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0UDC 612.392.98: 613.21
JUSTIFICATION OF THERAPEUTIC AND PREVENTIVE NUTRITION DIETS FOR PERSONS WORKING IN CONDITIONS OF EXPOSURE TO IONIZING
RADIATION
TURAKHANOV FERUZA
Tashkent State Dental Institute, assistant, Department of Public Health, Healthcare Management and Physical Education
KHUDAIBERGANOV ANATOLY Center for the Development of Professional Skills of Medical Workers, Professor of the Department of Hygiene and Radiation Safety, Head of the Laboratory of Food Hygiene of the Research Institute of Sanitation and Hygiene and Occupational Diseases of the Ministry of Health of the Republic of Uzbekistan, Doctor of Medical Sciences, Professor. Tashkent, Uzbekistan
TUKHTAROV BAKHROM Samarkand State Medical University, Head of the Department of General Hygiene and
Ecology
Annotation. The aim of the study was to select the optimal diet of LPP, taking into account the average daily energy costs of workers employed under the influence of ionizing radiation and the protective properties of local food products. The objects of research were employees of the Institute of Nuclear Physics of the Academy of Sciences of the Republic of Uzbekistan. According to the research results, it was found that the average daily energy costs of employees working under the influence of ionizing radiation in men are 4078.1±62.0 Kcal, in women 3908.66±44.0 Kcal, and the average value is 3993.3±60.0 Kcal per day . As a result of the use of LPP, there was a significant increase in the proportion of proteins in diets from 45-47% to 70-71%, and animal proteins from 2526% to 60-61%. The content of vitamin A, vitamin C, folacin , thiamine, riboflavin, pyridoxine, cyancobalamin , niacin, magnesium, selenium, potassium, choline, essential amino acids - leucine, lysine, tryptophan, threonine, histidine and methionine increased by 20-25% .
Keywords: food rations, ionizing radiation, therapeutic and preventive nutrition.
Introduction. Prevention of occupational diseases is one of the most important state tasks [1]. For this purpose, all industrial enterprises of our country carry out a set of technical, technological, sanitary and other measures aimed at limiting the adverse effects of harmful factors of the production environment on workers. At the same time, with the help of these measures it is not always possible to completely eliminate, and sometimes even ensure constant compliance with the maximum permissible values of harmful chemical and physical factors in production. In these conditions, the importance of medical and biological measures increases especially, among which an important place is given to therapeutic and prophylactic nutrition (TPN). The basis of this nutrition is rational nutrition, built taking into account the metabolism of xenobiotics (foreign compounds) in the body and the role of individual food components that have a protective effect when exposed to harmful physical factors, especially ionizing radiation. Therefore, therapeutic and prophylactic nutrition should be differentiated taking into account the pathogenetic mechanisms of action of harmful factors.
The aim of the study was to select an optimal diet for LPP, taking into account the average daily energy expenditure of workers employed in conditions of exposure to ionizing radiation and the protective properties of local food products.
The objects of the research were employees of the Institute of Nuclear Physics of the Academy of Sciences of the Republic of Uzbekistan (308 people) under individual dosimetric control during 2019-2023 .
Average daily energy expenditure was determined on the basis of 24-hour timing, taking into
account the actual time allocated for all types of activity, BMR (basal metabolic rate) - determined by height -weight data using the generally accepted Harris -Benedict tables [2]. The assessment of the nutritional status was studied by analyzing more than 200 menu layouts of daily rations for 26 indicators: total and animal proteins, total and vegetable fats, carbohydrates, di -monosaccharides, polysaccharides, pectin, cholesterol, energy value, calcium salts, phosphorus, iron, magnesium, the content of vitamins A , beta -carotene, thiamine, riboflavin, pyridoxine, cyanocobalamin , vitamin C, D , E, PP, folic acid and fiber by seasons of the year according to I.M. Skurikhin, M.N. Volgarev . [3]. The results obtained were compared with official nutritional standards [4] .
Results of research and discussion. The main determining value of daily energy expenditure of employees in harmful working conditions is the time and quality characteristics of individual types of activity. In this connection, special attention is paid to a full analysis of timekeeping during the day and the accepted values of energy equivalents for various types of employee activity. Analysis of daily timekeeping by observation and questionnaires made it possible to determine the daily energy expenditure of employees working under conditions of exposure to ionizing radiation.
Table 1. Daily timing and energy expenditure of employees under conditions of exposure to
ionizing radiation (M ±m).
Activities Duration in hours Energy consumption by CFA ( Kcal.h ) Energy expenditure for activity ( Kcal )
A B A B A B
Morning exercises 0.6 0.25 97.5 97.5 64.3 ±2 24.3 ±3
Morning toilet 0.5 0.66 82.0 82.0 41.0 ±1 54.1 ±2
Making the bed 0.25 0.33 117.2 117.2 29.3 ±1 38.6 ±2
Breakfast 0.66 0.83 99.6 99.6 49.8 ±2 82.6 ±3
Washing dishes 0.25 0.25 132.5 132.5 33.1 ±1 33.1 ±1
Dressing 0.25 0.33 88.8 88.8 22.2 ±2 29.3 ±3
Walking to work 0.66 0.66 200 200 132.0 ±4 132.0 ±6
Preparing for work 0.25 0.25 110 110 27.5 ±3 27.5.0 ±4
Prof. activity 8.0 8.0 132.4 123.3 1059.2 ±12 986.4 ±11
Eating 0.5 0.5 30 30 15.0 ±5 15.0 ±6
Rest (conversations) 0.5 0.5 42 42 21.0 ±3 21.0 ±4
Shower 0.66 1.0 195 195 128.7 ±4 195.0 ±6
Walking home 0.66 0.66 200 200 132.0 ±4 132.0 ±6
Active recreation 1.0 1.0 120 120 120.0 ±7 120.0 ±8
Eating 0.5 0.5 30 30 15.0 ±5 15.0 ±6
Watch TV shows 1.0 0.5 30 30 30.0 ±4 15.0 ±2
Evening dress 0.5 0.66 82 82 41.0 ±4 54.1 ±6
Getting ready for bed 0.05 0.12 33 33 1.65 ±0.02 3.96 ±0.2
Night sleep 7.0 7.0 25.0 25.0 175.0 ±6 175.0 ±8
VOO 1677 ±22 1595 ±28
SDDP 167.7 ±2.2 159.5 ±2.8
Total : 24 h 24 h 4078.1±62.0 3908.66±44.0
Note: A- men; B- women;
VOO-Men: number A 1029 + number B 648 = 1677;
VOO-Women: number A 1420 + number B 175 = 1595;
SDDP-Men 167.7; Women 159.5.
CFA - physical activity coefficient.
Thus, the average daily energy expenditure of employees working under conditions of exposure to ionizing radiation is 4078.1±62.0 kcal for men and 3908.66±44.0 kcal for women, and the average value is 3993.3±60.0 kcal per day. According to generally accepted principles, LPP diets should cover at least 40% of the average daily energy expenditure, i.e., on average, the energy value of LPP for this contingent of employees should be at least 1597.3±40.0 kcal.
Familiarization with the organization of LPP in the institute's divisions showed the lack of purposefulness of LPP, since compensation is given to wages when working with ionizing radiation. Comparison of the energy and nutritional value of average daily rations of home and work food showed that the qualitative composition of food in the daily rations of employees does not meet the hygienic standards of preventive nutrition in many respects. An imbalance in the ratio of nutrients in the form of 1:1.2:6 is noted for both men and women, instead of the required 1:1:5 for physiological needs. A deficit of both total (by 20%) and animal proteins (by 25-30%) was revealed, with an excess of vegetable fats (by 10-12%) and carbohydrates (by 12-15%). As a comparative assessment of the nutrient content in the average daily diets of employees shows, both men and women have a deficiency of the most important biologically active substances, such as vitamin A (by 50-60%), vitamin C (by 20-25%), folate (by 10-12%), thiamine (by 20-25%), riboflavin (by 30-40%), pyridoxine and cyanocobalamin (by 50-60%), niacin (by 10-15%), magnesium (by 35-40%), selenium (by 150-200%), potassium and choline (by 40-50%), essential amino acids - leucine and lysine (by 15-20%), tryptophan, threonine , histidine and methionine (by 40-50%).
The basis for ensuring the effectiveness of the LPP for workers exposed to harmful and unfavorable production factors is the correct formation of average daily recommended food set standards. To form the food set standards, we used the following principles:
- ensuring at least 40% of daily energy expenditure through LPP;
- literary data on the mechanisms of action of harmful factors and the protective properties of
food;
- enhancing the functions of physiological barriers that help shield the body from ionizing radiation;
- increasing the antitoxic function of the liver due to local food products;
- compensation for nutritional deficiencies arising as a result of exposure to harmful factors;
- support of autoregulatory reactions of the body, endocrine regulation, immune system, metabolism;
- data on the average chemical composition of products, calculated on the basis of tables of the chemical composition of food products, information on the average losses of nutrients during heat treatment and in the process of food consumption;
- established skills, national characteristics for the consumption of individual products.
Considering that one of the first requirements for the composition of the set is related to
satisfying the needs for animal protein and its importance in protecting the organs and systems of the body, the formation of the norms of the set of products was made starting with animal products: meat, milk, fish, eggs. Meat and dairy products provide the main amount of animal protein, being at the same time the most important sources of vitamins, easily digestible iron and other bioelements. With dairy products, the human body receives valuable proteins and the main amount of calcium. A deficiency of these products will not only fail to provide optimal levels of animal protein, but also rational ratios between minerals.
For further calculation of the norms of the food set, it is important to determine the level of bread products in its structure. This group of products provides the main share of plant proteins (up to 70%) and is the most important source of carbohydrates in daily rations (up to 50%).
Vegetables and fruits play an extremely important role in the LPP. Without making a significant contribution to satisfying the need for proteins and fats, and providing only a small share of the need
for carbohydrates, they are regulators of metabolism, by participating in maintaining the internal ecology and membrane nutrition, are sources of vitamins, minerals and dietary fiber.
The last to be added to the list of food standards was a group of vegetable oils in quantities that ensure the content of vegetable fats at a level of at least 30% of their total content in daily rations, except in cases where it is necessary to limit fats and oils.
The conducted comparative assessment of the proposed diets of the LPP for employees working in conditions of exposure to ionizing radiation with the actual nutrition showed the normalization of the energy value of the LPP diets and the achievement of the required 40% of the daily requirements. Against the background of the changed diet, there was a reliable increase in the specific gravity of proteins in the LPP diets from the average daily content from 45-47% to 70-71%, proteins of animal origin from 25-26% to 60-61%. Against the changed diet, compared with the actual diet, the content of vitamin A , vitamin C, folate , thiamine, riboflavin, pyridoxine, cyanocobalamin , niacin, magnesium, selenium, potassium, choline, essential amino acids - leucine, lysine, tryptophan, threonine , histidine and methionine increased on average by 20-25%.
Table 2. Nutritional and energy value of the recommended food set for the diet of LPP for workers exposed to ionizing radiation using local products.
№ p / p Name of products Norm, in g (gross) Squirre ls Fats Carbohy drates Kcal
1. Rye bread 100,0 6.5 1.0 40.1 190,0
2. Wheat bread 100,0 8.1 1,2 46.6 220,0
3. Wheat flour* 10.0 1.06 0.13 7.32 32.9
4. Cereals, pasta* 25.0 2.67 0.26 18.55 83.2
5. Legumes (beans, mung beans , peas, soybeans, chickpeas , etc.) 10.0 2,3 0.15 5.4 30.1
6. Sugar 17.0 - - 16.9 63.5
7. Rabbit meat 130.0 24.57 16.12 1.3 243.1
8. Fish* 20.0 3.6 1.74 - 19.0
9. Liver* 30.0 5.61 0.87 1.7 30.3
10. Egg* 0.5 pcs 6.35 5.75 0.35 78.5
11. Kefir 200,0 6.0 6.4 7.6 112.0
12. Milk* 70.0 1.96 2.24 3.29 40.6
13. Cottage cheese* 40.0 6.68 3.6 0.52 62.4
14. Sour cream (kaymak)* 10.0 0.26 2.5 0.2 24.8
15. Cheese* 10.0 2.35 3.0 - 38.0
16. Animal oil 20.0 0,1 16.4 0,1 149.6
17. Vegetable oil* 7.0 - 6.9 - 62.9
18. Potato* 150,0 3.0 0.15 29.5 43.5
19. Cabbage* 150,0 2.7 - 8.1 42.0
20. Vegetables ( beets , turnip, onion) 90.0 1,2 0,1 6.6 30.0
21. Fresh fruits or juices 130.0 0.6 - 10.0 42.4
22. Salt 5.0
23. Tea 0.4 0.08 - 0.02 0.4
24 Toma t- puree 5 0.18 - 0.58 3.15
TOTAL 85.8 68,61 204.8 1642.3
Conclusions:
1. To use special therapeutic and prophylactic nutrition for employees exposed to ionizing radiation, it is necessary to determine the amount of daily energy expenditure.
2. The average daily energy expenditure of employees of the Institute of Nuclear Physics of the Academy of Sciences of the Republic of Uzbekistan, exposed to ionizing radiation, is 4078.1±62.0 kcal for men, 3908.66±44.0 kcal for women, and the average value is 3993.3±60.0 kcal per day. According to generally accepted principles, LPP rations should cover at least 40% of the average daily energy expenditure, i.e., on average, the energy value of LPP for this contingent of employees should be at least 1597.3±40.0 kcal.
3. Against the background of the modified diet using LPP, there was a reliable increase in the specific gravity of proteins in LPP diets from the average daily content from 45-47% to 70-71%, proteins of animal origin from 25-26% to 60-61%. Against the modified diet, compared with the actual diet, the content of vitamin A , vitamin C, folate , thiamine, riboflavin, pyridoxine, cyanocobalamin , niacin, magnesium, selenium, potassium, choline, essential amino acids - leucine, lysine, tryptophan, threonine , histidine and methionine increased on average by 20-25%.
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