Clinical nutrition and metabolism

Научно-практический медицинский журнал, цель которого – публиковать актуальную информацию о современных подходах к проведению нутриционной поддержки при различных состояниях и заболеваниях.

Целевая аудитория журнала –  специалисты в области анестезиологии- реаниматологии, пульмонологии, хирургии, онкологии, неврологии, гастроэнтерологии, диетологии, педиатрии, терапии, а также врачи общей практики.

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Current Issue

Vol 1, No 3 (2020)

ORIGINAL STUDIES
Vitamin status of patients with certain chronic non-communicable diseases
Sharafetdinov K.K., Kodentsova V.M., Vrzhesinskaya O.A., Kosheleva O.V., Beketova N.A., Leonenko S.N., Plotnikova O.A., Pilipenko P., Gapparova K.M., Pilipenko V.I., Derbeneva S.A.
Abstract

Background. Inadequate supply with vitamins is a risk factor for the development of many nutritionally-related diseases and their progression. Data on the actual vitamin status of patients are necessary to develop measures for its improvement.

Aim. To characterize the supply of persons with non-communicable diseases with vitamins A, E, C, B2 and β-carotene by determining their level in the blood of patients.

Material and methods. The blood serum level of vitamins C, A, E, B2 and β-carotene in 138 patients (41 men and 97 women) 22–80 years old with cardiovascular diseases, obesity, gastrointestinal diseases, type 2 diabetes mellitus (T2DM), osteoarthrosis has been determined.

Results. Vitamin C concentration corresponded to adequate status in approximately 2/3 of the examined patients; among patients with T2DM, such sufficiency occurred 1.6–1.9 fold less often than in other groups. The frequency of reduced levels of vitamins C, A and E was statistically significantly more frequent in patients with gastrointestinal diseases. The γ-/α-tocopherol ratio in the serum of patients in all groups was close to 1:50, while in patients with gastrointestinal diseases reached 1:60.7. The proportion of patients sufficiently supplied with all studied vitamins ranged from 15.8 to 70.0%. Patients with osteoarthrosis were best of all provided with all vitamins: multiple (3 or more vitamins) vitamin deficiency was not found. In other groups of patients, multiple vitamin deficiency occurred in 5.3–27.6% of the examined (an average of 16.4%). Among patients with gastrointestinal diseases there was not a single person sufficiently provided with all the studied vitamins. Multiple vitamin deficiency in patients with gastrointestinal diseases was detected more often (p <0.01) compared with patients with T2DM and osteoarthrosis. Given the high prevalence of vitamin D deficiency, it is possible to extrapolate that a significant proportion of patients with a combined deficiency of 2 vitamins (6.9–31.6% in the samples examined) will move into the category of persons with a simultaneous deficiency of 3 vitamins.

Conclusion. The purposeful development of supplements containing effective doses of vitamins for various nosologies is necessary.

Clinical nutrition and metabolism. 2020;1(3):105-116
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REVIEWS
The Role of Nutritional Support in the Treatment of Liver Malignancies.
Obukhova O.A., Kurmukov I.A., Yunaev G.S.
Abstract

In order to describe the necessity and safety of nutritional support in liver malignancies, we performed a search and analysis of publications on the topic published in the medical databases eLibrary, PubMed, Medline. Based on the data obtained, it was shown that patients with malignant liver disease have anorexia-cachexia syndrome. Nutritional support for perioperative hepatic malignancies improves immediate surgical outcomes. Isocaloric enteral nutrition with a high protein content is considered the drug of choice. The additional use of branched chain amino acids (BCAA) is not unambiguously interpreted. When conducting modern anticancer treatment, nutritional support is considered as an integral component of complex therapy, contributing to the achievement of the best results at all stages of the treatment process.

Clinical nutrition and metabolism. 2020;1(3):117-126
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Oxidative stress and increasing antioxidant defence in type 2 diabetes
Sharafetdinov K.K., Plotnikova O.A., Pilipenko V.V., Nikitjuk D.B.
Abstract

The article discusses topical issues reflecting the high prevalence of diabetes mellitus (DM), the continuing trend towards an increase in the number of patients, the high incidence of vascular complications that lead to early disability and high mortality. The review presents current data on the role of oxidative stress in the development and progression of vascular complications in patients with type 2 diabetes, as well as the mechanisms underlying the imbalance between prooxidants and the antioxidant defense system in this disease. The article presents the role of a balanced diet in achieving metabolic goals and increasing antioxidant protection in type 2 diabetes. The review provides data on the role of vitamins in the correction of metabolic disorders in type 2 diabetes. The increased need for antioxidant vitamins in diabetes is due to impaired glucose metabolism in this category of patients. Food products, which contain polyphenolic compounds, have a pronounced antioxidant and antithrombotic activity, which favorably affect metabolic parameters that contribute to weight loss. Thus, one of the ways to optimize the therapeutic nutrition of patients with type 2 diabetes is the inclusion in the standard hypocaloric diet of specialized food products containing antioxidant vitamins and minor biologically active substances with pronounced antioxidant properties.

Clinical nutrition and metabolism. 2020;1(3):127-136
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Risk groups for multiple vitamin and mineral deficiencies in the population
Pogozheva a., Kodentsova V.M.
Abstract

Lack of several vitamins, calcium, magnesium, zinc, iodine and other minerals in the diet now is typical for the majority of the adult and children’s population of Russia, regardless of where they live, throughout the year. In addition, population groups that are additionally at risk of developing micronutrient deficiencies exist. Children 2–3 years old when switching to food from a common table, early puberty, pregnant and lactating women, persons with food intolerances and allergies, persons on elimination diets (vegetarians, vegans, etc.), or enriching the diet with dietary fiber, obese persons (reduced by caloric content of the diet), persons with gastrointestinal diseases (sparing diets, persons receiving drug therapy, persons with increased physical and psycho-emotional stress, the elderly, persons observing long-term religious fasts, athletes controlling body weight are among them. The role of each micronutrient depends on the sufficiency of the body with other micronutrients involved in the metabolism or necessary for the realization of the final function in the body. A recognized and scientifically grounded way to improve micronutrient status is the enrichment of the diet with vitamins and minerals. In the absence of mandatory fortification of mass-market foods the use of vitamin and mineral supplements is a great idea. The selection criterion is a complete set of vitamins and microelements, the deficiency of which is characteristic for a particular group of the population, and in doses close to the physiological needs of the body.

Clinical nutrition and metabolism. 2020;1(3):137-143
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Regulatory framework in sports nutrition in the Russian Federation (review)
Kobelkova I.V., Nikitujk D.B., Radzhabkadiev R.М., Vybornaya K.V., Lavrinenko S.V., Semenov M.М.
Abstract

Nutrition plays a key role in achieving high professional results and maintaining the health of athletes. Terms in the nutrition of athletes are interpreted in different ways. In the Russian Federation, there are normative act regulating definitions of athletes' nutrition, specialized foodstuffs and biologically active food additives for athletes, and parameters of diets. Uniformity in the use of terminology will lead to uniqueness and accuracy of descriptions and analysis of research results, as well as an understanding of recommendations in the field of nutrition of athletes.

Clinical nutrition and metabolism. 2020;1(3):144-152
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