Current status and improvement of nutrition in medical and preventive treatment institutions

The relevance of the study is determined by the main purpose of state policy in the field of preservation and strengthening of health, prevention of diseases caused by poor and unbalanced nutrition. Up-to-date requirements for catering in the Russian Federation and statistics of diseases associated with nutritional disorder of the population are given. On the basis of the information about life expectancy of the population as a key indicator of the population health, the main characteristic features of qualitatively heterogeneous types of regional differences in life expectancy in Russia are presented. The article includes a retrospective of catering in Russia: the M. I. Pevzner’s numbered system of diets, the concept of a balanced diet, formulated by A. A. Pokrovsky, and the modern theory of adequate nutrition, developed by Professor A. M. Ugolev. On the basis of performed catering analysis, modern approaches to rational and therapeutic nutrition, along with the basic objectives in therapeutic catering and document management in medical institutions are given. The study of catering on the example of the Regional specialized center of medical rehabilitation, which uses the main variant of standard diet corresponding with the numbered diets No.5, No.9, No.15 is conducted. The structure of the diet - 3 meals a day (breakfast, lunch, dinner) which can be increased to 5 meals a day (breakfast, second breakfast, lunch, afternoon snack, dinner). The diet meets the requirements of Order No. 330, as well as the principles of dietary nutrition. During the estimated period, no repetition of products (dishes) is registered, the output meets the requirements. Energy value of the diet is 3400 kcal, 2300 kcal by the CHI system, the ratio of proteins, fats, carbohydrates corresponding to 1:1:4. Existing problems (absence of nutritionists, lag of material and technical resources of nutrition units, narrow range of dishes in menu, the inability to order vegetarian or vegan cuisine and raw food) are revealed. It is shown that the system of clinical nutrition is not closed or isolated, it is a part of the overall medical care system in a medical institution. General scheme of clinical nutrition, including document management and analytical accounting of food in a Medical and Preventive Treatment Institution is presented.