About the journal

About the magazine Practical Dietetics»

"Practical Dietetics" - a project of the National Association of Clinical Nutrition

"Practical Dietetics" Russia's first information and practical magazine on dietetics for specialists. Published since 2011.

Edition uniqueness:

the journal presents a rich practical experience of dietitians, specialists in the field of nutrition of a sick and healthy person;
The materials of the magazine are executed in newspaper and magazine genres.

Purpose of publication:

exchange practical experience among professionals in the field of nutrition and related disciplines;
coverage of issues of diets and nutrition in medical institutions, the organization of the work of catering units, personnel, the choice of food equipment, etc.;
coverage of legal and nutritional issues;
consideration of special clinical cases;
answers to exciting professional questions, assistance in making decisions in case of problem situations.

The main criteria for selecting materials for publication in the journal are not only the uniqueness of the text, the relevance of the topic, the public interest, the freshness of the ideas presented, but, above all, the reliability and legal literacy.

The magazine contains the most interesting results of practical dietology, consultations of doctors of various specialties, comments on the fundamental documents that determine the organization of therapeutic and preventive nutrition, trends and consequences of the adoption management decisions. In the materials of the publication you can find different points of view of representatives of numerous schools and movements.

The target audience

Specialized specialists (nutritionists, nutritionists, general practitioners, pediatricians, etc.), Russian healthcare organizers, chief physicians, administrations of medical institutions.

Permanent sections of the journal:

word of law
Standardization
Chief physician
Workshop
Nutritional Risks
Situation
According to the taste of the patient

Periodicity: 4 times a year.

Volume: 100-140 full color pages.

Circulation: 5,000 copies.

Thank you for being with us!

Approximately 20,000 readers per print run - each copy is read by an average of four people.

Distribution in the regions of the Russian Federation and neighboring countries:

Subscription
Distribution at specialized events

Free mailing to ministries and departments of the Russian Federation - more than 700 addresses.

V. A. Tutelyan, Doctor of Medical Sciences, Professor, Academician of the Russian Academy of Sciences, scientific adviser Federal State Budgetary Institution "Federal Research Center for Nutrition and Biotechnology", Chief Freelance Dietitian of the Ministry of Health of Russia,Honored Worker of Science Russian Federation

T. Yu. Grozdova, MD, Vice-President of the National Association clinical nutrition

Yu. V. Abakumova, Doctor of Medical Sciences, Professor, Chairman of the Saratov regional office Academy of Medical and Technical Sciences of the Russian Federation,

A. Yu. Baranovsky, Doctor of Medical Sciences, Professor, Head of the Scientific, Clinical and Educational Center for Gastroenterology and Hepatology, St. State University”, chief gastroenterologist of the NW Federal District of the Russian Federation, member of the specialized commission in the specialty “gastroenterology” of the Ministry of Health of the Russian Federation,

O. I. Danilov, PhD, CEO National Association for Clinical Nutrition,

A. Ya. Kalinin, Academician of the Russian Academy of Natural Sciences, active member New York Academy of Sciences, CEO of the National Consumer Protection Fund,

I. I. Kim, Head of the Department of Practical Dietetics, expert of the National Association of Clinical Nutrition, Moscow,

M. A. Kovalevsky, Professor of the Moscow State University of Medicine and Dentistry named after A.I. A. I. Evdokimova, President of the Association medical law St. Petersburg,

K. A. Kudis, Legal Counsel, Executive Director of the National Association for Clinical Nutrition,

G. I. Mendelson, k. b. PhD, chief expert of the National Association of Clinical Nutrition,

A. V. Pogozheva, MD, leading Researcher, professor of Federal State Budgetary Educational Institution "Federal Research Center of Nutrition and Biotechnology",

H. H. Sharafetdinov, Doctor of Medical Sciences, Head of the Department of Metabolic Diseases of the Federal State Budgetary Institution "Federal Research Center for Nutrition and Biotechnology", Professor of the Department of Dietology and Nutrition of the RMANPO, Chief Freelance Nutritionist of the Ministry of Health of the Russian Federation in the Central Federal District

Editorial

Chief editor Alena Grozdova

Design, layout Valery Shimchuk

Photographer Maria Kulinichenko, Yuri Kabanov

Proofreader Svetlana Fomina

Administrative editor Marina Fisenko

Head of the online version of the magazine "Practical Dietology" Sergey Chirkov

SpoilerTarget"> Spoiler: Description
WE SURPRISE!
SPRING INSIDE
on pages 5, 38
Dietetics for therapists
In mid-March, leading dietitians of the country, experts in the field of nutrition of the sick and healthy people made presentations at the I Congress of Therapists of the Moscow Region with international participation, held in Krasnogorsk in the Government House of the Moscow Region. What nutritionists told their fellow therapists and doctors of other specialties, read in the latest issue of the magazine on page 16.
40 or more events, it-exclusive in Leningrad region, about sanatoriums in the south of the country and much more
How was the year 2016 for the National Association of Clinical Nutrition, what the most significant events for the life of Russian dietology took place thanks to the work of the association, read in the news of the spring issue on page 12.
Ministry in touch!
Feedback - in 2017, a large-scale monitoring center was launched in the dietary service to collect reporting information from the subjects of the Federation for the formation of a final report - " Personal accounts nutritionists." Analytical material is intended for consideration by the profile committee on dietetics of the Expert Council in the field of healthcare of the Ministry of Health of Russia and the chief freelance nutritionist of the Ministry of Health of Russia for making management decisions and submitting recommendations and proposals to the Ministry of Health of Russia (p. 32).
What did you buy? And what did you get?
6 STAGES OF CORRECT FOOD SHOPPING
3 RULES OF HOW TO NOT BECOME DECEIVED
A nutritionist and a legal adviser tell how to minimize risks and how to avoid them during the bidding procedure, when accepting food from a supplier (pp. 22, 26).
The best day of a dietician
What is the ideal day of a dietitian, we asked practicing dietitians. Imagine that a new department has been opened in our country - the Ministry of Dietetics of the Russian Federation - and you are the head of it. What would you do, what changes would you make to have the nutritionist have her perfect day? (page 38).
Chronic kidney disease: current principles medical nutrition
A low-protein diet for kidney pathology is a thing of the past. Thanks to the development of efferent methods of treatment, the practice of a dietitian includes new algorithms for prolonging life and preserving High Quality life - the use of specialized food (p. 46).
Body weight management
1,900,000,000 ADULTS ON THE WORLD ARE OVERWEIGHT
600,000,000 OBESIOUS
Epidemic Formula
Weight Loss Strategy
Nutrition Mathematics
Patient care plan
-20 KG
Diagnosis of patient G.: exogenous-constitutional obesity of the 1st stage, mixed type obesity, hypercholesterolemia
10 months joint work with a dietitian, psychotherapist, fitness trainer.
Rational nutrition, training, specialized food products, bioimpedance analysis, lymphatic drainage massage.
Minus 18.1 kg of fat mass (p. 76).
No pain - no diet?
A rather banal plot: the patient is ready to take the most bitter medicine, agrees to any dietary restrictions, up to starvation, in order to save himself from pain. However, after the disappearance of pain symptoms, he quickly forgets how bad he was, and continues to indulge himself with products that can cause another exacerbation. What is the secret of the psychology of pain and why does a person forget about all the promises to the doctor when the pain goes away? (p. 92).
A boring conversation about the right bread
Are there preservatives, dyes, flavor enhancers in bread?
What are bread improvers, are they safe for health?
How to choose bread, what should you pay attention to when looking at the label of bread and bakery products?
Frozen bread for hot business - is the product obtained from frozen convenience foods healthy?
What is the shelf life of bread and what does it depend on?
What do they do with expired bread left on store shelves?
These and other questions were answered by E. V. Nevskaya, Ph.D., head of the department microbiological research FGANU "Scientific Research Institute of the Baking Industry" in an interview with the editor-in-chief of the journal "Practical Dietology" A. V. Grozdova (p. 108).
Diet Lawyers
Everyone reading this article will make a lot of discoveries for themselves (how a person gets sick, why spilling salt is a disaster, how the ancients learned about microbes, bacteria and viruses in food, why the ancient Egyptians washed their stomach every month for three days in a row, etc.) and think hard about what attitude modern society to food, in particular to its quality, safety, and in general what is its place in our life: is food used to prevent diseases and treat the patient, or is it just a source of taste for an idle life, what is its vector: is it aimed at development or extinction … (p. 120).

And at the same time, they mentioned how important it is to have a good understanding of the mathematical component of the processes of losing weight, since parameters such as energy reservation and release lend themselves well to numerical description, thereby providing us with specific numbers to rely on. Today we will talk about the most important thing: how to calculate and plan proper nutrition.

Meal plan: what, how much and when?

The plan that competent nutritionists follow when building a menu is as follows:

calorie calculation;

filling the menu with protein;

calculation of the amount of fat;

filling with carbohydrates;

correction for vitamins and microelements.

Now let's take a closer look at each point.

First: calorie calculation

The caloric content of the diet at the rate of active weight loss (200 - 220 g per day) should be a deficit of 25% of the "base amount" of calories (which, recall, is the calorie content needed for basal metabolism, plus the number of calories that cover additional expense energy). At a moderate pace (100 g per day), the calorie deficit is 15%. When we are talking about the loss of 7-8 kg, this particular pace is recommended - easy, stress-free weight loss, which allows you to maintain skin tone and makes it possible to use this period for recovery and rejuvenation.

(OO + DE - 200 kcal) - 25%,

where OO is the main metabolism, DE is the additional energy consumption, 200 kcal are the so-called hidden kilocalories, that is, those that usually give an error in the calculations. We subtract 25% from the total amount and get the calorie content of the diet, which will allow you to lose weight by 200 g per day.

If you eat out at least once a day, then increase the hidden calories to 400, - therefore, the formula is as follows: (OO + DE - 400 kcal) - 25%.

In the case of a moderate rate of weight loss, the calculation is slightly different. If you eat homemade food, use the formula (OO + DE - 200 kcal) - 15%.

And if at least once a day you have lunch (breakfast, dinner) in a restaurant or use semi-finished products, then, as in the case of intensive weight loss, consider 400 hidden calories: (00 + DE - 400 kcal) - 15%.

Women over 40 should consume dairy products with high level fat content, since it is very important to preserve membrane lipids.

A big mistake is to fill the menu at random (had breakfast - counted calories, had lunch - counted again) - this leads to the fact that all the "calories" are eaten in the first half of the day, in addition, there is an imbalance of macronutrients. The menu must be determined in advance!

As carbohydrates, you can use not only classic foods (rice, pasta, potatoes or vegetables), but also many grains.

Low protein diets are justified only in cases where there are problems with protein excretion. In any other case, it would be more correct to keep the recommended amount of protein - it is these diets that have not only effectiveness, but also stability.

Remember that the calorie content of the diet during the diet will decrease every time the BMI decreases!

Be sure to use your favorite foods when compiling the menu: dieting is already a stressful event, so do not force yourself to eat what you do not like.

Second: filling the menu with protein

There are three protein load standards that are used for healthy people. It is imperative to clarify that when it comes to any pathology of the liver, kidneys, chronic or autoimmune diseases, weight loss should take place under the strict supervision of a doctor, while the protein load should be calculated taking into account the nitrogen excreted in the urine.

What is the norm of protein in the period of weight loss?

0.8 protein per 1 kg of weight - at low physical activity;

1 g of protein per 1 kg of weight - with moderate physical activity (up to 120 minutes of aerobic exercise per week) or a baseline BMI above 30;

1.2 g of protein per 1 kg of weight - with high physical exertion.

How are proteins introduced into the diet? The total amount is always divided into three parts - that is, protein should be part of every meal! Preference should be given to low-fat foods with a high protein content.

Third: filling the diet with fats

Fats are the second essential macronutrient (substances needed in large quantities For normal growth and development), which cannot be excluded during weight loss. Yes, there are diets with a minimum amount of fat, but it must be remembered that if a person receives less than 8 g of fat per day, there is a possibility that the viscosity of bile will change, increase, and even people who are not prone to stone formation initially may form stones. This is a very common complication of self-rigid diets.

Fat is membranes, brain lipids, skin protection, lung immune protection!

So, what you need to know about filling the diet with fats?

8 g of fat per day is the necessary minimum, below which you can never fall.

The recommended norm is 15-20 g of fat per day. 30% off total must be animal fats, since only they contain sterols, which are the basic material for building huge amount important structural elements of the body, ranging from brain neurons to sex hormones. After filling the diet with proteins, return to the already “given” products and calculate how much fat they contain. Very often, the products used to calculate the protein already contain enough high percent fats.

Fourth: filling the diet with carbohydrates

It is carbohydrate restrictions that make dieters feel miserable. And it is carbohydrates that are responsible for the feeling of satiety.

What you need to know when filling the diet with carbohydrates?

The entire proportion of calories remaining after deducting the part that went into the calculation of proteins and fats is filled with carbohydrates.

Preference should be given to "slow" carbohydrates with low glycemic index(from 10 to 40).

The glycemic index is the rate at which glucose is released into the bloodstream after we have eaten a food. The highest glycemic index is glucose, directly sugar. The feeling of satiety is minimal, the feeling of energy is maximum, the amount of energy is large. The risk that it will "lie down" in the fat cell, unless we immediately "burn" this energy, is also great.

Foods with a low glycemic index release glucose very slowly, sometimes over several hours. For example, brown rice or baked potatoes release carbohydrates for 2-3 hours. Consequently, the energy is distributed more evenly, there is a feeling of satiety.

"Fast" carbohydrates can be introduced in a very small amount (50 - 100 kcal per day), preferably in the time period from 15:00 to 17:00. It is during this period that fast carbohydrates are more easily “utilized”. The ideal source of "fast" carbohydrates during the diet is fruits.

Practical lesson

Let's look at an example of a dietary calculation. Imagine a woman at the age of 36, weight - 72 kg, height - 168 cm (BMI - 25.5), according to the type of figure - normosthenic. The goal is to enter the bottom point of stability (BMI - 22, weight - 60-61 kg). The lady works at the computer 8 hours a day, walks 30 minutes every day, swims in the pool 45 minutes a week. On weekdays, he dine in a cafe. Plans for intense weight loss. What calorie content should be her menu?

We consider the main exchange

According to the above formula, the basal exchange will be:

(8.7 x 72 (body weight)) + 829 \u003d 1,455 kcal.

Calculate additional cost

Keeping in mind the rule of "aerobic exercise", we do not include in the calculation the energy spent on working at the computer and walking. Of the listed activities, only swimming is an aerobic exercise. The calorie counter tells us that 45 minutes in the pool takes about 350 kcal. Further, this figure should be divided by 7 days (since the load is only once a week, and we calculate the menu daily). As a result, we get 50 kcal per day.

We use the formula for calculating calories for intensive weight loss

1,455 kcal (basic metabolism) + 50 kcal (additional energy expenditure) - 200 kcal (hidden calories on weekdays) or 100 kcal (hidden calories on weekends when a woman dine at home):

(1455 + 50 - 400) = 1105 (working days)

(1455 + 50 - 200) = 1305 (holidays)

Subtract the required "deficit interest":

1 105 - 25% = 828 kcal (working days)

1 305 - 25% = 978 kcal (weekends)

Of course, we can only talk about exact calorie numbers if we use pharmacy substitutes for products with a declared energy value.

In the case of eating ordinary foods, the calorie content of the menu will be “floating”, approximate. Please don't forget about it!

We count required amount squirrel

Since the physical activity of our hypothetical lady is low, the need for protein will be 0.8 g per 1 kg of body weight, that is, 58 g per day. In this case, the daily diet may look like this:

breakfast: 100 g cottage cheese 9% (169 kcal, 18 g protein) or cottage cheese 2% (114 kcal, 20 g protein);

lunch: 100 g tuna (116 kcal, 25 g protein);

dinner: 2 eggs (155 kcal, 13 g protein).

Total: 58 g of protein, 440 kcal.

Checking the fat content of already "given" products

The need for fats, as we remember, is 15–20 g per day. An example of a daily diet:

breakfast: 100 g cottage cheese 2% (114 kcal, 20 g protein - 2 g fat);

lunch: 100 g tuna (116 kcal, 25 g protein - 5 g fat);

dinner: 2 eggs (155 kcal, 13 g protein - 11 g fat).

Total: 58 g protein, 440 kcal, 18 g fat.

Filling the diet with carbohydrates

We consider what part of the calories remained for carbohydrates: 978 kcal (recommended calorie content per day) - 440 kcal (the part that proteins and fats "ate") \u003d 538 kcal. That is, we need to “fill in” 538 kcal with carbohydrates. Add them to every meal:

breakfast: 100 g cottage cheese 2% + 2 whole grain toasts (250 kcal);

lunch: 100 g tuna + 150 g wild rice (150 kcal);

afternoon snack: a medium-sized apple, or 100 g of fruit yogurt, or 150 g of raspberries, tangerine, etc. (about 80 kcal);

dinner: 2 eggs (155 kcal, 13 g protein, 11 g fat) + 200 g green salad (60 kcal).

Total: 980 kcal, 58 g protein, 18 g fat.

Different ages, different needs

How to adjust the diet according to age? There are a few rules to keep in mind.

Youth (up to 25 years). Minimal amount protein - 1 g per 1 kg of weight, even with low physical exertion, since at this age protein is consumed intensively. Mandatory additional correction for vitamins (multivitamins are administered daily).

Youth (25–35 years). The minimum amount of protein is 0.8 g per 1 kg of weight. An additional correction is carried out for vitamins and microelements (multivitamins, iron, magnesium, zinc are required).

Average age (35–45 years). The minimum amount of protein is 0.8 g per 1 kg of weight, additional correction for vitamins and microelements (multivitamins, iron, magnesium, zinc, selenium, iodine).

Maturity (45–60 years). Protein - at least 0.8 g per 1 kg of weight, fats - at least 20–22 g. It is mandatory to include PNNA (omega acids), vitamins and trace elements (multivitamins, iron, magnesium, potassium, selenium, zinc, omega acids, iodine ).

Aging (60 years and older). We increase the amount of protein. The minimum calculation is 1 g per 1 kg of weight, we prefer easily digestible protein (coming from dairy products, offal, fish and poultry). Fats - 20-22 g, 70-75% of them are of plant origin. Vitamins and trace elements: multivitamins (preferably age-related), magnesium, potassium, calcium, selenium, omega acids.

In general, by the time you start losing weight, you need to have the following calculations: the number of calories, the calorie content of the diet, an approximate menu (ideally for a week). As an option, write down several options for breakfast, lunch and dinner, from which you can choose and - importantly - make the necessary purchases for a week in advance. And - start the path to harmony!