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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medsovet</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинский Совет</journal-title><trans-title-group xml:lang="en"><trans-title>Meditsinskiy sovet = Medical Council</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2079-701X</issn><issn pub-type="epub">2658-5790</issn><publisher><publisher-name>REMEDIUM GROUP Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21518/2079-701X-2019-2-200-208</article-id><article-id custom-type="elpub" pub-id-type="custom">medsovet-2877</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>Школа педиатра</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>School for pediatrician</subject></subj-group></article-categories><title-group><article-title>Недостаточность питания в практике педиатра: дифференциальная диагностика и возможности нутритивной поддержки</article-title><trans-title-group xml:lang="en"><trans-title>Malnutrition in pediatric practice: differential diagnosis and possibilities for nutritional support</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Захарова</surname><given-names>И. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Zakharova</surname><given-names>I. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Захарова Ирина Николаевна – доктор медицинских наук, профессор, заведующая кафедрой педиатрии с курсом поликлинической педиатрии им. Г.Н. Сперанского Федерального государственного бюджетного образовательного учреждения дополнительного профессионального образования «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской Федерации</p><p>125993, г. Москва, ул. Баррикадная, д. 2/1, стр. 1 , </p><p>125373, г. Москва, ул. Героев Панфиловцев, д. 28 </p></bio><bio xml:lang="en"><p>Zakharova Irina Nikolaevna – Dr. of Sci. (Med.), Professor, Speransky Chair of Paediatrics with Course of Polyclinic Paediatrics, Federal State Budgetary Educational Institution of Additional Professional Education «Russian Medical Academy of Continuing Professional Education» of the Ministry of Health of the Russian Federation</p><p>125993, Moscow, Barrikadnaya St., 2/1, b. 1, 125373, Moscow, 28, Geroev Panfilovtsev St. </p></bio><email xlink:type="simple">kafedra25@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Дмитриева</surname><given-names>Ю. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Dmitrieva</surname><given-names>Yu. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Дмитриева Юлия Андреевна – кандидат медицинских наук, доцент кафедры педиатрии с курсом поликлинической педиатрии им. Г.Н. Сперанского Федерального государственного бюджетного образовательного учреждения дополнительного профессионального образования «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской Федерации</p><p>125993, г. Москва, ул. Баррикадная, д. 2/1, стр. 1 , </p><p>125373, г. Москва, ул. Героев Панфиловцев, д. 28 </p></bio><bio xml:lang="en"><p>Dmitrieva Yulia Andreevna – Cand. of Sci. (Med.), Associate Professor, Speransky Chair of Paediatrics with Course of Polyclinic Paediatrics, Federal State Budgetary Educational Institution of Additional Professional Education «Russian Medical Academy of Continuing Professional Education» of the Ministry of Health of the Russian Federation</p><p>125993, Moscow, Barrikadnaya St., 2/1, b. 1, 125373, Moscow, 28, Geroev Panfilovtsev St. </p></bio><email xlink:type="simple">kafedra25@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сугян</surname><given-names>Н. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Sugyan</surname><given-names>N. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Сугян Нарине Григорьевна – кандидат медицинских наук, доцент кафедры педиатрии с курсом поликлинической педиатрии им. Г.Н. Сперанского Федерального государственного бюджетного образовательного учреждения дополнительного профессионального образования «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской Федерации, заведующая консультативно-диагностическим отделением Государственного бюджетного учреждения здравоохранения города Москвы «Детская городская поликлиника №133 Департамента здравоохранения города Москвы»</p><p>125993, г. Москва, ул. Баррикадная, д. 2/1, стр. 1 , </p><p>125373, г. Москва, ул. Героев Панфиловцев, д. 28, </p><p>125445, г. Москва, Смольная улица, д. 55 </p></bio><bio xml:lang="en"><p>Sugyan Narine Grigoryevna – Cand. of Sci. (Med.), Associate Professor, Speransky Chair of Paediatrics with Course of Polyclinic Paediatrics, Federal State Budgetary Educational Institution of Additional Professional Education «Russian Medical Academy of Continuing Professional Education» of the Ministry of Health of the Russian Federation; Head of Consultative and Diagnostic Department, State Budgetary Healthcare Institution of Moscow «Children’s City Outpatient Clinic No 133 of Moscow Health Department»</p><p>125993, Moscow, Barrikadnaya St., 2/1, b. 1, 125373, Moscow, 28, Geroev Panfilovtsev St., </p><p>125445, Moscow, Smolnaya St., 55 </p><p> </p></bio><email xlink:type="simple">kafedra25@yandex.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Симакова</surname><given-names>М. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Simakova</surname><given-names>M. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Симакова Мария Александровна – аспирант кафедры педиатрии с курсом поликлинической педиатрии им. Г.Н. Сперанского Федерального государственного бюджетного образовательного учреждения дополнительного профессионального образования «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской Федерации</p><p>125993, г. Москва, ул. Баррикадная, д. 2/1, стр. 1 , </p><p>125373, г. Москва, ул. Героев Панфиловцев, д. 28 </p></bio><bio xml:lang="en"><p>Simakova Mariya Alexandrovna – a postgraduate student of Speransky Chair of Paediatrics with Course of Polyclinic Paediatrics, Federal State Budgetary Educational Institution of Additional Professional Education «Russian Medical Academy of Continuing Professional Education» of the Ministry of Health of the Russian Federation</p><p>125993, Moscow, Barrikadnaya St., 2/1, b. 1, 125373, Moscow, 28, Geroev Panfilovtsev St. </p></bio><email xlink:type="simple">kafedra25@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Федеральное государственное бюджетное образовательное учреждение дополнительного профессионального образования «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской Федерации;&#13;
Государственное бюджетное учреждение здравоохранения города Москвы «Детская городская клиническая больница имени З.А. Башляевой Департамента здравоохранения города Москвы»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Federal State Budgetary Educational Institution of Additional Professional Education «Russian Medical Academy of Continuing Professional Education» of the Ministry of Health of the Russian Federation;&#13;
State Budgetary Institution of Health Care of the City of Moscow «Children’s City Clinical Hospital named after Z.A. Bashlayeva» of the Department of Healthcare of the city of Moscow</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Федеральное государственное бюджетное образовательное учреждение дополнительного профессионального образования «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской Федерации;&#13;
Государственное бюджетное учреждение здравоохранения города Москвы «Детская городская клиническая больница имени З.А. Башляевой Департамента здравоохранения города Москвы»;&#13;
Государственное бюджетное учреждение здравоохранения города Москвы «Детская городская поликлиника №133 Департамента здравоохранения города Москвы»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Federal State Budgetary Educational Institution of Additional Professional Education «Russian Medical Academy of Continuing Professional Education» of the Ministry of Health of the Russian Federation;&#13;
State Budgetary Institution of Health Care of the City of Moscow «Children’s City Clinical Hospital named after Z.A. Bashlayeva» of the Department of Healthcare of the city of Moscow;&#13;
State Budgetary Healthcare Institution of Moscow «Children’s City Outpatient Clinic No 133 of Moscow Health Department»</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2019</year></pub-date><pub-date pub-type="epub"><day>15</day><month>02</month><year>2019</year></pub-date><volume>0</volume><issue>2</issue><fpage>200</fpage><lpage>208</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Захарова И.Н., Дмитриева Ю.А., Сугян Н.Г., Симакова М.А., 2019</copyright-statement><copyright-year>2019</copyright-year><copyright-holder xml:lang="ru">Захарова И.Н., Дмитриева Ю.А., Сугян Н.Г., Симакова М.А.</copyright-holder><copyright-holder xml:lang="en">Zakharova I.N., Dmitrieva Y.A., Sugyan N.G., Simakova M.A.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.med-sovet.pro/jour/article/view/2877">https://www.med-sovet.pro/jour/article/view/2877</self-uri><abstract><p>Питание имеет огромное значение для поддержания нормальных темпов роста и развития ребенка, обеспечения способности к обучению и устойчивости к неблагоприятным факторам внешней среды. Ввиду более высокой потребности в нутриентах, ограниченных запасов питательных веществ, а также особенностей течения метаболических процессов дети более предрасположены к формированию различных нарушений нутритивного статуса, в частности белково-энергетической недостаточности. Особое значение фактор питания приобретает на фоне сопутствующих острых и хронических заболеваний ребенка. Результаты проведенных исследований убедительно продемонстрировали, что недостаточность питания приводит к удлинению госпитализации, увеличению частоты осложнений и повышает риск неблагоприятного исхода. Таким образом, своевременная диагностика нарушений нутритивного статуса является неотъемлемым фактором сохранения здоровья и повышения качества жизни ребенка. В статье рассмотрена современная классификация недостаточности питания, освещены основные этапы проведения атропометрического обследования, определены подходы к проведению дифференциальной диагностики причин белково-энергетической недостаточности, обсуждены возможности нутритивной поддержки с использованием специализированных смесей.</p></abstract><trans-abstract xml:lang="en"><p>Nutrition is of great importance in maintaining normal growth and development of the child, ensuring the ability to learn and resistance to adverse environmental factors. Due to the higher need for nutrients, limited nutrient reserves, and particular characteristics of metabolic processes, children are more prone to the development of various nutritional disorders, in particular, protein and energy deficiency. The nutritional factor becomes of great importance on the background of the accompanying acute and chronic diseases in children. The studies convincingly demonstrated that malnutrition leads to a prolongation of hospital stay, increased frequency of complications and increased risk of adverse outcomes. Therefore, timely diagnosis of nutritional disorders is an essential factor in maintaining health and improving the children’s quality of life. The article presents the current classification of malnutritiion, illustrates the main stages of the anthropometric examination, identifies approaches to the differential diagnosis of protein-energy deficiency causes, and discusses the possibilities of nutritional support using specialized mixtures.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>нутритивный статус</kwd><kwd>недостаточность питания</kwd><kwd>белково-энергетическая недостаточность</kwd><kwd>дети</kwd><kwd>антропометрия</kwd><kwd>фактический рацион питания</kwd><kwd>нутритивная поддержка</kwd><kwd>сиппинг</kwd><kwd>изокалорийные смеси</kwd><kwd>гиперкалорийные смеси с пищевыми волокнами</kwd></kwd-group><kwd-group xml:lang="en"><kwd>nutritional status</kwd><kwd>malnutrition</kwd><kwd>protein-energy deficiency</kwd><kwd>children</kwd><kwd>anthropometry</kwd><kwd>actual diet</kwd><kwd>nutritional support</kwd><kwd>sipping</kwd><kwd>isocaloric mixtures</kwd><kwd>hypercaloric mixtures with dietary fibres</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">de Onís M., Monteiro C., Akré J., Glugston G. 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