Практические рекомендации по введению прикорма с позиций современных представлений о профилактике пищевой аллергии

Введение. Начиная приблизительно с шестимесячного возраста ребенка его физиологические потребности в питательных веществах уже не могут быть полностью удовлетворены исключительно грудным молоком или адаптированной смесью, что обусловливает необходимость введения прикорма. Термин «прикорм» (complementary feeding) охватывает все продукты питания, как твердые, так и жидкие, за исключением грудного молока и детских смесей. Введение прикорма является одним из критических периодов первого года жизни ребенка. Питательная ценность, форма и способ употребления продуктов прикорма влияют на вкусовые предпочтения и пищевые привычки на протяжении всей жизни. Выбор корректного возраста для начала прикорма и составление адекватного индивидуального плана введения продуктов питания в рацион имеют огромное значение для обеспечения физиологических потребностей ребенка в энергии и питательных веществах, формирования здорового пищевого поведения, а также, как показали недавние исследования, для процессов, связанных с пищевой толерантностью. На успешное введение разнообразных продуктов в рацион ребенка влияет множество факторов, таких как способы приготовления пищи, очередность введения продуктов в рацион и социально-психологический климат в семье. В настоящее время ряд исследований направлен на изучение влияния продуктов прикорма на формирование кишечного микробиома и иммунный ответ с точки зрения риска развития пищевой аллергии.
Результаты. В данном обзоре мы приводим анализ как научных исследований, так и согласительных документов последних лет, посвященных нюансам введения в рацион ребенка первого года жизни распространенных пищевых аллергенов и воздействию прикорма на микробиоту кишечника и иммунную систему. Также даются основанные на доказательной базе и согласительных документах практические рекомендации по введению прикорма с позиций понимания профилактических стратегий в отношении аллергических болезней, а также нюансы введения прикорма детям с пищевой аллергией.

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