COVID-19: new challenges for medical science and practical health
Currently, due to the wide spread of the new coronavirus infection COVID-19 and the need for anti-epidemic measures, medical science should integrate all efforts to ensure, on the one hand, at the global level - the fight against the spread of infection, on the other hand, at the individual level - increasing the adaptive capacity and immune response of the organism to protect against COVID-19. Nutrition is the most important factor determining human health and the functioning of all mechanisms to protect a person from negative environmental factors. For the prevention and treatment of new coronavirus infection COVID-19, a significant role is played by the correction of eating disorders, including vitamin and micronutrient deficiency. Federal Research Centre of Nutrition and Biotechnology, together with Russian Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor), prepared Recommendations on nutrition for children and adults, requiring a self-isolation regime or quarantine at home in connection with COVID-19. In order to promptly inform and advise the population on nutrition optimization in the early days of anti-epidemic measures, an information reference Contact Center was created and is continuously functioning on the basis of the Federal Research Centre of Nutrition and Biotechnology. Equally important is the implementation of measures aimed at the prevention of food contamination with COVID-19 agent. In this regard, the Federal Research Centre of Nutrition and Biotechnology, together with Rospotrebnadzor prepared guidelines on measures to prevent the transmission of a new coronavirus infection through foods. Another aspect that the medical community has faced in connection with the pandemic is the need to reorient specialized medical organizations that have not previously worked with patients with infectious diseases in order to create Clinical centers for the treatment of the new coronavirus infection COVID-19. Thus, in the context of the spread of the new coronavirus infection COVID-19, many areas of medicine are involved in the process of providing anti-epidemic measures. Successful completion of the tasks will significantly reduce the negative consequences of the C OVID -19 pandemic for the state and citizens.
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.
Fat-soluble vitamins and immunodeficiency: mechanisms of influence and opportunities for use
The role of vitamins in the formation of the immune response, both innate and acquired immunity, is well known. At the same time, deficit of fat-soluble vitamins A, E, D leads to impaired response of the immune system to the infectious invasion and to disorders of immune system functioning.
The aim of this article is to analyze the literature data on the impact of fat-soluble vitamins on the function of the human immune system and the possibilities of their use in patients with immunodeficiency.
Results. Сurrently, there are enough evidences of the successful use of fat-soluble vitamins in secondary immunodeficiencies. Data on the usage of vitamins A, E, D in the treatment of primary immunodeficiencies are few. However, even reducing of antibiotics and other medicines administration in children with primary immunodeficiency indicates the feasibility of their using. The results of scientific studies on the successful use of vitamins D and A in the treatment of allergic diseases, vitamin D in the prevention and improvement of the treatment of autoimmune and oncological diseases indicate the possibility of their use as adjuvant immunomodulatory therapy in children with primary immunodeficiency. Promising may be the use of vitamins A and E, as powerful antioxidants in patients with primary immunodeficiencies with defects in DNA repair processes.
Conclusion. The analysis of the literature data has shown that despite many questions need to be resolved, fat-soluble vitamins A, D, and E, and their analogues can be used in clinical settings to enhance the therapeutic effect in children with immune deficiency.
Nutritional status of children in rural areas of the Komi Republic and Khanty-Mansi Autonomous Okrug - Yugra by anthropometric data
A characteristic feature of the “global obesity epidemic” in recent decades is the rapid spread of overweight among the rural population. However, there is a lack of objective data on how this process is unfolding in the northern and Arctic regions of the Russian Federation.
The aim of the work was to analyze the prevalence of malnutrition and rates of overweight and obesity in children living in Khanty-Mansi Autonomous Okrug - Yugra (KhMAO) and the Komi Republic (KR).
Material and methods. We conducted a study of the nutritional status of rural children in the northern regions of the Russian Federation in 2018-2019. The subjects of the study were children aged 3-17 years of KhMAO, ethnic Khanty, Mansi and of various non-indigenous descent in small remote settlements (n=302) and 956 children in the administrative center of the northern district, a town-type residency. We also examined 7-17-year-old children (n=628) in large settlements of the KR, over 90% of them were ethnic Komi. For each individual, body mass index values (BMI) were calculated. The nutritional status was assessed by comparing the individual BMI with the age and sex specific standards set by the Ministry of Health of the Russian Federation (2017).
Results and discussion. 74.4% of children aged 3-6 in KhMAO, and 70% of the 7-17-year-old children of KR and KhMAO meet the standards for their age-sex groups; 6.1% of children aged 3-17 are underweight and 19.5% are overweight. Among the 7-17-year-olds, the ratio of the underweight and overweight (including obese) differs significantly in the settlement dwellers of the KR from that in the living in small settlements of KhMAO (p=0.004), as well as in the group of town residents of KhMAO (p=0.017). The children of the KR have slightly higher percentage of the overweight and obese (26.6 vs 25.7 and 24.8% in the town and settlements of KhMAO, respectively), but significantly lower percentage of those who are underweight (1.9 vs 5.0 and 6.8%). The proportion of obese schoolchildren in small remote settlements of KhMAO is higher than that in the large settlements of KhMAO and in large settlements of the KR (13.1, 7.7 and 9.2%, respectively).
Conclusion. There were no differences found between ethnic groups, however the role of social and anthropological factors in the formation of the nutritional status differences between the indigenous and non-indigenous children in Western Siberia calls for further investigation.
Analysis of the association of diet energy from macronutrients and prevalence of overweight and obesity among the Russian population
The fundamental cause for the development of overweight and obesity in adults is a positive balance of energy. However, many environmental factors can contribute to or restrain the development of obesity. These, of course, include the composition of the diet and the structure of its energy value.
The aim of the study was to explore the relationship between the prevalence of overweight and obesity with the macronutrients’ energy intake of Russian adult population.
Material and methods. Assessment of dietary intake and anthropometric parameters (height, weight) of the adult population were obtained in a cross-sectional survey of households in Russia (Russian longitudinal monitoring surveys, RLMS project). For analysis, we selected data from a survey of adults of both sexes (24 767 men and 30 040 women) aged 19-60 years, obtained in 7 rounds of the project during the period 2000-2012. Association of dependent variables of macronutrients’ energy as a percentage (%E) (fat, protein, total carbohydrates, natural mono - and disaccharides, added sugar), and independent (factor) variables namely gender and 4 categories of body mass index (BMI), characterizing nutritional status, was investigated using the ANOVA. The total daily energy intake and age were used as covariates in the model.
Results and discussion. The intake of total daily energy, the absolute values of macronutrients’ intake and %E of macronutrients are significantly higher in obesity (with the exception of the consumption of various fractions of carbohydrates) compared to normal BMI values. A direct association of the %Eprotein and the BMI category has been established. This relationship is more pronounced in men, but statistically significant in women as well (p<0.001 when comparing all BMI groups). A linear increase in the proportion of %E of fat with an increase in the BMI category in the direction from malnutrition to obesity was found in men (p<0.001 when comparing all BMI groups). In women, statistically significant differences in %E of fat intake in BMI groups were observed only between obesity and normal. In men, the consumption of %E due to total carbohydrates is lower in groups with overweight and obesity compared with normal and malnutrition. The exception is only for %E of natural mono- and disaccharides, the consumption of which in men increases in the range from malnutrition to obesity. In women with overweight and obesity, consumption of %E due to polysaccharides and natural sugar doesn’t differ from consumption in persons with normal BMI. Consumption of %E due to added sugar and the frequency of consumption of more than 10%E due to sugar are reduced in people of both sexes in the direction normal, overweight, and obesity. The opposite effect of BMI on the consumption of %E of fat and carbohydrates is clearly manifested in an increase in the ratio of %E fat/%E carbohydrates in people with overweight and obesity. Analysis of variance was confirmed when assessing the frequency of distribution of respondents with overweight and obesity in quartiles of macronutrients ’ %E differentiated by gender. The frequency of overweight and obesity is significantly higher in the groups of highest quartiles of %E of protein, total fat, saturated fatty acids and lowest quartiles of %E of total carbohydrates and their individual fractions, including added sugar.
Conclusion. The data obtained indicate a more significant role of the energy of the diet fat component in the prevalence of overweight and obesity, while the energy of carbohydrates, including added sugar, has no direct association with the prevalence of these conditions. The results obtained should be taken into account when developing measures to prevent and reduce the prevalence of obesity, both at the population and individual levels.
On the regulate tropane alkaloids in grain products
Tropane alkaloids (TA) are metabolites of various plant species in the families Brassicaceae, Solanaceae and Erythroxylaceae. Seeds of these weeds are found in flax, soy, sorghum, millet, sunflower, buckwheat and food products obtained from them, in herbals used as a part of food supplements and herbal teas. Despite the fact that the contamination of grain seeds by various parts of weeds reduces by sorting and clean up, a certain amount of TA gets into processed foods. An analysis of the consumption of TA with all types of foods, conducted by the European food safety Agency (EFSA), showed that TA intake with ration of various population groups can exceed the established level of single safe intake (ARfD) - 0.016 yg/kg of body weight (by 11-18% for adults, and by 5-25% for children depending on the age).
The aim of the research was to justify the need to introduce regulations for the safe content of TA in grain products.
Material and methods. The study process used hygiene, analytical methods, expert assessments on the basis of generalization and analysis of contemporary scientific researches published in databases Scopus, Web of Science, PubMed, RISC, Russian and international regulatory and legislative documents.
Results. The established risks associated with TA contamination of grain and grain-based foods, as well as food supplements based on herbs and herbal teas, make it necessary to monitor food products for it’s presence.
Conclusion. Due to the greater study of the risks associated with the presence of atropine and scopolamine in foods, scientific justification of safe levels of these TA in foods based on cereals, including baby foods for children under 3 years old containing millet, sorghum, buckwheat or products based on these cereals is required.
Multiplex polymerase chain reaction for genetically modified potato event AV43-6-G7 quantification. Proof of efficiency
One of the ways to improve the laboratory control methodology of genetically modified organisms of plant origin (GМО^) is to use multiplexing - an approach that allows you to increase the number of targets and enlarge the number of simultaneously processed samples, maximizing the potential of polymerase chain reaction in real time (PCR-RT). The aim of the study is to develop a quantitative identification protocol for genetically engineered (GE) potato event AV43-6-G7 in the format of duplex PCR-RT with the use of TaqMan® PCR technology.
Material and methods. The duplex system included 2 types of specific DNA-primers and fluorescence-labeled probes: the first one is for detection of transformation event AV43-6-G7 DNA sequence, the second is for detection of Stp23 taxon-specific potato gene. PCR parameters were chosen by empirical selection of concentrations of primers and probes, Mg2+ ions, deoxyribonucleotides, stabilizing agent for polymerase, as well as primer annealing temperature and incubation duration for each stage of the cycle.
Results. As a result of these studies, the composition of the reaction mixture was optimized for the detection and quantification of GE potato event AV43-6-G7 in food. Oligonucleotide primers and fluorescent probes were selected. The compositions of reaction mixtures and temperature-time parameters of PCR were tested: 2.5-fold reaction buffer for PCR-RT in the presence of ROX (carboxy-X-rhodamine), specific to the GE component primers (AV43-6-G7-f/AV43-6-G7-r) and target taxon (GRF3/ GRR3) at 300 пМ/300 пМ and 100 пМ/100 пМ, probes at 200 пМ and 200 пМ, respectively; bovine serum albumin - 0.04%; MgCl2 - 3.5 mM, deoxynucleoside triphosphates - 0.3 mM, as well as the temperature-time profile of the reaction (initial denaturation of 95 °C - 5 min, followed by 45 cycles: 95 °C - 20 sec, 58 °C - 20 sec, 62 °C -40 sec).
Conclusion. The validity of the developed method is confirmed by laboratory studies and testifies to its reliability.
Peroral toxicological assessment of bentonite nanoclay used in the food industry
Bentonite nanoclay (NC) manufactured from the natural sedimentary mineral bentonite contains more than 90% montmorillonite. Currently, it is widely used in food industry as processed aids - adsorbents for the purification of vegetable oils and beverages. Clay minerals have also applications as food additives and components in composite package materials. In vitro studies have shown that various forms of NC exerted cytotoxicity in many cell lines, whereas in vivo evidence of NC oral toxicity is contradictory.
Therefore, this study aimed to assess the acute oral toxicity of NC and to evaluate its toxicological characteristics in a subacute 92-day experiment on Wistar rats with a daily oral administration in doses of 1, 10, and 100 mg/kg body weight (bw).
Material and methods. The NC acute toxicity was evaluated in 8 male and 8 female rats with the initial bw 236±10 and 203±10 g, respectively. NC was administered as an aqueous dispersion intragastrically at a dose of 5 g/kg bw. On the 14th day (end of the experiment), an autopsy of the chest and abdominal organs was performed. The subacute experiment was carried out on 64 male rats with an average initial bw of 117±7 g. During the experiment the levels of anxiety and memory function were evaluated using the test “Conditional reflex of passive avoidance”. On the 90th day of the experiment, diurnal urinary excretion of creatinine and selenium was evaluated. At the end of the experiment, the integral parameters, the state of the intestinal wall permeability were assessed. Hematological and biochemical parameters were examined in blood, the content of non-protein thiols and the number of cells in apoptosis were determined in liver, and the state of cultivated microbiome populations was studied in cecum.
Results. The results of the determination of NC acute toxicity showed the absence of rat’s mortality and specific pathological changes in the internal organs at a dose as large as 5000 mg/kg bw, which allowed attributing NC to the Vhazard class. Nevertheless, under the conditions of the 92-day experiment, NC caused some adverse biological effects on rat’s organism. So, even at an NC dose of 1 mg/kg bw, there was a sharp inhibition of the symbiotic bifidobacterium growth, an increase in platelet count, in LDL and the LDL/HDL ratio, together with the presence of hypertriglyceridemia. At a dose of 10 mg/kg bw, an increase in spleen mass and a decrease in the de Ritis coefficient (AsAT/AlAT) were established. At a dose of 100 mg/kg bw there were shifts in the leukocyte blood count, an excessive enterococci growth in the cecum, significantly increased animal bw, along with the decrease of AsAT/AlAT and the level of serum nitrogen metabolites, indirectly indicating inhibition of catabolic processes. However, at the highest dose of NC, intestinal absorption of the protein antigen - ovalbumin, was apparently completely blocked.
Conclusion. The data obtained have shown that NC has potentially adverse effects on the rats mainly at a dose of 100 mg/kg bw, nevertheless, its NOAEL in the 92-day daily oral exposure experiment is probably less than 1 mg/kg bw.
Exploiting dietary supplements with antioxidant properties for enhancing physical efficiency at the state of physical fatigue in sports
The aim of the review was to analyze the current scientific data concerning the dietary supplements (DS) with antioxidant activity to be recommended for using in order to improve physical performance in professional athletes experiencing fatigue.
Material and methods. Online publications reviewing has been performed using the PubMed, Web of Science, Google Scholar databases, eLibrary platform, Cyberleninka. Results. Maintaining an athlete organism various systems functioning at the optimum level is known to be represented enough effective only with application of dietary supplements. The results of comprehensive up-to-date foreign and domestic scientific researches concerning dietary supplements including components with antioxidant activity to be recommended for delaying fatigue onset and improving physical performance in athletes have been analyzed. Application of such dietary supplements is dictated by the necessity to increase antioxidant organism defense, to maintain the normal functioning of a number of enzymes and prevent oxidative stress. The effectiveness of dietary supplements containing such components as vitamins E, A, and C; selenium, succinic and alpha-lipoic acid, coenzyme Q10, glutathione and other natural sources of antioxidants have been discussed in the review. The analysis of the data presented in the current scientific literature have confirmed the urgency of additional researches with the aim of receiving sufficient pieces of evidences of effectiveness of a number of dietary supplements with antioxidant activity in physical fatigue.
Conclusion. For postponing fatigue and improving physical efficiency in sports there appear to be reasonable to use dietary supplements possessing antioxidant properties with effectiveness confirmed by scientific researches.
Evaluating the efficacy of diet therapy with protein component modification at Wilson disease
Wilson disease (WD) is a rare hereditary disorder of copper metabolism, based on of the ATP7B gene mutation, resulting in defect of cooper excretion, which leads to accumulation of cooper in tissues and internal organs (especially in the liver and brain). The basic principle of diet therapy for patients with WD is a diet with reduced copper content, adherence to which is accompanied by significant dietary restrictions, so patients with WD, compared to other liver diseases, represent the most difficult contingent for adjustment of diet.
The aim: to assess of the effect of diet therapy with modification of the protein component on nutritional status of patients with WD.
Material and methods. The study included 33 patients (15 men and 18 women, 31.4±10.2 years old) with WD. All patients had liver damage: non-cirrhotic stages (NCC) -in 12 (36.3%) patients, liver cirrhosis (LC) - in 21 (63.7%) patients. Out of the last, 14 (66.7%) patients had compensated LC, 7 (33.3%) patients had decompensated LC. The average age of the patients. All patients were divided into two groups, comparable by body mass index. For 2 months outpatients of the 1st group (n=17) received a specialized diet with a modification of the protein component, made by incorporating 20 g of dry composite protein mix (containing 50% protein in the form of milk protein concentrate, 4% dietary fiber) into the daily diet. Outpatients of the 2nd group (n=16) received the same diet without modification. All patients were provided anthropometry, including shoulder circumference and triceps skin-fold measurement, and analysis of the body mass composition with bioimpedance analyzer, the index of lean mass was additionally calculated. Clinical and biochemical blood tests were also conducted for all patients.
Results and discussion. As a result of the diet therapy, statistically significant (p<0.05) changes were observed in patients of the 1st group who received a diet with a modification of the protein component: an increase in the index of lean mass (by 3.0%) and circumference of the shoulder muscles (by 2.3%), serum total protein and albumin (by 7.9 and 6.1%), an increase in the absolute number of lymphocytes (by 18.8%) and decrease in serum total bilirubin (by 20. 2%). A statistically significant decrease in the level of free copper was observed in both groups (by 2.1 and 1.8 fold).
Conclusion. The use of a specialized diet with a modification of the protein component, based on the inclusion of a protein composite dry mix in the diet, improves the nutritional status indicators in patients with Wilson disease.
Association of thermal food processing methods and small intestinal bacterial overgrowth syndrome
Small intestinal bacterial overgrowth (SIBO) is a widespread disease which antibiotic therapy is not effective enough and the relapse rate is high. Microbiota is dependent on dietary pattern of the patient and specific nutrients, therefore the diversity of dietary patterns may be one of the major factor promoting SIB O or its relapses after treatment.
The aim: to compare the patterns of thermal food processing methods in patients with and without SIBO.
Material and methods. We performed retrospective single center database search to identify unique depersonalized records of patients with SIBO and the data of lactulose breath test and nutritional assessment with the use of 24-hours dietary recall. Inclusion criteria were complete data on patient’s demography, adequate data of nutritional assessment and the lactulose breath test, absence of previous history of SIB O treatment in a special form of the database. In accordance with the results of lactulose breath test, patients were assigned into groups with the presence of SIBO with excess production of hydrogen (H2), methane (CH4), both gases (CH4-H2) or without SIBO (control group). According to the data of 24 h dietary recall, we divided all dishes and products consumed by a patient to 6 categories (Cat) depending on thermal food processing method: those that were not processed (raw) (Cat-r), boiled (Cat-bl), fried (Cat-f), stewed (Cat-s), baked in the oven (Cat-bk) or grilled (Cat-g). To analyze the structure of thermal food processing, we divided the weight of all products or dishes that underwent specific method of processing to the total weight of the food eaten. We did not take into the account the weight of thermally stable components like water and salt. The pattern of thermal food processing within each patients group was obtained as a quotient of the total percentage (by weight) of the food processed with the certain method by the number of patients in the group.
Results and discussion. The data of 1108 patients were available for the final analysis: 602 patients in the SIBO-H2 group, 140 in the SIBO-CH4 group, 248 in the SIBO-CH4-H2 group, and 118 patients in the control group. The distribution of thermal food processing categories was in patients with SIBO-H2 as follows: Cat-r - 45.8±17.3%, Cat-bl - 31.9±15.7%, Cat-s - 3.5±7.7%, Cat-f -6.3±10.4%, Cat-bk - 12.2±10.2%, Cat-g - 0.3±3.3%); in patients with SIBO-CH4: Cat-r-47.9 ±17.4%, Cat-bl-29.6±15.6%, Cat-s -4.4±7.6%, Cat-f - 5.8±9.8%, Cat-bk - 12.3±10.4%, Cat-g - 0,2±2,7%; in patients with SIBO-CH4-H2: Cat-r - 45.6±16.3%, Cat-bl - 31.5±16.2%, Cat-s - 4.0±8.0%, Cat-f - 5.1±9.3%, Cat-bk - 13.4±10.8%, Cat-g - 0.4±2.3%. Similar results were obtained in the control group (Cat-r - 44.7±17.0%, Cat-bl - 32.6±16.5%, Cat-s - 2.7±6.0%, Cat-f - 55±8.0%, Cat-bk - 14.2±10.6%, Cat-g -0.3±2.0%). There were no significant differences between the SIBO and control groups by mean percentage of raw, boiled, stewed, fried, baked and grilled food intake.
Conclusion. We found no association between thermal food processing patterns and SIBO. It seems that thermal food processing patterns has no influence on SIBO and its variants.
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.