[Estimation of gammaaminobutyric acid intake from the human diet].

Gamma-aminobutyric acid (GABA) is an endogenous bioactive compound with essential properties for the normal functioning of the human nervous system. As a potent neurotransmitter, it plays an important role in modulating synaptic transmission by exerting phasic inhibition of neurons. This and other effects of GABA provide the phenomenon of neural tissue plasticity underlying learning, memory, maturation and repair of neural tissue after damage. It also has a wide range of biological actions, including antihypertensive, anti-diabetic, antioxidant, and anti-inflammatory. In this regard, GABA is increasingly used in the composition of food for special dietary uses and dietary supplements. However, its adequate intake levels have not yet been assessed and its dietary intake has not been characterized. The aim of the review was to estimate the level of GABA intake under balanced consumption of foods, corresponding to rational norms that meet modern requirements of a healthy diet. Material and methods. The existing literature on the problem in recent years was reviewed using the databases RISC, CyberLeninka, Pubmed, and ResearchGate. Results. Based on the analysis of scientific literature, we evaluated the content of GABA in the average daily diet, compiled on the basis of the rational norms of food consumption that meet modern requirements for healthy nutrition (Order of the Ministry of Healthcare of the Russian Federation dated August 19, 2016. No. 614). The balanced diet can provide about 740 mg of GABA per day, mainly due to vegetables (potatoes - 419 mg/day, beet - 49 mg/day, pumpkin - 41 mg/day), fruits (apple - 15 mg/day, grapes - 3.8 mg/day), as well as low-fat dairy products (92 mg/day). Conclusion. The presented data may be useful in assessing the adequacy of enrichment of foods for special dietary uses and dietary supplements with GABA.

[Use of a controlled attenuation parameter for the diagnosis of non-alcoholic fatty liver disease].

AIM: To evaluate the efficacy of vibration-controlled transient elastography (VCTE) with a controlled attenuation parameter (CAP) in a population of patients with non-alcoholic fatty liver disease (NAFLD)and to compare to US and different non-invasive indices. MATERIALS AND METHODS: Single center NAFLD patients' database of 2021-2023 years was retrospectively analysed. Data of VCTE evaluation with CAP (FibroScan 530® and FibroScan 630 Expert®) as well as liver US examination results and values of HSI, FLI, BAAT and NAFLD-LFS were extracted. AUROCs for all methods used were constructed and sensitivity and specificity analysis was performed. RESULTS: The data of 1081 patients were available for analysis (385 with steatosis, 274 with NASH, 422 without NAFLD as a control). Ultrasound examination in the diagnosis of liver steatosis compared to VCTE with CAP showed sensitivity and specificity of 94.6 and 63.7%, respectively. Diagnosis of liver steatosis using indices and scales showed sensitivity and specificity of HSI: 97.9 and 60.1% (AUROC 0.90), FLI: 92.5 and 85.3% (AUROC 0.93), BAAT: 76.6 and 73.5% (AUROC 0.82), NAFLD-LFS: 56.7 and 81.8% (AUROC 0.85). CONCLUSION: The sensitivity of the US of the liver was consistent with previous studies, but the specificity was low. The HSI index had the best indicators of sensitivity and specificity in relation to the diagnosis of liver steatosis. Combination of liver US and HSI can be used in screening of liver steatosis, however, for the complete diagnosis better tools which can simultaneously evaluate liver steatosis and fibrosis should be used.

[Prospects of dietary fibers food fortification for the treatment and prevention of gastrointestinal diseases: A review].

Epidemiological studies have proven the connection between high consumption of dietary fiber and a reduction in the risk of many diseases. In clinical trials, the possibility of functional regulation of the intestine and intestinal microbiome by dietary fibers has been revealed, which may be significant in certain diseases of the digestive system. This review provides information on the relationship between the physico-chemical properties and functional characteristics of dietary fibers, discusses evidence of the effectiveness of their use in the treatment of diseases of the digestive system, discusses the need to enrich food with dietary fibers.

[Clinical evaluation of the efficacy of innovative spread of a given fatty acid composition enriched by adaptogens].

Adaptogens are a group of substances capable to increase the nonspecific resistance of the organism to a wide range of harmful effects and stress. However, only limited data exist on their use in the composition of foods for special dietary uses. The aim of the study was to evaluate the effect of a diet that included vegetable-fat spread enriched with 5-hydroxytryptophan, L-theanine and γ-aminobutyric acid on memory, general well-being and emotional status of healthy volunteers. Material and methods. The single-center, single-blind randomized prospective trial that enrolled persons without signs of significant organic pathology have been performed. Participants were randomly allocated to receive either 45 g/day standard spread enriched with 5-hydroxytryptophan (0.67%), L-theanine (0.56%) and γ-aminobutyric acid (0.45%) (main group, MG) or 45 g/day standard spread (control group, CG) for 10 days. Beside this, all participants followed a standard diet. Initially, as well as on the 10th day after the start of using the diet, the emotional state was assessed using the HADS anxiety and depression scale and Beck's depression inventory (BDI), general well-being by SAN questionnaire, memory according to the Lurie method; reaction time and attention concentration were assessed using the Krepelin counting test and the Burdon correction test. A 5-point Likert visual-analogue scale was used to assess the palatability (pasting) of the product, the severity of feelings of hunger and satiety at the baseline and on the 10th day of the study. All tests were performed under the supervision of staff. During the study, daily monitoring of the presence of adverse events was performed. Results. There were 70 subjects in MG and 70 in CG. Lurie memory score significantly increased in the MG (59.9±6.7 vs 58.1±7.4 points at the baseline; p=0.001), but not in the CG (58.0±6.9 vs 57.3±7.3 points, p>0.05). According to the SAN questionnaire, significant increase of well-being values (46.9±13.4 vs 44.2±13.5 points; p=0.01) and mood (49.9±12.6 vs 47.4±12.9 points; p=0.01) was found in MG, while in CG there was an increase of the mood category only (54.4±10.8 vs 52.2±12.1, p=0.04). At the end of the study an increase of «Satiety¼ (60.3±22.8 vs 51.5±24.8, p=0.022) and decrease of «Hunger¼ score (24.1±19.8 vs 29.1±19.4, p=0.02) were revealed in CG but not in the CG. No significant change was found by the results of other tests, stool form and its frequency in both groups. Conclusion. Newly developed spread enriched with 5-hydroxytryptophan, L-theanine, γ-aminobutyric acid was well-tolerated, did not affect the feeling of hunger and satiety, and improved memory and well-being parameters.

[Food diversity analysis based on data of food purchasing in supermarket chain].

Diversity in nutrition is of fundamental importance for health. According to research in recent decades, the diversity of the population's diet has greatly decreased, which carries health risks. The aim of the study was to analyze food diversity in population based on their purchasing activity in large trading network. Material and methods. From the depersonalized data of 1 800 319 loyalty program unique members of the retail network in Moscow, 201 904 buyers were selected according to the following criteria: the presence of a dense segment of purchases (more than 4 weeks, where there was at least 1 purchase in 2 weeks), in which the total cost of purchases was not less than 4700 rubles and at least 4 different food groups were purchased. Data from the cashier's receipts for 12 months (median 124 days) as well as the food labels for extracting the data about ingredients were used. Food diversity was analyzed by using count-base score method in which absolute number of different foods in every of 6 food groups (grains, fish and meat, fats, dairy products, vegetables, fruits and berries) was calculated. Total score as a sum of all scores from all food groups was also calculated. Results. According to the food diversity analysis, 73.9% of buyers purchased 2 or less types of grains. Only 31.4% of buyers purchased more than 4 types of vegetables, only 36.2% purchased more than 2 types of fruits and berries, 41.9% purchased less than 2 types of meat and fish, 61.3% purchased only 1 type of fat, and at least 2 types of dairy products was purchased by 53,3% of buyers. Acceptable rate of food diversity of 20 different types of food per week was achieved only in 11.4% of buyers. Conclusion. Food diversity in buyers of trading network is low, with the lowest scores in buying different grains, vegetables, fruits and berries, meat and fish as well as fats. Better diversity was demonstrated in buying dairy products, as they traditionally are accounted as healthy by consumers.

[Spectrum of food diversity of megapolis' inhabitants obtained by the analysis of buying activity].

The food diversity is a significant indicator of a healthy diet. The aim of the study was to assess the indicators of food diversity in the metropolis (Moscow) based on the analysis of consumer activity in a large retail chain. Material and methods. 201 904 holders of loyalty cards of the retail network were selected from the depersonalized purchase data for 2016-2018 according to the following selection criteria: the presence of a dense segment of purchases (more than 4 weeks, where there was at least 1 purchase in 2 weeks), where the total cost of purchases was at least 4700 rubles and at least 4 different products were purchased. From of these, 111 136 buyers have data available by gender, 43 046 by age. The classification of a set of purchased products and dishes by food groups was carried out, and complex dishes were transformed into a set of their ingredients and the distribution of the unique values of the corresponding food groups was carried out. Counting the number of unique preferences (count base diversity) by the number of positions in each of the 6 food groups (cereals, fish and meat, fat products, dairy products, vegetables, fruits and berries) allowed us to estimate the amount of food diversity. The total number of food categories in all subgroups was also calculated. Results. The low value of food diversity in the category of cereals and cereals was found in 2/3 of buyers, in the category of vegetables and fruits in 60% of buyers, in the category of meat and fish products in half of buyers, in the category of fat-and-oil products in 63.7% and in 44.2% of buyers of dairy products. An acceptable total number of categories of purchased products (more than 20 per week) was achieved only in 14.5% of men and 16.7% of women from our sample. In general, lower indicators of dietary diversity are typical for men and young people (up to 45 years old). Conclusion. Thus, it can be concluded that the importance of food diversity as a factor of health protection is underestimated by the population, especially by young people, which can lead to an increase in the burden on healthcare due to the earlier debut of a wide range of chronic diseases.

[Efficacy of newly developed kombucha-based specialized food product for treatment of constipation-predominant irritable bowel syndrome].

According to studies, the prevalence of constipation in the population can reach 27% due to the low intake of dietary fiber. Increasing dietary fiber intake can improve bowel movements. The aim of the study was to assess the efficacy of a non-alcoholic fermented pasteurized kombucha drink enriched with inulin and vitamins in patients with constipation-predominant irritable bowel syndrome (IBS). Material and methods. The study (NCT05164861) was approved by Local Ethics Committee and enrolled subjects with IBS (according to ROME IV). The subjects were randomized to receive either 220 ml of a non-alcoholic drink, based on pasteurized kombucha (KG), enriched with inulin (1.15 g/100 ml) or 220 ml water (control group, CG), for 10 days. Standard examination included evaluation of stool frequency (bowel movements per day), stool form (with the Bristol stool scale) and evaluation of concomitant symptoms (abdominal pain/discomfort, abdominal fullness, bloating, and feeling of incomplete bowel emptying) with the use of 5-point Likert scale before (BL) and 10 days after the start of intervention (EOT). Using visual analog scales (VAS), the palatability of the studied food was assessed at the beginning and end of the observation period. Results. Significant increase of stool frequency was found at the EOT compared to BL in KG (n=20), Mean±SD: 0.60±0.31 to 0.85±0.19 times/day; p=0.004, while there was no change in CG (n=20): 0.63±0.33 vs 0.72±0.28, p=0.6. Mean values of stool scale form increased in KG (3.0±1.2 to 4.4±1.0, p=0.001), while remained unchanged in CG (2.9±1.2 vs 3.4±1.2, p=0.6). Mean values of the Bristol stool scale in KG and CG differed significantly at EOT (p=0.018). Significant decrease in mean values of incomplete bowel emptying feeling was found in KG (1.88±0.78 at BL vs 1.41±0.56 points at EOT, p=0.015), but not in the control group. There were no statistically significant differences between patient's reports of the studied groups for other symptoms (bitterness and dryness in the mouth, heartburn, nausea, abdominal pain and heaviness in the stomach after eating). Conclusion. The effectiveness of a pasteurized fermented non-alcoholic drink based on kombucha enriched with inulin has been proven by reducing the intensity of complaints significant for constipation, normalizing the frequency and consistency of stools.

[Modification of dietary patterns in patients with non-alcoholic steatohepatitis].

AIM: To assess efficacy of dietary patterns modification with the use of specialized food in patients with non-alcoholic steatohepatitis (NASH). MATERIALS AND METHODS: We developed new specialized food (SPP2) based on literature data on the role of dietary patterns in pathogenesis of NASH. It contained -3 PUFAs, soluble dietary fiber, phospholipids, -lipoic acid, coenzyme Q10, L-carnitine, complex of vitamins. Patients with NASH (per EASL guidelines), were invited to participate in the study and were randomly assigned to receive either isocaloric diet (ICD) alone (based on the results of indirect calorimetry Cosmed, Italy) or isocaloric diet with specialized food (2 portions of SPP2 a day), for 14 days. Repeated examinations of body composition with phase angle analysis (InBody, Republic of Korea) and blood chemistry were performed at baseline (BL) and after 14 days (EOT). The patients were advised to follow usual physical activity during the study. Non-parametric statistics was used to compare BL and EOT characteristics in the groups. RESULTS: The groups did not differ by age, proportion of females, and baseline characteristics of body composition. Adherence to the diet was 87.5% in the ICD group and 88.2% in the ICD+SPP group (p=0.65). Compliance with the use of SPP was 100%. In the ICD+SPP group significant reduction of body weight was achieved (117.530.1 kg initially, vs 114.928.8 kg at EOT; p=0.007), whereas in the ICD group it was not statistically significant (106.722.1 kg at BL vs 104.016.8 kg at EOT, respectively; p=0.07). In contrast to the ICD group, in those who received ICD+SPP significant decrease in cholesterol (5.31.3 mmol/L at BL vs 4.61.3 mmol/L at EOT; p=0.003), LDL (3.71.0 mmol/L vs 3.31.0 mmol/L, respectively; p=0.009), alkaline phosphatase (132.699.1 vs 112.087.0 U/L; p=0.04), GGT (54.533.2 vs 37.519.7 U/L; p=0.04), insulin resistance index (6.13.2 vs 3.21.5, respectively; p=0.04) was detected. CONCLUSION: Modification of dietary patterns with the use of a specialized food in combination with low-calorie diet allows achieving significant reduction of weight and improve lipid and carbohydrate metabolism, reduce severity of cholestasis in patients with NASH.

[Efficacy of newly developed food for special dietary use in the diet of patients with non-alcoholic steatohepatitis].

Although diet plays a leading role in treatment of non-alcoholic fatty disease (and, in particular, non-alcoholic steatohepatitis), specialized foods for the treatment of these patients have not yet been developed. The aim of the study was to assess efficacy of the food for special dietary use (FSDU) in patients with non-alcoholic steatohepatitis. Material and methods. New FSDU contained (% of the RDAs): protein - 8%; fat - 7% (including ω-3 PUFA - 40%); soluble dietary fiber - 180%; phospholipids - 25%; alpha-lipoic acid - 33%; betaine - 10%; 12 mineral substances - 13-44%; 13 vitamins - 24-140%. The study (NCT04308980) was approved by local ethics committee and enrolled patients with diagnosis of NASH. Subjects were randomized to the following groups: those received iso-calorie diet (according to resting energy expenditures, by indirect calorimetry) alone (ICD) and iso-calorie diet + FSDU (2 portions per day, 14 days) (ICD + FSDU group). Safety was assessed based on clinical and laboratory data. Repeated measurements (baseline vs those on the 15th day of the study) of body composition assessed by bioelectrical impedance analysis, and blood chemistry were compared. Results. The results of complex examination of 20 subjects (12 in ICD + FSDU and 8 in ICD group) served as a source for the study. Initially, groups did not differ by age, sex, and body mass index (BMI). The product was well tolerated. In contrast to ICD group, those in ICD + FSDU group demonstrated greater decrease of weight: BMI initially (BMI0) (M±σ): 38.7±5.4 kg/m2 vs BMI at the end-point (BMIEOT) 36.7±5.1 kg/m2, p=0.003 in ICD + FSDU group, whereas in the ICD group BMI0=38.9±7.2 vs BMIEOT=38.9±7.3 kg/m2, p=0.08. These results were reached predominantly by a decrease of fat mass: body fat weight (BFW0) 50.2±10.7 vs BFWEOT=48.5±10.8 kg, p=0.002 in ICD + FSDU group, whereas BFW0=48.9±11.4 vs BFWEOT=47.8±11.6 kg, p=0.07 in ICD group. The activity of alanine and aspartate aminotransferase, gamma-glutamil transpeptidase and alkaline phosphatase decreased in ICD + FSDU group (р=<0.05), whereas in ICD group the difference between initial and control assessment was not significant (р=<0.10). Conclusion. The new FSDU is well tolerated by patients with NASH. In combination with iso-calorie diet, it may increase efficacy of weight loss, predominantly by fat.

[Specialized products for dietary correction of the diet of patients with non-alcoholic steatohepatitis].

Non-alcoholic steatohepatitis (NASH) is a widespread disorder associated with a number of metabolic disorders. Lifestyle modification, including diet and physical activity are currently a first-line treatment for the disease. However, there is lack of specialized products (SP) with modified carbohydrate and fat composition, containing biologically active ingredients with proven physiological effects on the liver for this disorder. The aim of the paper is to summarize present knowledge on the biologically active ingredients with proven hepatoprotective effect and to describe the process of the development of two specialized products for clinical use in patients with NASH. Material and methods. Food ingredients containing soy and milk proteins, soluble dietary fiber, mono- and polyunsaturated fatty acids, vitamins, minerals, soy lecithin, L-carnitine, coenzyme Q10, α-lipoic acid, betaine, flavoring and aromatic additives were used in the development of SP formulations. The mass fraction of moisture in the SP was determined by the thermo-gravimetric method on a humidity analyzer, and the water activity was determined by measuring the dew point. The nutritional and energy value of the SP was calculated using data from chemical composition tables and information from manufacturers of food ingredients. Results and discussion. Taking into account the requirements for dietary therapy, the ingredient composition was scientifically justified and the formulations of two SP with a balanced amino acid composition were developed by using a combination of milk whey proteins, casein and soy protein isolate. The fat component included microencapsulated rapeseed oil, that is a source of mono- and polyunsaturated fatty acids (PUFAs) with the addition of ω-3 PUFAs. The carbohydrate composition was modified by eliminating mono- and disaccharides, traditionally used in sweet drinks, and adding maltodextrin in combination with sweeteners (polyols and natural sweeteners). Polydextrose, citrus pectin, inulin, and hydrolyzed guar gum are used as soluble dietary fibers. The SP included essential micronutrients (vitamins, mineral substances) and bioactive substances that have a proven physiological effect (coenzyme Q10, α-lipoic acid, L-carnitine, betaine hydrochloride, phospholipids). Technical documentation was developed and a pilot batch of SP-1 was developed for inclusion in the complex treatment of patients with NASH. Conclusion. The formulations and technology of SP (SP-1, SP-2) for therapeutic nutrition with a given chemical composition, designed to optimize the diet therapy of patients with NASH, have been developed. SP are sources of animal and vegetable proteins, soluble dietary fiber, mono- and polyunsaturated fatty acids, including ω-3 family, vitamins, minerals and trace elements, as well as bioactive substances with antioxidant, hepatoprotective and hypolipidemic effect. The technical documentation was developed and approved, according to which a pilot batch of SP-1 was produced to assess its effectiveness as a part of complex therapy of patients with NASH.

[Food patterns in Russian patients with gastroesophageal reflux disease: the results of pilot comparative study].

AIM: To evaluate nutritional patterns in patients with gastroesophageal reflux disease (GERD) compared to the control group without GERD. MATERIALS AND METHODS: The data of complex examination of patients referred to perform esophageal pH-impedance recording and who gave written informed consent to participate in the study served as a source data. All the participants underwent complex examination, including clinical data (presence of heartburn and acid regurgitation), symptom evaluation (GERD-Q questionnaire), esophagogastroscopy, esophageal pH-impedance recordings and food frequency questionnaire. Diagnosis of GERD was based on GERD-Q score 8, acid exposure time 6%, number of gastroesophageal refluxes 80/day by 24-hrs esophageal pH-impedance recordings. Nutritional patterns were assessed with the use of healthy eating pyramid principles. RESULTS: Overall 165 patients were enrolled and the data of 150 of them (34 with confirmed GERD and 116 of the control group) were available for the final analysis. The patients of the both groups consumed lower compared to the recommended amounts of dairy and higher amounts of meat. Those with GERD consumed larger amounts of fruits (0.910.68 compared to the values of healthy eating pyramid vs 0.520.57 in the control group, p=0.001), and fats (0.690.55 vs 0.490.55, p=0.001). Compared to the controls, patients with GERD consumed lower amounts of vegetables (0.860.46 of the healthy eating pyramid vs 0.940.63 in the control group, р=0.004) and sugars confectionaries (0.380.39 vs 1.930.98, p=0.0001). CONCLUSION: Nutritional patterns of patients with gastroesophageal reflux disease significantly differ compared to the control group. The obtained data may be used for diet modification in patients with arterial hypertension.

[Association of nutritional patterns and arterial hypertension in Russia: does it exist?]

AIM: To evaluate nutritional patterns in patient with arterial hypertension (AH) compared to the control group without elevated blood pressure. MATERIALS AND METHODS: Retrospective search for unique records of the patients aged 1875 y.o. with complete data on usual nutrition with food frequency methods who had no mentions of diabetes mellitus, food intolerance or allergies, and history of major abdominal surgery, as well as signs of secondary reasons of AH. Nutritional patterns were assessed with the use of healthy eating pyramid principles. Ststistical analysis was performed with the use of SPSS 13.0 for Windows software (SPSS Inc., USA). RESULTS: The data of 711 patients were available for the final analysis (595 of them in AH group). Both groups consumed lower compared to the recommended amounts of fruits, dairy and higher amounts of meat. Those with AH consumed larger amounts of vegetables (1.130.74 compared to the values of healthy eating pyramid vs 0.940.63 in the control group; p=0.004), fruits (0.800.66 vs 0.520.57; p=0.001), meat (1.851.05 vs 1.620.91; p=0.002) and fats (0.770.60 vs 0.490.55; p=0.001). On the other hand, there were lower rates of consumption of sugars, and confectionaries in the structure of nutritional patterns in patients with AH compared to the control group: (0.350.44 of the healthy eating pyramid in AH vs 1.930.98, in the control group; p=0.0001). CONCLUSION: Nutritional patterns of patients with arterial hypertension significantly differ compared to the control group. The obtained data may be used for diet modification in patients with arterial hypertension.

[Innovative approaches to study food patterns in functional gastrointestinal disorders].

Dietary patterns play an important role in pathogenesis and treatment of functional gastrointestinal disorders. The aim - to perform literature review on modern approaches to perform nutritional assessment in functional gastrointestinal disorders and to summarize available data on its role in assessment of clinical manifestations and treatment of these conditions. Material and methods. A search was performed in the PubMed and Google scholar system with the use of keywords: "nutritional pattern", "dietary pattern", in combination with "methodology", "assessment", "functional gastrointestinal disorders", "GERD", "gastroesophageal reflux disease", "irritable bowel syndrome", "IBS", "small intestinal bacterial overgrowth", "treatment". The inclusion criteria were type of the paper (original study); they had to contain data on nutrition of patients with functional gastrointestinal disorders; main digital data should be present (sample size, design, diagnostic criteria, patients' eligibility criteria, control group characteristics, as well as results in quantitative characteristics and measure of dispersion of values). Results and discussion. Based on the data of 81 selected papers structured literature review was performed. We summarized the data on the methods of food patterns assessment, the knowledge on the food patterns in patients with functional gastrointestinal disorders (including gastroesophageal reflux disease and irritable bowel syndrome), clinical utility of the nutritional assessment with the use of food patterns. Assessment of nutritional patterns in patients with functional gastrointestinal disorders provides additional evidence that allows to correct the diet of these patients more effectively, to achieve better results of treatment in shorter time, to reduce the number of medications, and may be of use for the development of new functional foods.

[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 SIBO 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 SIBO 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%, Catbl - 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 - 5.5±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 dietary diversity in the formation of syndrome intestinal bacterial overgrowth].

Small intestinal bacterial overgrowth (SIBO) is a widespread disease characterized by a significant decrease of the quality of life. Antibiotic treatment of SIBO is usually effective, however, the recurrence 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 SIBO or its relapses after treatment. The aim of the study was to compare nutritional diversity in patients with SIBО-H2 and in healthy controls. MATERIAL AND METHODS: Оne thousand twenty three patients with suspected SIBО were examined. Hydrogen-methane breath test with lactulose was performed in 973 patients, the results of which identified groups with SIBO-H2 (n=522), with SIBO-CH4 (n=340) and without signs of SIBO (n=108). Data on food intake was collected with 24 h recall from all participants. Dietary diversity was assessed using method of calculation of unique values (count base diversity) for 11 groups of food: cereals, meat and eggs, fish and non-fish seafood, fat containing products, dairy products, nuts, vegetables, fruits and berries, confectionery, drinks, sauces and spices. The pattern of food diversity for each patient was obtained by counting the items in each of the studied food groups. Comparison of the mean values of the number of items in each of the studied food groups was used to compare food diversity in patients with and without SIBО-H2. RESULTS AND DISCUSSION: A comparison of nutritional diversity in patients with SIBO-H2 revealed a lower count base diversity in the groups of dairy products (2.70±1.37 vs 3.19±1.34, p<0.001), vegetables (5.50±2.22 vs 6.29±1.90, p<0.001), fruits (1.54± 1.38 vs 1.99±1.69, p=0.018) in compare with controls. Count base diversity in grains, meats, fishes, fat products, nuts and legumes and sweets did not demonstrate significant differences. CONCLUSION: Significant differences in the diversity of dietary patterns in patients with SIBО were found in dairy products, vegetables and fruits and berries. The obtained data may be used to develop diet for SIBO patients additionally to the treatment and prevention of its relapses.

[Recommendations for the Protocol of functional examination of the anorectal zone and disorders classification: the International Anorectal Physiology Working Group consensus and Russian real-world practice].

This manuscript summarizes consensus reached by the International Anorectal Physiology Working Group (IAPWG) for the performance, terminology used, and interpretation of anorectal function testing including anorectal manometry (focused on high-resolution manometry), the rectal sensory test, and the balloon expulsion test. Based on these measurements, a classification system for disorders of anorectal function is proposed. Aim to provide information about methods of diagnosis and new classification of functional anorectal disorders to a wide range of specialists general practitioners, therapists, gastroenterologists, coloproctologists all who face the manifestations of these diseases in everyday practice and determine the diagnostic and therapeutic algorithm. Current paper provides agreed statements of IAPWG Consensus and comments (in italics) of Russian experts on real-world practice, mainly on methodology of examination. These comments in no way intended to detract from the provisions agreed by the international group of experts. We hope that these comments will help to improve the quality of examination based on the systematization of local experience with the use of the methods discussed and the results obtained. Key recommendations: the International Anorectal Physiology Working Group protocol for the performance of anorectal function testing recommends a standardized sequence of maneuvers to test rectoanal reflexes, anal tone and contractility, rectoanal coordination, and rectal sensation. Major findings not seen in healthy controls defined by the classification are as follows: rectoanal areflexia, anal hypotension and hypocontractility, rectal hyposensitivity, and hypersensitivity. Minor and inconclusive findings that can be present in health and require additional information prior to diagnosis include anal hypertension and dyssynergia.

[Features of nutrition pattern of patients with small intestinal bacterial overgrowth resistant to therapy].

Small intestinal bacterial overgrowth (SIBO) is a widespread disease characterized by a significant decrease in the quality of life. Antibiotic treatment with SIBO is not effective enough and the recurrence rate is high. Long-term dietary patterns can shift the composition of the microbiota. The aim of the study was to compare the pattern of nutrition of patients with SIBО, resistant to therapy and cured patients. Materials and methods. SIBO H2 has been identified in 458 patients using hydrogenmethane breath test with lactulose, and therapy with intestinal antiseptics and control breath test after 2 months was prescribed. 24 hour recalls or three-day food records were collected from all participants. The photographs were used to estimate the size of the portions eaten. According to food composition and portion all dishes in food diary were converted into constituent products by food groups, which were summed by weight per day and compared with the norms of consumption of the pyramid of healthy nutrition for a given caloric intake. The study compared dietary patterns of patients with resistance to the therapy of SIBO and those who had successful therapy. Results and discussion. Control of the hydrogen content in the exhaled air was performed only in 79 re-appeared patients, 38 (48.9%) of them in 2 months after therapy revealed the presence of SIBO H2>20 ppm. A comparison of the nutrition of these patients showed that patients resistant to therapy had higher consumption of buckwheat (0.41±0.47 vs 0.14±0.35 relative to the rate of consumption of cereals, p<0.001) and millet (0.036±0.11 vs 0.007±0.021, p=0.047), poultry meat (0.80±0.64 vs 0.54±0.62, p=0.01) and butter (0.54±0.24 vs 0.39±0.22, p<0.01). The diet of patients with resistant to SIBO therapy was also сharacterized by a lower consumption of mono- and disaccharides (75.2±32.7 vs 95.5±41.5 g/day; p=0.015) and cottage cheese (0.07±0.08 vs 0.17±0.19, p=0.018). Consumption of fruits and vegetables did not have significant differences. Conclusion. Treatment is ineffective in roughly half the patients with SIBO H2. According to the results of the study, significant differences in the nutrition pattern of patients resistant to SIBO therapy with respect to the consumption of cereals, poultry, butter, added sugars and cottage cheese were established. The obtained data may be used to develop dietetic maintenance of SIBO therapy and prevention of its relapses.

[Association of food patterns with different forms of small intestinal bacterial overgroth syndrome and treatment efficacy].

AIM: To assess food patterns in patients with different types of SIBO and their impact onto the course and treatment outcomes. MATERIALS AND METHODS: The data of 988 patients who signed informed consent surved as a source data. On the basis of lactulose breath test (LBT; GastroCH4eck, Bedfont, UK), the patients were selected into one of the studied groups: SIBO-H2, SIBO-CH4, SIBO-CH4-H2 and control. Twenty - four hours food recall test was used to analyze nutritional habits. In patients with SIBO-H2, standard treatment with Tilichinol 100 mg/Tilbrochinol 200 mg (Intetrix, Beaufour-Ipsen International, France) 2 caps BID for 10 days) was provided. Efficacy of treatment was assessed on the bass of the result of LBT 2 month after treatment completion. Mann-Whitney T test (Statistica 10, StatSoft, USA) was used to compare nutritional patterns in patients with or without SIBO, in different types of SIBO and in accordance to the results of treatment. RESULTS AND DISCUSSION: Nine hundred eighty eight patients were enrolled. On the basis of hydrogene breath test they were divided into 4 main groups: SIBO of hydrogen - producing flora (SIBO-H2, n=526), methane - producing flora (SIBO-CH4, n=129), SIBO with hyperproduction of methane and hydrogene (SIBO-CH4-H2, n=225). The control group consisted of 108 patients with no no excessive gas production on LBT. In contrast to controls, nutritional patterns of patients with SIBO were characterized by low dietary fiber and amount of red meat dishes in the rations. Those with SIBO-CH4 consumed more fruits (p=0.03), vegetables (p=0.003), and fish (p=0.026), compared to those with other variants of SIBO and the control group. Nutritional patterns of SIBO-H2 group were characterized by larger amount of poultry meat consumption (p=0.026) compared to other SIBO groups and controls. In SIBO-H2 "cured" group greater amounts of buckwheat (p.

[Methanobrevibacter smithii in irritable bowel syndrome: a clinical and molecular study].

AIM: To assess the role of Methanobrevibacter smithii in patients with irritable bowel syndrome associated with small intestinal bowel overgrowth. MATERIALS AND METHODS: Sixty - seven patients with IBS according to Rome IV were enrolled into the study in whom hydrogen breath test was performed. Thirty - two healthy subjects with negative breath test was used as a control. All IBS symptoms assessed daily with 5 grade Lykert scale for 7 days, stool was assessed by Brystol stool scale. M. smithii was confirmed in stool samples by PCR. RESULTS AND DISCUSSION: In 67 IBS patients CH4 overproduction was found in 32 (47.7%), H2 overproduction in 31 (46.2%) and normal values in 4 (5.9%) by hydrogen breath test. M. smithii was confirmed by stool PCR in all patients with CH4 overproduction. Severity and prevalence of main clinical features of IBS were similar in both SIBO groups but were significantly higher than in control (p.

[Assessment of clinical efficacy and tolerability of meat-containing canned food for enteral nutrition].

AIM OF STUDY: to evaluate the efficacy and tolerability of meat-containing canned food for enteral nutrition in clinical settings in patients with gastrectomy. The product was made from animal protein (beef) with the addition of vegetable oils, soy protein, maltodextrin, stabilizer, vitamins and minerals. 40 patients with gastrectomy were included to the study and randomly formed 2 groups of 20 persons: the main group (8 men and 12 women, mean age 64.4±12.4 years) on the background of standard mashed diet for 14 days received 2 portions of the tested product (240 ml), the control group (5 men and 15 women, mean age 64.8±12.9 years) was treated with standard diet. Daily registration of the symptoms was carried out filling the 5-point scale of the Likert (the presence and severity of abdominal pain, flatulence, heartburn, nausea, a feeling of heaviness after eating, incomplete evacuation of the intestine). The Bristol stool scale was used to assess the dynamics of the stool. Laboratory parameters (hemoglobin, blood serum level of total protein, albumin and iron) and body composition parameters were evaluated before and after treatment. Consumption of meat-containing canned food for enteral nutrition was accompanied by significant decrease in the severity of nausea (from 1.20±0.29 to 1.02±0.05 points of the Likert scale, p=0.017), a decrease in abdomen heaviness (from 1.8±0.8 to 1.4±0.6 points, p<0.05), contributed to an improvement in stool consistency, an increase in all body composition parameters, a positive dynamic of protein metabolism (increase of hemoglobin level from 119.2±9.6 to 122.6±6.8 g/l, p>0.05, blood serum protein and albumin). A tendency to increase the mental component of the quality of life (+4.2%) was found. Thus, meat-containing canned foods for enteral nutrition can be used in the diet of patients in the postoperative period, they are well tolerated in conditions with loss of appetite, are effective in patients with protein-energy malnutrition.