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Results of the study of the provision with vitamins and some micro- and macroelements of limited groups of people, who suffered from the accident at the Chornobyl nuclear power plant (ChNPP), which have been carried out by Ukrainian and Russian scientists during various periods after the accident, are generalized in the paper. Persons which participated in liquidation of the accident and lived during the accident in the territory, adjoining to Pripyat (the Kyiv region, town of Slavutich), people which worked at the object "Shelter" and ChNPP were involved in the inspection. It was noted, that in 1-4 years after the ChNPP accident in blood of liquidators the biochemical parameters displaying security of their organism by vitamins A and B1, remain lower in comparison with the same parameters in a group of relatively healthy persons which were not affected by the accident (control), that testifies to stable metabolic disturbance in the organism of people under irradiation influence. Selective inspection of the vitamin status of ChNPP and object "Shelter" personnel in 1992 has shown, that provision with vitamins C, B1, B2, B6 of the overwhelming majority of these people (67-91%) are much below the norm. Deficiency of vitamins C, B1, B6, folate and selenium is also revealed in an organism of 50-90% of women and children living in Slavutich. Deficit of vitamins in most of persons was characterized by polyhypovitaminoses, that is a combination of several group B vitamins deficiency at simultaneously low provision with selenium, and in a part of women and children--by low amount of iron. The results of long-term complex studies by groups of authors give evidence on importance and urgency of formulation and execution of International program on optimisation of nutrition, micronutrition status and health among population of affected areas in Ukraine, Bielorus' and Russia.

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The article concisely illustrates the vitamin and mineral state of population of town of Slavutich, including personal of Chernobyl Nuclear Power Station, children of pre-school age and pregnancy women, studied in 1992. Vitamins and minerals deficiency in the main of C and B vitamins and selenium was revealed in all the studied groups. Appropriate measures were developed and introduced to eliminate the detected dusturbances; but however some unsolved problems remained. Taking into account the forthcoming 20th anniversary of Chernobyl disarter, the authors of the come back to considering the obtained data in hope to atlract attention of medical scientific and public to the remained unsolved problems of micronutrient deficiency.

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The investigations carried out in 1983-1993 showed increasing of insufficiency of vitamin C and carotene in population of almost all investigated areas of Russian Federation. Insufficiency of vitamin C was found in 70-95%, pronounced deficit in 45-70% of adults. Deficiency of carotene was was detected in 30-90% of adults. Insufficiency of these nutrients is unfavourable long condition detected not only during spring but also in summer in different occupational groups of population. Vitamins A and E nutritional status of different groups of population are good enough in all seasons.

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The present paper is a continuation of the previous communication ("Problems of Nutrition" No4/95). The paper contains the generalized analysis of the data obtained by the laboratory of vitamin and mineral metabolism of the Institute of Nutrition during investigation of vitamin B1, B2, B6, B12 and folic acid provision of adult able to work population (men and women) of different regions of Russian Federation (Moscow, Ekaterinburg, Orenburg, Kusnetzk Basin, West and East Siberia, Far East, Bashkyria, Mary-El) from 1983 till 1993.

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As shown by mathematical analysis of a dependence of vitamin C excretion with urine on its content in blood as well as by plotting and mathematical interpretation of the variation curves exhibiting distribution of the ascorbic acid detected in blood plasma of persons additionally treated with vitamin C, the values 0.4-0.5 mg/dl of vitamin C (lower limit of normal values) may be recommended as a criterion of the vitamin normal consumption which corresponded to literature data. The value 0.7 mg/dl used in literature is the optimum content of vitamin C in blood. Excretion of vitamin C with urine, corresponding to lower limits of the vitamin consumption, constituted 0.4 mg/h in adults and 0.2 mg/h-in children of 5-14 years old. Metabolism of vitamin C in patients with diabetes mellitus was considerably distinct from that of healthy persons. As a criterion of normal vitamin C consumption in children of 9-13 years old impaired with diabetes mellitus, the content 1 mg/dl of vitamin C in blood plasma should be considered and its excretion with urine--more than 1.8 mg/h.

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Population based studies of vitamin nutritional status in Russia, Ukranian, Belarus and Baltic States in 1983-1991 give evidence about satisfied vitamin A nutritional status and insufficient carotenoids nutrition of population. The retinol level below 30 MK2/dl (lower reference level) was revealed in 6% of the adults, 19% of the children and 6% of the pregnant women. The level of carotene below 80 MK2/dl took place in 39% of the adults, 28% of the children and 18% of the pregnant women. Worst vitamin A and carotene nutritional status was detected in adults and children living in Mogilevskaya and Gomelskaya regions suffering from accident on Chernobyl station as well as inhabitants of large industrial centres (Ekaterinburg, Orenburg, Kemerovo, Norilsk, Zaporoz'e) with bad ecological situation It was pointed on probable connection between insufficient consumption of carotene and increased risk of cancer and cardiovascular diseases. It is recommended the realization of large-scale actions upon cardinal improvement of vitamin A and carotene supplying of population.

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Correlation between the state of vitamin metabolism and the impairments in carbohydrate, lipid and protein metabolism was studied in 35 children of 9-13 years of age with diabetes mellitus of various severity standing for up to 7 years. Deterioration of riboflavin metabolism in insulin-dependent diabetes mellitus, expressed as an increase of the vitamin excretion with urine, was augmented with prolongation of the disease duration; the deterioration was sometimes related to the value of glycemia and glucosuria, being the indicative symptom of the disease. In spite of some limitations in validity of experiments related to insufficient number of children in some groups, a decrease in excretion of 1-methyl nicotinamide with urine was detected in all the children with the comatose state, in acidoketosis and glucosuria (above 20 g/day), whereas normal content of nicotinamide coenzymes was found in erythrocytes. Deficiency in vitamins B1, B6 and C was observed more often (5-100%) in children with elevated content of cholesterol as compared with 7-67% of children exhibiting normal level of cholesterol. Optimization of vitamins B and C consumption in children as well as use of any means for correction of these vitamins deficiency are discussed.

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Supply of the Chernobyl NPP staff and Slavutich children with vitamins and minerals has been examined in spring 1992. From 43 to 100% of people have moderate deficiency of vitamin C, B1, B2, B6 and folic acid, 6-61%--deep deficiency of these nutrients. Most of the people have insufficient supply with vitamins in the form of polyhypovitaminosis, i.e. combined deficiency of ascorbic acid and of 2 or 3 vitamins of the B group. Deficiency of 2 vitamins was found in 20% of adults of 3 vitamins in 37%, of 4 vitamins in 29% and of 1 vitamin in 10% of adults. Only 4% of examined adults are sufficiently supplied with all vitamins and none of children. Deficiency of 1 vitamin was found in 11% of children, of 2 vitamins in 15%, of 3 vitamins in 17%, of 4 vitamins in 35%, of 5 vitamins in 20% and of 6 vitamins in 2% of children. Supply of children with all vitamins has been improved when they received combined vitamin-mineral preparation "Duovit" for one month. Universal prophylactic vitaminization by means of administration of ascorbic acid and polyvitamin preparations in doses corresponding to the daily physiological requirement should be recommended as the most reliable, effective and economical measure aimed to improve supply of the population with vitamins.

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A vitamin status was studied in 32 children of both sexes at the age of 9-15 years with insulin-dependent diabetes mellitus within 2-3 years. The adequate consumption of all the vitamins studied was found only in two children. Polyhypovitaminosis was detected in 19% of these children. Deterioration of riboflavin metabolism observed was manifest, as a decrease in the vitamin content in tissues in line with an increase in its excretion with urine. As a result of this impairment metabolism of vitamins B6 and PP was disturbed with development of these vitamins secondary deficiency of the non-alimentary type. Obligatory correction of the water soluble vitamin deficiency in the patients with diabetes mellitus is discussed.

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The 1992 nutritional survey of the population living in the Republic of Bashkortostan found out that the population suffer from definite vitamin deficiency which concerns all the vitamins except A and E. Vitamin status was found satisfactory in 3.5% of the examinees. The rest needed vitamin supply by one, two, three, four and 5 vitamins (15%, 29%, 27%, 20% and 5.5%, respectively). Most frequently the subjects were deficient by vitamins C, B1, B2, B6, folic acid, carotenoids. Multivitamin deficiency presented most commonly with combination of ascorbic acid with two or three vitamins B. The authors point to the need in wide-scale vitamin supply of the Republic's population. The intake of vitamin C plus multivitamin preparations in doses satisfying physiological requirements are recommended.

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Providing with vitamins of schoolchildren was studied in some regions of Lithuania during the winter-spring period. The biochemical blood count has revealed insufficient providing of schoolchildren with ascorbic acid, beta-carotene, vitamins B1, B2 and B6. Decreased levels of ascorbic acid in urine, as well as micro-symptoms of hypovitaminosis (ascorbic acid, thiamine and riboflavine deficiencies) have been recorded.

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The effect of the prophylactic use of multivitamin "Undevitum" on parameters of vitamin providing of schoolchildren in Norilsk was studied. The results of the investigation showed a positive effect of the prophylactic vitamin administration on providing with vitamins of schoolchildren in Norilsk and proved the necessity of conducting mass vitamin administration to schoolchildren.

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The study of providing with vitamins of schoolchildren in Orenburg conducted in the spring of 1985-1986 has revealed decreased content of ascorbic acid in 92%, vitamin E in 62%, vitamin A in 39%, folic acid in 38%, vitamin B12 in 14% of the children, the incidence rate of vitamin deficiency among the children in the senior forms was higher as compared to that in the junior forms and in boys it was more frequent than in girls. Additional intake of multivitamin "Undevitum" by schoolchildren during 2-4 months led to a significant improvement of their providing with vitamins that was expressed in normal vitamin levels and elimination of cases of deep vitamin deficiency.

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The investigation on providing with vitamins of varying population groups: preschool children, schoolchildren, students of trade schools and higher schools, workers and employees was conducted in Sverdlovsk. Low levels of vitamin C were detected in the blood of 40-92%, folic acid--in 10-76%, vitamin A--in 4-28%, carotene--in 8-60%, tocopherol--in 4-50% of the examinees. Vitamin B1 deficiency was noted in 36-68%, vitamin B2--in 17-71%. The highest deficiency of ascorbic acid was recorded in workers and students of trade schools and higher schools, of folic acid--in workers and adolescents of 15-18 years, of vitamins B1, E, A and carotene--in children and adolescents, vitamin B1--in employees. The mass character of vitamin deficiencies and their negative effects on the health of the population have necessitated broad-scale prophylactic measures: production of vitamin-enriched foods, regular use of multivitamins.

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The investigation of providing with vitamins of river transport workers in Western and Eastern Siberia and of oil men in the Tyumen Region conducted in the summer period of 1984-1986 has revealed significant deficiencies of vitamins C, E, B1, B2, B6, A and carotene in them. Vitamin administration to the workers with "Undevitum" resulted in a significant improvement of their vitamin status that was expressed in elevation of their biochemical parameters and in diminution of the percentage of subjects with vitamin deficiencies.

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Some parameters of vitamin providing and immune status were studied in 133 workers and employees of metallurgic industry in Zapolyarie. The data obtained have evidenced that the contingent studied was insufficiently provided with ascorbic acid, vitamins B1, B2, B6, had low content of vitamin A and beta-carotene. Combined vitamin deficiency was recorded in 88.6% of 44 workers subjected to investigations. A total of 87.7% of persons with low vitamin levels had shifts in the immunity system. The highest disorders in the cellular immunity parameters were observed in subjects with polyhypovitaminosis. The results of the study have necessitated taking measures for correction of vitamin providing.

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The content of vitamins C, E, A and beta-carotene was studied in the blood serum of 404 workers and employees of the Kuzbass industrial enterprises. Insufficient providing of the body with ascorbic acid, tocopherol and beta-carotene has been revealed. The number of workers and employees with vitamin C deficiency comprises at an average 95%, with vitamin E deficiency--9%, and with beta-carotene deficiency--34%. Industrial enterprises characterized by hard physical labor and occupational health hazard have been found to be most unfavourable with respect to providing with vitamins. The results of the investigations conducted have evidenced the necessity of correcting the vitamin nutrition of the subjects studied.

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Ninety children with varying renal diseases were under observation. The investigations conducted have shown that disorders in phosphoric-calcium metabolism depend on the type, activity of chronic glomerulonephritis (CGN) and etiology of chronic renal insufficiency (CRI). Significant disorders in phosphoric-calcium metabolism were detected in patients with nephrotic and mixed types of CGN. Most manifest clinical and x-ray changes of the osseous system were observed in patients with CRI that developed as a result of the tubulointerstitial pathologic process. Low-phosphate diets with preset amounts of Ca and P were developed, composed of products with relatively low content of P, and of new dietetic products rich in Ca. The diets were used for correction of hyperphosphatemia in children with CGN and in those with CRI, simultaneously with drug therapy, to prevent or diminish disorders in phosphoric-calcium metabolism, and to reduce the risk of invalidism among children with chronic renal diseases.

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