[DIETARY PREVENTION OF PROTEIN-ENERGY MALNUTRITION IN ELDERLY PATIENTS IN THE POSTOPERATIVE PERIOD].

The occurrence of protein-energy malnutrition in the late postoperative period in elderly patients with gastroduodenal ulcers is an indication for the earliest possible appointment of a specialized diet the prevention of this complication. Specific dietary recommendations for the prevention of protein-energy malnutrition in the postoperative period were given.

[Enteral dysfunction as a factor of protein-energy insufficiency development in elderly persons following gastric surgery].

264 patients within the age group of 61-93 were observed both by the gastroenterologist and surgeon for 3-6 years following gastroduodenal ulcer surgical treatment. 31,8% developed protein-energy insufficiency (PEI) in late terms, i.e. 3-12 months after the operation. Comparative analysis with a control group showed that PEI development in elderly patients occurs under conditions of membrane and cytosol enzyme synthesis decrease in small intestine and transport system disturbance in its mucosa in postoperative period. Risk of PEI development is especially high in elderly patients with the accompanying cardiovascular pathology resulting in membrane digestion depression and absorption inhibition. The importance of membrane small intestinal digestion disorders in elderly patients in postoperative period was suggested to play a significant role in prognosis and detection of PEI in early stages.

[Gerontodietology].

Gerontodietology is one of the most important parts of dietetics studying problems of nutrition of elderly and old persons and persons with high risk of early and pathological aging, developing principles of rational nutrition, prophylactic and curative nutrition and methods of its organization. Functional structure of modern gerontodietology, its scientific-methodical bases, terminological features are presented. Composition and features of healthy nutrition of elderly people is described in details, methods of its optimization and individualization are given. Notions of geriatric dietotherapy, its principal difference from curative nutrition of patients of other ages are described. Large section of the article is devoted to the modern problems of prophylactic gerontodietology, intended more for persons with high risk of early aging than for elderly persons. Theoretic basis and methodological contents of prophylactic gerontodietology are presented; practical recommendations on dietetic means to prevent intensive development of involution processes and organic pathology in the body are described.

[Dietary prevention of protein-energy malnutrition during early postoperative period in elderly patients with gastroduodenal diseases].

The modified diet of postoperative rehabilitation program in elderly patients with gastroduodenal ulcers and prognosis of development of protein-energy malnutrition (PEM) is presented. It is shown that early initiated special diet in postoperative period, blocks mechanisms of malnutrition and can significantly improve the functional status of the small intestine and activate, thus, membrane digestion, which leads to normalization of all types of metabolism in elderly patients. In comparison with control group, where 72% of patients in postoperative period had malnutrition, malnutrition in the study group revealed a mild degree in only 17.3% of patients.