Ministry of Public Health of Ukraine
Kharkov National Medical University

Module 1
General Problems of Hygiene

Hygiene of nutrition 

Methodical guideline for students

Module 1
General Problems of Hygiene

Hygiene of nutrition 

Methodical guideline for English medium students

Модуль 1
Общие вопросы гигиены

Гигиена питания
Методические рекомендации для студентов

Рекомендовано
Ученым советом ХНМУ
Протокол № 7 от 22.11.2012

Харьков
ХНМУ
2012

Hygiene of nutrition: Methodical guideline for English medium students / Compl. V.А.Korobchanskiy, O.I.Gerasimenko, Yu.O.Oliynyk, А.G.Reznichenko / - Kharkov, KhNMU, 2012. -  52  p.

Compilers: Vladimir O.Korobchanskiy, Olga I.Gerasimenko, Yuliya O.Oliynyk, Аlexandеr G. Reznichenko

Гигиена питания: Метод.рекомендации для студентов / Сост. В.А.Коробчанский, О.И.Герасименко, Ю.А.Олейник, А.Г.Резниченко. – Харьков, ХНМУ, 2012. – 52 с.

CONTENT

Сhapter 1.	Physiological and hygienic fundamentals of nutrition ….…………….	4	
Сhapter 2.	Hygienic character of the qualitative composition  of rational
nutrition …….………………………………………………………….	
8	
Сhapter 3.	Hygienic estimation of vitamin C insufficiency in human organism …	16	
Сhapter 4.	Hygienic assessment of food products………………………………....	21	
Сhapter 5.	Food poisonings …………………………………………………….…	34	
	Test questions ………………………………………………………...	47	

Сhapter 1.
Physiological and hygienic fundamentals of nutrition

Nutrition is a biosocial factor of the environment. It influences the organism by social factors. According to World Health Organization report every third person on the Earth dies from causes connected with nutrition. 
There are 3 types of nutrition. The first type is rational nutrition. This is a reasonably organized prophylactic nutrition of a healthy man. Main purposes of rational nutrition are: to provide a normal course of all physiological functions in the human organism, to provide a high level of work ability. Rational nutrition is a factor of prophylaxis of cardiovascular, gastrointestinal, malignant diseases, and others.
The second type of nutrition is medical-preventive nutrition. It is nutrition of industrial workers. The tasks of medical -preventive nutrition are reduction of the industrial factors negative influence on the workers' organism and prophylaxis of occupational diseases.
The third type of nutrition is clinical nutrition. It is nutrition of patients with different diseases. The tasks of clinical nutrition are correction of the changed metabolism with help of food-stuffs, prophylaxis of the aggravation, complication and recurrences of diseases. Besides, clinical nutrition prevents to change of the active form of diseases into the chronic one.
Besides there are preventive nutrition and nontraditional nutrition. Preventive nutrition is nutrition for the risk groups of people. Nontraditional nutrition consists of vegetarian nutrition; it includes only vegetable food products. Lacto-vegetarian is the next kind of nutrition. In the case of lacto-vegetarian nutrition man eats vegetable food products, milk and dairy products. Reductive ration. Reductive ration includes a limited quantity of caloric content (about 1000 kcal per day). Separate nutrition, it means that man can use (eat) only one product per meal.
Rational nutrition is properly organized nutrition, which provides optimum course of all physiological processes in the organism. Medical-preventive nutrition and clinical nutrition are based on rational nutrition principles.
Physiological and hygienic requirements to rational nutrition. Nutrition must be adequate to its quantity ratio. It is the law of quantity adequacy. It means that a person must get the same quantity of energy that he spends every day. Quantity adequacy of nutrition depends on the type of work (professional group), age group, sex group, climatic zone, the level of municipal service and kind of rest.
The second requirement to rational nutrition is qualitative adequacy of nutrition (qualitative adequacy law): the food ration must contain all nutrients without any exception (namely proteins, fats, carbohydrates, mineral substances and vitamins) in optimum quantities, because every component is carrying out its definite irreplaceable function in the organism.
Nutrition must be balanced. The balanced nutrition principle includes the optimum quantitative ratio between separate nutrients. For example, the ratio between proteins, fats and carbohydrates must be 1:1:4 as to weight, the ratio between proteins and vitamin C must be as 100 g of proteins for 100 mg of vitamin C as to weight, etc. There must be the optimum ratio between animal and vegetable components of the food, namely animal and vegetable proteins must be 1:1 as to weight. The fat balance principle is realized in such way: 75% of animal fats, 25% of vegetable fats. The ratio between different kinds of carbohydrates is realized in the following way: monosaccharides are 20 %, polysaccharides (starch) are 75%, cellulose is 2%, pectin substances are 3 %. Food chemical composition must correspond to the enzymes set of the human organism.
Nutrition must be various and includes products of both animal and vegetable origin. The ration must include various dishes from the same products also.
Nutrition must have the physiologically optimum regimen. The regimen of nutrition includes the following concepts: the number of meals during a day must be 3- 4. Food stays in the stomach about 2 hours on average. Next 2 hours secretary and motive functions are restored, so the digestive cycle makes up 4 hours. During 24 hours a person sleeps 8 hours and he is awaking 16 hours. If we divide 16 hours into 4 hours we get 4. It is the number of taking food during a day. Under such regimen the energy value must make up breakfast 25-30% of the daily caloricity, lunch must be 10-15% of daily energy value, dinner is 40-45% of the daily caloric content and supper is 15-20% of the energy value. Caloricity of the ration in case of three meals a day must be distributed in such a way: breakfast 25-30%, dinner 5-50%, supper 20-25% of a daily caloric content of the ration.
Intervals between having meals must be about 4-6 hours, but not more than 6 hours. The person must have his meals at the same time. Supper must be not less than 2 hours before going to bed.
Culinary thermal treatment must be of a sparing character. It means that heat treatment should improve food taste and its assimilation but not get worse organoleptic properties of food and not result in loss of nutrients. Correct culinary treatment of provision increases food assimilation, makes better food taste and enlarges the variety of food that one person eats, provides an antiepidemiological effect (kills microbes, eggs of helmints). The negative sides of the heat treatment are as follows: during the heat treatment the loss of proteins is 6 %, fats about 12 % and carbohydrates about 9% (an average). During the heat treatment vitamins (especially vitamin C) are lost. The greatest loss of vitamin C takes place during the second heat treatment, cooking food in open pans (it means without any lid, when the contact of vegetables and fruits with oxygen of the air is presented). Besides, the loss of vitamin C takes place when vegetables and fruits are put in cold water during their cooking.
Food must have sanitary and epidemiological safety. It must not contain any viruses, toxins and xenobiotics such as nitrates, salts of heavy metals, pesticides, radionuclides, and so on. Food must be of good quality and ecologically clean. Food must be digestible, i.e. well assimilated in the alimentary tract. If food contains a lot of animal products it is better assimilated. During mixed nutrition, proteins are assimilated by 84%, fats by 94%, carbohydrates by 95%. Mushrooms, peas, beans and meat products rich in connective tissue, fresh bread, and over roasted products are characterized by bad assimilation. Food must have a certain volume, to produce a sense of satiation, but not to replete the stomach.
Food must have a certain temperature. The food temperature improves its absorption and provides gustatory sense. The temperature of the first dishes must be 40-450C, second dishes 600C, stewed fruit, juice 7-120C, coffee, tea 700C.
Food must have a pleasant outward appearance and it must have the national character. For example, the best meat products in Ukraine are pork, beef and poultry. Some castes of Hindus do not eat beef (meat), because in their country the cow is a sacred animal. In China and Korea people eat dogs, in Indo-China – rats. In the most fashionable restaurants of Tokyo you can order poisonous snakes, Frenchmen like frogs, Americans like oysters, etc.
There are 4 professional groups. The first group includes engineers, teachers, physicians (except surgeons), the heads of enterprises, scientific workers, secretaries, etc. They are named workers of mental work. 
The second group includes men occupied with light physical work. They are nurses, coaches, salesmen, workers of automated industrial processes and etc. 
The third group includes workers occupied with physical work. They are chemists, surgeons, shoe-makers, drivers, cooks, railway men and etc. 
The fourth group includes people, who do very hard physical work. They are builders, foundry men, miners, steel-makers, dockers. 
Every professional group includes 3 age groups: the 1st age group includes men from 18 to 29 years, the 2nd age group consists of 30-39 year old men, the 3d age group consists of 40-59 year old men.  This division is connected with fact that every 10 years metabolism decreases by 5 %. The young person should have higher level of basic metabolism. Each age group consists of 2 sex groups: male and female.
In the cold climatic zone the food ration caloricity is higher by 10-15 % because it is necessary to have more energy for supporting the heat balance of the organism due to a more intensive heat transfer. In areas with a low level of the municipal service (areas where water-pipes, sewerage systems, centralized heat system are absent) human spends more calories of energy by 5-10 %. Caloricity of the ration depends on different kinds of rest. During an active rest man needs more calories of energy than during a passive one. Active rest includes sports and games, going in for sports, work in the garden and vegetable garden.
Coefficient of physical activity can rise to seven and more. It depends on the kind of work.
Besides, basic metabolism depends on the body mass and age. 

Hygienic requirements for menu

Menu is a list of dishes ready for serve distributed by meals within a day. It is the basic document for nutrition of collectives of people. It is made up by the dietian of the nutrition unit with help of a card file. This document is made up for one week or a longer term.
1.	In a menu there is a variety of food-stuffs, which should be provided for cooking of dishes ready for serve within the one week: meat, fish, milk and dairy products, eggs, vegetables, fruits, flour products (bread), cereals (buckwheat, rice, etc.), beans, peas, etc.
2.	The first (liquid) dishes should be planned daily for dinner. Second (concentrated) dishes should be planned for breakfast, dinner and supper. The absence of the first dish for dinner and presence of two first dishes is irrational for dinner, presence of the first dish for breakfast and for supper is irrational too.
3.	In one meal the dishes should not be cooked planning from identical products. For example, the first dish includes soup with macaroni; the second dish is macaroni with meat. It is also irrational to plan for one meal dishes cooked from similar products. For example, for the first dish is a soup with beans, for the second one –puree with peas.
4.	In each meal there should be snack dish (vegetables, salads, etc.), stimulating appetite.
5.	Cereal and vegetable dishes should alternate for meals during a day and during a week.
6.	The first high seasoning dishes such as borsch, tomato soup should alternate with neutral dishes such as potato soup, soup with groats.
7.	The dessert dishes and drinks should be various every day.
8.	The same dish should be planned in “Menu” not more than two times a week.
9.	Breakfast should have drinks stimulating the central nervous system. The supper should be easy and include mainly milk, vegetable food. It is not recommended to plan for supper tea, coffee, cocoa, and also dishes digested for a long time (meat, leguminous).
10. The dishes rich in protein including those of the animal origin and also highly-calorie dishes should be planned for dinner meals.

Сhapter 2.
Hygienic character of the qualitative composition
 of rational nutrition

The qualitative value of nutrition provides presence of all nutrients (proteins, fats, carbohydrates, vitamins, etc.) in the food ration without exception, because each of them accomplishes fixed physiological role. Each nutrient must be present in the ration in its optimum quantity according to physiological needs. 
These nutrients must be present in the ration in their optimum physiological correlation.
All nutritional substances, which present in nutrition, are divided into:
1. Irreplaceable substances, which cannot be replaced by other substances. They are essential amino acids, polyunsaturated fatty acids (PUFA), vitamins.
2. Replaceable (non-essential) substances are substances, which can be synthesized in the organism, namely fats; they can be synthesized from the carbohydrates. Vitamins D and K can be synthesized in the organism too.
Besides, all the nutrients are divided into: substances of plastic predestination (proteins, mineral substances), substances of mainly energy predestination (fats and carbohydrates) and substances of catalytic or regulatory predestination (vitamins, microelements, polyunsaturated fatty acids).
According to this classification, all food products can be divided into: food products with plastic predestination (meat and meat products, milk and dairy products, fish, eggs); products with energy predestination (bread and bakery products, all confectionery); products with regulatory and stimulant predestination (fruits, vegetables, berries); products with gustatory predestination, namely onion, garlic, horse-radish, mustard. 

Functions of separate components of nutrition

Proteins perform many functions in the organism. Proteins consist of amino acids and take part in the synthesis of human body proteins, it is a plastic function of protein. Proteins ensure structure and catalytic functions of enzymes and hormones. Proteins take part in the synthesis of immune bodies, they take part in the formation of specific γ-globulins and protein of blood, which is called properdin; it takes part in the formation of natural immunity. Proteins take part in the formation of actin and myosin, which ensure muscle contraction. Proteins take part in the synthesis of visual purple of the eye retina - rhodopsin. Proteins are a structural component of cellular membranes.
Protein is the regulator of other kinds of metabolism (metabolism of fats and carbohydrates). Proteins fulfill the informative function being a part of deoxyribonucleic acid and ribonucleic acid (DNA and RNA). Proteins perform the transport function being a part of hemoglobin, which is the cellular carrier of oxygen and carbon dioxide, as well as transport steroid hormones, metals, etc.  They also fulfill the energy function (1 g of protein gives 4.1 kcal of energy in the organism.). Proteins act as buffer systems in the organism. They ensure the normal course of physiological functions in the organism, growth and development, a high level of capacity for  work.
There are about 80 amino acids. The most significant amino acids for nutrition are only 20-25 ones, eight of them are essential for adults. They are not synthesized in the organism: leucine, isoleucine, valine, lysine, methionine, tryptophan, phenylalanine, threonine. For children there are two additional amino acids: histidine and arginine. Replaceable amino acids are synthesized in the organism at the expense of reusing (this is an endogenous formation) and partly at the expense of their arrival with food.
The standard of proteins in the nutrition is determined according to nitrogen balance. A minimum safe norm of protein is 55-60 g per day, plus an additional one  for physical work, stress, etc. The share of proteins in nutrition makes up 11-13% of the day caloricity. The quantity of proteins must be increased in the period of growth and development of children, in time of pregnancy and breast feeding of child, in the period of infectious and non-infectious diseases, during stress, during the action of low and high temperature, after bleedings and operations, during an active rest. The quantity of proteins in this case must be increased from 3 till 10 g per day. In towns and cities with bad developed municipal services the quantity of proteins in the ration must be increased to 3-5 g.
The ration of nutrition should contain proteins of the animal and vegetable origin. The ratio between animal and vegetable proteins depends on the age of a person. Infantile ration contains all proteins of animal origin (100 %), from 6 months to 1 year quantity of animal origin proteins must be 80 %, from 1 year to 3 years- 70-75%, from 4 years till 6 years-60-65 %, from 7 years till 13 years 50-60 % (like an adults). The sources of animal proteins are milk and dairy products, meat and meat products, fish, eggs. The sources of proteins of vegetable origin are beans, soy-beans, haricot-beans, peas, and others. 
The proteins, which contain all essential amino acids, are called biologically complete proteins. A protein, which does not contain even one essential amino acid is called biologically incomplete protein.
Fats are organic substances of compound ethers and fatty acids. Fats perform the energy function. One gram of fats gives 9.3 kcal of energy in the organism. The other function of fat is plastic one. Fats are a structural component of cells and cellular membranes. Fats and proteins form a plastic structural substance – lipoprotein; lipoprotein lecithin is a structural substance of the nervous tissue. Fats increase the nourishing value of the ration and improve gustatory quality of the food. Fats are sources of fat-soluble vitamins and ensure their absorption in the organism. They ensure absorption of β-carotene. If fats are absent in the nutrition, β-carotene is not absorbed from the food. Presence of fats in nutrition ensures β-carotene absorption by 80-90%. Some fats are regulators of water metabolism. Oxidation of 100g of fats gives 107g of water. In the same time oxidation of 100g of proteins gives only 41g of water. Fats have an effect on the permeability of cellular membranes. Reserved fat is carried out mechanical and heat protection of the organism. Fats are a source of polyunsaturated fatty acids such as linolic, linolenic and arachidonic acids. The biological value of fat depends upon its quantity in the ration, its fatty acid composition, its melting temperature. Adults need about 80-100g of fats daily. Among them there must be about 25-30 % of vegetable fats and the rest are fats of the animal origin.
There are 3 kinds of fatty acids: saturated fatty acids (SFA), they must be about 30 % in the ration, monounsaturated fatty acids (MUFA) – about 60 % in the ration and polyunsaturated fatty acids (PUFA) – about 10% of total quantity of fats in the ration. PUFA are contained in all vegetable fats (coy-bean oil, corn oil, sunflower seed oil).  An adult needs 5g of PUFA per day. It means that a person needs to eat 454g of butter or 10-15g of sunflower seed oil every day. PUFA have the antisclerotic effect. They regulate cholesterol metabolism and favor it removal from the organism. Besides, PUFA normalize metabolism in the organism in a whole. They increase elasticity of the blood vessels walls. PUFA take part in the synthesis of prostaglandins, which perform functions similar to those of hormones and control all functions in the organism.
The degree of fat assimilation is determined by its melting point. If the melting point is lower than 37o C the fat is assimilated by 97-98 %. This fat is called low melting point fats. They are butter, sunflower seed oil. If the melting point is about 37-50oC, the degree of assimilation is 90 % , for example, lard. If the melting point is above 50oC, the fat is assimilated only by 50-60 %. These fats are mutton and beef ones.
Carbohydrates. The main function of carbohydrates is energy function. One gram of carbohydrates gives 4.1 kcal of energy. Carbohydrates provide more than one half of caloric content in the ration. Carbohydrates are components of cellular membranes and tissues. It means that carbohydrates fulfill the plastic function. Carbohydrates with proteins form mucopolysaccharides and are components of the testicles, vitreous body and cartilage. Heteropolysaccharides determine specificity of a blood group. Carbohydrates take part in the synthesis of nucleinic acids, amino acids and coenzymes.
Carbohydrates influence the completeness of fats utilization. During physical work they can transform into fats and vice versa. Carbohydrates ensure the dis-intoxicating function of liver. Carbohydrates are assimilated in the organism by 85-98%. Low molecular (simple) carbohydrates (monosaccharides, oligosaccharides, disaccharides – saccharose, lactose and maltose) are sources of quickly mobilized energy. These carbohydrates transform in fats if they are not used at once (right away). One hundred grams of carbohydrates give 30g of fats.
There are protected and unprotected carbohydrates. Protected carbohydrates are in food products in a bound state. They are protected by cellulose and are not exposed to the direct influence of enzymes. Protected carbohydrates ensure peristalsis and the secretory function of the alimentary tract and favor removal cholesterol from the organism. Share of carbohydrates in the ration is 56-61%. The sources of protected carbohydrates are bread and cereals, mealy products, macaroni, potatoes, beans and other vegetables, all fruits and berries. The sources of unprotected carbohydrates are honey, sugar, all confectionery.

Vitamins are low molecular compounds of the organic origin, which are not formed, in the organism (but vitamins of groups D and K), they do not have energy and plastic properties. They are active in small doses. About 30 vitamins аrе known today, but only 20 of them аrе significant for nutrition.
Тhеrе аrе wаtеr-soluble and fat-soluble vitamins.
Vitamins of А group (retinols) are antixerophthalmic vitamins, they are contained in animal products; in the form of provitamin (саrotene) they are in vegetable products. Vitamin А is а regulator of metabolism; it influences the children growth and forms rhodopsin (vision purple). The sources of vitamin А are liver, red and black caviar, beef liver, eggs, milk, butter, sour cream, cheese. Hygienic norm of vitamin А is 1 mg per day for adults, for children according to their age.
Some food composition tables give separate values for retinol and beta-carotene. To convert these into a single value, the form „retinol equivalent” (RE) has been conventionally adopted. 
The liver has an enormous capacity for storing vitamin A, mostly in the form of retinol palmitate. Under normal conditions, a well- fed person has sufficient vitamin A reserves to meet his needs for 6 to 9 months or more. Free retinol is highly active but toxic and is therefore transported in the blood stream in combination with retinol-binding protein, which is produced by the liver. In severe protein deficiency, decreased production of retinol-binding protein prevents mobilization of liver retinol reserves.
Vitamin B complex includes vitamins B1, B2, B3, etc.
Vitamin B1 (thiamine) is antineuritic vitamin. Its action consists of the following: it takes part in all kinds of metabolism (metabolism of proteins, fats, carbohydrates); it increases secretory and motive functions of the alimentary canal; by the way of n.vagus thiamine normalizes work of heart, physiological functions of CNS and endocrine system. Hygienic norm of vitamin Вl is 1.3 - 1.6 mg per day (or 0.6 mg per 1000 kcal of ration). The main sources of this vitamin are beery yeast, cereals and bean products.
Vitamin В2 (ribof1avin) regulates metabolism of amino acids; it improves the visual function, improves the nervous system functioning and a1imentary canal. Vitamin B2 stimulates blood formation (hemopoiesis), regulates the functions of liver, skin and mucous membranes. The hygienic standard of vitamin В2 is 1.6-2 mg реr day. The sources of vitamin В2 аrе milk аnd dairy products, eggs, bread and bakery products, cereals. Potatoes, cabbage and carrot contain vitamin B2 less than bread and cereals.
Vitamin В3 (pantothenic acid) takes part in the metabolism of fats and carbohydrates; it takes part in the synthesis of proteins, it regulates the function of the nervous system and endocrine glands. Vitamin B3 is an antidermatitis factor. 
Vitamins of group D are antirachitic vitamins. This group includes vitamin D2 (calciferol or ergocalciferol), vitamin D3 (dimethyldihydrocalciferol) and others. Vitamins of this group normalize  absorption of salts in the organism; they regulate calcium and phosphorous metabolism, stimulates children growth. The standard of vitamin D3 is 100 IU for adults, for children 400 IU, for pregnant and nursing mothers 500 IU. The sources оf vitamins D group are hеrring, cod liver, salmon, caviar, sea реrсh, milk and dairy products.
Vitamin С (ascorbic acid) takes part in the process of oxidation and reduction in the organism as а cata1ytic agent. Vitamin С provides а high level of capacity for work and high level of resistance of the organism to infections. It increases blood antibacterial function (the phagocyte function of leucocytes). Vitamin С is important for normal funсtiоning of cells, which synthesize collagen. Vitamin С affects the blood-forming function, which is called erythropoiesis and improves the prothrombin-producing function of liver. Vitamin С improves the protein- producing function of pancreas, it detoxicates the organism in case of а chemical poisoning and improves treatment of а radial pathology. Food- stuffs with vitamin С are raw cabbage, young carrot, onions, tomatoes, potatoes, orange, strawberries, citric fruits. Hygienic standard of vitamin С is 70-80 mg per day.
Vitamins of К group (phillochinones). This group includes vitamins K1, К2, К3, etc. They are fat-soluble vitamins. Vitamins K group take part in the process of blood coagulation; they take part in the synthesis of АТРА and normalize energy store in the organism. These vitamins are synthesized in the large intestine. The physiological need in vitamin К is 0.2 - 0.3 mg per day.
Vitamin РР (nicotinic acid, niacin) takes part in cellular respiration; it takes part in all kinds of metabolism. Vitamin PP normalizes the secretory and peristaltic functions of the liver, stomach, pancreas. The hygienic standard of vitamin PP is 16-22 mg per day. The sources of vitamin РР аrе: liver, kidneys, meat, eggs, vegetables, bean products, cereals.
Mineral substances аrе plastic соmроnents of bones and teeth, they realize а regulatory function in the оrgаnism and take part in the vitamin formаtion. They regulate osmotic pressure, concentration of hydrogenous ions, and acid- alkaline equilibrium. About 32 % of chemical substances take place in the organism physiological process. 
Mineral substances take part in all liquids and tissues of the human organism, influence all kinds of metabolism (metabolism of proteins, fats, carbohydrates, vitamins and water balance). Mineral substances take place in the processes of hemopoiesis, digestion and neutralization of waste products of metabolism. All chemical elements are divided into macrobioelements (calcium, phosphorus, sulfur, chlorine, sodium, magnesium, potassium), and microelements (trace elements): iron, zinc, copper, iodine, fluorine, etc.). Deficiency of mineral substances in a ration is accompanied by different pathology in the organism. 
Calcium is a part of bones, it influences the nervous and muscular irritation, it has effect on the blood coagulation.  The physiological need of calcium is 1200 mg a day for men and 1100 mg for women. The sources of calcium in ration are milk, dairy products and cabbage.
Calcium is a major mineral element of the body. An average adult body contains about 1200 g of calcium of which over 98% of it is found in the bones. The amount of calcium in blood is usually about 10 mg/d. The developing fetus requires about 30 g of calcium. There is a dynamic equilibrium between the calcium in the blood and that in the skeleton; this equilibrium is maintained by the interaction of vitamin D, parathyroid hormone, and probably calcitonin.
Ionized calcium in the plasma has many vital functions including formation of bones and teeth, coagulation of blood, contraction of muscles, cardiac action, milk production, relay of electrical and chemical messages that arrive at a cell’s surface membrane to the biochemical machinery within the cell, keeping the membranes of cells intact and in the metabolism of enzymes and hormones. It also plays a crucial role in the transformation of light to electrical impulses in the retina. In short, the calcium ion controls many life processes ranging from muscle contraction to cell division.
Phosphorus makes one per cent of the body mass, i.e. 600-700g: in bone tissues 80%, in muscles 10 %, and in other tissues 10%. Phosphorus with the protein and fatty acids take part in the formation of biological complexes, named nucleoproteins of nucleus and phosphatides. It is a component of adenosine triphosphoric acid and creatine phosphate.
Phosphorus is essential element for the formation of bones and teeth. It plays an important role in all kinds of metabolism. Phosphorus is widely distributed in food-stuffs; its deficiency rarely occurs. A large part of phosphorus present in vegetable foods occurs in combination with phytin and is available to the body only to the extern of 40-60 per cent. Phosphorus requirements have not been specifically considered by FAO\WHO Committees, but other groups of experts have suggested that phosphorus intake should be at least equal to calcium intakes in most age groups, except in infancy where the ratio suggested is 1:1.
Sodium is found in all body fluids. The adult human body contains about  100 - 300 g of sodium ion. Sodium regulates acid-alkaline balance and osmotic pressure of blood, tissues, and nucleus. The daily need of sodium is 4-5 g. The source of sodium is sodium chloride. Chlorine takes part in the synthesis of hydrochloric acid in stomach. It contributes to deposition of glycogen in liver, it is a part of buffer systems. The hygienic norm of chlorine is 2-6g per day. The increased content of chlorine is necessary in spite of diarrhea, physical work, bronze disease, recurrent vomiting.
Sodium occurs in many foods, and is also added to food during it cooking in form of sodium chloride. Sodium is lost from the body through urine and sweat; that which passed out in urine is regulated by the kidneys but that which is lost by sweating is not controlled. Depletion of sodium chloride causes muscular cramps. The requirement of sodium chloride depends upon climate, occupational and physical activity. Adult requirement is about 10 to 15 g. People who engaged in hard work will need more.
Magnesium takes part in bone formation. It normalizes nervous stimulation. Magnesium has antispasmodic action and vasodilative effect. It stimulates peristalsis of the alimentary tract, influence  the synthesis of proteins, regulates metabolism of carbohydrates. The hygienic norm of magnesium is 350 – 400 mg per day for men and 350 mg per day for women. 
Magnesium is a constituent of bones, and it presents in all body cells. Human adult body contains about 25 g of magnesium, about half of it is found in the skeleton. Magnesium is essential for the normal metabolism of calcium and potassium. Magnesium deficiency may occur in chronic alcoholics, in patients with cirrhosis of liver, during toxicosis of pregnancy and protein-energy malnutrition, and of patients with  malabsorption syndrome.
Potassium influences the nervous stimulation process and also the removing water and sodium from the organism. The adult human body contains about 250 g of potassium. Potassium occurs widely in food-stuffs, so there is little likelihood of its deficiency. The daily requirement of potassium has not been determined accurately.
Sulfur is a structural component of proteins, vitamins and hormones. Microelements take part in hormones and increase their activity.
Iron is a blood formation hormone that is part hemoglobin of erythrocytes and brings oxygen all organs and tissues.
Copper is a blood formation microelement that takes part in synthesis of hemoglobin.
Iodine takes part in the formation of hormone of the thyroid gland. Iodine daily requirement is 100-200 mcg. The ways of iodine entrances the organism are drinking water, air and food products of vegetable origin (about 60%) and animal origin (about 30% of daily need). The lack of iodine leads to the thyroid gland pathology. 
Fluorine along with calcium and phosphorus is a part of the crystal lattice of bones, enamel of teeth, it normalizes phosphorus and calcium metabolism. The daily need of fluorine is about 4 mg. A deficiency of fluorine results in pathology of teeth and bones.

Сhapter 3.
Hygienic estimation of vitamin C insufficiency in human organism 

Vitamin С (ascorbic acid) is a water-soluble nutrient that is easily excreted from the body when not needed. It's so critical to living creatures that almost all mammals can use their own cells to make it. Humans, gorillas, chimps, bats, guinea pigs and birds are some of the few animals that cannot make vitamin C inside of their own bodies. 
Vitamin C serves a predominantly protective role in the body. As early as the 1700's, vitamin C was referred to as the "antiscorbutic factor," since it helped prevent the disease called scurvy. This disease was first discovered in British sailors, whose sea voyages left them far away from natural surroundings for long periods of time. Their body stores of vitamin C fell below 300 milligrams, and their gums and skin lost the protective effects of vitamin C. Recognizing limes as a good shipboard source of vitamin C, the British sailors became known as "limeys" for carrying large stores of limes aboard ship. 
The protective role of vitamin C goes far beyond our skin and gums. Cardiovascular diseases, cancers, joint diseases and cataracts are all associated with vitamin C deficiency and can be partly prevented by optimal intake of vitamin C. Vitamin C achieves much of its protective effect by functioning as an antioxidant and preventing oxygen-based damage to our cells. Structures that contain fat (like the lipoprotein molecules that carry fat around our body) are particularly dependent on vitamin C for protection. 
Vitamin С provides а high level of capacity for work and high level of resistance of the organism to infections. It increases blood antibacterial function (the phagocyte function of leucocytes). Vitamin С is important for normal funсtiоning of cells, whiсh synthesize collagen. Vitamin С affects the blood-fоrming funсtiоn, which is called erythropoiesis and improves the prothrombin-producing function of liver. Vitamin С improves the protein- producing function of pancreas, it detoxicates the organism in case of а chemical poisoning and improves treatment of а radial pathology. Food- stuffs with vitamin С are raw cabbage, young carrot, onions, tomatoes, potatoes, orange, strawberries, citric fruits. Тhе hygienic standard of vitamin С is 70-80 mg per day.
Deficiency Symptoms
Full-blown symptoms of the vitamin C deficiency disease called scurvy - including bleeding gums and skin discoloration due to ruptured blood vessels - are rare in the U.S. Poor wound healing, however, is not rare, and can be a symptom of vitamin C deficiency. Weak immune function, including susceptibility to colds and other infections, can also be a telltale sign of vitamin C deficiency. Since the lining of our respiratory tract also depend heavily on vitamin C for protection, respiratory infection and other lung-related conditions can also be symptomatic of vitamin C deficiency. 
Toxicity Symptoms
There are very few research studies that document vitamin C toxicity at any level of supplementation, and there are no documented toxicity effects whatsoever for vitamin C in relation to food and diet. At high supplemental doses involving 5 or more grams of vitamin C, diarrhea can result from the fluid in the intestine becoming too concentrated ("osmotic diarrhea"). Large supplemental doses of vitamin C can also increase levels of uric acid in the urine, because vitamin C can be broken down into uric acid. However, it is not clear that increased uric acid in the urine can increase a person's risk of forming uric acid kidney stones. Finally, vitamin C can increase a person's absorption of iron from plant foods; and persons who have health problems related to excess free iron in their cells may want to consider avoiding high supplemental doses of vitamin C. It is important to remember that all of the above toxicity-related issues involve vitamin C in supplemental form, not as it naturally occurs in food. 
Impact of Cooking, Storage and Processing
Vitamin C is highly sensitive to air, water, and temperature. About 25% of the vitamin C in vegetables can be lost simply by blanching (boiling or steaming the food for a few minutes). This same degree of loss occurs in the freezing and unthawing of vegetables and fruits. Cooking of vegetables and fruits for longer periods of time (10-20 minutes) can result in a loss of over one half the total vitamin C content. When fruits and vegetables are canned and then reheated, only 1/3 of the original vitamin C content may be left. Consumption of vitamin C-rich foods in their fresh, raw form is the best way to maximize vitamin C intake. 
Factors that Affect Function
Poor intake of vitamin C-rich vegetables and fruits is a common contributor to vitamin C deficiency. In Russia and Ukraine 90% of all adults get less vitamin C from their diet than is recommended. Smoking and exposure to second hand smoke also increase the risk of vitamin C deficiency. The body's immune and detoxification systems make special use of vitamin C, and overload in either of these systems can increase risk of deficiency. The immune system relies on a wide variety of mechanisms to help protect the body from infection, including white blood cells, complement proteins, and interferons; and vitamin C is especially important in the function of these immune components. Vitamin C is also critical during the first phase of the body's detoxification process. This process occurs in many types of tissue, but it is especially active in the liver. When the body is exposed to toxins, vitamin C is often required for the body to begin processing the toxins for elimination. Excessive toxic exposure is therefore a risk factor for vitamin C deficiency. 
Food Sources
Excellent food sources of vitamin C include broccoli, bell peppers, cauliflower, strawberries, lemons, mustard and turnip greens, brussels sprouts, papaya, chard, cabbage, spinach, kiwifruit, cantaloupe, oranges, grapefruit, limes, tomatoes, zucchini, raspberries, asparagus, celery, pineapples, lettuce, watermelon, fennel, peppermint and parsley. 

Methods of vitamin C sufficiency control

 Vitamin C sufficiency is controlled in the following directions:
1. Control over the correctness of food ration preparing taking into account the inclusion of fresh vegetables and fruits (potato, cabbage, onion, greens, oranges, strawberries, and so on) into its composition.
2. Test for vitamin C presence in fresh vegetables included into a food ration because the amount of ascorbic acid tends to decrease during the process of storing in winter time.
3. Test for vitamin C presence in the dishes ready to serve. This is necessity because vitamin C, being the least stable of all the vitamins, may be destroyed in the process of unproper culinary treatment.
4. Test for vitamin C presence in the biological substrata (blood, urine) and proceeding from micro-symptoms. This method of checking the sufficiency of vitamin C supply is the most effective.

Test for vitamin C presence in urine

As a criterion of a sufficient supply of a human organism with ascorbic acid one can use its content in the daily portion of the urine. It has been found that on condition of a sufficient supply of vitamin C, its daily amount released by a healthy human organism through its kidneys is not less than 20 mg. When the consumption of vitamin C is not sufficient, its release with the urine decreases, and its daily amount of 13-14 mg is considered to be the lower limit of the norm. Lower value gives reasons for an assumption that the organism is in the state of hypovitaminosis. Providing this person with a large quantity of ascorbic acid may at first have practically no effect on its content in the urine, because it is reserved in the tissues; and, on the contrary, in case of a sufficient supply of an organism with ascorbic acid, its additional consumption leads to a sharp increase of vitamin C in the urine. For mass research of nutrition, a convenient method is the one in which secretion of the level estimation supply of an organism with ascorbic acid is considered its milligram per hour release with the fasting morning urine. This index fully corresponds to the content of ascorbic acid in the blood plasma. An average normal amount of ascorbic acid in the urine of healthy adult people equals to 0.8 mg/hour, in the urine of children at the age of 8-13 years-old it is 0.7 mg/hour. The tests are performed with help of the Tilman's reagent titration. A water solution of sodium salt of 2,6-dichlorphenolindophenol (Tilman's reagent) used in the test for vitamin C is intensively blue in a neutral and alkaline environments. In an acid medium the blue color of Tilman's reagent changes to pink. During the interaction of indicator pigmented form with ascorbic acid, decoloration (color restoration) takes place, and ascorbic acid is transformed itself during this process into  dehydroascorbic acid and Tilman's reagent is transformed in colorless leucoform: 

C6H8O6   +   C6H2Cl2N-C6H4ONa    =   C6H6O6   +   C6H2Cl2-NH2-C6H4ONa
ascorbic acid                  2,6-dichlorphenolindophenol             dehydroascorbic acid                  leucoform of Tilman's reagent 

When titration runs up to the equivalent point, next drop of the Tilman's reagent added in this solution paints it pink. Basing on the quantity of the applied solution of Tilman's reagent, it is possible to determine the content of vitamin C in the solution under study. According to chemical reaction 1ml of 0.001 N solution of 2.6-dichlorphenolindophenol corresponds to 0.088 mg of the ascorbic acid.

Method of analysis
The urine extracted for a certain period is selected for the analysis. For this purpose after getting up in the morning it is necessary to mark the time between the first and the second urinations (before the first meal) and select the second portion of the urine for the analysis, measuring its volume in ml. 5ml of the urine are immediately taken from the sample. Then it is poured out into a test-tube with 0.33 ml of 2% hydrochloric acid solution and titrated by 0.001 N solution of 2.6-dichlorphenolindophenol until a light pink coloring appears (the coloring should not disappear within 30 seconds). Meanwhile a parallel titration is carried out. The correction for the “blind” test (for the reagents) is deducted from the obtained average value. It usually equals to 0.03-0.05ml.  Calculation is made in accordance with the formula as follows:

X=	(a1-a2)·K·0.088·V	
	    t · b	

where X is a searched amount of vitamin C in the urine (mg/hour),
a1 is amount of Tilman's reagent, used for  titration of 5 ml urine (ml),
a2 is amount of Tilman's reagent, used for titration of distilled water with hydrochloric acid (ml), 
K is correction for the titer of the Tilman's reagent, 
0.088 is amount of ascorbic acid (mg) corresponding 1 ml of 0.001 N of the Tilman's reagent (according to formula), 
V is volume of the second urine portion (ml), 
b is amount of the urine, taken for the analysis (ml), 
t is time between two urinations  (hours). 

Example: the internal between the first and second urinations is 1.08 hours, the volume of the second urine portion is 70 ml, amount of Tilman's reagent used for titration of 5 ml urine is 0.75 ml. The correction for the "blind" test equals to 0.03 ml, coefficient of correction for Tilman's reagent is 0.98.

X=	(0,75 - 0,03) · 0,98 · 0,088 · 70	= 0.8mg/hour	
	           1.08 · 5		
                          
It is necessary: if it is not possible to carry out the analysis immediately after taking the urine sample, the later should be conserved it in order to prevent of vitamin C destruction, namely 6-7 ml of 2% solution of hydrochloric acid are added to 100 ml of the urine. And from now on the acid is not added before titration. Instead of hydrochloric acid it is possible to take 40% acetic acid in the amount of 5 ml per 100 ml of the urine.
The calculation can also be made on the base of a person's daily urinary excretion without taking into account the interval between the urinations. The calculation is made according to the following formula: 
X=	(a1-a2) · 0.088 · K · 1150	, 	
	             V		

where
X is amount of vitamin C in urine (mg/day),
a1 is amount of Tilman's reagent, used in  the "direct" test (ml),
a2 is amount of Tilman's reagent, used on the "blind" test (ml), 
1150 is a average daily urinary excretion of a healthy adult,
K is correction for the titer of the Tilman's reagent in solution; 
V is volume of the second urine portion (ml), 
0.088 is amount of ascorbic acid (mg) corresponding 1 ml of 0.001 N of the Tilman's reagent.

Сhapter 4.

Hygienic assessment of food products

Hygienic estimation of milk quality
Milk is a valuable food product. It is the main product for newborn babies and children; it plays a big role in the nutrition of patients, convalescents, as well as healthy adults.
One of big merits of milk is its taste and ability to quench thirst. Milk proteins are utilized by 93-95%, its fats by 95-97% and carbohydrates by 98-99%.
Cow milk contains: proteins 2.8-4.0 % ( they are albumins, casein, globulins and all essential amino acids), fats 0.05-3.2% (saturated, monounsaturated, polyunsaturated fatty acids; lipoids: cholesterol, lecithin), carbohydrates 4-5.6 % (milk sugar); vitamins dissoluble in fats (A, D, E, K), vitamins dissoluble in water: B1, B2, B6, B12, C, PP, enzymes, hormones, iron, fluorine, chlorides, iodine, calcium. Taking of 0.75-1 liter of milk a day can fully compensate our needs in most mineral salts and vitamins. In cases of taking more than 1 liter of milk there is a possibility of an increase in the processes of fermentation in the stomach.  Milk reduces cholesterol level in the blood at the expense of methionine, choline and tocopherol.   
At the same time milk has its hygienic shortcomings. It is a good medium for the growth of microorganisms, including pathogenic ones; milk quickly spoils due to the growth of lactic acids bacteria.
Milk can be easily denaturated by adding water and removal of cream and falsificated by adding soda and starch. 
Bruccelosis and tuberculosis can be transmitted through milk. 

Indices characterizing milk quality
Milk quality is determined by organoleptic, physical and chemical properties, samples for falsification, freshness, pasteurization, by bacterial indices and results of serological samples. The organoleptic properties of milk include color, smell, taste, consistence; the physical ones are cleanliness, specific gravity, temperature; the chemical properties are acidity, dry residue, fatness. Freshness of milk is determined by the alcohol sample and reductase content. By the presence of phosphatase enzymes and peroxidase content we can determine whether the milk has been pasteurized. For character the bacteriological contamination of the milk you have to determine the coli-titer and the maximum amount of bacteria in 1ml of milk (microbic number). Serological ring samples are done to find out if there are antibodies to brucelossis in the milk.

Hygienic standards of cow milk quality
Organoleptic properties.
Color of milk must be white with some yellowness and sterilized milk is brownish. There is a possibility of others colors depending on the fodder present. Bluish color means that the milk was diluted. Reddish color means that the cow has an udder illness or has eaten carrots.
Smell must be specific milky. There is a possibility of other smells that do not meet hygienic norms such as a sour smell (if the milk is sour) or other smells depending on milk store near soap, fuel, fish, etc.
Consistence of milk must be usual, moderately liquid without any lumps. Watery milk consistence (due to water adding), mucous milk and tensile milk consistence (due to bacterial growth) is not permissible.
Physical properties.
Temperature of milk storage in summer (from May to September) should be 12oC, during the rest time of the year - 15oC.
Cleanliness (by the State Standards) for bottle milk should be not less than the 1st group, for flask milk not lower than the 2nd group.
Specific gravity (density) of the whole milk is 1.028 – 1.034. With the removal of cream the specific gravity of milk increases and with the dilution of it the specific gravity decreases.
Chemical indices of milk depend on its type. Firstly acidity of milk: milk that has acidity of 16-18o is fresh, milk that has acidity of 20-22o is fresh enough, milk that has acidity of 23o and more is not fresh with exception proteinized milk, which has acidity of  25o in normal conditions.
Dry residue for whole fresh milk is 12-12.5%, for skim one it is 8.5%
Denaturation (removal of cream, dilution with water) and falsification (adding of admixtures) of milk is not permitted.

Bacteriological indices: microbial number and coli-titer. 
The maximum amount of bacteria in 1ml of milk is 75000-400000, coli- titer for milk of group A is 3, other groups – 0.3 by the State Standards.  Milk that satisfies the State Standards is called conditioned.  

Determination of organoleptic properties of milk 
Color is determined on a white background, comparing color of the milk with the white paper.
Consistence is determined visually by the nail sample. It is necessary to put a drop of milk on finger-nail and observe whether a touch causes appearance of thread-like lines. Taste and aftertaste are determined only if you know that the cow (was) is healthy.

Determination of milk physical properties 
Milk temperature is determined with a thermometer during 10-15 min.

“Record”
Device for determination of milk degree of cleanliness 	

The degree of cleanliness of milk is determined with “Record device”. It is a bottle without a bottom, its neck is covered with a metallic net and a ring of wadded filter is put inside.
Two hundred ml of well mixed milk are poured into the bottle for filtration and analyzed the sediment on the filter.  	

There are 4 degrees of milk cleanliness:
•	Irreproachable milk. This milk is without any visible sedimentation on the filter.
•	Satisfactory is milk with microparticles on the filter after its filtrarion. 
•	Dirty milk is called if visible sedimentation on the filter consisting of small or big particles of mechanical admixtures (hair, particles of hay, sand) are present,
•	Very dirty milk. It contains highly marked stains of dirt, blood or pus.
The bluish color of milk is an evidence of the lowering of the fat percentage, its denaturation by the way of cream removal or dilution with water. With these types of denaturation the specific gravity of milk changes. With the removal of cream (the lightest fraction of milk), the specific gravity increases, when dilution milk with water it reduces. In case of double denaturation, the specific gravity does not change and it is determined by milk fatness. Specific gravity (density)of milk is determined by a lactodensimeter. This is device that has scale with a narrow upper part and gradation from 20 to 40 showing the last 2 figures of specific gravity. Thoroughly mixed milk is poured into a 250 ml cylinder up to 2/3 of it.  Specific gravity is determined at the temperature of milk 20oC. If the milk temperature is above 20oC ˝0.2˝ is added to the index of the lactodensimeter, if it is below 20oC it is necessary to subtract ˝0.2˝ from the two last figures of lactodensimeter. Specific gravity of milk may be determined by the table.
In some lactodencimeters there are two colored scales by one on each side of main scale. By the yellow scale you can determine the amount of added water to whole milk.
Determination of milk chemical indices 
Milk acidity depends on milk-sour fermentation. It is determined in Terner’s degrees. One degree corresponds to the amount of milliliters of the normal solution of alkali that was used for titration of 100 ml of milk. For determination of acidity, we add 20 ml of distilled water to 10 ml of milk, plus 3-4 drops of phenolphthalein and titrate with 0.1 N alkali solution till the appearance of pink coloration. Calculation is done for 100 ml of milk.
The amount of fat contained in the milk depends on the strains of cattle, their breed and the season of the year. Gerber’s volumetric method is used for determination of fat in milk.
The essence of this method consists of the fact that sulphuric acid dissolving milk proteins contributes to isolation and sticking of fat particles together.
Isoamyl alcohol lowers the surface stretch, facilitating connection of fat particles in the form of a mixed layer. This layer is measured by volume and expressed in percentage. 
Butirometer and a centrifuge are used for fat determination.  Butirometer is a glass device with a narrow part and a soldered top (it is also called fatmeter). Along the neck there are points with which exact measures can be made up to 0.1%. Into a dry butirometer, trying not to wet the neck, pour 10 ml of sulfuric acid. Then carefully along wall side of the butirometer add 11 ml of milk and 1 ml of isoamyl alcohol. The butirometer is closed with a dry cork, shaken holding its ends until the protein substances are totally dissolved, then the butirometer is put upside down for 5 min in a water bath and heated till 65-750C. Then all butirometers are put into a centrifuge with their narrow part directed to the center and centrifuged for 5 min. After that the butirometers are placed again for 5 min in a water bath after which a fat content is quickly measured. The butirometer is held in the left hand vertically against the light while the right hand regulates the border of the fluid column by screwing and unscrewing the cork. 

                             Butirometer
        Device for fat determination in milk

The dry residue of milk is determined by weighing a specific amount of milk (before and after drying) and also the amount of dry residue is calculated with a modificated Farrington’s formula:
, where
      X is dry residue of milk (%),               
      F is amount of fat in the milk (%), 
      A is specific gravity of the milk (only two last figures),
      4.8, 4 and 0.5 are coefficients for calculation.  

Revealing of milk falsification
The bluish color of milk is an evidence of the lowering of the fat percentage, its denaturation by the way of cream removal or dilution with water. With these types of denaturation the specific gravity of milk changes. With the removal of cream (the lightest fraction of milk), the specific gravity increases, when dilution of milk with water it reduces. In case of double denaturation, the specific gravity does not change and it is determined by milk fatness.
Falsification of milk quality is done more frequently by adding soda or starch. Soda is added for the preservation of milk quality and prevention of its souring; while starch is added to white the milk after denaturation. We add some drops of 0.2% rosolic acid solution in 96% alcohol and shake then discover the presence of soda in milk. If soda is present, the fluid will turn orange color. To determine the presence of starch in the test tube we pour 3-5ml of milk and 2-3 drops of Lugol’s solution, shake; if the solution turns blue color it means that there starch is in the milk.

Hygienic standard for milk quality

	Kind of milk	Acidity in %	Dry residue	Fatness	
1	Whole	21	8.1	3.2	
2	High fatness	20	7.8	6.0	
3	Proteinized	25	10.5	2.5	
4	Skim milk	21	8.1	-	
5	Vitaminized, whole	21	8.1	3.2	
6	Vitaminized, skim	21	8.1	-	

Hygienic estimation of bread quality

Nutritious value of bread
Bread takes main place in nutrition of population in whole world. Bread has excellent organoleptic properties, good absorption in alimentary tract and causes  sense of satiation;  bread has not sense of pall. Nutritious value of bread depends on grade and kind of flour used for its cooking. One hundred grams of bread contain proteins 6-8 g, fats 1 g, carbohydrates 40-50 g; caloric value of bread is 200-250 kcal with 100g bread. Bread quality is determined by its main organoleptic and physico-chemical properties. 

Sampling of bread
Beforehand, 2-3 trays of each buggy or 10 % of products on each shelf of bread are to be selectively examined. For an average sampling it is necessary to take 0.2 %, but not less than 5 pieces of bread, rolls and buns, if each piece weighs over 1 kg, and 0.3 % of the whole lot, but not less than 10 pieces, if the weight of each piece is below 1 kg. The number of products selected as laboratory samples from the average sample depends upon the mass of these products and is not less than 1 piece if the product weighs over 400 g, not less than 2 pieces weighing 200 g and not less than 6 pieces weighing over 100 g. Prior to their sending to the laboratory, bread, rolls are to be packed in paper and sealed.
A covering document should contain data of the product name, its baking date and time, the name of the manufacturing establishment, the person who performed sampling, and the purpose of the examination. Physico-chemical indices should be determined 1 hour after small-piece products weighing 200 g leave the oven and after 3 hours for the rest of products.

Organoleptic properties of bread
The surface of bread should be smooth, without any large cracks and peelings, from light yellow to brown in color, without burns and paleness of color. By its shape, the bread should not be crumpled or have side overlaps. The crumb of bread should be well baked elastic not sticky or damp by touch, without any traces of a bad kneading. The porosity of bread should be homogenous, without cavities and porousless areas. The taste and smell should be typical for this grade of bread. It is not admissible for bread to have any signs of a disease and mould, as well as foreign inclusions.

Physical properties of bread
Main physical properties of bread are humidity and porosity.  For determination of humidity it is necessary to take from the middle part of the analyzed sample a slice about 3 cm cut it with a knife and then put in 2 metal boxes by 5 g in each; after that the boxes with the bread are weighed with an error up to 0.01 g and put in an open form into a drying oven, preheated up to 130°C for 45 minutes, the covers of the boxes being laid under them. Then the boxes are taken out, immediately closed with their covers and put into desiccators for cooling, after that they are weighed again.
Humidity in the examined bread sample is determined by the formula:
	                  % ,  where      
H   is humidity of bread,
M1 is the total mass of the box with the bread sample before drying (g),
M2 is the total mass of the box with the bread sample after drying (g);
  a is the mass of the bread sample before drying (g). 
Humidity of the examined sample is an average value of the humidity of two parallel tests. The norms of humidity for some grades of bread, rolls and buns are listed in the table.
Zhuravlyov’s device (Zhuravlyov’s knife) is used for determination of bread porosity. It consists of a metal cylinder with a sharpened edge from one side and a ring from the other one and wooden tray. A slices of bread should be cut from the middle part of it at a distance not less than 1 cm from the crust. Three or four bread cylinders are made one by one with help Zhuravlyov’s device. 
The obtained bread cylinders are weighed simultaneously and their total mass is determined.
Bread porosity is determined by the Zavialov’s  formula: 
P=100-3.086x d, where
 P        is required porosity,
 d        is weight 27 cm3 cylinder of bread,
 3.086 is the constant coefficient.
For determination of bread porosity with the Zavialov’s table it is necessary 3 bread cylinders for wheaten one and 4 bread cylinders for rye one to weigh on the scales and find tested index on the Zavialov’s table.
Besides, the porosity of bread can be determine by other formula.
 %, where
A is bread porosity,
V is the total volume of the bread cylinders (cm3),
m is the mass of one cylinder (g),
d is density of the porousless mass of the crumb, which is 1.21 for rye bread, rye
   wheaten bread and wheaten bread with bran, 1.31 for wheaten bread of the 1st     grade, 1.26 for wheaten bread of the 2nd grade. 
The norms of porosity for some grades of bread are listed in the table.

The quality of some grades of bread

Name of bread	Porosity (%),
not less	Humidity (%) of crumb, not more	Acidity (0), 
not more	
Wheaten bread (higher grade)	72-74	43-44	3	
Wheaten bread 
(first grade)	67-70	44-45	3	
Rye bread	48	51	12	
                 
Chemical properties of bread
Acidity of bread is caused by the acids present in its crumb and is measured in degrees. Degrees of acidity designate the amount of 1 N solution of alkali (ml) required for complete neutralization of the acids presented in 100 g of bread crumb.
In order to determine acidity 250 ml of distilled water are warmed in a conical flask up to 60°C. In another flask with a ground stopper it is necessary to put 25 g of the finely divided crumb, pour some warmed water (approximately 50 ml) and rub with a wooden pallet up to formation of a homogenous mass, where the rest of the water is added. The flask is covered with a stopper and vigorously shaken during 3 minutes. Then the mixture is allowed to settle for 1 minute, after that the supernatant layer of the fluid is drained through gauze into the conical flask. From the glass 50 ml of the filtrate are poured into the conical flask, 2-3 drops of 1 % alcohol solution of phenolphthalein are added and the fluid is titrated with 0.1 N solution of alkali until appearance of a pale-orange color which does not disappear during 1 minute.
Acidity in degrees is determined by the formula:
                                           , where
A    is acidity of tested bread,
a     is the amount of the alkaline solution, spending for titration (ml),
25   is the mass of the bread sample (g),
C    is correction factor for the titer of 0.1 N alkaline solution,
250 is the total volume of the water taken for dissolution of the examined bread  sample (ml),
50   is the volume of the filtrate taken for the titration (ml),
100 is scaling to 100 g of bread,
10  is scaling factor for 1 N alkaline solution.

Hygiene estimation of meat and meat products quality

Nutritious value of meat
Meat and meat products are the main elements of nutrition. They are sources of biological complete proteins, which are used for plastic and regenerative purposes. 
Besides,  meat and meat products are sources of fats, phosphatides, vitamins A, D, B – group, mineral and extractive substances. Meat has nice taste, influence  the secretory function of elementary system. Coefficient of section of meat is about 83-85%, meat protein is sectioned till 98%. Quantity of proteins in different kinds of meat is from 8 to 16%, fats from 2 till 6%. 
There is some classification of meat, namely classification by the origin, classification by the freshness degree, by possibility for use and by the thermal condition.
Hygienic estimation of meat carries out by the organoleptic, physical and chemical, bacteriological and helminthological indices.
Firstly it is necessary to take the sample of meat for analysis.
Samples of meat for research take at a tuck on a neck, in district of 4-5 cervical spondyle, about a scapula and also at a femur. Mass of each sample should be not less than 200 g. Wrapped up in a parchment paper or alimentary polyethylene film, samples seat in occluded metal box.
The accompanying document should keep information about date and place of sampling, species of animals, number of carcass, cause and purpose of research, and also data about a person which has carried out selection of probe. 

Organoleptic researches of meat
At organoleptic research of meat outward, color and smell of meat, its consistence, state of fats and tendons, transparence and fragrance of a broth. Outward, color and smell analyze both during outer inspection of carcass and on a  fresh section of meat. Simultaneously determine outward, color and smell of meat, its consistence, state of fats, of tendons, transparence and smell of a broth. Simultaneously determine stickiness by a palpation of a surface of meat and on a section. Thus determine its elasticity, for what by mild pressing of a dactyl do a fossa, and then observe of its smoothing. For moisture determination of meat will utilize a filter paper, affixing it in a surface of carcass or to a section.
State of fats and tendons is determined while the samples are taken. It is necessary to describe the color, smell and consistence of fats, elasticity and density of tendons, the state of joint surface.
Smell of broth is estimated at the moment of steam appearance at temperature 80-85 o C during heating 20 g of meat in conical flask with water. 
For definition of a transparence 20 ml of a beef-infusion broth pour in a measuring graduated bottle by a diameter of 20 mm of capacity 25 ml. A transparence is estimated visually.  Conclusion about freshness of an examined product can be done on the basis of outcomes of organoleptic research of meat and broth. The data on organoleptic properties of meat and by-products are submitted in table.

Bacteriological investigation of meat
To samples of meat (weight 60 g) it is necessary to take from diaphragm or intercostal muscles for definition of animal trichinellosis. Make up 12 sections from these probes and investigation them with help of compressorium. Number of trichinella must be not more than one per 24 sections. In this case meat can be use.

 The chemical probes for freshness of meat
1. Probe for determination of ammonia.
Not fresh meat contains ammonia. Chemical sense of reaction: when meat rots, ammonia appears. Ammonia with Eber's reagent get white cloud of ammonia chloride. Eber’s reagent consists of 1 part of ether, 3 parts of spirit (96%) and 1 part of hydrochloric acid.
For determination of ammonia in meat it is necessary to drop piece of meat on the hook into glass test-tube with Eber's reagent. Meat should not touch the solution (Fig. l). When meat is not fresh white cloud appears. This meat is not suitable.    
                                                       Estimation of reaction: 
-	reaction is negative (ammonia absent), 
                  white cloud does not appear,
                                              +  reaction is feebly positive, cloud quickly
                                                  disappears after its appearance, 
 Meat                                     ++ reaction is positive (white cloud appears 
                                                    quickly and does not disappear),
                                              +++  reaction is sharply positive ( white cloud  
                                                 of ammonia chloride appears before dropping 
                                                 meat into test-tube).

                              Eber's reagent
Probe for determination of hydrogen sulphide. When meat rots hydrogen sulphide appears. For the determination of hydrogen sulphide in meat it is necessary to cut very small piece 15 - 25 g of meat and put it into the weighing bottle (volume 40-50 ml) with lid. Filter paper moistened by lead acetate is placed between brim of the weighing bottle and lid on the distance 1 cm from probe of meat. Duration of the experiment is 15 min.
If hydrogen sulphide presents in the meat filter paper has brown or black color. 
Intensity of reaction is estimated by degree of paper coloration.

Intensity of reaction is estimated by the following way:
- reaction is negative,
+ present only traces of hydrogen sulphide,
+  feebly positive reaction,
++ positive reaction,
+++ sharply positive reaction.

Meat                                                                    Filter paper

Organoleptic performance of meat and subproducts

Organoleptic parameters	Degrees of  freshness	
	Fresh	Doubtful freshness	Stale	
Outward and color of a surface of carcass	Crust without withers, of acyanotic-red color or light pink, refrozen carcass - red color, fat of a pulp particularly painted in bright red color.
	Placely humidified, slightly sticky, darkened
	Strongly dried up, coated by gray-brown slime or mould	
State of muscles on a section
	Slightly wet, do not abandon a wet stain on a filter paper; color: a beef -from light-red up to dark red, pork - from light pink up to red, mutton - from red up to red - cherry, young mutton – pink
	Wet, abandon a wet stain on a filter paper, slightly sticky, darkly-red color. For the refrozen meat from a cut surface the slightly cloudy meat juice runs down	Wet, abandon a wet stain on a filter paper, sticky, red -brown color. For the refrozen meat - from a cut surface the cloudy meat juice runs down	
Consistence
	On a section meat is hard and resilient, formed by pressing of a dactyl the fossa fast is aligned
	On a section meat is less hard and less resilient, formed by pressing of a dactyl the fossa is aligned slowly (during 1 minute), fat is mild, of refrozen meat – chipping
	On a section meat is flabby, formed by pressing of a dactyl fossa is not aligned, fat is mild, refrozen meat –chipping, with scarf of lard	
Smell
	Specific, inherent to each aspect of fresh meat

	A little bit acescent or a little bit rotten	Acidic, rotten or a little bit decayed	
Organoleptic parameters	Degrees of  freshness	
	Fresh	Doubtful freshness	Stale	
State of tendons
	Tendons are resilient, dense; the surface of joints is sleek. Tendons of the refrozen meat are mild, chipping, of bright red color
	Tendons have less dense, of mat-white color. Joints surfaces are slightly coated with slime	Tendons are softened, grayish color. Joints surfaces are coated with slime	
Transparence and smell of a broth
	Transparent, fragrant
	Transparent or cloudy, with a smell, that is not correspond to fresh broth
	Cloudy, with a great amount of floccules, with sharp unpleasant flavor	

Contents of essential amino acids in the meat of different animals

Amino acids	Contents of amino acids (% to proteins)	
	Beef	Pork	Mutton	
Leucine	7.6	7.2	8.1	
Isoleucine	5.7	5.7	5.4	
Valine	5.3	5.5	5.4	
Lysine	8.9	8.7	8.8	
Methionine	2.5	2.4	2.4	
Tryptophan	1.4	1.4	1.4	
Phenylalanine	4.2	4.2	4.3	
Threonine	4.5	4.5	4.8	
Arginine	6.4	6.4	6.2	
Histidine	3.9	3.8	3.2	

Сhapter 5.

Food poisonings

Nozological form	Etiological factor	
	Microbial origin	
1.Toxicoinfections

2.Toxicoses
- Bacterial toxicoses         

- Mycotoxicosis

3. Mixed etiology
	Potentially pathegenic microorganisms: Proteus mirabils and vulgaris, E. coli (enteropathogenic serotypes), Bac. cereus, Cl. perffingen type A, Str. faecalis var. Liquefaciens and Zymogenes, Vibro parahaemoliticus, others less studied microbes (Citrobacter, Hafnia, Klebsiella, Eduradsiella, Jersinia, Pseudomonas, Aeromonas, etc.)
Bacterial toxins produced by
Staphylococcus aureus and Cl. botulinum 

Mycotoxins that are produced by  microscopic fungi of genus Aspergillus, Fusarium and also Claviceps purpurea, etc

Bac.Cereus and enterotoxic staphylococcus, Bac.proteus and enterotoxic staphylococcu) 	

Non-microbial  origin	
1. Poisonings of poisonous plants and animals tissues 
1.1 Plants that are poisoned by their nature.

1.2 Animal tissues that are poisoned by their nature. 

2. Poisonings from the products of the plant and animal origin which are poisoned in certain conditions
2.1 Products of plant origin

2.2 Products of animal origin

3. Poisonings with chemical substances.	

Poisoned fungi (pale toadstool, fly agaric, devil fungus and others.); conditionally edible fungi that under went incorrect culinary treatment (milk mushroom, volnushka, morel and others.); plants (fad, torn apple, hemlock, belladonna, water hemlock, aconite, elderberry and so on); seeds of culture cereal weeds (sofophora, trichodesma, heliotrope, and others.)

Organs of some fish (puffer fish (Fugu), madder, whisker, Schizothorax and others.)

Cores stones of pit fruits (peach, apricot, cherry, migdal), that have amigdalin; nuts (beech, tungtree, ricina), growning (green) potatoes, that contain own solanin; bobs of raw beans that have fasin.

Liver, roe and milt of some fish types in the period of spawning (min, pike, mackerel and so on); bee honey when bees collects nectar from the poisoned plants.

Pesticides, salts of heavy metals food additives entered in the amounts that exceed admissible values; substances that migrate in food products from equipment, stock, containers, packing material; other chemical impurity	

Non-identified origin	
 Alimentary paroxysmal-toxic myoglobinuria: (Gaffskaya disease)	Fish grains of some areas of the world, in some years.	

Microbial food poisonings

Microbial food poisonings include toxicoinfections, toxicosis and poisonings of the mixed etiology. 

Toxicoinfections are acute or sub-acute diseases, appearing on consumption of the food, containing a large quantity of life cells of a specific agent. Food toxicoinfections are caused by opportunistic pathogenic microorganisms, namely enteropathogenic serotypes of opportunistic E. coli, Proteus vulgaris, Proteus mirabilis and spore-producing microorganisms (Bac. cereus, Cl. perfringes). Main causes of food toxicoinfections are continuous inappropriate storage of dish ready to serve for consumption. Such food poisonings are 58%. The second reason of food toxicoinfections is consumption of inferior food products. These food poisonings are 14%. Food products insufficient thermal treatment are the next case of all poisonings of this pathology: they are 9% of food poisonings. At last 19% of all cases consist food poisoning of non-identified etiology.
Common rises of toxicoinfections:
a) short incubation period (average 6-24 h);
b) spesific dietary history for all sick persons;
c) outbreaks and epidemics if product was realized through centralized catering organisation or trade organisation;
d) local epidemiology;
e) fast outbreak cessation after removal of source (incrimed product);
f) gastroenteritis.
   Prophylaxis of toxicoinfections. For prophylaxis of toxicoinfections it is necessary to carry out medical examination of workers at food enterprises to detect carriers of the enteropathogenic intestinal bacilli and provide medical treatment of them. Besides, one’s should conduct veterinary control over the animals with gastrointestinal and purulent diseases, control over production, storage and transportation of the products, which are not undergoing thermal treatment.
  Food toxicoinfections cause by spore-producing microorganisms is the main important food poisonings. Spore-producing microorganisms are widely present in the environment, namely in the soil, air and food products. Meat and meat products are disseminated in 35.6% of all cases. Fish and fish products are contained by spore-producing microorganisms in 10% of cases, milk and diary products – in 19%. Prophylaxis of food poisonings caused by spore-producing microorganisms is conducted by prevention of products infection possibility, by proper veterinary-sanitary control over animals, revealing carriers of thermoresistant strains of microorganisms among the workers and their medical treatment. 
Toxicoses are acute and chronic (in case of mycotoxicosis) diseases, which appear after eating some products, which contain a toxin accumulated in it as a result of the specific agent action. Any live cells of the agent may be absent in the food under consideration. It is possible to distinguish (between) bacterial toxicoses and mycotoxicoses. Bacterial toxicoses, especially staphylococcal toxicosis and botulism, occur very often. Staphylococcal toxicosis can be caused by enterotoxic strains of pathogenic staphylococci. The enterotoxin is thermoresistant: 30 minutes exposure to temperature 100ºC does not inactivate it. Sources of staphylococcal toxicoses are people with pyodermia, acute disease in their mouth cavity, tonsillitis and so on; carriers of different infections are people and mastitis-infected animals. Prophylaxis of staphylococcal toxicoses: withdrawal of persons with different purulent skin diseases, abscesses, catarrh of respiratory tracts, tonsillitis from working places; revealing of infections carriers among the workers, who contact with food products; conduction of veterinary-sanitary examination of the cattle.
Botulism (a sausage poisoning) -  widely spread food poisoning. The word “botulism” comes from the Latin word “Botulus”(sausage). Bacillus botulinum produces a specific exotoxin. The lethal dose of the botulinum toxin for man is 0.035 mg. Botulism is a non-contagious disease. Its agents are widely spread in the nature. The sources of botulism are warm-blooded animals, in whose intestines the bacillus of botulism parasitizes and then excretes into the environment. Contamination of products with the soil is very important. Typically there is a nest-like contamination of food products (sausages, ham, and fish), 83% of the outbreaks result from home bottling and drying of such products. Bacillus botulinum is capable to reproduce and it forms the toxin not only in hermetically sealed bottles, but also is dried and smoked fish made of tainted raw products, which could provide favorable conditions for anaerobiosis. Affection of the organism is mainly caused by the toxin. The toxin affects on the autonomic nervous system and it also selectively affects locomotor nuclei of the brain trunks and the anterior horns of the spinal cord. 
Clinical picture of botulism. The incubation period lasts from several hours to 2-5 days. Shorter incubation is the graver the disease. The ophthalmoplegic syndrome  appears firstly. It manifests itself in the form of “mist” and “net” in front of the eyes. Phagonasoglossoneurological    syndrome shows in species of paresis of the soft palate, difficult swallowing, under the condition of total paralysis of the pharyngeal muscles, dysphagia turns into aphagia. Phonolaryngoneurological syndrome manifests itself in huskiness of the voice, hypernasal voice, and incomprehensible speech. Respiratory disorders and haemodynamic disorders (toxic myocardial dystrophy) are typical for this pathology. General myoneuroplegia syndrome: generalized affection of muscles, including the ones of the neck, limbs, total adynamia are characterized of the last period of disease.
Prophylaxis of botulism includes the following measures: examination of rules of treatment, storing and selling of food products, to eliminate a possibility of contamination and multiplication of microbes in these products; use of a long-thermal treatment to make the microflora in products harmless; strength control over the quality of products undergoing home bottling and drying (primary cooking of the products, thermal processing without hermetic sealing).

Staphylococcal food poisoning (staphyloenterotoxicosis) is the name of the condition caused by the enterotoxins which some strains of S. aureus produce. S. aureus is a spherical bacterium (coccus) which in microscopic examination appears in pairs, short chains, or bunched, grape-like clusters. These organisms are Gram-positive. Some strains are capable of producing a highly heat-stable protein toxin that causes illness in humans.
All people are believed to be susceptible to this type of bacterial intoxication; however, intensity of symptoms may vary. The onset of symptoms in staphylococcal food poisoning is usually rapid and in many cases acute, depending on individual susceptibility to the toxin, the amount of contaminated food eaten, the amount of toxin in the food ingested, and the general health of the victim. The most common symptoms are nausea, vomiting, retching, abdominal cramping, and prostration. Some individuals may not always demonstrate all the symptoms associated with the illness. In more severe cases, headache, muscle cramping, and transient changes in blood pressure and pulse rate may occur. Recovery generally takes two days, However, it us not unusual for complete recovery to take three days and sometimes longer in severe cases.
A-toxin dose of less than 1.0 mg in contaminated food will produce symptoms of staphylococcal intoxication. This toxin level is reached when S. aureus population exceeds 100,000 per gram.
In the diagnosis of staphylococcal foodborne illness, proper interviews with the victims and gathering and analyzing epidemiologic data are essential. Incriminated food-stuffs should be collected and examined for staphylococci. The presence of relatively large numbers of enterotoxigenic staphylococci is good circumstantial evidence that the food contains toxin. The most conclusive test is the linking of an illness with a specific food or in cases where multiple vehicles exist, the detection of the toxin in the food sample(s). In cases where the food may have been treated to kill the staphylococci, as in pasteurization or heating, direct microscopic observation of the food may be an aid in the diagnosis. A number of serological methods for determining the enterotoxigenicity of S. aureus isolated from food-stuffs as well as methods for the separation and detection of toxins in food-stuffs have been developed and used successfully to aid in the diagnosis of the illness. Phage typing may also be useful when viable staphylococci can be isolated from the incriminated food, from victims, and from suspected carrier such as food handlers.
Food-stuffs that are frequently incriminated in staphylococcal food poisoning include meat and meat products; poultry and egg products; salads such as eggs, tuna, chicken, potatoes, and pasta; bakery products such as cream-filled pastries, cream pies, and chocolate eclairs; sandwich fillings; and milk and dairy products. Food-stuffs that require considerable handling during preparation and that are kept at slightly elevated temperatures after preparation are frequently involved in staphylococcal food poisoning.
Staphylococci exist in air, dust, sewage, water, milk, and food or on food equipment, environmental surfaces, humans, and animals. Humans and animals are the primary reservoirs. Staphylococci are present in the nasal passages and throat and on the hair and skin of 50% or more of healthy individuals. This incidence is even higher for those who associate or come in contact with sick individuals and hospital environments. Although food handlers are usually the main source of food contamination in food poisoning outbreaks, equipment and environmental surfaces can also be sources of contamination with S. aureus. Human intoxication is caused by ingesting enterotoxins produced in food by some strains of S. aureus, usually because the food has not been kept hot enough (60°C or above) or cold enough (7.2°C or below).

Mycotoxicoses are poisonings with the products made from cereals affected by fungi, which produce toxins. The following mycotoxicoses are important for people: ergotism, fusariotoxicoses and aflatoxicoses.

Ergotism is caused by consumption of bread products made of grain and flour containing ergot (Claviceps Purpurea fungus). The pharmacological properties of ergot were recognized in the second half of the 16th century, and about 100 years later, cereal grains containing ergot were shown to be the cause of these epidemics in Europe. In 1951 there was an outbreak of "bread poisoning" in a small town in France. Apparently moldy rye was sold illegally (to avoid a grain tax) in central France to a miller, who ground the rye and mixed it with flour which he then sold to a baker.
On August 15, 1951, many people ate small amounts of bread which may have been made from this contaminated flour. About 200 people became ill, as did many domestic animals, dogs, cats, poultry, fish, fed the same bread. A total of 25 people suffered from severe delirium. A recent outbreak occurred in Ethiopia, 97 of 42,000 people developed gangrenous ergotism. Claviceps purpura is the common ergot on rye and wheat. The fungus lives over winter in the form of sclerotium, a dense mass of fungus cells. Usually the sclerotia are somewhat larger and also less dense than the seeds of the host plant on which they are borne.
The ergot alkaloids are derivatives of Lysergic acid (ergotamine), isolysergic acid (ergocristine) or dimethyl ergoline (agoclacine). Pharmacologically, these compounds are rapid acting, powerful oxytoxics, i.e. they stimulate the smooth muscle of the uterus. They are also weak vasoconstrictors.
Descriptions of ergot poisoning written in the Middle Ages were quite vivid. There were severe internal feeling of heat and intense thirst, multiple ulcerations of the skin, a burning sensation of the limbs, the feeling of ants and mice crawling underneath the skin, the drying and turning black of hands, arms, feet and legs, blindness, dementia and mental degeneration.
Acute ergot poisoning today is essentially a problem only in chemotherapy and rarely has it occurred recently as a result of eating. The symptoms include vomiting, diarrhea, intense thirst, a tingling, itchy and cold skin, a rapid, weak pulse, confusion, and unconciousness.
Chronic ergot poisoning today seems limited to accidents in treating patients for migraine headaches. The extremities, especially the feet and legs, become cold, pale, and numb because of the constriction of the local blood vessels resulting in diminished blood flow. Walking becomes painful and eventually gangrene develops.

Fusariotoxicoses are connected with consumption of grain affected by different kinds of fusarium fungi. Fusariotoxicoses include alimentary-toxic aleukia or septic tonsillitis and poisoning with “drunken” bread. Alimentary-toxic aleukia is a disease, which connected with consumption of the products (bread, macaroni and so on) made from winter standing crops (covered by snow). Fusariotoxicoses, known as a poisoning with “drunken” bread, are caused by consumption of bread made from the grain affected by fusarium fungus. On a single consumption of a small quantity of “drunken” bread, the picture of the disease is characterized by the symptoms of severe intoxication and acute excitement. 

Aflatoxicosis is poisoning that results from ingestion of aflatoxins in contaminated food or feed. The aflatoxins are a group of structurally related toxic compounds produced by certain strains of the fungi Aspergillus flavus and A. parasiticus. Under favorable conditions of temperature and humidity, these fungi grow on certain food-stuffs and feeds, resulting in the production of aflatoxins. The most pronounced contamination has been encountered in tree nuts, peanuts, and other oilseeds, including corn and cottonseed. The major aflatoxins of concern are designated Bl, B2, Gl, and G2. These toxins are usually found together in various food-stuffs and feeds in various proportions; however, aflatoxin B1 is usually predominant and is the most toxic.
Aflatoxins produce acute necrosis, cirrhosis, and carcinoma of the liver in a number of animal species; no animal species is resistant to the acute toxic effects of aflatoxins; hence it is logical to assume that humans may be similarly affected.
The adverse effects of aflatoxins in animals (and presumably in humans) have been categorized in two general forms.
Acute aflatoxicosis is produced when moderate to high levels of aflatoxins are consumed. Specific, acute episodes of disease may include hemorrhage, acute liver damage, edema, alteration in digestion, absorption and/or metabolism of nutrients, and possibly death.
Chronic aflatoxicosis results from ingestion of low to moderate levels of aflatoxins. The effects are usually subclinical and difficult to recognize. Some of the common symptoms are impaired food conversion and slower rates of growth with or without the production of an overt aflatoxin syndrome.
In the world aflatoxins have been identified in com and corn products, peanuts and peanut products, cottonseed, milk, and tree nuts such as Brazil nuts, pecans, pistachio nuts, and walnuts. Other grains and nuts are susceptible but less prone to contamination.

Penicillium Poisoning. Toxin producing fungi are Penicillium islandicum, P/ citreoviride, P.rugulosum, P.citrinum. The clinical manifestation begins with palpitation, precordial distress, tachypnea; followed by nausea and vomiting, and difficult breathing.
Within a few days, the patient suffers severe anguish, pain, severe restlessness, or sometimes violent mania. Heart sounds are abnormal, blood pressure is low, and pulse is rapid, sometimes exceeding 120 beats/min, and the patient faints.
The dyspnea increases, the skin of extremities becames cold, dry and cyanotic, and the voice becomes husky. Finally the pulse becomes feeble, the pupils dilated, consciousness is lost, and respiration fails.
The only prophylaxis of mycotoxicoses is laboratory examination of suspicious food products, which includes determination of the level of toxicity of food products by biological methods and mycological analyses. All suspicious food products must be withdrawn from nutrition. Creation of optimum conditions for grain storage is very important for prophylaxis of mycotoxicoses. 

Non-microbial food poisonings

There are unhomogeneus group of foodborne diseases. They are not spread so widely as microbial food poisonings but can have high incidence in the regions with poor sanitary control on food safety.
Poisoning with admixture of chemical substances: toxic effect of metals; toxic effect of other inorganic substances, including arsenic; toxic effect of pesticides; poisoning with fertilizers, animal growth-promoting factors, food adjuncts, applied in excessive quantity, toxic substances which migrate into foodstuffs from technological equipment, utensils, containers, package etc. 
Poisoning with poisonous substances of animal origin: Toxic effect of poisonous substances resulted from the sea food consumption: whitefish, mollusks, algae (saxtoxins, hallucinogens, ichthyotoxins, algotoxins etc.); poisoning with other poisonous substances which are present in consumed endocrine glands of animals, liver, fish milt and caviar during spawning, bee honey during the collection of the ling flower nectar etc. 

Ciguatera Fish Poisoning
Ciguatera is a form of human poisoning caused by the consumption of subtropical and tropical marine finfish which have accumulated naturally occurring toxins through their diet. The toxins are known to originate from several dinoflagellate (algae) species that are common to ciguatera endemic regions in the lower latitudes.
Manifestations of ciguatera in humans usually involves a combination of gastrointestinal, neurological, and cardiovascular disorders. Symptoms defined within these general categories vary with the geographic origin of toxic fish.
Marine finfish most commonly implicated in ciguatera fish poisoning include the groupers, barracudas, snappers, jacks, mackerel, and triggerfish. Many other species of warm-water fishes harbor ciguatera toxins. The occurrence of toxic fish is sporadic, and not all fish of a given species or from a given locality will be toxic.
Initial signs of poisoning occur within 6 h after consumption of toxic fish and include perioral numbness and tingling (paresthesia), which may spread to the extremities, nausea, vomiting, and diarrhea. Neurological signs include intensified paresthesia, arthralgia, myalgia, headache, temperature sensory reversal and acute sensitivity to temperature extremes, vertigo, and muscular weakness to the point of prostration. Cardiovascular signs include arrhythmia, bradycardia or tachycardia, and reduced blood pressure. Ciguatera poisoning is usually self-limiting, and signs of poisoning often subside within several days from the onset. However, in severe cases the neurological symptoms are known to persist from weeks to months. In a few isolated cases neurological symptoms have persisted for several years, and in other cases recovered patients have experienced recurrence of neurological symptoms months to years after recovery. Such relapses are most often associated with changes in dietary habits or with consumption of alcohol. There is a low incidence of death resulting from respiratory and cardiovascular failure.
All humans are believed to be susceptible to ciguatera toxins. Populations in tropical/subtropical regions are most likely to be affected because of the frequency of exposure to toxic fishes. However, the increasing per capita consumption of fishery products coupled with an increase in interregional transportation of seafood products has expanded the geographic range of human poisonings.

Shellfish Poisoning
Shellfish poisoning is caused by a group of toxins elaborated by planktonic algae (dinoflagellates in most cases) upon which the shellfish feed. The toxins are accumulated and sometimes metabolized by the shellfish. The 20 toxins responsible for paralytic shellfish poisonings (PSP), diarrheic shellfish poisoning (DSP), neurotoxic shellfish poisoning (NSP) and amnesic shellfish poisoning (ASP).
Ingestion of contaminated shellfish results in a wide variety of symptoms, depending upon the toxin(s) present, their concentrations in the shellfish and the amount of contaminated shellfish consumed. In the case of PSP, the effects are predominantly neurological and include tingling, burning, numbness, drowsiness, incoherent speech, and respiratory paralysis. Worse characterized symptoms are those associated with DSP, NSP, and ASP. DSP is primarily observed as a generally mild gastrointestinal disorder, i.e. nausea, vomiting, diarrhea, and abdominal pain accompanied by chills, headache, and fever. Both gastrointestinal and neurological symptoms characterize NSP, including tingling and numbness of lips, tongue, and throat, muscular aches, dizziness, reversal of the sensations of hot and cold, diarrhea, and vomiting. ASP is characterized by gastrointestinal disorders (vomiting, diarrhea, abdominal pain) and neurological problems (confusion, memory loss, disorientation, seizure, coma). Diagnosis of shellfish poisoning is based entirely on observed symptomatology and recent dietary history.

Scombroid Poisoning (Histamine Poisoning)
Scombroid poisoning is caused by the ingestion of food-stuffs that contain high levels of histamine and possibly other vasoactive amines and compounds. Histamine and other amines are formed by the growth of certain bacteria and the subsequent action of their decarboxylase enzymes on histidine and other amino acids in food, either during the production of a product such as Swiss cheese or by spoilage of food-stuffs such as fishery products, particularly tuna or mahi mahi. However, any food that contains the appropriate amino acids and is subjected to certain bacterial contamination and growth may lead to scombroid poisoning when ingested.
Initial symptoms may include a tingling or burning sensation in the mouth, a rash on the upper body and a drop in blood pressure. Frequently, headaches and itching of the skin are encountered. The symptoms may progress to nausea, vomiting, and diarrhea and may require hospitalization, particularly in the case of elderly or impaired patients.
The onset of intoxication symptoms is rapid, ranging from immediate to 30 min. The duration of the illness is usually 3 h, but may last for several days. All humans are susceptible to scombroid poisoning; however, the symptoms can be severe for the elderly and for those taking medications such as isoniazid. Because of the worldwide network for harvesting, processing, and distributing fishery products, the impact of the problem is not limited to specific geographical areas.

Pufferfish Poisoning (Tetradon Poisoning, Fugu Poisoning)
Fish poisoning by consumption of members of the order Tetraodontiformes is one of the most violent intoxications from marine species. The gonads, liver, intestines, and skin of pufferfish can contain levels of tetrodotoxin sufficient to produce rapid and violent death. The flesh of many pufferfish may not usually be dangerously toxic. Tetrodotoxin has also been isolated from widely differing animal species, including the California newt, parrotfish, frogs of the genus Atelopus, the blue-ringed octopus, starfish, angelfish, and xanthid crabs.
The first symptom of intoxication is a slight numbness of the lips and tongue, appearing between 20 min to 3 h after eating poisonous pufferfish. The next symptom is increasing paraesthesia in the face and extremities, which may be followed by sensations of lightness or floating. Headache, epigastric pain, nausea, diarrhea, and/or vomiting may occur. Occasionally, some reeling or difficulty in walking may occur. The second stage of the intoxication is increasing paralysis. Many victims are unable to move; even sitting may be difficult. There is increasing respiratory distress. Speech is affected, and the victim usually exhibits dyspnea, cyanosis, and hypotension. Paralysis increases and convulsions, mental impairment, and cardiac arrhythmia may occur. The victim, although completely paralyzed, may be conscious and in some cases completely lucid until shortly before death. Death usually occurs within 4 to 6 h, with a known range of about 20 min to 8 h.

Poisoning with poisonous substances of vegetable origin: Toxic effect of poisonous substances containing in consumed mushrooms; Toxic effect of poisonous substances containing on consumed berries; Toxic effect of poisonous substances containing in other poisonous plants: jimson weed, hemlock, elder, seeds of grain crop weeds etc.; Poisoning with other poisonous substances containing in consumed foodstuffs: cyanogenic glycosides of drupaceous fruit, phytotoxins of crude haricot, beech nuts, etc.

Mushroom Poisoning (Toadstool Poisoning)
Mushroom poisoning is caused by the consumption of raw or cooked fruiting bodies (mushrooms, toadstools) of a number of species of higher fungi. Mushroom poisonings are generally acute and are manifested by a variety of symptoms and prognoses, depending on the amount and species consumed. Because the chemistry of many of the mushroom toxins (especially the less deadly ones) is still unknown and positive identification of the mushrooms is often difficult or impossible, mushroom poisonings are generally categorized by their physiological effects. There are four categories of mushroom toxins: protoplasmic poisons (poisons that result in generalized destruction of cells, followed by organ failure); neurotoxins (compounds that cause neurological symptoms such as profuse sweating, coma, convulsions, hallucinations, excitement, depression, spastic colon); gastrointestinal irritants (compounds that produce rapid, transient nausea, vomiting, abdominal cramping, and diarrhea); and disulfiram-like toxins. Mushrooms in this last category are generally nontoxic and produce no symptoms unless alcohol is consumed within 72 h after eating them, in this case a short-lived acute toxic syndrome is produced.
Mushroom poisonings are almost always caused by ingestion of wild mushrooms that have been collected by nonspecialists (although specialists have also been poisoned).
Health promotion is very important in the prevention of mushroom poisonings. People should avoid to collect unknown mushrooms. It's prohibited to sell mixture of the mushrooms at the market.

Red Kidney Bean (Phaseolus vulgaris) Poisoning, Kinkoti Bean Poisoning, Fabism
The onset time from consumption of raw or undercooked kidney beans to symptoms varies from between 1 to 3 h. The onset is usually marked by extreme nausea, followed by vomiting, which may be very severe. Diarrhea develops somewhat later (from one to a few h), and some persons report abdominal pain. Some persons have been hospitalized, but recovery is usually rapid (3-4 h after the onset of symptoms) and spontaneous.
The syndrome is usually caused by the ingestion of raw, soaked kidney beans, either alone or in salads or casseroles. As few as four or five raw beans can trigger symptoms. Several outbreaks have been associated with "slow cookers" or crock pots, or in casseroles which had not reached a high enough internal temperature to destroy the glycoprotein lectin. It has been shown that heating to 80°C may potentiate the toxicity five-fold, so that these beans are more toxic than if eaten raw. In studies of casseroles cooked in slow cookers, internal temperatures often did not exceed 75°C.
The disease course is rapid. All symptoms usually resolve within several h from the onset. Vomiting is usually described as profuse, and the severity of symptoms is directly related to the dose of toxin (number of raw beans ingested). Hospitalization has occasionally resulted, and intravenous fluids may have to be administered. Although of short duration, the symptoms are extremely debilitating.
All persons, regardless of age or gender, appear to be equally susceptible; the severity is related only to the dose ingested. In the seven outbreaks mentioned above, the attack rate was 100%. Prevention: do not use raw beans and bean flour for baking.

Honey Intoxication
Honey intoxication is caused by the consumption of honey produced from the nectar of rhododendrons. The grayanotoxins cause the intoxication. The specific grayanotoxins vary with the plant species. These compounds are diterpenes, polyhydrox-ylated cyclic hydrocarbons that do not contain nitrogen. Other names associated with the disease is rhododendron poisoning, mad honey intoxication or grayanotoxin poisoning.
The intoxication is rarely fatal and generally lasts for no more than 24 h. Generally the disease induces dizziness, weakness, excessive perspiration, nausea, and vomiting shortly after the toxic honey is ingested. Other symptoms that can occur are low blood pressure or shock, bradyarrhythmia (slowness of the heart beat associated with an irregularity in the heart rhythm), sinus bradycardia (a slow sinus rhythm, with a heart rate less than 60), nodal rhythm (pertaining to a node, particularly the atrioventricular node), Wolff — Parkinson — White syndrome (anomalous atrioventricular excitation) and complete atrioventricular block.
In humans, symptoms of poisoning occur after a dose-dependent latent period of a few minutes to two or more h and include salivation, vomiting, and both circumoral (around or near the mouth) and extremity paresthesia (abnormal sensations). Pronounced low blood pressure and sinus bradycardia develop. In severe intoxication, loss of coordination and progressive muscular weakness result. Extrasystoles (a premature contraction of the heart that is independent of the normal rhythm and arises in response to an impulse in some part of the heart other than the sinoatrial node; called also premature beat) and ventricular tachycardia (an abnormally rapid ventricular rhythm with aberrant ventricular excitation, usually in excess of 150 per minute) with both atrioventricular and intraventricular conduction disturbances also may occur. Convulsions are reported occasionally.
Grayanotoxin poisoning most commonly results from the ingestion of grayanotoxin-contaminated honey, but although it may result from the ingestion of the leaves, flowers, and nectar of rhododendrons.-

Test questions

1. What dish is not recommended to be planned for breakfast?
A.	Cake			D.Frying fish
B.		Mushroom soup		E. Mashed potatoes 
C.	Fried eggs

2. What dish is not recommended to be planned for supper?
A.	Tinned fish		D. Roasted beef
B.	Baked pudding		E. Vinaigrette
C.	Boiled cauliflower

3. What drink is not recommended for supper?
A.	Milk			D. Apple juice
B.	Tomato juice		E. Chocolate cocktail 
C.	 Yoghurt

4. How many professional groups of workers are divided the population on?
A.	3			D. 5
B.	4			E. 6
C.	2

5. To which professional group of workers does surgeon belong?
A.	5			D. 3
B.	2			E. 1
C.	4

6. Name  the optimum share of proteins in the nutrition
A.	11-13% 			D. 5-10%
B.	20-25%			E. 30-40%
C.	14-18%
7. How many of proteins in the nutrition of adults must belong to proteins of animal origin?
A.	75%			D.30%
B.	55%			E. 20%
C.	80%

8. Nutrition of adult person consist of 12% proteins, 40% fats, 47% carbohydrates (by weight). Does such nutrition correspond with hygienic rules?
A.	Too many fats, not enough of carbohydrates 
B.	Too many fats, not enough of proteins
C.	Too many carbohydrates, not enough of proteins
D.	Too many proteins, not enough of fats
E.	Nutrition correspond with hygienic rules

9. Point rational percentage of carbohydrates in ration.
A.	33-45%			D. 15-20%
B.	25-30%			E. 65-70%
C.	54-56%

10. Power inputs of man should be compensated on 54-56% of carbohydrates. How much of carbohydrates must belong to sugar?
A.	50%			D. 90%
B.	   75%			E. 15%
C.	20%

11. What is the optimal ratio between nutrients in the senior man diet:
A.	1:1:2			D. 1:1:6
B.	1:0,5:3			E. 1:2:3
C.	1:1:4
D.	
12. What product could you recommend for correction of calcium deficit in the diet?
A. Wheaten bread		D. Fish
B. Soybean products		E. Cottage curd 
C. Eggs

13. What ratio between Ca and P in a daily diet is recommended?
A.	1:1.5 			D. 2:3
B.	1.5:2			E. 1.5:1
C.	1:1

14. What food consist a lot of vitamin B1
A.	Eggs			D. Cereals and beans 
B.	Potato, beet		E. Cabbage, onion 
C.	Dairy product

15. What food consist a lot of vitamin PP?
A.	Bread, corn 		D. Cabbage, onion
B.	   Potato, beet		E. Carrot, cucumbers
C.	Cherry, plum

16. What food consist a lot of vitamin E?
A.	Grapes, plum		D. Onion, garlic
B.	Potato, cabbage		E. Tomato, red pepper
C.	Seed-oil 

17. For estimation of vitamin C sufficiency any food products and materials from human organism are researched. What method is not used for estimation of vitamin C sufficiency?
A. Determination of vitamin C in digestive juice
B. Determination of vitamin C in fruit juice
C. Determination of vitamin C in dishes ready to serve 
D. Determination of vitamin C in urine
E. Determination of vitamin C in blood plasma

18. What disease can course in the case of vitamin C insufficiency?
A.	Angular stomatitis	D. Pellagra
B.  	Obesity			E. Scurvy 
C.	Rachitis

19. What vitamin is not collected in organism?
A.   C 			D. A
B.	D			E. E
C.	K

20. A vegetable diet is indicated to a patient with urine acid diathesis and signs of A-hypovitaminosis. Which of the listed foodstuffs what this diet includes is the main source of carotene?
A.	Green peas			D. Spring onions
B.    Carrot 			E. Potato
C.	 Lettuce

21. What vitamin is formed in the human organism under influence of solar radiation?
A.	Vitamin A		D. Vitamin D
B.	 Vitamin B1		E. Vitamin B12
C.	Vitamin C

22. What disease can cause in the case of vitamin D insufficiency?
A.	Rachitis 			D. Scurvy 
B.	Angular stomatitis	E. Pellagra
C.	Obesity 

23. What population group is not group of risk in accordance of UV deficiency?
A.	Children			D. Miners
B.	Workers of metro		E. Teachers 
C.	People in North region

24. What food could you advise for diet correction by iron?
A.	Liver			D. Rice
B. Carrot			E. Grapes
C. Butter

25. Nutrition of girl 17 years old consist of: vitamin A – 1.5 mg, D – 3 mcg, B2 – 0.6 mg, PP – 16 mg, C – 85 mg. Girl complaints of helyosis, glossitis, angular stomatitis, conjunctivitis. What is your diagnosis?

A. Hypovitaminosis PP		D. Hypovitaminosis C
B.	Hypovitaminosis D		E. Hypovitaminosis B2
C.	Hypovitaminosis A

26. What device is used for definition of fatness of milk?
A.	 Stroboscope			D. Spectrometer
B.	Butirometer 			E. Anemometer
C.	Hygrometer 

27. What device is used for definition of density of milk?
A.	 Butirometer 			D. Batometer
B.	Spirometer			E. Lactodensimeter 
C.	Hygrometer 

28. What mean of acidity from the lower listed is characterized for fresh milk?
A.	 23-25 °C			D. 13-15 °
B.	18-22 °C			E. 10-12 °
C.	16-18 ° 

29. What mean of acidity from the lower listed is characterized for fresh enough milk?
A.	16-18 °				D. 23-25 °
B.	20-22 °				E. 26-30 °
C.	13-15 °

30. It is necessary to estimate the quality of milk at results of analysis: color – whitish, smell and taste – without peculiarities, density – 1.028, acidity - 18T, fat – 3.2 %.
A.	 Milk is of poor quality		D. Milk is of good quality 
B.	Milk is of decreased quality		E. Milk is adulterated
C.	Milk is conditionally suitable 

31. What mean of acidity from the lower listed is characterized for wheaten bread?
A.	3-4 °				D. 5-6 °
B.	12-14 °				E. 7-8 °
C.	18-20 °

32. What mean of acidity from the lower listed is characterized for rye-bread?
A.	18-20 °				D. 11-12 °
B.	3-4 °				E. 7-8 °
C.	5-7°

33. What mean of porosity is premised for wheaten bread?
A.	Not less 20 % °			D. Not less 60 °
B.	Not more 50 %			E. Not more 72 % 
C.	Not more 40 %

34. What mean of porosity from the lower listed is premised for rye-bread?
A.	Not less 85 % °			D. Not less 20 °
B.	Not less 60 %			E. Not more 35 % 
C.	Not more 48 %

35. Which reagents are used for chemical probes for freshness of meat?
A.	Lead acetate and Eber’s reagent 
B.	 Phenolphthalein and sodium carbonate
C.	Potassium chloride and methyl orange
D.	Tilman’s reagent and sulphuric acid 
E.	Nessler’s reagent and segnetic salt

36. What kind of food poisoning mostly is connected with consumption of confectionery with cream?
A. Botulism				D. Staphylococcal toxicosis 
B. Fusariotoxicosis			E. Ergotism
C. Aflatoxicosis

37. What kind of food poisoning may be connected with consumption of grain products?
A. Fusariotoxicosis 			D. Botulism
B. Staphylococcal intoxication		E. Food toxicoinfection 
C. Alimentary paroxysmal-toxic myoglobinuria

38. What kind of food poisoning may be connected with consumption of products made from winter standing crops?
A. Ergotism				D. Alimentary-toxic aleukia 
B. Food toxicoinfection			E. Botulism
C. Staphylococcal intoxication 

39. After eating of raw hen's eggs the family with signs of gastroenterocolitis was delivered to hospital. What disease can be the most probable?
A. Aflatoxicosis			D: Botulism
В: Salmonellosis 			Е: Ergotism
С: Leptospirosis

40. The man in unconscious state delivered to hospital by the ambulance after a dinner in Japan restaurant. The dinner included a dish cooked from Fugu fish. What toxin was found in this dish?
А: Aflatoxin				D: Phasin
В: Ergotoxin				Е: Grayanotoxin
С: Tetrodotoxin