Centralized food in kindergartens. Organizing meals for children in preschool institutions

Svetlana Tsedrik
Organization of nutrition for children in preschool and family

A child comes into this world helpless and defenseless. His life, health, future depend entirely on peace on Earth, on his parents, on the actions of other adults. The child believes in their love and good attitude and hopes very much for their protection.

One of the main tasks of the kindergarten is to ensure the constitutional right of every child to protect his life and health. Health children impossible to save without rational food, which is a necessary condition for their harmonious growth, physical and neuropsychic development, resistance to infections and other adverse factors external environment. Food in preschool childhood is of particular importance for the health of the child, since it must not only cover the energy he expends, but also provide the material necessary for the growth and development of all organs and systems of the body.

Food child in preschool and family should be combined. To ensure correct food three terms:

The presence of all the necessary ingredients in food;

Proper cooking technology and rational mode food;

A healthy digestive tract, the presence in it of all enzymes for the proper processing of nutrients.

Mode food is one of the main conditions for ensuring rational food.

Culture of health children includes not only knowledge about the main regime moments, the need for alternating physical activity and rest, but also knowledge of the elementary rules of a healthy food and cultural and hygienic skills children.

Correctly organized diet includes:

Compliance with the time of eating and the interval between them;

Physiologically rational frequency of meals;

The correct distribution of calories for individual meals throughout the day.

The health of the child depends on the level of awareness of parents in matters of healthy food in the family. The forms and methods of working with parents should be aimed at improving the pedagogical culture, strengthening the interaction between the kindergarten and families, strengthening it educational capacity for rational food. Special attention when catering in preschool and family should be given to the variety and vitaminization of dishes. The use of non-traditional approaches to interaction with parents on issues food, allowing you to give the settings for the correct catering at home, contributes to increasing the literacy of parents and strengthening their health children.

Children who are accustomed to living according to the regime in kindergarten willingly fulfill it at home. But as practice shows, the daily routine in most families is not fulfilled. This is a great omission of parents, since such a situation is dangerous not only for the health of the child, but also for education. Neglect of parents to the regime can lead to negative consequences. Parents must follow a number of rules. The main ones are:

Parents should know and follow the rules food adopted in kindergarten, both in terms of the frequency of meals and the duration of the intervals between them.

Do not give children sandwiches, sweets between meals.

It is important that parents know which foods are healthier for children.

Parents need to know what foods should be in without fail use in feeding children every day.

It is important to observe the daily intake of milk, meat, the widespread use of vegetables, fruits, butter and vegetable oil.

Sweets can be given in small amounts after the main meal.

In preschool educational institutions the daily routine is carried out completely. But here, too, one can note the disadvantages associated with the lack of flexibility in organization of children's lives. Compliance with the basic principles catering preschool should be unshakable:

- Food must be complete and balanced.

Energy value should correspond to energy consumption children.

The more diverse the set of products, the more fully the need for food is satisfied.

Food must be delicious.

You should limit the need for foods and dishes with a high content of salt, sugar and spices.

The volume of the diet and regimen should be age-appropriate children's body.

It is necessary to ensure the correct drinking regimen of the child.

There must be an individual food.

Conditions for catering for children must meet the requirements.

It is necessary to comply with hygiene requirements.

Rational food should be supported by a carefully composed menu.

Constant monitoring of the correct catering.

There has been a decline in quality lately. children's nutrition, which leads to an increase in the number children with a low level of physical development, since malnutrition, a lack of vitamins and trace elements in it adversely affects muscle function. But, despite the difficulties that degrade the quality food in kindergartens and family is unacceptable.

Life proves when there is parental love, care and proper balanced food the baby grows up healthy and happy.

Bibliographic list

1 Scientific and practical journal "Physician of the preschool educational institution" № 4 (24) /2011.

2 Scientific and practical journal "Physician of the preschool educational institution" № 3 (39) /2013.

3 Dronova, T. N. Protection of the rights and dignity of a small child: coordination of efforts families and children. garden: allowance for preschool workers. educate. Institutions/ [T. N. Dronova, A. E. Zhichkina, L. G. Golubeva and others]. - 2nd ed. - M.: Enlightenment, 2006. -143 p.

4 Mayer, A. A. 555 ideas for involving parents in the life of the kindergarten / A. A. Mayer, O. I. Davydova, N. V. Voronina. - M .: TC Sphere, 2011-128 p. (Supplement to the magazine "DOW Management").

Catering in

children's educational institutions

Properly organized nutrition of children of pre-preschool and preschool age in the conditions of preschool education is an important factor in shaping the growth and development of the child, his health, not only at the moment, but also in the future. Catering, regardless of the type of preschool institution and the time the child stays in it, should be based on the following principles:

Proper organization of the diet;

Adequate energy value of food rations

(at least 70%) corresponding to the energy consumption of children;

A balanced diet for all the necessary food ingredients (proteins, fats, carbohydrates, vitamins, macro- and microelements);

The use of adequate technological and culinary processing of products, providing high taste qualities dishes and the preservation of the nutritional value of products;

Compliance with all sanitary and hygienic requirements for the receipt and transportation of products, places and conditions for their storage, culinary processing (taking into account the specifics of preschool educational institutions), distribution of dishes, processing of dishes in group cells;

Implementation of daily monitoring of the implementation of sanitary and hygienic requirements;

Accounting (as far as possible in the preschool educational institution) of the individual characteristics of children.

In preschool institutions, daily the head, together with the medical worker, draws up a menu-requirement based on an approximately 10-day or two-week menu. The menu is a list of dishes included in the daily diet of the child. When compiling the menu, they proceed from the physiological needs of the child in various nutrients.

Children should be fed 4 times in day with intervals between meals no more than 4 hours. Breakfast is 25% of the daily energy value diet, lunch - 35%, afternoon snack - 15 - 20%, dinner - 25%.

For breakfast, cereals, vegetable purees or other solid dishes, as well as hot drinks should be given: tea with milk, coffee, cocoa; for dinner, dairy and vegetable food is better with a limited amount of liquid. Lunch should include the first liquid dish, the second - predominantly meat or fish, and the third - a sweet dish. Within one day, homogeneous dishes should not be repeated. Using the same product during the week, you should vary the preparation of dishes from it: for example, boiled potatoes, potato cutlets, mashed potatoes, etc.

Meat and fish dishes are best served for breakfast and lunch, dairy vegetable and cereal dishes - for dinner, milk, lactic acid products, berries, fruits, sweets, cookies - for an afternoon snack. If there are no certain products, it is possible to replace them with equivalent ones (in terms of protein and fat content).

The doctor or the head of the preschool educational institution is present when laying the main products and distributing ready meals. They make sure that during cooking the products do not lose their valuable qualities, so that the volume of prepared food exactly corresponds to the number of servings according to the approved norm.

Before eating, preschoolers go to the toilet to wash their hands. If it is located next to the room where the children have lunch, they, after washing their hands, sit down at the tables on their own andThey begin to eat the already served first course. It is necessary to ensure that those pupils who eat slowly are the first to wash their hands and sit at the table. If the toilet is separated from the dining room by a corridor, the children, having washed their hands, return all together, accompanied by the teacher, and sit down at the table at the same time.

In the room where children eat, you need to create a cozy atmosphere. Tablecloths or oilcloths on the tables should be clean, the dishes in which food is served should be small, aesthetic (preferably the same shape and color, at least for each table).

Prepared food should be distributed immediately after it is prepared. This is necessary to preserve vitamins and taste in it, as well as to prevent food poisoning. Finished food is covered with lids. Vitaminization of food is carried out daily in the catering unit or group children's institution immediately before distribution.

The first dishes at the time of distribution should have a temperature of about 70 ° C, the second - not lower than 60 ° C, cold dishes and snacks (salads, vinaigrette) - from 10 to 15 ° C. Pouring and laying out ready-to-eat food should be done with special pouring scoops or spoons, forks, spatulas. You should pay attention to its culinary design: beautiful, attractive dishes stimulate appetite, and hence better digestion.

During meals, it is necessary to create a calm, friendly environment and maintain a good mood in children, since the state of the child's nervous system affects his appetite. One should not be impatient if children eat slowly, forbid them to ask friends or adults during meals, constantly make comments. This distracts, unnerves the children and reduces their appetite.

If the child refuses any healthy food, you should gradually accustom him to it, giving food in small portions. It is better to plant such a child with children whoeat food with pleasure, and do not force the child if he cannot eat the entire portion, since the recommended average norms are not designed for the individual characteristics and needs of the body. If in one feeding he did not finish his portion,no need to force him to eat everything. If the child systematically eats less than the norm, his body weight does not grow well,it should be shown to a doctor. Perhaps he is unwell and needs a change in diet or general daily routine.

Often children do not eat up the food offered to them, as they get tired of acting on their own. Adults must come to their aid.

Transportation of products must also be carried out in accordance with sanitary and hygienic requirements. For each type of product, you need to have a special container or transport. This will protect the products from dust, dirt, rain. Meat should be brought in 1-3 days, depending on the existing storage conditions, in boxes upholstered in galvanized iron or duralumin sheets. Sausages are also brought in special boxes. Salted fish is delivered in barrels or boxes in original packaging. For fresh fish, closable baskets or boxes are needed. Milk, sour cream, cream are brought in special packaging or containers, dry or bulk products - in factory containers: bags or closed boxes. For the transportation of bread and bakery products, a well-closable box with shelves is used. Persons involved in the loading and unloading of products undergo regular medical examinations. They are provided special clothing: dressing gown, apron, mittens. Food products entering children's institutions must be fresh and of good quality: without foreign impurities, pollution, rodent and insect infestation. This largely depends on the transportation and storage of food.

Delivered products are subject to sanitary inspection and rejection. All inspection data is recorded in a special journal. Before inspecting the products, you should familiarize yourself with the accompanying documents, from which you can obtain preliminary data on the products: the date of their release, storage conditions, terms of sale. These data are especially important when receiving perishable products: meat, sausage, ham, fish, milk, etc. Products are rejected not only upon receipt at the warehouse or in the refrigerator, but also upon receiptthem from the warehouse to the kitchen.

The quality of products is usually assessed by a medical worker of a children's institution and a cook. At the slightest suspicion of the poor quality of a particular product, it should be separated from the rest and subjected to additional laboratory research, which is carried out by the sanitary and epidemiological station.

Meat and meat products have great nutritional value, as they contain high-grade proteins. As a rule, large meat is consumed cattle(beef); lamb, pork, goose meat, ducks in the diet of preschool children are not Recommended.

When accepting meat, attention is paid to the availability of documents that guarantee the quality of meat or meat products. Delivery of ready minced meat is not allowed. Meat products are stored in refrigerators.

Educating children about hygienic eating habits

Children are taught to wash their hands before eating, to sit properly while eating (do not lean back in a chair, do not spread their elbows I do not put them on the table), use cutlery. Preschoolers are taught to use a knife: properly cut meat, cucumbers, tomatoes. Adults grind food for younger children.

While eating, children should not rush, be distracted, play with appliances, fill their mouths with food and talk at the same time, etc. The teacher teaches them to use a napkin. Babies put on bibs before eating, for older ones they put a glass with paper napkins on the table.

Every week or once every 10 days, a medical worker monitors the fulfillment of the average daily norm for the distribution of products 1a 1 child and, if necessary, corrects nutrition in the next decade. The calculation of the main food ingredients based on the results of the cumulative statement is carried out by a nurse I once a month (calculate the energy value, the amount of proteins, fats and carbohydrates).

SANITARY AND HYGIENE REQUIREMENTS FOR DELIVERY, RECEPTION, QUALITY, CONDITIONS

STORAGE AND SALES OF FOOD PRODUCTS IN PRESCHOOL INSTITUTIONS

The delivery and storage of food should be under the strict control of the head and medical workers of the preschool institution, since the quality of the food being prepared depends on it.

Each preschool institution is provided with refrigerators. In addition, there are pantries for storing dry products such as flour, sugar, cereals, pasta, confectionery, and vegetables. Warehouses and cold rooms must be kept clean and well ventilated.

Basic principles of rational nutrition.

(Journal of preschool education, 2004, No. 10, Kokotkina O.)

In a preschool where the child spends most of the day, proper nutrition is of great importance.

Proper organization of nutrition for children in a preschool institution provides for the need to comply with the following basic principles:

Compilation of complete diets;

The use of a diverse range of products that guarantee sufficient content of essential minerals and vitamins;

Strict adherence to a diet that meets physiological characteristics children of different age groups; its correct combination with the daily routine of each child and the mode of operation of the institution;

Compliance with the rules of the aesthetics of nutrition, the education of the necessary hygiene skills, depending on the age and level of development of children;

The correct combination of nutrition in a preschool institution with nutrition at home, conducting the necessary sanitary and educational work with parents, hygienic education of children;

Accounting for climate, national characteristics region, season, change in connection with the diet, the inclusion of appropriate foods and dishes, increasing or decreasing the caloric content of the diet, etc .;

Individual approach to each child, taking into account the state of his health, developmental characteristics, the period of adaptation, the presence of chronic diseases;

Strict observance of technological requirements in the preparation of food, ensuring the correct culinary processing of food products;

Daily control over the work of the catering unit, bringing food to the child, the proper organization of nutrition for children in groups;

Accounting for the effectiveness of children's nutrition. (Kokotkina O.)

Nutrition of children with health problems.

Preschool institutions are often attended by children with some health problems. It is these children who, due to their disorders, more often than others get sick with acute respiratory infections. viral infections, acute intestinal diseases, children's drip infections, are the sources of the spread of infections in the team. Such children need an individual approach in organizing their nutrition.

Undoubtedly, this complicates the work of staff, both in groups and in the catering department. However, as the experience of advanced preschool institutions shows, the proper organization of nutrition for children with various health problems makes it possible to achieve good results in their recovery and reduces the overall incidence of children in the institution.

For what diseases or deviations in the state of health do children attending a preschool institution need specially organized nutrition?

In recent years, allergic diseases, especially food allergies, have become increasingly common among both young and older children.

Big specific gravity among children of preschool age, especially in large cities, there are children with overweight, prone to obesity or with already developed obesity. Proper nutrition plays a key role in the prevention and treatment of this disease.

Children with chronic diseases of the digestive system, kidneys, endocrine diseases require serious attention in the organization of nutrition.

Among young children, there are often children with rickets, anemia, with manifestations of malnutrition or with reduced body weight.

The organization of nutrition of children who have had acute respiratory infections, acute intestinal diseases, as well as frequently ill children, has its own characteristics. Their percentage is very high, especially in young age groups.

Food for allergies.

In preschool institutions, one often encounters children suffering from intolerance to certain foods. Food allergies in children are manifested by various lesions. skin(exudative diathesis), sometimes intestinal disorders, as well as an increased susceptibility to respiratory diseases (respiratory allergies). These disorders are most pronounced in young children, although older children often have a pronounced intolerance to certain products.

The main method of treating allergic reactions is diet therapy, based on the exclusion from the child's diet of products that cause allergy manifestations. At the same time, the excluded products are replaced with other equivalent ones in such a way that the total amount of basic nutrients remains in the child's diet within the age norms.

The most common manifestations of allergies in children are the so-called obligate allergens: chocolate, cocoa, coffee, strawberries, strawberries, raspberries, oranges, tangerines, less often carrots, fish, eggs. Some children may have hypersensitivity to cow's milk and dairy products.

The doctor of the preschool institution participates in organizing the nutrition of children with allergies. He instructs children's group staff which foods the child cannot tolerate and which foods should be substituted. To do this, in children's groups, special sheets of food for children suffering from food allergy. They indicate which products are contraindicated for a child and what they should be replaced with. For example, some children are given milk or kefir instead of cocoa or coffee, apples instead of oranges, etc.

On the basis of doctor's prescriptions, the nurse of the preschool institution makes sure that the catering unit prepares the necessary replacement meals for children in need. So, some children suffering from intolerance to cow's milk may also have an increased sensitivity to beef meat. In this case, you can try using pork meat (lean) or turkey for them.

In the diet of children suffering from exudative diathesis, it is useful to introduce vegetable oil, which has a positive effect on skin manifestations. For such children, you can increase the dose of vegetable oil when dressing salads, add it to porridge instead of butter.

In the diet of a child with allergies, it is recommended to slightly reduce the amount of carbohydrates, limiting the amount of sugar, sweets, replacing them with vegetables and fruits. Cereal and flour dishes are also better to replace with vegetables.

One of the fairly common forms of allergic diseases in childhood is lactase deficiency (absence or decreased activity of lactase, an intestinal enzyme that breaks down milk sugar). The disease is manifested by intolerance to milk, including maternal, and dairy products, since they contain milk sugar. With the use of dairy products, such a child develops dyspepsia, appetite decreases sharply, vomiting appears, and a lag in body weight is observed.

Children with lactase deficiency need special food using products partially or completely devoid of lactose (milk sugar). Such children can be successfully brought up in preschool institutions provided they are provided with the necessary dietary nutrition. (Alekseeva A. S., Druzhinina L. V., Ladodo K.)

Nutrition for overweight children.

Among preschool children, children with excess body weight are more common than those with a lack of it.

The main reason for the development of obesity in children is a violation of the diet: an unbalanced diet with a large amount of carbohydrates and fats, overeating in the evening. A sedentary lifestyle also affects.

The only way to prevent and treat obesity is a balanced diet combined with sufficient physical activity. It is important that dietary treatment is carried out consistently and consistently. A lot of work is done with parents.

The staff of the preschool institution should pay special attention to overweight children, make sure that they do not violate the diet, replace some dishes for them, actively involve them in outdoor games, physical education classes.

Fat children replace wheat bread with rye bread, porridge with vegetable dishes, confectionery products are completely excluded from the diet, and they try to reduce the amount of sugar. Since dairy products in the diet of overweight children are given without restriction, instead of sweet tea, they can drink milk or kefir, preferably fat-free, without sugar.

Fat children are recommended cucumbers, cabbage, zucchini, tomatoes, radishes, leafy greens, watermelons, apples, various seasonings, spices, extractives are completely excluded, as they stimulate appetite, limit salt intake.

In addition to the rational nutrition of overweight children, it is important to pay attention to their motor mode. Usually such children are calm, phlegmatic, avoid noisy outdoor games. They cause little concern to educators, and they do not pay enough attention to them. Obese children should be involved in vigorous activity, encouraged to be more active during physical exercises, walks, games, competitions, etc.

Parents are encouraged to organize active holidays on weekends and holidays(tourist trips, excursions, ski trips, etc.), and in the evening hours limit children's viewing of television programs, replacing them with walks on fresh air. Parents can also be advised to involve their children in housework as early as possible, performing feasible tasks related to active movements.

Despite the fact that morning hygiene exercises are carried out in a preschool institution, it is useful for overweight children to do morning exercises at home with their parents, preferably in the fresh air. If the kindergarten is located at a distance of 2-4 stops from the house, you should not use public transport, it is useful to walk this distance on foot. So the child will receive a certain physical activity.

In the recommendations for parents on the composition of home meals, they should be advised to use mainly vegetables (salads and vegetable oil) and dairy products. The last meal should be no later than 2 hours before bedtime.

Given that overweight children are recommended to have more frequent meals (but in correspondingly smaller quantities), parents can be advised to give such a child easy in the morning breakfast (a glass of yogurt, Rye bread, apple), informing the teacher about it. Accordingly, the teacher reduces the nutritional value of the breakfast received by the child in kindergarten.

Nutrition in chronic diseases of the digestive system.

In preschool institutions there may be a certain percentage of children suffering from various chronic diseases of the digestive system that do not require inpatient or sanatorium treatment, but in need of a certain sparing diet, taking into account the pathology.

The basic principle diet food such children - sparing culinary processing of products with the exception of frying. In the diets of children suffering from chronic diseases of the digestive system, it is not recommended to include products containing extractives, essential oils, coarse fiber, as well as spicy and salty dishes.

Basically, the technology of cooking in preschool institutions meets these requirements, but it happens that some dishes are replaced by children or they are completely excluded from the diet, and sometimes certain foods with medicinal properties are added to the diet.

For example, for children with chronic diseases of the gallbladder and biliary tract, food is only steamed, milk is widely included in diets, dairy products and especially cottage cheese, which should be given daily in the amount of 70-100 g. Fats are given only in an easily digestible form (2/3 butter and 1/3 vegetable). It is not allowed to eat rye bread, meat and fish broths, chocolates, cocoa, beans, peas. Cold food and drinks are not recommended.

In the nutrition of children with chronic gastritis, it is necessary to take into account the pathogenesis and characteristics of the course of the disease. So, for gastritis with high acidity, products that have the ability to reduce the secretion of gastric juice are widely used: milk, cream, eggs, cereals, non-acidic fruits and vegetables containing delicate fiber. Children are recommended pureed vegetarian soups, boiled lean meat, fish, steam cutlets, pureed cereals with butter and milk, mashed vegetables. In chronic gastritis with low acidity, products are used that enhance the secretion of gastric juice: meat, fish and vegetable soups, vegetable and fruit purees, juices, dairy products.

With all types of gastritis, spicy and salty foods, vegetables with coarse fiber, smoked meats, and cold dishes are excluded.

Nutrition in renal pathology.

Children who have had acute kidney disease (nephritis, pyelonephritis), as well as those suffering from chronic pyelonephritis, should long time(up to one year or more) be on a sparing diet. Spicy and salty foods, fatty foods, broths, and smoked meats are excluded from their diet.

The amount of proteins, fats, carbohydrates should correspond to age physiological norms. However, the set of products for these children is strictly controlled. For example, they should not be given cocoa, rye bread, legumes, sorrel, lettuce, spinach.

In the diets of these children, a significant proportion is milk, which has a diuretic effect.

Nutrition for rickets.

Most often, rickets affects children whose diet lacks a protein component, there is an excess of carbohydrates and the ratio of calcium and phosphorus is disturbed. Therefore, for the rational nutrition of children with rickets, it is necessary to provide for a sufficient intake of high-grade proteins of animal origin into the child's body, which are actively involved in the processes of absorption and assimilation of calcium, phosphorus and vitamin D salts. Equally important is the sufficient intake of vegetables and fruits - the main carriers of minerals and vitamins.

Nutrition for anemia.

Anemia is one of those diseases, the development of which is associated with malnutrition of the child. Lack of proteins, vitamins and minerals, especially iron, can cause anemia even in older children.

Since proteins and iron are the main material for building red blood cells, the diet of children with anemia should contain a sufficient amount of animal proteins, as well as foods rich in iron salts. Children should receive enough cottage cheese, meat, fish, eggs, a variety of vegetables and fruits. Of the cereals, buckwheat, oatmeal and millet are the most rich in iron. From vegetables and fruits, Antonov apples, black currants, gooseberries, pomegranates, green peas, beets, tomatoes, parsley are recommended. It is advisable to include daily apples, fresh (or canned) juices and fruit purees in the diets of children with anemia. Useful mashed prunes, apricots.

Nutrition for malnutrition.

Hypotrophy is most often observed in young children with serious malnutrition: insufficient intake of essential nutrients, especially protein, with a low caloric content of the diet, with violations in the ratio of food ingredients, as well as as a result of previous diseases and in the presence of a number of congenital factors.

In older preschool age, low body weight in children is most often the result of diseases accompanied by persistent anorexia.

With malnutrition, the nutrition of the child must fully cover his need for basic nutrients and at the same time correspond to his physiological capabilities.

In the nutrition of children of both early and older age, products rich in high-grade protein are widely used: milk, kefir, cottage cheese, meat, fish, eggs, cheese.

Often in children with malnutrition, there is a decrease in appetite. In such cases, the volume of individual dishes is reduced for the child. In order to introduce the most complete foods in a smaller volume, use a more concentrated diet. For children with malnutrition, special dishes are prepared with a high content of meat, eggs, cottage cheese (for example, casseroles are made with double the amount of cottage cheese, eggs). It is important to include in their diets foods and dishes that enhance the separation of digestive juices and thereby increase appetite: strong broth (in a small amount), raw vegetable salads, sauerkraut, pickled cucumber, herring.

In the nutrition of children with malnutrition, a variety of dishes, good taste and beautiful design are of great importance. All this must be taken into account when organizing the nutrition of children in a preschool institution and conducting sanitary and educational work with parents.

Nutrition of children who have had acute illnesses and are often ill.

As a rule, children who returned to kindergarten after an illness suffer from reduced appetite and are physically weak. Therefore, the basic principles of organizing the nutrition of these children coincide with the principles of organizing the nutrition of children with malnutrition. This also applies to frequently ill children. They are primarily provided with a sufficient amount of animal proteins rich in essential amino acids. For this, it is necessary to ensure that a frequently ill child completely eats the portion of meat, fish, cottage cheese that is due to him.

It is better if these portions are slightly increased (by 10-15%) by reducing the amount of garnish, since children weakened after illness need additional protein, which they receive less due to reduced appetite.

The amount of fat in the diet of children should correspond to the age norm. Some parents, and sometimes educators, believe that a child who has had a disease should be given more nutritious fatty foods, increase his portion of butter, give him cream, sour cream. This is a big mistake. An excess amount of fat adversely affects the appetite of the child, already disturbed due to the disease. To improve appetite and increase the body's defenses, children weakened after illness are somewhat reduced in the amount of animal fats, replacing them with vegetable oil rich in polyunsaturated fatty acids, which have a beneficial effect on the development of immunity. The total amount of vegetable fats in a child's diet should be about 20% of the total amount of fat.

While feeding weakened children (at lunch), they increase the portion of salad by adding a little vegetable oil to it. It is useful to give salads with vegetable oil several times a day. Parents can be advised to give their child such a salad in the morning before leaving for kindergarten and in the evening before dinner.

To increase appetite and adequately supply the body of children with vitamins and minerals, it is recommended to widely include in their diets a variety of fruits and vegetables, fruit, vegetable and berry juices, decoctions from vegetables and fruits, and avoid excessive consumption of sweets and sugar.

It is advisable for children weakened after an illness to replace milk with fermented milk products that stimulate digestion. Their total number can be slightly increased. For example, parents can be advised to give their child a glass of kefir before bed.

In sick children, the need for vitamins increases. Within two weeks, they are given vitamins C, groups B, A, E (in age-specific therapeutic dosages).

The food of children who have had acute illnesses should be easily digestible, varied, and beautifully designed.

Nutrition of children in the period of adaptation to a preschool institution. Admission to a preschool institution for each child is accompanied by certain psychological difficulties associated with the transition from the usual home furnishings in the environment of the children's group. The younger the child, the more difficult it is to endure this transition. The period of adaptation to a preschool institution for different children lasts from 3 weeks to 2-3 months and is often accompanied by various disorders in their health. During this period, in young children, appetite may decrease, sleep is disturbed, neurotic reactions(lethargy or irritability, emotional instability, vomiting, etc.). As a result, many children have reduced resistance to adverse environmental factors, and increased susceptibility to infectious diseases. Often, during the period of adaptation in children, body weight decreases significantly, motor and neuropsychic development is delayed.

It is important even before the child enters a preschool institution to carry out the necessary work with parents to prepare the child for education in a children's team. This work is carried out more directly and concretely by the staff of the institution where the child enters. Parents are introduced to the conditions of life and upbringing of the child in kindergarten, with the daily routine, the peculiarities of the nutrition of children in the institution, they are recommended to parents to try to bring the diet and composition of the child's diet closer to the conditions of the children's team.

In the first days of a child's stay in a children's institution, one cannot drastically change the stereotype of his behavior, including his established eating habits. The child should not be offered dishes that are unusual for him. If the child does not know how or does not want to eat on his own, the teacher or junior teacher feeds him for the first time. Some children who are difficult to get used to the team can be fed at a separate table or after the rest of the children have finished eating.

If the child refuses to eat, in no case should you force-feed him: this will further worsen the negative attitude of the baby to the team: in these cases, you can allow the mother or another close to the child person to feed him in a group or give him home for 1 - 2 days.

To increase the body's defenses, children during the adaptation period are given lighter, but complete and enriched with vitamins and minerals food, they are offered juices or fruit purees with meals, and sour-milk drinks are more often used. From a conversation with parents, the teacher finds out what kind of food the child eats most willingly.

Typically, children enter preschool autumn period when there is the greatest risk of occurrence and spread of acute respiratory diseases in the team. During this period, it is rational to give children a course of vitamin therapy, especially vitamin C, which increases the resistance of the child's body to various adverse factors, including infectious agents.

It is important to establish a close relationship with the parents of newly admitted children. It is necessary to inform them daily about the behavior of the child, his appetite, about what foods and dishes the child did not receive during the day, to give specific recommendations on feeding the child at home.

Features of nutrition of children in the summer.

In the summer, especially when a preschool institution operates in the countryside, the most optimal opportunities are created for health-improving work in the children's team. Children spend most of their time in the fresh air, take long walks, conduct various hardening procedures with them more actively, increase their load during physical education classes.

All this is associated with increased energy consumption and requires an increase in the calorie content of the daily diet of children.

To meet the increased need for nutrients and energy in children, appropriate changes must be made to nutrition.

Firstly, the calorie content of children's nutrition in kindergarten needs to be increased by about 10--15%, which is achieved by increasing the amount of milk (mainly in the form of fermented milk drinks, which have a beneficial effect on the child's body), as well as fresh vegetables, fruits and berries.

Secondly, the biological value of children's diets in the summer is increased through the use of fresh herbs enriched with vitamins and microelements. In summer, garden greens are included in the diets of children: dill, parsley, sorrel, green onion, spinach, lettuce.

In the summer, in many preschool institutions, especially those located in areas with a hot climate, some change in the diet is practiced: lunch and afternoon tea change places, which is more physiologically justified. Lunch is postponed to the time after daytime sleep. In the hot afternoon, when children's appetite drops sharply, they are offered a lighter meal in the form of a second breakfast, consisting of fermented milk products, juices, fruits, and yagoy. Children rested after a nap and hungry after a light second breakfast do well with lunch at 4 pm.

In the summer, in the heat, the need for fluid increases in children. This must be remembered and always have a sufficient amount of drink in stock. Drinking is offered to children in the form of fresh boiled water, rosehip decoctions, vegetables, unsweetened juices.

Drinking is recommended to be given to children after returning from a walk and before carrying out water hardening procedures. When organizing long excursions, educators must take with them a supply of drink (boiled water, unsweetened tea) and cups according to the number of children.

Prevention of gastrointestinal intestinal diseases.

According to Vedrashko VF, the basis for the prevention of gastrointestinal diseases is the strict observance of sanitary and hygienic measures, properly organized both the general regimen and the diet.

It is known that non-compliance with the diet associated with incorrect intervals between meals, the volume of food, can lead to indigestion, and in the future, be the cause serious illnesses intestines.

So, with long intervals between meals, the secreted gastric juice has an irritating effect on the gastric mucosa, which can lead to gastritis. Frequent meals lead to inhibition of the food center, food in the stomach and intestines does not have time to be digested and is thrown out of the body in an unprocessed form.

Gastrointestinal diseases in children can occur as a result of the introduction of pathogenic microbes that enter the body in different ways: through the air, food, insects.

Some contagious diseases - tuberculosis, brucellosis and a number of others are transmitted not only from humans, but also by eating milk, meat of sick animals. That is why hygienic requirements for food preparation must be strictly observed. Otherwise, it can lead to a serious gastrointestinal disease - dysentery. Treatment of this disease takes place in a clinical setting. Strict isolation of the patient is required. Dysentery affects people of all ages, most often young children.

Dysentery microbes - dysentery bacilli from infected objects enter the child's body. The so-called bacillus carriers, i.e. practically healthy people in the intestines live and multiply dysentery microbes.

Dysentery microbes are quite stable, they can exist outside the human body. In soil contaminated with faeces, microbes can remain alive for up to three months, even in winter; on the skin of unwashed hands 3-5 hours. (Vedrashko V.F.)

Many microbes, including dysentery, survive well on food. So in milk, kefir, butter, cheese, they last up to 5-10 days, on berries - 5-6 days, on tomatoes - 7-8 days, on cucumbers up to 15 days. Dysentery microbes survive well in ready-made dishes - meat, fish, vegetables. Therefore, in the manufacture of these dishes, it is necessary to strictly observe sanitary rules and immediately eat them.

Patients with dysentery are observed throughout the year, but carrier outbreaks occur in the summer months (July, August). This is due to the fact that in summer children eat more berries, fruits, vegetables, on the surface of which there may be microbes.

The reproduction of microbes can be stopped by carefully heating or boiling them. Dishes and contaminated items must be disinfected.

Worms enter the gastrointestinal tract by swallowing the child's eggs and their larvae. Being in the body of the child secrete toxic substances(toxins), which have adverse effects on the nervous system, appetite disappears, digestion is upset. It is necessary to prevent helminthic diseases. To do this, first of all, it is necessary to deal with the source of infection (unwashed or poorly washed vegetables, berries, eaten especially in the summer, raw water, unboiled milk, etc.), carriers of diseases (insects, rodents).

To combat gastrointestinal diseases, along with the observance of personal hygiene rules by adults, it is necessary to instill in children from an early age cultural and hygienic skills: Wash hands before eating, after using the toilet, after playing with dogs, cats, which are often carriers of diseases. (Vedrashko V.F.)

Food poisoning.

A great danger to children, especially in the conditions of a children's team, is food poisoning, which can be bacterial and not bacterial origin. Food poisoning of bacterial origin (toxic infections) occurs as a result of ingestion of harmful microbes that release toxins. Typical forms of toxic infections are most often caused by a number of microorganisms of the paratyphoid group (Salmonella) and in the form of various Escherichia coli, among them dysentery. Toxic infections can occur when eating contaminated meat, infected animals, birds, fish, dairy products. (Vedrashko)

Very often cause toxic infections products stored in chopped form, at a temperature conducive to the development of microbes. Such semi-finished products as minced meat, pate, goulash, jelly, aspic dishes, liver sausages, it is dangerous to store even in the cold. (Vedrashko V.F.)

Products eaten without additional heat treatment should be carefully isolated from raw foods. Poisoning can occur when eating poorly cooked or fried meat.

Bacterial poisoning can be caused by staphylococci. The source of infection of staphylococcus products are mainly workers in the food unit, who have various skin lesions (abrasions, burns, abscesses). Prevention of staphylococcal and other types of toxic infections consists in strict observance of the sanitary improvement of the food unit, monitoring the health of its employees. Often staphylococcal diseases associated with the consumption of milk from sick cows. Staphylococci can multiply rapidly in perishable foods (meat, fish, scrambled eggs), especially at room temperature.

Severe forms of poisoning are caused by the toxin of the botulinum bacillus. Most often this disease is observed when eating stale sausage products, sturgeon fish, salted and smoked bream, canned fish.

Food poisoning of non-bacterial origin can be caused by eating poisonous mushrooms, berries of wild plants.

Perhaps food poisoning with poisons of lead, copper, arsenic, which can pass into food from the inner walls of the dish, especially if acidic foods are stored in this dish. (Vedrashko V.F.)

A rationally composed menu in a preschool institution is such a selection of daily ration dishes that provides children with basic nutrients (proteins, fats, carbohydrates) and energy, taking into account age, health status and conditions of their upbringing (see.

Tab. four).

For children aged 1 to 3 years and children from 4 to 7 years, separate menus are prepared. Nutrition in these groups of children differs in the number of products, the volume of the daily diet and the size of single portions, as well as in the characteristics of the culinary processing of products.

Children who are in a preschool for 9-10 hours (day stay) receive 3 meals a day, which provides approximately 75-80% daily requirement children in nutrients. Breakfast is 25% of daily calories, lunch - 40% and afternoon snack - 15% (dinner - 20% - the child receives at home).

For children who are in a preschool for 12-14 hours (long day), you can organize both 3 and 4 meals a day. In the first case (if the children are in the institution for 12 hours), their meals consist of breakfast (15% of daily calories), lunch (35%) and afternoon tea (20-25%).

For children who are on a round-the-clock stay, as well as with an extended day with a 14-hour stay, the 4th meal is provided - dinner, which is 25% of the caloric content of the daily diet. The calorie content of the afternoon snack should be 10-15%.

In a preschool institution, a specific menu is compiled for each day. It is important to observe the correct ratio of essential nutrients in the diets of children - the principle of a balanced diet. In the diets of preschool children, the ratio of proteins, fats and carbohydrates should be 1:1:4. Insufficient, excessive or unbalanced nutrition can have a negative impact on the child's body.

With malnutrition, there is a poor weight gain, a decrease in the physical development of the child, a deterioration in immunological protection, which contributes to the onset of diseases and their more severe course. With excessive nutrition, there is an excessive increase in body weight, the development of obesity, a number of metabolic diseases occur, and violations of the cardiovascular and other systems are noted. It is necessary to constantly strive to maintain optimal amounts of proteins, fats and carbohydrates in the diets of children and their correct ratio, avoiding violations even on certain days.

Table 4. The need of children of early and preschool age for basic nutrients and energy*

"Approved by the Chief Sanitary Doctor of the USSR on May 28, 1991, No. 578691.

Some products included in this set are included in the child's diet daily, others - children can receive every other day or 2 times a week. So, in the menu of children every day it is necessary to include all daily allowance milk, butter and vegetable oil, sugar, bread, meat. At the same time, fish, eggs, cheese, cottage cheese, sour cream can be given to children not every day, but after 2-3 days, but it is necessary to ensure that all the required amount of food is used up in 10 days.

When compiling a menu for feeding children in a preschool institution, the correct distribution of products during the day is observed, based on the physiological characteristics of the digestion of preschool children. So, given that foods rich in protein, especially in combination with fat, stay longer in the child's stomach and require more digestive juices to digest, dishes containing meat and fish are recommended to be given in the morning - for breakfast and lunch. For dinner, dairy, vegetable and fruit dishes should be given, because. lacto-vegetarian food is digested more easily, and during sleep, digestion processes slow down.

These requirements for the preparation of the menu in preschool institutions are reflected in the approved norms of natural food sets. There is no difference in the amount of protein-containing products for children with daytime and round-the-clock stay. The difference is only in the amount of milk, vegetables, cereals, fruits. In day groups, their number is reduced compared to round-the-clock and extended stay groups.

When compiling the menu, first of all, you should consider the composition of the dinner, for the preparation of which it is spent maximum amount meat, fish, vegetables. As a rule, the norm of meat is completely consumed for lunch, mainly as a second course. For second courses, in addition to beef, you can use lean pork, lamb, chicken, rabbit meat, offal (in the form of soufflé, cutlets, meatballs, boiled goulash, stew, etc.).

The choice of first courses in the nutrition of preschoolers is not limited - you can use various soups on meat, fish and chicken broths, vegetarian, dairy, fruit soups.

Given the need for widespread use of various vegetables in the diet of children (both fresh and boiled), a salad, mainly from raw vegetables, preferably with the addition of fresh herbs, must be included in the lunch. To improve the taste, you can add fresh or dry fruits to the salad (for example, cook grated carrots with apples, fresh cabbage salad with prunes, etc.).

As a third course, it is better to give children fresh fruits or juices, fresh berries, and in their absence - fresh or dried fruit compotes, as well as canned fruit or vegetable juices, fruit purees (for baby food).

For breakfast, as well as for dinner, children are given various milk porridges, preferably with vegetables or fruits (oatmeal, semolina or rice with carrots, prunes, dried apricots, raisins, etc.), vegetable dishes (carrots in milk sauce, vegetable stew, stewed cabbage, beets, vegetable caviar), cereal and vegetable dishes (stuffed cabbage with rice, carrot cutlets, various casseroles), cottage cheese dishes (cheesecakes, casseroles, lazy dumplings), egg dishes (scrambled eggs, scrambled eggs with tomatoes, potatoes, etc. .), mild cheese varieties. For breakfast, children can receive children's sausages or sausages, soaked herring, steamed or boiled fish. Of the drinks for breakfast, they usually give cereal coffee with milk, tea with milk, milk; for dinner - milk, kefir, less often - tea with milk.

For breakfast and dinner, it is desirable, as well as for lunch, to give children salads from fresh vegetables and fruits.

An afternoon snack usually consists of two dishes - dairy (kefir, fermented baked milk, milk, yogurt, biokefir, etc.) and pastries or confectionery(cookies, waffles, gingerbread). It is advisable to include a variety of fresh fruits and berries in the afternoon snack. For children who are on 3 meals a day with an extended day, a vegetable or cereal dish (casserole, pudding) or a cottage cheese dish can be included in the afternoon snack.

When compiling the menu, special attention is paid to the variety of dishes throughout the day and the whole week, they make sure that the same dish is not repeated not only on this day, but also in the coming days. It is necessary that during the day the child receives two vegetable dishes and only one cereal. As side dishes for main dishes, one should strive to give vegetables, and not cereals or pasta. Diversity in children's nutrition can be achieved by preparing a wide range of dishes. For example, beef can be used to cook not only cutlets, but also soufflé, goulash, meat and potato and meat and vegetable casseroles.

The compiled menu is fixed on a special menu-layout form, which lists all the dishes included in the daily diet, their output (weight of each serving), the consumption of products for preparing each dish (written as a fraction: in the numerator - the amount of product per child, in the denominator - the amount of this product for all children fed).

The menu for children under 3 years old and from 3 to 7 years old can be common, but the layout indicating the consumption of products should be separate. It is necessary to strictly fix the number of children of each age group present in the institution on a given date.

To determine the yield of a dish, losses during cold and hot cooking of products are taken into account, as well as the welding of some ready-made dishes, using special tables.

Specially designed promising weekly, ten-day or two-week menus, which allow for a greater variety of dishes and eliminate the laborious process of daily menu preparation, are of great help in compiling diets in a preschool institution.

In some preschool institutions, such promising menus are developed on the basis of different seasons of the year.

In addition to promising menus, a preschool institution must have specially designed card files of dishes that indicate the layout, calorie content of the dish, the content of proteins, fats, carbohydrates in it, their ratio and energy value. The use of these cards allows, if necessary, to replace one dish with another of equal composition and calorie content.

In the absence of any products, they can be replaced by others equivalent in terms of the content of basic nutrients, primarily protein. For the correct replacement of products, they use a special table of product replacement for the main nutrients, approved by the Ministry of Health of the Russian Federation. For example, 100 g of fish can be replaced with beef, which should be taken 87 g, but at the same time, 1.5 g of oil should be excluded from the child’s daily diet, because. meat contains more fat than fish.

Strict adherence to the diet is of great importance in organizing the nutrition of children. The time of eating should be constant and correspond to the physiological characteristics of children of different age groups.

Strict observance of the hours of eating ensures the development of a conditioned food reflex for a while, i.e. secretion of digestive juices and good digestion of ingested food. With indiscriminate feeding of children, the food reflex fades away, appetite decreases and the normal functioning of the digestive organs is disrupted.

In children of early and preschool age, the process of gastric digestion lasts approximately 3-3.5 hours. By the end of this period, the stomach is emptied and the child has an appetite. Therefore, preschoolers should receive food at least 4 times a day with intervals between separate feedings of 3-3.5-4 hours.

The most physiological is the following diet:

Breakfast 7.30 - 8.30

Lunch 11.30-12.30

Afternoon snack 15.00-16.00 Dinner 18.30-20.00

The diet of children in preschool institutions is established depending on the length of stay of children in them. In children's institutions with daytime stay of children (for 9-10 hours), children receive 3 meals a day:

Breakfast 8.30 Lunch 12.00-12.30 Snack 16.00

Dinner (at home) 19.00 - 20.00

Children who are on an extended day (12-14 hours) or on a 24-hour stay receive 4 meals a day. At the same time, breakfast and other meals are slightly shifted to an earlier time:

Breakfast 8.00 Lunch 12.00 Afternoon snack 15.30 Dinner 18.30-19.00

In round-the-clock groups, it is advisable for children to give a glass of kefir or milk before going to bed at 21.00.

Meal times in preschools must be strictly adhered to. Deviations from the set time may be allowed only in exceptional cases and no more than 20-30 minutes. Therefore, heads of preschool institutions should pay maximum attention to the proper organization of work in the food unit and the timely delivery of food to children's groups. Breaks in food should not be allowed. Each new dish the child should receive immediately after he ate the previous one. Children are recommended to be at the table during lunch no more than 25-30 minutes, during breakfast and dinner - 20 minutes, during afternoon tea - 15 minutes.

One of the important points of the diet is the prohibition to give children any food in the intervals between feedings, primarily various sweets, cookies, buns. It is necessary to pay special attention to the attendants and parents.

The correct diet provides for the observance of the physiological norms of the daily and single volume of food, which strictly corresponds to the age of the child, the level of his physical development and state of health. Excessively large portions of food lead to a decrease in appetite, can cause disturbances in the normal function of the digestive organs. Small volumes do not cause a feeling of fullness.

Kemerovo Technological Institute of Food Industry

Baby food in preschool

KEMEROVO-2008

Introduction

List of sources used

Introduction

Good nutrition of children is a necessary condition for ensuring their health, resistance to infections and other adverse factors, and the ability to learn in all periods of growing up. The priority role of nutrition in maintaining the health of children and adolescents is enshrined in a government decree Russian Federation"The concept of state policy in the field of healthy nutrition of the population of the Russian Federation until 2010" and the presidential program "Children of Russia".

Food is the only source of vital substances necessary for the growth and formation of the child's body, its vigorous activity and resistance to adverse environmental influences. In this regard, it is very important to study the organization of nutrition of children in preschool institutions, because the health of pupils is largely due to the proposed diets.

Rational nutrition that meets physiological needs a growing organism in nutrients and energy, ensures the normal harmonious development of the child, increases its resistance to various adverse factors, and contributes to the development of immunity to various infections. Unsatisfactory organization of nutrition, especially among children attending kindergartens, is one of the main reasons for the spread of acute respiratory diseases, an increase in the number of frequently and long-term ill children.

The study of the organization of nutrition, the sanitary and hygienic state of the catering unit in the framework of social and hygienic monitoring showed that the role of nutrition in modern conditions is significantly increasing due to the influence on the growing organism of such social factors as a sharp acceleration in the pace of life, an increase in the cognitive information received by children in the nursery - gardens and at home, involving children in physical education and other types of physical activity (rhythm, dancing, etc.).

In addition, the period of early and preschool age is characterized by the most intensive growth of the body, the rapid course of metabolic processes, the development and improvement of the functions of many organs and systems (especially nervous), motor activity, which in turn requires a sufficient supply of nutrients, which are the only source of energy for the growing organism.

Human health is largely determined by the quality of his nutrition in childhood. A child's body differs from an adult's rapid growth, intensive course of metabolic processes. During the first years of life, the structure is formed, and the functions of the nervous, bone, muscle, cardiovascular, endocrine and other vital systems are improved. In this regard, the child's body has a high need for all nutrients - a source of plastic material.

Proper nutrition ensures the normal physical development of the child, prevents the occurrence of deviations in development and growth.

Sufficient provision of the child with all nutrients, especially vitamins, mineral salts and microelements, is one of the main points in the prevention of infectious diseases.

The state of immunity is determined not only by the quantitative side of nutrition, but by its quality and biological value. In addition, rational nutrition increases the resistance of the child's body to the effects of harmful environmental factors.

Nutrition has a decisive effect on the development of the central nervous system of the child, his intelligence, and the state of working capacity. In our time - a time of great overload, the acceleration of the pace of life, the possibility of stressful situations - it should be remembered that proper nutrition in childhood will help in many ways to overcome the difficulties of life.

1.1 Features of the physiological development of preschool children (3-7 years old)

The age of 3-7 years refers to the preschool period, which is very important in the development of the child, as it is characterized by a qualitative and functional improvement of the brain, all organs and body systems.

The dynamics of the physical development of a child in preschool age is uneven. At the 4th and 5th years of life, the growth of the child slows down somewhat, the child grows by 4-6 cm per year, and during the subsequent period of life (at the age of 6-7 years) the increase in growth reaches 8-10 cm per year. The rapid increase in the growth of children at this age is called the "first period of stretching." It is associated with functional changes in the endocrine system (increased function of the pituitary gland). Over the years, the proportions of the child's body have changed significantly. By the age of 7, his upper and lower limbs noticeably lengthen, and the chest circumference increases.

The increase in body weight of children by the 4th year of life, as well as the increase in growth, somewhat slows down and averages 1.2-1.3 kg per year, and then again a more intensive increase in body weight is noted: over the 5th year of life, the child adds an average of 2 kg, for the 6th -2.5 kg, for the 7th about 3.5 kg. By the age of 6-7, the body weight of a child doubles compared to its weight at the age of one.

Preschool children develop further musculoskeletal system. Bone tissue becomes denser, body weight increases.

By the age of 5, her strength and performance increase significantly. The contractility of the muscles improves, their strength increases. The development and differentiation of the central nervous system in preschool children is expressed in the improvement motor functions development of coordination of movements. Preschool children are more resilient compared to young children. physical activity. They have well-developed speech, children of this age have certain skills in self-service, work, and are prepared for schooling. Their resistance to diseases is much higher.

The activity of the digestive tract in children by the end of the preschool period reaches the level of an adult. By the age of 7, the child's molars erupt. From 6-7 years old, the change of all milk teeth begins. The volume of the stomach by the age of 5-7 reaches 400-500 ml, its muscular layer increases, the amount of digestive juices increases significantly and their enzymatic activity increases. Children of this age are much less likely to experience disorders of the gastrointestinal tract. Acute childhood infections are common, which is facilitated by the widespread communication of preschoolers with others. They proceed more easily than in young children, and less often lead to serious consequences. In connection with the constantly increasing sensitization of the body in preschool children, allergic and infectious-allergic diseases, such as bronchial asthma, rheumatism, hemorrhagic vasculitis, and others, are already encountered.

Preschool children often suffer from acute respiratory diseases, which is associated with relatively low immunity at this age and increasing contacts with adults and peers. This is especially noticeable among children attending preschool institutions, in which it is necessary to single out groups of children who are often and long-term ill (chdb). This group of children requires great attention and assistance in the process of adaptation to new conditions, as well as in strengthening and hardening their body.

1.2 Basic nutrient and energy needs of children

The diet of children should be varied and balanced in terms of essential nutrients. Daily rations should not differ sharply from each other and from physiological norms in terms of the content of basic nutrients.

The child's body needs nutrients of a certain quality and meet its needs in the process of growth. In addition, children have an increased metabolism. The daily allowance should cover the energy expenditure of children at each stage of growth. The need for proteins is determined by the cost of compensating for excretions (urine, feces, skin secretions) of body weight and the formation of new tissues, the balance of protein in food or the deficiency of undesirable changes in the body, manifested in growth retardation, especially of bones.

The ratio of proteins, fats and carbohydrates in a child's food should be approximately as follows: 1:2:4, that is, if the entire daily calorie content is taken as 100 percent, then proteins should be equal to fourteen, fats - thirty, carbohydrates - fifty-six percent, only in In this case, the food will be beneficial for the health, growth, development and performance of the child.

Proteins, especially in children's nutrition, cannot be replaced by any other food components. With their participation, all the most important functions of the body are carried out: growth, metabolism, muscle work, thinking, reproduction of offspring. The need for them is satisfied thanks to meat, fish and egg dishes. However, excess protein in the diet is also dangerous, such as impaired renal excretory function, dyspepsia.

An important role in the body is played by carbohydrates - an easily digestible source of energy: as part of DNA and RNA, they are involved in the transmission of hereditary information; as a structural element of the erythrocyte membrane, the blood group is determined; carbohydrate components are part of a number of hormones.

Carbohydrates are part of cell structures, participate in the synthesis of nucleic acids, the processes of regulation of the constancy of the internal environment of the body. The need for them is satisfied by vegetables, cereals and culinary products.

Lack of carbohydrates in the diet can lead to the use of protein for energy needs and the emergence of hidden protein deficiency. An excess of carbohydrates can lead to increased fat deposition, hypovitaminosis B1, water retention in the body and flatulence.

The biological role of dietary lipids is multifaceted. Being a "compact" source of energy and a supplier of substances indispensable for vital processes - polyunsaturated fatty acids (PUFAs) and fat-soluble vitamins, they also serve as a plastic material and have a protein-saving effect.

Fats, as part of food, are high in calories. An excess of fats adversely affects the body: the function of the glands of the gastrointestinal tract is disrupted.

It is important to ensure that the diet contains a sufficient content of saturated fatty acids (PUFAs) - linoleic. PUFAs have an increased reactivity, which is actively involved in metabolic processes, cholesterol, increase elasticity and clear vessels. In the absence or deficiency of PUFAs increased dryness skin, tendency to disorders of cholesterol and choline metabolism.

In the diet of young children, the ratio of proteins, fats and carbohydrates should be 1:1:4.

The nutritional usefulness of food is determined by the sufficient content of proteins, fats, carbohydrates, mineral salts, and vitamins.

Fat-soluble vitamin A (retinol) is involved in the formation of visual purple in the retina - rhodopsin, maintains the normal function of the skin, mucous membranes, and cornea of ​​​​the eyes.

Therefore, in the diet of children there should be a sufficient amount of animal products (animal liver, meat, fish, egg yolks, sour cream and cream).

Vitamin C plays important role in the processes of biological oxidation of various substrates, the synthesis of steroid hormones, the formation of collagen and intercellular substance; protects adrenaline, protein-enzymes from oxidation, promotes blood clotting and tissue regeneration. Vitamin C deficiency can occur if there is not enough fresh fruit in the diet. At the same time, preschool children usually receive a sufficient amount of ascorbic acid with food.

Riboflavin (vitamin B2) is part of numerous enzymes involved in the regulation of all types of metabolism. With its shortage, the processes of biological oxidation are disrupted.

Mineral salts, unlike proteins, fats and carbohydrates, do not have nutritional value, but are extremely necessary for the body as a plastic material (bone tissue) and as regulators of metabolic processes; they are involved in maintaining a certain level of osmotic pressure, acid-base state, etc.

Calcium is one of the main elements that perform a plastic function: the human skeleton consists of 97% of it. In young children, the need for calcium is 100% satisfied, but in older children we found a deficiency of 22.5%, which can lead to disruption of the osteogenesis process.

Phosphorus is a constituent of phospholipids, nucleotides, phosphoproteins and other organic compounds. Inorganic phosphorus salts are involved in maintaining the acid-base state of the body, in compounds with calcium and magnesium form a bone skeleton, are deposited in the teeth.

The most favorable ratio of calcium and phosphorus in the diet of children and adolescents is 1:1.2–1.5.

Excess phosphorus is dangerous for the child's body, since the kidneys cannot cope with the phosphorus load and metabolic disorders and related diseases occur.

Magnesium - vital important element involved along with potassium in cellular metabolism. An excess of magnesium can be explained by a large number of bread and cereal products in the children's menu.

The optimal ratio of calcium and magnesium is 1:0.22 for preschoolers. It is known that an excess of magnesium can lead to a deterioration in the absorption of calcium.

Iron in the composition of hemoglobin is involved in the transfer of oxygen from the lungs to tissues; as part of enzymes, it performs a catalytic function and participates in redox processes.

Iodine is involved in the formation of thyroid hormones that regulate energy metabolism, the intensity of basal metabolism, affect protein, lipid, carbohydrate, mineral and water-salt metabolism.

It should also take into account the fact that Kuzbass is endemic for this microelement.

In Kuzbass, since September 2005, a governor's food fortification program has been implemented, according to which 200,000 children of preschool and school age receive fortified foods.

In particular, enriched foods, such as fortified jelly, are included in the diet. The main goal of the program is to significantly improve the quality of nutrition and, as a result, the health of children.

Minerals are found in all human organs and tissues. They are involved in water-salt metabolism, the formation of the bone skeleton, hematopoiesis processes, in the regulation of pH, osmotic pressure of blood and other tissue fluids, are part of enzymes, hormones and cell membranes.

When compiling diets for children, the correct ratio between calcium and phosphorus is important. It is usually taken 2:1. This ratio is favorable for normal bone formation. Excess calcium can lead to calcification of the kidneys, aorta, and other organs. An excess of phosphorus disrupts salt metabolism, increases the load on the excretory system (kidneys). Increased phosphorus intake inhibits calcium absorption in the intestine.

Compared with adults, children need more vitamins (per 1 kg of body weight) due to intensive growth and increased metabolism.

Vitamins are biocatalysts of many biochemical processes occurring on cellular level. . Many vitamins are the starting material for the biosynthesis of Co-enzymes and prosthetic groups of enzymes, which determines their need for the normal course of metabolic processes. Vitamins increase the resistance of the child's body to infectious and other diseases.

There are pathological forms of various provision of the body with vitamins:

Avitaminosis - Absence or deficiency in food of one of the vitamins.

Hypovitaminosis - A state of the body that characterizes a partial deficiency of vitamins that does not manifest itself in a specific way.

Vitamin A - is part of the visual pigment-rhodopsin, which converts the light that enters the retina into electrical impulses that enter the brain and create a visual image.

If the deficiency of vitamin A is aggravated, then a serious eye disease may occur - xerophthalmia, when the cornea of ​​\u200b\u200bthe eye - the cornea is involved in the process. In this case, the structure of the protective epithelium lining it is disturbed, it undergoes keratinization, dries up, loses transparency and sensitivity, and the cornea turns into a thorn. With xerophthalmia, the function of the sebaceous glands is also disrupted - constantly gradually washing the surface of the eyes, mechanically removing foreign particles from it, and destroying microbes with the help of the lysozyme enzyme contained in the lacrimal fluid. With xerophthalmia, microbes invade the cornea, it becomes inflamed, softened, ulcerated and dies. It is clear that such processes in the eye end in partial or complete loss of vision - blindness.

With vitamin A deficiency, changes are also observed in the epithelium lining the mucous membranes of the respiratory tract, digestive tract, kidneys and other internal organs. Tuberculosis, pneumonia, bronchitis, acute respiratory infections and other infectious diseases in people with A-vitamin deficiency occur more often than in the normal supply of the body with this vitamin. In addition, with A-hypovitaminosis, the mechanisms of anti-infective protection of immunity are weakened: the ability of white blood cells, the so-called leukocytes, to phagocytosis decreases, and the production of antibodies decreases. These phenomena are especially dangerous in early childhood - that's why A-avitaminosis increases child mortality.

vitamins

In the human body, vitamin A is converted to carotene, so it is called provitamin A. In addition to carrots, carotene is rich in red pepper, nettle, parsley leaves, pumpkin, sea buckthorn fruits, rose hips, apricots. Ready-made vitamin A is found in butter, fish oil, liver, sour cream and cream.

Vitamin D (calcium ferrol) promotes the absorption, assimilation of calcium and phosphorus in the intestine, as well as the mobilization (release) of these elements from bone depots with an increase in the body's need for them

The role of calcium is not limited to the formation of the skeleton. Calcium is necessary for normal blood clotting, it is involved in muscle contraction, adhesion (adhesion) of cells when they are combined into organs and tissues. Calcium is involved in numerous molecular mechanisms by which various hormones regulate metabolism and affect the activity of various cells.

Participating in providing the body with calcium, vitamin D is also necessary for all calcium-related processes.

Vitamin D deficiency results in rickets.

Vitamin E (tocopherol) is involved in reproductive function person. Other manifestations of E-avitaminosis are muscle weakness and anemia, or anemia, due to premature wear and destruction of muscle fibers and red blood cells, erythrocytes.

All these severe and life-threatening disorders are caused by defects in the system of biological antioxidants or the so-called bioantioxidants, among which vitamin E plays the most important role. organism, reduce the effectiveness immune system increase the risk of cardiovascular (atherosclerosis, ischemic disease heart), cancer, cataracts and other degenerative changes.

Vitamin E deficiency is very dangerous for newborns and, especially, premature babies. This can cause anemia, pulmonary diseases, severe visual impairment. That's why this vitamin is included in all formulas for artificial feeding of babies and multivitamin preparations for pregnant and lactating women. The best source of vitamin E are vegetable oils; it is also contained in wholemeal bread, buckwheat, greens.

Vitamin K - is involved in the process of blood coagulation, it gives the protein prothrombin and other proteins of the blood coagulation system the ability to bind calcium, which, in turn, is necessary for platelets to "glue" and form a blood clot. Vitamin K is one of those vitamins that is synthesized by microorganisms that inhabit the intestines.

The inability of the body to produce one of the proteins of this system is the cause of a severe hereditary disease, hemophilia.

Along with blood clotting proteins, vitamin K is involved in the formation of other proteins that bind calcium. One of them, osteocalcin, plays an important role in bone tissue.

Vitamin C is involved in many redox reactions, as well as in the biosynthesis of special connective tissue proteins: collagen and elastin - the supporting components of cartilage, bones, and vessel walls. Vitamin C prevents the formation of nitrosamines in the body of substances that have a powerful carcinogenic effect, that is, the ability to cause the development of cancer.

Ascorbic acid facilitates absorption in the intestines and absorption of iron by the body. This element is very deficient, especially in women, which, in turn, leads to iron deficiency anemia (anemic).

With a lack of vitamin C, the ability of leukocytes to destroy pathogenic microorganisms is sharply reduced.

The main source of vitamin C are fresh vegetables, fruits, berries, herbs. Especially rich in this vitamin are rose hips, black currants, red peppers, lemons and oranges.

B vitamins are involved in many bodily functions.

So vitamin B1 (thiamine) is involved in the synthesis of acetylcholine, a substance that plays an extremely important role in the transmission of a nerve impulse. Therefore, with vitamin B1 deficiency, symptoms are observed that indicate a violation of the functions of the nervous system. These symptoms include changes in mood, skin sensitivity, sleep disorders, memory, paralysis, convulsions. Other consequences of B1-avitaminosis are severe disorders of the heart, digestive organs, general exhaustion of the body (cachexia).

The main source of B1 is wholemeal bread. Also found in peas, beans, lentils, soybeans, buckwheat and oatmeal. From meat products, the largest amount of vitamin B1 is found in lean pork, liver and kidneys. A good source of thiamine is brewer's yeast, both liquid and dry.

Vitamin B2 (riboflavin) is involved in energy metabolism and color perception processes, in the absorption of iron by the body, as well as in the synthesis of hemoglobin.

Avitaminosis B2 is accompanied by general weakness, loss of strength. A characteristic manifestation of deficiency is inflammatory changes in the mucous membrane oral cavity: painful cracks in the corners of the mouth, covered with crusts. The tongue becomes inflamed: it becomes bright red, swollen, dry, teeth marks are visible along its edges.

The organ of vision is also affected in ariboflavanosis: eye fatigue, photophobia, pain in the eyes, inflammation of their mucous membrane (conjunctivitis) and eyelids (blepharitis) are noted.

Another manifestation of vitamin B2 deficiency is seborrheic dermatitis, in which the skin on the face, in the upper lip and nose, around the eyelids and on the ears begins to peel off intensively. Prolonged lack of riboflavin can lead to the formation of trophic ulcers.

Riboflavin is also necessary for the normal development of the fetus. Its deficiency during pregnancy can lead to miscarriage, the appearance of deformities in children.

Vitamin B2 occupies a somewhat special position among vitamins. This feature lies in the fact that, like all vitamins, participating in metabolism, it is simultaneously necessary for the formation of active forms of a number of other vitamins in the body, in particular, vitamins D, B6, folic acid and synthesis nicotinic acid from tryptophan. Deficiency of vitamin B2 inevitably disrupts the normal implementation of the listed vitamins of their various functions, leading to the development of a secondary, functional deficiency of these vitamins, even if they are adequately supplied with food.

Vitamin B2 is present in foods such as liver, kidneys, brewer's yeast.

Vitamin PP (niacin) also takes part in the processes of energy metabolism. This vitamin can be synthesized in the human body from the essential amino acid tryptophan. However, this synthesis is not enough to fully cover our need for vitamin PP.

Vitamin PP deficiency causes pellagra. Clinical picture pellagra is characterized by three main manifestations: diarrhea, dermatitis, dementia.

The richest in vitamin PP are brewer's yeast, liver and kidneys of cattle, wheat bran, bread made from wholemeal flour or whole grains, and some mushrooms.

Vitamin B6 is part of the active centers of numerous enzymes that catalyze various transformations of amino acids and some other nitrogenous compounds.

With a lack of vitamin B6 in children, inhibition processes in the central nervous system are disturbed, convulsive conditions develop that cannot be treated with conventional anticonvulsant drugs.

Vitamin B6 is found mainly in meat products, especially in the liver and kidneys, as well as in wholemeal bread, buckwheat, barley, millet, but it is absorbed worse from grain products than from animal products.

Vitamin B12 deficiency leads to anemia and degenerative changes in the nervous tissue.

Vitamin B12 is widely distributed in animal products and is usually found in adequate amounts in food.

Folic acid is involved in the processes that prepare biosynthesis, doubling of nucleic acids that provide cell division and tissue growth. This vitamin is found in the leaves of green plants: spinach, onions, lettuce and other greens. Also found in kidney and meat.

A rationally compiled menu in preschool institutions is such a selection of daily ration dishes that meets the needs of children for basic nutrients, taking into account age, upbringing conditions and health status, as well as climatic, geographical and national nutritional characteristics.

Children who are in preschool for 9-10 hours receive three meals a day, providing 75-80% of the daily diet. At the same time, breakfast is 25% of the daily calorie content, lunch is 5-40%, afternoon snack is 15-20%. Children should have dinner at home.

Children who are in preschool for 12 hours should receive four meals a day. In this case, the calorie content of an afternoon snack does not exceed 10-12%, and the calorie content of dinner is 20-25% of the daily requirement.

The main principles of organizing the rational nutrition of children in a preschool educational institution are to ensure a sufficient supply of all the nutrients necessary for the normal growth and development of the child's body, and compliance with the sanitary rules for cooking, hygienic basics and aesthetics of nutrition.

In order to avoid the occurrence of toxic infections and food poisoning, it is necessary to observe the rules of personal hygiene and equip the catering unit in accordance with the current sanitary and hygienic rules and regulations.

A rationally designed menu involves a certain combination of products and the correct ratio of the main food ingredients. In the preschool educational institution, it is recommended that an approximate menu be drawn up for 10-12 days, which allows you to more accurately distribute products, taking into account their calorie content and chemical composition, and facilitates the timely delivery of products to the institution. Based on an approximate ten-day menu, a working daily menu is compiled.

The nurse of the preschool educational institution periodically calculates the chemical composition and caloric content of children's food according to the amount of food actually consumed on average per day. The initial data for these calculations are taken from the cumulative accounting statement of the actual consumption of products for the past month or any 10 consecutive days of each month, from which the average daily consumption of products is calculated. This allows you to make the necessary adjustments to the nutrition of children in a timely manner.

When compiling the menu, you should first of all take care of the sufficient content of the protein component in it - the main building material for a growing organism. The main source of proteins is meat, fish, milk and dairy products containing complete proteins of animal origin. From herbal products legumes are the richest in protein, as well as some cereals (buckwheat, oatmeal, millet) and rye and wheat bread. These products must be included in the diet of children in accordance with daily norms.

The fat component should consist mainly of fats of animal origin, preferably in the form of butter, sour cream, partly in the form of fat contained in milk, dairy products, and fats in meat products. Equally indispensable are vegetable fats, as they are rich sources of polyunsaturated fatty acids and fat-soluble vitamins. The total amount of vegetable fats should be at least 15-20% of the total daily fat requirement.

A growing body also needs carbohydrates. The richest carbohydrates are sugar, jam, jam, various confectionery. However, these are refined carbohydrates and their total amount should not exceed 0.25-0.20% of the daily carbohydrate requirement. The main sources of carbohydrates should be cereals, bread, pasta and, most importantly, vegetables and fruits. The latter are especially desirable, as they contain essential vitamins, mineral salts, as well as pectin, dietary fiber and fiber, which have a beneficial effect on the digestive process. Vegetables and fruits also contain aromatic substances, essential oils, organic acids, which enhance the production of digestive juices and stimulate appetite. Such products are especially indicated for weakened and often ill children.

In order to prevent iodine deficiency, it is necessary to use only iodized salt in the diet.

The listed food ingredients: proteins, fats, carbohydrates - should be included in the daily diet in a certain ratio - 1:1:4. In this case, proteins should be approximately 14%, fats - 31%, carbohydrates - 55% of the total calorie content of the daily diet.

Imbalance of a number of basic nutrients, including vitamins and minerals, is one of the factors that delay the physical development of children and the formation of some alimentary diseases in them (thyroid pathology, visual impairment). The spread of infectious diseases may be associated with reduced immunity. All this indicates the need to adjust the diet and expand the range. functional products used in children's nutrition.

1.3 The principles of rational nutrition for children aged 3-7 years attending preschool institutions (DOE). Catering for children in preschool

Today, modern society has become more attentive when choosing and evaluating baby food. As a result of unbalanced diets, more than 70% of children suffer from gastrointestinal diseases, allergies, anemia, obesity and other chronic diseases by the end of school. One of important reasons In the current situation, this is the wrong organization of the nutrition system for children in preschool, school institutions and even at home, based on the use of general-purpose products that do not meet the requirements for baby food products. To date, the number of students eating in the school canteen is decreasing, and at the same time the number of children having a meal break of more than 6 hours is increasing. Children are increasingly eating the so-called "fast foods", which contain salty, fatty and spicy foods - harmful to the child's body. Goods that are not always beautifully packaged are healthy foods: excess carbohydrates, flavorings, artificial colors can lead to serious allergic reactions. Thus, the subject of aggressive advertising in the media, which form stereotypes of nutrition in children, are products that are far from harmless to the health of the younger generation.

Nutrition should provide the growing body of children with energy and basic nutrients. When organizing nutrition, age-related physiological norms of the daily need for basic nutrients should be observed (table)

Norms of physiological needs of children in nutrients and energy (per day)

The organization of rational nutrition of children provides for strict implementation of the regimen. In a preschool educational institution with a 10-hour stay, children organize 3 meals a day with enhanced afternoon snacks, with a 12-hour stay - 4 meals a day; with round-the-clock - 5 meals a day with an additional dinner before going to bed, with only a night stay - a single meal (dinner).

Table

In the daily diet, a calorie deviation of +/- 5% is allowed.

In a preschool with a round-the-clock stay, 1 hour before a night's sleep, it is recommended to give children a glass of milk or a fermented milk product.

For groups of short-term stay of children in a preschool educational institution (3-4 hours), a one-time meal is organized (second breakfast, lunch or afternoon snack), depending on the time the group works (first or second half of the day), while the diet should provide at least 15-25 % daily requirement for nutrients and energy.

Each institution should have a sample 10-day or 2-week menu based on physiological nutrient requirements and nutritional norms. A sample menu should be agreed with the institutions of the State Sanitary and Epidemiological Supervision.

Products such as bread, cereals, milk, meat, butter and vegetable oil, sugar, vegetables are included in the menu daily, and other products (cottage cheese, cheese, eggs) 2-3 times a week. Within a decade, the child must receive the full amount of products, calculated according to the established norms.

Based on the approximate 10-day menu, a menu-requirement of the established sample is compiled, indicating the output of dishes of different ages. Recommended serving sizes for children of different ages are presented in the table. When compiling the menu, national and territorial peculiarities of the nutrition of the population and the state of health of children should be taken into account. In the absence of any products, it is allowed to replace them with products of equal composition in accordance with the product replacement table, in order to ensure a complete balanced diet.

Currently, the baby food market in Russia is developing steadily. Optimal nutrition of children is a necessary condition for ensuring their health, resistance to infections and other external adverse factors, and also contributes to learning at all ages. “Rational nutrition of children, as well as their state of health, should be the subject of special attention of the state” - is designated as one of the main principles of state policy in the field of healthy nutrition. On June 1, 2005, the Decree of the Chief State Sanitary Doctor of the Russian Federation "On the Enactment of SanPiN 2.3.2.1940-05 "Organization of Baby Food" came into force. According to which products for young children should not contain flavors, dyes, stabilizers, preservatives. The presence of sweeteners, salt over 0.4%, individual spices is not allowed.Confectionery products for children should not contain coffee, alcohol, apricot kernels, cooking and confectionery fats, mayonnaise.Packaging of baby food should ensure the safety and preservation of nutritional value.Recommended small package.

Providing children and adolescents with sufficient quantities of benign and optimally balanced micronutrient composition (vitamins, micro- and macroelements) products is a necessary condition for their growth and harmonious development. It is recommended that school students follow a diet - eating hot meals at least 3 times a day, breaks in eating should not exceed 6 hours, and for younger children, snacks in the form of a 2nd breakfast or afternoon snack. There should be regular consumption of vegetable, meat and dairy products. An important part of the diet of children are products of processed grain crops, which have unique nutritional properties, serving as the main sources of vegetable proteins, carbohydrates (polysaccharides), B vitamins, macro and microelements, dietary fiber. Especially unique is buckwheat, whose proteins have a high nutritional value, contain many essential amino acids, especially lysine, and do not contain gluten, which explains its high digestibility and dietary properties.

For the normal development of the child's body, special foods are needed that take into account the physiological needs of children from infancy to high school students. Currently, the domestic industry produces a small range of special products for children.

At this stage in Russia there is a domestic enterprise for the production of extruded products from cereals. Ready breakfasts have been clinically and nutritionally evaluated and tested at the Institute of Nutrition of the Russian Academy of Medical Sciences, at the Scientific Center for Children's Health of the Russian Academy of Medical Sciences and at the Research Institute of Gastroenterology, according to the results of which these products are a healthy food product.

An important condition for the organization of rational nutrition is the implementation of the regimen. A five-time meal is optimal at intervals of 3.5–4 hours. At the same time, the calorie content of the daily diet should be distributed as follows: breakfast - 25% of calories, second breakfast - 10%, lunch - 35–40%, afternoon snack - 10%, dinner - 20 -25%.

The food that the child receives must be satisfying, the feeling of satiety is provided by a certain volume and weight of food, which should be an average of 1-2 kilograms.

There must be a certain diet, if this regime is observed, conditioned food reflexes are developed, appetite increases, digestive juices are secreted, that is, it is provided normal work digestive system, diet, that is, the number of meals and meal times change with age, four to five meals a day are recommended for preschoolers (three main meals: breakfast, lunch and dinner and 1-2 additional ones - a light afternoon snack or second breakfast), in In the intervals between them, you should not give children buns, sweets, etc., the habit of “biting” in the most detrimental way affects the appetite and the digestive system.

Accurate implementation of the diet, eating at a certain time ensures a more efficient use of food, strengthens the nervous system and increases defensive forces child's body.

1.5 Monitoring the proper organization of nutrition for children in preschool

According to the data of the Federal Service for Supervision of Consumer Rights Protection and Human Welfare, a number of organizational and practical measures have been taken recently to prevent harmful effects foodstuffs on public health.

In most constituent entities of the Russian Federation, control over the quality and safety of food raw materials and food products during their production, storage, transportation and sale has been strengthened. At the same time, special attention is paid to compliance with sanitary legislation at milk processing enterprises, meat processing plants, and food industry enterprises.

The administration of the Kemerovo region, the regional center of state sanitary and epidemiological supervision, the Kemerovo Technological Institute of the Food Industry were among the first in Russia to develop a regional gubernatorial program in the field of improving nutrition and health of the population of Kuzbass "To health - through nutrition." This program is carried out within the framework of the implementation of the state concept "Healthy nutrition of the population of Russia until 2010". Nutrition and quality of life are inextricably linked. Chronic deficiency of trace elements and vitamins in childhood adversely affects health and physical development, hindering the formation of a healthy generation. To remedy this situation, you need to enrich the diet of preschoolers with specialized fortified foods. By decision of the regional governor Aman Tuleyev, in 2005, 50 million rubles were allocated from the regional budget for the entire academic year for the purchase of products enriched with various vitamins, iodine, and iron. These are milk, fortified jelly, cottage cheese, kefir, cookies, waffles, bread and other bakery products - a total of 10 types of products produced at Kuzbass enterprises.

The Russian Federation has created a regulatory legal and methodological framework that regulates the production, introduction and circulation of food products obtained from genetically modified organisms (hereinafter referred to as GMOs) or containing GMOs. These products are undergoing sanitary and epidemiological examination, including the assessment of allergenic, immunomodulatory and mutagenic properties, the study of quality and safety indicators.

Developed and put into practice methods of laboratory research necessary for effective supervision of food products containing components obtained using GMOs. Established head centers for the quantitative determination of GMOs in food, equipped with appropriate equipment and specialists.

During the implementation of the State Sanitary and Epidemiological Supervision in 2006, 19,795 samples of food products were examined for the presence of components derived from GMOs. At the same time, they were found in 6.8% of samples, including 14.4% in meat products. In 526 cases, there was no declaration of the presence of such components, and therefore the sale of products was suspended.

In order to strengthen the prevention of diseases associated with deviations from the recommended nutritional standards, special attention is paid to the study of its structure in various regions of the country, the organization of rational nutrition, including therapeutic and prophylactic.

As part of the implementation of the Concept of the state policy in the field of healthy nutrition, approved by the Decree of the Government of the Russian Federation of August 10, 1998 No. 917 (Collected Legislation of the Russian Federation, 1998, No. 34, Art. 4083) and the Decree of the Government of the Russian Federation of October 5, 1999 No. 1119 "On measures for the prevention of diseases associated with iodine deficiency ”(Collection of Legislation of the Russian Federation, 1999, No. 42, item 5037) in recent years, large-scale epidemiological studies of the nutritional structure of the population have been carried out, confirming the widespread deficiency of vitamins, macro- and microelements, primarily iodine, iron, fluorine, selenium.

Given the significance of the problem, Rospotrebnadzor and its territorial departments are carrying out purposeful work to overcome micronutrient deficiencies.

In most subjects of the Russian Federation, appropriate preventive programs have been developed. Organizations and individual entrepreneurs are taking measures to enrich flour and bakery products, dairy products with iron, vitamin and mineral premixes. Production iodized salt satisfies 92% of the needs of the population. The output of fortified juices has been significantly increased.

Proposals have been submitted to the executive authorities on the inclusion of food products enriched with micronutrients in the diets of children in organized groups and schools.

The volumes of therapeutic and prophylactic and dietary nutrition of patients in medical institutions are expanding.

Micronutrients are monitored everywhere. An important direction in the elimination of micronutrient deficiency is the production of biologically active food supplements (BAA). The recommended levels of consumption of food and biologically active substances, methods of quality control and safety of dietary supplements have been developed.

In accordance with the Decree of the Chief State Sanitary Doctor of November 11, 2004 No. 6 "On strengthening the state sanitary and epidemiological supervision over the production and circulation of dietary supplements" (according to the conclusion of the Ministry of Justice of Russia, it does not need state registration, letter dated November 20, 2004 No. 07 / 11354-YUD), the state sanitary and epidemiological supervision has been strengthened for the production and circulation of dietary supplements, the procedure for organizing control over enterprises and their products has been developed.

In order to protect the rights of consumers, special attention is paid to preventing cases of false advertising of dietary supplements, the availability of accompanying documents confirming their origin, quality and safety.

Decree of the Government of the Russian Federation dated May 23, 2006 No. 305 “On measures to ensure state supervision and control over the quality and safety of cereals, flour, pasta and bakery products” (Collected Legislation of the Russian Federation, 2006, No. 22, Art. 2337) established that Rospotrebnadzor should carry out accreditation and verification of the activities of testing laboratories that conduct relevant research, as well as state supervision over the quality and safety of these products. All this requires the necessary organizational measures.

At the same time, despite the strengthening of the state sanitary and epidemiological supervision of food products, in a number of constituent entities of the Russian Federation there are serious shortcomings in providing the population with benign food products, which has Negative influence on the health of the population.

The number of food items that do not comply with sanitary rules is slowly decreasing; in 2006, their share was 9.1%. The number of samples of food raw materials and food products that do not meet hygiene requirements in terms of microbiological indicators, it exceeds 6% (2000 - 7%). The most unsatisfactory results are noted in the study of milk and dairy products, fish and fish products, imported meat and meat products. In 3.5% of the studied food samples, heavy metals, pesticides and other pollutants chemical nature. For this reason, a large number of batches of food raw materials and food products are rejected, and primarily meat and dairy products, sugar, and confectionery.

This is the result of an unsatisfactory sanitary condition a number of food facilities, lack of modern technological equipment, insufficient level of mechanization of technological processes, violations of the sanitary and anti-epidemic regime. The professional training of personnel of food enterprises, as well as the level of hygienic knowledge, is insufficiently carried out, especially for workers in food units, preschool, educational and health institutions.

There are still instances when these institutions purchase food products without proper documents confirming their quality.

This situation leads to outbreaks of dysentery, salmonellosis in these institutions and among the population. In just 7 months of the current year, 27 outbreaks were registered as a result of the consumption of food products and ready-made meals that were infected during their preparation and storage.

The structure of nutrition of the population, and especially of schoolchildren, remains unsatisfactory, characterized by a decrease in the consumption of the most biologically valuable food products - meat, fish and dairy products, vegetables and fruits.

This leads to an increase in the incidence of anemia, gastritis and duodenitis. The morbidity associated with micronutrient deficiencies remains high.

There are facts of the sale of dietary supplements that have not passed the sanitary and epidemiological examination and registration in the prescribed manner, as well as false advertising of these products.

1.6 Control over the technology of cooking and the quality of finished dishes

The requirements for the device, equipment, maintenance of the catering unit must comply with the sanitary rules and regulations for public catering organizations, the production and handling of food products and food raw materials in them, as well as standard instructions for labor protection when working in catering units.

Technological equipment, inventory, utensils, containers are made from materials that have a sanitary and epidemiological certificate of compliance with sanitary rules, and are marked for raw and finished products. During the operation of technological equipment, the possibility of contact between raw and ready-to-eat products should be excluded.

For cooking, use electrical equipment (juicers, mixers, mashers, etc.) and electric stoves. In gasified areas, the installation of gas stoves is allowed. In rural preschools with a capacity of up to 50 places, the use of solid fuel stoves with a firebox leading to a separate room is allowed. In newly built and reconstructed institutions, it is not allowed to install stoves that run on coal, wood, solid fuel. The kitchen area is equipped with exhaust ventilation.

Instructions for the use of detergents and disinfectants must be brought to the attention of all employees using this product (taking into account the specific mode of treatment being carried out).

In pantry, washing tableware and kitchen utensils, as well as near all baths that are used for processing inventory, they post instructions on the mode of washing dishes and processing inventory, indicating the concentrations of detergents and disinfectants currently used, the rules for preparing working solutions.

Detergents and disinfectants are stored in a dry, well-ventilated area. The solutions are stored in dark glass containers with a well-fitting stopper, avoiding exposure to light and moisture, for no more than 5 days.

For washing kitchen utensils, metal baths of the type VM-1, VM-2, VM-1A, VM-2A (at least 2 made of stainless steel, aluminum, duralumin, etc.) are used with hot and cold water supply with installation mixers. The temperature of hot water at the point of parsing is not less than 65 degrees.

For technological, household purposes, hot water from the water heating system is not used.

At the point where the bath is connected to the sewer, there must be an air gap of at least 20 mm from the top of the intake funnel.

Cooking cauldrons after being freed from food residues are washed with hot water not lower than 40 degrees. With the addition of detergents, rinse with hot water using a hose with a shower head and dry upside down on lattice shelves, racks. Clean kitchen utensils are stored on racks at a height of at least 0.5 m from the floor.

Cutting boards and small wooden utensils: spatulas, stirrers, etc., after washing in the first bath with hot water (50 degrees C) with the addition of detergents, rinse with hot water with a temperature of at least 65 degrees. C in the second bath, doused with boiling water, and then dried on lattice metal racks.

Metal inventory after washing is calcined in the oven; after use, meat grinders are disassembled, washed, doused with boiling water and dried thoroughly.

Tableware and tea utensils are allocated for each group. It can be made of faience, porcelain (plates, saucers, cups), and cutlery (spoons, forks, knives) - stainless steel. It is not allowed to use dishes with chipped edges, cracks, chips, deformed, damaged enamel, plastic and aluminum cutlery.

The number of simultaneously used tableware and cutlery must correspond to the list of children in the group. Staff should have separate tableware.

Dishes are stored in the buffet. Dishes and cutlery are washed in 2 or 3-hole bathtubs installed in the pantry of each group room.

Tableware after mechanical removal of food residues is washed with the addition of detergents (first bath) with a water temperature of at least 40 degrees, rinsed with hot running water at a temperature of at least 65 degrees. (second bath) using a flexible hose with a shower head and dried on special grates.

The cups are washed with hot water using detergents in the first bath, rinsing with hot running water is carried out in the second bath and dried.

Cutlery after mechanical cleaning and washing with detergents (first bath) is rinsed with hot running water (second bath). Clean cutlery is stored in pre-washed metal cassettes in a vertical position with the handles up.

In the event of cases of infectious diseases, disinfection (disinfection) of dishes is carried out in the prescribed manner.

For disinfection of dishes, it is recommended to use a dry-heat cabinet, which is installed in each group cell. If it is not available, for disinfecting dishes in each group, you should have a container with a lid for soaking dishes in a disinfectant solution.

Work tables in the catering unit and tables in the group after each meal are washed with hot water and detergents with special rags.

Washcloths, brushes for washing dishes, rags for wiping tables in case of a complicated epidemiological situation are boiled for 15 minutes in water with the addition of soda ash or soaked in a disinfectant solution, then washed at the end of the day with detergent, rinsed, dried and stored in a special labeled container.

Food waste at the catering unit and in groups is collected in marked metal buckets with lids or pedal tanks, which are cleaned as they are filled to no more than 2/3 of the volume. Every day at the end of the day, buckets and tanks, regardless of their filling, are cleaned with hoses above the sewer drains, washed with a 2% solution of soda ash, and then rinsed with hot water and dried.

Cleaning is carried out daily in the premises of the catering unit: mopping, removing dust and cobwebs, wiping radiators, window sills; weekly, with the use of detergents, walls, lighting fittings are washed, windows are cleaned from dust and soot, etc. Once a month, it is necessary to carry out a general cleaning followed by disinfection of all premises, equipment and inventory.

In the premises of the catering unit, sanitary and preventive measures are carried out to combat flies, cockroaches and rodents, and when they appear, they are exterminating, using permitted chemicals, in the manner established by the Ministry of Health of Russia.

Control over the proper organization of nutrition for children in preschool institutions should be carried out at all stages, from the head of the institution to the parent committee.

The head of the preschool institution is responsible for the entire organization of work in the institution. In the Regulations on the preschool institution, approved by the USSR Ministry of Education, the USSR Ministry of Health in agreement with the All-Union Central Council of Trade Unions in 1985, it is written: "The head of the preschool institution ... is responsible for protecting the life and health of children, organizing rational nutrition, sanitary and hygienic status of the institution. The head, being the head of the work of all the personnel of the institution, ensures the timely submission of requirements to the trading organizations - applications for the necessary products for the year, quarter, month; controls the activities of the head of the household to ensure the timely delivery of food products, their proper storage; monitors the use of food allocations; if necessary, takes part in the preparation of menu layouts; monitors the work of the staff of the catering unit, compliance with sanitary and hygienic conditions during the preparation and distribution of food; periodically checks the organization of meals for children in groups.

The senior nurse (paramedic) of a nursery, a nursery-kindergarten, in accordance with the same Regulations, constantly monitors the proper nutrition of children. Her responsibilities include monitoring the quality of the delivered food products, their proper storage, compliance with the deadlines for implementation, as well as compliance with the natural norms of products when compiling menu layouts, the quality of food preparation, and compliance with her physiological needs of children in basic nutrients. The elder sister also controls the sanitary condition of the catering department, the observance of personal hygiene by its employees, bringing food to the children, and the nutrition of children in groups.

Control over the quality of the products obtained, their storage conditions and the timing of their implementation is carried out daily. All food products entering the children's institution must comply with the requirements of state standards. When receiving perishable products, it is imperative to require quality certificates for them indicating the date of production, variety or category, the period of sale, a number of laboratory data (for example, for milk and dairy products - fat content, protein content).

Raw foods and foods that go into the diet of children without heat treatment must be stored separately. Particular attention should be paid to the correct storage and timely use of perishable products (meat, fish, milk, sour-milk products, etc.), while strict adherence to the requirements of the Sanitary Rules for the Design and Maintenance of Preschool Institutions, approved by the USSR Ministry of Health in agreement with the USSR Ministry of Education in 1985

Control over compliance with natural norms of products is carried out by the head nurse through daily participation in the preparation of menu layouts, which should be compiled separately for children of toddler and preschool age, taking into account the length of stay of children in the institution. At the same time, it should be borne in mind that some products should be included in the menu every day in full daily volume, and some (such as fish, cottage cheese, eggs) can be included in the diet of children after 1-2 days, but it is necessary to use them up within a week the full norm corresponding to the approved set of products for preschool institutions.

In the absence of any products, they can be replaced with equivalent ones in chemical composition, using the product replacement table for the main nutrients.

The quality of food preparation, strict control over compliance with the rules of culinary processing of products, and measures to prevent food poisoning require great attention.

It is necessary to constantly monitor the observance by the catering staff of the rules for processing raw and cooked products (on different tables, using special marked cutting boards, knives, meat grinders); fulfillment of all technological requirements for cooking (processing vegetables without prolonged soaking, maintaining the required heat treatment time, timely cooking, etc.).

Particular attention should be paid to the inadmissibility of using products and dishes that are not allowed by the sanitary service for feeding children in organized groups. Thus, the Sanitary Rules for the Arrangement and Maintenance of Preschool Institutions prohibit the manufacture of yogurt-samokvas (sour milk can only be used to make dough), cottage cheese and other fermented milk products, as well as pancakes with meat, pasta in a navy style, brawns, creams, drinks, fruit drinks, mincemeat, deep-fried products, jellies, pates. It is strictly forbidden to eat mushrooms, use flask and barrel milk without boiling, cottage cheese and sour cream without heat treatment, eggs and meat of waterfowl, meat that has not passed veterinary control, canned home-made products.

Control over the quality of food preparation also provides for the presence of medical workers when laying the main products in the boiler and checking the yield of dishes.

Checking the correctness of laying the main products (butter, meat, fish, etc.) is carried out by weighing the products allocated for the preparation of this dish, and comparing the data obtained with the menu layout, where these products must be recorded for each dish, indicating the amount per one a child and for all children (for example, at lunch for 100 children: butter in the 1st dish - 1.5 / 150 g, as a side dish for the 2nd dish - 3/300 g).

It is important to pay attention to the correspondence of the volumes of prepared food to the number of children and the volume of single servings, avoiding the preparation of excessive amounts of food, especially the 1st meal, which leads to a decrease in the calorie content of food, a decrease in its biological value and to more leftover food.

For the convenience of controlling the output of dishes, the dishes in the kitchen should be measured, and appropriate marks should be made on the boilers for dishes I and III. The output of II dishes is checked by weighing several portions and comparing the average weight of the portion with the set output according to the layout.

The results obtained are recorded in the journal for quality control of finished food (screening), which is maintained by a medical worker.

For the convenience of monitoring the output of dishes in the catering unit, there should be tables of food waste during their cold cooking, the output of cereals of various consistency, the output of meat, fish, cottage cheese, vegetable dishes during their various culinary processing.

Control over the good quality of food ends with the grading of finished products, which is carried out mainly by the organoleptic method. The Sanitary Rules stipulate that the distribution of ready-made food to children should be carried out only after taking a sample and recording by a health worker in the rejection log the results of evaluating ready-made meals and allowing them to be issued. At the same time, it is necessary to note the result of the sample of each dish, and not the diet as a whole, in the journal, paying attention to such indicators as appearance, color, smell, taste, texture, stiffness, juiciness, etc. Persons conducting an organoleptic evaluation of food should be are familiar with the methodology for conducting this analysis.

A daily sample of ready meals should be left daily. The selection and storage of daily samples are under the constant control of medical workers. The sample should be taken into a sterile glass dish with a lid (garnishes are taken into a separate dish) and stored in a specially designated place in the refrigerator at a temperature of 6-8°C.

The duty of the nurse is to carry out C-fortification of prepared food in accordance with the Instruction approved by the order of the Ministry of Health of the USSR dated July 24, 1972 N 695 "On further improvement of the mandatory C-vitaminization of food in the USSR in medical and preventive and other institutions." Fortified, as a rule, III dishes immediately before distribution.

See organization instructions medical nutrition in medical institutions, approved by order of the USSR Ministry of Health of April 23, 1985 N 540

Control over the compliance of food rations with the physiological needs of children is carried out by the head nurse by calculating the chemical composition and calorie content of food according to the official tables of the chemical composition of food products *. Nutrition calculations for the content of proteins, fats, carbohydrates and calories are carried out once a month according to the accumulative accounting statement (for the entire month or for any 10 consecutive days of each month) separately for toddlers and preschool children. The received data are compared with physiological norms children of this age in the main nutrients, taking into account the length of stay of children in the institution (for children who are in the institution for 12 hours or more, the need is fully satisfied, with a 9 - 10.5-hour stay - by 75 - 80%). When making calculations, special attention is paid to the sufficient content of animal proteins in the diets of children.

The results of calculating the chemical composition of the food received by children should be brought to the attention of the doctor and the head of the preschool institution, especially in cases where there are deviations from the recommended standards, in order to take prompt measures to rationalize the nutrition of children.

Along with periodic calculations of the chemical composition of food, health care workers should roughly analyze the diet daily. daily meals children, the range of products used in the menu, the content of animal proteins, butter and vegetable oil. This is the initial information for giving recommendations to parents on the selection of products for children's dinner at home, which should complement the food received by children in a preschool institution.

Monitoring the sanitary condition of the catering unit consists in daily checking the quality of cleaning the kitchen and all utility rooms, observing the rules for washing dishes, equipment, using appropriate detergents and other points provided for by the Sanitary Rules for the Design and Maintenance of Preschool Institutions.

The correctness of washing dishes can be controlled by measuring the temperature of the water in the washing baths, determining the percentage of detergents, the activity of the disinfectant solutions used. Attention should be paid to the use of only detergents approved by the sanitary service.

Only healthy people who have passed a medical examination in accordance with the requirements of the "Instructions for conducting mandatory medical examinations of persons applying for work and working at food enterprises, at water supply facilities, in children's institutions, etc.", approved , and agreed with the All-Union Central Council of Trade Unions. State Sanitary Inspectorate of the USSR 6.02.61, N 352-61 and amendments and additions to the specified instruction N 10-8 / 314-104 of 08.26.65. Food unit workers are also required to take a sanitary minimum course with an exam and subsequently pass this course 1 time in 2 years.

The head nurse of a preschool institution is obliged to strictly control the observance of the terms for the passage of medical examinations by personnel with obligatory marks in the sanitary books; conduct daily inspections of food service workers for the presence of pustular diseases skin with a corresponding record of the test results; monitor the correct maintenance of the health log, filled in by each employee of the catering department with a personal signature and certifying that they do not have diseases; monitor the observance of personal hygiene by employees of the catering department.

It is also necessary to monitor the timely change of sanitary clothing (as it gets dirty, but at least 1 time in 2 days), the mandatory change of a jacket or apron when one employee moves from processing raw products to working with finished products.

It should be remembered that catering workers are prohibited from fastening sanitary clothing with pins, needles, storing foreign objects in their pockets (money, keys, cigarettes), wearing beads, brooches, rings, clips, etc.

Control over the organization of nutrition of children in groups is carried out by medical workers during visits to groups (daily rounds at different times). At the same time, attention is drawn to the observance of the diet, bringing food to children (if necessary, portions taken from the table are weighed), and the organization of feeding children. During meals, a calm atmosphere should be created in the group, without noise, loud conversations, distractions. It is important to monitor the aesthetics of food, table setting, instilling hygiene skills in children. It should be noted the appetite of children, their attitude to new dishes, the presence of food debris. It is very important to help educators to ensure the organization of individual nutrition for children who are allergic to any products, as well as those who are debilitated and with other deviations in health; give recommendations on feeding children with poor appetite (offer water or juice during feeding, make sure that the child first of all eats a more complete protein part of the dish, do not force feed, etc.).

All the above duties of nurses in monitoring the quality of nutrition of children in kindergartens, where there are no positions of a nurse, are carried out by nurses of preschool and school departments of children's clinics allocated for medical care in kindergartens.

The duties of a doctor providing medical and preventive care to children in a preschool institution include monitoring the compliance of nutrition with the physiological needs of children, the quality of nutrition, and its effectiveness.

A doctor working in a preschool institution prescribes individual nutrition for children of the first year of life with nutrition calculations and the necessary correction, gives recommendations on the organization of nutrition for older children, taking into account the characteristics of development, health, and educational conditions. He periodically takes part in the preparation of the menu, checks the nurse's calculations of the chemical composition of the baby food ration, and makes the necessary adjustments.

When monitoring the quality of nutrition of children in a preschool institution, the doctor should seek the greatest variety of dishes, the inclusion of a wide variety of foods in the diet of children, which is a guarantee that children will receive a more rational diet. It is very important to widely use vegetables such as zucchini, pumpkin, turnip, radish, green beans, give children fresh greens daily (well-chopped young children), as well as green onions, garlic, especially during the period of seasonal rises in the incidence of acute respiratory infections , more widely introduce vegetable oil into the diet of children in in kind(with salads).

When compiling the menu or supervising its preparation, the doctor should pay attention to the mandatory inclusion in the diet of children of salads from raw vegetables and fruits (for young children in a pureed form), the wider use of fruit and berry juices, canned fruits and vegetables for baby food. It is impossible to allow children to be given tea or jelly from concentrate as a third course, as is often, unfortunately, practiced.

The organization of nutrition for children during the summer health campaign, when additional allocations are allocated for the nutrition of children, requires a certain attention of the doctor. At the same time, it is important to control that they are spent expediently. In summer, when the calorie content of food should be slightly increased, given the high energy expenditure by children due to prolonged exposure to fresh air, greater mobility, active hardening measures, and the appetite of children decreases on hot days, more fermented milk products should be included in the diet of children, fresh fruits, berries, juices, fresh herbs, including wild ones - nettle, sorrel, rhubarb; as a drink, use vegetable and fruit decoctions, rosehip infusion. It should also be recommended to change the diet: move lunch to later hours, and in the hot afternoon give a second breakfast in the form of dairy products, fruits, juices.

In each preschool institution there are children with certain health problems (with allergic diseases, overweight or underweight, chronic diseases of the digestive system, etc.). Controlling the organization of nutrition for children in the institution, the doctor must take care of providing this group of children with individual nutrition. Despite certain difficulties, in the conditions of any preschool institution it is quite possible to organize the preparation of special sparing meals or individual dishes with the exception of foods that cause allergic reactions(for example, for children with allergic diseases, instead of broth, prepare vegetable soup), allocate additional food for children with a lag in body weight, and for overweight children, replace cereals and pasta with vegetable dishes, prepare a third dish with less sugar, etc. .

It is very important to ensure strict control over the implementation of medical prescriptions for individual nutrition of children directly in groups. To this end, group staff must give specific instructions on the nutrition of children with health problems, compiling a list of such children or individual nutrition sheets indicating which foods the child cannot tolerate, what should be replaced, what additional food the child should receive. In the layout menu for such children, a separate column should be allocated.

The doctor, as well as the average medical worker of a preschool institution, should periodically visit children's groups in order to monitor the feeding process, paying attention to the organization of nutrition for newly arrived children, especially young children, children who returned to the team after a disease, and also, as indicated above, children with various developmental and health disorders.

The doctor should also periodically monitor the operation of the catering department, its sanitary condition, the quality of food preparation, the output of dishes, etc.

One of the main duties of a doctor in monitoring the organization of child nutrition in a preschool institution is to evaluate its effectiveness. The most objective indicators of the adequacy of children's nutrition, the correspondence of diets to the physiological needs of the child's body should be considered clinical and physiological parameters: the general status of the child, the level of his physical and neuropsychic development, morbidity, and some laboratory data.

In the clinical assessment of the general status of the child, the general state of health, emotional tone, the state of mucous membranes, skin, tissue turgor, the development of the subcutaneous fat layer, muscle and bone systems, the functional state of the gastrointestinal tract and other internal organs and systems are taken into account.

With nutrition that meets the needs and functionality organism, the child has a good appetite, joyful emotional mood, active behavior; he willingly comes into contact with other children, attendants, takes part in games. The physical and neuropsychic development of such a child corresponds to the age. The process of adaptation to some negative influences is going well for him.

Early clinical signs of malnutrition include changes in the child's behavior: increased fatigue, excitability, tearfulness, nervousness, which can be caused by polyhypovitaminosis. In this case, slight dystrophic changes in the skin and its appendages and mucous membranes are observed. Timely detection of such conditions will make it possible to make an appropriate correction in nutrition or prescribe medications in time.

Pronounced symptoms of malnutrition are: loss of appetite, dysfunction of the digestive system, pallor, dystrophic changes in the skin and mucous membranes, a decrease in the severity of the subcutaneous fat layer, a decrease in the rate of increase in body weight, and in more severe cases - and growth, physical inactivity.

When assessing the effectiveness of nutrition, great importance is attached to monitoring the dynamics of the physical development of children, which is directly dependent on the quality of nutrition, especially in young children. Assessment of the level of physical development is carried out in children under 1 year old once a month, from 1 to 3 years old - once a quarter, from 3 to 7 years old - once every six months, using tables of body weight distribution depending on height and age, according to local regional standards. Along with such an assessment, absolute indicators of body weight gain for certain periods of time (monthly) should also be taken into account. It is especially important to monitor the dynamics of this indicator in children at risk.

The neuropsychic development of children is assessed by age. At the same time, attention is drawn to the timely development of static and motor functions, speech, self-service skills, personal and public hygiene, gaming and labor activity readiness for schooling.

Of the laboratory data that can serve as criteria for nutritional efficiency, it is important clinical analysis blood, which allows you to timely detect the presence of iron deficiency anemia (low hemoglobin, color index, red blood cell count), allergies (leukopenia, eosinophilia, delayed ESR, hypovitaminosis (leukopenia).

A coprological study gives an idea of ​​the degree of digestibility of food in the gastrointestinal tract of a child. The detection of muscle fibers in the feces, a large amount of undigested fiber, starch, neutral fat, fatty acids indicates a mismatch of food with the functionality of the digestive organs. In this case, there may be a decrease in appetite, dyspeptic disorders.

As an assessment of the adequacy of nutrition, the incidence of children can serve, especially acute respiratory infections and intestinal diseases, since with improper nutrition, immunity decreases and the resistance of the child's body decreases.

The results of the assessment of the health status of children and the identified shortcomings in the organization of their nutrition must be brought to the attention of the head of the preschool institution, the teaching staff, food service workers, and the parent committee in order to take prompt measures to rationalize children's nutrition. Assistance should be sought if necessary public education, health care, departments and organizations, Soviet and party bodies.

The control of the sanitary and epidemiological service over the proper organization of nutrition for children in a preschool group consists in conducting periodic inspections of the implementation of the Sanitary Rules for the Design and Maintenance of Preschool Institutions, which contain specific requirements for the arrangement and equipment of a food unit, storage and processing of food, food preparation, and the quality of children's nutrition. , prevention of intestinal diseases and food poisoning, compliance with the sanitary and anti-epidemic regime, personal hygiene of personnel, etc.

The sanitary service bodies organize measures to prevent violations in the organization of child nutrition, and if the latter are identified, they take the necessary measures to eliminate them.

The Sanitary and Epidemiological Station, allowing the operation of the newly opened children's preschool institution, draws attention to the availability of a sufficient set of catering facilities, which should at least include: a kitchen with a dispensing area, rooms for processing vegetables, washing dishes and pantries (separately for dry foods and vegetables ), which must be isolated from the kitchen. For processing and cooking food, the catering unit, as a rule, must be equipped with electric stoves. For the storage of perishable products, refrigeration units with thermometers must be available.

When checking the sanitary condition of the catering unit and utility rooms, special attention should be paid to compliance with the rules for storing products, strict compliance with the requirements for processing products (raw and boiled), washing dishes, etc.

The results of the inspection, regardless of the presence or absence of violations, must be recorded in the institution’s sanitary state record book (account form 309 / y), and also brought to the attention of the head of the preschool institution and medical workers. If violations are identified, it is necessary to indicate the deadline by which they must be eliminated, and ensure that a re-inspection is carried out to monitor the implementation of the proposals made.

An important part of the control of sanitary and epidemiological stations over the quality of nutrition of children in preschool institutions is the conduct of periodic checks of children's food rations for calorie content and completeness of investment (the content of basic nutrients and vitamin C).

In practice, for laboratory research, most often any one part of the diet is selected, usually lunch; however, it is necessary to periodically monitor other meals. Samples are taken directly in the group from the table at the time of distribution of food. A dish of medium size and weight is chosen. Sampling is carried out in the presence of a person responsible for the nutrition of children (head, educator, nurse).

Depending on the purpose of the study (checking the work of the cook, finding out the causes of deviations in caloric content, etc.), sampling can be carried out simultaneously from the boiler. It is important to follow the correct sampling procedure.

When taking a sample of the first dish from the boiler, it is thoroughly mixed and 5-10 portions are taken into a separate pan with a pouring spoon. In the pan, mix again and select portions at the exit.

When selecting second courses, products from meat, fish, cottage cheese are weighed in the amount of 5-10 servings. Then one product is selected for analysis and indicated in the direction average weight portions. Garnish is selected by weight, paying attention to the uniformity of mixing. When selecting dishes seasoned with sauce, it must be taken separately at the exit.

For the dishes selected for analysis, a menu layout is written for each dish separately to compare these data with the results of a food study. For fortified dishes, the amount of ascorbic acid introduced per 1 serving is indicated.

The results of the analysis must be brought to the attention of the head of the preschool institution in a timely manner, and, if necessary, to senior management.

The issues of organizing the nutrition of children in preschool institutions are also dealt with by employees of health authorities and public education, heads and trade union organizations of enterprises and agriculture operating preschool institutions. They take care of the supply of children's institutions with the necessary food, every time they visit institutions they are interested in the quality of children's nutrition, given that this issue is one of the most important points that contribute to the harmonious development of children and reduce their morbidity. The organization of nutrition for children in preschool groups is also the object of attention of the Interdepartmental Commissions on Child Nutrition, which since 1979 have been organized everywhere under health authorities and institutions. Members of these commissions supervise the provision of baby food in all medical and preventive and educational institutions, regardless of their departmental affiliation. Due to the fact that the Interdepartmental Commissions include representatives of the trade authorities, Soviet, party bodies, and public organizations, they can provide effective assistance in the proper organization of children's nutrition.

One of the effective methods of monitoring the nutrition of children in a preschool institution is to involve representatives of the people's control, members of the parent committee, who are the most interested in ensuring proper order in this section of the institution's work, in this matter. It is very important that employees involved in the activities of children's institutions, public catering establishments, medical institutions, etc., take part in these checks, i.e. those who can be admitted to the food unit and children's groups without additional examinations. Therefore, when creating a parent committee, care should be taken to ensure that such workers are included in its composition.

The depth, objectivity and effectiveness of the check largely depends on the appropriate training of supervisors, who must be familiar with the methodology for checking nutrition in organized children's groups, know the basic requirements for rational nutrition of children of different age groups.

When checking the state of baby food in an institution, first of all, it is necessary to take an interest in the organization of food supply. It should be clarified whether justified applications for the necessary products are submitted to trading organizations in a timely manner, paying attention to the inclusion of a wide range of products (various cereals, fish, poultry, various types of meat, offal, various dairy products, butter and vegetable oils, a wide variety of vegetables). , fresh and dry fruits, greens, special canned food for baby food), compliance with their approved set of products. How requests are made. What measures are taken by the head of the preschool institution if they are not implemented.

It is important to establish how products are delivered to the institution, whether there is special transport, its use (the best option is ring delivery), the availability of special containers for transporting products, its labeling, processing.

It is necessary to check the correctness of keeping a journal for monitoring the good quality of perishable products entering the catering department (a journal of product rejection). It should contain daily marks by a nurse or doctor about the quality of the products received, the conditions for their storage, and the timing of their implementation. It is advisable to selectively check the terms of storage and timely use of perishable products, which must comply with the terms recommended by the Sanitary Rules for the Design and Maintenance of Preschool Institutions. Pay attention to the observance of the necessary storage conditions for these products, the presence of a refrigerator, refrigerators, the observance of the required temperature (4-8 °) in them, the serviceability of thermometers, the provision of isolated storage of such products as meat, fish, dairy products, the availability of appropriate containers.

The quality of children's nutrition can be approximately estimated based on the analysis of menu layouts for several randomly taken days (4-5 days during the last 1-2 weeks and the day before the test). At the same time, attention is drawn to the presence of separate menus for children under 3 years old and from 3 to 7 years old; clear filling of all columns (for each dish, the amount of each product for one child and a fraction for all children, the output of dishes and their components, especially from meat, fish, cottage cheese); the correct distribution of products during the day (meat dishes in the first half of the day, for dinner - vegetable, cottage cheese, cereals); a variety of dishes, especially breakfasts and side dishes for the second course, which often suffer from a limited set of products; daily inclusion in the diet of children of salads from raw vegetables (for young children - in a pureed form); the inadmissibility of using tea or jelly from concentrates as a third course.

A clearer idea of ​​the usefulness of the rations and their compliance with the age-related physiological needs of children is given by an analysis of a set of actually consumed products for a certain period of time (10 days, a month, a quarter), calculated for 1 child per day.

According to the set of products, one can judge its compliance with the approved nutritional standards for children in preschool institutions, the sufficient content of biologically complete products that are sources of animal proteins, vitamins, and minerals.

Particular attention should be paid to sufficient provision of children with milk and cottage cheese (on average, at least 500 ml of milk and 40-50 g of cottage cheese), note whether fermented milk products are used. By the amount of milk and dairy products, one can indirectly judge the provision of children with calcium salts. So, if the diet contains only 250 ml of milk and there is no cottage cheese, then the need for calcium salts is provided by only 30%.

The set of products shows which fats are used in the nutrition of children, whether they receive enough vegetable oil as a source of polyunsaturated fatty acids necessary for the normal development of the child.

Attention is also drawn to the assortment of vegetables, which should be the most diverse, the presence enough fresh fruits, berries, juices, whether the norms for spending cereals, pasta, confectionery are not exceeded, which is often noted in practice.

Then it is necessary to inquire about the results of calculations of the chemical composition of diets, which are carried out by a nurse on a cumulative accounting sheet. At the same time, attention is drawn to the balance of nutrition, i.e. the ratio of proteins, fats and carbohydrates (which should be 1:1:4), and the correspondence of their amount to the physiological needs of children. To do this, the obtained calculated data are compared with the recommended norms for the consumption of basic nutrients by children of early and preschool age during daytime and round-the-clock stay in a preschool institution.

If any nutritional ingredients actually received by children do not meet the recommended values, attention should be paid to the measures taken. Find out to whom the malnutrition was reported, how it was corrected, whether this is confirmed by subsequent calculations (or the health workers limited themselves to stating the facts).

When checking the operation of the kitchen, you should pay attention to the yield of dishes, the correspondence of the amount of cooked food to the volumes and number of servings indicated in the layout menu. If necessary, you can carry out the removal of residues by checking for necessary products for the next meal and the correspondence of their actual quantity to the data of the layout menu.

When checking the quality of cooking, compliance with the rules for processing vegetables and other products that ensure the preservation of their biological value is noted. The correctness of the C-fortification of food is checked, the availability of appropriate documentation, where the name of the dish, the number of servings, the total amount of ascorbic acid introduced, the time of fortification should be noted.

When visiting the catering unit, it is necessary to pay attention to the observance of the sanitary regime (the presence of marked cleaning equipment, a sufficient number of marked cutting boards, their storage in special metal cassettes or directly at the workplace; compliance with the rules for processing dishes, the availability of appropriate detergents, disinfectants, their storage).

The correctness of maintaining a health journal is checked, the presence of daily records of a nurse conducting an examination of catering workers is checked there.

The correctness and clarity of keeping a marriage log of the results of evaluating ready-made meals is also checked, in which, before each distribution of food to groups, a medical worker's record of the results of sampling and permission to distribute food should be made. The presence of a sample of the daily product and the correct storage of it should be checked.

In children's groups, the entire organization of the process of feeding children, the presence of food residues is checked; if necessary, the weight of the dish taken from the table when distributing food to children can be checked (in order to control the delivery of food to children), as well as the direction of the food sample for laboratory research (to check for completeness of the investment).

The quality of washing dishes in groups should be checked, especially in the case of an unfavorable epidemiological situation (boiling or treatment with disinfectants in conditions that exclude the presence of children).

All comments and suggestions made during the verification process are entered in the record book of the sanitary state of the institution, indicating the deadlines for implementation, which must be taken under control. During the verification of their execution, attention is drawn to the implementation of proposals made by other inspecting persons during previous or subsequent inspections.

1.7 Menu basics

When compiling a diet, it is necessary to provide for the correct distribution of products during the week and, especially, during the day. It is unacceptable when there are two cereals in the daily menu, and even a cereal side dish for the second course. It is desirable that children receive two vegetable dishes and only one cereal during the day. It is also important to remember that foods rich in protein, especially when combined with fat, stay longer in the child's stomach and require a large amount of digestive juices, so it is recommended to give dishes containing meat, fish, eggs in the morning - for breakfast and lunch.

For dinner, dairy-vegetable, easily digestible food is preferable, since at night, during deep sleep digestion slows down.

When developing a menu, it should be borne in mind that some foods should be included in the child's diet daily, and he can receive some foods every other day or 2-3 times a week. So in the menu of children every day it is necessary to include the entire daily norm of milk, butter and vegetable oils, sugar, bread, meat. At the same time, fish, eggs, cottage cheese, sour cream can not be given to children every day, but within a decade (10 days), the amount of these products should be provided in full for the age requirement. Permissible repetition of dishes no more than 3 times in 10 days.

The volume of food and the output of dishes should strictly correspond to the age of the child. A large volume helps to reduce appetite, causes a violation of the normal function of the digestive organs. Often, large portions are diluted low-calorie foods. Small volumes do not cause a feeling of fullness.

The choice of first courses for children 3-7 years old is not limited by anything. They are shown: broths; soups on these broths, seasoned with vegetables, cereals, dumplings, dumplings, vegetarian soups, milk and fruit soups.

As second courses they give cutlets, meatballs, meatballs, stewed vegetables with meat, fish, poultry.

The composition of the dinner must necessarily include a salad, mainly from raw vegetables, preferably with the addition of greens.

As a third course, it is best to give children fresh fruits or juices, and in their absence compotes from fresh or dried fruits, as well as canned fruit or vegetable juices, fruit purees for baby food.

For breakfast and dinner, children can be given various milk porridges, cereals with vegetables and fruits.

An afternoon snack in a preschool educational institution usually consists of two dishes - a milk drink (kefir, fermented baked milk, milk) and pastries or confectionery (cookies, crackers, waffles). It is very good to give children a third dish - fresh fruit, juice or mashed potatoes.

Each preschool educational institution should have a promising menu for 2 weeks and a specially designed card file of dishes, which indicates the layout, calorie content of dishes, the content of proteins, fats, and carbohydrates in it. The use of ready-made cards makes it easy to calculate the chemical composition of the diet, if necessary, replace one dish with another that is equivalent in composition, and monitor children's nutrition on a daily basis.

Proper catering requires that food be prepared with regard to the yield of finished dishes. On the basis of an approximate two-week menu, a layout menu is compiled daily in the preschool educational institution, which indicates the number of children, the consumption of food for each dish and its weight in raw and cooked form.

The basis for cooking should be the TTK of the Collection of technological standards of 1994, but taking into account the requirements for the organization of sparing nutrition.

The main document for cooking at the catering department of the preschool educational institution is the layout menu, the preparation of which is guided by: - ​​technological maps;

an approximate 10-12 day menu;

availability of products;

norms of physiological needs;

daily norms of food for one child; - information about the cost of products; - norms of interchangeability of products; - norms of losses during cold and heat treatment of products and output of finished products;

tables of chemical composition and energy value of food products. .

When organizing a sparing diet, some changes are made to the recipe of dishes: bone broths are excluded from the menu, vinegar is replaced with citric acid, margarine is replaced with butter. Special technological processing of products is envisaged: meat and fish are boiled or steamed in chopped form, cereals and vegetables are boiled until soft. Light baking of dishes is allowed, fried is excluded.

For the proper organization of nutrition of preschool children, the whole environment in which food is eaten is of great importance. Children should be provided with appropriate utensils, comfortable tables and chairs. Dishes should be nicely presented, not too hot, but not too cold. Toddlers need to be taught to be clean and tidy at the table. Teachers must be calm. Babies with poor appetite should not be force-fed.

In organizing the nutrition of children attending a preschool educational institution, it is very important to ensure a clear continuity between the preschool educational institution and the child's family. It is important that nutrition complements the nutrition in preschool. To this end, parents should post in groups recommendations on the nutrition of children in the evening, on weekends and holidays. At the same time, specific recommendations are given on the composition of home dinners, taking into account what products the children received during the day. .

Bibliographic list

1. Mayurnikova L. Healthy nutrition of children is the key to the future health of the nation // Business Kuzbass, No. 8, August 2005 and No. 2, February 2006.

2. Decree of the chief state sanitary doctor of the Russian Federation "On the entry into force of SanPiN 2.3.2.1940-05 "Organization of baby food" dated June 1, 2005.

3. SanPiN 2.3.2.1940-05 "Organization of baby food".

4. Decree of the Government of the Russian Federation of 10.08.1998 No. 917 // Collection of Legislation of the Russian Federation, 1998, No. 34, Art. 4083

5. Decree of the Government of the Russian Federation dated 05.10.1999 No. 1119 “On measures to prevent diseases associated with iodine deficiency” // Collection of Legislation of the Russian Federation, 1999, No. 42, Art. 5037

6. Decree of the Chief State Sanitary Doctor of November 11, 2004 No. 6 "On strengthening the state sanitary and epidemiological supervision over the production and circulation of dietary supplements" (according to the conclusion of the Ministry of Justice of Russia, it does not need state registration, letter of November 20, 2004 No. 07 / 11354-YUD)

7. Decree of the Government of the Russian Federation of May 23, 2006 No. 305 “On measures to ensure state supervision and control over the quality and safety of cereals, flour, pasta and bakery products” // Collection of Legislation of the Russian Federation, 2006, No. 22, Art. 2337

8. "The concept of state policy in the field of healthy nutrition of the population of the Russian Federation until 2010"

9. Bisaliev N.B., Karakulov S.A., Abashin A.I., Shotova O.A. Actual use of food products in preschool institutions of the Republic of Karakalpakstan. ZKGMA them. M. Ospanova, Aral Research Center for Child Nutrition of the Ministry of Health of the Republic of Uzbekistan, Regional Children's Clinical Hospital, Aktobe, Nukus.