Healthy nutrition is the most important component of the quality of life of the population. Disorders of the nutritional structure lead to the development of alimentary-dependent diseases, including cardiovascular, oncological, diabetes mellitus, obesity, osteoporosis, etc., that are the main causes of premature mortality of the population of economically developed countries, including Russia. This is due, among other things, to the low level of knowledge of the population about the principles of healthy nutrition. In order to eliminate the existing gap in the competence of the population on healthy nutrition, the Centre for Hygienic education of the population of the Russian Federal Service for Supervision of Consumer Rights Protection and Human Welfare, Moscow, as a part of the implementation of the federal project ‘Formation of a system of motivation of citizens to a healthy lifestyle, including healthy nutrition and rejection of bad habits' (‘Strengthening the Public Health'), which is a part of the national project ‘Demography', conducts systematic activities aimed at creating and maintaining an information and educational environment.

As the world continues to fight COVID-19, along with the search for effective treatments, attention is focused on food ingredients that can help strengthen the immune system. This review outlines the potential role of vitamins and minerals as immunonutrients in supporting the body's nonspecific defenses against COVID-19.

Thousands of studies have been conducted to study the new SARS-CoV-2 coronavirus, its infectious properties, transmission routes and all associated with the clinical manifestations and severity of COVID-19, especially with potential treatments. Lactoferrin is a member of the transferrin family, which is synthesized by epithelial cells of mammalian internal glands and is widely present in various secretory fluids such as milk, saliva, tears, and nasal secretions. Lactoferrin is one of the components of the innate humoral immunity, regulates the functions of immunocompetent cells and is a acute phase protein. Lactoferrin has strong antioxidant and anti-inflammatory properties. This review assesses the possibility of using lactoferrin as a supplement in immunocorrective therapy programs for viral diseases, including the novel coronavirus infection COVID-19.

The main aspects of the antiviral, anti-inflammatory, antioxidant and hepatoprotective properties of dihydroquercetin (DHQ), which may affect the course of COVID-19, are considered. Given the low toxicity and a wide range of biological activity, aimed not only at suppressing enzymatic reactions with the participation of coronavirus, but also at eliminating the lesions caused by it in all the main target organs, dihydroquercetin can be recommended for inclusion in the complex therapy of the disease and during the recovery period of COVID-19.

The first thousand days of a child's life have important role in their future health. The adequacy of nutrition during this period critically affects the growth of the child, the development of his functional abilities, the full formation of all body systems. A well-planned mother's diet is important during pre-conception, during pregnancy and lactation. The choice of a vegetarian or vegan diet often occurs even in the pre-conception period, and at the onset of pregnancy, vegetarian women most often do not change their type of diet. Due to the risk of a number of nutrient deficiencies, the use of plant-based diets during pregnancy and lactation requires high awareness of mothers regarding diet planning, as well as special attention from pediatricians and nutritionists due to the increased nutritional risks.

The features of food preferences of schoolchildren and the role of alternative nutrition in the prevention of alimentary-dependent diseases have been revealed. Food preferences have been determined: for breakfast, lunch, afternoon tea and dinner. Children with allergies, diseases of the gastrointestinal tract and other nutritional diseases had the opportunity to choose an alternative diet, fully balanced on the days of the week, in accordance with sanitary standards and the requirements of the Russian Federal Service for Surveillance on Consumer Rights Protection and Human Welfare. Meeting the needs of schoolchildren for nutrients and energy during the day provides for the presence of a basic diet at school (alternative food, in case of intolerance or allergy to certain foods), a regulated range of buffets in an educational organization (additional meals) and meals at home (dinner). Correctly compiled diet during the day contributes to the prevention of alimentary-dependent diseases. The necessity of organizing alternative nutrition at school to ensure the provision of children with intolerance to certain food products by means of an equivalent substitution for products permitted by a pediatrician and a nutritionist in the diet of children with alimentary diseases, including allergies, celiac disease, etc.

Relevance of topic. Atopic dermatitis is a wide-spread skin disease that can significantly reduce patient’s quality of life. Many authors around the globe conduct research to find correlation between atopic detmatitis in children, their growth, development of allergic comorbidities (food allergy in particular) and elimination diet prescription.

Aim of the study. To estimate growth indices and nutritional status in children with severe atopic dermatitis and allergic comorbidities on the elimination diet.

Methods. This study included children of age 0-17 years 11 months, hospitalized in Dermatology with the Laser Surgery department in the National Medical Research Centre of Children’s Health from September 2020 to May 2021. Anthropometric indices, levels of serum vitamin D, albumin, hemoglobin and total IgE were estimated in all children.

Results. This study included 80 children. There was a moderate negative correlation between the number of excluded food groups, the disease longitude (p = 0.003; r = -0.333) and HAZ (p = 0.010; r = -0.351). There was a moderate negative correlation between the age of children and serum vitamin D (p = 0.040; r = -0.317) and a moderate positive - between BAZ and serum vitamin D (p = 0.030; r = 0.332). There was a weak negative correlation between serum vitamin D and total serum IgE (p = 0.033; r = -0.239) and between BAZ and serum hemoglobin (p = 0.028; r = 0.246).

Conclusions. The results of this study demonstrate a low intake of vitamin D in children with severe atopic dermatitis, worsening with age. Vitamin D level correlated with BAZ, also the results showed lower vitamin D intake in children with high levels of total Ig E.

Congenital epidermolysis bullosa (CEB) is a group of rare genetic diseases of varying severity, which are characterized with the formation of blisters on the skin and/or mucous membranes with minor trauma. In this case, the clinical course of the disease in some cases is aggravated by the development of malnutrition, which further worsens the quality of life of patients.

Aim of the study. To assess the physical development and laboratory findings of nutritional status in children with simple (SCEB) and dystrophic forms of CEB (DCEB).

Methods and materials. The study included children with SCEB and DCEB at the age of 8 months to 18 years old, treated at the National Medical Research Centre of Children's Health (Moscow, Russia) from January 2018 to January 2019. Anthropometric parameters were assessed in all patients, and a biochemical blood test was performed for total calcium, phosphorus, albumin, and magnesium. Data are presented using the median (Me) and quartiles of 25 % and 75 % [Q25; Q75], as well as the mean (M) and 95 % confidence interval (95 % CI) for variables with a normal distribution.

Results. A total of 87 children were included in the study, 70 with DCEB and 17 with SCEB. There were no differences in sex and age between the groups. According to the results of the study, all anthropometric parameters (WAZ, HAZ and BAZ) in children with DCEB were statistically significantly lower (p < 0.001) than in children with SCEB. Although in both forms of CEB the averaged values of WAZ, HAZ and BAZ turned out to be within the normal range, in children with DCEB, a decrease in HAZ less than -2 was noted in 22 children (31%). Moderate protein-energy malnutrition (-3 < BAZ < -2) was detected in 29 patients (41 %), while 20 of them (29%) were diagnosed with severe protein-energy malnutrition (BAZ < -3). Biochemical parameters were within the reference values, however, the levels of albumin and total calcium were statistically significantly reduced in children with DCEB compared with SCEB children (p < 0.001 and p = 0.005, respectively). Hypoalbuminemia was observed in 64 %, and hypocalcemia in 9 % of DCEB children.

Conclusion. All anthropometric values in children with DCEB were lower than in children with SCEB. The study of albumin and total calcium level in the blood of children with DCEB can reveal preclinical forms of malnutrition.

Objective. To assess nutritional status of children with undernutrition without chronic diseases.

Patients and methods. Eighty one children without chronic diseases and with undernutrition aged 3 months to 17 years and 2 months, 41 boys (50.6 %), 40 girls (49.4 %), were examined. The anthropometry was assessed by WHO criteria. The complete blood count (n = 69), blood biochemistry (n = 62), insulin level and vitamin status were examined. Bioelectric impedance analysis (n = 58) and indirect respiratory calorimetry (n = 28) were performed. The food intake was assessed in 28 patients.

Results. Mild undernutrition was diagnosed in 35 (43.2 %) children, moderate - in 30 (37 %), severe - in 16 (19,8 %) children. The stunting (Z-score height to age < -2) was revealed in 3 (3,7 %) children. Anemia was found in 4 (5.8 %) children, absolute lymphopenia - in 2 (2.9 %), hypoproteinemia in 8 (12.9 %), hypoalbuminemia - in 1 (1.5 %), hypocholesterolemia - in 7 (11.3 %), hypercholesterolemia - in 6 (9.7 %) children. None of children had hypoglycemia. Insulin was decreased in 9 (15.5 %) children. Deficiency of vitamin D was found in 11 (13.6 %) patients. Decrease of fat mass was found in 52 (89,7 %) patients, muscle mass - in 42 (72.4 %), active cell mass - in 18 (31 %), protein - in 37 (63.8 %), minerals - in 41 (70.7 %), total body water - in 36 (62.1 %) patients. Decrease of the phase angle (<4.4) was recorded in 13 (22,4 %) children. Resting energy expenditure was normal in 12 (42,8 %) patients. Carbohydrate oxidation rate was decreased in 20 (71,4 %) children, fat oxidation rate was increased in 15 (53,6 %), protein oxidation rate was normal in 15 (53,6 %) children. The food intake was characterized by low energy intake in 21 (75 %) children. Deficiency of protein, fat and carbohydrate intake were found in 42.9, 60.7 and 82.1 % patients, respectively. Low energy intake due to all macronutrients deficiency was revealed in 35.7 % children.

Conclusion. Most children with undernutrition without chronic diseases have a decrease in fat and muscle body components, low energy value of diet and imbalance of macronutrients. Changes in resting metabolism were also revealed.

The study of diet as a factor influencing the formation of an exogenous constitutional form of obesity in children and adolescents is an urgent task of modern health care. The distribution of energy by meals has a significant impact on the degree of overweight and the severity of obesity. In the course of the study, a weak positive correlation (r = 0.26) was revealed between the proportion of dinner in terms of calorie content and the degree of overweight: the higher the proportion of dinner in the overall structure of the caloric content of the diet, the higher the degree of obesity in a child. With regard to breakfast, an inverse negative relationship was revealed (r = -0.27): the lower the proportion of breakfast in terms of calorie content, the higher the BMI value by gender and age. The high proportion of calories in the evening meals (afternoon snack and dinner) is more important for the degree of obesity in boys (r = 0.40) than in girls (r = 0.34). The older the child, the stronger the correspondence between excess calorie intake in evening meals and the degree of excess weight (at 8-10 years old r = 0.26; at 11-13 years old r = 0.31; at 14-18 years old r = 0.48).

Aim. To study the features of the nutritional status, including physical growth, body composition, energy value of the diet and the amount of cholesterol consumed with food, in children with familial hypercholesterolemia (FH).

Patients and methods. The study included 39 children (19 girls, 20 boys) with familial hypercholesterolemia, both genetically confirmed (n = 11) and established on the basis of Simon Broome criteria (n = 28), aged 9.9 [6.0; 12.9] years. All children were assessed for physical growth based on the Z-score BMI, Z-score height, Z-score body weight/height calculated using the programs Anthro and Anthro plus; analysis of actual nutrition using a standard application program; study of body composition using the InBody 770 bioimpedance analyzer, the basal metabolic rate measured by indirect calorimetry.

Results. 55 % of children with FH had harmonious physical growth, 27 % had a body weight deficit, 18 % were overweight or obese. 53 % of patients consumed more than 200 mg of cholesterol per day, while half of them consumed more than 300 mg of cholesterol per day. The range of excess consumption of cholesterol in comparison to the recommended physiological needs for patints with FH ranged from 24 to 67 %. The fat mass according to the body composition in 47 % of patients with FH is within the normal range, in 39 % it is reduced by 18-74 %, in 14 % it is increased by 14-197 %. The median fat percentage was 17.8 [12.7; 22.4]%. According to indirect calorimetry, it was found that the level of resting energy needs corresponded to age needs in 21 % patients, in 8 % it was decreased of 2-26 %, in 2/3 of children its increase was recorded by 3-69 %. The rate of fat oxidation, on the contrary, was increased in 71 % of children by 3-86 % and reduced only in 6 %.

Conclusion. The physical growth of children with FH was mainly average, harmonious, while a third of the children had a mass deficit. The level of the main indicators of lipid metabolism did not depend on the physical growth of patients. This pathology in children with normal body weight or with a body weight deficit often remains undiagnosed.

The purpose of the review is to analyze the results of the use of vitamin-mineral supplements (MMS) during pregnancy using the databases of the RSCI, CyberLeninka, pubMed. The detection of micronutrient deficiency in a significant part of pregnant women requires its unconditional correction by taking vitamin-mineral supplements. In recent years, the emphasis has shifted to studying the effect of MMS intake on the course and outcomes of pregnancy. The effects described in the literature should be treated critically. Most of the studies are based only on a retrospective survey of pregnant women (according to the ‘yes' or ‘no' principle), their supply of micronutrients is not monitored; no causal relationship is established. There is no objective monitoring of the MMS intake. Uncertainties include the composition and doses of micronutrients in the MMS used, the lack of data on drug intake, the assumption that all MMS are equivalent in composition and micronutrient content, and the grouping of women taking MMS with different composition into one group. In addition, the use of incorrect indicators in assessing the physical growth of children occurs. The positive effect of additional intake of MMS is manifested only if initially there was a deficiency of micronutrients.

Conclusions. The intake of MMS during pregnancy improves the supply of vitamins for those women in whose diet there is a lack of them. This prophylaxis reduces the risk of adverse pregnancy outcomes due to vitamin deficiencies.

Lactation contributes to the recovery of the mother after pregnancy and can affect many aspects of maternal health later in life. The short-term benefits of breastfeeding are associated with faster postpartum psychological and emotional recovery. In the long term, lactation reduces the risk of breast, ovarian and endometrial cancer, as well as a number of other diseases, more if exclusive breastfeeding continues for six months or more. Inappropriate nutrition of a nursing mother is one of the most destructive factors for her health. It is also important to remember that the amount of milk depends on the frequency of breastfeeding, and there is no evidence for foods, herbs or medications to prolong lactation or increase milk volume. A varied, balanced diet, including natural and specialized foods for nursing mothers, as well as dietary supplements, sources of vitamins and minerals, can ensure that the mother is consuming enough nutrients for both herself and her baby.

The priority of breast feeding is a well-known fact many times described in pediatric scientific literature. However we decided to summarize in a brief review all positive influences of breast feeding both for a baby and for mother and for society in general. For infant one should mention an optimal growth, protection from infections, reduced risk of adult diseases, better mental development. For mother it means better recovery after delivery, weight control, lower risk of postpartum bleeding. Economic profit for family budget is connected with the price of infant formulas which are unnecessary in breast feeding.

Despite advances in the diagnosis and treatment of various forms of cardiac arrhythmias, atrial fibrillation (AF) remains a serious problem in the internal medicine clinic, especially acute in gerontology. Prevention of the development of cardiac arrhythmias is an important medical and social task. Adequate nutrition plays an important role in the cardiovascular diseases prophylaxis. At the same time, a deficiency of vitamins and minerals, including vitamin D, can create a pathogenetic basis for the development of arrhythmias. Experimental and clinical studies have demonstrated the effect of vitamin D on the mechanisms underlying the formation of AF. Screening for vitamin D deficiency in cardiac patients should become routine. Correcting vitamin D deficiencies must be personalized. Further clinical trials are needed to investigate the clinical endpoints (morbidity and mortality) of vitamin D supplementation in arrhythmology.

The problem of population aging in developed countries poses new challenges for the medical community. Sarcopenia is one of the most common problems that decrease the quality of life of older people and increase the risk of disability and death. Currently, several dietary approaches to the prevention and correction of sarcopenia have been developed. Hydroxymethyl butyrate is one of the innovative substances designed to optimize the diet of elderly patients, primarily those with a sedentary lifestyle or on bed rest.

Adequate interaction between macroorganism and microbiota underlies the correct metabolism, growth and development of а human. The microbiome is a collection of microorganisms that is closely related to the human body and has a comprehensive impact on its health and function. Additional administration of probiotics can assist targeted correction of metabolic disorders, inflammation, immune response, and resistance to adverse factors. At the same time, it must be considered that the effectiveness of a probiotics depend on the selected strain of the microorganism, form, dose and duration of use. This review is devoted to current data on the role of probiotics in the prevention and adjuvant therapy of somatic diseases.