[Body composition and basal metabolic rate in overweight and obese patients].

Diet therapy is a key moment in the treatment of patients with obesity. The energy value of the diet must directly depend on the daily energy expenditure. It is extremely important for a specialist who determines a diet for a patient, using an individual approach, to most accurately calculate daily energy expenditure. On the one hand, the calculation method should be as accurate as possible, on the other hand, it should be simple and economically affordable. The aim of the study was to evaluate the body composition in patients depending on gender and body mass index and to identify the optimal method for calculating the basal metabolic rate (BMR) in patients with various degrees of obesity. Material and methods. The study included data from 338 men aged 39.0±11.9 years and 847 women aged 44.0±12.5 years. The study of the body composition was carried out by the multi-frequency bioelectrical impedance analysis on the analyzer "InBody 770", which simultaneously provides information on the BMR, calculated taking into account the composition of the body according to the Ketch-McArdle formula. The BMR was also calculated using the Mifflin-St. Jeor formula and the results were compared. Results. In men and women, with an increase in body weight, an increase in skeletal muscle mass is noted, which entails an increase in the BMR. The BMR, calculated by the formula that does not take into account the volume of the main body energy-consuming tissues, differed from that calculated by the formula that takes into account the value of metabolically active components of the human body composition, towards an increase in men with obesity of class 2 and class 3 degrees, by 141 kcal and by 294 kcal, respectively, in women with obesity class 1 - by 81 kcal, class 2 - by 139 kcal, class 3 - by 262 kcal. Conclusion. When conducting primary diagnostics on an outpatient basis in patients with overweight and obesity, along with simple anthropometry, it is necessary to perform a body composition study. The calculation of the BMR as a component of daily energy expenditure should be carried out taking into account the characteristics of the body composition. If it is not possible to conduct a bioelectrical impedance study and accurately calculate the BMR, the results obtained during this research can be used: BMR in men with obesity of the class 1 - 18.5 kcal/day kg body weight, with obesity of the class 2 - 16.6 kcal/day kg body weight, with obesity class 3 - 14.6 kcal/day kg body weight; BMR in women - respectively 16.7, 15.0 and 13.5 kcal/day kg body weight.

[Nutrition and nutritional status of underweight patients].

Insufficient body weight is one of the manifestations of nutritional disorders. Diseases associated with malnutrition occur in 10-12% of the population. The aim of the work was to study indicators of nutritional status and actual nutrient intake in patients with insufficient body weight. Material and methods. The study included 48 women aged 31.4±11.8 years, with a body mass index below 18.5 kg/m2. The body composition was estimated by bioelectrical impedance analysis. Nutrient intake was assessed using food frequency questionnaire, physical activity was evaluated by the survey method, using the computer program "Evaluation of nutrition", also blood biochemical parameters were determined. Results. Body fat mass was below average values in 93.8% of patients, while only 50.0% of women had a skeletal muscle deficiency, and 10.4% surveyed had skeletal muscle mass above average values. The energy value of the daily diet was 1982± 282 kcal, and daily energy expenditure was 2158±255 kcal. In the structure of the diet, fats prevailed (42.0±10.5% of daily calorie intake) and there was a significant lack of total carbohydrates (39.9±10.4% of daily calorie intake) and dietary fiber. Fat intake was exceeded in 92.9% of patients. Insufficient carbohydrate intake was also observed in 92.9% of patients. In most patients, daily intake of potassium, calcium, magnesium, iron, B vitamins did not reach the recommended level, while sodium and phosphorus intake was excessive. The nutrient intake imbalance affected blood biochemical parameters in hypercholesterolemia (in 41.7% of patients) and hypertriglyceridemia (31.3%), and decreased calcium (30.0%), iron (12.8%) and vitamin D (52.2%) levels. Conclusion. Thus, for underweight patients, correction of the diet and dispensary observation is required to determine body composition and biochemical parameters, in particular, the fat and muscle components of the body weight, lipid metabolism indicators, the supply with macro- and micronutrients in order to develop treatment and prevention tactics of diet-related diseases, combined with reduced body weight.

[Magnesium and vitamin B2 status of children with bronchial asthma and obesity].

Insufficiency or deficiency of some micronutrients may be additional modifying factors that influence the pathogenesis of the disease and the effectiveness of standard pharmacotherapy. The aim of the study - to evaluate the level of magnesium and vitamin B2 in blood serum of patients with bronchial asthma and obesity in order to develop methods for individual correction of deficiency. Material and methods. The study included 51 children aged 12-17 years. The first group included 23 patients (12 girls and 11 boys) with asthma with comorbidities (obesity), and the second group consisted of 28 children (10 girls and 18 boys) with obesity. The concentration of magnesium in blood serum was determined by a colorimetric method without deproteinization, and vitamin B2 - by an immunological microbiological method. Results and discussion. When analyzing the concentration of magnesium in blood serum of the examined children, it was found that in patients with bronchial asthma and obesity, a reduced content of this mineral was observed in 15 (65.2%) patients. The average magnesium concentration was 0.66±0.02 mmol/l at a rate of 0.7-1.2 mmol/l. A statistically significant decrease in the magnesium level in children suffering from asthma and obesity was noted, compared with the level in children with obesity (0.66 [0.57; 0.73] vs 0.71 [0.67; 0.73] mmol/l, р<0.05). Low serum magnesium levels in obese patients were detected more rarely (р<0.05) - only in 6 (21.4%) children, mostly in patients with grade III obesity. The remaining 22 (78.6%) children had magnesium level within the normal range. Patients with low serum magnesium levels showed increased irritability, sleep disturbance, loss of memory and concentration. Vitamin B2 levels in all examined children were within the normal range (137-370 ng/ml). Conclusion. The results indicate a decrease in the concentration of magnesium and normal levels of vitamin B2 in serum in patients with bronchial asthma and obesity. Low serum magnesium levels were observed in children with low bronchial asthma control. To increase the effectiveness of therapy and control the symptoms of bronchial asthma, especially when combined with obesity, correction of the accompanying magnesium deficiency is necessary.

[New way in dietotherapy of infants with food allergy]. / Novyi podkhod k dietoterapii detei s pishchevoi alergiei.

The authors followed up (in outpatient conditions) a total of fifty 1-to-9-mounth-old infants with the diagnosis of atopic dermatitis, disseminated form, of subacute course. The infants were followed up for 3-12 months, with 83% of the 113 examined patients 1-3 weeks after the beginning of treatment having shown clinical improvement of cutaneous inflammatory processes. Of the 172 infants subjected to immunological examination, in 100--the level of total IgE in blood serum was significantly elevated. These children also had elevated level of the specific IgE antibodies to cow's milk proteins. The outcomes of the carried out dietotherapy using mixture "Nanny" showed that this therapeutic product resulted in remission in the majority of the followed up infants suffering from allergy to cow's milk proteins.