ГИПЕРТОНИЯ ТАШХИСЛАНГАН ҲАРБИЙ ХИЗМАТЧИЛАРНИНГ СОҒЛОМ ОВҚАТЛАНИШИГА ҚЎЙИЛАДИГАН ГИГИЕНИК ТАВСИЯЛАР

217 ActaCAMU № 4 (12) 2025 ISSN: 2181-4155 ГИПЕРТОНИЯ ТАШХИСЛАНГАН ҲАРБИЙ ХИЗМАТЧИЛАРНИНГ СОҒЛОМ ОВҚАТЛАНИШИГА ҚЎЙИЛАДИГАН ГИГИЕНИК ТАВСИЯЛАР ГИГИЕНИЧЕСКИЕ РЕКОМЕНДАЦИИ К ОРГАНИЗАЦИИ ЗДОРОВОГО ПИТАНИЯ ВОЕННОСЛУЖАЩИХ, СТРАДАЮЩИХ ГИПЕРТОНИЕЙ HYGIENIC RECOMMENDATIONS FOR ORGANIZING HEALTHY NUTRITION FOR MILITARY PERSONNEL WITH HYPERTENSION Эрматов Низом Жумакулович - т.ф.д., профессор https://orcid.org/0000-0002-9964-5962 Туракулов Эркин Хасанович https://orcid.org/0009-0007-8187-6491 Бердиев Олим Довронович https://orcid.org/0009-0009-3949-0688 Тошкент давлат тиббиёт университети Аннотация. Ушбу мақолада гипертония хасталиги ташихисланган ҳарбийларнинг фаол кун тартиби, саломатлик ҳолатини даврийлилигини таъминлаш, ҳарбий лаёқатсизлигини олдини олиш, юрак қон томир тизими касалликлари тарқалиши ва унга олиб келадиган хавф омиллари ва асоратларини олдини олишга қаратилган соғлом овқатланишни ташкиллаштириш тамойилларнинг ўрни ва унинг таркибий қисмлари гигиеник таҳлил қилинган. Назорат остига олинган ҳарбийларнинг кун давомида уй шароитида овқатланишида эътибор қартиши зарур гигиеник талаблар ва уларнинг тамоийиллари гипертония хастлигини олдини олиш ва хавф омилларини камайтириш, харох касалликлар ва асоратларни юзага келишини бартараф қилишга қартилган. Ҳарбийлар учун белгиланган овқатланиш тартибига ажратилган вақт, таркиби ва унинг сон ва сифат кўрсаткичларининг ўрни ёритилган. Нонуштанинг таркибида аҳамиятли ва зурур бўлган ёрмаларнинг турлари, ёғсиз ва сифатли сут маҳсулотлари, қуён гўштининг аҳамияти, гликемик индекси паст мева ва сабзовотларнинг ўрни асосланган. Йил фасллари давомида истеъмол қиландиган сувининг миқдори ва сифати, қуритилган мева ва от гўштидан тайёрланган тузсиз қазининг ўрни ёритилган. Кетирилган манбалар илмий мушохада қилинган ва зарарли спиртли ичимликлар, энергетиклар ва рангли ичимликлар, аччиқ маҳсулотлар, дудуланган ва иккиламчи илов берилган маҳсулотларнинг ўрни, ортиқча туз ва тузламаларнинг ман қилиниши тавсия қилинган. Кун давоимида уй ва хизмат давомида ортиқча ёки энергия етишмаслиги натижасидаги толиқиш, хасталикларнинг асоратларини ривожланиши ва ҳарбий лаёқатсизлик ва ногиронликка олиб келиши ва уларни олдини олишга қаратилган илмий асосланган тавсиялар келтирилган. Калит сўзлар: ҳарбийлар, кун тартиби, гипертония касаллиги, соғлом овқатланиш мезонлари, ман қилинадиган маҳсулотлар, гигиеник тавсиялар Аннотация: В данной статье приведен гигиенический анализ места принципов организации здорового питания и его состава, направленный на обеспечение активного режима дня, периодичности состояния здоровья, предотвращения военной непригодности, распространения системы сердечно-сосудистых заболеваний и профилактики факторов риска и осложнений у военнослужащих, диагностированных гипертонической болезни. Гигиенические требования и принципы, на которые необходимо обратить внимание при питании в домашних условиях в течение дня контролируемых военнослужащих, направлены 218 ActaCAMU № 4 (12) 2025 ISSN: 2181-4155 на профилактику гипертонической болезни и уменьшение факторов риска, предотвращение возникновения сопутствующих болезней и их осложнений. Обоснованы роль времени, состава и показателей количества и качества выделенного режима питания, определенного для военнослужащих. В составе завтрака обоснованы наличие и значение необходимых видов круп, обезжиренной и качественной молочной продукции, значение кроличьего мяса, фруктов и овощей с низким гликемическим индексом. Освещено также потребление в течение сезонов года количества и качества воды, сухофруктов и бессолевой казы, приготовленной из конины. Были научно исследованы приведенные источники и рекомендованы исключить из рациона вредные спиртные напитки, энергетики и цветные напитки, горькие продукты, копченности, и переработанные продукты, соль и соленья. Приведены научно обоснованные рекомендации, направленные на предотвращение усталости в результате нехватки энергии или излишней деятельности в течение дня дома или на службе, развития осложнений болезни, военной непригодности и инвалидности. Ключевые слова: военнослужащие, режим дня, гипертония, критерии здорового питания, запрещенные продукты, гигиенические рекомендации Abstract. This article provides a hygienic analysis of the principles of healthy nutrition and its composition, aimed at ensuring an active daily routine, maintaining a healthy state of health, preventing military unfitness, the spread of cardiovascular diseases, and the prevention of risk factors and complications in military personnel diagnosed with hypertension. The hygienic requirements and principles that must be considered when consuming meals at home during the day for supervised military personnel are aimed at preventing hypertension, mitigating risk factors, and preventing the development of concomitant diseases and their complications. The role of timing, composition, quantity, and quality in the nutritional regimen prescribed for military personnel is substantiated. The breakfast composition is substantiated by the presence and importance of essential cereals, lowfat and high-quality dairy products, rabbit meat, and low-glycemic index fruits and vegetables. The seasonal consumption of water, dried fruit, and salt-free kazy (made from horse meat) is also discussed. The cited sources have been scientifically examined, and it is recommended to exclude harmful alcoholic beverages, energy drinks, colored drinks, bitter foods, smoked and processed foods, salt, and pickles from the diet. Scientifically based recommendations are provided to prevent fatigue resulting from a lack of energy or excessive activity during the day at home or on duty, the development of illness complications, military unfitness, and disability. Keywords: military personnel, daily routine, morning exercises, healthy eating, hygiene recommendations, hypertension, healthy eating criteria, prohibited foods Introduction. An analysis of the incidence of diseases of the circulatory system by class (class IX according to ICD-10) showed that among military personnel serving under contract in the RF Armed Forces, a significant (almost 5-fold) increase has been recorded in recent years [3]. According to Evdokimov V.I. (2019), the overall incidence rates for class IX among officers of the Russian Navy in the period 2003–2018 averaged 124±6.0 ‰ (13.5% overall in the structure; diseases characterized by high blood pressure alone – 6.8% at a level of 62.1±2.3 ‰); Among officers of the Ground Forces (RF Ground Forces) – 114.4±8.4‰ (11.4% in the structure; diseases characterized by high blood pressure alone – 7.0% at a level of 71.0±5.0‰). Moreover, the dynamics of the indicator was represented by a U-curve of decrease with low determination coefficients R2= 0.27 and R2= 0.1 [4–6]. In the structure of the primary morbidity indicator in the period 2003–2018, diseases characterized by high blood pressure among officers of the Russian Navy occupy the 2nd rank position (4.7%), and among officers of the Russian Ground Forces – the 5th rank (5.6%), with an insignificant decrease and a low determination coefficient in both groups[2]. However, in the structure of dispensary observation, this pathology among military personnel of the Russian Ministry of Defense reaches the top rank positions [2]. The average annual level of dispensary observation for this nosology was 6.8±0.6‰ [3]. 219 ActaCAMU № 4 (12) 2025 ISSN: 2181-4155 In the structure of hospitalized morbidity among military personnel of the Russian Ministry of Defense, this pathology accounts for 44.6±1.2‰ – 31.4±3.7‰ for officers of the Russian Navy and Army, respectively [2]. Similar data are presented by a number of authors [3] for employees of the Ministry of Internal Affairs of the Russian Federation (MVD RF): from 41.3% to 46.2% of those hospitalized due to diseases of the circulatory system (ICD-10 codes I00 to I99). The most common cause of hospitalization among all nosological units was arterial hypertension. According to Grigoriev S. G. et al. (2017), in the structure of diseases for which officers of the RF Ministry of Defense are recognized as unfit for military service, diseases characterized by high blood pressure (I10 I15) rank second [1,3]. In the period 2003–2018, in the structure of dismissals of Russian Navy officers, diseases characterized by high blood pressure occupied the first rank, with a share of 13.9% (at a level of 2.20 ± 0.43 ‰). Among Russian Navy officers, the average level of work days lost due to diseases characterized by high blood pressure is 41.8 ± 2.5 per 100 military personnel; among Ground Forces officers – 32.0 ± 1.9 per 100 people. The polynomial trend in days of work loss among Russian Navy officers with diseases characterized by high blood pressure, with a low coefficient of determination (R2 = 0.49), resembles an inverted U-curve with maximum indicators in 2008-2012, while among officers of the Russian Ground Forces, with a low coefficient of determination (R2 = 0.26), it shows an increase in data [1,2,3,4,14]. It should also be noted that military personnel with neurotic disorders have a 4-5 times higher incidence of cardiovascular pathology [1]. The significance of this pathology for military personnel associated with neurotic disorders, stress, somatoform disorders, is also determined by the fact that in the structure of the dismissal indicator, it occupies a 4-6 rank position, choosing this indicator by 5.25-8.11% [4,14]. It should be noted that the development of arterial hypertension is more related to the reactivity of the blood vessel wall than to the degree of increased blood pressure [5-13], and the composition of food consumed together with alcoholic beverages creates conditions for the accumulation of excess fats in the blood vessels and changes in their composition. The professional activity of military personnel is closely related to repeated stressful situations, and therefore, taking into account the connection between the characteristics of the course of arterial hypertension and nutrition in these contingents, the development of a healthy lifestyle and a healthy therapeutic diet aimed at timely prevention of complications of cardiovascular diseases, and the development of hygienic recommendations corresponding to it, is one of the urgent problems. Taking into account the above, a hygienic analysis of the diet of military personnel diagnosed with various stages of hypertension and the development of hygienic recommendations for it are one of the most urgent problems facing specialists in this field. Purpose of the research. The purpose of the study was to assess the role of healthy eating in optimizing the health of military personnel diagnosed with hypertension. Materials and Methods. The materials of the study were materials on daily, weekly and periodic nutrition recommendations for military officers and servicemen serving in the Armed Forces of the Republic of Uzbekistan, who are at risk of developing high blood pressure and are diagnosed with hypertension, in accordance with working conditions and aimed at improving their health. The age group of the military personnel under supervision was from 18 to 60 years old, and their age groups and sections correspond to the requirements for the age classification of the contingents under supervision. It is necessary to carry out the assessment of the work activity and daily workload of young people on a time-based basis and ensure that the daily diet meets the requirements of local rations aimed at optimizing blood pressure. The daily routine and its composition are based on the established requirements of the organization and the food situation in the established official documents of the Cabinet of Ministers and the order of the products and the place of the ration made from local products. The daily routine should be organized in such a way that it takes into account the requirements for performing the main tasks of this team and consists of a ration corresponding to the state of the loads. 220 ActaCAMU № 4 (12) 2025 ISSN: 2181-4155 Breakfast, lunch, afternoon tea and dinner at home. In working conditions, it should consist of breakfast, second breakfast, lunch, afternoon tea and dinner, as well as morning physical education classes and morning walks, preparation for breakfast, breakfast, continuation of work, lunch, spiritual and educational activities and dinner, evening walks, rest, preparation for sleep and sleep. It was carried out on the basis of statistical and analytical methods of analysis of the obtained materials. Results and Discussion. Based on the goals and objectives of the work, the hygienic recommendations aimed at improving the daily healthy diet of military personnel diagnosed with various degrees of cardiovascular diseases, hypertension, and other diseases of the cardiovascular system, carried out in the Ministry of Defense, in accordance with their health status, form the basis of our study, and we must not forget that the organization of daily healthy nutrition today should comply with the 12 principles in demand: Before substantiating the principles, it is necessary to periodically observe the following, and these include: personal hygiene skills that form the basis of each person's daily routine, including oral hygiene, skin and prevention of infectious diseases caused by various pathogens and associated with infectious factors. Also, one of the most pressing problems of today is that the majority of military men, who are considered to be the cause of cardiovascular and other somatic diseases, have harmful habits, such as smoking and alcohol, and the consumption of spicy and salty foods, which leads to inflammation of the mucous membranes of the oral cavity, dental caries and other dental diseases, some defects in the respiratory system and diseases related to nutrition, the development of hypertension from cardiovascular diseases, and in this regard, it is advisable to create and recommend a diet that strictly adheres to healthy eating principles and promotes a healthy lifestyle. Conditions should be created to prevent food poisoning in military personnel due to noncompliance with established personal hygiene rules and during mobilization. Before drawing up a diet, taking into account the characteristics of each profession, a chronometer that includes all activities is of great importance for professions. At the same time, a diet based on the requirements of healthy nutrition and hygienic substantiation of its nutritional and biological value are appropriate to cover the energy expenditure spent during the day [5,6,7,8,9,13]. As a result of assessing the daily activities of military personnel with hypertension based on chronometers, a daily diet should be drawn up aimed at compensating for the lost energy and restoring health, and the quality of the products in its composition should comply with hygienic requirements. The diet consists of breakfast, lunch and dinner, and breakfast plays a major role in restoring the health of military personnel diagnosed with hypertension, and skipping breakfast is the basis for increasing blood pressure. The composition of the military breakfast should include cereals from wheat, rice, oats, buckwheat, lentils, fenugreek, and millet, bread and bakery products from the second grade of Uzbekistan, eggs and hot dishes, low-fat dairy products, 72% butter, low-fat cottage cheese, cheese, and juices of pure and dried fruits in accordance with the seasons. Products that are strictly prohibited for breakfast include fried foods, sweets, margarine, coffee, excess sugar, sausage products, highgrade flour products, spicy and salty products. It is advisable to take into account the technology of preparation of breakfast and the place of meat, dairy products, pure fruits that are not too sweet, pure vegetables that are not sour and not overripe. When organizing a healthy diet, first of all, your diet should consist of a variety of products - every day you should consume various products belonging to groups (milk, meat, fish, cereals, vegetables, fruits, legumes, etc.). This criterion is based on the provision of non-fat milk, 1 or 2%, fat-free cottage cheese, low-fat cream, 72% butter, meat products such as beef, rabbit meat and chicken, poultry meat, lean fish, bread products made from second-grade Uzbek flour with vitamins of group B. 221 ActaCAMU № 4 (12) 2025 ISSN: 2181-4155 The level of consumption of excess bread products in the daily diet of the military personnel under supervision, the excess of pickles, salty snacks, sugary coffee, cocoa, and confectionery products containing margarine were the basis for their increase in body mass index. For soldiers diagnosed with cardiovascular diseases, it is necessary to limit citrus fruits and bananas, melons, and grapes, introduce fruits with a low glycemic index, provide potatoes in moderation, and include turnips, radishes, garlic, onions, and various red, yellow, and white onions. Secondly, energy (power) expenditure should be balanced. Depending on the harmful working conditions and the chronometry of daily working hours, high energy expenditure and the corresponding energy intake, the energy expenditure of soldiers diagnosed with cardiovascular diseases should not exceed 2600-2800 kcal, and working conditions and nutrition should be aimed at restoring their health. The excess of daily energy expenditure at home and a sharp increase in carbohydrates in the composition of the soldiers under our supervision were considered one of the contributing factors to the diagnosis of the disease. The duration of the soldiers' work during the day depends on military loads. This condition, as a result of their years of stress, led to changes in metabolism and the development of cardiovascular diseases, hypertension, associated with an irregular daily routine and nutrition. In any case, taking into account the different seasons of the year, daily meal times and dinner time should not be organized after 18.00, but working hours, travel time from work to home can change the time of dinner and then create conditions for the exacerbation of the disease. The fact that the military personnel under our control had meals at home at 21-22.00 and even later, and excessive consumption of fried foods, is one of the main causes of the disease. The need to include only local fruit and vegetable juices, low-fat yogurt and chalap in the daily diet during the second lunch during field exercises in the hot season of the year, and the basis for preventing the exacerbation of this disease, has been proven in the works of a number of authors (12,13). Third, limit fats, especially animal fats, in the daily diet - instead, it is necessary to include olive oil, along with the use of vegetable oils and Omega-3 sources, which, along with iron, sodium, potassium, are rich in vitamins E, A, K and group B. The fourth criterion is to monitor the body mass index of soldiers and monitor the achievement of a normal consumption of sugar and sweets in the daily diet. The daily amount of sugar should not exceed 50 grams, and the level of consumption of sweets should not exceed 60 grams. The level of consumption of sugar and sweets in the daily diet of the soldiers under supervision was 3.0-4.0 times higher. A number of recommendations should be implemented in this regard. Taking into account the fact that the daily consumption of the soldiers under supervision was 3 and 5 times higher, the daily salt intake should not exceed 5 grams and the consumption of iodized salt should be ensured. The fact that excess salt and pickles create conditions for an increase in blood pressure and the appearance of its varieties has been cited in the works of a number of authors (6,7,8,9,12). Sixth, it is necessary to ensure the optimal level of consumption of animal and vegetable proteins, to replace arginine and essential amino acids in their composition, to replace fatty meats with rabbit meat in the daily diet of soldiers, to introduce beans and peas, to ensure their norm and to monitor them. Excessive consumption of products containing vegetable oil and margarine in household conditions, a lack of legumes, and a shortage of meat products have created conditions for a sharp decrease in animal proteins. Seventh, a sufficient amount of vegetables should be consumed during the day, at least 800 grams, and fruits at least 400 grams. The amount of vegetables and fruits in the daily diet of the soldiers under observation showed a sharp decrease in household conditions. 222 ActaCAMU № 4 (12) 2025 ISSN: 2181-4155 It is necessary to introduce dried varieties of local fruits and vegetables, as well as walnuts and edible seeds, sunflower seeds, pumpkin seeds, as well as enrich them with selenium, vitamins, and minerals, taking into account their norms, and to monitor the promotion of mass nutritionists and dietitians in hospitals. The role of dried apricots, figs, and prunes in the daily diet of military personnel suffering from hypertension is invaluable. Eighth, the amount of water consumed in the daily diet of military personnel suffering from hypertension, in addition to water contained in other products, should be 1.5-2.0 liters in the winter season and 2.5-3.0 liters in the summer season. The water consumed must fully comply with hygienic requirements. Ninthly, reducing the amount of processed and fried foods in the daily diet will improve the functioning of the heart and digestive system. In order to restore the health of soldiers in the current era of development and localize the diet, it is necessary to include unsalted kazi instead of sausage products in their daily diet, and nuts with dried grapes, apricots, figs, prunes in the morning and evening shifts. The analyzes studied by us have shown that excessive consumption of fried pasta products, fatty soups, and smoked products at home are considered sources of the development of the disease. Tenthly, compliance with the diet is the basis of the military's activities, the daily diet is 3-4 times, and 4-5 times in the hot season of the year, but the level of energy should not increase. Our analysis shows that the daily diet of military personnel diagnosed with hypertension at home was reduced by 3 places, in the hospital by 3 places, and in the hot season, the consumption of individual sugar-free liquids was reduced at breakfast and lunch. Eleventh, it is necessary to exclude harmful drinks, alcohol, and carbonated drinks from the daily diet of military personnel diagnosed with hypertension. The results obtained show that the consumption of harmful drinks, energy drinks, colored drinks, and alcohol was reduced in the diet of military personnel under control at home and during their free time. A number of scientific analyses show that the increased odds ratio of the risk factors for cardiovascular diseases is presented in the works of a number of authors (11,12,13). The twelfth principle is to follow the rules of hygiene when preparing food, observe the rules for cleaning, storing, and preparing products. Our results showed that the food preparation technologies and product quality were not compromised. Failure to adhere to the established daily routine and the above-mentioned dietary requirements in the order and composition of meals by military personnel with hypertension leads to an irregular distribution of energy expenditure, a decrease in the efficiency of daily workloads, the development of nutrition-related diseases, and a decrease in the functional state of the body, which subsequently leads to economic damage and the need for a reserve of jobs. Conclusion. 1. The diet of hypertensive soldiers at home, taking into account the deviation from the hygienic requirements, does not comply with the established rules. 2. Breakfast, taking into account the health status of the soldiers, should include wheat, rice, oats, buckwheat, lentils, fenugreek, millet, second-grade Uzbek bread and bread products, low-fat dairy products, 72% butter, low-fat cottage cheese, cheese, juices made from fresh and dried fruits and vegetables, as well as high-grade flour products, jams. 3. Lunch should consist of vegetable soups and stews, lean meat products, rabbit meat, chicken meat, steamed fish products, buckwheat, barley, mashed chickpeas, bean dishes, fruit and vegetable salads. 4. In the evening, it is necessary to eat light meat and vegetable stews, liquid dishes, low-fat yogurt, fruit and vegetable juices, second-class Uzbek bread and bakery products, not to exceed the norm. 5. 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