Motuzka I. Management of safety and quality of foods for enteral nutrition

The dissertation is devoted to the scientific justification of theoretical, methodological and practical principles for management of safety and quality of foods for enteral nutrition with consideration to the needs of the target segment of consumers by use of the methodology of commodity research, to investigating the tendencies specific to creating and preserving their consumer properties at the phases of life cycle and confirmation of the hypothesis about the physiological effectiveness of food products. The terminology in the field of standardization of food products for special medical purposes is developed; a classification of foods for enteral nutrition by the hierarchical principle is created. A set of criteria for optimization of consumer properties of foods is systematized and developed by investigating the demand for foods for enteral nutrition from the target consumer category. The tools of mathematic modeling and the principles of food combinatorics are used for creating recipes of four groups of foods for enteral nutrition with the purposefully formed composition (series «Vitalprod»), for the following categories of patients: patients in critical conditions; patients with the impaired tolerance to glucose; patients with oncologic illnesses; patients with kidney failure. Their use in form of dry mixtures, beverages and puddings on their base or pill products is justified for the variability of these foods consumption for patients staying in medical clinics and in a longer run, when staying at home. A comprehensive commodity research of foods for enteral nutrition has experimentally confirmed their high sensor characteristics, nutritional and biological values conforming to general and specific criteria of optimization: the optimal ratios of proteins : lipids : carbohydrates; non-protein calories: inserted nitrogen; Ca:Mg; Ca:P; K:Na; ω-6:ω-3. The recommended ratio is achieved by the purposeful projecting of the prescription composition: the amount of non-protein calories to the amount nitrogen; Ca:Mg, Ca:P and K:Na. The ratio ω-6:ω-3 (2:1-4:1) is achieved, recommended for persons with risks of the progressing syndrome of systemic inflammatory response, which highest value (3,9:1) is established in the product «Vitalprod-Renal», which is optimal for normalizing the nitrogen balance and reducing the clinical displays of uremic syndrome. Theoretical and practical principles for attaining the stability of foods for enteral nutrition in storage are developed. The advisability of use of various types of package materials depending of the food category is experimentally confirmed; the terms of food storage are defined. Measures on quality management of foods for enteral nutrition are developed using the methodology of commodity research, decomposition of the phases of their life cycle is made. The regression analysis is used for modeling complex indicators of food quality depending on the phases of life cycle and temperature regimes approximated to the real conditions of consumption. The set of measures on management of safety of foods for enteral nutrition is scientifically justified. The nutritional safety of the analyzed foods by microbiological indicators, inclusion of heavy metals, pesticides and radio nuclides is demonstrated. The identification of unsafe factors at the phases of life cycle of foods for enteral nutrition is made using the principles of HACCP conception. The experimental confirmation (in vitro and in clinic conditions) of the proposed scientific hypothesis on the physiologic effectiveness of developed foods for enteral nutrition is obtained. Measures for protecting the rights of consumers of this group of foods are proposed (including the program of comparative testing), and recommendations for their rational consumption are elaborated. Recommendations to the State Targeted Program for the Development and Production of Foods for Enteral Nutrition till 2020 are elaborated, to introduce foods for enteral nutrition and tackle the problem of their import substitution. The normative documents for foods for enteral nutrition are developed, the patenting of developments is made. The foods have been tested and introduced in practice of medical institutions and food industry companies in Ukraine.