FIELD: medicine.
SUBSTANCE: invention refers to medicine, nutriology, nutritional science, immunology, endocrinology and can be used in persons of working age, having reduced body weight (BW) against underlying metabolic disorders for various reasons (somatic, nervous, mental diseases, oncology). Method comprises a high-protein diet (HPD), intake of balanced protein mixtures and food additives under control of objective indicators of body state: body weight index (BWI) dynamics, bioimpedance analysis of body composition, biochemical, immunological blood indices and intestinal microbiocenosis parameters. Base of HPD is low-fat veal, chicken, turkey, dairy products and eggs. Dry nutritional formula Nutrinor is added to the main course and beverages 3-4 times a day starting the diet with the energy requirement of 20 kcal/kg/day. In case of reduced BWI by 3 kg/m2 from the lower limit of the norm, the diet is first followed by providing 50 % of the daily energy requirement of the patient (PDER), before increasing BWI by 1 kg/m2 compared to initially reduced before correction. Further, the same diet with Nutrinor is followed, providing 75 % PDER, to BWI = 17 kg/m2. Further, the same diet with Nutrinor is observed, providing 100 % PDER, to BWI = 18 kg/m2, after which the patient switches to natural nutrition. If initially reduced BWI by 1–2 kg/m2 50 % PDER HPD with Nutrinor is ensured from the lower norm within first 3 days of correction; 75 % PDER is provided in following 3 days. Further, HPD with Nutrinor intake is continued, providing 100 % PDER to a BWI value which is the lower limit of norm of 18.5 kg/m2. At the end of the diet, the patient changes over to natural diet – a general version of the diet (GDO) with additional Nutrinor intake, daily dividing its volume into 5 equal meals a day, adding it to food and/or beverages in a combination with enzymes specified in the group: Hermitel, Creon, Mezim, Pancreatin, in dose of 15,000–20,000 units for each main meal – breakfast, lunch and dinner – until reaching BWI = 19 kg/m2. Food additives throughout the course of correction are Hepamin 2 pill/d. during meals and Stimbifid after meals: on 1st day - 2 pills 1 time/day, in 2nd – 2 pills 2 times/day, in 3rd – 2 pills 3 times/day, while taking this dose of Stimbifid and Hepamine for at least one month after reaching BWI = 18.5 kg/m2. Course is combined with the stimulation of appetite with the intake of the mineral water therapeutic table water "Lipetsky byuvet" at room temperature 15 minutes before meals 3 times day for 150 ml, starting with 100 ml once a day, water is sipped, at least as far as possible for patient. Efficiency of correction is judged by the dynamics of the above indices. If the PEI is caused by anorexia nervosa, in addition to the above correction methods, a psychotherapeutic effect corresponding to the patient's condition is performed.
EFFECT: achieving simultaneous adequate metabolic correction of PEI in the absence of side effects of polypharmacy with normalization of metabolism, intestinal biocenosis, immune and electrolyte status, adequate neuroimmune-endocrine regulation of metabolism with preservation of effect up to 12 months.
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Authors
Dates
2020-02-14—Published
2019-10-23—Filed