝脏保护和降血脂作用的生物活性物质的来源。制定并批准了技术文件,据此生产了一批SP-1试验批次,以评估其作为NASH患者综合治疗一部分的有效性。

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