The Aim. The aim of the study was to develop and evaluate the effectiveness of dietary therapy in obese patients on the basis of studying the polymorphism rs9939609 of the FTO gene. Materials and methods. 100 patients with obesity of I-III degree aged from 18 to 55 years were examined. All patients underwent genotyping using allele-specific amplification with real-time detection of results. Depending on the genotypes of the FTO gene, obese patients received different diet therapy and were divided into 3 groups: patients with the TT and AT genotype received a standard low-calorie diet, and with the AA genotype a personalized diet. Results. It was found that a decrease in the caloric content of the diet contributed to a decrease in body weight in obese patients, mainly due to muscle mass in carriers of the genotype AT, and in carriers of genotypes TT and AA - mainly due to the fat component. Conclusions. Thus, the carriers of the mutant allele A in the homozygous and heterozygous variant require the selection of only a personalized diet. Therefore, in the appointment of dietary therapy to obese patients, it is recommended to carry out molecular genetic studies that will not only identify individuals with increased need for personalization of dietary therapy, but also increase the effectiveness of treatment for obesity and prevent the development of its complications.

Background/Objectives: Evidence-based nutritional recommendations for obesity management require understanding of sex-specific and age-specific body composition patterns and their associations with metabolic biomarkers, habitual dietary intake and chronic low-grade inflammation. This study aimed to characterize body composition phenotypes in a large clinical cohort of adults with obesity, to evaluate associated metabolic and inflammatory biomarker patterns, to contextualise these patterns against habitual nutrient intake assessed in a dietary subcohort, and to derive age- and sex-specific nutritional recommendations based on the identified patterns. Methods: We performed a cross-sectional analysis of 29,544 adults with obesity (BMI ≥ 30; 21,374 women, 8170 men; age 30–69) who underwent multi-frequency bioelectrical impedance analysis (BIA; InBody 770). Biochemical assessments (fasting glucose, lipid profile, uric acid, HbA1c, insulin) were available for 2019 hospitalized patients from the same population. Habitual dietary intake was quantitatively assessed in a dietary subcohort of 423 patients using the validated Russian software-based questionnaire “Scientific Nutrition Analysis Tool”. Inflammatory biomarkers (high-sensitivity CRP, IL-6) and adipokines (leptin, adiponectin) together with serum 25(OH)D were measured in an inflammation/adipokine subcohort of 116 patients. A body composition phenotype with low relative muscle mass and high visceral fat (VFA ≥ 100 cm²) was defined using FNIH criteria (ALM/BMI < 0.789 men, <0.512 women). Benjamini–Hochberg FDR correction (q < 0.05) was applied for multiple comparisons. Results: The body composition phenotype prevalence increased progressively with age: men 24.6% (30–39) to 42.0% (60–69); women 10.3% (30–39) to 31.8% (60–69). Skeletal muscle mass (SMM) was positively associated with uric acid (r = +0.347, p < 0.001, FDR q < 0.05) and inversely associated with HDL-cholesterol (r = −0.321, p < 0.001, FDR q < 0.05)—both associations with direct nutritional implications. BMI was associated with fasting insulin (r = +0.233, p < 0.001, FDR q < 0.05). Women showed significant age-related metabolic differences between the 30–39 and 60–69 age groups: fasting glucose +12.9%, triglycerides +34.8%, uric acid +15.0% (all p < 0.001); in men, significant differences were observed for fasting glucose (+7.0%) and HbA1c (+5.2%) (both p < 0.001), while lipid parameters did not reach significance. In the dietary subcohort, habitual saturated-fat intake exceeded recommended values in 70–72% of patients of both sexes, dietary fibre intake was below recommended levels in 73–85%, and habitual calcium intake decreased significantly with age in women (1022 → 746 mg/day, p = 0.028). Serum CRP was elevated (median 5.59 mg/L, n = 59). In a separate extended laboratory subcohort, serum oestradiol declined markedly with age in women (55.0 → 16.8 pmol/L between 30–39 and 50–59 years, p < 0.001), consistent with the menopausal transition; serum testosterone in men remained stable across age groups; and 25(OH)D insufficiency (<30 ng/mL) was prevalent in 49.7–55.8% of patients. Conclusions: The identified sex-specific and age-specific body composition patterns provide a rationale, supported by observed dietary and inflammatory patterns, for targeted nutritional intervention: increased dietary protein, omega-3 fatty acids supplementation, low-glycemic-index dietary patterns, and purine restriction with hyperuricemia. Routine BIA-based nutritional screening combined with quantitative dietary assessment should begin at age 30, with preventive monitoring at age 40 and intensification of control at age 50, to guide personalized dietary planning in obesity.

Introduction. Type 2 diabetes mellitus (type 2) is a major health problem worldwide. The progression of type 2 diabetes is contributed by usual for this patient group number of micronutrient deficiencies. Aim. To study the micronutrient status in patients with type 2 diabetes and obesity on the basis of molecular genetic studies. Materials and methods. The study involved 80 women with type 2 diabetes and obesity of I-II degree. All patients were tested for vitamin C, B6, B12, folate, a 25-hydroxyvitamin D, as well as potassium, magnesium, calcium, zinc and phosphorus in serum. DNA was isolated from blood by standard method using multicomponent lysis solution. Genotyping was performed using allele-specific amplification detection results in real time. Results. Comparative analysis of the manifestations of the polymorphic marker rs659366 UCP2 gene in patients with type 2 diabetes and obesity showed that the genotype of T/T and C/T is characterized by a low content of vitamin C in the serum than genotype of C/C. Polymorphism rs1801133 of MTHFR gene in patients with type 2 diabetes and obesity revealed that genotype C/T and T/T showed a lower content of vitamins B6, B12, folate in serum as compared with those indices in genotype C/C. Conclusion. The recommendation of vitamin-mineral complexes to patients with type 2 diabetes and obesity should be quided by molecular genetic studies, which might individually appoint the necessary micronutrients to improve the metabolic performance and reduce the risk of vascular complications in these patients.

Comorbidities, such as asthma and obesity, present significant medical and social challenges. Their biological mechanisms are closely interrelated with mental and behavioral factors, forming a vicious circle where traditional pharmacotherapy is often insufficient. Unlike other publications, this review takes an in-depth look at the essential role of multidisciplinary rehabilitation in the management of comorbidities. The focus is to review the current evidence on the importance of a personalized, multimodal diagnostic approach that incorporates bioimpedance analysis, indirect calorimetry, and biochemical and genetic marker assessments in order to develop individualized nutritional support programs. The analysis showed that patients with both asthma and obesity require a comprehensive management strategy that includes three components: a diet to modulate systemic inflammation, a structured physical rehabilitation program combining aerobic exercise, breathing exercises and inspiratory muscle training, and a lifestyle modification program. Multidisciplinary rehabilitation is shown to simultaneously target the key components of asthma and obesity pathogenesis, such as systemic inflammation, respiratory mechanical limitations, and metabolic dysfunction, to improve asthma control, facilitate weight loss, provide a sustained improvement in functional parameters and a significant enhancement in quality of life, and minimize the medication burden. This article provides a comprehensive understanding of the methodology for developing and implementing rehabilitation programs for patients with comorbidities. The proposed structured strategies, including diagnostic algorithms, physical rehabilitation protocols, and effectiveness criteria, represent the primary research and practical contributions of this work, facilitating the clinical implementation of this integrated strategy and optimizing treatment outcomes for a challenging patient population.

Obesity is a global medical and social problem, and its prevalence continues to rise steadily. Scientific studies confirm that genetic predisposition accounts for 40–70% of the variability in body mass index, and its manifestation is intensified by environmental factors. This article systematizes current data on the molecular and genetic mechanisms underlying obesity, with an emphasis on their significance for the development of effective comprehensive and individual approaches to obesity prevention. An analysis of scientific literature published over the last 20 years was conducted using the PubMed, Scopus, and eLIBRARY databases. Particular attention was paid to genes associated with the regulation of energy metabolism, adipogenesis, lipolysis, and those affecting micronutrient metabolism. It was shown that gene polymorphisms determine individual characteristics of eating behavior, physical endurance, and micronutrient requirements. The following genes are of interest in the context of obesity: FTO, MC4R, ADRB2, PPARG, TCF7L2, CD36, BCMO1, VDR, ALPL, FUT2, MTHFR. The implementation of a personalized approach to obesity prevention will increase its efficacy and reduce the burden on the healthcare system. Promising areas for further research include the study of epigenetic mechanisms, the development of polygenic risk scores, and the integration of genetic data into clinical practice. Key words: genetics, micronutrients, obesity, personalized medicine, gene polymorphisms, prevention