The use of dietary supplements in neurology. Chudakov, S.Yu. - Biologically active dietary supplements - luxury or necessity? Chudakov sergey yurievich doctor about badakh descending

In September, the first ONF Forum dedicated to health issues was held in Russia. Public councils have also been formed under the relevant ministries. Can the population really influence state policy on health issues? What formats can bring the greatest impact?

Expert opinion of the coordinator of the School for the Activation of Citizenship (STEP) Sergey Chudakov -candidate of Medical Sciences, Associate Professor of the Department of General Medical Practice (Family Medicine), member of the working group on public health of the Commission on the Quality of Life and Health Protection of the Social Platform of the WFP "United Russia" - AHRF.

- The emergence of various kinds of public associations on health issues is not an exclusively public initiative. I must say that at the state level there are regulatory documents that regulate the creation and functioning of public expert councils. Such associations exist under different departments, not only in health care, and should monitor the work of the department by the public.

At its core, community councils are the right idea. But the existing mechanism of their formation does not correspond to the functions that were assigned to them. Namely - to broadcast the opinion of people through representatives in public councils. As practice shows, most representatives do not represent anyone but themselves. Or they are small local public organizations with 10-30 members who are trying to promote something. Or - retired officials. As a rule, these people do not express the opinion of the majority. Which leads to the problem: departments are on their own, people are on their own. Such councils have no real influence on the work of departments. Rather, they are a formal entity that enables the department to report that it is complying with the regulatory guidelines.

The same applies to public councils under the ministries of health. These are the structures "under the ministries" that do not conduct an independent dialogue.

It is good that the ONF forum made an attempt to solve this problem and rely on the people's controllers. But control alone will not solve the problem. We need to create, we need changes. And such a constructive mechanism must be formed.

It should have two supports. The first is popular health strategy. The second is interdepartmental interaction, in which the policy of any ministries - social, economic - is formed taking into account whether decisions will lead to a deterioration in health. Because it is known that doctors are already dealing with the result, and problems begin in areas far from healthcare.

As for popular strategizing, this is a technology of working with civil society, which gives it a real opportunity to influence politics and participate in decision-making. After all, it is the population that is the main customer of the national health care system. Therefore, it should form the agenda - what the system should be like. The same technology is being implemented, which has been developed and has already been tested in a number of regions by the “School for the Activation of Citizenship,” through strategic, project sessions. Such events gather people of different social and demographic groups, different communities, including professional ones. A wide representation allows us to take into account the whole palette of problems, opinions, approaches and form an image of the future: what kind of people would like to see a health care system.

And one of the main results of using the format of popular strategizing is that people who have formed a new image are ready to participate in events that would make it real. Not only did they cut tasks for someone, but they have their own initiatives that they want and can translate into business.

I note that this ideology fits into the concept of "public health". Similar norms and scenarios are already being applied in foreign countries. And in Russia it is necessary to create a similar system. To get out of the zone in which only doctors are responsible for health. The main customer of the state health policy should be the population.

Victor Alexandrovich Lopaev
Physician-psychophysiologist, consultant of the Russian Association of Pharmaconutriciology
Olga Petrovna Mironova
Head the neurological department of the Central Clinical Hospital of the Russian Academy of Sciences
Sergey Yurievich Chudakov
Vice President of the Russian Association of Pharmaconutriciology

For a long time in the science of nutrition, the main attention was paid to assessing its usefulness in terms of sufficient calorie content (energy function of food) and protein supply (plastic function) of the diet. Research aimed at studying the role of micronutrients in the maintenance of vital processes was presented in a much smaller volume.

And the role of fats and fiber has been clearly underestimated. The situation changed after many years and mass surveys of the population of various regions of Russia, carried out by employees of the Institute of Nutrition of the Russian Academy of Medical Sciences, revealed a number of serious violations in the nutritional status of the population. In the diet of the majority of the country's population there is a deficiency of a number of vitamins (vitamin C, vitamins B1 and B2, folic acid, vitamin A and_carotene, vitamin E and some others) and minerals (zinc, selenium, calcium, iron, iodine and fluoride); excessive consumption of animal fats; deficiency of complete (animal) proteins, polyunsaturated fatty acids (PUFA) and dietary fiber.

The identification of these nutritional characteristics of the population prompted a large number of studies aimed at clarifying the mechanisms of the participation of micronutrients in ensuring the functioning of organs and systems of a healthy and sick organism. It turned out that eating disorders play a very significant role in the development of a number of diseases. The nervous system turned out to be especially sensitive to the deficiency of a number of vitamins and minerals, which is manifested in a significant spread of its functional diseases. The need to make a correction to the provision of the body with micronutrients in such cases became obvious.

After a certain period of accumulation of knowledge and development of technologies that make it possible to extract micronutrients from medicinal and food plants in sufficient quantities, a new class of therapeutic and prophylactic agents has appeared, called biologically active food additives (BAA).

Studies devoted to the study of both the role of micronutrients (dietary supplements_nutraceuticals) and small doses of biologically active substances obtained from medicinal plants (dietary supplements_parapharmaceuticals) in ensuring the vital processes of the body are currently distinguished as an independent scientific direction, called "micronutrientology" or "pharmaconutriciology" ...

In order to understand what caused such transformations, let us consider the comparative characteristics of some of the features of therapy using pharmacological drugs, herbal medicine and therapy using dietary supplements.

Traditional phytotherapy is characterized by the use of a large number of biologically active substances contained in plants, many of which form homogeneous groups and complement each other's action on the body.

That is why the effect of, for example, vitamin preparations obtained directly from plants (this is, as a rule, a whole complex of substances) is more effective than preparations containing synthetic analogs of one of these substances.

The therapy with the use of dietary supplements has retained the same feature. Both in herbal medicine and in therapy with the use of dietary supplements for the regulation of body functions, precisely those substances are used in relation to which it can be assumed that their use for these purposes is “provided for” by the evolutionary process. In therapy with the use of synthesized pharmaceutical preparations, it is allowed to use substances foreign to the body, which in some cases can have a toxic effect and cause allergic reactions. And although such effects are possible when using natural drugs, the likelihood of their development in the latter case is about an order of magnitude less than when using synthetic drugs. There are also two features that distinguish therapy with dietary supplements from traditional herbal medicine. The first of them is that the creators of dietary supplements have developed special technologies for obtaining dry extracts of plants that can retain their medicinal properties for several years.

The use of preparations made from well-proven medicinal plants, the use of which was previously limited (in the form of decoctions or infusions) to the areas of distribution of these plants, has become possible in all countries of the world. The second feature is that thanks to the use of modern equipment (plasma photometers and other devices), the creators of dietary supplements were able not only to control the content of the main active substances in plant raw materials, but also to standardize the finished preparations in terms of the content of these substances. According to this indicator (certainty of the composition of drugs, which ensures the standardization of the therapeutic effect on the patient), dietary supplements, although they do not reach the level of pharmaceuticals, approach them to a much greater extent than phytopreparations. The study of the role of factors on which the state of health of the population depends, showed that the factor "lifestyle characteristics" (among which dietary habits play a major role) is of much greater importance than the factor "level of medical support".

However, for a long period this situation was only stated as a fact, practically remaining outside the sphere of influence of doctors armed only with pharmaceuticals.

The appearance of dietary supplements in the arsenal of a practitioner provides at least the opportunity to correct the nutritional deficiencies in patients.

For a certain period of time, representatives of theoretical and clinical medicine distanced themselves from the question of the use of dietary supplements in medicine. After the revival of the interest of scientists and the medical community in the physiological role of micronutrients in the body, a period of recognition of the possibility of using dietary supplements as a means of prevention and general strengthening agents began. However, attempts to talk about the therapeutic effect of dietary supplements were still not taken seriously and were not approved. Today, under pressure from the results of a large number of recently published studies, most doctors recognize it as an undoubtedly established fact: the complex use of drugs and dietary supplements as auxiliary means, as a rule, can significantly reduce the number of medications used.

Even if we imagine that the possibilities of using dietary supplements in the treatment process are limited by this result alone, this already deserves the most serious attention.

Practitioners have neither the opportunity nor the need to delve into the details of the disputes arising between supporters of the use of pharmaceuticals (who do not recognize the advantages of dietary supplements) and active advocates of the use of dietary supplements (sometimes unreasonably belittling the advantages of pharmaceuticals). One can try to move away from the currently dominant tradition of dividing medicinal preparations into drugs of etiological, pathogenetic and symptomatic action and suggest a slightly different approach. Pharmaceuticals can be regarded as fast-acting and, as a rule, quite powerful regulators of functions. At the same time, BAA_parapharmaceuticals (the amount of the main active ingredient in BAA, by definition, is less than the therapeutic dose established for pharmaceuticals) should be recognized as means by which a long-term and “mild” regulatory effect on the functioning of organs and systems is carried out. Nutraceutical dietary supplements (defined as means designed to compensate for insufficient intake of certain biologically active substances with food) can be considered as means that allow to normalize the work of "metabolic conveyors" and, thereby, not only create preconditions for the restoration of normal functioning of organs and systems , but also ensuring the implementation of this process.

With such an assessment of the role of various types of drugs, the conclusion suggests itself: it is unlikely that one should so fundamentally oppose the appointment of these drugs (some as preventive measures, others as therapeutic agents). It seems much more expedient, adequately assessing the capabilities of these two groups, to combine their use in the treatment process.

This report provides a brief overview of dietary supplements with micronutrients containing vitamins and vitamin-like substances.

Vitamin A (carotenes and carotenoids)

Fat-soluble vitamin A is found only in animal products. Plants also have provitamin activity. Other substances that make up a large group of carotenoids (more than 500 have been described in recent years) are used as antioxidants and have no provitamin activity. Vitamin A itself, in addition to antioxidant activity, is involved in the production of visual pigments and promotes the regeneration of epithelial cells. It is mainly used in ophthalmic and dermatological practice.

In addition, vitamin A promotes the production of sex hormones and increases overall body resistance. The use of vitamin A in neurology is primarily associated with its participation in the mechanisms that stabilize blood sugar levels. It is advisable to use preparations containing vitamin A in the complex treatment of convulsive syndrome.

Vitamin D

Vitamin D is involved in the metabolism of calcium and phosphorus, which are vital for the functioning of the brain. It enhances the action of drugs that cause antidepressant, sedative and hypnotic effects. It is prescribed for sleep disorders, as well as in combination with antidepressants and sedatives.

Vitamin C

Vitamin C has an antitoxic effect due to its activating effect on the detoxification of the liver enzyme systems.

At the same time, vitamin C has an antiatherogenic effect, increasing the content of high-density lipoprotein cholesterol and lowering the content of low-density lipoprotein cholesterol. Vitamin C, reducing the likelihood of a platelet aggregation reaction, helps to maintain the elasticity of blood vessels and, by strengthening the capillaries, has a normalizing effect on the blood supply to the brain. Directly participating in the synthesis of hormones of the adrenal cortex, it contributes to an adequate response to increased stress.

Of great importance is its ability to restore the oxidized forms of vitamins A and E - fat-soluble antioxidants and, thus, to take part in the protection of phospholipids of cell membranes from the destructive action of oxidants.

The listed functions of vitamin C are extremely important for the normal functioning of the brain. Of great interest are information on the effect of vitamin C on the formation of norepinephrine, dopamine, serotonin and endorphins, which indicates its direct effect on the psychoemotional state. Along with independent use, vitamin C is also included in the complex of antioxidant drugs.

Bioflavonoids (a group of substances with P-vitamin activity)

The main function of bioflavonoids (of which there are already about 4000 today) is the antioxidant protection of tissues. When talking about the role of antioxidants in the maintenance of the brain, the following should be borne in mind.

The brain, which has an extensive network of small blood vessels, is one of the main “targets” of the atherosclerotic process. It is the brain tissues that are richest in lipid fractions and therefore, to a greater extent than other tissues, are damaged during the development of the process of lipid peroxidation. Bioflavonoids have a pronounced angioprotective effect (as hyaluronidase inhibitors) and are usually used in conjunction with vitamin C.

Vitamin B1

Vitamin B1 (thiamine) is involved in carbohydrate, fat and protein metabolism. Important from the point of view of ensuring the functioning of the nervous system, the functions of vitamin B1 are its especially significant role in the aerobic metabolism of carbohydrates and, thus, in providing neurons with energy, as well as the participation of vitamin B1 (together with coenzyme A) in the synthesis of acetylcholine. A lack of vitamin B1 can manifest itself as increased fatigue, a decrease in the level of intellectual activity, the appearance of absent-mindedness, which is accompanied by a long and sustained decrease in mood. It is recommended to use it as a prophylactic agent in order to avoid the appearance of periods of decreased mental performance with a large intellectual load (study, scientific work, etc.).

Niacin (nicotinic acid, vitamin PP)

Niacin contributes to the supply of oxygen to the brain cells and is used in carbohydrate and fat metabolism reactions, during which energy is produced. With a lack of niacin in the body, the consumption of tryptophan for these purposes increases, which can lead to a decrease in the amount of synthesized serotonin.

Therefore, niacin deficiency can manifest itself as sleep disorders, a predominance of low and depressed mood, a tendency to develop anxiety-depressive states. The drug in appropriate doses is used for the prevention and treatment of atherosclerosis. Niacin reduces anxiety, improves sleep. In combination with other drugs, it is used in the treatment of depressive conditions. Niacin is also used to treat migraines.

After taking the drug, there may be a feeling of heat and reddening of the skin (short-term vasodilating effect of the drug), sometimes accompanied by the appearance of rashes such as urticaria. As a result, it is advisable to start the course of treatment with half doses of the drug. Taking aspirin when the first signs of a reaction appear in most cases allows you to stop the side effects of the drug.

Niacinamide

Niacinamide, unlike niacin, does not have a pronounced lipid-lowering effect. It also does not have a pronounced vasodilator effect and, accordingly, does not cause a feeling of heat and redness of the skin. In terms of the effect on the level of produced serotonin and the development of the corresponding symptoms, it acts in the same way as niacin. In combination with other drugs, it is used in the treatment of depression. Reduces anxiety, improves sleep.

Vitamin B5

Vitamin B5 (pantothenic acid) is a constituent of coenzyme A, one of the most versatile coenzymes in the body. Coenzyme A is involved in the reactions of carbohydrate, fat and protein metabolism, in particular in the reactions of glucose breakdown, important for the functioning of the brain, the synthesis of phospholipids and neurotropic amino acids, as well as in the process of converting choline into acetylcholine. Contributes to the restoration of the working capacity of the nervous system after suffering psychoemotional stress. Prophylactic use of the drug to maintain the efficiency of the nervous system is possible (a lack of vitamin B5 leads to an inadequately rapid development of fatigue).

Vitamin B6

Vitamin B6 promotes glucose uptake by brain cells. It participates in the metabolism of amino acids important for the functioning of the brain, such as glutamic acid and tryptophan, and helps to normalize the production of neurotransmitters - dopamine, norepinephrine and serotonin. It is necessary for the normal functioning of both the central and peripheral nervous systems. Improves liver detoxification function. As a rule, when prescribing to a patient preparations containing amino acids, vitamin B6 is also prescribed.

Used in the treatment of depressive conditions. It has a beneficial effect on memory and attention disorders. It is advisable to use the drug in the treatment of pathological addiction to alcohol.

Para-aminobenzoic acid (PABA)

A sufficient supply of PABA is necessary for normal metabolism in brain cells. It plays an important role in the process of assimilation of proteins, promotes the formation of folic acid, increases the effectiveness of vitamin B5. Lack of PABA can be manifested by the emergence of a persistent feeling of fatigue, “lack of strength”, there is also no need for physical activity. In some cases, the use of PABA can increase the patient's performance, prevent the overly rapid development of fatigue, or save the patient from fatigue.

Complex of vitamins of group "B"

B vitamins (B1, B2 and B6) are involved in various stages of glucose metabolism, ie. the process of providing cells with energy directly depends on their activity. B vitamins are involved in the synthesis of a number of neurotransmitters. They are actively consumed during psycho-emotional stress. The drug normalizes metabolic processes in the brain, normalizes the synthesis of neurotransmitters. Reduces the adverse effect of psycho-emotional stress. Increases mental and physical performance. Normalizes emotional state and mood.

Vitamin E

Vitamin E improves peripheral blood circulation, reduces blood clotting and normalizes capillary permeability. As an antioxidant, it prevents the oxidation of fat-soluble vitamins and polyunsaturated fatty acids, prevents the violation of the permeability of cell membranes. It is used as a means that prevents the development of cerebral atherosclerosis and reduces the likelihood of complications of atherosclerosis.

Coenzyme Q10

Coenzyme Q10 - “ubiquitous quinone” (ubiquinone) - promotes the movement of oxygen into the cell and the accumulation of ATP molecules in mitochondria. The American scientist Peter Mitchell was awarded the Nobel Prize in 1978 for the discovery and study of this process. The effect of the use of drugs containing Q10 is to increase the functionality of the heart muscle, first of all, as well as other organs actively consuming energy - liver, kidneys, pancreas. Has a hypotensive effect. Protects the mitochondrial apparatus of cells from damage by free radicals, and also protects the lipids of cell membranes from peroxidation (the antioxidant effect of coenzyme Q10 is higher than that of vitamin E). Possesses geroprotector properties. In neurological practice, it is used to improve performance. For better absorption, the drug is recommended to be taken simultaneously with the use of fatty foods.

According to the World Health Organization (WHO), human health depends on: 10% of social conditions, 15% of factors associated with heredity, 8% of medical conditions, 7% of climatic conditions and 60% of the lifestyle of the person himself.

Think about it:

What we eat and drink, what we breathe (eat and inhale poisons and toxins).

We move a little (muscles, cardiovascular system atrophy).

We are experiencing stress (acidification of the body by free radicals).

Enough, perhaps. It's also amazing how you can survive in such conditions! To complete the picture, a few lines from an interview with the Chief Immunologist of the Irkutsk Region, Academician of the EAN BV Gorodiskiy: “We have a sad truth before us: the internal environment of the body - blood, lymph - is so polluted that it loses its susceptibility to pharmaceuticals. It turns out that internal pollution interferes with metabolism. The body does not receive the necessary substances from the outside and is not able to remove metabolic products outside. The methods of purification that exist today either do not bring the expected results (hemosorption, plasmaphoresis), or are very expensive (lymphosorption). "

Therefore, we suggest to CONSTANTLY drink herbal tea drinks "Stronger" - they ALL help to cleanse the body of toxins. Of course, adults are better off starting with special cleansing # 10, 11, 16, 17 or 19.

For the whole family, including even babies, it is more convenient to brew No. 1, 14.

Most often, the first signs of many diseases appear several years before the onset of the acute stage. It is very important to be able to GIVE YOURSELF a TIMELY diagnosis. There is no causeless pain, even short-term. The doctor cannot make a diagnosis with a minimum of information (for example, a stab in the right side). Incorrect diagnosis makes treatment useless. Observe, think, analyze - no one else is interested in your health.

If a person gets tired quickly, this does not mean old age. This is a warning: something is wrong in the body. The Health Navigator program, adopted by the Russian Ministry of Health in 2003, is aimed at early diagnosis, and is being successfully implemented in various regions of Russia with the help of the Longevity consumer society. The President of the Longevity holding Sergey Yuryevich Chudakov tells about the program of monitoring the health of healthy people: “The activation of the preventive focus of the national health care aims at finding ways to protect the population from non-transmissible functional diseases and numerous industrial, transport and domestic injuries that cause mass disability and premature mortality of the population. working age.

WHO experts have identified and proclaimed that the health of the population is formed under the influence of 4 groups of factors: genetics, ecology, medical service and lifestyle.

Modern civilization has formed in highly developed countries a certain lifestyle of the population, which is characterized by increased comfort and sterility of the environment, frequent stress, excess calorie intake and an extremely low level of physical activity.

Medical observations state that a significant part of the population has dystrophy of the muscular system and hypertrophy of adipose tissue, increasing allergy dependence, poor protection from viral attacks, high blood pressure and heart palpitations.

Modern civilization has relieved many people of the need to perform physical work with the help of muscular efforts. Deficiency of movement constantly leads many organs to ineffective functioning, chronic atrophy and organic disease.

The structure of bones is demineralized, their strength decreases, there is a deficiency in the production of erythrocytes, which negatively affects the quality of blood.

Adaptation of the heart and blood vessels to a sedentary lifestyle results in a decrease in the size of the heart, a decrease in the diameter of the main arteries and a decrease in the number of functioning capillaries.

The Longevity Holding Group of Companies is engaged in the complex provision of health and active aging programs. The main areas of activity are: medical, health and educational programs. The concept is based on the process of preserving and strengthening human health, which can only be achieved with the joint efforts of a doctor and a patient, which must be built on the basis of objective knowledge about the state of one's body and clear medical recommendations for the use of adequate health measures and lifestyle correction. Longevity specialists actively use family medicine programs, conduct face-to-face and remote consultations of Moscow's leading natural medicine specialists in all specialties, provide a full range of unique diagnostic services that combine European and Oriental medicine methods, implement targeted longevity and rejuvenation programs with natural medicine.

With the help of the Health Navigator technology approved by the Ministry of Health, a detailed description of the functional reserves of organ systems and the human body as a whole is provided in a form that is quite understandable for an ordinary person. This makes it possible to control the age-related dynamics of health, to identify early signs of functional failure of the neuromuscular, bone, respiratory and cardiovascular systems, to activate targeted prevention and significantly reduce the incidence of the population of all age groups, especially young people. The means of safe correction developed in Longevity allow to restore people's health for a long time, regardless of the initial state. "

I am proud to announce that Omsk tea drinks "Stronger!" also included in the list of safe correction tools that allow you to restore health.

Separately about children. Very short, because good parents have probably read a lot on this topic. And the unlucky ones, perhaps, a brief information will give an impetus for action, they will not read much. Very simple truths around which there are no longer even disputes among the luminaries of medical science.

1. A child cannot be made a vegetarian from birth. Not receiving essential amino acids for up to five years, he will grow up mentally disabled, then it is impossible to fix it.

2. Modern products do not contain enough vitamins and minerals. Therefore, if you want to raise a child physically and mentally full, take care of this from an early age.

Once I listened to the speech of nutritionist, biochemist Konstantin Demidov on dietary supplements. He talked about a young mother who refused to give her child drugs containing macro- and microelements that are so necessary during the growth period: “Declaring that you do not want to experiment, you are setting up a cruel experiment on yourself and your family, leaving yourself and them to the mercy of fate.

Give your child the opportunity to develop powerful intelligence and good health. This is possible up to the age of 12. And only then - what has grown has grown. Calcium, iodine, zinc are necessary during the growth period. Under conditions of oxidative load, iron becomes one of the first places. The health of your children is in your hands! It's time to act! "

I don't have a first aid kit at home - there is simply no need for medicine. But vitamins, minerals, dietary supplements are necessary even for those who drink medicinal herbal teas. For myself, I chose products from different companies (see Appendix 4). This is not so important - there are many companies offering high quality vitamins and dietary supplements. However, I decided that most of all I can trust companies that have been on the market for a long time.

It is not difficult to teach a child from early childhood not to poison himself with soda, black tea and coffee, there is an excellent substitute - freshly squeezed juices, delicious herbal teas No. 14, 1, 3, 17, 19, Sikanjubin balm and ORDINARY FILTERED WATER.

№14 "CARAPUZ" (FOR MOMS AND CHILDREN) Tea for pregnant women, nursing mothers and children (any age). Eases toxicosis during pregnancy, promotes the bearing of healthy offspring. Increases lactation in nursing mothers. Improves digestion, sleep in capricious and often ill children. Helps Cope with Postpartum Depression.

№1 "HEALTH" (FITNING, ENVIRONMENTAL) We recommend drinking it to those who live in a difficult environmental situation, and these are ALL residents of cities and most of the inhabitants of villages. The drink is useful for general weakening of the body, after illnesses, before and after surgery (the herbs that make up the tea have tonic, immunomodulating, anti-toxic, regenerative properties, enhance the therapeutic effect of medications).

№ 3 "SPRING" (VITAMIN) This vitamin drink is especially useful for winter-spring vitamin deficiency, and is also necessary for children who are often ill. We recommend EVERYONE to use this drink in the pre- and postoperative period to reduce the harmful side effects of drugs.

№17 "Svetoch" (VASCULAR, ANTI-SCLEROTIC) As a powerful torch disperses the darkness, so "Svetoch" clears the blood vessels of blood vessels, makes them elastic, fights against atherosclerosis, disorders of blood supply to the heart muscle and brain. Tea is also useful for varicose veins, hemorrhoids. Removes headache, improves memory, vision, hearing.

"... food should be considered not only as a source of energy and plastic substances, but also as a very complex pharmacological complex"

academician A.A. Pokrovsky

Systematic epidemiological studies carried out by the Institute of Nutrition of the Russian Academy of Medical Sciences in various regions of Russia in the past few years have revealed significant deviations in the diet of Russians from the formula for a balanced diet, primarily in the level of consumption of micronutrients - vitamins, trace elements, unsaturated fatty acids, and many other organic compounds of plant and animal origin. , which are important in the regulation of the metabolic process and the functions of individual organs and systems.

It is clear to nutritionists that using the most common set of food products in our country, with the optimal energy value of food at the level of 2200 kcal / day for women and 2600 kcal / day for men (corresponding to the daily energy consumption typical for an average Russian and not causing obesity), it is not possible to provide the body with essential nutritional factors.

The consequence of this is the presence in the population of a large number of people, on the one hand, with overweight - one of the leading risk factors for atherosclerosis, coronary heart disease, hypertension, diabetes mellitus, and on the other hand, with a reduced nonspecific resistance to unfavorable environmental factors and immunodeficiencies. The composition of modern food products forces doctors to solve a dilemma: to reduce the consumption of food containing an excess of saturated fats, monosaccharides and salt, in order to prevent atherosclerosis, obesity and hypertension, thereby aggravating the deficiency of essential micronutrients, or to increase the amount of food eaten, eliminating micronutrient deficiency, but dramatically increasing the risk of the above-mentioned "diseases of civilization".

From these positions, in the process of optimizing the nutrition of the population at the present stage, three possible ways of rationalization should be taken into account. The first way consists in a strict selection of the daily ration from high-quality food products with a clear preponderance of plant products over animals. This is the classic and most natural route used for millennia. However, taking into account depletion by unreasonable use of soils, widespread use of herbicides and subsequent irrational storage, even plant products that have not been treated with temperature are an unsatisfactory source of micronutrients, covering only 60-70% of the daily requirement. In addition, some essential nutrients have recently ceased to enter the diet of many Russians due to the narrowing of the range of food products used, caused by their sharp rise in price. The second way is the creation of food products with a given chemical composition and properties, or the so-called enrichment of food products with essential nutrients. Unfortunately, in comparison with the countries of Europe and North America, such products are still produced in Russia catastrophically, both in quantity and in assortment. Another problem is that some of the micronutrients added to such food products can be destroyed during the production process, which greatly complicates their accurate dosing. And, finally, the third way consists in the wide production and introduction of biologically active food additives (BAA), which, as a supplement to the diet, contain in a small volume a complex of daily plastic and regulatory substances of plant, mineral and animal origin. According to many scientists and practitioners in Russia and abroad, the widespread use of dietary supplements is perhaps the only fastest, most economically acceptable and scientifically sound way to solve the seemingly fatal problem of the end of the 20th century related to nutrition, since it does not require a radical restructuring. food industry and agriculture and can be implemented using the existing food and pharmaceutical production facilities. In addition, already produced dietary supplements can be quickly transported to any region, including remote regions of the North and Siberia, zones of ecological disadvantage, and the shelf life of dietary supplements significantly exceeds those of traditional and modified food products.

History of the problem

In addition to the question of changing the prevailing vicious nutrition system that has become aggravated in all countries in the past 20 years, there were other reasons that led to the rapid development of a new field of knowledge bordering between dietetics and pharmacology, which was called pharmaconutriciology, or the science of treating individual micronutrients and their balanced complexes ( and not classic food, as is typical for diet therapy).

First, significant discoveries were made in the field of nutritional science itself, which significantly expanded our understanding of the irreplaceable factors of nutrition and almost doubled their total number. Secondly, this was facilitated by the successes of bioorganic chemistry and biotechnology, which made it possible to obtain biologically active components in a sufficiently purified form from almost any biosubstrate (plant, animal, mineral). Thirdly, it should be noted the progress of pharmacology, which deciphered the pharmacodynamics and pharmacokinetics of most essential nutritional factors. Fourthly, the production of dietary supplements for a number of manufacturers turned out to be simply economically more profitable in comparison with synthetic drugs, since the production itself is much cheaper, and the population (with an appropriate level of information support) constantly buys preventive supplements, unlike drugs. acquired only in the presence of a specific disease.

Currently, in developed countries around the world, experiencing the same problems with unbalanced diets, as in Russia, dietary supplements are produced and consumed on a huge scale, which has made it possible to significantly affect the health of entire nations.

Russia also, in spite of the difficult economic situation, is taking a number of measures for the widespread introduction of positively proven foreign dietary supplements and, of course, for the production of domestic ones. It should be noted that certain successes have already been achieved on this path: the "State program in the field of nutrition" was drawn up taking into account the widespread use of dietary supplements, interesting Russian developments in this area have appeared, thanks to the efforts of doctors and the media, a whole group of people has formed that systematically uses dietary supplements for the purpose of prevention, many medical institutions began to show interest in this group of drugs in terms of their use in complex treatment and rehabilitation. However, unfortunately, due to the lack of appropriate methodological literature and special periodicals on this issue among specialists, the absence of a course on pharmacological nutrition in the system of higher education, our country continues to lag behind economically developed countries by almost an order of magnitude in terms of the use of dietary supplements.

Definition, modern classification and role of dietary supplements

According to order No. 117 of the Ministry of Health of the Russian Federation dated 04.15.97 "On the procedure for examination and hygienic certification of biologically active food additives", biologically active food additives are concentrates of natural or identical natural biologically active substances intended for direct intake or introduction into the composition food products in order to enrich the human diet with individual bioactive substances and their complexes. Nutritional supplements are obtained from plant, animal and mineral raw materials, as well as by chemical or biotechnological methods. They also include enzyme and bacterial preparations (eubiotics) that have a regulatory effect on the microflora of the gastrointestinal tract. BAA are produced in the form of extracts, infusions, balsams, isolates, powders, dry and liquid concentrates, syrups, tablets, capsules and other forms. The use of dietary supplements allows: