Кисломолочные продукты и функциональное питание у детей

Бельмер С.В., Ковтун Т.А. Кисломолочные продукты и функциональное питание у детей. Педиатрия. Consilium Medicum. 2023;4:231-237. DOI: 10.26442/26586630.2023.4.202543

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Belmer SV, Kovtun TA. Fermented milk products and functional nutrition for children: A Review. Pediatrics. Consilium Medicum. 2023;4:231-237. DOI: 10.26442/26586630.2023.4.202543

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Аннотация

Еще в древнейшие времена люди заметили, что прокисшее молоко может быть не просто продуктом питания или способом его хранения в течение определенного срока, в ряде случаев – это целебный напиток. В настоящее время для получения кисломолочных продуктов (КП) используют широкий спектр микроорганизмов, преимущественно лактобациллы и бифидобактерии. Они в большинстве случаев обладают пробиотическими свойствами. В то же время в эти продукты нередко вводят дополнительные пробиотические штаммы, что значительно повышает их питательную, профилактическую и лечебную ценность. Кроме того, в состав КП могут вводить пребиотики, чаще всего олигофруктозу и инулин. Во всем мире в питании широко употребляют йогурты, получаемые путем сбраживания молока с применением Lactobacillus delbrueckii subsp. bulgaricus и Streptococcus thermophilus. Их свойства хорошо изучены на протяжении более 100 лет. В результате сбраживания получается густой продукт с увеличенным сроком хранения.
Йогурт является богатым источником кальция в биодоступной форме, а также хорошим источником фосфора, калия, витаминов А, В₂ и В₁₂. Он содержит белки высокой биологической ценности и незаменимые жирные кислоты. КП улучшают расщепление лактозы, обладают антиатерогенным действием, снижая уровень холестерина в крови, повышают плотность костной ткани, обладают многими другими положительными свойствами для организма человека. КП, и йогурты в частности, в полной мере можно отнести к функциональным продуктам питания, полезным детям и взрослым.
Продукты, предназначенные для детей, должны отвечать особым требованиям, учитывающим возрастные особенности метаболических процессов. Таким образом, пробиотические КП, включая йогурты, оказывают положительное влияние на здоровье детей и взрослых, как здоровых, так и при ряде заболеваний. Регулярное их употребление целесообразно на протяжении всей жизни человека.

Ключевые слова: кисломолочные продукты, йогурт, пробиотики, пребиотики, функциональные продукты, Lactobacillus bulgaricus, Streptococcus thermophilus, дети, взрослые, профилактика, лечение

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Even in ancient times, people noticed that sour milk could be not just a food or a way of storing it for a certain period; in some cases, it is a healing drink. Currently, many microorganisms, mainly lactobacilli and bifidobacteria, are used to produce fermented milk products (FMP). Most of the microorganisms have probiotic properties. Also, additional probiotic strains are often introduced into these products, significantly increasing their nutritional, prophylactic and therapeutic value. In addition, prebiotics, most often oligofructose and inulin, can be included in the FMP. Yogurts are widely consumed throughout the world. They are prepared by fermenting milk using Lactobacillus delbrueckii subsp. bulgaricus and Streptococcus thermophilus. Their properties have been well-studied for more than 100 years. The fermentation results in a thick product with an extended shelf life.
Yogurt is a rich source of calcium in bioavailable form and a good source of phosphorus, potassium, vitamins A, B2 and B12. It contains proteins of high biological value and essential fatty acids. FMPs improve lactose cleavage, have an anti-atherogenic effect, reduce blood cholesterol, increase bone density, and have many other favourable properties for the human body. FMPs, particularly yogurts, can be entirely attributed to functional foods and are good for children and adults.
Products intended for children must meet special requirements considering the age-related features of metabolic processes. Thus, probiotic FMPs, including yogurts, positively affect the health of a child and an adult, both healthy and in many diseases. Their regular consumption is advisable throughout a person's life.

Keywords: fermented milk products, yogurt, probiotics, prebiotics, functional products, Lactobacillus bulgaricus, Streptococcus thermophilus, children, adults, prevention, treatment

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Список литературы

1. Oberman H. Fermented milks. In: Microbiology of Fermented Foods. Ed. by BJB Wood. Vol. 1. London, UK: Elsevier Applied Science Publishers, 1985.
2. Parvez S, Malik KA, Ah Kang S, Kim HY. Probiotics and their fermented food products are beneficial for health. J Appl Microbiol. 2006;100(6):1171-85.
DOI:10.1111/j.1365-2672.2006.02963.x
3. Allen SJ, Martinez EG, Gregorio GV, Dans LF. Probiotics for treating acute infectious diarrhoea. Cochrane Database Syst Rev. 2010;2010(11):CD003048. DOI:10.1002/14651858.CD003048.pub3
4. Hume ME. Historic perspective: Prebiotics, probiotics, and other alternatives to antibiotics. Poult Sci. 2011;90(11):2663-9. DOI:10.3382/ps.2010-01030
5. Alhaj OA, Kanekanian A. Milk-derived Bioactive Components from Fermentation. In: Milk and Dairy Products as Functional Foods. Ed. by A Kanekanian. Hoboken, NJ, USA: Wiley-Blackwell, 2014.
6. Karaolis C, Botsaris G, Pantelides I, Tsaltas D. Potential application of Saccharomyces boulardii as a probiotic in goat’s yoghurt: Survival and organoleptic effects. Int J Food Sci Technol. 2013;48(7):1445-52. DOI:10.1111/ijfs.12111
7. Fisberg M, Machado R. History of yogurt and current patterns of consumption. Nutr Rev. 2015;73(Suppl. 1):4-7. DOI:10.1093/nutrit/nuv020
8. Ivanov I, Petrov K, Lozanov V, et al. Bioactive Compounds Produced by the Accompanying Microflora in Bulgarian Yoghurt. Processes. 2021;9(1):114. DOI:10.3390/pr9010114
9. Hadjimbei E, Botsaris G, Chrysostomou S. Beneficial Effects of Yoghurts and Probiotic Fermented Milks and Their Functional Food Potential. Foods. 2022;11(17):2691. DOI:10.3390/foods11172691
10. Manifold BM. Bone mineral density in children from anthropological and clinical sciences: A review. Anthropol Rev. 2014;77(2):111-35. DOI:10.2478/anre‑2014-0011
11. Bridge AD, Brown J, Snider H, et al. Consumption of Greek yogurt during 12 weeks of high-impact loading exercise increases bone formation in young, adult males – a secondary analysis from a randomized trial. Appl Physiol Nutr Metab. 2020;45(1):91-100. DOI:10.1139/apnm‑2019-0396
12. Benjamin S, Spener F. Conjugated linoleic acids as functional food: An insight into their health benefits. Nutr Metab (Lond). 2009;6:36. DOI:10.1186/1743-7075-6-36
13. Bayless TM, Huang SS. Inadequate intestinal digestion of lactose. Am J Clin Nutr. 1969;22(3):250-6. DOI:10.1093/ajcn/22.3.250
14. Goodenough ER, Kleyn DH. Influence of viable yogurt microflora on digestion of lactose by the rat. J Dairy Sci. 1976;59(4):601-6. DOI:10.3168/jds.S0022-0302(76)84247-6
15. Kolars JC, Levitt MD, Aouji M, Savaiano DA. Yogurt – An autodigesting source of lactose. N Engl J Med. 1984;310(1):1-3. DOI:10.1056/NEJM198401053100101
16. Fox MJ, Ahuja KD, Robertson IK, et al. Can probiotic yogurt prevent diarrhoea in children on antibiotics? A double-blind, randomised, placebo-controlled study. BMJ Open. 2015;5(1):e006474. DOI:10.1136/bmjopen‑2014-006474
17. Patro-Golab B, Shamir R, Szajewska H. Yogurt for treating antibiotic-associated diarrhea: Systematic review and meta-analysis. Nutrition. 2015;31(6):796-800. DOI:10.1016/j.nut.2014.11.013
18. Conway S, Hart A, Clark A, Harvey I. Does eating yogurt prevent antibiotic-associated diarrhoea? A placebo-controlled randomised controlled trial in general practice. Br J Gen Pract. 2007;57(545):953-9. DOI:10.3399/096016407782604811
19. Pashapour N, Iou SG. Evaluation of yogurt effect on acute diarrhea in 6–24‑month-old hospitalized infants. Turk J Pediatr. 2006;48(2):115-8. PMID:16848109
20. Roberts LM, McCahon D, Holder R, et al. A randomised controlled trial of a probiotic “functional food” in the management of irritable bowel syndrome. BMC Gastroenterol. 2013;13:45. DOI:10.1186/1471-230X‑13-45
21. Mann GV, Spoerry A, Gray M, Jarashow D. Atherosclerosis in the Masai. Am J Epidemiol. 1972;95(1):26-37. DOI:10.1093/oxfordjournals.aje.a121365
22. Harrison VC, Peat G, de Heese HV. Fetal growth in relation to histamine concentration in urine. Obstet Gynaecol Br Commonw. 1974;81(9):686-90.
DOI:10.1111/j.1471-0528.1974.tb00541.x
23. Gill HS, Guarner F. Probiotics and human health: a clinical perspective. Postgrad Med J. 2004;80(947):516-26. DOI:10.1136/pgmj.2003.008664
24. Van de Water J, Keen CL, Gershwin ME. The influence of chronic yogurt consumption on immunity. J Nutr. 1999;129(Suppl. 7):1492S‑5S. DOI:10.1093/jn/129.7.1492S
25. Pu F, Guo Y, Li M, et al. Yogurt supplemented with probiotics can protect the healthy elderly from respiratory infections: A randomized controlled open-label trial. Clin Interv Aging. 2017;12:1223-31. DOI:10.2147/CIA.S141518
26. Noakes M, Clifton PM, Doornbos AM, Trautwein EA. Plant sterol ester-enriched milk and yoghurt effectively reduce serum cholesterol in modestly hypercholesterolemic subjects. Eur J Nutr. 2005;44(4):214-22. DOI:10.1007/s00394-004-0513‑z
27. Rybka S, Kailasapathy K. The survival of culture bacteria in fresh and freeze-dried AB yoghurts. Aust J Dairy Technol. 1995;50(2):51-7.
28. Kailasapathy K, Harmstorf I, Phillips M. Survival of Lactobacillus acidophilus and Bifidobacterium animalis ssp. lactis in stirred fruit yogurts. LWT – Food Sci Technol. 2008;41(7):1317-22. DOI:10.1016/j.lwt.2007.08.009
29. Sendra E, Fayos P, Lario Y, et al. Incorporation of citrus fibers in fermented milk containing probiotic bacteria. Food Microbiol. 2008;25(1):13-21. DOI:10.1016/j.fm.2007.09.003
30. Хавкин А.И., Комарова О. Н. Пробиотический штамм Bifidobacterium animalis subsp. lactis (ВВ‑12) – опыт и перспективы применения в клинической практике. Вопросы практической педиатрии. 2017;12(5):25-34 [Khavkin AI, Komarova ON. An experience and prospects of using the probiotic strain Bifidobacterium animalis subsp. lactis (ВВ‑12) in clinical practice. Clinical Practice in Pediatrics. 2017;12(5):25-34 (in Russian)]. DOI:10.20953/1817-7646-2017-5-25-34
31. Fukuda S, Toh H, Taylor TD, et al. Acetate-producing biﬁdobacteria protect the hose for enteropathogenic infection via carbohydrate transporters. Gut Microbes. 2012;3(5):449-54. DOI:10.4161/gmic.21214
32. Bush RS, Milligan LP. Study of the mechanism of inhibition of ketogenesis by propionate in bovine liver. Can J Anim Sci. 1971;51:121-7. DOI:10.4141/CJAS71-016

________________________________________________

1. Oberman H. Fermented milks. In: Microbiology of Fermented Foods. Ed. by BJB Wood. Vol. 1. London, UK: Elsevier Applied Science Publishers, 1985.
2. Parvez S, Malik KA, Ah Kang S, Kim HY. Probiotics and their fermented food products are beneficial for health. J Appl Microbiol. 2006;100(6):1171-85.
DOI:10.1111/j.1365-2672.2006.02963.x
3. Allen SJ, Martinez EG, Gregorio GV, Dans LF. Probiotics for treating acute infectious diarrhoea. Cochrane Database Syst Rev. 2010;2010(11):CD003048. DOI:10.1002/14651858.CD003048.pub3
4. Hume ME. Historic perspective: Prebiotics, probiotics, and other alternatives to antibiotics. Poult Sci. 2011;90(11):2663-9. DOI:10.3382/ps.2010-01030
5. Alhaj OA, Kanekanian A. Milk-derived Bioactive Components from Fermentation. In: Milk and Dairy Products as Functional Foods. Ed. by A Kanekanian. Hoboken, NJ, USA: Wiley-Blackwell, 2014.
6. Karaolis C, Botsaris G, Pantelides I, Tsaltas D. Potential application of Saccharomyces boulardii as a probiotic in goat’s yoghurt: Survival and organoleptic effects. Int J Food Sci Technol. 2013;48(7):1445-52. DOI:10.1111/ijfs.12111
7. Fisberg M, Machado R. History of yogurt and current patterns of consumption. Nutr Rev. 2015;73(Suppl. 1):4-7. DOI:10.1093/nutrit/nuv020
8. Ivanov I, Petrov K, Lozanov V, et al. Bioactive Compounds Produced by the Accompanying Microflora in Bulgarian Yoghurt. Processes. 2021;9(1):114. DOI:10.3390/pr9010114
9. Hadjimbei E, Botsaris G, Chrysostomou S. Beneficial Effects of Yoghurts and Probiotic Fermented Milks and Their Functional Food Potential. Foods. 2022;11(17):2691. DOI:10.3390/foods11172691
10. Manifold BM. Bone mineral density in children from anthropological and clinical sciences: A review. Anthropol Rev. 2014;77(2):111-35. DOI:10.2478/anre‑2014-0011
11. Bridge AD, Brown J, Snider H, et al. Consumption of Greek yogurt during 12 weeks of high-impact loading exercise increases bone formation in young, adult males – a secondary analysis from a randomized trial. Appl Physiol Nutr Metab. 2020;45(1):91-100. DOI:10.1139/apnm‑2019-0396
12. Benjamin S, Spener F. Conjugated linoleic acids as functional food: An insight into their health benefits. Nutr Metab (Lond). 2009;6:36. DOI:10.1186/1743-7075-6-36
13. Bayless TM, Huang SS. Inadequate intestinal digestion of lactose. Am J Clin Nutr. 1969;22(3):250-6. DOI:10.1093/ajcn/22.3.250
14. Goodenough ER, Kleyn DH. Influence of viable yogurt microflora on digestion of lactose by the rat. J Dairy Sci. 1976;59(4):601-6. DOI:10.3168/jds.S0022-0302(76)84247-6
15. Kolars JC, Levitt MD, Aouji M, Savaiano DA. Yogurt – An autodigesting source of lactose. N Engl J Med. 1984;310(1):1-3. DOI:10.1056/NEJM198401053100101
16. Fox MJ, Ahuja KD, Robertson IK, et al. Can probiotic yogurt prevent diarrhoea in children on antibiotics? A double-blind, randomised, placebo-controlled study. BMJ Open. 2015;5(1):e006474. DOI:10.1136/bmjopen‑2014-006474
17. Patro-Golab B, Shamir R, Szajewska H. Yogurt for treating antibiotic-associated diarrhea: Systematic review and meta-analysis. Nutrition. 2015;31(6):796-800. DOI:10.1016/j.nut.2014.11.013
18. Conway S, Hart A, Clark A, Harvey I. Does eating yogurt prevent antibiotic-associated diarrhoea? A placebo-controlled randomised controlled trial in general practice. Br J Gen Pract. 2007;57(545):953-9. DOI:10.3399/096016407782604811
19. Pashapour N, Iou SG. Evaluation of yogurt effect on acute diarrhea in 6–24‑month-old hospitalized infants. Turk J Pediatr. 2006;48(2):115-8. PMID:16848109
20. Roberts LM, McCahon D, Holder R, et al. A randomised controlled trial of a probiotic “functional food” in the management of irritable bowel syndrome. BMC Gastroenterol. 2013;13:45. DOI:10.1186/1471-230X‑13-45
21. Mann GV, Spoerry A, Gray M, Jarashow D. Atherosclerosis in the Masai. Am J Epidemiol. 1972;95(1):26-37. DOI:10.1093/oxfordjournals.aje.a121365
22. Harrison VC, Peat G, de Heese HV. Fetal growth in relation to histamine concentration in urine. Obstet Gynaecol Br Commonw. 1974;81(9):686-90.
DOI:10.1111/j.1471-0528.1974.tb00541.x
23. Gill HS, Guarner F. Probiotics and human health: a clinical perspective. Postgrad Med J. 2004;80(947):516-26. DOI:10.1136/pgmj.2003.008664
24. Van de Water J, Keen CL, Gershwin ME. The influence of chronic yogurt consumption on immunity. J Nutr. 1999;129(Suppl. 7):1492S‑5S. DOI:10.1093/jn/129.7.1492S
25. Pu F, Guo Y, Li M, et al. Yogurt supplemented with probiotics can protect the healthy elderly from respiratory infections: A randomized controlled open-label trial. Clin Interv Aging. 2017;12:1223-31. DOI:10.2147/CIA.S141518
26. Noakes M, Clifton PM, Doornbos AM, Trautwein EA. Plant sterol ester-enriched milk and yoghurt effectively reduce serum cholesterol in modestly hypercholesterolemic subjects. Eur J Nutr. 2005;44(4):214-22. DOI:10.1007/s00394-004-0513‑z
27. Rybka S, Kailasapathy K. The survival of culture bacteria in fresh and freeze-dried AB yoghurts. Aust J Dairy Technol. 1995;50(2):51-7.
28. Kailasapathy K, Harmstorf I, Phillips M. Survival of Lactobacillus acidophilus and Bifidobacterium animalis ssp. lactis in stirred fruit yogurts. LWT – Food Sci Technol. 2008;41(7):1317-22. DOI:10.1016/j.lwt.2007.08.009
29. Sendra E, Fayos P, Lario Y, et al. Incorporation of citrus fibers in fermented milk containing probiotic bacteria. Food Microbiol. 2008;25(1):13-21. DOI:10.1016/j.fm.2007.09.003
30. Khavkin AI, Komarova ON. An experience and prospects of using the probiotic strain Bifidobacterium animalis subsp. lactis (ВВ‑12) in clinical practice. Clinical Practice in Pediatrics. 2017;12(5):25-34 (in Russian). DOI:10.20953/1817-7646-2017-5-25-34
31. Fukuda S, Toh H, Taylor TD, et al. Acetate-producing biﬁdobacteria protect the hose for enteropathogenic infection via carbohydrate transporters. Gut Microbes. 2012;3(5):449-54. DOI:10.4161/gmic.21214
32. Bush RS, Milligan LP. Study of the mechanism of inhibition of ketogenesis by propionate in bovine liver. Can J Anim Sci. 1971;51:121-7. DOI:10.4141/CJAS71-016

Авторы

С.В. Бельмер*¹, Т.А. Ковтун²

¹ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н. И. Пирогова» Минздрава России, Москва, Россия;
²ФГБУ «Национальный медицинский исследовательский центр детской гематологии, онкологии и иммунологии им. Дмитрия Рогачева» Минздрава России, Москва, Россия
*belmersv@mail.ru

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Sergey V. Belmer*¹, Tatiana A. Kovtun²

¹Pirogov Russian National Research Medical University, Moscow, Russia;
²Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
*belmersv@mail.ru

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