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An urgent problem of modern healthcare is overweight and obesity, accompanied by many concomitant diseases. Negative trends in the health of the population and the growth of alimentary pathology puts domestic medicine in the front of the need to create units whose main task will be to provide specialized nutritional care and conduct sanitary and hygienic education among the population. Objective. Evaluation of the effectiveness of the comprehensive programs of the medical center «Healthy Nutrition» of the Samara State Medical University in the prevention of non-communicable diseases in the population of the Samara region. Material and methods. A retrospective analysis of the data of medical records of 2.271 patients of the medical center «Healthy Nutrition» of Samara State Medical University was carried out. Based on the anthropometric examination, the body mass index was calculated, and bioelectrical impedance analysis was performed to assess the body composition. The assessment of the actual nutrition was carried out by an automated method using the computer program «Nutri-prof». Results. Among the examined, only 14% of patients had a normal body weight, in 27% of cases overweight was observed, in 56% - obesity of varying degrees at the start of diet therapy. Type 2 diabetes mellitus and insulin resistance were found in 27% of cases with overweight, with obesity of the 3rd degree their prevalence increased more than twice in men and almost twice in women. Patients were recommended weight loss programs that include not only diet therapy, but also hardware techniques. Upon completion of the comprehensive body weight correction program, the number of patients of both sexes with normal body weight increased more than 4.5 times - from 14 to 66%. Conclusion. The comprehensive weight loss program provided at the medical center «Healthy Nutrition» has shown its effectiveness in the treatment of overweight, obesity, as well as in the prevention of non-communicable diseases.

Studies of the recent decades indicate the prevalence of insufficient blood vitamin D levels in the population of many regions of the Russian Federation, which varies significantly depending on the age of a person and the season. The aim of the research was to study the seasonal variability of vitamin D status in different age groups of the population of the Khanty-Mansiysk Autonomous Okrug - Ugra. Material and methods. Data on the vitamin D status of the population living in the Khanty-Mansiysk Autonomous Okrug - Ugra in 2020-2022 were obtained based on statistical processing of 31,595 impersonal measurements of calcidiol levels [total 25(OH) D₂ and 25(OH)D₃] in the blood serum of residents of the Autonomous Okrug, carried out in the laboratories of INVITRO-Ural LLC using the chemiluminescent microparticle immunoassay. After rejection, the materials were divided into the following age groups: 0-11 months (n=320), 1-2 years (n=398), 3-6 years (n=881), 7-10 years (n=954), 11-14 years (n=1002), 15-17 years (n=861), 18-20 years (n=661), 21-24 years (n=1137), 25-30 years (n=1704), 31-40 years (n=8708), 41-50 years (n=5310), 51-60 years (n=3686), 61-70 years (n=1997), over 70 years (n=570). Results. In the Khanty-Mansiysk Autonomous Okrug - Ugra, the highest serum concentration of 25(OH)D, which did not fall below 30 ng/ml during the year, was observed in infants (under one year of age). As age increased, serum calcidiol levels decreased in each age group (p<0.0001), and the prevalence of vitamin D deficiency increased. The lowest mean serum calcidiol level (up to 12-14 ng/ml) was observed in the spring months in adolescents and young adults aged 11 to 24 years. In higher age groups, vitamin D status increased gradually, but statistically significantly (p<0.0001). In middle-aged and elderly residents (30-70 years), the average calcidiol level did not fall below 22 ng/ml throughout all seasons, and in summer and autumn it was at a level of 26-29 ng/ml, close to sufficient (30 ng/ml). In residents over 70 years of age, vitamin D status was slightly lower than in the 61-70 age group in winter (p≤0.05), and did not differ in summer, but regardless of the season it was significantly higher (p≤0.001) than in adolescents and young adults. Conclusion. The obtained results allow us to recommend vitamin D supplementation in moderate doses to middle-aged and elderly individuals who do not belong to risk groups during the period of detection of the lowest serum 25(OH)D level from December to May. Adolescents and young adults aged 11 to 24 years need periodic screening of 25(OH)D level in blood serum throughout the year, especially in the winter and spring months, and vitamin D intake in doses that ensure maintenance of serum calcidiol at a level of at least 30 ng/ml.

In order to navigate the research results when determining the somatotype profile, it is necessary to know certain patterns that the somatotype undergoes during growth and development, as well as the features of body type formation depending on gender, age, race and the level of physical activity. The purpose of the research was to identify the main patterns of somatotype formation and dynamics during ontogenesis depending on gender, age, race, the level and nature of physical activity. Material and methods. 40 literature sources were analyzed, searches by keywords "Heath-Carter scheme", "Sheldon scheme", "somatotype", "sports somatotyping", "children's somatotyping" were performed in the PubMed, Scopus, Web of Science Elsevier, eLibrary databases. Results. There are no differences in the distribution of somatotypes between boys and girls aged 1-4 years. After 5 years, the somatotype profile of boys shifts towards a higher mesomorph score, and the somatotype profile of girls - towards higher endomorph and ectomorph scores, which reflects a typical adolescent restructuring, expressed in masculinity of boys and endomorph changes of girls. This divergence of somatotypes continues until the age of 18. Further, in the subgroups of adult men and women, the somatotype undergoes the same changes regardless of gender, expressed by an increase in the score values of the endomorph and mesomorph components up to the age of 60. The differences in the somatotype profile depending on ethnicity and place of residence (rural or urban residents) are associated with different physical activity, eating habits, diet and genetic hereditary factors. The score values of the somatotype components in athletes differ from those in persons with sedentary lifestyle, and athletes of various sports specializations differ from each other in somatotype profile. Conclusion. Along with the assessment of morphological parameters and body composition, somatotyping is one of the methods for a comprehensive assessment of the level of physical development, expanding the understanding of the ratio of muscle and fat components of body mass. The existing data on the prevalence of various somatotypes in the a conditionally healthy population are indicative for a comparative assessment of newly examined individuals, since on the one hand the somatotyping results depend to a certain extent on the method of obtaining data; and on the other hand the somatotype profile changes during ontogenesis, and is influenced by gender, age, ethnicity, as well as the level of physical activity and even sports specialization.

The intestinal mucosa selectively passes food antigens, which are foreign agents but do not provoke an immune response in the intestine. The increased permeability of the intestinal barrier is affected by chronic sluggish inflammation, deficiency of IgA, impaired paracellular transport and the frequency of food consumption. The aim of the study was to provide a comparative quantitative assessment of IgG class antibodies to food antigens in patients with metabolic syndrome and practically healthy people, depending on the type of diet and levels of general inflammation.

Material and methods: In the prospective cohort study in 230 people, including 110 patients with metabolic syndrome (average age 33.9±1.1 years), clinical and biochemical parameters: total cholesterol, low and high density lipoproteins, triglycerides and glucose, cytokines: IL-1b, IFN-γ, IL-10, C-reactive protein, levels of apoptosis and necrosis of lymphocytes, catecholamines: adrenaline, noradrenaline, dopamine, serotonin, as well as levels of specific IgG to food antigens in blood serim have been compared. The analysis of personal data on the nutrition (frequency of food consumption) and hereditary predisposition to metabolic syndrome was carried out.

Results: It was found that the parents of the examined individuals with metabolic syndrome are twice as likely to hav e obesity and type 2 diabetes mellitus (correspondingly in 73.3 and 36.4% vs 36.7 and 23.3% in healthy persons, p<0.05). The diet of people with metabolic syndrome is characterized by more frequent consumption of foods containing refined carbohydrates, salt, saturated and trans-isomers of fatty acids, with low levels of plant products, dietary fiber, polyunsaturated fatty acids and complex carbohydrates. A 3-fold increase in IgG levels to food antigens in patients with metabolic syndrome was associated with a higher (p<0.05) blood serum level of pro-inflammatory cytokines (IL-1β - 8.99±1.05 vs 1.99±0.30 pg/ml in healthy persons, IFN-γ - 22.21±6.50 vs 7.59±0.96 pg/ml), IL-10 (13.90±1.96 vs 5.03±0.81 pg/ml), C-reactive protein (1.96±0.31 vs 4.47±0.61 mg/ml), noradrenaline (168.4±6.8 vs 131.3±2.8 ng/ml), which was not compensated by adrenaline (52.3±9.3 vs 54.3±2.4 ng/ml).

Conclusion: Against the background of impaired glucose and lipid homeostasis in metabolic syndrome and higher levels of general inflammation, epithelial dysfunction is formed, resulting in increased permeability to antigens through the intestinal barrier. Changes in the level of antibodies to food antigens in metabolic syndrome are non-specific, which is reflected in an increase in IgG levels for all food groups independent from the frequency of their consumption.

The athletes' energy and nutrient requirements are calculated based on individual energy expenditure and body composition indicators. This takes into account the different ratios of proteins, fats and carbohydrates recommended for sports with different physical activity levels, as well as the changing ratio of macronutrients depending on the physical activity coefficient. The purpose of the research was to assess the energy and nutrient requirements of female athletes involved in synchronized skating based on the results of assessing morphological indicators and daily energy expenditure.

Material and methods: The study involved female athletes (n=22, age 21.4±4.5 years) specializing in synchronized skating, who were divided into three groups according to their sports ranks (8 candidates for master of sports, 10 masters of sports of Russia and 4 masters of sports of Russia of international class). Overall dimensions were assessed using anthropometry, body composition and basal metabolic rate were assessed using bioimpedancemetry, resting metabolic rate was assessed using indirect calorimetry, a dosed load test was performed on a bicycle ergometer, daily heart rate monitoring was performed, and athletes' daily activity was recorded using self-registration.

Results: Changes in morphological indices were revealed that occur when female athletes move from one athletic skill group to another, higher one. With the growth of athletic skill, female athletes become taller and more massive, their indices of metabolically active tissues (lean and skeletal-muscular) increase while maintaining the level of fat mass. In general, the basal metabolic rate of female athletes in the group was 1426 [1382; 1486] kcal/day, daily energy expenditure was 3177 [2788; 3507] kcal/day. Daily energy expenditure varied significantly and depended on both the training and non-training activities of the athletes. The calculation of the need for nutrients and energy complies with the requirements of MR 2.3.1.0253-21, as well as recommendations for the ratio of macronutrient shares in the diet of female athletes in complex coordination anaerobic sports, and with a Physical Activity Coefficients (PA Values) of 2.4, 2.6 and 2.8 was made based on the principle of not exceeding the need for macronutrients per 1 kg of body weight: in proteins - no more than 1.96 g/kg body weight; in fats - no more than 1.66 g/ kg body weight; in carbohydrates - on a residual basis.

Conclusion: For athletes whose requirements exceed the regulated norms with PA Values of more than 2.2 (according to MR 2.3.1.0253-21), when calculating the need for proteins, fats and carbohydrates, and their share contribution to the calorie content of the diet, the percentage ratio of macronutrients should be changed depending on the need in grams per 1 kilogram of body weight.

The upper tolerable intake levels (ULs) for vitamins and minerals and their content in the widely consumed foods and in a specialized nutrition (SN) become very relevant due to the growing interest in both segments fortification. The substantiation of these micronutrients' tolerance limits in fortified foods and dietary supplements (DS) is complicated by the fact that such products are dedicated to eliminate micronutrient deficiencies without excessive intake at the population and individual levels. ULs substantiation for vitamins and minerals is the key element in this issue resolving, while ULs of these micronutrients have not been updated for more than 17 years in the Russian Federation. The aim of the research was to analyze and to summarize the current approach to the substantiation of micronutrient safe levels of intake based on health risk and safety assessment, in particular for vitamins and minerals, as well as for other bioactive compounds.

Material and methods: A literature search was conducted in Russian and in English using the peer reviewed sources database PubMed, Russian on-line scientific platforms eLibrary and CyberLeninka, official European Food Safety Authority (EFSA) on-line platform.

Results: The paper describes current approaches to safe intake level determination for micronutrients (vitamins and minerals) based on the risk assessment. Both scientific and regulatory sources in the field of setting safe levels of intake for micronutrients and bioactive compounds were reviewed. The four steps risk assessment process for establishing ULs for vitamins and minerals is given. The process is based on the complex assessment of possible adverse health effects on humans. The need to update the ULs is identified for the following micronutrients: vitamin A (retinol) and carotenoids, vitamin B9 (folates), vitamins D and C; minerals - calcium, magnesium, potassium; trace elements - iodine and iron.

Conclusion: Actual data based on the latest scientific information for the purpose of consumption levels substantiation and, in turn, micronutrient content standardization in food - is a necessary element to ensure the disease prevention efficiency using fortified foods, SN and DS. For the vitamin A (retinol) and carotenoids; vitamins B9 (folates), D and C; minerals (calcium, magnesium, potassium); trace elements (iodine and iron) - it is advisable to provide an action plan allowing to update the existing Russian ULs for DS and SN dedicated to the adult population.

Congenital epidermolysis bullosa (EB) is a rare genetically heterogeneous disorder characterized by blistering and erosions of the skin and mucous membranes. The dystrophic form of EB is particularly associated with severe complications including cutaneous squamous cell carcinoma (cSCC) and gastrointestinal tract involvement (esophageal strictures, malabsorption). These conditions frequently lead to protein-energy malnutrition, significantly worsening patient prognosis and quality of life. The purpose of the study was to present a clinical case of nutritional support implementation in a patient with dystrophic EB complicated by cSCC.

Material and methods: From 2015 to 2025, 79 EB patients (age range 18-74 years, mean age 29.4±11.1 years) were monitored at the Burn Department of the Nikiforov Russian Center of Emergency and Radiation Medicine, EMERCOM of Russia. This cohort represented 62.6% of all registered EB cases in the Russian Federation. cSCC was diagnosed in 14 (17.7%) patients. We present a clinical case demonstrating the impact of nutritional support in an adult patient with dystrophic EB and cSCC.

Results: Timely nutritional intervention was shown to enhance wound healing and overall clinical status, reduce catabolic stress, optimize preparation for antitumor therapy.

Conclusion: Our findings emphasize the critical importance of early nutritional support implementation within a multidisciplinary management approach for EB patients with oncological complications. The study demonstrates that appropriate nutritional intervention can significantly improve clinical outcomes in this challenging patient population.