The organization of a child's nutrition is important at any age - and this is the area of ??responsibility of parents. Common problems of adults - excess weight, diabetes, hypertension - are often programmed even in infancy.

Our expert, the head of the department of faculty and polyclinic pediatrics of Nizhny Novgorod State Medical University, tells us about what parents should do to make their children grow slim and healthy.. ? m. , Professor Elena Lukushkina.

The program "1000 days" Elena Shitova, "Lekoboz": Elena Fyodorovna, how is excess weight and other metabolic disturbances of a person connected with the behavior of his parents?.

Elena Lukushkina: Today the whole world actively develops the theory of metabolic programming, according to which many diseases of adults (including diabetes, obesity, hypertension, etc.. ) are laid during the first thousand days of life. Of this period, 270 days are due to intrauterine development, the rest - for the first two years after the birth of the child. Of particular importance is the nutritional factor: from what parents feed their baby, his health depends in the future. In particular, almost a third of all cases of alimentary adiposity of adults is programmed precisely in the first thousand days of life.

- Does heredity matter?.

- Yes, it does, but not as much as it was generally assumed. It is now generally accepted that the genetic component determines actual human health by no more than five percent, and the remaining 95% depends on the influence of the environment. If in the XX century, mainly studied genetics, then in the 21st century, epigenetics came to the forefront, allowing to reveal the possibilities of "switching" active genes. The gene responsible for the appearance of a disease, may be present, but will only show its effect under certain conditions. The main task is to create such conditions under which these genes will not become active.

Protein paradoxes - How does the manifestation of disease-causing genes depend on the conditions in which the child is in the first two years of life?.

- The main importance for the child is the nature of nutrition. For infants, the first year of life is ideal breast milk. Of course, lures also need to be introduced over time, but only competently, taking into account the correct combination of proteins, fats and carbohydrates.

- Less fat, more protein?.

-? On the contrary. In 1995, France conducted a large-scale study, which established a clear correlation between protein intake in the first years of life and excess body weight afterwards. Children who received protein food in 1-2 years, at 7-8 years were fuller than their peers. This is due to the presence in the proteins of the so-called insulinogenic amino acids that affect the secretion of insulin and insulin-like growth factor. The result of their action is the formation of an excess of fat cells, as well as a change in the reaction to insulin. A man who has an excess of fat tissue in his first years of life will be very difficult to fight against obesity, since cells already exist and there is nothing to be done about it. So the best way to prevent obesity in adults is the proper nutrition of infants.

The greatest danger is cow's milk, containing 3.5 times more protein than necessary.

- What is its negative impact?.

-? Cow and goat milk, as well as all products based on them, including kefir and unadapted formula, provoke a decrease in immunity, allergic reactions, development of rickets, dysbiosis, a risk of iron deficiency anemia, increase the burden on the kidneys. These effects become noticeable almost immediately, but there are also distant consequences - an increased risk of type 2 diabetes, obesity, cardiovascular disease.

How it starts, and will continue - you talked about a French study that established a link between the amount of protein consumed in the first years of life and the body mass index of 7-8 years. Is there evidence of the effect of malnutrition at an older age?.

-? At our department since 1999, studies have been carried out to study the effect of ineffective nutrition in the early years of life on health at an older age. We monitored the health of children from birth until they reach 10-12 years of age. It is definitely established that the frequency of development of the metabolic syndrome in 10-12 years is 3.17 times higher in children who were on unadapted artificial feeding. Children who received cow's milk and products based on it grew faster and gained weight, however, the metabolic syndrome became a payment for "rapid" development. The tendency to weight gain in such children persisted in the future. At the same time, families that practice early breastfeeding have seen a number of other risk factors associated with the formation of malnutrition.

- How is wrong eating behavior formed?.

- In families where children in infancy received unadapted nutrition, the situation did not improve over time. Parents who did not provide the baby with breastfeeding, and in the future, rather negligently treated his health issues. At school age, the nutrition of children from these families was characterized by a carbohydrate orientation, lack of a regime, a violation of the energy balance. The child learned negative food stereotypes: overeating, excessive use of fast food, carbonated drinks, pasta and t. ?P.

- Perhaps, the refusal of natural feeding and the subsequent negligence in the organization of nutrition are associated with the high employment of mothers at work?.

- We observed the opposite situation: the overemployed women leaders found the opportunity to provide the baby with breastfeeding. To the artificial feeding pass completely different families. We identified risk factors for early transfer to unadapted food: the age of the mother is younger than 20 years, the absence of parents of higher education, repeated pregnancies earlier than three years from the previous, the artificial interruption of pregnancies, later the first attachment to the breast and the baby's nutrition according to the regime.

- So, who feeds the regime, too, does it wrong?.

-? Yes, in infancy it is necessary to feed not according to the regime, but according to the need. Feeding by mode is important for older children.

- It turns out that the higher the intellect and the responsibility of parents, the more likely that the child will grow slim and healthy?.

Our long-term studies show that this is so. Children from families with a higher social level stayed longer on breastfeeding and less often had respiratory and alimentary-dependent diseases. I believe that it is extremely important to raise the level of knowledge of mothers about the role of natural feeding as the foundation of the future healthy life of the child. While the nutrition of children of the first year of life in Nizhny Novgorod is far from ideal: the duration of breastfeeding on average is 4.6 months. About 60% of children get cow's milk and kefir in the age of up to three months, which is absolutely unacceptable from the point of view of health.

About milk and not only - How is the problem of popularizing breastfeeding now solved?.

-? Unfortunately, it is far from the optimal solution, which is possible only at the level of adoption of federal target programs. Undoubtedly, the implementation of the WHO / UNICEF "Child Friendly Hospital" is of great importance (the National Coordinator in Russia - d. ? m. Lyubov Viktorovna Abolyan). However, maternity hospitals and hospitals certified under this program are not enough. I would like to extend the scope of this program to the maximum number of birth and childhood care institutions.

- But there are many public organizations engaged in promoting proper nutrition. Can they improve the situation?.

-? Not all social movements are equally useful. Often, along with the promotion of breastfeeding, such organizations are engaged in the spread of obscurantism, in particular, call for the refusal of vaccinations, discredit the scientific approach to health.

- Why, despite the proven harm of cow's milk at an early age, it is still widely used for artificial feeding? Does the well-established stereotype "Drink, children, milk - will be healthy!" "?".

-? I think that the main reasons are economic, since cow's milk is a fairly cheap product. As for the stereotypes, the milk is really useful, but not at an early age. Until a year, products based on cow and goat milk can not be used categorically, from year to three, use is highly undesirable, after three - recommended. In pre-school and school age, milk is an integral part of a healthy diet, but not before.

- The problem of obesity is becoming more important every year. Is it possible to solve it by transferring all children to natural feeding?.

-? The problem of obesity and metabolic disorders associated with it requires a serious study. It is the scourge of the whole world, and not only of civilized countries, as was believed until recently. I think that the spread of natural feeding would significantly reduce the severity of this problem.

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