References

nogr

Экспериментальная и клиническая гастроэнтерология

Experimental and Clinical Gastroenterology

1682-8658

«Global Media Technologies»

10.31146/1682-8658-ecg-228-8-163-180

nogr-2863

Research Article

ДИСКУССИЯ

DISCUSSION

Критический анализ обновленных международных рекомендаций по питанию пациентов с муковисцидозом

Critical analysis of updated international recommendations on nutrition of patients with cystic fibrosis

https://orcid.org/0000-0003-0503-6371

Каширская

Н. Ю.

Kashirskaya

N. Yu.

kashirskayanj@mail.ru

https://orcid.org/0000-0002-2367-9920

Симонова

О. И.

Simonova

O. I.

noemail@neicon.ru

https://orcid.org/0000-0001-9430-3448

Соколов

И. .

Sokolov

I. .

noemail@neicon.ru

https://orcid.org/0000-0003-3586-3458

Зинченко

Р. А.

Zinchenko

R. A.

noemail@neicon.ru

https://orcid.org/0000-0002-3993-1246

Рославцева

Е. А.

Roslavtseva

E. A.

noemail@neicon.ru

https://orcid.org/0000-0001-7308-7280

Хавкин

А. И.

Khavkin

A. I.

noemail@neicon.ru

ФГБНУ «Медико- генетический научный центр им. академика Н. П. Бочкова»; Государственное бюджетное учреждение здравоохранения Московской области «Московский областной научно- исследовательский клинический институт имени М. Ф. Владимирского»РоссияMedical Genetic Research Center named after. Academician N. P. Bochkov; Moscow Regional research clinical institute n. a. M. F. VladimirskiyRussian Federation

Федеральное Государственное Автономное Учреждение «Национальный медицинский исследовательский центр здоровья детей» Минздрава России; Первый московский Государственный медицинский университет имени И. М. Сеченова Минздрава России (Сеченовский Университет); Государственное бюджетное учреждение здравоохранения Морозовская детская городская клиническая больница Департамента здравоохранения города МосквыРоссияNational Medical Research Centre for Children’s Health; Sechenov Moscow Medical University; Morozov Children’s Clinical HospitalRussian Federation

Федеральное Государственное Автономное Учреждение «Национальный медицинский исследовательский центр здоровья детей» Минздрава РоссииРоссияNational Medical Research Centre for Children’s HealthRussian Federation

ФГБНУ «Медико- генетический научный центр им. академика Н. П. Бочкова»РоссияMedical Genetic Research Center named after. Academician N. P. BochkovRussian Federation

Общество детских гастроэнтерологов, гепатологов и нутрициологовРоссияSociety of Children’s Gastroenterologists, Hepatologists and NutritionistsRussian Federation

ГБУЗ МО «Научно-исследовательский клинический институт детства Министерства здравоохранения Московской области»; Белгородский государственный исследовательский университетРоссияResearch Clinical Institute of Childhood of the Moscow Region; Belgorod State Research UniversityRussian Federation

2024

03022025

08163180

2025

Каширская Н.Ю., Симонова О.И., Соколов И..., Зинченко Р.А., Рославцева Е.А., Хавкин А.И.

Kashirskaya N.Y., Simonova O.I., Sokolov I..., Zinchenko R.A., Roslavtseva E.A., Khavkin A.I.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.nogr.org/jour/article/view/2863

Цель обзора - проанализировать рекомендации, содержащиеся в обновленной версии Руководства ESPEN-ESPGHAN-ECFS 2024 года по вопросам питания младенцев, детей и взрослых при муковисцидозе (МВ). Предыдущая версия Руководства была опубликована в 2016 году. Рабочая группа экспертов, в которую вошли врачи, диетологи и представители пациентских сообществ, обновила рекомендации по питанию, включая методы его оценки и ведения в любом возрасте. Расширены главы о беременности, заболеваниях печени, диабете, связанном с МВ, заболеваниях костей, пищевых и минеральных добавках, пробиотиках. Появились новые главы, посвященные питанию при использовании высокоэффективной (таргетной) терапии модуляторами CFTR и питанию после трансплантации органов. Главное заключается в изменении концепции питания в эру таргетной терапии от гиперкалорийной высокожировой диеты для всех пациентов до «здорового питания» как основной рекомендации. Руководство ESPEN-ESPGHAN-ECFS 2024 года по вопросам питания при МВ содержит целый ряд важных положений, которые будут полезны практическим врачам педиатрам и терапевтам, пульмонологам, гастроэнтерологам и диетологам, специализирующимся в области МВ. Следует учитывать существенные различия в клинико-эпидемиологической ситуации в РФ при диагностике нарушений нутритивного статуса и определении тактики нутритивной поддержки пациентов с муковисцидозом.

The aim of the review is to analyse the Guidelines in the updated version of the ESPEN-ESPGHAN-ECFS 2024 Guidelines on infant, child and adult nutrition in cystic fibrosis (CF). The previous version of the Guideline was published in 2016. An expert working group of physicians, dietitians, and patient community representatives updated the nutritional recommendations, including methods for nutritional assessment and management at all ages. Chapters on pregnancy, liver disease, CF-related diabetes, bone disease, nutritional and mineral supplements, and probiotics have been expanded. There are new chapters on nutrition in the use of highly effective CFTR modulator (targeted) therapies and nutrition after organ transplantation. The main point is the change in the concept of nutrition in the era of targeted therapy from a hypercaloric high-fat diet for all patients to ‘healthy eating’ as the main recommendation. The ESPEN-ESPGHAN-ECFS 2024 Guidelines on nutrition in CF contain a number of important provisions that will be useful to paediatricians and general practitioners, pulmonologists, gastroenterologists and dietitians specialising in CF. Significant differences in the clinical and epidemiological situation in the Russian Federation should be taken into account when diagnosing disturbances of nutritional status and determining the tactics of nutritional support for patients with CF.

муковисцидозрекомендации по питаниюмеждународныероссийскиеобновление

cystic fibrosisnutrition guidelinesinternationalRussianupdate

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The authors declare that there are no conflicts of interest present.