This article was originally published in the Russian language in Health and Illness ( ) 7_2011 ).

. It was translated and edited in Almaty, Kazakhstan and is published with permission of the authors and original publisher: Sharmanov T. Sh., President of the Kazakh AcademyofNutrition.ThefullRussiantextisavailableathttp://kankaz.org/states/7_2011.pdf

.. ProperNutritionforSchoolchildren Children'sPolyclinicNo.8,InternationalSchoolLyceumDostar,Almaty Abstract Aproperregimeoffoodismostimportantmeanstoensurethehealth,normalgrowthand developmentofachild.Thebasicprinciplesofrationalnutritionareconformityoftheenergyvalueof foodmeetingthemajornutrientneedsandoptimalmeals. Healthbeginsinchildhoodwhentheprocessofgrowthanddevelopmentoftheorganismismost intense.However,attendingschooldemandsagreatdealofmentalstressandphysicalenergy.Tooffset thislossofenergy,oneoftheimportantconditionsforenhancingthehealthofschoolchildrenisabalanced diet.Propernutritionforchildrenisessentialfortheirhealthaidingresistancetotheeffectsofinfection andotheradversefactors,andtheabilitytolearnforallagelevelsandschoolmealsplayanimportant roleintheoverallstructureofthenutritionalstatusofchildrenandadolescents.Thenutritionofstudents duringtheirschooldayisakeyfactorinmaintainingtheirhealthandtheeffectivenessoftheirlearning. Healthyschoolmealshavebecomeespeciallyimportantinrecentyearsbecausechildrenspenda considerabletimeatschoolandthelearningprocessisveryintense.Aswell,thelowsocioeconomiclevel ofmanyfamiliesmeanstheyareunabletoprovidechildrenwithadequatefoodathome. NutritionalRequirementsandSources Thebodyusesenergytomaintainlifeatrest,fooddigestion,andmuscleactivity.Theneedfor energydependsonage,sex,climaticzone,andactivitiesandisdeterminedbytheoverallenergyvalue

(caloric)intakeandmajorfoodsubstances.Thedietmustcontainproteins,fats,carbohydrates,minerals andvitamins. Proteinsareincludedinallbodycellsandareneededtobuildnewcellsandtissuesduringgrowth anddevelopment.Theyarepartoftheimmunesystemstructures,therebyensuringitsimmunobiological resistance.Proteinsareessentialaminoacidsthatarenotsynthesizedinthebody.Sourcesofprotein includemeat,dairyproducts,legumes,eggs,andsomecereals. Fatsparticipateinmetabolism,buildcellsofnervoustissue,andprovideimmunity.Theyincrease theenergyvalueoffood,improveitsflavorandaidinthedigestionofprotein,mineralsandvitamins.The mostimportantsourcesoffatarevegetableandanimaloils,andsincepolysaturatedfattyacidsarenot synthesizedinthebody,vegetablefatsmustbeincludedinthedietofchildren. Carbohydratesarethemainsourceofenergy,beinginvolvedinmetabolismandpromotenormal oxidationoffatsandproteins.Carbohydratesaremainlycontainedinproductsofplantorigin:fruits, berries,vegetables,andcereals. Mineralsarealsonecessaryforpropergrowthanddevelopmentofbone,muscle,bloodand nervoussystem.Theyareinvolvedinmetabolism,arepartofhormones,andregulatetheacidbase balanceinthebody.Especiallyimportantforagrowingorganismarecalcium,phosphorus,iron,and magnesium.Calcium,phosphorusandmagnesiumarenecessaryfortheformationofbone,teethCalcium forproperoperationofthenervousandmuscularsystemsphosphorusformuscleandbraintissues, andironforhemoglobin.Inaddition,otherelementsarerequired:e.g.sodiumandpotassiumareinvolved intheregulationofwatersaltExchange. Dairyproducts,nuts,beans,andvegetablesaretherichestinsaltsofcalcium.Whereasfish,meat, cereals,legumes,andvarietiesofdarkvegetablescontainhighlevelsofphosphorus.Potassiumsources includepotatoes,beans,applesmagnesiumryebreadandoatmealandironproductsofanimaland vegetableorigin(meat,liver,oatmeal,etc.)

Vitaminsregulatemetabolicprocessesthataffectthegrowthanddevelopmentofanorganism, contributetothedevelopmentofimmunity,andareinvolvedinbloodprocesses.Vitaminsarenot synthesizedinthebodyandthereforemustcomefromfood.Itisparticularlyimportanttoensureschool childrenvitaminsCband,aswellasfatsolubleA,D,andE. ThemainsourcesofvitaminCarefreshvegetables,fruits,andberries.Bvitaminsarecontained inmeat,liver,andmilkvitaminAinfishoil,butter,milk,cream,andliver.Plantproducts(greenonions, lettuce,carrots,tomatoes)containcaroteneProAandvitaminDincodliveroil,halibut,tuna,fishoil,and eggyolk.Provitaminsarecontainedintheskinandhelpdevelopthebodyundertheinfluenceof ultravioletrays.VitaminEisfoundinvegetables(wheat,corn,oats)andanimals(liver,eggs)products. RecommendedDiet Thecontentofmajornutrientsinthedietshouldbebalancedwithanoptimalratioofproteins,fats, carbohydratesinthefoodof1:1:4.(1) Table1Recommendedintakesofprotein,fatandcarbohydrates(grams/day) No Age,years Calories Protein Fats 1 6to11 2350 77 79 2 11andolder 2713 90 92

Carbohydrates 335 383

Thedailydietforchildrenandteenagerscontainsasetofproductsforschoolsandafterschoolcare recommendedbythesanitaryrulesandnormsintheRepublicofKazakhstanasshowninthefollowing table: Table2 Recommendeddailyproductconsumption

No Nameofproducts The amountof products depending ontheage ofthe students Gmorml, gross 610 80 150 15

1 2 3

Rye(ryewheat) Wheatbread Wheatflour

Gmorml, net 1118 120 200 20

610 80 150 15

1118 120 200 20

4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27

Cereals,legumes MacaroniProducts Potatoes Vegetables(fresh),greens Fruit(fruit)fresh Fruit(fruit)dry,includingwildrose Fruitandvegetablejuices,drinks,specialized vitaminsincludinginstant Meattrimmed(meatonthebone)1cat. Category1drawnchickens(hens1.p/p) Fishfillet Sausageproducts ilk(2.53.2%fatcontent) Sourmilkproducts(2.53.2%fatcontent) Cottagecheese(fatcontentofnotmorethan 9%) Cheese SourCream(notmorethan15%fatcontent) Butter VegetableOil Eggs Sugar CandyProducts Tea Cocoa Bakingyeast

45 15 250 350 200 15 200 77(95) 40(51) 60 15 300 150 50 10 10 30 15 1 40 10 0,4 1,2 1

50 20 250 400 200 20 200 86(105) 60(76) 80 20 300 180 60 12 10 35 18 1 45 15 0,4 1,2 2

45 15 188 280 185 15 200 70 35 58 14,7 300 150 50 9,8 10 30 15 40 40 10 0,4 1,2 1

50 20 188 320 185 20 200 78 53 77 19,6 300 180 60 11,8 10 35 18 40 45 15 0,4 1,2 2

28

Salt

SchoolRegime Whenchildrenstayinbeforeschoolclassesformorethanfourhoursfoodshouldbesupplied. Hotmealsinsecondaryschoolsshouldbeorganizedasfollows:halfboardforchildreninbeforeand afterschoolcareandhotmealsfortherestofthechildren.Anutritionalintakemodelforschoolshas beendevelopedtakingintoaccountdifferencesbetweenfirstandsecondsessions. Forthefirstsession(8amto2pm)itisrecommended: breakfast(25%ofthediet)beforegoingtoschoolatabout7:30a.m., asecondbreakfastatschool(1520%ofthediet),11.0012.00, lunch(3540%ofthediet)onreturnhomefromschoolat15.0016.00and dinner(about20%ofthediet)isat8pm.

For2ndsession(2pmto7pm): firstbreakfastat8a.m., lunchbeforegoingtoschoolat12.0013.00, lunchatschoolat4p.m., dinnerat8pm.

Table3:Rationedamountsofoutputsofprepareddishesaccordingtoage(ingrams)forschoolmeals No TypeofDish PortionSize(in grams) Forstudentsaged: 6to11years 11yearsandolder 1 2 3 4 5 FirstCourse(soup) SecondCourse(cereal,vegetables,eggs,cheese, dishes) ThirdCourse(Tea,Cocoa,Juice,Milkormilk products) Salad Meat(cutlet,hamburg),Fish,Poultry 200250 150200 200 60100 80120 250300 200250 200 100150 100120

6 7

Garnish Fruit

150200 100

180230 100

So,thedaythestudentbeginswithahomemadebreakfast.Thebreakfastshouldbeahotdish, bestcontainingstarch,cereals,potatoes,pasta.Starchisdigestedprettyslowly,sosmallamountsofthe glucoseproducedenterthebloodandtheenergylastsforalongtime.Goodadditionsarevegetablesor fruits.Fordrinks,coffee,tea,andjuiceswithmeatorfishinthemorningmayoverstretchthefunctionsof thegastrointestinaltractandpathologicalprocesses.Itisbettertomovetheseproductstolunchorevening meals. Thelunchmenuincludesasmallamountafirstdish(soup),asecondcourse(salad),maindish (boiledorstewedmeat,fish)withvegetablesandgarnish(potatoes,rice),anddessert.Thisdietforschool children617yearstakesintoaccountchangesinphysiologicalneedsfornutrientsandenergydepending ontheageandsexofthechild(2).Withthisbasicknowledgeofnutrition,medicalstaffandhealth educatorswillbeabletohelpwiththecontroloftheregime. LISTOFREFERENCES 1.sanitaryregulationsNo.834from25.10.2010thehygienicrequirementsforthedevice,contentand conditionsoflearningingeneraleducationandresidentialcareinstitutions.C.67,1819. 2.SerdkovskaG.N.,AnanievN.a.Guideforphysicians.M.:Medicine.P.144146. 3.KuchmaV.r.hygieneofchildrenandteenagers..,geotarmedia,2010.S.269.