RU2691145C2 - Method of individual dietary recommendations formation based on dna analysis - Google Patents

Abstract

FIELD: medicine.SUBSTANCE: invention refers to medicine, particularly to personalized diet therapy. Disclosed is a method for forming individual dietary recommendations based on DNA analysis, involving detection of causes of overweight and/or food intolerance by analyzing gene sections. For analysis, polymorphic sections of LCT, PPARG, ADRB2, FABP2, TCF7L2 genes are examined together and HLA-DQ haplotype is determined. Formation of a dietary plan and personalized menu are carried out depending on versions of detected polymorphism of genes associated with metabolic and/or immunological processes in the body.EFFECT: invention provides effective treatment and prevention of overweight, food intolerance by selecting an adequate diet without using pharmacological preparations.54 cl, 4 ex

Description

The invention relates to medicine, namely to personalized diet therapy, in particular the creation of individual nutrition plans based on DNA analysis. To do this, the causes of overweight and food intolerance are specified by studying the polymorphism of genes selected from the LCT, PPARG, ADRB2, FABP2, TCF7L2 series and the HLA-DQ haplotype is being determined. In this case, the compilation of personalized menus and dietary recommendations is carried out depending on the variants of the identified polymorphism. The method provides effective treatment and prevention of the appearance of overweight, food intolerance due to the choice of an adequate diet without the use of pharmacological agents. The method can be used in the practice of a dietitian, an endocrinologist and a gastroenterologist for the treatment and prevention of obesity, type 2 diabetes, as well as identifying the main causes of food intolerance.

The variety of food products is currently increasing. However, the number of people with problems associated with improper diet and leading to the development of such common diseases as obesity, type 2 diabetes, as well as common diseases of the gastrointestinal tract - celiac disease and lactase deficiency. On the other hand, the development of these diseases and the metabolic response of the body is determined by genetically determined causes and has a contribution of 40 to 70%, depending on the nature of the disease [19]. Thus, finding out the genetic reasons for the development of these diseases can help in identifying suitable prophylactic and therapeutic measures to prevent or more effectively treat them. The possibilities of genetic analysis at the current time allow us to identify an individual reaction to certain nutritional components and prevent diseases associated with an imbalance or intolerance to certain substances in the diet.

Obesity and overweight - the result of the formation of abnormal or excessive body fat that can be harmful to health - 39% of the world's population are overweight, 13% are obese. From 1980 to 2014, the number of obese people around the world more than doubled [1]. The main cause of obesity and overweight is an imbalance of consumed and expended energy, in which the caloric intake of the diet exceeds the energy needs of the body. Currently, there are many studies on the relationship between human genetic characteristics and the ability to increase and decrease weight in response to changes in nutrition and prevent the onset of type 2 diabetes, this knowledge allows not only to determine the susceptibility to obesity and identify the causes, but also to choose the optimal nutrition plan for normalization of weight [17].

Celiac disease is a systemic immunological disorder that develops from consuming dense foods. Celiac disease has a prevalence of 0.6% to 1% of the population [6]. However, in addition to overt pathological cases of celiac disease, 8% of the population has asymptomatic celiac disease, and up to 20% of the population has an immunological response to gliadin [14]. Thus, the question of developing a personalized diet plan that takes into account the genetic susceptibility to gluten intolerance matters to 20% of the population. The appearance of gluten intolerance is determined by the presence of a genetic predisposition, and has dose-dependent effects. A preliminary genetic analysis allows for an effective dietary nutrition plan that helps prevent the onset of celiac disease [23].

Lactase deficiency is the inability of the body to absorb milk sugar, which is the main component contained in milk and dairy products. The presence of lactase deficiency can lead to the development of open symptoms such as diarrhea, flatulence and vomiting, as well as contribute to the growth of pathogenic microflora and inflammatory processes in the intestine. From 5% to 95% of people, depending on the region, have lactase deficiency [25]. The body's ability to digest lactose is genetically determined [22].

Based on the results of genetic analysis, with subsequent identification of genetic risk factors for diseases, it is possible to use personal diet therapy methods with individual recommendations on the consumption of products. This allows you to purposefully prevent the development of the described diseases and contribute to their more effective treatment.

At the moment there are a number of inventions that allow you to create individual recommendations on nutrition.

There is a method of providing individual recommendations on nutrition and sports loads based on an analysis of lifestyle, personal data and human goals (see application US 20030204412, MKI G06F 017/60, 2003). This method allows you to create individual wellness plans, taking into account the user's personal data and in order to improve his athletic performance, reduce weight or reduce stress levels. The main advantage of this method is a multilateral assessment of personal data about a person.

However, this method has several disadvantages: first, it does not take into account the genetic characteristics of a person for the selection of a diet for weight loss. It is not possible to determine the most effective dietary nutrition plan, which does not allow to achieve the greatest effects of diet therapy.

Secondly, this method does not allow you to create diet plans with regard to the intolerance of certain foods and does not reveal intolerance to gluten or lactose. Recommendations without regard to the genetic characteristics of a person may result; based on this method to the development of diseases such as celiac disease, type 2 diabetes and obesity.

There is a method of establishing personalized mass loss programs of the subject, based on the results of genetic analysis (see Application WO 018875, MKI G06F 19/00, 2013). The method includes the development of personalized weight loss programs of the subject, based on the results of the subject's genetic analysis of 5 polymorphic DNA loci, which can be used to select the dietary regime: FABP2 (rs1799883); PPARG (rs180l282); ADRB3 (rs4994); ADRB2 (rs1042713) and ADRB2 (rs1042714). This method allows you to identify an individual response to low-fat and low-carb diets, to determine the effectiveness of regular exercise.

The main disadvantages of this method are: firstly, that this method does not take into account the genetic susceptibility to type 2 diabetes and does not allow for the development of individual nutrition programs taking into account this susceptibility.

Secondly, it lacks a definition of genetic markers of lactase deficiency, which can lead to a person being prescribed a nutrition program that includes lactose-containing products, which can lead to lactose intolerance in an open form or to inflammatory diseases in the intestine in a hidden form.

Thirdly, the method does not allow detection of gluten intolerance, therefore following dietary recommendations, in which products containing gluten are present, can lead to celiac disease in a person who has a genetic predisposition to this disease.

Fourthly, the method does not allow to unequivocally choose the list of suitable food products in accordance with the genetic characteristics of a person, but only indicates the general direction of diet therapy.

Thus, this method does not allow the development of individual nutrition programs and menus, taking into account food intolerance and individual risk of developing type 2 diabetes.

A known method of analyzing, detecting and correcting food intolerance in humans (see application US 20100227340, MKI G01N 33/53, 2010) allows the method based on the analysis of immunoglobulins to develop individualized dietary plans, excluding food that causes latent food intolerance, foods that cause hidden allergic reactions.

However, this method has several disadvantages: firstly, it does not allow to choose a suitable diet, aimed for the treatment or prevention of obesity, or overweight.

Secondly, it does not reveal lactose intolerance, since this intolerance does not manifest immunological reactions.

Thirdly, the method does not allow developing dietary nutrition plans taking into account the risk of developing type 2 diabetes.

Thus, this method does not allow to develop an individual diet for the treatment and prevention of overweight and obesity, type 2 diabetes and lactase deficiency, which are significantly common diseases.

Closest to the claimed method is a method of treatment and / or prevention of overweight and / or obesity and / or metabolic disorders selected as a prototype (see patent RU 2403038, MKI AK 61/365). The method identifies and specifies the causes of overweight by studying the polymorphism of genes selected from the series: LPL, GREL, INS, FABP2, ADRB3. In this case, the choice of diet and pharmacotherapy is carried out depending on the variants of the revealed polymorphism. The method allows to identify the effectiveness of low-carb and low-fat diets for the patient and create an individual list of food, by two-color classification of food.

The analysis of the given data indicates a number of disadvantages of this method and its internal contradictions.

Firstly, the method does not take into account the genetic susceptibility to lactase deficiency, and does not allow this to be added to the dietary nutrition plan using a two-color scale.

Secondly, the method does not take into account the presence, or predisposition, or intolerance to gluten. Therefore, dietary recommendations, the main on this method can lead to the development of intolerance to celiac disease and celiac disease.

Thirdly, the method includes the use of pharmacological drugs, which do not need to create health and preventive nutrition programs to reduce body fat and prevent food intolerances.

Fourthly, in the process of analysis, no genes related to the effectiveness of fasting days and periods with caloric restriction of food are detected.

Fifth, the method does not allow to determine which dietary nutrition plan should be selected in the case of the presence of several pathologically-associated genes in one patient.

Based on the above contradictions, it can be concluded that there is a serious disadvantage of this method - it does not take into account data on intolerance of basic foods, does not allow creating a personalized menu in the presence of several pathologically-associated variants of genes.

The basis of this invention is the problem of eliminating the above disadvantages of the known method, allowing to form dietary nutrition plans that can be used on a daily basis, thereby contributing to the treatment / prevention of overweight and obesity, lactose intolerance and gluten, and the prevention of diabetes mellitus 2nd type

The technical result in the method of forming individual dietary recommendations based on DNA analysis, including identifying the causes of overweight and / or food intolerance, by analyzing sections of genes, is achieved by conducting a joint study of polymorphic sections of LCT, PPARG, ADRB2, FABP2, TCF7L2 genes for analysis and the definition of the HLA-DQ haplotype, with the formation of a dietary nutrition plan and a personalized menu, carried out depending on the variants of the detected polymorphism of genes associated with metabolic and / or immunological processes in the body.

The inventive method, based on the identified polymorphism of genes, allows you to select individual nutrition programs in the form of recommendations on the formation of the menu, the norms of consumed products, recommendations for adding, limiting and excluding food with certain properties. Selection of an individual food ratio is based on the results of the genetic analysis of the polymorphic loci of the TCF7L2, FABP2, PPRAG, ADRB2, LCT genes and the HLA haplotype associated with diseases. The results of genetic analysis can be obtained by real-time polymerase chain reaction, by genotyping on DNA chips, by determining the nucleotide sequence of genes by the Sanger method or by results of genome-wide sequencing. For genetic analysis, it is possible to use human biological material, which contains human DNA and the minimum number of foreign sources of DNA. In particular, a sample of buccal epithelium from the human oral cavity can serve for these purposes. The results obtained are applicable for people of different ages from 1 year and do not have the maximum age limit, since the results of genetic analysis do not change during their lifetime. A restriction of 1 year is established only if the baby is breastfed and the buccal epithelium is used as a biological sample, since it is possible to detect maternal genetic material in the sample.

The method allows you to create new 53 variants of individual diets, based on which, the doctor or nutritionist develops a daily menu, recommendations on food intake, recommendations on exclusion / restriction of certain foods. Based on the results of the analysis, an individual nutrition plan, menus, and personal recommendations for a person are created. The choice of gene variants for genetic analysis is determined by the high contribution to the studied trait, the presence of authoritative studies and clinical trials on the associations of the gene variant with the disease and the results of diet therapy.

Let us consider in more detail the influence of the polymorphism of the above genes on metabolic and immunological processes in the body.

The TCF7L2 gene encodes a regulatory protein that is involved in the regulation of the WNT genes of the signaling pathway and in suppressing the synthesis of proglyogon in enteroendocrine cells [9]. A single nucleotide substitution in this gene has the greatest contribution to the development of type 2 diabetes [24]. Studies show that prescribing a dietary diet with a higher fiber content in food is associated with higher rates of weight loss and prevents the development of insulin resistance [18]. On the other hand, studies show that nutrition with a low glycemic index reduces the risk of type 2 diabetes, especially in people with pathologically associated variants of the TCF7L2 gene [4]. Thus, for carriers of pathologically-associated variants of the TCF7L2 gene, a diet is recommended, aimed at preventing the development of type 2 diabetes. With an anti-diabetic diet, the proportion of foods with a high glycemic load (cereals, grains, sugar) is reduced due to an increase in foods with a high proportion of dietary fiber in the diet. Includes natural sweeteners. Assigned multiple meals with breaks for 4-5 hours. As additional components in the diet, it is recommended to take chicory, inulin and carnosine as antiglycation agents, which reduce the level of glycemic load and glycemic index.

The ADRB2 gene encodes a protein called adrenoreceptor, which interacts with the hormone and neurotransmitter adrenaline [20]. Its activation in the cells of the liver and muscles accelerates the destruction of glycogen stores [12]. Studies show that an increase in the proportion of carbohydrates leads to the development of obesity in carriers of the pathologically-associated variant of the gene ADRB2 [16]. Also, the polymorphic variant of this gene is associated with the rate of fat oxidation during physical activity [15]. Thus, to reduce weight, the owners of the pathologically-associated form of the gene ADRB2 recommend reducing the proportion of carbohydrates, primarily due to fast-digesting, since their accumulation leads to an increase in glycogen stores and their subsequent transition to fats in the liver. Diet with restriction of fast-digesting carbohydrates - the proportion of carbohydrates with a high glycemic index (> 60) in the diet decreases to 5%. Excluded sugar, pastries, drinks with a high proportion of sugar in the composition, white bread of the premium, bakery products. The proportion of fast-absorbing carbohydrates is replaced by carbohydrates with a low glycemic index. The consumption of products containing a high proportion of fast-absorbing carbohydrates in the evening hours is excluded.

The FABP2 gene encodes a transporter of saturated fatty acids, which are located on the surface of enterocytes in the small intestine [3]. The pathologically associated gene variant is associated with an increase in the rate of fatty acid transport through the intestinal wall [13]. A diet containing a large proportion of saturated fat in the diet for people with pathologically associated gene variants increases the level of triglycerides in the blood and contributes to the development of coronary heart disease [2]. Thus, these people are recommended to reduce the proportion of saturated fatty acids in the diet. Diet with restriction of saturated fat - a diet in which the proportion of animal and vegetable saturated fat decreases from 10-15% to 3-5%. It excludes fatty meats: pork, lamb, whole milk, cream and high fat dairy products. Saturated fats are replaced by unsaturated and polyunsaturated fats. The consumption of products containing a high proportion of saturated fats (more than 5%) in the evening hours is completely excluded.

The PPRAG gene encodes a regulatory protein that is involved in the regulation of the growth and division of fat cells. Its activity increases in response to an increase in fat in the diet [10]. This gene contains functional polymorphism, leading to the replacement of proline to alanine in 12th position, which leads to a decrease in receptor activity, a decrease in body mass index and an increase in insulin sensitivity [5]. Periods with calorie restriction in the diet also lead to a decrease in the activity of PPRAG [21]. Clinical studies show that increasing the proportion of fat while maintaining the level of energy consumption in the diet for carriers of a variant of the pathologically associated variant increases the fat mass of the body [11]. Therefore, the carrier of this option requires the appointment of unloading periods with limited energy consumption (fasting days). Diet with fasting days - includes the introduction of fasting days low calorie up to 50% of the daily ration once every 7-10 days. Fasting days are of three types - low-fat, low-carb and mixed. Low-fat fasting days imply the exclusion of products containing more than 5% fat per dry weight of the product. Foods containing a high proportion of proteins and carbohydrates with a low glycemic index (turkey, legumes) are allowed. Low carbohydrate fasting days imply the exclusion of products containing more than 40% of carbohydrates per dry weight of the product. Products with a high proportion of proteins and vegetable fats (rabbit, linseed or olive oil) are allowed. Mixed fasting days implies the exclusion of food containing more than 40% carbohydrates per dry weight and 15% fat per dry weight. Products containing a large proportion of proteins and dietary fiber (low-fat cottage cheese, non-starchy vegetables) are allowed.

The LCT gene is lactase, an enzyme in the intestine that destroys dairy sugars - lactose [7]. Most people cannot digest whole milk in adulthood, especially in the Asian and African region. In such people, the amount of lactase begins to actively decline from 3 years, and actually disappears at the age of 14 years. Polymorphic substitution in the regulatory region of this gene leads to the emergence of the ability to digest lactose in adulthood [7]. Such a replacement is common in 80-95% of Europeans, but has a lower incidence in other regions [8]. Thus, for people who do not have this polymorphic substitution, it is recommended to replace lactose-containing products in their diet, or to use preparations containing lactase. Lactose-free diet - excluded foods containing lactose in its composition. Whole and condensed milk, confectionery and meat products in which there is a part of lactose are removed. Dairy products with reduced lactose content are left - cheeses, cottage cheese, butter.

The HLA-DQ gene encodes a protein, a human leukocyte antigen, located on the surface of the antigen of the percentile cells. This protein is the basis of the main histocompatibility complex, and in humans it is responsible for the regulation of the immune system and the recognition of foreign antigens. This gene is in several variants - haplotypes. More than 90% of patients with celiac disease have a HLA-DQ2 human leukocyte antigen haplotype [6]. Studies show that a 6-month gluten-free diet can reduce the immunological response to gluten and alleviate clinical symptoms [26]. Also, the presence of this haplotype is associated with the asyptomatic intolerance of gluten, therefore such people are also recommended a trial 6-month gluten-free diet under medical supervision. This prevents the development of dose-dependent effects of gluten and the appearance of celiac disease, due to the absence of an antigen that stimulates an immunological response. Gluten-free diet - excludes foods containing gluten in its composition. Grain crops are excluded - wheat, rye, barley, oats and products in which these components are part of (pasta and bakery products). It is allowed to use pastries made from rice, buckwheat and corn flour, as well as products in which there is no gluten.

In most clinical cases, there is not one, but several variants of genes that are pathologically associated with diseases. Under such conditions, it is necessary to take into account the mutual effects of genes on the physiological processes in humans and to determine suitable diets for the prevention and treatment of diseases, taking into account the mutual effects of genes. The inventive method of forming individual dietary recommendations based on DNA analysis allows you to create new diets, taking into account the joint influence of genes on metabolic processes.

If the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2 and PPARG genes, then a 6-month "diet with prevention of type 2 diabetes with fasting days" is prescribed. This diet is characterized by an increase in the proportion of dietary fiber to 1 g per kg of body weight; the introduction of fasting days 1 every 7-10 days with a reduction in the total caloric intake to 50-60%. It is recommended to conduct meals in 2.5-3 hours. In between meals, it is recommended to drink only clean water. It is not recommended to consume on an empty stomach sugary drinks, sweets, sweet fruits and dried fruits. It is recommended to drink freshly squeezed and packaged juices only after meals and in a small amount no more than 2 times a week.

If the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2 and FABP2 genes, then a 6 month "diet with restriction of saturated fat with prevention of type 2 diabetes" is prescribed. This diet is characterized by restriction of saturated fat in the diet to 3-7% of the total caloric intake; an increase in the proportion of dietary fiber to 1 g per kg of body weight. Excluded: sausages and deli meats (meat nut, chop, etc.); fatty meats (pork, lamb), poultry (duck, goose, chicken skin), fish (oily fish, halibut, sturgeon); offal (tongue, heart, stomach; dairy products and high-fat cheeses; sweets containing fats (biscuits with filling, sweets, waffles, baked pastries, milk chocolate, cakes, pastries) In the intervals between meals, it is recommended to drink only clean water.It is not recommended to drink sugary drinks, sweets, sweet fruits and dried fruit on an empty stomach.

If the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, FABP2 and PPARG genes, then a 6 month "low fat diet with prevention of type 2 diabetes with fasting days" is prescribed. This diet is characterized by limiting the overall proportion of fat in the diet to 15-20%, with the proportion of saturated fat to 3-7% in the diet; an increase in the proportion of dietary fiber to 1 g per kg of body weight. Excluded: sausages and deli meats (meat nut, chop, etc.); fatty meats (pork, lamb), poultry (duck, goose, chicken skin), fish (oily fish, halibut, sturgeon); offal (tongue, heart, stomach; dairy products and high fat cheeses; sweets containing fats (biscuits with filling, sweets, waffles, baked pastries, milk chocolate, cakes, pastries). Red meat (beef, veal) is limited, including including red poultry meat (chicken legs, red turkey meat); red fish varieties (salmon, trout, salmon); medium-fat dairy products: milk 3.5%, sour cream 15-20%, cottage cheese 5-9%, cheese 17- 25%. These products are recommended to be consumed 1-2 times a week in a small amount. look for 2.5-3 hours. In the intervals between meals, it is recommended to drink only clean water.It is not recommended to drink on an empty stomach, sweet drinks, sweets, sweet fruits and dried fruits. more than 2 times a week.

If the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, ADRB2 genes, then a 6-month "low-carb diet with prevention of type 2 diabetes" is prescribed. This diet is characterized by limiting the total proportion of carbohydrates to 45-50% and fast-absorbing carbohydrates to 5% of the diet. Increasing the proportion of dietary fiber to 1 g per kg of body weight. Excluded: refined sugar and all products containing it; refined flour (top grade) and all products from it. Limited to: sweet fruits (bananas, grapes, figs, persimmon, melon) and dried fruits (dates, raisins, figs); natural sweeteners (honey, Turkish delight, Jerusalem artichoke syrup, etc.); white and yellow cereals (semolina, rice, corn, millet); fried and crushed potatoes; boiled carrots and beets, since the glycemic index of these vegetables after boiling increases significantly. These products can be consumed in small quantities no more than 1-2 times a week exclusively in the morning. It is recommended to conduct meals in 2.5-3 hours. In between meals, it is recommended to drink only clean water. It is not recommended to consume on an empty stomach sugary drinks, sweets, sweet fruits and dried fruits. It is recommended to drink freshly squeezed and packaged juices only after meals and in a small amount no more than 2 times a week.

If the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, ADRB2 and PPARG genes, then a 6 month "low-carb diet with prevention of type 2 diabetes with fasting days" is prescribed. This diet is characterized by limiting the total proportion of carbohydrates to 45-50% and fast-absorbing carbohydrates to 5% of the diet; increasing the proportion of dietary fiber to 1 g per kg of body weight; the introduction of fasting days 1 every 7-10 days with a reduction in the total caloric intake to 50-60%. Excluded: refined sugar and all products containing it; refined flour (top grade) and all products from it. Limited to: sweet fruits (bananas, grapes, figs, persimmon, melon) and dried fruits (dates, raisins, figs); natural sweeteners (honey, Turkish delight, Jerusalem artichoke syrup, etc.); white and yellow cereals (semolina, rice, corn, millet); fried and crushed potatoes; boiled carrots and beets, since the glycemic index of these vegetables after boiling increases significantly. These products can be consumed in small quantities no more than 1-2 times a week exclusively in the morning. It is recommended to conduct meals in 2.5-3 hours. In between meals, it is recommended to drink only clean water. It is not recommended to consume on an empty stomach sugary drinks, sweets, sweet fruits and dried fruits. It is recommended to drink freshly squeezed and packaged juices only after meals and in a small amount no more than 2 times a week.

If the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, ADRB2 and FABP2 genes, then a 6-month "low-carb diet with restriction of saturated fat with prevention of type 2 diabetes" is prescribed. This diet is characterized by limiting the total proportion of carbohydrates to 45-50% and fast-absorbing carbohydrates to 5% of the diet; increasing the proportion of dietary fiber to 1 g per kg of body weight; restriction of saturated fats in the diet to 3-7% of the total caloric intake. Excluded: refined sugar and all products containing it; refined flour (top grade) and all products from it. Also sausages and deli meats (meat nut, chop, etc.) are excluded; fatty meats (pork, lamb), poultry (duck, goose, chicken skin), fish (oily fish, halibut, sturgeon); offal (tongue, heart, stomach; dairy products and high fat cheeses; sweets containing fats (biscuits with filling, sweets, waffles, pastry, milk chocolate, cakes, pastries). Limited: sweet fruits (bananas, grapes, figs, persimmon, melon) and dried fruits (dates, raisins, figs); natural sweeteners (honey, Turkish delight, Jerusalem artichoke syrup, etc.); white and yellow cereals (semolina, rice, corn, millet); fried and ground potatoes; boiled carrots and beets, because the glycemic index of these vegetables after boiling significantly It is permissible to consume these products in small quantities no more than 1-2 times a week exclusively in the first half of the day. It is recommended to have meals in 2.5-3 hours. In the intervals between meals, it is recommended to drink only clean water. an empty stomach, sugary drinks, sweets, sweet fruits and dried fruits. It is recommended to drink freshly squeezed and packaged juices only after meals and in a small amount no more than 2 times a week.

If the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, ADRB2, FABP2 and PPARG genes, then a 6-month "low-carb low-fat diet with prevention of type 2 diabetes with fasting days" is prescribed. This diet is characterized by limiting the overall proportion of fat in the diet to 15-20%, with the proportion of saturated fat to 3-7% in the diet; the introduction of fasting days 1 every 7-10 days with a reduction in the total caloric intake to 50-60%; limiting the total proportion of carbohydrates to 45-50% and fast-absorbing carbohydrates to 5% of the diet; an increase in the proportion of dietary fiber to 1 g per kg of body weight. Excluded: sausages and deli meats (meat nut, chop, etc.); fatty meats (pork, lamb), poultry (duck, goose, chicken skin), fish (oily fish, halibut, sturgeon); offal (tongue, heart, stomach; dairy products and high-fat cheeses; sweets containing fats (pastry, sweets, waffles, pastry, milk chocolate, cakes, pastries), refined sugar and all products containing it; refined flour (Extra Class) and all products made of it. Limited to: red meat (beef, veal), including red poultry meat (chicken legs, red turkey meat); red fish varieties (salmon, trout, salmon); dairy products of average fat content. : milk 3.5%, sour cream 15-20%, cottage cheese 5-9%, cheese 17-25%. products are recommended to use 1-2 times a week in a small amount; sweet fruits (bananas, grapes, figs, persimmon, melon) and dried fruits (dates, raisins, figs); natural sweeteners (honey, Turkish delight, Jerusalem artichoke syrup, etc.); white and yellow cereals (semolina, rice, corn, millet); roasted and crushed potatoes; boiled carrots and beets, since the glycemic index of these vegetables after boiling increases significantly. These products can be consumed in small quantities no more than 1-2 times a week exclusively in the morning.

If the causes of overweight and / or food intolerance are associated with the HLA-DQ haplotype and polymorphism in the PPARG gene, then a 6 month "gluten-free diet with fasting days" is prescribed. This diet is characterized by the introduction of fasting days 1 time in 7-10 days with a reduction in total caloric intake to 50-60%; restriction or exclusion from the use of gluten-containing products (rye, barley, wheat, oats, all cereals and products from these cereals).

If the causes of overweight and / or food intolerance are associated with the polymorphism in the FABF2 gene and the HLA-DQ haplotype, then a 6-month "gluten-free diet, with a restriction of saturated fat" is prescribed. This diet is characterized by restriction of saturated fat in the diet to 3-7% of the total caloric intake; restriction or exclusion from the use of gluten-containing products (rye, barley, wheat, oats, all cereals and products from these cereals). Excluded: sausages and deli meats (meat nut, chop, etc.); fatty meats (pork, lamb), poultry (duck, goose, chicken skin), fish (oily fish, halibut, sturgeon); offal (tongue, heart, stomach; dairy products and high-fat cheeses; sweets containing fats (biscuits with filling, sweets, waffles, pastry, milk chocolate, cakes, pastries).

If the causes of overweight and / or food intolerance are associated with polymorphism in the FABP2 and PPARG genes, and the HLA-DQ haplotype, then a 6-month "gluten-free low-fat diet with fasting days" is prescribed. This diet is characterized by the introduction of fasting days 1 time in 7-10 days with a reduction in total caloric intake to 50-60%; limiting saturated fat in the diet to 3-7% of the total caloric intake; restriction or exclusion from the use of gluten-containing products (rye, barley, wheat, oats, all cereals and products from these cereals). Excluded: sausages and deli meats (meat nut, chop, etc.); fatty meats (pork, lamb), poultry (duck, goose, chicken skin), fish (oily fish, halibut, sturgeon); offal (tongue, heart, stomach; dairy products and high-fat cheeses; sweets containing fats (biscuits with filling, sweets, waffles, pastry, milk chocolate, cakes, pastries). Red meat (beef, veal) is limited, including including red poultry meat (chicken legs, red turkey meat); red fish varieties (salmon, trout, salmon); medium-fat dairy products: milk 3.5%, sour cream 15-20%, cottage cheese 5-9%, cheese 17- 25%. These products are recommended to use 1-2 times a week in a small amount.

If the causes of overweight and / or food intolerance are associated with the polymorphism in the ADRB2 gene and the HLA-DQ haplotype, then a 6-month "gluten-free diet with restriction of fast-acting carbohydrates" is prescribed. This diet is characterized by limiting the proportion of fast-absorbing carbohydrates to 5% of the diet; restriction or exclusion from the use of gluten-containing products (rye, barley, wheat, oats, all cereals and products from these cereals). Excluded: refined sugar and all products containing it; refined flour (top grade) and all products from it.

If the causes of overweight and / or food intolerance are associated with polymorphism in the genes ADRB2, PPARG, and the HLA-DQ haplotype, then a 6-month "gluten-free diet with limited fast-acting carbohydrates with fasting days" is prescribed. This diet is characterized by limiting the proportion of fast-absorbing carbohydrates to 5% of the diet; the introduction of fasting days 1 every 7-10 days with a reduction in the total caloric intake to 50-60%; restriction or exclusion from the use of gluten-containing products (rye, barley, wheat, oats, all cereals and products from these cereals). Excluded: refined sugar and all products containing it; refined flour (top grade) and all products from it.

If the causes of overweight and / or food intolerance are associated with polymorphism in the ADRB2, FABP2 genes and the HLA-DQ haplotype, then a 6 month "gluten-free diet with restriction of fast-digesting carbohydrates with restriction of saturated fats" is prescribed. This diet is characterized by restriction of saturated fat in the diet to 3-7% of the total caloric intake; limiting the share of fast-absorbing carbohydrates to 5% of the diet; restriction or exclusion from the use of gluten-containing products (rye, barley, wheat, oats, all cereals and products from these cereals). Excluded: sausages and deli meats (meat nut, chop, etc.); fatty meats (pork, lamb), poultry (duck, goose, chicken skin), fish (oily fish, halibut, sturgeon); offal (tongue, heart, stomach; dairy products and high fat cheeses; sweets containing fats (baked cookies, sweets, waffles, pastry, milk chocolate, cakes, pastries); refined sugar and all products containing it; refined flour (top grade) and all products from it.

If the causes of overweight and / or food intolerance are associated with polymorphism in the ADRB2, FABP2, PPARG genes and the HLA-DQ haplotype, then a 6-month "gluten-free low-fat diet with limited fast-acting carbohydrates with fasting days" is prescribed. This diet is characterized by limiting the overall proportion of fat in the diet to 15-20%, with the proportion of saturated fat to 3-7% in the diet; the introduction of fasting days 1 every 7-10 days with a reduction in the total caloric intake to 50-60%; restriction or exclusion from the use of gluten-containing products (rye, barley, wheat, oats, all cereals and products from these cereals). Excluded: sausages and deli meats (meat nut, chop, etc.); fatty meats (pork, lamb), poultry (duck, goose, chicken skin), fish (oily fish, halibut, sturgeon); offal (tongue, heart, stomach; dairy products and high-fat cheeses; sweets containing fats (biscuits with filling, sweets, waffles, pastry, milk chocolate, cakes, pastries). Red meat (beef, veal) is limited, including including red poultry meat (chicken legs, red turkey meat); red fish varieties (salmon, trout, salmon); medium-fat dairy products: milk 3.5%, sour cream 15-20%, cottage cheese 5-9%, cheese 17- 25%. These products are recommended to use 1-2 times a week in a small amount.

If the causes of overweight and / or food intolerance are associated with the polymorphism in the TCF7L2 gene and the HLA-DQ haplotype, then a 6-month "gluten-free diet with the prevention of type 2 diabetes" is prescribed. This diet is characterized by an increase in the proportion of dietary fiber to 1 g per kg of body weight; restriction or exclusion from the use of gluten-containing products (rye, barley, wheat, oats, all cereals and products from these cereals). It is recommended to conduct meals in 2.5-3 hours. In between meals, it is recommended to drink only clean water. It is not recommended to consume on an empty stomach sugary drinks, sweets, sweet fruits and dried fruits. It is recommended to drink freshly squeezed and packaged juices only after meals and in a small amount no more than 2 times a week.

If the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, PPARG genes and the HLA-DQ haplotype, then a 6-month "gluten-free diet with prevention of type 2 diabetes with fasting days" is prescribed. This diet is characterized by an increase in the proportion of dietary fiber to 1 g per kg of body weight; the introduction of fasting days 1 every 7-10 days with a reduction in the total caloric intake to 50-60%; restriction or exclusion from the use of gluten-containing products (rye, barley, wheat, oats, all cereals and products from these cereals). It is recommended to conduct meals in 2.5-3 hours. In between meals, it is recommended to drink only clean water. It is not recommended to consume on an empty stomach sugary drinks, sweets, sweet fruits and dried fruits. It is recommended to drink freshly squeezed and packaged juices only after meals and in a small amount no more than 2 times a week.

If the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, FABP2 genes and the HLA-DQ haplotype, then a 6-month "gluten-free diet with restriction of saturated fat with prevention of type 2 diabetes" is prescribed. This diet is characterized by restriction of saturated fat in the diet to 3-7% of the total caloric intake; increasing the proportion of dietary fiber to 1 g per kg of body weight; restriction or exclusion from the use of gluten-containing products (rye, barley, wheat, oats, all cereals and products from these cereals). Excluded: sausages and deli meats (meat nut, chop, etc.); fatty meats (pork, lamb), poultry (duck, goose, chicken skin), fish (oily fish, halibut, sturgeon); offal (tongue, heart, stomach; dairy products and high-fat cheeses; sweets containing fats (biscuits with filling, sweets, waffles, baked pastries, milk chocolate, cakes, pastries) In the intervals between meals, it is recommended to drink only clean water.It is not recommended to drink sugary drinks, sweets, sweet fruits and dried fruit on an empty stomach.

If the causes of overweight and / or food intolerance are associated with the polymorphism in the TCF7L2, FABP2, PPAGR genes and the HLA-DQ haplotype, then a 6-month "gluten-free low-fat diet with prevention of type 2 diabetes with fasting days" is prescribed. This diet is characterized by limiting the overall proportion of fat in the diet to 15-20%, with the proportion of saturated fat to 3-7% in the diet; increasing the proportion of dietary fiber to 1 g per kg of body weight; restriction or exclusion from the use of gluten-containing products (rye, barley, wheat, oats, all cereals and products from these cereals). Excluded: sausages and deli meats (meat nut, chop, etc.); fatty meats (pork, lamb), poultry (duck, goose, chicken skin), fish (oily fish, halibut, sturgeon); offal (tongue, heart, stomach; dairy products and high fat cheeses; sweets containing fats (biscuits with filling, sweets, waffles, baked pastries, milk chocolate, cakes, pastries). Red meat (beef, veal) is limited, including including red poultry meat (chicken legs, red turkey meat); red fish varieties (salmon, trout, salmon); medium-fat dairy products: milk 3.5%, sour cream 15-20%, cottage cheese 5-9%, cheese 17- 25%. These products are recommended to be consumed 1-2 times a week in a small amount. look for 2.5-3 hours. In the intervals between meals, it is recommended to drink only clean water.It is not recommended to drink on an empty stomach, sweet drinks, sweets, sweet fruits and dried fruits. more than 2 times a week.

If the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, ADRB2 genes and the HLA-DQ haplotype, then a 6-month "gluten-free low-carb diet with prevention of type 2 diabetes" is prescribed. This diet is characterized by limiting the total proportion of carbohydrates to 45-50% and fast-absorbing carbohydrates to 5% of the diet. Increasing the proportion of dietary fiber to 1 g per kg of body weight; restriction or exclusion from the use of gluten-containing products (rye, barley, wheat, oats, all cereals and products from these cereals). Excluded: refined sugar and all products containing it; refined flour (top grade) and all products from it. Limited to: sweet fruits (bananas, grapes, figs, persimmon, melon) and dried fruits (dates, raisins, figs); natural sweeteners (honey, Turkish delight, Jerusalem artichoke syrup, etc.); white and yellow cereals (semolina, rice, corn, millet); fried and crushed potatoes; boiled carrots and beets, since the glycemic index of these vegetables after boiling increases significantly. These products can be consumed in small quantities no more than 1-2 times a week exclusively in the morning. It is recommended to conduct meals in 2.5-3 hours. In between meals, it is recommended to drink only clean water. It is not recommended to consume on an empty stomach sugary drinks, sweets, sweet fruits and dried fruits. It is recommended to drink freshly squeezed and packaged juices only after meals and in a small amount no more than 2 times a week.

If the causes of overweight and / or food intolerance are associated with the polymorphism in the TCF7L2, ADRB2, PPARG genes and the HLA-DQ haplotype, then a 6-month "gluten-free low-carb diet with prevention of type 2 diabetes with fasting days" is prescribed. This diet is characterized by limiting the total proportion of carbohydrates to 45-50% and fast-absorbing carbohydrates to 5% of the diet; increasing the proportion of dietary fiber to I g per kg of body weight; the introduction of fasting days 1 every 7-10 days with a reduction in the total caloric intake to 50-60%; restriction or exclusion from the use of gluten-containing products (rye, barley, wheat, oats, all cereals and products from these cereals). Excluded: refined sugar and all products containing it; refined flour (top grade) and all products from it. Limited to: sweet fruits (bananas, grapes, figs, persimmon, melon) and dried fruits (dates, raisins, figs); natural sweeteners (honey, Turkish delight, Jerusalem artichoke syrup, etc.); white and yellow cereals (semolina, rice, corn, millet); fried and crushed potatoes; boiled carrots and beets, since the glycemic index of these vegetables after boiling increases significantly. These products can be consumed in small quantities no more than 1-2 times a week exclusively in the morning. It is recommended to conduct meals in 2.5-3 hours. In between meals, it is recommended to drink only clean water. It is not recommended to consume on an empty stomach sugary drinks, sweets, sweet fruits and dried fruits. It is recommended to drink freshly squeezed and packaged juices only after meals and in a small amount no more than 2 times a week.

If the causes of overweight and / or food intolerance are associated with a polymorphism in the TCF7L2, ADRB2, FABP2 genes and the HLA-DQ haplotype, then a 6-month "gluten-free low-carb diet with the restriction of type 2 diabetes is prescribed." This diet is characterized by limiting the total proportion of carbohydrates to 45-50% and fast-absorbing carbohydrates to 5% of the diet; increasing the proportion of dietary fiber to 1 g per kg of body weight; limiting saturated fat in the diet to 3-7% of the total caloric intake; restriction or exclusion from the use of gluten-containing products (rye, barley, wheat, oats, all cereals and products from these cereals). Excluded: refined sugar and all products containing it; refined flour (top grade) and all products from it. Also sausages and deli meats (meat nut, chop, etc.) are excluded; fatty meats (pork, lamb), poultry (duck, goose, chicken skin), fish (oily fish, halibut, sturgeon); offal (tongue, heart, stomach; dairy products and high fat cheeses; sweets containing fats (biscuits with filling, sweets, waffles, pastry, milk chocolate, cakes, pastries). Limited: sweet fruits (bananas, grapes, figs, persimmon, melon) and dried fruits (dates, raisins, figs); natural sweeteners (honey, Turkish delight, Jerusalem artichoke syrup, etc.); white and yellow cereals (semolina, rice, corn, millet); fried and ground potatoes; boiled carrots and beets, because the glycemic index of these vegetables after boiling significantly It is permissible to consume these products in small quantities no more than 1-2 times a week exclusively in the first half of the day. It is recommended to have meals in 2.5-3 hours. In the intervals between meals, it is recommended to drink only clean water. an empty stomach, sugary drinks, sweets, sweet fruits and dried fruits. It is recommended to drink freshly squeezed and packaged juices only after meals and in a small amount no more than 2 times a week.

If the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, ADRB2, FABP2, PPARG genes and the HLA-DQ haplotype, then a 6-month “gluten-free, low-carb, low-fat diet with prevention of type 2 diabetes with discharge days” is prescribed. This diet is characterized by limiting the overall proportion of fat in the diet to 15-20%, with the proportion of saturated fat to 3-7% in the diet; the introduction of fasting days 1 every 7-10 days with a reduction in the total caloric intake to 50-60%; limiting the total proportion of carbohydrates to 45-50% and fast-absorbing carbohydrates to 5% of the diet; increasing the proportion of dietary fiber to 1 g per kg of body weight; restriction or exclusion from the use of gluten-containing products (rye, barley, wheat, oats, all cereals and products from these cereals). Excluded: sausages and deli meats (meat nut, chop, etc.); fatty meats (pork, lamb), poultry (duck, goose, chicken skin), fish (oily fish, halibut, sturgeon); offal (tongue, heart, stomach; dairy products and high-fat cheeses; sweets containing fats (pastry, sweets, waffles, pastry, milk chocolate, cakes, pastries), refined sugar and all products containing it; refined flour (Extra Class) and all products made of it. Limited to: red meat (beef, veal), including red poultry meat (chicken legs, red turkey meat); red fish varieties (salmon, trout, salmon); dairy products of average fat content. : milk 3.5%, sour cream 15-20%, cottage cheese 5-9%, cheese 17-25%. products are recommended to use 1-2 times a week in a small amount; sweet fruits (bananas, grapes, figs, persimmon, melon) and dried fruits (dates, raisins, figs); natural sweeteners (honey, Turkish delight, Jerusalem artichoke syrup, etc.); white and yellow cereals (semolina, rice, corn, millet); roasted and crushed potatoes; boiled carrots and beets, since the glycemic index of these vegetables after boiling increases significantly. These products can be consumed in small quantities no more than 1-2 times a week exclusively in the morning.

If the causes of overweight and / or food intolerance are associated with polymorphism in the LCT and PPARG genes, then a 6-month “food ration with the exclusion of lactose-containing products and fasting days” is prescribed. This diet is characterized by the introduction of fasting days 1 time in 7-10 days with a reduction in total caloric intake to 50-60%; restriction or exclusion in the consumption of foods such as whole, dry, condensed milk and cream, as well as confectionery products that contain lactose in the composition. However, dairy products (sour cream, varenets, ryazhenka, kefir, cottage cheese, cheese, etc.) are not recommended to be excluded.

If the causes of overweight and / or food intolerance are associated with polymorphism in the LCT and FABP2 genes, then a 6-month "diet with restriction of saturated fat with the exception of lactose-containing products" is prescribed. This diet is characterized by restriction of saturated fat in the diet to 3-7% of the total caloric intake; restriction or exclusion in the consumption of foods such as whole, dry, condensed milk and cream, as well as confectionery products that contain lactose in the composition. Excluded: sausages and deli meats (meat nut, chop, etc.); fatty meats (pork, lamb), poultry (duck, goose, chicken skin), fish (oily fish, halibut, sturgeon); offal (tongue, heart, stomach; dairy products and high-fat cheeses; sweets containing fats (biscuits with filling, sweets, waffles, pastry, milk chocolate, cakes, pastries).

If the causes of overweight and / or food intolerance are associated with polymorphism in the FABP2, PPARG and LCT genes, then a 6-month "low-fat diet with the exception of lactose-containing products with fasting days" is prescribed. This diet is characterized by limiting the overall proportion of fat in the diet to 15-20%, with the proportion of saturated fat to 3-7% in the diet; restriction or exclusion in the consumption of foods such as whole, dry, condensed milk and cream, as well as confectionery products that contain lactose in the composition. Excluded: sausages and deli meats (meat nut, chop, etc.); fatty meats (pork, lamb), poultry (duck, goose, chicken skin), fish (oily fish, halibut, sturgeon); offal (tongue, heart, stomach; dairy products and high-fat cheeses; sweets containing fats (biscuits with filling, sweets, waffles, pastry, milk chocolate, cakes, pastries). Red meat (beef, veal) is limited, including including red poultry meat (chicken legs, red turkey meat); red fish varieties (salmon, trout, salmon); medium-fat dairy products: milk 3.5%, sour cream 15-20%, cottage cheese 5-9%, cheese 17- 25%. These products are recommended to use 1-2 times a week in a small amount.

If the causes of overweight and / or food intolerance are associated with polymorphism in the ADRB2 and LCT genes, then a 6-month "diet should be prescribed with a restriction of fast-digesting carbohydrates with the exception of lactose-containing products." This diet is characterized by limiting the proportion of fast-absorbing carbohydrates to 5% of the diet; restriction or exclusion in the consumption of foods such as whole, dry, condensed milk and cream, as well as confectionery products that contain lactose in the composition. Excluded: refined sugar and all products containing it; refined flour (top grade) and all products from it.

If the causes of overweight and / or food intolerance are associated with polymorphism in the ADRB2, PPARG and LCT genes, then a 6-month "diet with restriction of fast-digesting carbohydrates with the exception of lactose-containing products with discharge days" is prescribed. This diet is characterized by limiting the proportion of fast-absorbing carbohydrates to 5% of the diet; the introduction of fasting days 1 every 7-10 days with a reduction in the total caloric intake to 50-60%. Excluded:

refined sugar and all products containing it; refined flour (top grade) and all products from it.

If the causes of overweight and / or food intolerance are associated with polymorphism in the genes ADRB2, FABP2, LCT, then a 6-month “diet with restriction of fast-digesting carbohydrates with restriction of saturated fats with the exception of lactose-containing products is prescribed. This diet is characterized by restriction of saturated fat in the diet to 3-7% of the total caloric intake; limiting the share of fast-absorbing carbohydrates to 5% of the diet; restriction or exclusion in the consumption of foods such as whole, dry, condensed milk and cream, as well as confectionery products that contain lactose in the composition. Excluded: sausages and deli meats (meat nut, chop, etc.); fatty meats (pork, lamb), poultry (duck, goose, chicken skin), fish (oily fish, halibut, sturgeon); offal (tongue, heart, stomach; dairy products and high fat cheeses; sweets containing fats (baked cookies, sweets, waffles, pastry, milk chocolate, cakes, pastries); refined sugar and all products containing it; refined flour (top grade) and all products from it.

If the causes of overweight and / or food intolerance are associated with polymorphism in the genes ADRB2, FABP2, PPARG and LCT, then a 6-month "low-fat diet with restriction of fast-digesting carbohydrates with the exception of lactose-containing products with fasting days" is prescribed. This diet is characterized by limiting the overall proportion of fat in the diet to 15-20%, with the proportion of saturated fat to 3-7% in the diet; the introduction of fasting days 1 every 7-10 days with a reduction in the total caloric intake to 50-60%; restriction or exclusion in the consumption of foods such as whole, dry, condensed milk and cream, as well as confectionery products that contain lactose in the composition. Excluded: sausages and deli meats (meat nut, chop, etc.); fatty meats (pork, lamb), poultry (duck, goose, chicken skin), fish (oily fish, halibut, sturgeon); offal (tongue, heart, stomach; dairy products and high-fat cheeses; sweets containing fats (biscuits with filling, sweets, waffles, pastry, milk chocolate, cakes, pastries). Red meat (beef, veal) is limited, including including red poultry meat (chicken legs, red turkey meat); red fish varieties (salmon, trout, salmon); medium-fat dairy products: milk 3.5%, sour cream 15-20%, cottage cheese 5-9%, cheese 17- 25%. These products are recommended to use 1-2 times a week in a small amount.

If the causes of overweight and / or food intolerance are associated with polymorphism in the LCT and TCF7L2 genes, then a 6-month "diet with prevention of type 2 diabetes with the exclusion of lactose-containing products" is prescribed. This diet is characterized by an increase in the proportion of dietary fiber to 1 g per kg of body weight; restriction or exclusion in the consumption of foods such as whole, dry, condensed milk and cream, as well as confectionery products that contain lactose in the composition. It is recommended to conduct meals in 2.5-3 hours. In between meals, it is recommended to drink only clean water. It is not recommended to consume on an empty stomach sugary drinks, sweets, sweet fruits and dried fruits. It is recommended to drink freshly squeezed and packaged juices only after meals and in a small amount no more than 2 times a week.

If the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, PPARG and LCT genes, then a 6-month "diet with prevention of type 2 diabetes with the exception of lactose-containing products with fasting days" is prescribed. This diet is characterized by an increase in the proportion of dietary fiber to 1 g per kg of body weight; the introduction of fasting days 1 every 7-10 days with a reduction in the total caloric intake to 50-60%; restriction or exclusion in the consumption of foods such as whole, dry, condensed milk and cream, as well as confectionery products that contain lactose in the composition. It is recommended to conduct meals in 2.5-3 hours. In between meals, it is recommended to drink only clean water. It is not recommended to consume on an empty stomach sugary drinks, sweets, sweet fruits and dried fruits. It is recommended to drink freshly squeezed and packaged juices only after meals and in a small amount no more than 2 times a week.

If the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, FABP2 and LCT genes, then a 6 month "diet with restriction of saturated fat with prevention of type 2 diabetes with the exception of lactose-containing products" is prescribed. This diet is characterized by restriction of saturated fat in the diet to 3-7% of the total caloric intake; increasing the proportion of dietary fiber to 1 g per kg of body weight; restriction or exclusion in the consumption of foods such as whole, dry, condensed milk and cream, as well as confectionery products that contain lactose in the composition. Excluded: sausages and deli meats (meat nut, chop, etc.); fatty meats (pork, lamb), poultry (duck, goose, chicken skin), fish (oily fish, halibut, sturgeon); offal (tongue, heart, stomach; dairy products and high-fat cheeses; sweets containing fats (biscuits with filling, sweets, waffles, baked pastries, milk chocolate, cakes, pastries) In the intervals between meals, it is recommended to drink only clean water.It is not recommended to drink sugary drinks, sweets, sweet fruits and dried fruit on an empty stomach.

If the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, FABP2, LCT and PPARG genes, then a 6-month "low-fat diet with prevention of type 2 diabetes with the exception of lactose-containing products with fasting days" is prescribed. This diet is characterized by limiting the overall proportion of fat in the diet to 15-20%, with the proportion of saturated fat to 3-7% in the diet; increasing the proportion of dietary fiber to 1 g per kg of body weight; restriction or exclusion in the consumption of foods such as whole, dry, condensed milk and cream, as well as confectionery products that contain lactose in the composition. Excluded: sausages and deli meats (meat nut, chop, etc.); fatty meats (pork, lamb), poultry (duck, goose, chicken skin), fish (oily fish, halibut, sturgeon); offal (tongue, heart, stomach; dairy products and high-fat cheeses; sweets containing fats (biscuits with filling, sweets, waffles, pastry, milk chocolate, cakes, pastries). Red meat (beef, veal) is limited, including including red poultry meat (chicken thighs, red turkey meat); red fish varieties (salmon, trout, and ice); medium-fat dairy products: milk 3.5%, sour cream 15-20%, cottage cheese 5-9%, cheese 17-25%. These products are recommended to be consumed 1-2 times a week in a small amount. food in 2.5-3 hours. In the intervals between meals, it is recommended to drink only clean water.It is not recommended to use on an empty stomach sugary drinks, sweets, sweet fruits and dried fruits. It is recommended to drink freshly squeezed and packaged juices only after meals and in a small amount more than 2 times a week.

If the causes of overweight and / or food intolerance are associated with a polymorphism in the TCF7L2, ADRB2 and LCT genes, then a 6-month "low-carb diet with prevention of type 2 diabetes with the exception of lactose-containing products" is prescribed. This diet is characterized by limiting the total proportion of carbohydrates to 45-50% and fast-absorbing carbohydrates to 5% of the diet. Increasing the proportion of dietary fiber to 1 g per kg of body weight; restriction or exclusion in the consumption of foods such as whole, dry, condensed milk and cream, as well as confectionery products that contain lactose in the composition. Excluded: refined sugar and all products containing it; refined flour (top grade) and all products from it. Limited to: sweet fruits (bananas, grapes, figs, persimmon, melon) and dried fruits (dates, raisins, figs); natural sweeteners (honey, Turkish delight, Jerusalem artichoke syrup, etc.); white and yellow cereals (semolina, rice, corn, millet); fried and crushed potatoes; boiled carrots and beets, since the glycemic index of these vegetables after boiling increases significantly. These products can be consumed in small quantities no more than 1-2 times a week exclusively in the morning. It is recommended to conduct meals in 2.5-3 hours. In between meals, it is recommended to drink only clean water. It is not recommended to consume on an empty stomach sugary drinks, sweets, sweet fruits and dried fruits. It is recommended to drink freshly squeezed and packaged juices only after meals and in a small amount no more than 2 times a week.

If the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, ADRB2, PPARG and LCT genes, then a 6 month "low carbohydrate diet with prevention of type 2 diabetes with fasting days" is prescribed. This diet is characterized by limiting the total proportion of carbohydrates to 45-50% and fast-absorbing carbohydrates to 5% of the diet; increasing the proportion of dietary fiber to 1 g per kg of body weight; the introduction of fasting days 1 every 7-10 days with a reduction in the total caloric intake to 50-60%; restriction or exclusion in the consumption of foods such as whole, dry, condensed milk and cream, as well as confectionery products that contain lactose in the composition. Excluded: refined sugar and all products containing it; refined flour (top grade) and all products from it. Limited to: sweet fruits (bananas, grapes, figs, persimmon, melon) and dried fruits (dates, raisins, figs); natural sweeteners (honey, Turkish delight, Jerusalem artichoke syrup, etc.); white and yellow cereals (semolina, rice, corn, millet); fried and crushed potatoes; boiled carrots and beets, since the glycemic index of these vegetables after boiling increases significantly. These products can be consumed in small quantities no more than 1-2 times a week exclusively in the morning. It is recommended to conduct meals in 2.5-3 hours. In between meals, it is recommended to drink only clean water. It is not recommended to consume on an empty stomach sugary drinks, sweets, sweet fruits and dried fruits. It is recommended to drink freshly squeezed and packaged juices only after meals and in a small amount no more than 2 times a week.

If the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, ADRB2, FABP2 and LCT genes, then a 6 month "low carbohydrate diet with restriction of saturated fats with prevention of type 2 diabetes with the exclusion of lactose-containing products" is prescribed. This diet is characterized by limiting the total proportion of carbohydrates to 45-50% and fast-absorbing carbohydrates to 5% of the diet; increasing the proportion of dietary fiber to 1 g per kg of body weight; limiting saturated fat in the diet to 3-7% of the total caloric intake; restriction or exclusion in the consumption of foods such as whole, dry, condensed milk and cream, as well as confectionery products that contain lactose in the composition. Excluded: refined sugar and all products containing it; refined flour (top grade) and all products from it. Also sausages and deli meats (meat nut, chop, etc.) are excluded; fatty meats (pork, lamb), poultry (duck, goose, chicken skin), fish (oily fish, halibut, sturgeon); offal (tongue, heart, stomach; dairy products and high fat cheeses; sweets containing fats (biscuits with filling, sweets, waffles, pastry, milk chocolate, cakes, pastries). Limited: sweet fruits (bananas, grapes, figs, persimmon, melon) and dried fruits (dates, raisins, figs); natural sweeteners (honey, Turkish delight, Jerusalem artichoke syrup, etc.); white and yellow cereals (semolina, rice, corn, millet); fried and ground potatoes; boiled carrots and beets, because the glycemic index of these vegetables after boiling significantly It is permissible to consume these products in small quantities no more than 1-2 times a week exclusively in the first half of the day. It is recommended to have meals in 2.5-3 hours. In the intervals between meals, it is recommended to drink only clean water. an empty stomach, sugary drinks, sweets, sweet fruits and dried fruits. It is recommended to drink freshly squeezed and packaged juices only after meals and in a small amount no more than 2 times a week.

If the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, ADRB2 and FABP2, PPARG and LCT genes, then a 6-month "low-carbohydrate low-fat diet with prevention of type 2 diabetes with the exclusion of lactose-containing products with discharge days" is prescribed. This diet is characterized by limiting the overall proportion of fat in the diet to 15-20%, with the proportion of saturated fat to 3-7% in the diet; the introduction of fasting days 1 every 7-10 days with a reduction in the total caloric intake to 50-60%; limiting the total proportion of carbohydrates to 45-50% and fast-absorbing carbohydrates to 5% of the diet; increasing the proportion of dietary fiber to 1 g per kg of body weight; restriction or exclusion in the consumption of foods such as whole, dry, condensed milk and cream, as well as confectionery products that contain lactose in the composition. Excluded: sausages and deli meats (meat nut, chop, etc.); fatty meats (pork, lamb), poultry (duck, goose, chicken skin), fish (oily fish, halibut, sturgeon); offal (tongue, heart, stomach; dairy products and high-fat cheeses; sweets containing fats (pastry, sweets, waffles, pastry, milk chocolate, cakes, pastries), refined sugar and all products containing it; refined flour (Extra Class) and all products made of it. Limited to: red meat (beef, veal), including red poultry meat (chicken legs, red turkey meat); red fish varieties (salmon, trout, salmon); dairy products of average fat content. : milk 3.5%, sour cream 15-20%, cottage cheese 5-9%, cheese 17-25%. products are recommended to use 1-2 times a week in a small amount; sweet fruits (bananas, grapes, figs, persimmon, melon) and dried fruits (dates, raisins, figs); natural sweeteners (honey, Turkish delight, Jerusalem artichoke syrup, etc.); white and yellow cereals (semolina, rice, corn, millet); roasted and crushed potatoes; boiled carrots and beets, since the glycemic index of these vegetables after boiling increases significantly. These products can be consumed in small quantities no more than 1-2 times a week exclusively in the morning.

If the causes of food intolerance are associated with polymorphism in the LCT gene and the HLA-DQ haplotype, then a 6-month "hypoallergenic diet with the exception of gluten-containing and lactose-containing products" is prescribed. This diet is characterized by limiting or excluding the consumption of foods such as whole, dry, condensed milk and cream, as well as confectionery products that contain lactose in the composition. However, dairy products (sour cream, varenets, ryazhenka, kefir, cottage cheese, cheese, etc.) are not recommended to be excluded. Limited to or excluded from the use of gluten-containing products (rye, barley, wheat, oats, all cereals and products from these cereals).

If the causes of overweight and / or food intolerance are associated with polymorphism in the PPARG, LCT genes and the HLA-DQ haplotype, then a 6-month "hypoallergenic diet with the exception of gluten-containing and lactose-containing products with fasting days" is prescribed. This diet is characterized by the introduction of fasting days 1 time in 7-10 days with a reduction in total caloric intake to 50-60%; restriction or exclusion in the consumption of foods such as whole, dry, condensed milk and cream, as well as confectionery products that contain lactose in the composition. Limited to or excluded from the use of gluten-containing products (rye, barley, wheat, oats, all cereals and products from these cereals). The use of coarse and solid foods that can mechanically damage the intestines is limited.

If the causes of overweight and / or food intolerance are associated with polymorphism in the FABP2, LCT genes and the HLA-DQ haplotype, then a 6 month "hypoallergenic diet with restriction of saturated fats with the exception of gluten-containing and lactose-containing products" is prescribed. This diet is characterized by restriction of saturated fat in the diet to 3-7% of the total caloric intake; restriction or exclusion in the consumption of foods such as whole, dry, condensed milk and cream, as well as confectionery products that contain lactose in the composition. Limited to or excluded from the use of gluten-containing products (rye, barley, wheat, oats, all cereals and products from these cereals). Excluded: sausages and deli meats (meat nut, chop, etc.); fatty meats (pork, lamb), poultry (duck, goose, chicken skin), fish (oily fish, halibut, sturgeon); offal (tongue, heart, stomach; dairy products and high-fat cheeses; sweets containing fats (biscuits with filling, sweets, waffles, pastry, milk chocolate, cakes, pastries).

If the causes of overweight and / or food intolerance are associated with polymorphism in the FABP2, PPARG, LCT genes and the HLA-DQ haplotype, then a 6-month "hypoallergenic low-fat diet with the exception of gluten-containing and lactose-containing products with fasting days" is prescribed. This diet is characterized by limiting the overall proportion of fat in the diet to 15-20%, with the proportion of saturated fat to 3-7% in the diet; restriction or exclusion in the consumption of foods such as whole, dry, condensed milk and cream, as well as confectionery products that contain lactose in the composition. Limited to or excluded from the use of gluten-containing products (rye, barley, wheat, oats, all cereals and products from these cereals). Excluded: sausages and deli meats (meat nut, chop, etc.); fatty meats (pork, lamb), poultry (duck, goose, chicken skin), fish (oily fish, halibut, sturgeon); offal (tongue, heart, stomach; dairy products and high-fat cheeses; sweets containing fats (biscuits with filling, sweets, waffles, pastry, milk chocolate, cakes, pastries). Red meat (beef, veal) is limited, including including red poultry meat (chicken legs, red turkey meat); red fish varieties (salmon, trout, salmon); medium-fat dairy products: milk 3.5%, sour cream 15-20%, cottage cheese 5-9%, cheese 17- 25%. These products are recommended to use 1-2 times a week in a small amount.

If the causes of overweight and / or food intolerance are associated with polymorphism in the ADRB2, LCT genes and the HLA-DQ haplotype, then a 6-month "hypoallergenic diet with a restriction of fast-acting carbohydrates with the exception of gluten-containing and lactose-containing products" is prescribed. This diet is characterized by limiting the proportion of fast-absorbing carbohydrates to 5% of the diet; restriction or exclusion in the consumption of foods such as whole, dry, condensed milk and cream, as well as confectionery products that contain lactose in the composition. Limited to or excluded from the use of gluten-containing products (rye, barley, wheat, oats, all cereals and products from these cereals). Excluded: refined sugar and all products containing it; refined flour (top grade) and all products from it.

If the causes of overweight and / or food intolerance are associated with polymorphism in the ADRB2, PPARG, LCT genes and the HLA-DQ haplotype, then a 6-month “hypoallergenic diet with restriction of fast-acting carbohydrates with the exception of gluten-containing and lactose-containing foods with discharge days” is prescribed. This diet is characterized by limiting the proportion of fast-absorbing carbohydrates to 5% of the diet; the introduction of fasting days 1 every 7-10 days with a reduction in the total caloric intake to 50-60%; restriction or exclusion in the consumption of foods such as whole, dry, condensed milk and cream, as well as confectionery products that contain lactose in the composition. Limited to or excluded from the use of gluten-containing products (rye, barley, wheat, oats, all cereals and products from these cereals). Excluded: refined sugar and all products containing it; refined flour (top grade) and all products from it.

If the causes of overweight and / or food intolerance are associated with polymorphism in the ADRB2, FABP2, LCT genes and the HLA-DQ haplotype, then a 6-month “hypoallergenic diet with restriction of fast-acting carbohydrates with a restriction of saturated fats with the exception of gluten-containing and lactose-containing foods” is prescribed. This diet is characterized by restriction of saturated fat in the diet to 3-7% of the total caloric intake; limiting the share of fast-absorbing carbohydrates to 5% of the diet; restriction or exclusion in the consumption of foods such as whole, dry, condensed milk and cream, as well as confectionery products that contain lactose in the composition. Limited to or excluded from the use of gluten-containing products (rye, barley, wheat, oats, all cereals and products from these cereals). Excluded: sausages and deli meats (meat nut, chop, etc.); fatty meats (pork, lamb), poultry (duck, goose, chicken skin), fish (oily fish, halibut, sturgeon); offal (tongue, heart, stomach; dairy products and high fat cheeses; sweets containing fats (baked cookies, sweets, waffles, pastry, milk chocolate, cakes, pastries); refined sugar and all products containing it; refined flour (top grade) and all products from it.

If the causes of overweight and / or food intolerance are associated with polymorphism in the ADRB2, FABP2, PPARG, LCT genes and the HLA-DQ haplotype, then a 6-month "hypoallergenic low-fat diet with restriction of fast-absorbing carbohydrates with the exception of gluten-containing and free-flow and free-flow and free-from-liquid and free-from-liquid and free-from-liquid and free-from-liquid and free-from-liquid and free-from-liquid and free-from-liquid and free-from-liquid and free-from-liquid and free-from-liquid and free-from-liquid and free-from-liquid and free-from-liquid and free-from-liquid and liquid wounds are not used. . This diet is characterized by limiting the overall proportion of fat in the diet to 15-20%, with the proportion of saturated fat to 3-7% in the diet; the introduction of fasting days 1 every 7-10 days with a reduction in the total caloric intake to 50-60%; restriction or exclusion in the consumption of foods such as whole, dry, condensed milk and cream, as well as confectionery products that contain lactose in the composition. Limited to or excluded from the use of gluten-containing products (rye, barley, wheat, oats, all cereals and products from these cereals). Excluded: sausages and deli meats (meat nut, chop, etc.); fatty meats (pork, lamb), poultry (duck, goose, chicken skin), fish (oily fish, halibut, sturgeon); offal (tongue, heart, stomach; dairy products and high-fat cheeses; sweets containing fats (biscuits with filling, sweets, waffles, pastry, milk chocolate, cakes, pastries). Red meat (beef, veal) is limited, including including red poultry meat (chicken legs, red turkey meat); red fish varieties (salmon, trout, salmon); medium-fat dairy products: milk 3.5%, sour cream 15-20%, cottage cheese 5-9%, cheese 17- 25%. These products are recommended to use 1-2 times a week in a small amount.

If the causes of overweight and / or food intolerance are associated with polymorphism in the LCT and TCF7L2 genes, and the HLA-DQ haplotype, then a 6-month "hypoallergenic diet with prevention of type 2 diabetes with the exclusion of gluten-containing and lactose-containing products" is prescribed. This diet is characterized by an increase in the proportion of dietary fiber to 1 g per kg of body weight; restriction or exclusion in the consumption of foods such as whole, dry, condensed milk and cream, as well as confectionery products that contain lactose in the composition. Limited to or excluded from the use of gluten-containing products (rye, barley, wheat, oats, all cereals and products from these cereals). It is recommended to conduct meals in 2.5-3 hours. In between meals, it is recommended to drink only clean water. It is not recommended to consume on an empty stomach sugary drinks, sweets, sweet fruits and dried fruits. It is recommended to drink freshly squeezed and packaged juices only after meals and in a small amount no more than 2 times a week.

If the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, PPARG and LCT genes, and the HLA-DQ haplotype, then a 6-month "hypoallergenic diet with prevention of type 2 diabetes with the exclusion of gluten-containing and lactose-containing products with relief days ". This diet is characterized by an increase in the proportion of dietary fiber to 1 g per kg of body weight; the introduction of fasting days 1 every 7-10 days with a reduction in the total caloric intake to 50-60%; restriction or exclusion in the consumption of foods such as whole, dry, condensed milk and cream, as well as confectionery products that contain lactose in the composition. Limited to or excluded from the use of gluten-containing products (rye, barley, wheat, oats, all cereals and products from these cereals). It is recommended to conduct meals in 2.5-3 hours. In between meals, it is recommended to drink only clean water. It is not recommended to consume on an empty stomach sugary drinks, sweets, sweet fruits and dried fruits. It is recommended to drink freshly squeezed and packaged juices only after meals and in a small amount no more than 2 times a week.

If the causes of overweight and / or food intolerance are associated with the polymorphism in the TCF7L2, FABP2, LCT genes and the HLA-DQ haplotype, then a 6 month "hypoallergenic diet with restriction of saturated fat with prevention of type 2 diabetes with the exception of gluten-containing and lactose-containing products ". This diet is characterized by restriction of saturated fat in the diet to 3-7% of the total caloric intake; increasing the proportion of dietary fiber to 1 g per kg of body weight; restriction or exclusion in the consumption of foods such as whole, dry, condensed milk and cream, as well as confectionery products that contain lactose in the composition. Limited to or excluded from the use of gluten-containing products (rye, barley, wheat, oats, all cereals and products from these cereals). Excluded: sausages and deli meats (meat nut, chop, etc.); fatty meats (pork, lamb), poultry (duck, goose, chicken skin), fish (oily fish, halibut, sturgeon); offal (tongue, heart. Stomach; dairy products and high-fat cheeses; sweets containing fats (biscuits with filling, sweets, waffles, pastry, milk chocolate, cakes, pastries). It is recommended to take meals in 2.5-3 hours In the intervals between meals, it is recommended to drink only clean water.It is not recommended to drink sugary drinks, sweets, sweet fruits and dried fruits on an empty stomach. It is recommended to drink freshly squeezed and packaged juices only after meals and in a small amount no more than 2 times a week.

53. If the causes of excess weight and / or food intolerance associated with polymorphisms in genes TCF7L2, FABP2, PPARG, LCT and haplotype HLA-DQ, then appoint 6 month "hypoallergenic low-fat diet to prevent diabetes type 2 with the exception of glyutenosoderzhaschih and lactose products with fasting days. " This diet is characterized by limiting the overall proportion of fat in the diet to 15-20%, with the proportion of saturated fat to 3-7% in the diet; increasing the proportion of dietary fiber to 1 g per kg of body weight; restriction or exclusion in the consumption of foods such as whole, dry, condensed milk and cream, as well as confectionery products that contain lactose in the composition. Limited to or excluded from the use of gluten-containing products (rye, barley, wheat, oats, all cereals and products from these cereals). Excluded: sausages and deli meats (meat nut, chop, etc.); fatty meats (pork, lamb), poultry (duck, goose, chicken skin), fish (oily fish, halibut, sturgeon); offal (tongue, heart, stomach; dairy products and high fat cheeses; sweets containing fats (biscuits with filling, sweets, waffles, baked pastries, milk chocolate, cakes, pastries). Red meat (beef, veal) is limited, including including red poultry meat (chicken legs, red turkey meat); red fish varieties (salmon, trout, salmon); medium-fat dairy products: milk 3.5%, sour cream 15-20%, cottage cheese 5-9%, cheese 17- 25%. These products are recommended to be consumed 1-2 times a week in a small amount. look for 2.5-3 hours. In the intervals between meals, it is recommended to drink only clean water.It is not recommended to drink on an empty stomach, sweet drinks, sweets, sweet fruits and dried fruits. more than 2 times a week.

If the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, ADRB2, LCT genes and the HLA-DQ haplotype, then a 6-month “hypoallergenic low-carb diet with prevention of type 2 diabetes with the exception of gluten-containing and lactose-containing products” is prescribed. This diet is characterized by limiting the total proportion of carbohydrates to 45-50% and fast-absorbing carbohydrates to 5% of the diet. Increasing the proportion of dietary fiber to 1 g per kg of body weight; restriction or exclusion in the consumption of foods such as whole, dry, condensed milk and cream, as well as confectionery products that contain lactose in the composition. Limited to or excluded from the use of gluten-containing products (rye, barley, wheat, oats, all cereals and products from these cereals). Excluded: refined sugar and all products containing it; refined flour (top grade) and all products from it. Limited to: sweet fruits (bananas, grapes, figs, persimmon, melon) and dried fruits (dates, raisins, figs); natural sweeteners (honey, Turkish delight, Jerusalem artichoke syrup, etc.); white and yellow cereals (semolina, rice, corn, millet); fried and crushed potatoes; boiled carrots and beets, since the glycemic index of these vegetables after boiling increases significantly. These products can be consumed in small quantities no more than 1-2 times a week exclusively in the morning. It is recommended to conduct meals in 2.5-3 hours. In between meals, it is recommended to drink only clean water. It is not recommended to consume on an empty stomach sugary drinks, sweets, sweet fruits and dried fruits. It is recommended to drink freshly squeezed and packaged juices only after meals and in a small amount no more than 2 times a week.

If the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, ADRB2 and PPARG genes, LCT, and the HLA-DQ haplotype, then a 6-month "hypoallergenic low-carbohydrate diet with prevention of type 2 diabetes with the exception of gluten-containing and lactose-containing diet is excluded fasting days. " This diet is characterized by limiting the total proportion of carbohydrates to 45-50% and fast-absorbing carbohydrates to 5% of the diet. Increasing the proportion of dietary fiber to 1 g per kg of body weight; restriction or exclusion in the consumption of foods such as whole, dry, condensed milk and cream, as well as confectionery products that contain lactose in the composition. Limited to or excluded from the use of gluten-containing products (rye, barley, wheat, oats, all cereals and products from these cereals). Excluded: refined sugar and all products containing it; refined flour (top grade) and all products from it. Limited to: sweet fruits (bananas, grapes, figs, persimmon, melon) and dried fruits (dates, raisins, figs); natural sweeteners (honey, Turkish delight, Jerusalem artichoke syrup, etc.); white and yellow cereals (semolina, rice, corn, millet); fried and crushed potatoes; boiled carrots and beets, since the glycemic index of these vegetables after boiling increases significantly. These products can be consumed in small quantities no more than 1-2 times a week exclusively in the morning. It is recommended to conduct meals in 2.5-3 hours. In between meals, it is recommended to drink only clean water. It is not recommended to consume on an empty stomach sugary drinks, sweets, sweet fruits and dried fruits. It is recommended to drink freshly squeezed and packaged juices only after meals and in a small amount no more than 2 times a week.

If the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, ADRB2, FABP2, LCT genes and the HLA-DQ haplotype, then a 6-month "hypoallergenic low-carb diet with restriction of saturated fats with prevention of type 2 diabetes with the exception of gluten free sodium is prescribed - zahaschimi and lactose-containing products. This diet is characterized by limiting the total proportion of carbohydrates to 45-50% and fast-absorbing carbohydrates to 5% of the diet; increasing the proportion of dietary fiber to 1 g per kg of body weight; limiting saturated fat in the diet to 3-7% of the total caloric intake; restriction or exclusion of the consumption of foods such as whole, dry, condensed milk and cream, as well as confectionery products that contain lactose in the composition. Limited to or excluded from the use of gluten-containing products (rye, barley, wheat, oats, all cereals and products from these cereals). Excluded: refined sugar and all products containing it; refined flour (top grade) and all products from it. Also sausages and deli meats (meat nut, chop, etc.) are excluded; fatty meats (pork, lamb), poultry (duck, goose, chicken skin), fish (oily fish, halibut, sturgeon); offal (tongue, heart, stomach; dairy products and high fat cheeses; sweets containing fats (biscuits with filling, sweets, waffles, pastry, milk chocolate, cakes, pastries). Limited: sweet fruits (bananas, grapes, figs, persimmon, melon) and dried fruits (dates, raisins, figs); natural sweeteners (honey, Turkish delight, Jerusalem artichoke syrup, etc.); white and yellow cereals (semolina, rice, corn, millet); fried and ground potatoes; boiled carrots and beets, because the glycemic index of these vegetables after boiling significantly It is permissible to consume these products in small quantities no more than 1-2 times a week exclusively in the first half of the day. It is recommended to have meals in 2.5-3 hours. In the intervals between meals, it is recommended to drink only clean water. an empty stomach, sugary drinks, sweets, sweet fruits and dried fruits. It is recommended to drink freshly squeezed and packaged juices only after meals and in a small amount no more than 2 times a week.

If the causes of overweight and / or food intolerance are associated with the polymorphism in the TCF7L2, ADRB2 and FABP2, PPARG, LCT genes and the HLA-DQ haplotype, then a 6-month "hypoallergenic low-carbohydrate low-fat diet with the prevention of type 2 diabetes with type 2 gluten-suppressant, with the exclusion of gluten-free 2-carbohydrate low-fat diets with prevention of type 2, with the exclusion of gluten-free 2-carbohydrate low-fat diets with prevention of type-2 diabetes mellitus with the prevention of type 2 glucose-allergenic low-carbohydrate low-fat diets with the prevention of type 2 diabetes mellitus with the prevention of type 2 gluten-allergenic low-carbohydrate low-fat diets with the prevention of type 2 diabetes mellitus should be prescribed. lactose-containing products with fasting days. " This diet is characterized by limiting the overall proportion of fat in the diet to 15-20%, with the proportion of saturated fat to 3-7% in the diet; the introduction of fasting days 1 every 7-10 days with a reduction in the total caloric intake to 50-60%; limiting the total proportion of carbohydrates to 45-50% and fast-absorbing carbohydrates to 5% of the diet; increasing the proportion of dietary fiber to 1 g per kg of body weight; restriction or exclusion in the consumption of foods such as whole, dry, condensed milk and cream, as well as confectionery products that contain lactose in the composition. Limited to or excluded from the use of gluten-containing products (rye, barley, wheat, oats, all cereals and products from these cereals). Excluded: sausages and deli meats (meat nut, chop, etc.); fatty meats (pork, lamb), poultry (duck, goose, chicken skin), fish (oily fish, halibut, sturgeon); offal (tongue, heart, stomach; dairy products and high-fat cheeses; sweets containing fats (pastry, sweets, waffles, pastry, milk chocolate, cakes, pastries), refined sugar and all products containing it; refined flour (Extra Class) and all products made of it. Limited to: red meat (beef, veal), including red poultry meat (chicken legs, red turkey meat); red fish varieties (salmon, trout, salmon); dairy products of average fat content. : milk 3.5%, sour cream 15-20%, cottage cheese 5-9%, cheese 17-25%. products are recommended to use 1-2 times a week in a small amount; sweet fruits (bananas, grapes, figs, persimmon, melon) and dried fruits (dates, raisins, figs); natural sweeteners (honey, Turkish delight, Jerusalem artichoke syrup, etc.); white and yellow cereals (semolina, rice, corn, millet); roasted and crushed potatoes; boiled carrots and beets, since the glycemic index of these vegetables after boiling increases significantly. These products can be consumed in small quantities no more than 1-2 times a week exclusively in the morning.

Clinical example 1.

Patient S., 49 years old. He complained of overweight, heaviness when walking and exertion, shortness of breath, lethargy, fatigue, depression. From the anamnesis, it is known that the patient began actively gaining body weight at the age of 29, against the background of a sedentary lifestyle and improper, unbalanced nutrition. In the future, the weight gradually increased, and for 20 years the total increase was 57 kg. During the last 12 years I tried to lose weight on my own. For help, the doctor did not apply. He applied the methods of traditional and alternative medicine: hypnosis, acupuncture, Smelov coding, took drugs with a laxative effect, Reduxin. There was no clinically pronounced effect, since all of the weight loss methods listed were used by the patient for a short time. Physical loads are absent. I do not smoke. Alcohol consumed moderately. Family history: family of four, wife, two children. All are overweight or obese. 4 years ago, a diagnosis was made: obstructive sleep apnea syndrome (sleep apnea), a severe degree (position-dependent form). Conducted surgical treatment. Uses electromotive podbuzhivayuschy device. 2 years ago, a therapist diagnosed with arterial hypertension of 2 degrees. Chronic heart failure 1 degree. Takes "Capoten" 50 mg 2 times a day.

Food irregular 2-3 times a day, frequent nightly snacks due to the characteristics of the profession (night duty). Breakfast is mostly absent. At dinner, consume a large amount of carbohydrates and foods with a high glycemic index. Daily caloric 5500-5800 kcal at a rate of 2500-2900 kcal.

Objective: height - 175 cm, weight - 135 kg, BMI - 44.1 kg / m ² (at a rate of 18.5-24.9 kg / m ² ), waist volume (FROM) - 135 cm (at a rate up to 88 cm), thighs (OB) - 130 cm, OT / OB - 1.04 (with a norm of 0.8, an increase in the OT / OB index indicates the abdominal pattern of the distribution of adipose tissue). Blood pressure (BP) is 130/85 mm Hg.

Bioimpedance data: fat mass of the body - 64.9 kg (at a rate of up to 16-17 kg), skeletal muscle mass - 30 kg (tendency to hypotrophy), specific basal metabolism - 827 kcal / day (at a rate of about 900 kcal / day and higher).

Biochemical examination of blood revealed: glucose 5.0 mmol / l (normal up to 6.1 mmol / l), insulin 9.2 μm / ml (norm 2.7-10.4 μm / ml), total cholesterol 6.7 mmol / l (norm 0-6,2 mmol / l), HDL 0.7 mmol / l (norm 0.9-1.68 mmol / l), LDL 3.9 mmol / l (norm 1.9-4.14 mmol / l), TSH 1.52 μMe / ml (normal 0.4-4.0 μMe / ml).

When conducting genetic analysis, the A / A genotype was detected by the FABP2 gene, corresponding to two pathological alleles, which predispose to a high degree of absorption of saturated fatty acids in the small intestine. With such a mutation, weight gain can occur when consuming animal products, even if the amount of these products is not exceeded as compared with the age norm. Also, in a patient, the carriage of the C / C genotype on the PPARG gene, which promoted the growth of fat mass in the body in response to the appearance of fats in food. The G / T genotype for the TCF7L2 gene was also identified, predisposing an increased risk of type 2 diabetes.

Diagnosis: Morbid obesity grade 3 (WHO). 2 stages on AA / AE (2014). Associated diseases. Arterial hypertension 2 degrees, risk 3. Chronic heart failure 1 degree. Obstructive sleep apnea, severe degree (position-dependent form). Metabolic syndrome. Dyslipoproteinemia. Gipopolivi-taminoz (vitamins of group B, beta carotenes). Trace elements (deficiency of Ca, Zn, Mg). Homozygous carriage of allele A of the FABP2 gene, homozygous carriage of the C / C genotype of the PPARG gene, heterozygous carriage of the G / T genotype of the TCF7L2 gene. Prescribed therapy:

1. Personalized diet therapy, compiling a 7-day menu.

2. "Low-fat diet with the prevention of type 2 diabetes with fasting days." This diet is characterized by limiting the overall proportion of fat in the diet to 15-20%, with the proportion of saturated fat to 3-7% in the diet; an increase in the proportion of dietary fiber to 1 g per kg of body weight. The ratio of proteins: fat: carbohydrates (B: W: Y) = 30: 20: 50%.

The following were excluded: sausages and deli meats (meat nut, chop, etc.); fatty meats (pork, lamb), poultry (duck, goose, chicken skin), fish (oily fish, halibut, sturgeon); offal (tongue, heart, stomach; dairy products and high-fat cheeses; sweets containing fats (biscuits with filling, sweets, waffles, pastry, milk chocolate, cakes, pastries). Limited in consumption to 1-2 times per week: red meat (beef, veal), including red poultry meat (chicken legs, red turkey meat); red fish varieties (salmon, trout, salmon); medium-fat dairy products: milk 3.5%, sour cream 15-20% , cottage cheese 5–9%, cheese 17–25%. It was prescribed to conduct meals in 2.5–3 hours. In between meals, the rivers it was recommended to drink only clean water.It was not recommended to drink sweet drinks, sweets, sweet fruits and dried fruits on an empty stomach.It was recommended to drink freshly squeezed and packaged juices only after meals and in small amounts. 50% of daily need.

3. Standard exercise is ineffective, you need an individual motor complex of exercises.

4. Additionally - "Vitrum omega cardio" 1 capsule 2 times a day for a long time.

5. Elkar 1500 mg 2 times per day of physical activity classes - 4 times per week.

6. Complex of vitamins "Formula mens" no 1 feces once a day for 2 months.

7. Bran 3 component (oats, wheat, rye), 4 tbsp. spoons once a day for a long time.

After 3 months, the patient reduced the weight by 20 kg (115 kg), which corresponded to obesity 2 stenois. BMI - 37.61 kg / m ² (-15% of the original). FROM 110 cm (-25 cm), OB 116 cm (-14 cm), FROM / OB 0.95 (-0.09). The fat mass is 47.4 kg (-17.5 kg), the musculoskeletal mass is 41.2 kg (+2.7 kg). The specific basal metabolic rate is 980 kcal / day (+ 30% of the initial).

Biochemical blood tests: total cholesterol 5.6 mmol / l (normal 0-6.2 mmol / l), HDL 1.2 mmol / l (normal 0.9-1.68 mmol / l), LDL 2.7 mmol / l (normal 1.9-4.14 mmol / l).

HELL - 120/80 mm Hg Adjusted the dosage of the drug "Capoten" to 12.5 mg 2 times a day.

Thus, the appointment of diet therapy, taking into account the data of genetic research and other tests, led to weight loss, a decrease in the OT / OB ratio, indicating a decrease in abdominal fat, a decrease in blood pressure, a decrease in the amount of fat mass, an increase in musculoskeletal mass and an acceleration of metabolic . Clinical example 2.

Patient O., 37 years old. He complained of overweight, heaviness during physical exertion, inability to lose weight on his own. From the anamnesis, it is known that the patient began to gain body weight at the age of 27, against the background of a sedentary lifestyle and an improper, unbalanced diet. In the future, the weight gradually increased, and over 10 years the total increase was 23 kg. During this time I tried to lose weight on my own. For help, the doctor did not apply. Observed various diets. Achieved a slight weight loss of 5-7 kg. Then she returned to the previous diet and the weight increased again. Physical loads are absent. I do not smoke. Alcohol consumed moderately. Family history: not married, no children. There are no cases of obesity in the family.

Meals are regular 3-4 times a day, frequent snacks between main meals. At dinner, consume a large amount of carbohydrates and foods with a high glycemic index. 1-2 times a week consume beer with a large number of snacks. Daily caloric intake is 3500-3800kkal at a rate of 1500-1600 kcal.

Objectively: height - 156 cm, weight - 78 kg, BMI - 32.1 kg / m ² (at a rate of 18.5–24.9 kg / m ² ), FROM - 106 cm (at a rate of up to 88 cm), OB -114 cm, OT / OB - 0.93 (at a rate of up to 0.8, an increase in the OT / OB index indicates the abdominal pattern of the distribution of adipose tissue). HELL - 120/80 mm Hg

Bioimpedance data: fat mass of the body - 29 kg (at a rate of up to 13-14 kg), skeletal muscle mass - 20 kg (tendency to hypotrophy), specific basal metabolism - 847 kcal / day (at a rate of 889-975 kcal / day).

A biochemical blood test revealed: glucose 5.2 mmol / l (normal up to 6.1 mmol / l), insulin 11.2 μm / ml (norm 2.7-10.4 μm / ml), HOMA insulin resistance index was 3.13 (at a rate of up to 2.77), total cholesterol is 7.2 mmol / l (normal is 0-6.2 mmol / l), HDL is 0.7 mmol / l (normal is 0.9-1.68 mmol / l), LDL 3.9 mmol / l (normal 1.9-4.14 mmol / l), TSH 2.6 μMe / ml (normal 0.4-4.0 μMe / ml).

When carrying out genetic analysis, the G / G genotype of the ADRB2 gene was detected, which predisposes to a slow rate of glycogen consumption under the action of adrenaline from the liver and muscle tissue; and the T / T genotype for the TCF7L2 gene, predisposing to a high genetic propensity for insulin resistance and type 2 diabetes. With such mutations, weight gain can occur when eating foods with a high glycemic index, as well as complex and simple carbohydrates in quantities that do not even exceed the age limit.

Diagnosis: Alimentary-constitutional obesity 1 degree, abdominal type (WHO). Metabolic syndrome. Insulin resistance. Dyslipoproteinemia. Hypopolivitaminosis (B vitamins, beta-carotene). Homozygous carriage of the allele A gene ADRB2. Homozygous carriage of the T allele of the TCF7L2 gene.

Prescribed therapy:

1. Personalized diet therapy, compiling a 7-day menu.

2. "Low-carb diet with prevention of type 2 diabetes." This diet is characterized by limiting the total proportion of carbohydrates to 45-50% and fast-absorbing carbohydrates to 5% of the diet. Increasing the proportion of dietary fiber to 1 g per kg of body weight. The ratio B: W: Y = 25: 30: 45%. The following were excluded: refined sugar and all products containing it; refined flour (top grade) and all products from it. Limited: sweet fruits (bananas, grapes, figs, persimmon, melon) and dried fruits (dates, raisins, figs); natural sweeteners (honey, Turkish delight, Jerusalem artichoke syrup, etc.); white and yellow cereals (semolina, rice, corn, millet); fried and crushed potatoes; boiled carrots and beets. These products can be consumed in small quantities no more than 1-2 times a week exclusively in the morning. It was recommended to carry out meals in 2.5-3 hours. In the intervals between meals, drink only clean water. Assigned not to consume on an empty stomach sugary drinks, sweets, sweet fruits and dried fruits, freshly squeezed and packaged juices were recommended only after meals and in small quantities.

3. Additionally - "Vitrum omega cardio" 1 capsule 2 times a day for a long time.

4. Elkar 1500 mg 2 times in the days of FA classes - 4 times a week.

5. Vitrum complex of vitamins 1 kale once a day for 2 months.

6. "Glucophage Long 500 mg" 1 tablet 1 time a day from the morning 6 months.

7. Bran 3 component (oats, wheat, rye), 4 tbsp. spoons once a day for a long time.

8. "Iodomarin" for the prevention of the development of diffuse nodular goiter 200 mg 1 time per day for a long time.

After 6 months, the patient reduced her weight by 22 kg (56 kg), which corresponds to normal body weight. BMI - 23 kg / m ² (-28% of the original). FROM 75 cm (-31 cm), ABOUT 97 cm (-17 cm), FROM / ABOUT 0.77 (-0.16). Fat mass of 12.5 kg (-16.5 kg), musculoskeletal mass of 24.4 kg (+4.4 kg). The specific basal metabolic rate is 940 kcal / day (+ 11% of the initial). Biochemical blood tests: total cholesterol 4.42 mmol / l (normal 0-6.2 mmol / l), HDL 1.09 mmol / l (normal 0.9-1.68 mmol / l), LDL 3.18 mmol / l (normal 1.9-4.14 mmol / l). Insulin 2.9 µMe / ml (normal 2.7-10.4 µMe / ml), insulin resistance index HOMA was 1.7 (at a rate of up to 2.77), TSH 1.61 µMe / ml (normal 0.4-4, 0 μMe / ml).

Canceled drug "Glyukofazh Long."

Thus, the appointment of diet therapy, taking into account the data of genetic research and other tests, as well as the appointment of drugs that reduce the flow of easily digestible carbohydrates into the blood, led to weight loss, normalization of the OT / OB ratio, indicating a decrease in abdominal fat, the elimination of insulin resistance, a decrease in the amount of fat mass, increase in musculoskeletal mass and accelerate the rate of metabolism. After 6 months of treatment, the patient is healthy.

Clinical example 3.

Patient S., 13 years old. She complained of marked deficiency of body weight, inability to independently gain weight, alternating constipation and diarrhea.

From the anamnesis, it is known that the patient from 4 years of age began to gain body weight more slowly than her peers (according to her mother). Particular importance was not attached to this, since the constitution of both parents is asthenic. However, over the past 2 years the girl has become very different in appearance from her peers. For help, the doctor did not apply. Observed hypercaloric, high-carb diet. There was no effect. Exercise regular, intense. Engaged in swimming, part of the team. Training 6-7 times a week for 2-3 hours. I do not smoke. Alcohol is not consumed. Family history: cases of weight deficit in the family are not registered.

Food regular 5-6 times a day, balanced, hyper-calorie. Daily caloric intake is 2200-2500 kcal at a rate of 1500-1600 kcal.

Objectively: height is 156 cm, weight is 37 kg, body mass index (BMI) is 15.2 kg / m ² (at a rate of 17.5–23.9 kg / m ² ), FROM is 52 cm (at a rate up to 88 cm), OB - 82 cm, OT / OB - 0.63 (with a norm of 0.8). HELL - 100/70 mm Hg

Bioimpedance data: fat mass of the body - 4.9 kg (at a rate of 5.9 kg), skeletal muscle mass - 10 kg (tendency to hypotrophy), active cell weight - 18 kg (at a rate of 20 kg, which indicates lack of protein).

Biochemical blood tests revealed: glucose 4.5 mmol / l (normal up to 6.1 mmol / l), total protein - 59 g / l (at a rate of 58-77 g / l, a tendency to decrease), total cholesterol 4, 2 mmol / l (norm 0-6.2 mmol / l), HDL 1.3 mmol / l (norm 0.9-1.68 mmol / l), LDL 2.9 mmol / l (norm 1.9- 4.14 mmol / l), TSH 0.8 μMe / ml (normal 0.4-4.0 μMe / ml). Biochemical analysis of blood for detection of antibodies to gutin was performed: antibodies to deamidated peptides gliadin, IgY, IgY; antibodies to reticulin IgY and IgY; class A immunoglobulins (IgY); IgY and IgG antibodies to tissue transglutaminase; antibodies to endomysium, IgA (Anti-Endomysial Antibodies, EMA, IgA) - the result is not informative.

When carrying out genetic analysis, the G / G genotype for the HLA-DQ2.2 gene was revealed, which is pathologically associated with gluten intolerance and the development of celiac disease. With such a mutation, according to scientific studies, in most cases during the life of the patient develops gluten intolerance and / or celiac disease. The manifestation, as a rule, occurs at any age, and the clinical picture is fuzzy. Often this disease is hidden. Invasive diagnosis is required to confirm the diagnosis, biopsy of the small intestinal mucosa. Parents did not give their consent to the survey. A heterozygous carriage of the FABP2 gene was also found, causing a high rate of transport of saturated fats in the intestine, which makes it possible to more effectively promote weight gain while increasing the proportion of saturated fats in the diet.

Diagnosis: Lack of body weight, mild. Homozygous carriage of the G allele of the HLA-DQ2.2 gene, pathologically associated with celiac disease.

Prescribed therapy:

1. Personalized diet therapy, compiling a 7-day menu.

2. "Gluten-free diet with hung saturated fat content", balanced in protein, carbohydrate, with an increased proportion of fat in the diet, but complete with the exclusion of gluten-containing food for 2 months (trial gluten-free diet). The ratio B: W: Y = 15: 30: 55%. In this dietary plan, gluten-containing products (rye, barley, wheat, oats, all cereals and products from these grains, bakery and pasta products) were excluded from consumption, and the amount of saturated animal fats was increased to 10-15% in the diet, by increasing in the diet the proportion of animal fats in the diet: milk, dairy products, high fat cheeses, lamb, beef, fatty fish.

3. High protein drink for children “Maloezhka” 1 bottle immediately after loading 6 times a week.

4. Elkar 1000 mg 1 time during the days of FA classes - 6 times a week.

5. Vitrum complex of vitamins 1 kale once a day for 2 months.

After 2 months, the patient gained 4 kg (41 kg) body weight. BMI - 16.8 kg / m ² (+ 10% of the original). FROM 55 cm (+3 cm), OB 83 cm (+1 cm), FROM / OB 0.66 (+0.03). Fat mass is 6.4 kg (+1.5 kg), musculoskeletal weight is 12.5 kg (+2.5 kg). Active cell mass - 21 kg (at a rate of 20 kg).

Biochemical examination of blood: total protein - 68 g / l (at a rate of 58-77 g / l).

Thus, the appointment of diet therapy, taking into account the data of genetic research and other tests, led to an increase in weight, due to fat and musculoskeletal mass, normalization of stool. After a 2-month diet, it was decided to continue to follow the gluten-free diet, while maintaining an increased proportion of animal products.

Clinical example 4.

Patient N., 35 years old. He complained of fatigue, weakness; decreased performance, muscle weakness, frequent headaches, flatulence, abdominal pain after eating, unstable chair.

From the anamnesis it is known that such complaints appeared about two years ago, when the patient began to go to the gym to restore the figure after the birth of her second child. Exercise regular, 3-4 times a week. I do not smoke. Alcohol consumed moderately. Family history: married, two children. Pathology of the gastrointestinal tract in the family was not identified.

Regular meals 3-4 times a day. Breakfast: porridge with milk; dinner is complex; high tea - protein shake, cooked in milk; dinner - vegetable salad, meat / fish or poultry; for the night - warm milk with cookies. Daily caloric 1500-1600kkal (normal).

Objectively: height - 170 cm, weight - 65 kg, BMI - 22.5 kg / m ² (normal), FROM - 70 cm (normal), OB - 92 cm, FROM / OB - 0.76 (normal). HELL - 110/70 mm Hg

Biochemical examination of blood revealed: glucose 5.2 mmol / l (normal), insulin 4.2 μM / ml (normal), total cholesterol 3.2 mmol / l (normal), HDL 1.2 mmol / l (normal) , LDL 2.1 mmol / l (normal), TSH 1.6 μMe / ml (normal).

Ultrasound of the abdominal organs: without pathology.

Coprogram: feces unformed, pH-5.8 (at a rate of 6.8-7.6), muscle fibers are negative, mucus is negative, the microflora is normal.

Analysis of feces for carbohydrates: 0.1% (at a rate of less than 0.05%).

When carrying out genetic analysis, the C / C genotype was detected by the LCT gene, predisposing to lactose intolerance in adulthood. With such a mutation, the production of the enzyme lactase is sharply reduced. An adult in this case can absorb no more than 6 g of lactose per day. Therefore, whole, dry, condensed milk, cream and other products rich in lactose should be excluded from the diet. Homozygous carriage of the PPARG C / C gene was also found, associated with high efficiency of fasting days.

Diagnosis: Lactase deficiency of the adult type. Homozygous carriage of allele C of LCT gene.

Prescribed therapy:

1. "Diet with the exception of lactose-containing products and fasting days" balanced for proteins, fats and carbohydrates, but complete with the exception of whole, dry, condensed milk and cream, as well as confectionery products that contain lactose in the composition. It is permissible to use dairy products: cottage cheese, cheese, butter, sour cream, yogurt in an amount of not more than 200 g per day in total. The ratio B: W: Y = 15: 30: 55%. It was also recommended the introduction of light fasting days with a reduction in the total caloric intake to 50-60%, to accelerate the recovery of the figure.

2. Additionally - "Laktazar" 1 capsule at each meal, in which dairy products are present. Duration of reception is 1.5-2 months.

After 2 months, the patient has no complaints, headaches and abdominal pain, flatulence, weakness, unstable chair no longer bother. Body weight was reduced to the desired 62 kg.

Coprogram: excrement, pH 6.8 (at a rate of 6.8–7.6), muscle fibers negative, mucus negative, microflora normal.

Analysis of feces for carbohydrates: 0.01% (at a rate of less than 0.05%).

The drug "Laktazar" canceled. Low-lactose diet should be respected for life, it is recommended to carry out fasting days in case of an increase in body weight.

Thus, the appointment of diet therapy, taking into account the data of genetic research and other tests, as well as the appointment of an enzyme preparation, led to the normalization of stool, the disappearance of complaints, the restoration of the patient's quality of life, and the achievement of optimal body weight.

Bibliography

1. Arroyo-Johnson C. Obesity Epidemiology Worldwide / S. Arroyo-Johnson, K. D. Mincey // Gastroenterol. Clin. North Am. - 2016. - V. 45 - №4 - 571-579 p.

2. Chamberlain A.M. There is no need for any further information on the use of fatty acid. Siscovick, E. Boerwinkle // Metabolism - 2009. - V. 58 - №9 - 1222-1228 p.

. The multigene family of fatty acid-binding proteins (FABPs): Function, structure and polymorphism /

// J. Appl. Genet. - 2006. - Т. 47 - №1 - 39-48 с.3

. The multigene family of fatty acid-binding proteins (FABPs): Function, structure and polymorphism /

// J. Appl. Genet. - 2006. - V. 47 - №1 - 39-48 p.

4. Cornelis M.C. TCF7L2, dietary carbohydrate and M.C. Cornelis, L. Qi, P. Kraft, F. B. Hu // Am. J. Clin. Nutr. - 2009. - T. 89 - №4 - 1256-1262 p.

,

, J. Kuusisto, M. Laakso, W. Fujimoto, J. Auwerx // Nat. Genet. - 1998. - Т. 20 - №3 - 284-287 с.5. Deeb SS A Pro12Ala substitution in PPARgamma2 associated with decreased receptor sensitivity. / SS Deeb, L. Fajas, M. Nemoto,

,

, J. Kuusisto, M. Laakso, W. Fujimoto, J. Auwerx // Nat. Genet. - 1998. - V. 20 - № 3 - 284-287 p.

6. Fasano A. Clinical practice. Celiac disease. / A. Fasano, C. Catassi // N. Engl. J. Med. - 2012.

7. Harvey C.B. Regional localization of the lactase-phlorizin hydrolase gene, LCT, to chromosome 2q21. / C. B. Harvey, M. F. Fox, P. A. Jeggo, N. Mantei, S. Povey, D. M. Swallow // Ann. Hum Genet. - 1993. - T. 57 - No. Pt 3 - 179-85 c.

8. Itan Y. A worldwide correlation of the phenotype and genotypes / Y. Itan, B.L. Jones, C.J. Ingram, D.M. Swallow, M.G. Thomas // BMC Evol. Biol. - 2010. - Vol. 10 - №1-36 c.

9. Jin T. Minireview: The Wnt Signaling Pathway Effector TCF7L2 and Type 2 Diabetes Mellitus / T. Jin, L. Liu // Mol. Endocrinol. - 2008. - T. 22 - №11 - 2383-2392 c.

10. Kubota N. PPAR gamma mediates high-fat diet-induced adipocyte hypertrophy and insulin resistance. / N. Kubota, Y. Terauchi, H. Miki, H. Tamemoto, T. Yamauchi, K. Komeda, S. Satoh, R. Nakano, C. Ishii, T. Sugiyama, K. Eto, Y. Tsubamoto, A Okuno, K. Murakami, H. Sekihara, G. Hasegawa, M. Naito, Y. Toyoshima, S. Tanaka, K. Shiota, T. Kitamura, T. Fujita, O. Ezaki, S. Aizawa, T. Kadowaki // Mol. Cell - 1999. - T. 4 -; № 4 - 597-609 c.

11. Lamri A. Dietary fat intake and polymorphisms at the PPARG locus modulate BMI and type 2 diabetes risk. prospective study / A. Lamri, C. Abi Khalil, R. Jaziri, G. Velho, O. Lantieri, S. Vol, P. Froguel, B. Balkau, M. Marre, F. Fumeron // Int. J. Obes. - 2012. - T. 36 - №2 - 218-224 c.

12. Levy B. INCREASED AEROBIC GLYCOLYSIS THROUGH? 2 STIMULATION IS A COMMON MECHANISM INVOLVED IN LACTATE FORMATION DURING SHOCK STATES / B. Levy, O. Desebbe, C. Montemont, S. Gibot // Shock - 2008. - T. 30 - №4 - 417-421 c.

13. Levy E. The Polymorphism at Codon 54 of the FABP2 Gene Increases Fat Absorption in Human Integral Explants / E. Levy, D. M? Nard, E. Delvin, S. Stan, G. Mitchell, M. Lambert, E. Ziv, JC Feoli-Fonseca, E. Seidman // J. Biol. Chem. - 2001. - T. 276 - №43 - 39679-39684 c.

14. Lionetti E. New Clues in Celiac Disease, Pathogenesis, C. Lionetti, C. Catassi // Int. Rev. Immunol. - 2011. - T. 30 - №4 - 219-231 c.

15. Macho-Azcarate T. Gln27Glu polymorphism in the beta 2 adrenergic receptor and lipid metabolism during obese women / T. Macho-Azcarate, A. Marti, A. Gonz? Lez, JA Martinez, J. Iba? Ez // Int. J. Obes. - 2002. - T. 26 - №11-1434-1441 c.

Obesity risk is associated with carbohydrate intake in women carrying the Gln27Glu beta2-adrenoceptor polymorphism. /

,

,

, L. Forga, A. Marti,

// J. Nutr. - 2003. - T. 133 - №8 - 2549-54 c.sixteen.

Obesity risk is associated with carbohydrate intake beta2-adrenoceptor polymorphism. /

,

,

, L. Forga, A. Marti,

// J. Nutr. - 2003. - T. 133 - №8 - 2549-54 c.

Genetics of weight loss: A basis for personalized obesity management /

, F. I. Milagro // Trends Food Sci. Technol. - 2015. - T. 42 - №2 - 97-115 c.17

Genetics of weight loss:

, FI Milagro // Trends Food Sci. Technol. - 2015. - T. 42 - №2 - 97-115 c.

18. Mattei J. TCF7L2 during the weight-loss intervention. / J. Mattei, Q. Qi, F. B. Hu, F. M. Sacks, L. Qi // Am. J. Clin. Nutr. - 2012. - T. 96 - №5 - 1129-36 c.

19. Polderman T.J.C. A study of their studies is carried out in two years. T. J. Polderman, B. Benyamin, C. A. de Leeuw, P. F. Sullivan, A. van Bochoven, P. M. Visscher, D. Posthuma // Nat. Genet. - 2015. - T. 47 - №7 - 702-709 c.

20. Rubenstein L.A. Molecular dynamics for a β2-adrenergic and G protein-coupled receptor activation / L.A. Rubenstein, R.J. Zauhar, R.G. Lanzara // J. Mol. Graph. Model. - 2006. - T. 25 - №4 - 396-409 c.

21. Sung B. Modulation of PPAR in aging, inflammation, and calorie restriction. / B. Sung, S. Park, B. P. Yu, H. Y. Chung // J. Gerontol. A. Biol. Sci. Med. Sci. - 2004. - T. 59 - №10 - 997-1006 c.

22. Swallow D.M. Genetics of Lactase Persistence and Lactose Intolerance / D.M. Swallow // Annu. Rev. Genet. - 2003. - T. 37 - №1 - 197-219 c.

23. Gluten-specific T cell responses. / W. Vader, D. Stepniak, Y. Kooy, L. Mearin, A. Thompson, J.J. van Rood, L. Spaenij, F. Koning // Proc. Natl. Acad. Sci. U. S. A. - 2003. - T. 100 - No. 21 - 12390-5 c.

24. Vaquero A.R. Using the gene-network landscape of the TCF7L2 genetic variant of the genotype and the cardiovascular risk / A. R. Vaquero, N. E. Ferreira, S. V. Omae, M. V. Rodrigues, S. K. Teixeira, J. E. Krieger, A. C. Pereira // Physiol. Genomics - 2012. - T. 44 - №19 - 903-914 c.

25. Vesa T.H. Lactose Intolerance / T. H. Vesa, P. Marteau, R. Korpela // J. Am. Coll. Nutr. - 2000. - T. 19 - № sup2 - 165S-175Sc.

26. Predictors of Clinical Response to Gluten-Free Diet in Patients Diagnosed With Diarrhea-Predominant Irritable Bowel Syndrome / // Clin. Gastroenterol. Hepatol. - 2007. - T. 5 - №7 - 844-850 c.

Claims (54)

1. The method of forming individual dietary recommendations based on DNA analysis, including identifying the causes of overweight and / or food intolerance by analyzing sections of genes, characterized in that for the analysis they conduct a joint study of the polymorphic sections of the LCT, PPARG, ADRB2, FABP2, TCF7L2 genes and determine HLA-DQ haplotype, with the formation of a dietary nutrition plan and a personalized menu carried out depending on the variants of the detected polymorphism of genes associated with metabolic and / or immunological The processes in the body. 2. The method according to p. 1, characterized in that if the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2 and PPARG genes, then a 6-month diet with prevention of type 2 diabetes with fasting days is prescribed. 3. The method according to p. 1, characterized in that if the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2 and FABP2 genes, then a 6-month diet with restriction of saturated fats with prevention of type 2 diabetes is prescribed. 4. The method according to p. 1, characterized in that if the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, FABP2 and PPARG genes, then a 6-month low-fat diet with the prevention of type 2 diabetes with unloading in days. 5. The method according to p. 1, characterized in that if the causes of overweight and / or food intolerance are associated with polymorphism in the genes TCF7L2, ADRB2, then a 6-month low-carb diet with prevention of type 2 diabetes is prescribed. 6. The method according to p. 1, characterized in that if the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, ADRB2 and PPARG genes, then a 6-month low-carbohydrate diet with prevention of type 2 diabetes with unloading in days. 7. The method according to p. 1, characterized in that if the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, ADRB2 and FABP2 genes, then a 6-month low-carbohydrate diet with restriction of saturated fats with diabetes prevention 2- th type. 8. A method according to claim 1, characterized in that if the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, ADRB2, FABP2 and PPARG genes, then a 6-month low-carbohydrate low-fat diet with the prevention of diabetes of the 2nd type with fasting days. 9. The method according to p. 1, characterized in that if the causes of overweight and / or food intolerance are associated with the HLA-DQ haplotype and polymorphism in the PPARG gene, then a 6-month gluten-free diet with fasting days is prescribed. 10. The method according to p. 1, characterized in that if the causes of overweight and / or food intolerance are associated with a polymorphism in the FABP2 gene and an HLA-DQ haplotype, then a 6-month gluten-free diet is prescribed, with restriction of saturated fats. 11. The method according to claim 1, wherein if the causes of overweight and / or food intolerance are associated with polymorphism in the FABP2 and PPARG genes and the HLA-DQ haplotype, then a 6-month gluten-free low-fat diet with fasting days is prescribed. 12. The method according to p. 1, characterized in that if the causes of overweight and / or food intolerance are associated with the polymorphism in the ADRB2 gene and the HLA-DQ haplotype, then a 6-month gluten-free diet with restriction of fast-absorbing carbohydrates is prescribed. 13. The method according to p. 1, characterized in that if the causes of overweight and / or food intolerance are associated with polymorphism in the ADRB2, PPARG genes and the HLA-DQ haplotype, then a 6-month gluten-free diet with restriction of fast-absorbing carbohydrates with discharge in days. 14. The method according to p. 1, characterized in that if the causes of overweight and / or food intolerance are associated with polymorphism in the genes ADRB2, FABP2 and haplotype HLA-DQ, then a 6-month gluten-free diet with restriction of fast-digesting carbohydrates with restriction saturated fat 15. The method according to p. 1, characterized in that if the causes of overweight and / or food intolerance are associated with polymorphism in the genes ADRB2, FABP2, PPARG, and the HLA haplotype, then a 6-month gluten-free low-fat diet with restriction of fast-absorbing carbohydrates is prescribed fasting days. 16. The method of claim 1, wherein if the causes of overweight and / or food intolerance are associated with the polymorphism in the TCF7L2 gene and the HLA-DQ haplotype, then a 6-month gluten-free diet with prevention of type 2 diabetes is prescribed. 17. The method according to p. 1, characterized in that if the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, PPARG genes and the HLA-DQ haplotype, then a 6-month gluten-free diet with the prevention of diabetes 2nd type with fasting days. 18. The method according to p. 1, characterized in that if the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, FABP2 genes and the HLA-DQ haplotype, then a 6-month gluten-free diet with restriction of saturated fats with prevention type 2 diabetes. 19. The method according to p. 1, characterized in that if the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, FABP2, PPAGR genes and the HLA haplotype, then a 6-month gluten-free low-fat diet with diabetes prevention 2- th type with fasting days. 20. The method according to p. 1, characterized in that if the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, ADRB2 genes and the HLA haplotype, then a 6-month gluten-free low-carbohydrate diet with the prevention of type 2 diabetes . 21. The method according to p. 1, characterized in that if the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, ADRB2, PPARG genes and the HLA-DQ haplotype, then prescribe a 6-month gluten-free low-carbohydrate diet with diabetes prevention Type 2 with fasting days. 22. The method according to p. 1, characterized in that if the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, ADRB2, FABP2 genes and the HLA-DQ haplotype, then a 6-month, gluten-free, low-carbohydrate diet with restriction of saturated fat with the prevention of type 2 diabetes. 23. The method according to p. 1, characterized in that if the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, ADRB2, FABP2, PPARG genes and HLA haplotype, then a 6-month, gluten-free, low-carbohydrate low-fat diet with prevention type 2 diabetes with fasting days. 24. The method according to p. 1, characterized in that if the causes of overweight and / or food intolerance are associated with polymorphism in the LCT and PPARG genes, then a 6-month diet should be prescribed with the exception of lactose-containing products and fasting days. 25. The method according to p. 1, characterized in that if the causes of overweight and / or food intolerance are associated with polymorphism in the LCT and FABP2 genes, then a 6-month diet with restriction of saturated fats with the exception of lactose-containing products is prescribed. 26. The method according to p. 1, characterized in that if the causes of overweight and / or food intolerance are associated with polymorphism in the FABP2, PPARG and LCT genes, then a 6-month low-fat diet with the exception of lactose-containing products with fasting days is prescribed. 27. The method according to p. 1, characterized in that if the causes of overweight and / or food intolerance are associated with polymorphism in the genes ADRB2 and LCT, then a 6-month diet should be prescribed with the restriction of fast-digesting carbohydrates with the exception of lactose-containing products. 28. The method according to p. 1, characterized in that if the causes of overweight and / or food intolerance are associated with polymorphism in the ADRB2, PPARG and LCT genes, then a 6-month diet is prescribed with a restriction of fast-digesting carbohydrates with the exception of lactose-containing products with unloading in days. 29. The method according to p. 1, characterized in that if the causes of overweight and / or food intolerance are associated with polymorphism in the genes ADRB2, FABP2, LCT, then a 6-month food ration with restriction of fast-digesting carbohydrates with restriction of saturated fats with the exception lactose containing products. 30. The method according to p. 1, characterized in that if the causes of overweight and / or food intolerance are associated with polymorphism in the genes ADRB2, FABP2, PPARG and LCT, then appoint a 6-month low-fat diet with restriction of fast-digesting carbohydrates with the exception of lactose-containing products with fasting days. 31. The method of claim 1, wherein if the causes of overweight and / or food intolerance are associated with polymorphism in the LCT and TCF7L2 genes, then a 6-month diet with prevention of type 2 diabetes with the exception of lactose-containing products is prescribed. 32. The method of claim 1, wherein if the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, PPARG and LCT genes, then a 6-month diet is prescribed for the prevention of type 2 diabetes with the exception of lactose-containing products with fasting days. 33. The method of claim 1, wherein if the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, FABP2 and LCT genes, then a 6-month diet with restriction of saturated fat with prevention of diabetes of the 2nd type with the exception of lactose-containing products. 34. The method of claim 1, wherein if the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, FABP2, LCT and PPARG genes, then a 6-month low-fat diet will be prescribed to prevent type 2 diabetes with with the exception of lactose-containing products with fasting days. 35. The method of claim 1, wherein if the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, ADRB2 and LCT genes, then a 6-month low-carb diet with prevention of type 2 diabetes with the exception lactose containing products. 36. The method of claim 1, wherein if the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, ADRB2, PPARG and LCT genes, then a 6-month low-carbohydrate diet with the prevention of type 2 diabetes with fasting days. 37. The method of claim 1, wherein if the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, ADRB2, FABP2 and LCT genes, then a 6-month low-carbohydrate diet with restriction of saturated fat with diabetes prevention Type 2 with the exception of lactose-containing products. 38. The method of claim 1, wherein if the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, ADRB2 and FABP2 genes, PPARG and LCT, then a 6-month low-carbohydrate low-fat diet with diabetes prevention 2 is prescribed th type with the exception of lactose-containing products with fasting days. 39. The method of claim 1, wherein if the reasons for food intolerance are associated with a polymorphism in the LCT gene and the HLA-DQ haplotype, then a 6-month hypoallergenic diet is administered with the exception of gluten-containing and lactose-containing products. 40. The method of claim 1, wherein if the causes of overweight and / or food intolerance are associated with the HLA-DQ haplotype and polymorphism in the PPARG, LCT genes and the HLA-DQ haplotype, then a 6-month hypoallergenic diet is prescribed with with the exception of gluten-containing and lactose-containing products with fasting days. 41. The method of claim 1, wherein if the causes of overweight and / or food intolerance are associated with polymorphism in the FABP2, LCT genes and the HLA-DQ haplotype, then a 6-month hypoallergenic diet with a restriction of saturated fat with the exception Gluten-containing and lactose-containing products. 42. The method of claim 1, wherein if the causes of overweight and / or food intolerance are associated with polymorphism in the FABP2, PPARG, LCT genes and the HLA-DQ haplotype, then a 6-month hypoallergenic low-fat diet with the exception of gluten-containing is prescribed and lactose-containing products with fasting days. 43. The method of claim 1, wherein if the causes of overweight and / or food intolerance are associated with polymorphism in the ADRB2, LCT genes and the HLA-DQ haplotype, then a 6-month hypoallergenic diet with a restriction of fast-absorbing carbohydrates with the exception Gluten-containing and lactose-containing products. 44. The method of claim 1, wherein if the causes of overweight and / or food intolerance are associated with polymorphism in the ADRB2, PPARG, LCT genes and the HLA haplotype, then a 6-month hypoallergenic diet with a restriction of fast-absorbing carbohydrates with the exception gluten-containing and lactose-containing products with fasting days. 45. The method of claim 1, wherein if the causes of overweight and / or food intolerance are associated with polymorphism in the genes ADRB2, FABP2, LCT and the HLA-DQ haplotype, then a 6-month hypoallergenic diet with restriction of fast-digesting carbohydrates is prescribed with restriction of saturated fats with the exception of gluten-containing and lactose-containing products. 46. The method according to p. 1, characterized in that if the causes of overweight and / or food intolerance are associated with polymorphism in the genes ADRB2, FABP2, PPARG, LCT and haplotype HLA-DQ, then appoint a 6-month hypoallergenic low-fat diet with restriction of fast-digesting carbohydrates with the exception of gluten-containing and lactose-containing products with fasting days. 47. The method of claim 1, wherein if the causes of overweight and / or food intolerance are associated with a polymorphism in the LCT and TCF7L2 genes, and an HLA-DQ haplotype, then a 6-month hypoallergenic diet with diabetes prevention 2- is prescribed th type with the exception of gluten-containing and lactose-containing products. 48. The method of claim 1, wherein if the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, PPARG and LCT genes, and the HLA-DQ haplotype, then a 6-month hypoallergenic diet with diabetes prevention Type 2 with the exception of gluten-containing and lactose-containing products with fasting days. 49. The method of claim 1, wherein if the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, FABP2, LCT genes and the HLA-DQ haplotype, then a 6-month hypoallergenic diet with restriction of saturated fat is prescribed with the prevention of type 2 diabetes with the exception of gluten-containing and lactose-containing products. 50. The method of claim 1, wherein if the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, FABP2, PPARG, LCT genes and the HLA-DQ haplotype, then a 6-month hypoallergenic low-fat diet is prescribed with prevention of type 2 diabetes with the exception of gluten-containing and lactose-containing products with fasting days. 51. The method of claim 1, wherein if the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, ADRB2, LCT genes and the HLA-DQ haplotype, then a 6-month hypoallergenic low-carb diet with diabetes prevention is prescribed Type 2 with the exception of gluten-containing and lactose-containing products. 52. The method of claim 1, wherein if the causes of overweight and / or food intolerance are associated with polymorphisms in the TCF7L2, ADRB2 and PPARG genes, LCT and the HLA-DQ haplotype, then a 6-month hypoallergenic low-carb diet is prescribed prevention of type 2 diabetes with the exception of gluten-containing and lactose-containing products with fasting days. 53. The method of claim 1, wherein if the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, ADRB2, FABP2, LCT genes and the HLA-DQ haplotype, then a 6-month hypoallergenic low-carbohydrate diet is prescribed restriction of saturated fats with the prevention of type 2 diabetes with the exception of gluten-containing and lactose-containing products. 54. The method of claim 1, wherein if the causes of overweight and / or food intolerance are associated with polymorphism in the TCF7L2, ADRB2 and FABP2 genes, PPARG, LCT and HLA-DQ haplotype, then a 6-month hypoallergenic low-carbohydrate low-fat is administered diet with the prevention of type 2 diabetes with the exception of gluten-containing and lactose-containing products with fasting days.