[Bioactive compounds in the nutrition of peri- and postmenopausal women within the concept of 4P-medicine]

An updated consensus statement from the European Menopause and Andropause Society noted that a woman's quality of life may decline during peri- and post-menopause as a result of various menopausal symptoms and age-related comorbidities. The purpose of the work was to assess the possibility of using bioactive compounds in periand postmenopausal women to prevent the development of menopausal complications and chronic diseases associated with aging. Material and methods. Literature search was carried out using PubMed, Google Scholar, ResearchGate, RSCI databases mainly over the past 10 years, with the exception of works of fundamental importance, according to the keywords "perimenopause", "postmenopause", "Affron® saffron extract", "special extract ERr 731". Results. The use of diet, dietary supplements including those containing extracts of saffron (Affron®) and Siberian rhubarb (ERr 731) and their biologically active substances, has a versatile effect on the correction of menopausal disorders due to the impact on various pathogenetic pathways of their development and can be used in women in this period as a phytonutrient support. Conclusion. The combined use of saffron and Siberian rhubarb extracts is promising from the point of view of correcting the female state during peri- and postmenopause, taking into account the pathogenetic moments of the development of menopausal complications and chronic diseases associated with aging.

[The role of magnesium and potassium in preventive and therapeutic nutrition]

Due to the versatility of its functions and participation in all types of metabolism, magnesium can be considered the main cation in the human organism. Equally important is the role of the main intracellular ion - potassium, which is a synergist of magnesium, especially with regard to the effect on cardiovascular system function. In Russia, there is insufficient consumption of magnesium and potassium by the population. The purpose of the work was to assess the role of magnesium and potassium in ensuring public health. Material and methods. Literature search was carried out using PubMed, Google Scholar, ResearchGate, RISC systems mainly over the past 10 years, with the exception of works of fundamental importance, according to the keywords "magnesium", "bioavailability", "potassium", "efficiency". Results. Chronic hypomagnesemia and hypokalemia are involved in the pathogenesis of various metabolic disorders (metabolic syndrome, insulin resistance and type 2 diabetes mellitus, hypertension, hyperlipidemia and sluggish inflammation). Magnesium deficiency increases the risk of cardiovascular (arrhythmia, hypertension, heart failure), neurological diseases (stroke) and depression, as well as diseases of the respiratory system (bronchial asthma, chronic obstructive pulmonary disease). Potassium deficiency is also associated with pathology of the cardiovascular system. Adequate intake of magnesium and potassium with food and/or dietary supplements prevents the development of chronic metabolic complications. Various magnesium compounds used to correct its deficiency, have different bioavailability. Conclusion. The expediency of compensating for magnesium and potassium deficiency in nutrition has been proven both for preventive purposes in a healthy person and as part of diet therapy in a patient. Enrichment of the diet with magnesium and potassium is a reliable non-drug, economical and safe prevention of chronic deficiency and associated metabolic disorders.

[The role of optimal nutrition in the prevention of cardiovascular diseases]

A balanced diet has always been part of a set of preventive measures with cardiovascular diseases (CVD). The aim of the research is to present relevant international data on the role of nutrients in reducing the risk of CVD. Results. This article discusses current data on the effect of consumption of saturated and unsaturated fatty acids, trans fats, cholesterol, dietary fiber, protein, edible salt potassium, magnesium and vitamins on the state of the cardiovascular system and the prevention of CVD. Recommendations on optimal nutrition are given to reduce cardiovascular risks, including those according to the new 3rd edition of the Guide to Cardiovascular Medicine (The ESC Textbook of Cardiovascular Medicine, 3 edn). Conclusion. When managing patients with cardiovascular diseases, it is necessary not only to take into account international nutritional recommendations, but also to focus the patient's attention on how to comply with them.

[The importance of nuts in the prevention of various diseases]

Nuts are rich in unsaturated fatty acids, protein, dietary fiber, a number of micronutrients and biologically active substances. The aim of this review is to summarize and analyze current data on the role of nuts in human nutrition. Results. Large prospective cohort studies show an association between regular consumption of nuts (>= 140 g per week) and a reduced risk of coronary heart disease. In randomized controlled trials, strong evidence has been obtained that consuming nuts lowers blood cholesterol and improves glycemic control in patients with type 2 diabetes. Recent epidemiological studies show that high nut consumption does not increase body weight; rather, the inclusion of nuts in the hypocaloric diet can help to control or reduce body weight and waist circumference. A meta-analysis of prospective cohort studies shows that nut consumption is associated with a reduced risk of death from all causes and from chronic diseases. "Nut snack" is a good strategy to avoid weight gain and improve chemical composition of the diet. Conclusion. Adequate replacement of some foods in the diet with nuts does not cause body weight increase and helps to prevent a number of diseases.

[To the health of the nation through multi-level educational programs for the population in the field of optimal nutrition]

Healthy nutrition is the most crucial component of the quality of life, which is understood as an integral indicator of mental, physical and social functioning of a person. The diet of Russians doesn't contain enough vegetables and fruits, dairy products, while white sugar, salt, products containing animal fat, and trans fats are in excess. Violations of the structure of nutrition and nutritional status lead to the development of diet related non-communicable diseases (cardiovascular, oncological, diabetes mellitus, obesity, gout, osteoporosis, etc.) that are the leading causes of mortality of the population. All this indicates a low level of knowledge of the people about the principles of healthy nutrition. 49.2% of Russians have almost no idea about the rules of healthy eating. In this regard, it is essential to eliminate the existing gap in the education of the population on healthy nutrition through the introduction of training programs. For this purpose, training (educational) programs on healthy eating have been developed for target groups of the population (preschool and school-age children; adults of all ages, including pregnant and breastfeeding women, people older than working age; people with an increased level of physical activity; persons working in severe and harmful conditions or living in territories with unique features in terms of the impact of environmental factors). Based on scientific institutions of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing and Federal Research Centre for Nutrition, Biotechnology and Food Safety, four scientific-methodical centres and one educational centre on the issues of healthy nutrition have been created for the development of training (education) programs. A great deal of work on the implementation of educational programs for the population on healthy nutrition is carried out by the Profile Commission on Dietetics of the Ministry of Health of the Russian Federation, which includes the chief dietitians of Federal districts of the Russian Federation.

[Lipoic acid: physiological role and prospects for clinical application]

α-Lipoic acid (also known as thioctic acid) is a natural vitamin-like compound. Lipoic acid contains asymmetrical carbon, which causes the presence of two possible optical isomers (enantiomers): R-lipoic acid (levogyrate isomer) and S-lipoic acid (rightspinning isomer). Lipoic acid functions as a cofactor for several important mitochondrial multienzyme complexes, enhances the uptake of glucose by the cells, and modulates the activity of various signaling molecules and transcription factors. It was shown that α-lipoic acid and its derivative, dihydrolipoic acid, have a direct antioxidant effect due to the neutralization of reactive oxygen species that are destructive to DNA, proteins and lipids of cells. Dihydrolipoic acid enhances the antioxidant properties of ascorbic acid, glutathione and ubiquinone. Available evidence suggests that supplementation with lipoic acid reduces the symptoms of peripheral diabetic neuropathy. Results from randomized controlled trials show that high doses of lipoic acid can improve the glycemic profile of subjects with metabolic disorders. Lipoic acid can be used to control body weight in people with obesity. R-Lipoic acid is synthesized in the human body and is contained in foods in a form covalently associated with lysine (lipoyllysine). Its dose in dietary supplements significantly exceeds the amount in the diet. Most dietary supplements contain a racemic mixture of R- and S-lipoic acid.

[Using of specialized food for the workers with skin occupational eczema of perlite production]

The research was conducted with participation of the perlite production workers with professional eczema (165 people in the main group and 152 from the control group without skin pathology). The effectiveness of the use of a specialized prophylactic food in the diet of workers was assessed on the basis of the study of the dynamics of the indicators of nutritional and clinical status. Inclusion of kissel, containing pectin, vitamin A (300% from RDA), vitamin E and zinc (40% from RDA), biologically active substances of plant origin in the diet of the examined against the background of the course of complex therapy, has resulted in a positive influence on individual laboratory values, demonstrating the optimization of metabolic processes, which characterize the pathogenesis of skin inflammation. Thus, the concentration of ascorbic acid in blood serum statistically significant (p<0.05) increased by 30.0%, tocopherol - by 36.3%, carotenoids - by 27.3%, phosphorus - by 28.9%, calcium level elevated by 16.3% (p<0.10). There was a decrease in the level of MDA in blood serum by 12.3% (p<0.05) and an increase in catalase activity by 12.2% (p>0.05). There was a tendency to reduce itching, infiltration, erythematous and eczematous manifestations of the disease. The data obtained make it possible to consider the use of a specialized food product of dietary preventive nutrition by workers in pearlite production as a mean to enhance the body's adaptive reserves and to prevent the occurrence, progression and development of occupational skin diseases (eczema) in the workplace.

[Assessment of the sufficiency of Moscow population with folic acid, depending on the combined effect of polymorphism of MTHFR and FTO genes]

The results of assessing the sufficiency of folic acid of the residents of the Moscow region have been presented depending on rs1801133 MTHFR gene polymorphism and rs9939609 FTO gene polymorphism. A total of 326 people were examined, including 74 men and 252 women aged 20 to 65 years. The results of determining the level of folic acid in blood serum showed insufficiency of this vitamin among the population of the Moscow region of the Russian Federation. The expressed vitamin deficit (level <3,0 ng/ml) was detected in 24.2% of the surveyed residents, in 22.8% folic acid level was at the lower bound of the norm (3.0-4.5 ng/ml). The results of genotyping showed a statistically significant association of low folic acid level with rs1801133 MTHFR gene polymorphism in carriers of A allele of rs9939609 FTO gene polymorphism both in the homozygous state (genotype AA) and in the heterozygous (genotype AT) state, OR=4.26; CI (1.40-12.9), p=0.008, as well as with rs9939609 FTO gene polymorphism in carriers of the T allele of rs1801133 MTHFR gene polymorphism both in the homozygous (genotype TT) and heterozygous (CT genotype) state, OR=3.29; CI (1.07-10.1), p=0.03. In carriers of 3 alleles of risk of folic acid deficiency [rs9939609 FTO gene polymorphism and rs1801133 MTHFR gene polymorphism (genotypes CT/AA and TT/AT)] blood serum level of folic acid was below the norm, that indicated folate deficiency in this category of persons.

[Optimizing nutrition of older people as a mean of preventing premature aging]

The review presents data on the characteristics of construction of the diet of older persons. It is shown that inadequate nutrition is a significant risk factor for cardiovascular diseases, obesity, type 2 diabetes mellitus, gout and others that contribute to premature aging. Optimization of the diet should be considered as one of the areas of prevention and rehabilitation of these diseases and the prevention of premature aging. Attention is drawn to the age peculiar properties of the energy value of the diet, the content and the ratio of macronutrients in it. Modern data on the recommended daily intake of micronutrients -vitamins, minerals and trace elements for the elderly are presented. From the positions of the theory of oxidative stress, chronic inflammation and high-calorie nutrition, it is considered expedient to include products containing antioxidant ingredients: vitamins, trace elements and minor biologically active food components in the diet.

[Preventive Counselling With the Use of Remote Technologies Provides Effective Control of Metabolic Risk Factors in Patients With High and Very High Cardiovascular Risk]

PURPOSE

to assess the impact of preventive counseling with focus on diet modification on lipid and metabolic parameters in patients with high / very high cardiovascular (CV) risk who visited Health centers.

MATERIALS AND METHODS

This was a prospective randomized controlled study of patients aged 40 to 65 years with high/very high CV risk (≥5% according to the Systematic Coronary Risk Evaluation scale [SCORE]) and any 2 criteria for metabolic syndrome. Patients were 1:1 randomized into 2 groups. The intervention group (n=50) received comprehensive preventive counseling with focus on diet modification followed by remote preventive counseling by phone every two weeks for the first 3 months after enrollment (a total of 6 sessions). The control group (n=50) received usual care in Health centers which also included basic preventive counseling.

RESULTS

A total of 100 patients (women 82%, age 59.74±4.66 years) were randomized. At baseline 81% of patients had high and 19% - very high CV risk. The groups were well balanced according to demographic and clinical features. At 1 year of follow-up patients from the intervention group experienced significant improvement of metabolic parameters compared with controls: their diastolic blood pressure (BP) decreased by 5.62±7.7 mm Hg, total and low-density lipoprotein cholesterol (TC and LDL-C) - by 0.5±0.83 and 0.46±0.62 mmol/l, respectively. Both groups experienced statistically and clinically significant decreases in systolic BP (intervention, - 17.76±16.2 mm Hg, control, - 13.44±15.6 mm Hg; both groups p.

[Characteristics of the diet and nutritional status of workers at various industrial enterprises of the Sverdlovsk Region]

Alteration of food patterns leads to changes in nutritional status, thus contributing to the development of non-communicable diseases accounting for over a half of all causes of death of the population of our country. Poor working conditions and occupational hazards play an important role in inducing metabolic disorders and cardiovascular diseases. The objective of joint studies conducted by two Healthy Nutrition Centers located in the cities of Yekaterinburg and Moscow was to assess the diet and nutritional status of workers at two industrial enterprises of the Sverdlovsk Region. The total of 347 unrefined copper production workers (Plant 1) and 267 iron ore miners (Plant 2) were included in the study (the average age was 45.7±0.4 and 50.4±0.6 years, respectively). The study design envisaged a study of actual nutrition by a frequency method, anthropometric indices, total body composition by bio-impedancemetry, and nutritional status biomarkers using biochemical blood indices. The workers' diet was characterized by a high energy value (more than 2,500 kcal/day) with an excess of total and saturated fats (40.7-41.0 and 15.2-15.3% by the calorie content) as well as mono- and disaccharides (19.0-21.0% by the calorie content). Vitamins C and A consumption of the iron ore miners was 78% (p<0.01) and 27% (p<0.05) lower than that of the unrefined copper production workers, respectively. High (>1.0) waist to hip ratios were estimated in 28.5% of the workers. Obesity (BMI>25.0 kg/m²) was established in 36-42% of our subjects and the fat mass excess - in 81% of them. High serum concentrations of low-density lipoproteins were measured in 28 and 35% of the workers of both plants, respectively. The metabolic syndrome was identified in 27.0% of Plant 1 workers and in 44.2% of Plant 2 miners, whereas cardiovascular diseases were diagnosed in 25.9 and 56.5% of the workers, respectively. The effect of genetic factors (rs993609 polymorphism of FTO gene and Trp64Arg polymorphism in ADRB3 gene) on the development of obesity and metabolic disorders was demonstrated.

[The association of rs993609 polymorphisms of gene FTO and rs659366 polymorphisms of gene UCP2 with obesity among Arctic Russian population]

It is known that particular qualities of the prevalence of obesity, characteristic for the population of the Far North, are connected with the presence of genetic polymorphisms. The association of two polymorphisms (rs993609 of FTO gene and rs659366 of UCP2 gene) with obesity was studied in 175 people living on the territory of the Russian Arctic (Yamalo-Nenets Autonomous District). The incidence of obesity risk allele (A) of FTO gene rs9939609 polymorphism in the surveyed population of the Arctic (30.8%) was lower by 15% than that of the population of the central regions of Russia, Caucasian Americans and Europeans, but was higher by 18-20% than in Alaska inhabitants. The frequency of the A allele of the FTO gene was significantly 1.4-fold lower in indigenous Arctic people than in the alien population (p<0.05), that had significantly higher content of body fat (by 12%) than the indigenous population, including the Nenets (p<0.05). Рositive association had been identified between T allele rs659366 polymorphism of UCP2 gene and obesity risk in the surveyed who lived in the Arctic zone. Thus, the inhabitants of the Far North revealed the presence of genetic variants that contribute to heat production.

[Vitamin status of rural residents, living in Russian Arctic]

The aim of this cross-sectional observational study was to estimate vitamin D, B2, A, E, β-carotene (BC) status in rural residents, living in Russian Arctic (Yamal-Nenets Autonomous Area). 216 healthy adults (166 women, 50 men, 45.4±0.8 years old; BMI 27.5±0.5 kg/m2), 76% aboriginal ethnicity and 24% non-aboriginals subjects have been surveyed in spring 2016. Nenets were 72% among the surveyed, Russians - 14%, other ethnic groups - 14%. A total of 69 and 78% of subjects had 25(OH)D and BC blood serum concentrations less than the recommended target threshold of 30 ng/ml and 20 μg/dL respectively. Deficiency of vitamins B2, A and E, when blood serum concentrations of riboflavin <5 ng/ml, retinol <30 μg/dL and tocopherols <0.8 mg/dL, were found in 34, 15 and 13% of participants, respectively. The indigenous population was better supplied with vitamins D and B2. The lack of these vitamins was detected 1.3 and 1.8 fold less often (p<0.05) than in the non-aboriginals; whereas non-aboriginals were better provided with vitamin A and BC: the deficiency of these micronutrients was detected 3.1 and 1.8 fold less often (p<0.05) than in the inhabitants. In general, only 2.4% of those surveyed were sufficiently supplied with all 4 studied vitamins and BC. The frequency of deficit of one or two vitamins was revealed in 62.2%, combined deficiency of 3 or more vitamins was detected in 35.4%. There were no statistically significant differences in the incidence of combined multivitamin deficiencies among the indigenous and non-aboriginals. High incidence of vitamin A deficiency in the indigenous female population (21%) along with insufficiency of vitamin B2 in female non-aboriginals (48%), the lack of vitamin E in men (22%) and vitamin D and BC in 70-78% of the surveyed dictate the need for targeted enrichment of the diet of people living in extreme conditions of the Russian Arctic with multivitamin complexes.

[The study of nutrition, anthropometric tеstes and body composition among native and alien population of Russian Arctic]

Arctic zone refers to the territories that are uncomfortable for living and working of people. Ecological features of the Far North have contributed to the adaptation of the indigenous population to the conditions of the external environment, which manifested in the peculiarities of nutrition and nutritional status, which is also related to the presence of genetic polymorphisms in the population of the Arctic zone. The study of nutrition and the nutritional status of 180 people (78.9% woman и 21.1% man) living in the Far North was conducted. The data obtained indicate that the prevalence of overweight and obesity (62.7%) among the surveyed people living in the Arctic zone, was higher than among Russian people (average 57.3%). Indigenous people (mean age - 45.6±1.3 years) compared with alien population (45.1±2.6 years old) had lower BMI (27.2±0.5 vs 28.8±1.3 kg/m²) and a smaller hips along with significantly (p<0.05) lower relative fat body mass (31.9±0.9 vs 35.4±1.4 kg), lean (67.1±0.8 vs 64.6±0.9 kg) and bone body mass, as well as exchange at rest (1329.9±16.0 vs 1455.4±44.0 kcal). Indigenous population consumed significantly more bakery products and fish (1.5-2.2 fold), and less - dairy products and vegetables (1.7-2.0 fold). Thus, the peculiarities of the nutritional status of the indigenous and alien populations of the Arctic seem to be associated with the traditions of nutrition and lifestyle.

[The investigation the combined effect of SNP rs9939609 (gene FTO) and rs4994 (gene ADRB3) polymorphisms on risk of obesity]

The genetic factor plays a significant role in the development of obesity, by present time the association of hundreds genetic polymorphisms with the risk of this disease is established. However, the combined influence of genetic polymorphisms remains practically unstudied. We aimed to investigate the combined effect SNP rs9939609 (gene FTO) and rs4994 (gene ADRB3) polymorphisms on risk of obesity. A case-control study was conducted, including255 obese case (BMI>30 kg/m2) and 427 non obese controls (BMI<30 kg/m2). Genotyping was performed using allele-specific amplification, detection results in real time using TaqMan-probes complementary DNA polymorphic sites. It has been shown, that presence of one mutant allele of rs9939609 (gene FTO) and rs4994 (gene ADRB3) leads to statistically significant association with obesity. Presence of two mutant alleles in different polymorphic variants increases risk of obesity by 15%, presence of three mutant alleles - by 2.63 fold. The quantity surveyed, suffering obesity, increased depending on the number of mutant alleles in studied genetic polymorphisms. Presence of one or two mutant alleles in one polymorphic variant increased the number of patients with obesity by 13.4%, presence of two or three mutant alleles in different polymorphic variants -by 18-19%.

[Vitamin status of citizens from Moscow Region]

Evaluation of vitamin status in healthy individuals (68 men and 70 women) aged from 18 to 60 years (median - 37 years), residents of Moscow and the Moscow region has been performed by means of determination of vitamin C, A, E, B2, B12 and folic acid level in blood serum. The nutrition was investigated by questionnaire method on frequency of food consumption. Both diet of men and women had excessive fat content (41.7 and 42.7% of total calories), saturated fatty acids (14.1 and 13.6%), added sugars (11.1 and 11.0%), sodium, and had lack of dietary fiber (2.5-fold reduced level comparing with RDA). Daily intake of vitamin B1 was 1.37±0.04 mg for men and 1.06±0.07 mg for women, vitamin B2 - respectively 1.72±0.06 and 1.62±0.07 mg, niacin - 18.5±0.72 and 14.8±0.88 mg and did not reach the optimal level. All persons were sufficiently supplied with vitamins A, C, E and B12: mean and median of blood serum level of retinol, tocopherols, ascorbic acid and cobalamins were in the range of optimum values. The lack of vitamins A and B12 has not been found in any person. The frequency of vitamin C and E insufficiency was insignificant and amounted to 2 and 8% respectively. The lack of vitamin B2, and β-carotene was most pronounced and took place in about a half of individuals. Only 34% of healthy people of working age were sufficiently supplied with all vitamins. A combined lack of two vitamins was detected in 26%, of three vitamins - in 8%. Women were better supplied with riboflavin and β-carotene. The blood serum level of β-carotene and vitamin E was significantly higher in individuals older than 30 years compared with persons of younger age. Individuals with overweight or obesity were worse supplied with β-carotene and folate. A negative correlation was detected between the levels of serum folate and homocysteine concentration (r=-0.262, p<0.05). A positive correlation has been revealed between the concentration of folic acid and the level of HDL-C (r=0.356, p<0.01), and iron (r=0.378, p<0.05).

[The study of energy balance in individuals with the Trp64Arg polymorphism of the β3-adrenoreceptor gene]

The study involved 104 people living in the Moscow region, including 18 men and 86 women aged 18 to 67 years. Genotyping of rs4994 ADRB3 polymorphisms was performed using allele-specific amplification, with result detection in real time and using TaqMan-probes complementary to polymorphic DNA regions. The frequency of the mutant allele in individuals was 8.0%, while the Trp64Trp genotype was detected in 84.0% of cases, Trp64Ar - in 16.0%, AA - in 19.0%. Compared with men with genotype Trp64Trp, the men with the Trp64Ar polymorphisms (rs4994) of ADRB3 gene had significantly lower energy expenditure at rest value, calculated per kg of body muscle mass that was associated with higher fat mass, levels of blood serum leptin and LDL cholesterol. The data obtained suggested that leptin could be a possible intermediary contributing to the association between the rs4994 polymorphism of ADRB3 gene and energy disbalance.

[The association of genetic polymorphisms with non-communicable disease among Arctic population]

The review analyzed genetic polymorphisms contribute to the development of non-communicable diseases among the inhabitants of the Arctic. It is known that the area belongs to the arctic areas of discomfort for living and employment rights. Ecological features of the Far North have contributed to the adaptation of the indigenous population to environmental conditions, which manifested itself in particular in the power features that provide a low prevalence of obesity, metabolic syndrome, type 2 diabetes and cardiovascular disease. Active development of the Arctic zone and the associated lifestyle changes in the population, including the nature of power, caused a change in the prevalence and trends of non-communicable diseases, which has its own characteristics in comparison with the ethnic groups living in more southern latitudes. These features, as follows from the results of a number of studies to be associated, including the presence of genetic polymorphisms characteristic of the population of the Arctic zone.

[The study of the association of polymorphism rs5219 gene KCNJ11 with obesity and the risk of type 2 diabetes among residents of the Moscow Region]

The study involved 1,050 people living in the Moscow region, including 311 men and 739 women. Genotyping of KCNJ11 rs5219 polymorphisms was performed using allele-specific amplification, result detection in real time and using TaqMan-probes complementary to polymorphic DNA regions. Results of the study of KCN11 rs5219 gene polymorphism showed that 14.2% of the patients had TT genotype, 44.8%--CT genotype, 41.0%--CC genotype. The frequency of the mutant T alele was 36.6%, C allele--63.4%. The frequency of the T allele didn't significantly differ in individuals with obesity (BMI ≥ 30 kg/m2) and individuals with a BMI < 30 kg/m2 (38.8% and 35.7%, respectively), OR--1.14; CI (0.907-1.439), p = 0.26. At the same time, the amount of energy expenditure at rest, calculated per kg lean body weight, and serum content of uric acid in were significantly higher in individuals with KCNJ11 rs5219 polymorphism, both in homo-, and in the heterozygous type. The frequency of the T allele and TT genotype in patients with hyperglycemia was higher than in the comparison group. Genotype TT is associated with type 2 diabetes (OR = 2.35, CI: 1.018-5.43, p = 0.04).

[Vitamin-mineral supplements in nutrition of adults]

The diet of population consisting of natural products is quite adequate and even excessive of energy consumption, but is not able to meet fully the need of organism in a number of micronutrients. Due to lack of sun exposure and long presence indoors endogenous synthesis of vitamin D in the skin by ultraviolet radiation does not provide the body’s need for this vitamin. Intake of vitaminmineral supplements (VMS) is appropriate because combined deficiency of vitamins and minerals takes place in population. Prophylactic doses (equal to physiological needs) provide a diet completeness and reduce the risk of vitamin deficiency and its consequences. The high incidence of combined deficiency of vitamins among population and the existence of vitamin interactions are the basis for the application of the multivitamins. The simultaneous intake of vitamins is more physiological, their combination is more effective than a separate or isolated destination of each of them. Efficacy of the VMS has been shown in the treatment and prevention of some diseases. The main requirements for the VMS are full list of vitamins and minerals, the lack of which is detected most frequently, in doses covering the needs of organism. For the health of the pregnant woman and her unborn child preference should be given for complexes, containing DHA and/or probiotics along with vitamins. The principles of the selection of the composition and vitamin doses in the VMS for using patients suffering from various pathologies should be based on data on the patient’s sufficiency with vitamins, the understanding of the role of vitamin deficiency in the pathogenesis of the disease, as well as on the composition of the diet and its modifications.

[Estimation of vitamin status of moscow student according to data on vitamins intake and their levels in blood]

Supply with vitamins C, A, E and B2 of 61 high school students (38 girls and 23 boys, aged 18–22 years, body mass index – 23.0±0.6 kg/m2) by means of determination of blood plasma concentration of ascorbic acid, retinol and carotenoids, tocopherols and riboflavin has been investigated in the period from May to September. All students were well supplied with vitamin C (only 2 boys had a reduced level of ascorbic acid) and vitamin A. Decreased level of carotenoids was more common in boys (48 versus 24% in girls). 20% of the students were insufficiently supplied with vitamin E, 38% – with vitamin B2. 39% of students (50% girls and 22% boys) were adequately provided with all studied vitamins. 5% of the students had a combined deficiency of 3 vitamins, 20% – 2 vitamins. Student’s sufficiency with vitamins B2, C, A, E, carotenoids did not depend on the season. Diet intake of vitamins C, A, carotenoids and vitamin B2 has been calculated basing on the data on the frequency of food consumption during the previous month. Reduced consumption relatively to the Russia RDA of vitamins В2, C and А took place in 63, 54 and 46% of the students respectively. The lack of vitamin B2 in the diet was most pronounced, the value of probabilistic risk corresponded to the average level in 34% of students. Average probabilistic risk of inadequate intake of vitamin A was present in 17% of students, vitamin C – 6%. Coincidence of the results of vitamin C and A status assessment obtained by calculation of vitamin diet intake and by biochemical methods (concentration of vitamins in the blood plasma) was 94 and 83%. These methods are interchangeable if you select the value of the average probability of risk failure intake of these vitamins as a criterion. Proportion of coinciding results of the estimation of vitamin B2 status was 56%. Special well-designed studies on larger sample surveyed are needed for the final output of the interchangeability of methods to assess riboflavin status.

[The study of the peculiarities of metabolism in individuals with rs9939609 polymorphism of FTO gene]

A total of 104 people, among them were 18 men and 86 women aged 18 to 67 years--people in the Moscow region of the Russian Federation, in the sanatorium treatment. Association embodiment rs9939609 FTO obesity was studied using allele-specific amplification, detection results in real time using TaqMan-probes complementary DNA polymorphisms. The frequency of the mutant allele in individuals was 47.0%, while the TT genotype was detected in 25.0% of cases, AT--in 56.0%, AA.0%. In men, prevalence rates of obesity risk allele (A) is higher than in women. In individuals with obesity (BMI over 30 kg/m2) indicated the presence of more AA genotypes (2 7.8%) compared to individuals with a body mass index of less than 30 kg/m2 (14.1%) and a high frequency of occurrence (54.2 versus 43.0%) risk allele A. Compared with individuals with genotype TT, the examinees with the AA genotype rs9939609 FTO gene was significantly higher BMI, waist circumference, hip circumference, fat mass. The same patients energy expenditure at rest value, calculated per kg of lean body mass or muscle, was slightly less than with TT genotype. In individuals with the AA genotype rs9939609 FTO gene compared with the TT genotype had significantly lower levels of HDL cholesterol and serum iron in the background significantly elevated concentrations of uric acid. Thus, the evaluation of patients with the use of innovative technologies in a spa treatment allows their personal alimentary correction for the prevention and treatment of non-communicable diseases.

[The study of the association of polymorphism rs659366 gene UCP2 c obesity and type 2 diabetes among residents of the Moscow Region]

1112 people from Moscow region have been surveyed. Genotyping of rs659366 polymorphism UCP2 gene was performed using allele-specific amplification, result detection in real time and using TaqMan-probes complementary DNA polymorphic sites. The study of rs659366 polymorphism of the UCP2 gene has showed that 36.9% of patients had genotype AA, 46.7%--genotype AG, and 16.5%--genotype GG. The frequency of allele A was 60.2%, allele G--39.8%. BMI, value of fat mass, visceral fat area, serum glucose and triglyceride levels were significantly higher in carriers of A allele in the homozygous and heterozygous state than in carriers of G allele in the homozygous state. Frequency of A allele compared with G allele in obese patients (BMI greater than 30 kg/m2) was: OR--1.52; CI (1.24-1.86), p = 0.001, and in diabetes mellitus type 2--OR--1.22; CI (0.910-1.622), p = 0.19.

[The dependence of diet macronutrient composition and energy intake from human phase of the weekly cycle – weekdays/weekends]

When planning your diet regime is desirable to focus on the natural feeding behavior of the person. However, many aspects of eating behavior are not studied. The aim of this work was to study the changes of diet calorie and nutrient composition depending on the body mass index (BMI), time of day, week cycle phase: weekends/weekdays, and the availability of rational installation in nutrition. The study involved 67 women aged 29 to 49 years with a BMI of 18.3 to 34.2 kg/m2. Macronutrient composition and energy value of the diet were evaluated by analyzing the food diaries, which were filled by all respondents continuously for 8 workdays and 4 weekends. The results of this study showed no significant correlation between BMI and calorie intake, while a positive correlation was observed between BMI and fat component of the diet (r=0.362, p≤0.05). It was also found that the restriction of food intake in the evening (after 8 pm) did not lead to a decrease in total daily energy value of the diet, and was characterized by the consumption in the evening about 31% of the total fat intake. Diet energy value was significantly higher on weekends than during the week and was 2376±394 against 1940±402 kcal (p<0.05). According to the data obtained, compliance «restriction of supply in the evening» does not lead to a significant reduction in daily caloric intake.

The Health and Functioning ICF-60: development and psychometric properties

Background

This paper describes the development and psychometric properties of the Health and Functioning ICF-60 (HF-ICF-60) measure, based on the World Health Organization (WHO) ‘International Classification of Functioning, Disability and Health: ICF’ (2001). The aims of the present study were to test psychometric properties of the HF-ICF-60, developed as a measure that would be responsive to change in functioning through changes in health and nutritional status, as a prospective measure to monitor health and nutritional status of populations and to explore the relationship of the HF-ICF-60 with quality of life measures such as the World Health Organization WHOQOL-BREF quality of life assessment in relation to non-communicable diseases.

Methods

The HF-ICF-60 measure consists of 60 items selected from the ICF by an expert panel, which included 18 items that cover Body Functions, 21 items that cover Activities and Participation, rated on five-point scales, and 21 items that cover Environmental Factors (seven items cover Individual Environmental Factors and 14 items cover Societal Environmental Factors), rated on nine-point scales. The HF-ICF-60 measure was administered to the Russian nationally representative sample within the Russian National Population Quality of Life, Health and Nutrition Survey, in 2004 (n = 9807) and 2005 (n = 9560), as part of the two waves of the Russian Longitudinal Monitoring Survey (RLMS). The statistical analyses were carried out with the use of both classical and modern psychometric methods, such as factor analysis, and based on Item Response Theory, respectively.

Results

The HF-ICF-60 questionnaire is a new measure derived directly from the ICF and covers the ICF components as follows: Body Functions, Activities and Participation, and Environmental Factors (Individual Environmental Factors and Societal Environmental Factors). The results from the factor analyses (both Exploratory Factor Analyses and Confirmatory Factor Analyses) show good support for the proposed structure together with an overall higher-order factor for each scale of the measure. The measure has good reliability and validity, and sensitivity to change in the health and nutritional status of respondents over time. Normative values were developed for the Russian adult population.

Conclusions

The HF-ICF-60 has shown good psychometric properties in the two waves of the nationally representative RLMS, which provided considerable support to using the HF-ICF-60 data as the normative health and functioning values for the Russian population. Similarly, the administration of the WHOQOL-BREF in the same two waves of the nationally representative RLMS has allowed the normative quality of life values for the Russian population to be obtained. Therefore, the objective assessment of health and functioning of the HF-ICF-60 could be mapped onto the subjective evaluation of quality of life of the WHOQOL-BREF to increase the potential usefulness of the surveys in relation to non-communicable diseases. © 2014 The Authors. Clinical Psychology & Psychotherapy. Published by John Wiley & Sons, Ltd.

Key Practitioner Message

[Evaluating the effectiveness of dietary management of patients with varying degrees of obesity]

The purpose of the research is to study the efficiency of a low-calorie diet in treatment of patients with various degree of expressiveness of obesity. 605 patients (188 men and 417 women) with a body mass index > 25 kg/m2 at age 18-79 years have been examined. All patients underwent a complex clinical and instrumental and laboratory examination on the "Nutritest IP-2" system, including studying of clinical status dynamics, anthopometrical indicators, composite structure of a body, parameters of a power exchange and the laboratory indicators characterizing a condition of lipid, carbohydrate and protein metabolism. It has been revealed that low-calorie diet in combination with traditional curative measures ("Nutrikor IP-2") in obese patients significantly improved clinical status, central hemodynamics (blood pressure and heart rate), anthropometric parameters and body composition, lipid profile and parameters of metabolic status. In particular, systolic arterial pressure decreased authentically by 18- 19% (p < 0.00I), diastolic arterial pressure--was reliable for 16-17% (p < 0.001), heart rate authentically decreased by 7-12% (p < 0.001). Concentration of blood glucose authentically decreased at patients with obesity of I and II degrees--by 6% (p < 0.01), at patients with obesity of the III degrees--for 8% (p < 0.001). The reduction of fatty body weight in patients without obesity was 2.3%, in patients with I degree of obesity--3.1% (p < 0.001), in patients with II degree of obesity--3.4% (p < 0.001), and in patients with III degree of obesity--4% (p < 0.001). It has been shown that the effectiveness of therapeutic interventions reduced according to the severity of obesity, that requires changes in the approach to the treatment of these patients, the search for new methods of drug and dietary management of this pathology.

[Regional features of obesity-associated gene polymorphism (rs9939609 FTO gene and gene Trp64Arg ADRB3) in Russian population]

Recent studies have shown a significant association with obesity polymorphisms: rs9939609 gene due to fat mass and obesity FTO in European and some Asian and African American populations Trp64Arg ADRB3 gene in several European populations. Association of variants rs9939609 and Trp64Arg obesity was studied in 1244 the inhabitants of Moscow and Sverdlovsk regions. Genotyping was performed using allele-specific amplification, detection results in real time using TaqMan-probes complementary DNA polymorphic sites. The frequency of the mutant allele of the FTO gene in the population of Moscow and Sverdlovsk region was 45.1%, with the TT genotype was detected in 30.2% of cases, AT--49.5%, AA--20.3%. Women had the presence of the mutant allele more likely than men (48.4 vs. 42.5%). People with obesity were more genotypes AA (26.3%) and AT (52.8%) compared to the surveyed with a BMI of less than 30 kg/m2 (respectively 18.1 and 50.7%). A significantly higher incidence of risk allele A was found in individuals with obesity (52.6 and 43.4%). The presence of the mutant allele of the gene ADRB3 among the population of Moscow and Sverdlovsk regions was noted in 7.4% of cases. While 15.5% of patients had a heterozygous genotype Trp64Arg ADRB3, that is consistent with international research. The frequency of the risk allele and genotype Arg64 Trp64Arg in women (9.3 and 18.5%) was significantly higher than men (6.2 and 12.2%). The presence of the mutant allele and genotype Trp64Arg ADRB3 (respectively, 9.1 and 18.1%) were significantly more marked in the examined obese compared with those with a body mass index less than 30 kg/m2 (7.4 and 14.9%), but these differences were not statistically significant. The results of these studies suggest that genetic variants of the FTO gene rs9939609 genotype and Trp64Arg ADRB3 contribute to the development of obesity among residents of Moscow and Sverdlovsk Region of Russia. The risk of obesity increases in the case of combined polymorphisms in both genes.

[The role of the Consultative and Diagnostic Centre "Healthy Nutrition" in the diagnosis and nutritional prevention of non-communicable diseases]

In a consultative and diagnostic center "Healthy Nutrition" of Institute of Nutrition the nutritional status of 3500 patients (mean age 48.4 ± 0.3 years) liv- ing in the Moscow region, using a system Nutritest IP-3, including genomic analysis has been examined. In the analysis of dietary intake by an average review, increased energy intake due to excess intake of the total (44.2% energy) and saturated fat (13.6%) has been shown. 30.0% of patients were overweight and 34.1% were obese. Osteopenia was detected in 31.0% of men and 25.0% women, osteoporosis--20.9% and 30.3%, respectively. Analysis of the results of biochemical studies revealed increased cholesterol in 68.7% of patients, LDL cholesterol--at 63.9%, triglycerides-- at 22.5%, glucose--at 29.4%. The frequency of the occurrence of risk alleles of genes associated with the development of obesity and type 2 diabetes mellitus was: 47.8%--for the polymorphism rs9939609 (FTO gene), 8.3%--for polymorphism rs4994 (gene ADRB3), 60.2%--for the polymorphism rs659366 (gene UCP2), 36.6%--for the rs5219 polymorphism in the gene of ATP-dependent potassium channel.

[Analysis of regulatory basis for organization of clinical nutrition in medical institutions of the Russian Federation]

The article analyzes regulatory basis for organization of clinical nutrition in medical institutions of Russia. It is shown that the strategy of therapeutic measures in acute and chronic diseases a central place to take dietary therapy with adequate provision of energy and plastic body's needs, correction of metabolic disorders and risk factors for comorbidity. Prior to the confirmation of the order of Ministry of Health of Russia from 05.08.2003, No 330 "On measures to improve nutritional care in health care institutions in the Russian Federation" clinical nutrition in medical institutions was based on the nosological principle, in the form of daily diet--a diet designed for each concrete Diseases which are identified by a number from 1 to 15. According to the order of Ministry of Health of Russia from 05.08.2003, No 330 in the health care practice has introduced a new range of diets (system standard diets), which is based on the principle of adapting the chemical composition and energy value of the diet to the individual clinical and pathogenic features of the disease and combines previously used diet numbering system. It is shown that the organization of clinical nutrition should be based on common requirements imposed on the federal level and at the level of the subject of the Russian Federation. In order to optimize clinical nutrition is necessary to determine the methodological approaches to personalization through the introduction of diet in health care practice of modern innovative technologies health food, performing preventive and treatment of the problem (implementation of Article 39 of the Federal Law of 21.11.2011 No 323--FZ "On the basis of health protection in the Russian Federation", the Order of the Government of the Russian Federation of 25.10.2010 No 1873-r "On the basis of the state policy in the field of nutrition to 2020 year").

[Features to improve health care in "dietology" profile in Voronezh Region]

Recent years, restructuring of the health care to the population, including a complex of measures to improve the human resources policy in health, spurring the practice of the disciplines to public health care, turning, organizing 3-tier health care system, including the profile "nutrition" is carried out in Voronezh region. Analysis of security by dietitians, dietary nurses and hi-tech medical equipment is carried out. Set of measures to developing interaction between health care institutions (accordingly Health Ministry order N 474 from 24.06.2010) was worked up. Implementation of order of medical care in "Dietology" profile, high-quality dietitians work at all stages of 3-tier system of organization of medical care will make an unconditional contribution to the overall development strategy of the national health care.

[The Trp64Arg polymorphism of beta3-adrenoreceptor gene study in persons with overweight and obesity]

The development of obesity is determined by lifestyle and genetic mechanisms. In particular, the polymorphisms in the adrenergic receptor genes (ADRB) have been extensively studied for association with obesity-related phenotypes. ADRB3 is an obvious candidate gene given its involvement in the regulation of lipolysis and thermogenesis. ADRB3 Trp64Arg polymorphism, a missense mutation in the first transmembrane domain of the R3-adrenergic receptor is associated with visceral obesity and insulin resistance in the Pima Indian, French, and Finnish populations. The recent meta-analysis that combined data of 6582 individuals from Japanese populations showed significant association the Arg64 allele with increased BMI. There are tested the polymorphisms in the beta3-Adrenoreceptor (ADRB3) gene in associated with body mass index (BMI), fat mass and biochemical parameters.We have been examined 91 persons from Moscow region with BMI >25 kg/m2. The Trp64Arg polymorphism of ADRB3 genes were genotyped with the use of an allelic discrimination assay. The TaqMan-based real-time PCR method was applied. There have been estimated of anthropometric and biochemicalparameters. The frequencies of the Trp64Trp and Trp64Arggenotypes of ADRB3 gene were 82% and 12%, respectively, the frequencies of mutant allele was 6%. Trp64Arg genotypes of ADRB3 compared to Trp64Trp genotypes had significantly higher body fat percentage (respectively 48,6 +/- 0,96% and 43,8 +/- 1,72%, p<0,05), serum glucose (6,51 +/- 0,18 mmol/l and 5,67 +/- 0,09 mmol/l, p<0,01) and uric acid concentrations (0,46 +/- 0,02 mmol/l and 0,38 +/- 0,01 mmol/l, p<0,05). The test of the ADRB3 gene polymorphisms can be used for the personalization of diet in persons with obesity.

[Peculiarities of vitamin status in men and women with cardiovascular disease and obesity]

We explored the characteristics of the vitamin status in 471 patients with cardiovascular diseases, according to sex, and BMI values. All patients underwent examination of the system Nutritest-IP: studying their actual meals at home, determined anthropometric measurement, body composition, using biochemical methods evaluated the state of the protein, lipid and carbohydrate metabolism, the functional state of liver and biliary tract, hemostasis, vitamin provision. The results suggest a lack of availability of patients with vitamins C and B group. The number of patients with deficient serum beta-carotene increased proportional to body mass index. The concentration of beta-carotene decreased and vitamin E - increased in blood serum proportionally to increase the degree of obesity. Thus the availability of vitamins in the blood serum depends from sex and body mass index values of the patients. These data suggest that the rate of supply of vitamins are reliable markers to assess the adequacy of the diet consumed by the content of vitamins in people with normal body weight. Appraisingly the content of beta-carotene and vitamin E in the serum of patients it should be taken into account that they have overweight or obese, and abnormality of lipid spectrum of blood serum.

[The study of FTO rs9939609-gene polymorphism in the Sverdlovsk Region]

Recently independent studies, including genome-wide scans, have shown that the rs9939609 single-nucleotide polymorphism (SNP) in the first intron of the fat mass and obesity associated (FTO) gene were significantly associated with obesity in populations of European origin, in certain Asian (e.g.,Japanese and Chinese) and African American populations. In this study we examined the association between rs9939609 FTO variant and obesity related parameters in 394 individuals (262 males and 132 females; ages 20-70 years) from the Sverdlovsk area, Russia. A SNP variant rs9939609 was genotyped with the use of an allelic discrimination assay. The TaqMan-based real-time PCR method was applied. The prevalence of TT, TA and AA genotypes of rs9939609 FTO gene of this study was 34%, 47.5%, 18.5%, respectively, the minor A-allele frequency was 42.3%. In comparison to males, females had significantly higher the frequency of minor A-allele and AA genotype. The AA genotype was significantly more frequent in obese individuals (defined as body mass index > or = 30 kg/m2) than in non-obese (27.7 and 13.0%, respectively). Compared to the carriers of TT genotype, the likelihood of obesity was 3.0 for the carriers of AA genotype and 1.73 for the carriers of AA+AT genotype. These results confirm that genetic variation (rs9939609) FTO gene contributes to the etiology of obesity in the Sverdlovsk area.

[Genetic approaches to nutrition personalization]

The paper presents the results of studies conducted in recent years, which show that nutrients and bioactive food components, directly or indirectly regulate the functional activity of genes influencing gene transcriptome, proteome and metabolome. A definition of "nutrigenomics" - the science that emerged at the turn of nutrition and genetics, and studies the relationship of human nutrition with the characteristics of its genome in order to understand how food affects gene expression, and ultimately, on human health. It is shown that the cellular and molecular level, nutrients, first serving as a ligand, the receptors are transcription factors, and secondly, as a substrate or intermediate metabolites are incorporated into metabolic pathways whose products control the expression of genes and, thirdly, positive or negative effect on signaling pathways. We present results of their research, which characterize the rate of prevalence of polymorphisms of genes that are markers of risk for obesity. On the basis of domestic and foreign studies concluded that genetic markers can be used for the diagnosis and prognosis of alimentary-dependent diseases such as obesity, and as well as a predictor for the development of a personalized diet and forecast its performance.

[Effect of diet enriched with selenium on the psycho-emotional and adaptive capacity of patients with cardiovascular diseases and obesity]

It was studied the effect of diet enriched with selenium on the clinical and biochemical status, psycho-emotional and adaptive capacity of the organism in patients with diseases of the cardiovascular system. We examined 59 patients with cardiovascular disease and obesity, treated for 3 weeks antiatherogenic reduced calorie diet. Of these 36 patients from the index group took on the back of ground diet selenium containing diet product (part of alimentotherapy). Patients underwent clinical examination, biochemical parameters and the availability of selenium were measured. To assess the adaptive capacity of the organism we used Program Apparatus Complex. Quality of life of patients, overall health, level of anxiety and the dynamics of mental processes were assessed using SAS procedures, Spielberger-Hanin anxiety test, Serdyuk Quality of Life Questionnaire, Kraepelin's counting test. The results indicate positive changes in clinical and biochemical status, availability of selenium, adaptive capacity, psycho-emotional state of patients with cardiovascular disease and obesity because of the diet enriched with organic form of selenium. We revealed increase in activity, improvement of overall health and cognitive functions, mood stabilization, reduction of anxiety and emotional lability. The main differences observed between the groups identified in the leveling of the anxiety radical in psycho-emotional status of patients.

[The study of polymorphism rs9939609 FTO gene in patients with overweight and obesity]

In 94 persons living in the Moscow region, with a body mass index >25 kg/m2 were identified on the polymorphism rs9939609 FTO gene. The results showed that 83% of them were carriers of the mutant allele, and 43%--contained the mutant allele in the homozygous state. Carriers of the mutant allele rs9939609 FTO gene were distinguished by higher absolute and relative values of fat mass and triglycerides in serum.

[Dietary fiber influence on vitamins assimilation in patients suffering from cardiovascular diseases and adiposity]

Dietary fiber influence on vitamins C, E, B2 and beta-carotene assimilation from dishes enriched with protein, vitamins and fiber which were included in low-caloric diet of patients suffering from cardiovascular diseases and adiposity has been studied. It has been shown that high content of fiber in the supplement decreased vitamins E, B2 and beta-carotene assimilation while didn't effect on vitamin C availability.

[Contemporary approaches to nondrug correction of hypercholesterolemia]

Hypercholesterolemia (HCE) together with arterial hypertension and smoking belongs to three most powerful risk factors of cardiovascular diseases. Dietetic correction of HCE includes limitation of consumption of animal fat containing cholesterol, saturated and trans fatty acids, limitation of other cholesterol containing products and simple carbohydrates, increase in consumption of mono and polyunsaturated acids, plant protein, nutritional fibers, vitamins, mineral substances, and minor food components. Efficacy of such minor components of food as phytosterols has been demonstrated. Their use as supplements to fermented dairy product has facilitated significant lowering of total and low density lipoprotein cholesterol without negative action on the state of hepato biliary system.

[Definite of nutritional status in patients with metabolic syndrome with the use of modern methods of nutrimetabolomica]

A comprehensive assessment of nutritional status in 73 patients with metabolic syndrome was assessed. The consumption food pattern of the majority of examined patients have had increased energy intake with excessive fat consumption inadequate intake of complex carbohydrates. In patients with type 2 diabetes inadequate compensation of carbohydrate and lipid metabolism was marked. When assessing body composition method bioelectrical impedance analysis increased content of adipose tissue was revealed are positively correlated with insulin and tumor necrosis factor-alpha. According to indirect calorimetry, increase in the level of resting energy expenditure, reducing the rate of oxidation of fat, increase the rate of oxidation of protein and carbohydrates was noted.

[The system of multilevel diagnostics and corrections of nutrition status disorders in the patients with cardiovascular diseases]

As is known, the pathology of cardiovascular systems depends on nutrition and occupies leading positions in structure general morbidity and mortality of the population of Russian Federation. The system of nutritional and medical aids--"Nutritest" and "Nutricor", represent the technology of diagnostics of infringements the status of nutrition, estimations of risk of development of cardiovascular diseases, and ways of their high-grade correction.

[Dietary correction of nutrition status in patients with metabolic syndrome]

Effectivity was studied of a low-caloric diet in patients with metabolic syndrome. Results of the study show that enrichment of a low-caloric diets in patients with metabolic syndrome improved clinic status, antropometric levels, metabolism and lipid spectrum of blood.

[Multilevel study of actual nutrition in the complex analysis of nutritial status of patients with obesity]

The peculiarities of actual nutrition of the patients suffering from obesity have been studied with the use of a computer program. This computer program is based on studying the frequency of foodstuffs consumption and on the type of consumable substance. The results of the research demonstrate the violation of the basic nutrients consumption according to sex and the extent of obesity.

[Clinical efficiency of using laminaria jam enriched with selenium]

Effectivity was studied of a new dietary product enriched with organic form of selenium--laminaria gel in patients with ischemic heart disease and hypertonia. Functional condition of nervous and cardiovascular systems improved after intake of testing product. There were no any adverse changes in biochemical indices of patients receiving studied product. Intake of the product gave reliable increase in the selenium levels of blood serum only in patients with low content of this trace element.

[Current views of nutritional therapy]

Epidemiologic studies in the Research Institute of Nutrition showed that dietary patterns of the Russian population are on the whole at variance with the balanced feeding formula largely due to excessive consumption of animal fat, insufficient consumption of proteins, vitamins, micro- and macroelements, polyunsaturated fatty acids, and dietary fibers. It is estimated that over 70% of total lethality in this country is due to diseases directly related to improper feeding (the so-called alimentary-dependent diseases), cardiovascular disorders, some neoplasms, diabetes mellitus, etc. Dietary therapy adjusted to specific pathogenetic features, clinical picture, stage of the disease, character of metabolic disorders in individual patients is an important factor having versatile beneficial effects on the patient's health, correcting metabolic problems, and improving quality of life. Decree No 330 of August 5, 2003 "On measures to improve nutritional therapy in medical institutions of the Russian Federation" introduced a new nomenclature of standard diets based on chemical composition of separate foods and the previously used system of numbered diets. Modern dietary therapy includes not only standard and special diets but also specific products to be used in concrete clinical conditions, enteral and parenteral nutrition, biologically active food additives, etc.

[Efficiency of diet therapy containing carbohydrate-protein product enriched with vitamins and minerals in patients with cardiovascular diseases, obesity, and osteopenia]

It has been shown that inclusion of the specialized product containing 50% from recommended daily consumption of calcium, 20% of protein, 17-60% of 11 mineral substances and 11 vitamins in the diet of patients with cardiovascular diseases, adiposity and osteopenia within 6 months has prevented seasonal deterioration of vitamin D sufficiency and age reduction of mineral bone density while it has not liquidated the existing vitamin B2 deficiency. The data obtained confirm the expediency of the development of specialized products of the set chemical composition intended for a concrete category of patients, and their inclusion in the diet.

[Vitamin status and bone mineral density at patients with adiposity and the cardiovascular pathology]

It has been shown that among patients suffering from adiposity and cardiovascular diseases and osteopenia deficiency of vitamins C, E and D, estimated on their blood serum level, and also raised daily urinary excretion of vitamin B2 take place more often, than among patients with the same pathologies, but without osteopenia. The data obtained confirm the important role of these vitamins in the maintenance of a normal bone function.

[Efficacy of the use of a sour milk product enriched with phytosterols in diet therapy of patients with cardiovascular diseases]

We studied effect of antiatherogenic diet with inclusion of a sour milk product Danacor enriched with phytosterols on clinical and biochemical parameters of patients with cardiovascular diseases. Results of the study showed that antiatherogenic diet with phytosterols facilitated improvement of clinical status, anthropometric parameters, and lipid spectrum of blood.

[Peculiarity mineralization of osteous tissue of patients wits cardiovascular and gastroenteric pathologic and provision with vitamins and calcium]

Two groups of patients were studied. Group 1: patients with cardiovascular diseases. Group 2: patients with diseases of a gastro-intestinal path. Half of group has weight less than 56 kg. The study reported that distinct changes of bone tissue (mineral density as well as a high rate of bone tissue resorption) expose more often by patient 2 group than patient 1 group. In the both groups, patients were sufficiently supplied with vitamin D; however, in group 1 the concentration of 25-OH D3 was 1.9 fold lower and was close to the lower norm bound.