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The most common mechanism of the development of cardiovascular diseases is atherosclerosis, caused by genetic predisposition, hyperlipidemia, inflammation and metabolic disorders. Statins used in medicine inhibit endogenous cholesterol synthesis, but are characterized by diabetogenic effect, development of intolerance in 9.1%, and muscle symptoms in 10-25% of patients. Therefore, a well-chosen diet is important in atherosclerosis preventing. The aim of the research was to summarize modern concepts on the possibilities of preventing the development and progression of atherosclerosis with the help of food. Material and methods. A literature search to determine the significance of diet in atherosclerosis mechanisms was conducted using the PubMed, Scopus, Web of Science, Google Scholar, ResearchGate, and RSCI databases by keywords "atherosclerosis", "nutrition effects", "vegetarians", "mediterranean diet", "vegan diet", "plant food", "atherogenic food", "antiatherogenic food", "statins", "side effects", «complications». Results. The analysis of literature data showed that raw and cooked (unfried) plant products and their components have an anti-atherosclerotic effect, which affects various links in atherosclerosis pathogenesis. Polyphenols contained in berries, tea, fruit and vegetables reduce low-density lipoproteins, pro-inflammatory cytokines, suppress platelet aggregation, and normalize endothelium state. The results of meta-analyses indicate suppression of atherosclerosis development with the consumption of ω-3 polyunsaturated fatty acids, soy protein, turmeric, hot peppers, and vitamin D. Water-soluble and insoluble dietary fibers adsorb cholesterol, reduce its absorption and contribute to anti-atherogenic properties of intestinal microflora. Fermented dairy products, probiotics and prebiotics potentiate the synthesis of hypolipidogenic substances by the intestinal microbiota. The development of atherosclerosis is promoted by food rich in cholesterol, iron and sugar, any fried foods regardless of the fats used, consumption of foods containing phosphates and calcium as food additives. Conclusion. The use of competent diet therapy helps prevent atherosclerosis, which is especially important for patients with intolerance or contraindications to statin use. A comprehensive approach is needed in choosing the diet with limiting cholesterol-rich foods, and proper cooking without frying in oil, eating foods with antiatherogenic action. The search for new medicines based on bioactive compounds contained in plant products is promising.

The development of technologies for producing bacterial concentrates and enzyme preparations using domestic microbial strains is an urgent task. The use of whey protein hydrolysates as components of nutrient media for probiotic bacteria consortia for the cultivation of lactic acid and bifidobacteria makes it possible to improve and develop innovative processes for obtaining bacterial concentrates with the required functional properties for the production of dietary supplements. A consortium of probiotic microorganisms (lactic acid and bifidobacteria) was created in the All-Russian Scientific Research Institute of Food Biotechnology as a starter culture for specialized dairy products. Using strain Aspergillus oryzae 21-154 LAP a new complex enzyme preparation with a laboratory name Protoorizin LAP has been obtained providing the extensive hydrolysis of protein substrates. The purpose of the research was to evaluate the possibility of using the new domestic proteolytic enzyme preparation Protoorizin LAP in preparing whey-based nutrient media for culturing a consortium of probiotic microorganisms to obtain bacterial concentrates. Material and methods. The object of the research was a symbiotic consortium, including lactic acid bacteria strains (Lactobacillus delbrueckii ssp. bulgaricus Д-16, Lactobacillus plantarum 578/25, Lactobacillus helveticus 842(D)-2, Lactococcus lactis subsp. lactis М-12, Streptococcus thermophilus В-92) and bifidobacteria (Bifidobacterium longum Б-2). Unclarified curd whey and whey protein concentrate were taken as the nutrient medium basis. The media were treated with β-galactosidase to reduce the lactose content. In order to hydrolyze proteins, the control culture medium was treated with commercial preparations: serine protease - Alcalase® 2.4 L and leucine aminopeptidase - Flavourzyme® 1000 L. In the experimental medium, two imported preparations were replaced with a laboratory sample of the enzyme preparation Protoorizin LAP. In the prepared nutrient media, the content of amine nitrogen, free amino acids and soluble protein was determined, and electrophoretic analysis of proteins and peptides was carried out. The consortium growth was monitored by the content of dry substances and reducing sugars, by active and titratable acidity, as well as by microscopy. The number of viable cells of lactic acid bacteria and bifidobacteria at the end of fermentation and in the resulting bacterial concentrates were determined by sieving on the appropriate selective agar media using an automatic colony counter. Results. The effectiveness of Protoorizin LAP in the hydrolysis of whey proteins significantly exceeded the result of the combined action of Alcalase® 2.4 L and Flavourzyme® 1000 L both in terms of reducing the undigested protein content, including immunogenic fractions, and in terms of the yield of soluble protein, amine nitrogen and amino acids. The nutrient media obtained using proteases ensured good

The body composition monitoring using bioimpedance analysis (BIA) is important in assessing the functional state of athletes in sports. Based on changes of body composition, it is possible to optimize the actual dietary intake, as well as successfully organize the training process. The purpose of this research was to conduct a comparative assessment of BIA parameters and rest energy expenditure (REE) in highly trained cross-country skiers and young non-athletes. Material and methods. The members of the national cross-country skiing team from the Komi Republic and Russian Federation (n=30; age - 22.3±2.7 years) were examined. Practically healthy medical students served as a control group for the present study (n=40; age - 20.2±2.4 years). The participants successively passed the following study steps: assessment of the body composition by BIA (ACCUNIQ BC380), REE determination by indirect non-fasting calorimetry and calculation technique. Results. The parameters of total body water, fat-free mass, lean tissue and body cell mass were higher in contrast to the fat mass percentage in the athletes (р<0.001). The calculated REE was lower than measured REE among all the participants. At the same time, the REE calculated by the Ketch-McArdle formula significantly differed between the groups, while no differences were found between the REE calculated by the Harris-Benedict prediction equation. The measured REE were significantly higher by 16% (p<0.001) i n athletes compared to those in the control group. Conclusion. The body composition of athletes was distinguished by a significantly higher amounts of total body water, fat-free mass, skeletal muscle, active cell mass, and lower percentage of fat mass compared to healthy untrained individuals. The results obtained among athletes coincided with the idea that the magnitude of REE is determined by the mass of metabolically active tissues and to a lesser extent depends on the fat mass. BIA results can be used to monitor athletes' body composition during the training process.

The development of innovative ingredients of specialized formula for children with intolerance to cow's milk proteins requires accounting the influence of the protein component on the allergic sensitivity. The aim of the research was to study the effect of lactoferrin (LF) from cow colostrum, cow's milk protein hydrolysate (CMPH) and mare's milk protein hydrolysate (MMPH) on the severity of the systemic anaphylaxis reaction, the levels of specific IgG antibodies and cytokines in rats parenterally sensitized with ovalbumin (OVA). Material and methods. The experiment was carried out on 4 groups of 26 male Wistar rats, which were sensitized intraperitoneally with chicken egg OVA and a systemic anaphylaxis reaction was induced on the day 29 by intravenous administration of a challenge dose of the antigen (6 mg per kg body weight). LF, CMPH and MMPH were introduced into the diet in doses of 1.4-2 g/kg body weight per day (on an average 1.59±0.04, 1.53±0.05 and 1.48±0.05 g per kg body weight respectively). The content of IgG antibodies in the blood serum was determined by an indirect ELISA; the levels of cytokines IL-1α, IL-1β, IL-2, IL-4, IL-5, IL-6, IL-10, IL-12(p70), IL-13, GM-CSF, IFN-γ and TNF-α were detected by multiplex immunoassay. Results. Dietary LF did not have a significant effect on the severity of active anaphylactic shock (AAS), concentrations of antibodies and cytokines in the blood of animals. As a result of CMPH consumption, there were no significant changes in AAS severity and IgG antibodies to OVA but significant increase in TNF-α level was observed as well as a significant decrease in IL-1α (p<0.05). In animals receiving MMPH, there were also no significant changes in the severity of AAS, but a 1.9-fold decrease in the level of IgG antibodies to OVA (p<0.001) was noticed along with a significant increase in IL-12(p70) (p<0.05) and IL-10 (p<0.10) level. Conclusion. Cosumption of LF by sensitized rats didn't significantly affect their anaphylactic sensitivity and cytokine profile, while CMPH intake induced some signs of pro-inflammatory processes. Consumption of MMPH was accompanied by the formation of an anti-inflammatory cytokine profile, which corresponds to a decrease in the intensity of the humoral immune response to the model allergen. Differences in the effects of two hydrolisates, which have similar degrees of hydrolysis, may be associated with the specific composition of glycopeptides formed during the enzymatic cleavage of milk protein produced by these two species of dairy animals.

Cholecystectomy (CE) is one of the most frequently performed surgical interventions and the main method of symptomatic gallstone disease treatment. Despite the widespread implementation of minimally invasive surgery techniques, significant proportion of patients develop spectrum of symptoms after CE. These manifestations require correction with different approaches including medical nutrition. The aim of the research was to perform structured review of recently published data related to diet therapy and nutritional support of patients after CE. Material and methods. A literature search was performed in PubMed/MEDLINE, EMBASE, Cyberleninka, eLibrary databases using the keywords "Cholecystectomy" in combination with "Diet", "Medical nutrition", "Nutritional support" and their Russianlanguage equivalents for the relevant databases. Correct description of interventions, analyzed outcomes, statistical processing and found effects where necessary for the inclusion to the analysis. Duplicate publications were excluded. Results and discussion. A review of the recommendations on nutritional support after CE has been conducted, including handbooks and clinical guidelines, results of relevant clinical trials evaluating the efficacy of different measures of nutritional support. The rational of traditionally used dietary approaches for the correction of symptoms that develop after CE has been assessed, as well as recently published data on the effectiveness of nutritional support methods. Conclusion. Disturbed regulation of bile secretion in the early CE postoperative period may support the need for limitation of fat consumption. Impaired circulation of bile acids and possible changes in the balance of intestinal microbiota may support the need for the use of prebiotics (like dietary fiber), as well as probiotics, especially when antibiotic treatment was administrated for the patient. These interventions may be important from the viewpoint of prevention of late complications after CE.

Chronic disturbances of consciousness (CDC) are a consequence of severe brain damage and are conditions that arise after emerging from a coma with the preservation of the sleep-wake cycle in the absence of signs of conscious behavior. When conducting inpatient medical rehabilitation of this group of patients, the state of nutritional status is not always taken into account and, as a rule, there is no nutritional support with an assessment of metabolic needs, including the introduction of various modes of physical activity during physical therapy and an increase in physical load on the patient's body. The purpose of the study was to assess the nutritional status and optimize the nutritional support system in patients with CDC at the inpatient stage of medical rehabilitation (MR). Material and methods. The study analyzed the results of examination and treatment of 152 patients with CDC of traumatic origin who received medical rehabilitation from 2016 to 2022 in the Department of Physical and Rehabilitation Medicine of the Nikiforov Russian Center of Emergency and Radiation Medicine, Ministry of Russian Federation for Civil Defense, Emergencies and Elimination of Consequences of Natural Disasters. Results. In patients with CDC of traumatic genesis, signs of malnutrition (objective, anthropometric, laboratory) were diagnosed at the inpatient stage of MR, and there were also risks of malnutrition progression with the introduction of additional physical activity. Conclusion. To create an effective and adequate nutritional support system during inpatient MR, metabolic monitoring (indirect calorimetry) is of fundamental importance, taking into account the influence of additional physical activity. The use of a calculation method for estimating energy requirements can lead to hyperalimentation.

Nowadays all over the world there is an active search for new promising bioactive compounds and evaluation of their efficiency and safety for the usage in food for special dietary uses in order to form balanced healthy diets for different groups of consumers (children, pregnant and lactating women, etc.) or inclusion in diet therapy in order to increase the effectiveness of prevention and treatment of non-communicable diseases and reduce the need for medical care. Such substances can be cyclic peptides - compounds with a unique structure, thanks to which the stability of their configuration and high bioavailability are achieved, which, in turn, allows them to exhibit a wide range of biological effects. Basically, these bioactive compounds are extracted from the leaves and stems of medicinal plants or plants that have no tradition of food use in our country. Common flax (Linum usitatissimum), a crop widely used in nutrition, is practically their only food source. The purpose of the research was to generalize information on biological activity of flax cyclic peptides in order to assess the prospects of their food application. Material and methods. Systematic analysis of scientific literature was carried out using keywords (Linseed, or Flaxseed, or Flax, or Linum usitatissimum) and (Orbitide, or Cyclolinopeptide, or Linusorb, or LOMIX) in Google Scholar, PubMed systems. A total of 500 publications were identified and analyzed. Publish or Perish software was used for analysis. The topics of the publications were analyzed using KH Coder software. Results. Cyclic peptides are among the least studied components of flax, and the profile of cyclic peptides of domestic flax seed varieties has not been described so far. At the same time, the results of preclinical studies of flax cyclic peptides represent promising data that open prospects for their use in the therapy of various diseases. Immunosuppressive and anti-inflammatory activity, as well as hypocholesterolemic and antioxidant effects of flax cyclic peptides have been demonstrated. Conclusion. The current information on the biological activity of cyclic peptides is incomplete and should be expanded by new data obtained, in particular, in in vivo models and clinical trials. The study of the composition of flax cyclic peptides from domestic raw materials, the development and implementation of the methods of their extraction will contribute to the sustainable development of the industry and will allow reorienting the production of oilseed raw materials from its export to the introduction of knowledgeintensive technologies.

Digital interactive learning is spreading across many medical specialties, using a variety of methods: from problem-solving simulators to standardized patients, from computer modeling to mannequins. The purpose of the study was to analyze innovative approaches to independent work when studying issues of child nutrition by pediatric students and practicing doctors. Material and methods. The pediatric simulator, developed by the Higher School of Education and Science in collaboration with the teaching staff of seven medical universities in Russia, allows you to train and test students in conditions close to real ones, and to reinforce the issues of child nutrition. An analysis of the effectiveness of organizing online education among students (n=150, 15.7% boys, 85.3% girls, average age - 20.0±1.4 years; duration - February-May 2020) of the 3rd year of Sechenov and Smolensk Medical Universities was carried out using a single-blind randomized controlled trial. Using Google forms, the questionnaire was created with questions regarding the respondents' attitude towards distance learning. The effectiveness of distance learning on the studied simulator was analyzed for 84 students (n=48 - main group, n=36 - control group), a case analysis was carried out with the prescription of the diet therapy to a virtual patient with the lactase deficiency. Results. In two modes of the program (training and testing) the imitation of a dialogue with a virtual 3D patient, examination, diagnosis and treatment, including diet therapy were implemented. A number of diet therapy algorithms are presented in additional illustrations. The use of a children's simulator with a 10-point assessment system showed greater effectiveness in mastering practical skills in the main group compared to the control group. The students who mastered the digital simulator indicated satisfaction in acquiring new knowledge and skills, increased motivation to learn and gain practical skills in examination, supervision and prescription of the diet therapy, approaching 6-9 points (р=0.005). For the control group, the questionnaire showed consistently low results (p<0.05). Analysis of the prescription of the diet therapy in a situational task showed good and excellent results for all students of the main group. Conclusion. The interactive digital simulator has shown high efficiency in training future pediatricians. Clinical cases help develop practical skills and build professional competencies, including child nutrition issues.

The study of the genetic determinants of the disaccharidase activity opens up new prospects for improving diagnostics and choosing medical tactics in gastroenterology. The aim of the study was to systematize the data on the role of the sucrase-isomaltase gene (SI) in regulating sucrose metabolism and the contribution of SI mutations to the prevalence of sucrose malabsorption disorders (sucrase-isomaltase deficiency, SID) and certain forms of enterological pathology in different population groups. Material and methods. A review of the peer-reviewed scientific literature, mainly in the PubMed database (https://pubmed.ncbi.nlm.nih.gov) and eLibrary (https://elibrary.ru), was conducted using key words: carbohydrate malabsorption, sucrase, sucrase-isomaltase deficiency, sucrase-isomaltase SI gene. The search depth was not specified, but particular attention was paid to recent publications. The gnomAD database (https://www.ncbi.nlm. nih.gov/snp/rs781470490) was also used. Results. According to the review results, 37 out of 150 known SI gene mutations have been confirmed to contribute to reduced sucrase activity or restricted sucrase production. The prevalence of point mutations in the SI gene is estimated at 0.0006%, but carrier rates of the SI delAG deletion (rs781470490), manifested as homozygosity in SID, are very high (5-21%) in indigenous populations of Arctic regions in East Asia and America. Medicalgenetic research methods improve the accuracy of differential diagnosis of primary and secondary SID and other forms of disaccharide and polysaccharide malabsorption. The formation of databases on the prevalence of genetic determinants of sucrase-isomaltase insufficiency is a promising way to refine the epidemiology of SID. There is an increased (0.2-2.3%) risk of clinical manifestations of SID in homozygous carriers of the SI delAG mutation in the Chukotka, Kamchatka, and Northern Priochotye populations. Verification of reports on a less pronounced tendency to lipid metabolism disorders in SI delAG carriers compared with the control group is recommended. Conclusion. Manifestations of mutant SI variants in the phenotype are associated with the presence of accompanying carbohydrate malabsorption variants and specific gut microbiota. The SI 15Phe variant (rs9290264) may contribute to the development of irritable bowel syndrome.