DIETOTHERAPY.
Diets or diet food --- is the use of nutrition for the treatment and prevention of exacerbation of chronic diseases, that is, proper nutrition for various diseases.
Food for these patients is boiled in water or steamed, cooked mainly in a well-boiled or pureed form. Meat, fish, mushroom broths and gravies, decoctions of vegetables (especially cabbage), all kinds of spicy, sour dishes and foods, spices, fried foods, raw vegetables, fruits, wholemeal bread, butter dough, pancakes, etc. are excluded from the diet.
Vitamins are added in the form of a decoction of rose hips, raw sweet berry juices, raw potato juice, as well as pharmaceutical preparations of vitamins. Food is moderately salted. It is recommended to eat food 5 times a day.
For gastritis with insufficient acidity, diet No. 2 is recommended.
You can take various broths, meat, fish, mushroom and vegetable sauces, sour fruit and berry juices, fried foods (without a rough crust), snacks in the form of chopped herring, grated cheese. The temperature of hot dishes should be about 60 degrees, cold - not lower than 10 degrees (the indicated temperatures are recommended for most diets). Food is prepared in pureed or well-chopped form, salted normally. It is recommended to eat at least 4 times a day.
The diet for peptic ulcer of the stomach and duodenum depends on the condition of the patient.
During periods of satisfactory health of the patient, you can use the above diet No. 1.
During periods of exacerbation of the disease, the patient's diet should be agreed with the doctor. Sometimes vegetables in any form and fruits are completely excluded from the patient's diet for 1-2 weeks, and bread is replaced with a small amount of crackers.
Wholemeal bread, raw vegetables and fruits, and vegetable and fruit dishes are prescribed. Various sugary foods (honey, sugar, jam, milk sugar) stimulate the activity of the intestine and contribute to its emptying.
The diet includes curdled milk, kefir, matsuni and other lactic acid products.
Lactic acid products should be fresh (one-day curdled milk, kefir No. 1, in which not all sugar has fermented). Pickled and salted vegetables and fruits are recommended. Vegetable oils promote bowel movements. You can mix 1-2 table. spoons of unrefined olive oil with a glass of yogurt, matsuni and take throughout the day.
It is recommended to drink sweets on an empty stomach in the morning. cold water with prunes or raisins soaked in it, dried apricots (you can use cold honey water).
It is necessary to limit the amount of products in the diet that have a gentle or astringent effect: kissels, cocoa, strong tea, blueberries.
Of course, this diet is suitable for ordinary constipation. If constipation is a consequence of irritable bowel syndrome, then an individual approach is needed, depending on the condition and complaints of the patient.
Vegetables and fruits, as well as fresh milk, are excluded from the diet. Instead of bread, the patient receives crackers. All dishes are prepared in a shabby form, boiled in water or steamed. The amount of fat in the diet is significantly limited (up to 40-50g per day), spices are excluded. Vitamins must be added in the form of rosehip broth and vitamin preparations.
It is recommended to eat 4 times a day in small portions.
Salt should be moderate. During the period of satisfactory health, it is recommended to follow diet No. 2, significantly limiting or completely eliminating fresh whole milk from the diet (which is consumed only in diluted form). Instead of milk, lactic acid products are recommended: three-day kefir, acidophilic yogurt.
In some forms of colitis accompanied by diarrhea, on the advice of a doctor, an apple diet is carried out (in bed rest) for 1-2 days: 5 times a day, 250-300 g of ripe raw apples in pureed form (without peel and seed box).
The diet includes foods that help remove fat from the liver (cod,
dairy products, especially cottage cheese), as well as vegetables, fruits, and vegetable oil. Eggs, brains, meat, fish and mushroom broths, gravies and soups, animal fats are limited in the diet, except for a small amount of butter.
Fried foods are excluded; food is cooked boiled or baked
form; meat and fish can be baked after pre-boiling. Very cold foods should be avoided. You can salt food normally (with an exacerbation, salt is limited).
Food is recommended to be taken at least 4, preferably 5 times a day. With exacerbation of diseases of the liver and gallbladder, accompanied by gastritis, diet No. 5 is prepared in a pureed form, raw vegetables are excluded from the diet
and fruits, black bread; all dishes are steamed or in water (not baked).
The amount of protein is reduced as directed by a doctor, primarily by limiting meat, fish and eggs. Of proteins, proteins of milk and dairy products are preferred.
The consumption of liquid (up to 1 liter per day) and salt is limited (up to cooking all food without salt and using salt-free bread).
It is recommended to take food in uniform portions 4-5 times a day. In some forms of kidney disease (nephrosis), the amount of protein in the diet is not only not limited, but also increased. Therefore, the nutrition of a renal patient should be carried out under the guidance of a doctor.
In diseases of the kidneys, the so-called. fasting days in the form of component, vegetable and fruit diet: 1 l compote or 1.2-1.5 kg of fruit or 1.2-1.5 kg of salt-free vegetable salad with sour cream (50 g) per day.
But it is necessary to limit liquids, use salt moderately.
Eat at least 5 times a day in small portions. Periodically
on the advice of a doctor, it is recommended to spend fasting days.
The use of salt, meat, fish and mushroom broths, soups and gravies, as well as liquids is limited. Days (apple, fruit compote) spent in bed rest are recommended.
Exclude from the diet foods containing a lot of fat-like substances - cholesterol (egg yolks, brains, lard); limit the use of butter by including vegetable oil in the diet; dairy products, sea fish (cod, chum) containing iodine, and soybeans are recommended, which help dissolve cholesterol and remove it from the body. Vegetables, fruits, wholemeal bread are very useful.
With a high content of animal proteins: milk and dairy products, meat, fish. The diet should include foods containing vitamin C - vegetables, fruits, rosehip broth; B vitamins - liver, yeast drinks; calcium salts - cottage cheese, cheese.
The same diet is prescribed for anemia, weight loss after surgery and after illness.
The diet is carried out individually only as directed by the doctor.
In the diet, carbohydrates are limited (to a certain extent, fats), which reduces the volume of the diet. Therefore, dishes are additionally prepared from specially processed vegetables: salads from greens, cabbage; bread with a high content of bran (washed in boiling water and running water, dried and ground). It is recommended to eat at least 4 times a day.
Limit the intake of carbohydrates and, to a lesser extent, fats.
With obesity, you need to eat food, consisting mainly of vegetables, which, with a significant volume, have a low calorie content and contribute to satiety, at least 5 times a day in small portions in order to avoid increased appetite.
For the same purpose, spices and spicy dishes are avoided. Limit the amount of liquids and table salt.
Meals should be frequent and small in volume (no more than 300 g).
In exocrine insufficiency, a low-fat diet (30–40 g/day) is mandatory, even if pancreatic enzymes are used in therapy. Are used vegetable fats which are well tolerated by patients. In the diet, even in violation of the carbohydrate should be dominated by high-molecular polysaccharides, and proteins 80-120 g / day.
Days from the onset of the attack.
0-3 days.
Assign hunger in the first 1-3 days of exacerbation. Perhaps, according to indications, parenteral nutrition, taking antacids (phospholugel, maalox, gasterin-gel, gastal) and degassed alkaline mineral water of the Borjomi type (every 2 hours). 4 days.
Can:
Start with slimy soups, liquid mashed milk porridges, vegetable purees and fruit juice jelly. You can weak tea, mineral water +, rosehip broth.
It is forbidden:
Broths, fatty meats and fish, lamb, pork, goose, duck, sturgeon, fried dishes, raw vegetables, fruits, smoked meats, sausages, cheeses, rich flour, confectionery, black bread, ice cream, alcohol, spices, spices, butter, sugar, salt, whole milk.
4-7 days.
Can
The same as in the first days. And you can also add crackers, meat and fish of low-fat varieties, steam protein omelette, fresh non-acidic cottage cheese, steam puddings. Unsalted butter in dishes (10 g/day), baked apples. Jelly, mousses on xylitol, sorbitol.
It is forbidden:
The same as in the first days.
6-10 days.
Can:
Gradual inclusion of an expansion of the diet, an increase in the volume of food and calorie content. Sugar can be increased up to 30 g/day, salt up to 5 g/day, butter up to 30 g/day in ready meals.
It is forbidden:
The same as before.
10-15 days.
Can:
Add low fat dairy products- yogurt, kefir, soft-boiled egg.
It is forbidden:
Same.
15-60 days
(the entire period of remission).
Can:
The same products as during an exacerbation, only the dishes can be less sparing. Pureed soups are replaced with ordinary vegetarian ones, cereals can be thicker, crumbly, pasta, raw vegetables, fruits, mild soups, doctor's sausage, boiled meat in pieces, baked fish. In a small amount, you can use sour cream and cream in dishes, kefir is non-acidic. Salt up to 6 g per day.
It is forbidden:
Pure fats, spicy, sour, spicy, canned food, meat broths, ice cream, coffee, chocolate, beans, sorrel, spinach, radishes, mushrooms, sour apples, lemons, cranberries, cherries, currants, sour juices, alcohol, carbonated drinks , kvass, pastry products.
Medical nutrition is part of the complex of all medical procedures and manipulations applied to a patient with any disease. The diet and menu are the basis on which the patient's treatment plan is built. It is important for a nurse to know the principles of therapeutic nutrition for his proper organization and timely competent control.
Before we talk about what medical nutrition is, let's remember the basics. For normal life the human body needs interaction with external environment in the form of metabolism. To live, a person consumes oxygen, liquids and food. Nutrition is one of basic needs person. The body receives the necessary substances through food:
Proteins, fats, carbohydrates (BJU), when participating in the metabolic processes of the body, contribute to the release of energy, which is measured in calories.
1 calorie (1 cal) is the amount of heat (energy) required to raise the temperature of 1 gram of water by 1 °C (degree Celsius)
1 kilocalorie (1 kcal)- the amount of heat required to heat 1 kilogram of water per 1 °C(degree Celsius)
The daily ration is compiled on the basis of the calorie content of the food. A healthy person, depending on the lifestyle, needs from 1700 to 4000 kcal / day. Nutrition is the basis building material» to replace tissue cells, and a source of energy to maintain the functioning of the body.
Diet determines the multiplicity (numerical quantity) and time of meals throughout the day, the duration of the intervals between them, the quantitative and qualitative distribution of the diet. Optimal time the break between two meals is 4 hours, the big night break should be 10-11 hours. 2 hours before going to bed without a special purpose, food should not be taken. 6 meals a day includes the following meals:
Since ancient times, certain foods and specially formulated diets have been used as a treatment for the sick. From the beginning of the 19th century, Russian scientists began to approach nutrition issues from the point of view of the interaction of physiology, hygiene, the chemical composition of food and the technology of its preparation.
Diet- a diet, a certain set of dishes and products, selected taking into account the condition of the patient's body.
Dietetics- a science that studies the nutrition of a healthy and sick person. The principles of nutrition are based on knowledge about the causes, form and mechanism of the course of the disease, the characteristics of the digestive processes in healthy and sick people.
Health food(dietary) - component complex treatment; nutrition that promotes recovery, organized taking into account the physiological needs of the patient.
diet therapy- "treatment by nutrition", the use of nutrition for the purpose of therapeutic effects on the body of a sick person.
Manuil Isaakovich Pevzner, a Russian general practitioner, one of the founders of dietology and clinical gastroenterology, pointed out in his writings that nutrition for a sick person is the main background against which a doctor can apply other therapeutic effects. Manuil Isaakovich founded a nutritional system of 15 treatment tables (diets), which is still used today.
To draw up a therapeutic diet, it is necessary to know the composition of food necessary for the patient, its calorie content, the proportions of the components (proteins, fats, carbohydrates), and the total amount (daily diet). A specialist doctor who develops a diet and prescribes a diet - nutritionist. A nurse who specializes in patient nutrition is a dietary nutrition nurse ( nutritionist).
Carrying out an important medical appointment - a diet, the doctor takes into account the mechanism of the development of the disease, the state of the body, the work of metabolic processes, the individual ability to assimilate food. Some foods and dishes are excluded due to poor digestibility, others because of the ability to cause harm, but some foods, on the contrary, are specifically prescribed for them. beneficial effect(for example, to remove toxins from the body).
Volume, weight, texture, temperature of food is determined by a specific diet. The average weight of the daily diet is 3 kg. In clinical nutrition, the amount of food can often be increased or decreased by liquid or vegetable fiber (non-nutritional carbohydrates).
If necessary, in the process of cooking and serving food, the principles of mechanical, chemical, thermal sparing are applied. With mechanical sparing, the dishes will be liquid, semi-liquid and puree. Chemical sparing involves the exclusion of hard-to-digest and irritating foods and foods.
One of the most important segments of the provision medical care in stationary medical institutions - patients, or patients, should have a balanced diet. The process of cooking, serving, eating should be organized in accordance with the existing regulatory framework. The main document in this case is the Order of the Ministry of Health of the Russian Federation of August 5, 2003 N 330 “On measures to improve clinical nutrition in medical institutions Russian Federation". The norms are regulated by the document Order of the Ministry of Health of the Russian Federation of June 21, 2013 N 395n "On approval of the norms of clinical nutrition".
The control over the organization of nutrition in medical institutions lies with the dietitian, the head nurse and the dietitian. In the departments of the hospital, post nurses every morning submit information to the head nurse about the number of patients, indicating diet numbers.
The head nurse, in turn, summarizes the data, summing up the number of tables. Then he makes a portion requirement (“portioner”), which he passes to the dietitian. The dietitian, having received portions from each department, submits a general summary to the catering unit. For newly admitted, especially for emergency indications, information is transmitted by the nurse of the admission department or the guard nurse immediately after the patient is admitted to the hospital.
In the kitchen of a hospital, sanatorium or dispensary, food is prepared on the basis of portion requirements. Buffet employees (distributors) either receive food for the department at the catering departments, or take food delivered directly to the department buffet. Patients are fed in the dining room or in the wards. Before eating, the nurse must complete all manipulations with patients. If feeding takes place in the ward, ventilation must be carried out. The patient needs to wash their hands.
For the optimal effect of therapeutic nutrition, the external conditions of food intake are also important. The dining room should be clean, bright, comfortable. Tables are set neatly, employees involved in the process of feeding patients must have a neat well-groomed appearance. Food is served warm. Dishes should look appetizing and beautiful. During meals, patients should maintain a calm environment.
Tables are cleaned and floors are washed after each meal. Tables and chairs must have surfaces that can be wet cleaned and disinfected with solutions. At the end of the working day, tables must be washed hot water in compliance with labor safety regulations. Dishes after use should be washed and disinfected in accordance with SanPiN 2.1.3.2630-10 and SanPiN 2.3.6.1079-01. Food waste is disposed of in accordance with SanPiN 2.1.7.2790-10.
In case of diseases of various organs and systems, as well as in the state after the operation, a specific diet (table) is prescribed. Here are the numbers of dietary tables with indications for the appointment. In the future, we will consider each diet in more detail.
In some situations, feeding the patient in a natural way is impossible: in case of unconsciousness, mental illness, tongue injuries, stenosis of the esophagus, conditions after surgery on the pharynx, esophagus and other problems. In such cases, food is introduced through a nasogastric tube or gastrostomy. When it is impossible to introduce food into the stomach nutrients are given through the rectum or intravenously (parenteral nutrition).
For a day, a patient on artificial nutrition should receive food with a calorie content of about 2000 kcal. At the same time, the ratio of BJU is 1:1:4. Water should be supplied in water-salt solutions in the amount of 2 liters per day. Vitamins are either added to food mixtures or administered as injections (parenteral).
Only liquid food is introduced through a probe or stoma: broth, milk, cream, melted butter, raw egg, vegetable soups(wiped or mucous), liquid kissels, compotes, juices, weak tea. Nutritional mixtures for artificial nutrition prepared using standard recipes. There are ready-made liquid mixtures, as well as dry ones that require dilution in the right proportion.
We hope that after reading the article, the readers have a picture in their heads about what medical nutrition is, how it is organized, and what responsibility lies with the nurse.
Entire treatises have been written about the fundamental difference in the perception of the same things by men and women. However, the difference in diets has hitherto been practically not discussed. But in vain, because representatives of both sexes are distinguished not only by primary and secondary sexual characteristics, but also by the hormonal system and genetics. As a result, women suffer from some diseases, and men - others.
Scientists have conducted more than a dozen studies in the field of male nutrition. As a result, they were able to establish that a competent approach to the choice of products allows men after 30 years to maintain good health, good spirits and strength. And also protect yourself from some of the diseases that they are most often exposed to. Among them: prostate cancer, hypertension, heart attacks and diseases of the cardiovascular system.
A beautiful, muscular body is the dream of many people. They spend days on end in gyms and fitness centers, constantly working on themselves and trying to finally make all their dreams come true. However, as paradoxical as it sounds, a miracle does not happen. Muscle mass Not only does it not increase, but it also decreases. The reasons for such phenomena, which most often lie in an improperly selected diet, are described in their publications by scientists, nutritionists and trainers of world renown.
The problem of small stature makes life difficult for many people. Proof of this is not only the reports of psychologists, but also hundreds of new questions to specialists left on forums and websites on medicine and sports. People of all ages are interested in whether it is possible to “deceive” nature and increase their actual height by at least a couple of centimeters.
Do you experience an irresistible feeling of fatigue, drowsiness and loss of energy by lunchtime or even worse - immediately after waking up? You clearly lack energy. In order to get it, it is not at all necessary to drink a certain cup of coffee or resort to the help of energy drinks. It is much wiser to review your diet and remove from it foods that steal vitality and vigor, and add those that give them.
Many of us first encounter the concept of metabolism only when they have an urgent need to quickly and easily lose weight. Certainly, this makes sense. But, did you know that not only the rate of weight loss depends on metabolism, but also the quality of our life.
Fashion on healthy lifestyle life is steadily increasing every year. Increasingly, people are thinking about the benefits of regular physical activity and the quality of their diet. An integral part of it is the consumption of special products that can normalize blood cholesterol levels.
The history of antibiotics dates back to the 1920s, when penicillin was first discovered by Alexander Fleming. It was with his appearance that for some reason they forgot about natural antibiotics. And they began to remember literally a few decades ago, only when the public began to vigorously discuss the harmful effects of such medicines on the human body. And look for ways to replace them. As it turns out, they don't have to go far.
Every person experiences the strongest feeling of thirst at some point. It can appear not only in summer, but also in winter, especially if it is preceded by intense physical activity. As a rule, in order to get rid of it, it is enough to drink a glass of water. It will allow you to replenish the lost fluid in the body, the lack of which causes similar sensations. But what if it is not at hand?
What is aching or throbbing headache probably everyone knows. According to recently published statistics, about 70 million people suffer from chronic headache. At the same time, some try to get rid of it with the help of medicines, others just survive, and still others try to find the right ways to prevent it and alleviate it in everyday life, for example, with the help of ordinary foods.
Do you know that beautiful voice, given to you by nature, requires care and attention? Moreover, they consist not only in the prevention and treatment of diseases of the throat and vocal cords, but also in providing proper nutrition, especially if you're into singing or often give speeches in front of large audiences. Well-known physiologists and nutritionists write about how it should be.
The state of the nervous system is directly affected by substances that enter the human body along with food. After carefully studying them, scientists presented a list of vitamins, trace elements and organic compounds, the use of which will calm the nervous system in the safest and most natural way.
Russian sociologists claim that almost 90% of women aged 13 to 50 encounter the concept of PMS in one way or another. At the same time, 10% of them have especially pronounced symptoms. But, the most surprising thing is that most of them do not fight this condition in any way, mistakenly considering it to be natural. But doctors say that many of the symptoms of PMS can be easily eliminated by simply adjusting your diet.
Children are flowers of life. This is our joy and weakness. We love them immensely and dream of them endlessly. But we can't always conceive. The most interesting thing is that the reasons for this often lie not so much in the health problems that women or men have, but in their diet. Moreover, in this case, to fulfill the cherished dream, you need very little: remove some products from it, replacing them with others.
The health of the unborn child directly depends on the quality and quantity eaten during pregnancy. With this in mind, many expectant mothers are trying to make drastic changes in their lifestyle and nutrition. And everything would be fine, only in the pursuit of perfection they often go to extremes. Leading pediatricians and nutritionists tell in their publications about how to avoid fatal mistakes, maintain excellent health and make an invaluable contribution to the health of the baby simply by adjusting your diet.
It's no secret that everything eaten by a nursing mother enters the child's body. He can react violently to some products, for example, with a rash or intestinal colic, and neutrally to others. But all of them, one way or another, affect its growth and development. That is why many pediatricians advise reviewing your diet during the feeding period, especially if it was previously far from correct. And remove harmful or low-quality products from it, replacing them with useful and safe ones.
They say parenting is the hardest job in the world. And it's hard to disagree with that. After all, a number of problems suddenly fall on their shoulders, each of which seems worse than the previous ones. The success of their solution often depends on the experience and knowledge in the field of medicine, nutrition, pedagogy, ethics and other sciences, and the result directly affects the future of the baby. In order to somehow facilitate this hard work, we have collected the recommendations of well-known practitioners in baby nutrition.
Both adolescents and their parents are interested in nutrition during puberty. Most often this is explained by the desire of the former to get rid of the problems with the figure that may arise during this period, and the desire of the latter to sincerely help their children to survive it painlessly.
Absolutely everyone knows that human memory, no matter how wonderful it is, deteriorates over time. And absolutely everyone also knows that this happens for various reasons, most often physiological. However, not everyone is ready to put up with this state of affairs. This article is a kind of review of the most effective, from the point of view of the world's leading nutritionists and physiologists, ways to improve memory.
A good diuretic can not only save you from edema, but also reduce pressure, and excess weight relieve without causing harm to the body. And you don't have to go far for it. The most effective and widely demanded diuretic products are most often already waiting in the wings in our kitchen. It's just that not everyone knows about them.
They say that a clean intestine is the key to strong immunity. And also a guarantee of health, excellent well-being, youth, beauty and Have a good mood! That is why scientists have devoted more than one scientific publication to the methods of its purification, describing the causes and consequences of such a phenomenon. Meanwhile, nutritionists assure that, in fact, you can perform colon cleansing on your own. All you need to do is introduce the right foods into your diet.
It is possible to increase efficiency, improve memory and concentration, as well as become more quick-witted and attentive even during periods of great mental stress. To do this, it is enough to introduce into your diet a complex of special products that are responsible for the functioning of the brain. Interestingly, they will also help improve sleep, get rid of irritability, stress and significantly improve the quality of your life.
It's hard to believe, but heavy physical activity is not a reason to abandon the good old fats and carbohydrates in favor of protein foods. On the contrary, this is a reason to seriously reconsider your diet, diversifying it as much as possible. And add healthy and healthy foods to it. Those that will not only be able to give strength and energy, but will also allow you to do more and, as a result, reach sports heights faster.
AT recent times ophthalmologists around the world are sounding the alarm: more and more people different ages face vision problems. Moreover, eye diseases are “getting younger”, affecting even small citizens. The question arises - can nutrition affect eye health and improve it?
For our immunity, winter is a difficult test of reliability. After all, a lack of sun, a sharp cold snap, and overdrying of the air inside heated rooms create favorable conditions for the growth of viruses and bacteria that cause seasonal diseases. They endlessly "attack" our body and weaken the immune system. As a result, at some point she can’t cope and the person gets sick. But this could have been avoided by simply adding special foods to your diet.
Some are sure that weight loss is impossible without a strict diet. Others are convinced that only a small restriction in food is enough to achieve the desired results and forms. However, our article is written specifically for the third. Those who do not accept any infringement of their own rights and freedoms, and, even more so, no prohibitions in nutrition, but at the same time always want to remain the most slender, fittest and most attractive.
At a time when the majority of the world's population is looking for effective ways to deal with excess weight, there are still people who dream of gaining it. And there may be several reasons for this. For example, the excessive thinness of women, which prevents them from getting pregnant, or the too small weight of men, which they want to increase in order to become more stately and beautiful. And sometimes banal diseases, which are frequent companions of an exhausted and weakened body.
The existence of special foods that can make the sexual life of both sexes brighter and richer has been known since time immemorial. This knowledge was carefully preserved and passed down from generation to generation. Despite the fact that earlier they were available only to a few - the nobility and priests, in our time, almost everyone can get acquainted with their list.
Scientists say that almost all men aged 16 to 60 are prone to problems with libido. This can be facilitated by a number of factors, including diseases and the negative impact environment. However, in any case, do not despair. All you need to do is change your diet. Perhaps the body does not receive the necessary substances that maintain libido at the proper level.
The key role of products is to ensure the entry into the body of such substances that would help it function properly, including reducing pressure, if necessary, or, conversely, increasing it. Recently, many scientists have been developing a special menu for hypertensive patients.
3. THERAPEUTIC NUTRITION IN DISEASES OF THE KIDNEY AND URINARY TRACT
4. THERAPEUTIC NUTRITION FOR DISEASES OF THE ENDOCRINE SYSTEM
5. THERAPEUTIC NUTRITION FOR METABOLIC DISEASES
6. THERAPEUTIC NUTRITION FOR RHEUMATIC DISEASES
7. THERAPEUTIC FOOD FOR INFECTIOUS DISEASES
8. THERAPEUTIC NUTRITION OF SURGICAL PATIENTS
9. THERAPEUTIC NUTRITION
10. RATIONAL AND HEALING NUTRITION
The foundation of good health is a healthy, nutritious diet.
Compound: milk (4-5 glasses), mucous cereals, such as semolina, milk or wheat bran soups with butter; porridge liquid, mashed, milk; soft-boiled eggs (2-3 times a day) or in the form of steam omelettes; steam soufflés from lean varieties of fish, meat; creamy unsalted (70-80 g per day) or olive oil (add to dishes), cream; berry, fruit (non-acidic) and milk jelly, carrot, fruit juices, rosehip broth, weak tea with milk (sugar up to 50 g per day). Limit salt to 5-8 g (remember that 3-5 g of salt is found in foods, 5-8 g in bread), free liquid is not more than 1.5 liters. Additionally vitamins A, C, group B (B1, B2, PP). Eating at bed rest every 2-3 hours in liquid and semi-liquid form, warm form. In case of poor milk tolerance (swelling of the abdomen, diarrhea), it is recommended to give it in small quantities, diluted with weak tea.
Table N 1b. Indicated in the subsidence of exacerbation of peptic ulcer and chronic gastritis with hyperacidity
Compound: in addition to the dishes listed above, it is allowed to steam meat, fish dishes in the form of quenelles, steam cutlets, pureed milk soups from rice, barley, pearl barley with pureed vegetables; grated porridge in milk; wheat crackers up to 100 g. Salt is limited to 8 g, in addition - vitamins A, C, group B. Six meals in a semi-liquid and puree form.
Table N 2. Indicated for chronic gastritis with low acidity or in its absence, chronic colitis (without exacerbation).
Compound: soups from cereals and vegetable, pureed, on meat, mushroom, fish broths; low-fat meat (chopped, fried), boiled chicken, steam, stewed, fried cutlets without a coarse crust, low-fat ham, low-fat boiled fish, well-soaked low-fat chopped herring, black caviar; milk (if it does not cause diarrhea), butter, kefir, yogurt, cream, non-acidic sour cream, fresh non-acidic cottage cheese, mild mashed cheese; soft-boiled eggs, fried scrambled eggs; cereals, well boiled or mashed (buckwheat, semolina, rice); flour dishes, (except for muffins), stale white, gray bread, lean crackers; vegetables, boiled fruits, raw grated; fruit, vegetable juices (also acidic); tea, coffee, cocoa on the water with milk, marmalade, sugar. Table salt up to 12-15 g. Vitamins C, B1, B2, PP are added. Meals five times a day, mostly in puree form.
Table N 3. Shown for atonic constipation.
Compound: foods rich in vegetable fiber, such as raw or boiled vegetables and fruits in large quantities, apple and other compotes, prunes, figs (vine berries), vegetable, fruit juices, beetroot, carrot puree, boiled dried fruit puree (prunes, dried apricots), black bread, curdled milk, milk, cream, one-day kefir, honey, buckwheat, pearl barley porridge, meat, fried fish, butter and vegetable oil, sugar. Drink plenty of fluids, including sodas mineral water. Excluded: strong tea, cocoa, mucous soups, kissels.
With spastic constipation associated with increased motor excitability of the intestine, foods rich in vegetable fiber are sharply limited (a few vegetables are acceptable - boiled and raw pureed).
Table N 4. It is indicated for acute bowel diseases and exacerbations during the period of ongoing diarrhea.
Compound: strong tea, cocoa, strong coffee on the water, stale white crackers, fresh mashed cottage cheese, one soft-boiled egg a day, slimy soups on the water, mashed rice, semolina porridge on the water, meat, boiled fish, steam in minced form with minced meat rice instead of bread, low-fat three-day yogurt, a decoction of dried blackcurrant, blueberries, jelly, blueberry jelly. Limit salt, add vitamins C, B1, B2, PP. Meals 5-6 times a day.
Table N 4a. It is indicated for colitis with a predominance of fermentation processes.
The composition is the same as in the N4 diet, but foods and dishes containing large amounts of carbohydrates are sharply limited (cereals; bread no more than 100 g per day; sugar no more than 20 g per day); increase protein content by meat dishes, mashed cottage cheese and so on.
Table N 4b. It is indicated for chronic colitis in the stage of fading exacerbation.
Compound: white bread, yesterday's baking, lean cookies, dry biscuit; cereal soups in a weak fish or meat broth, broth with meatballs, pureed cereals, except for millet, on water with the addition of 1/3 of milk, boiled and steamed pureed vegetables, mild cheese, non-acidic sour cream, kefir, yogurt, compotes, sweet berry kissels , mashed fruit, tea, coffee with milk, creamy milk (for adding to ready meals). Table salt 8-10 g. Add vitamins C, group B. Nutrition 4-6 times a day. Food is served warm.
Table N 4v. It is indicated for acute bowel diseases during the recovery period as a transition to rational nutrition; chronic bowel disease during the period of attenuation of exacerbation, as well as without exacerbation with concomitant lesions of other digestive organs.
by EppInk"> DIET is prescribed to provide adequate nutrition with some insufficiency of intestinal function, which will help restore the activity of other digestive organs. This is a physiologically complete diet with a slight increase in protein content and a moderate restriction of salt, mechanical and chemical irritants of the intestine, excluding foods and dishes , which increase fermentation and putrefaction in the intestines, sharply increase its secretory and motor functions, secretion of the stomach, pancreas, bile secretion.Food is cooked unground, steamed, boiled in water or baked.Diet: 5 times a day.
Chemical composition and energy value:
proteins - 100-120 g (60% animals),
fats - 100 g (15-20% vegetable),
carbohydrates - 400-420 g,
table salt - 10 g,
free liquid - 1.5 l.
Caloric content - 2900-3000 kcal.
Table N 5. Indicated for diseases of the liver, gallbladder, biliary tract without exacerbation.
Compound: vegetarian fruit, milk soups, cereal soups with vegetable broth, boiled meat, low-fat poultry, boiled low-fat fish, milk, fresh curdled milk, kefir, acidophilus milk, cottage cheese up to 200 g per day, cereals and flour dishes (except for muffins), white bread, black stale bread, ripe fruits, berries (except for sour varieties) raw, baked, boiled, boiled and raw vegetables and herbs (especially carrots, beets), jam, honey, sugar (up to 70 g per day) , vegetable, fruit juices in a significant amount, weak tea with milk. Limit fats (cream, butter up to 10 g, vegetable oil 20-30 g), an egg (one per day). Table salt up to 10 g. Add vitamins A, C, B1, B2, B12, folic acid, PP, K.
Eating 5 times a day in crushed form.
Excluded: alcoholic beverages, liver, brains, lard, legumes, mushrooms, spinach, sorrel, onions, muffins, fatty meats, fish, fried, spicy, smoked products, extractives of meat, fish, spices, vinegar, canned food, ice cream, cocoa, carbonated drinks, chocolate, creams (for chronic gallbladder lesions that occur with bile stasis, it is recommended to increase the amount of fat to 120-150 g, including 60% vegetable fats).
Table N 5a. Indicated in chronic pancreatitis.
It differs from the N5 diet in an increased content of proteins (up to 150 g, of which 80-85% of animal origin), products rich in lipotropic factors with a moderate carbohydrate content. All dishes are cooked in steam, pureed, chopped form.
Table N 6. It is indicated for gout, nephrolithiasis with the discharge of stones, consisting mainly of urates.
Compound: milk, dairy products, white and black bread, sugar, honey, vegetarian vegetable soups, dairy and fruit cereals, all sweet fruits, jam, fruit and berry juices, carrots, lettuce, cucumbers. From seasonings - lemon, vinegar, bay leaf. Eggs, meat, lean fish - 2-3 times a week. The amount of table salt is reduced to 6-8 g; introduce a large amount of liquid (up to 2-3 liters), add vitamins C and B1.
Excluded: spicy extractives, meat soups and decoctions, liver, kidneys, brains, fried, smoked meat, fried fish, fish soup, bacon, herring, sardines, anchovies, sprats, sprats, pates, mushrooms, legumes, sorrel, spinach, coffee, cocoa, chocolate, alcoholic drinks.
Table N 7. Indicated for chronic kidney disease with no symptoms of chronic renal failure.
Compound: soups vegetarian, dairy, fruit, low-fat meats, poultry, boiled in pieces, chopped and mashed, lean fish boiled, chopped and mashed, white, gray, bran bread, baked without salt, one egg a day, cereals, pasta in the form of cereals , puddings, flour dishes, milk, lactic acid products, fats, except for refractory ones (mutton, pork, beef), cottage cheese, raw, boiled vegetables, greens (except for radish, celery, spinach), berries, fruits, especially apricots, dried apricots, pumpkin , watermelons, melon, sugar, honey, jam.
Limit cream, sour cream. To improve the taste, you can use cumin, dried dill, cinnamon, citric acid. Table salt 3-5 g (given out on hand, and food is cooked without salt). Vitamins A, C, B1, B12, K are added. Free liquid up to 800-1000 ml per day. Meals 6 times a day. Excluded: carbonated drinks, legumes, cakes and creams, meat, fish, mushroom broths, pickles, snacks, smoked meats, canned food.
Table N 7a. It is indicated for acute renal diseases (acute nephritis or its exacerbations).
Compound: mainly boiled, mashed vegetables, fruits, especially rich in potassium salts (dried apricots, apricots, raisins), cereals and flour dishes in moderation ( buckwheat with milk), tea with milk, salt-free white bread, sugar up to 70 g, butter up to 30 g. Add vitamins C, K, group B. Fractional nutrition. Liquids up to 600-800 ml; table salt is completely excluded.
With developing uremia, the daily amount of proteins is reduced to 20-25 g (first of all, the content of vegetable proteins should be reduced - legumes, cereals, flour products, like bread, etc., since they are inferior in biological value to animal proteins and only overload the body with harmful products protein metabolism; prescribe large amounts of glucose or sugar (up to 150 g per day).
Table N 7b. It is indicated for the subsidence of an acute inflammatory process in the kidneys.
It is transitional from table N7a to table N7 (salt-free white bread, lean meats, boiled fish 1-3 times a week, table salt up to 2 g per hand, liquids up to 800-1000 ml; in products used for cooking contains 2-4 g of salt).
Table N 8. Obesity as a main disease or concomitant with other diseases that do not require special diets.
General characteristics:- a decrease in the energy value of the diet due to carbohydrates, especially easily digestible, partially fats, with a normal protein content, - restriction of free fluid, sodium chloride and appetite-stimulating foods and dishes.
(daily diet):
- proteins - 90-110 g
- fats - 80 g
- carbohydrates - 150 g
- energy value - 1700-1800 kcal
rye, protein-wheat and protein-bran bread (100-150 g per day);
vegetable soups with a small addition of cereals, cabbage soup, borscht, okroshka, beetroot;
2-3 times a week soups on a weak meat or fish broth with meatballs (up to 250-300g per meal);
lean meats, poultry, fish - boiled, baked or stewed, beef sausages or jelly;
seafood (pasta<Океан>, mussels, shrimp, etc.) - up to 150-200 g per day;
milk and dairy products, cottage cheese, cheese - low-fat types and varieties.
Vegetables and fruits are used widely, in all forms, some of them must be raw.
products made from wheat flour of the highest and 1st grade, pastry;
potato, cereal, bean, pasta soups;
fatty meats, poultry, fish;
sausages, smoked products, canned meat and fish;
fatty cottage cheese, cheeses, cream, rice, semolina and oatmeal, pasta, legumes, sweet varieties of fruits and berries;
sugar, confectionery, jam, honey, sweet juices, cocoa;
meat and cooking fats;
fatty and spicy snacks, sauces, mayonnaise, all spices and spices.
Table N 9. by EppInk "> DIABETES of moderate and mild severity.
General characteristics: - by EppInk"> DIET with moderately reduced energy value due to easily digestible carbohydrates and animal fats, with the exclusion of sugar and sweets and the use of sorbitol and xylitol.
Chemical composition and energy value(daily diet):
- proteins - 90-100 g
- fats - 75-80 g (30% vegetable)
- carbohydrates - 300-350 g (polysaccharides)
- energy value - 2300-2500 kcal
Recommended foods and dishes:
rye, wheat, protein-bran bread, non-butter flour products;
any vegetable soups, low-fat meat and fish broths;
lean meats, poultry and fish;
milk, dairy products, low-fat cottage cheese and cheeses;
cereals, buckwheat, barley, millet, oatmeal, barley; legumes, potatoes and vegetables;
fresh fruits and berries of sweet and sour varieties
Excluded foods and dishes:
pastry products;
strong and fatty broths;
lean meats, fish, poultry, sausages, salted fish;
salted cheeses, cream, sweet cottage cheese curds;
rice, semolina, pasta;
salted and pickled vegetables;
grapes, raisins, sugar, jam, sweets, sweet juices, sugar-based lemonades;
meat and cooking fats
Table N 10. Diseases of the cardiovascular system with circulatory failure degree I-IIA.
General characteristics:- a slight decrease in energy value due to fats and carbohydrates, restriction of chloride and substances that excite the cardiovascular and nervous systems.
Chemical composition and energy value(daily diet):
- proteins - 90 g (55-60% animals)
- fats - 70 g (25-30% vegetable)
- carbohydrates - 350-400 g
- energy value 2500-2600 kcal
Recommended foods and dishes:
bread from yesterday's baking, not rich cookies and biscuits;
any vegetarian soups;
lean meats, fish, poultry;
milk, sour-milk drinks and cottage cheese;
dishes from various cereals; boiled pasta;
boiled and baked vegetables;
soft ripe fruits and berries, honey, jam.
Excluded foods and dishes:
fresh bread, pastry products;
legume soups, meat, fish and mushroom broths;
fatty meats, fish, poultry;
kidneys, smoked meats, sausages;
salted fish, salty and fatty cheeses;
legumes;
salted, pickled and pickled vegetables; fruits with coarse fiber;
chocolate, strong tea, coffee and cocoa.
Table N 11. Tuberculosis of the lungs, bones, lymph nodes, joints with a mild exacerbation or attenuation, exhaustion after infectious diseases, operations, injuries.
General characteristics:
- by EppInk">DIET of increased energy value with a predominant increase in proteins, especially dairy, vitamins and minerals
Chemical composition and energy value(daily diet):
- proteins - 110-130 g (60% animals)
- fats - 100-120 g
- carbohydrates - 400-450 g
- energy value - 3000-3400 kcal
Recommended and excluded foods and dishes:
almost any food products and dishes are used, with the exception of very fatty meats and poultry, lamb, beef and cooking fats, as well as cakes and pastries with a lot of cream
Table N 12. Indicated for functional diseases of the nervous system.
The table is varied; spicy seasonings, strong rich soups, smoked meats, fatty, fried foods, especially meat ones that stimulate the nervous system, alcohol, strong tea, coffee are excluded, meat and salt are somewhat limited. Recommended dishes from the liver, tongue, dairy products and legumes containing phosphorus salts.
Table N 13. Indicated for acute infectious diseases.
General characteristics:- by EppInk">DIET with energy value reduced to a large extent due to fats and carbohydrates, with a high content of vitamins
Chemical composition and energy value(daily diet): - proteins - 75-80 g (60-70% animals) - fats - 60-70 g - carbohydrates - 300-350 g - energy value - 2200-2300 kcal
Recommended foods and dishes:
dried wheat bread;
fat-free meat and fish broths, soups on vegetable broth, mucous broths from cereals;
lean meats, poultry, fish;
lactic acid drinks, cottage cheese;
mashed rice porridge, semolina and buckwheat;
potatoes, carrots, beets, cauliflower, ripe tomatoes;
ripe soft fruits and berries, rosehip broth; sugar, honey, jam, jam, marmalade.
Excluded foods and dishes:
rye and any fresh bread, muffin;
fatty broths, cabbage soup, borscht;
fatty meats, poultry, fish, sausage, smoked meats, salted fish, canned food;
whole milk and cream, fat sour cream, cheeses;
millet, barley and barley groats, pasta;
White cabbage, radishes, radishes, onions, garlic, cucumbers, legumes;
fruits rich in fiber;
chocolate, cakes, cocoa.
Table N 14. Urolithiasis (phosphaturia).
General characteristics:- physiologically complete nutrition with restriction of alkalizing and calcium-rich foods
Chemical composition and energy value(daily diet): - proteins - 90 g - fats - 100 g - carbohydrates - 400 g - energy value - 2800 kcal
Recommended foods and dishes:
different kinds bread and flour products;
soups and broths (meat, fish, cereals);
meat and fish;
any cereals;
green peas, pumpkin;
mushrooms;
sour varieties of apples and berries
sugar, honey, confectionery
Excluded foods and dishes:
dairy, vegetable, fruit soups;
smoked meats, salted fish;
dairy;
potatoes, vegetables and fruits, other than those mentioned above, fruit, berry and vegetable juices;
meat and cooking fats.
Table N 15. Various diseases that do not require special therapeutic diets.
General characteristics:
- physiologically complete nutrition with the exception of indigestible and spicy foods.
Chemical composition and energy value(daily diet):
- proteins - 90-95 g
- fats - 100-105 g
- carbohydrates - 400 g
- energy value - 2800-2900 kcal
HEALING NUTRITION ( diet food) is used to treat various diseases or prevent their exacerbation. It is used in hospitals, sanatoriums, sanatoriums - dispensaries at industrial enterprises, as well as for outpatient treatment and at home. Diet canteens and dietary shops are open to the public; the food industry develops various dietary products (see).
Properly organized medical nutrition contributes to a faster and more beneficial effect of medicines, while improper nutrition can prevent them. healing effect and even harm.
It is possible to carry out medical nutrition only on the advice of a doctor and under his supervision., since a self-established permanent diet can lead to various disorders in the body.
People suffering from diseases of the stomach, liver, etc., need to organize therapeutic nutrition at home, especially when, for one reason or another, they cannot eat in a dietary canteen.
Medical nutrition should be varied and satisfy the tastes of the patient, if they do not contradict the requirements of the diet. However, it is necessary to strive to ensure that the patient tolerates food restrictions as easily as possible.
The temperature of the food taken is of great importance: the most favorable temperature for hot dishes is about 60 ° C, for cold dishes - about 10 ° heat. Hotter and colder food, as a rule, is not allowed in clinical nutrition.
Techniques of culinary processing of products in clinical nutrition in some cases have their own characteristics.
For example, with certain diseases of the heart, kidneys, inflammatory processes, food should be cooked without salt. So that unsalted food does not cause disgust, the dishes are given a sour or sweet taste by adding sugar, honey, vinegar, citric acid, various fruits and berries; boiled and then fried onions are also added to some dishes.
Often, mashed food is required for medicinal purposes; boiled vegetables are rubbed through a sieve or turned through a meat grinder with a fine grate, the potatoes are kneaded. For the preparation of pureed cereals or puddings, it is recommended to pre-grind the cereal in a coffee mill.
For patients with gastritis with insufficient acidity of gastric juice, cutlets are not rolled in breadcrumbs, therefore, after frying, they do not have a rough crust.
For some patients (for example, with diseases of the stomach and intestines, infectious diseases, etc.), it is necessary to cook steamed dishes so that they do not have a crust and in order to reduce the content of extractive substances in food (which are strong causative agents of the separation of gastric juice); meat and fish dishes are boiled in water for the same purpose.
For steaming, in the absence of a special saucepan (see article), you can use a regular saucepan; sieves are inserted into it upside down, water is poured below the bottom of the sieve, a mold with cooked food is placed on the sieve, the pan is covered with a lid and put on the stove.
It is very important that the products that make up the dish are taken in strict proportions, therefore, when cooking, you should use scales, graduated circles, measured spoons, cups, etc.
In case of liver damage in diabetes, products should be processed in the same way as with diet number 5, eggs should be replaced with cottage cheese. It is recommended to eat at least 4 times a day.
With obesity, therapeutic nutrition is based on the principle of sharp calorie restriction due to carbohydrates and, to a lesser extent, due to fats. Calorie content is set by the doctor depending on the degree of obesity.
It is advisable to include in the diet a sufficient amount of animal protein products that increase oxidative processes in the body: lean meat, chicken, lean fish, low-fat cottage cheese, yogurt. Limit the use of eggs, especially yolks (no more than 1 pc. per day). Eliminate meat and fish broths and gravies from the diet.
Vegetarian soups are recommended. Significantly limit such carbohydrate foods as bread and bread products, flour products, pasta, potatoes, sweet varieties of berries and fruits, sugar, honey, jam and sweets. Sugar is replaced by xylitol (see article Obesity).
An important role is played by vegetables that contain less digestible carbohydrates, but have a large volume, as they contain a lot of fiber and contribute to satiety. Of cereals, it is better to use buckwheat or pearl barley for making crumbly cereals.
The amount of fat should not be greatly reduced, it is better to use vegetable and butter (lard should be excluded). Also limit the amount of liquid and salt.
With toxicosis of pregnancy, therapeutic nutrition is prescribed by a doctor in accordance with the nature of the disease. You should eat little by little, 5-6 times a day, and it is recommended to eat the first breakfast in bed before getting up.
It is better to eat liquid and solid food separately, with an interval of at least half an hour. Fasting days are useful: cottage cheese (500-600 g of cottage cheese and 100 g of sour cream per day), compote days (1.5-2 liters of compote per day) as directed by a doctor.
Lit .: Pokrovsky A. A., Conversations about nutrition, [Moscow], 1964;
Marshak M.S., Nutrition and health, Moscow, 1967
The handbook provides information on the main nutrients, energy value food, diets of a healthy and sick person, the importance of individual foods, rational and especially therapeutic nutrition. Special attention is given to diet therapy for various diseases and the characteristics of diets, the organization of clinical nutrition, as well as the technology of preparing dietary dishes
This section presents the characteristics of the most common diets No. 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 13, 14, 15 (diet No. 12, which is practically not used, is not included). Many diets (No. 1, 4, 5, 7, etc.) have several options, indicated by letters that are added to the number of the main diet (for example, No. 7a, 76, 7c, 7d), or in separate words (No. 15 hyposodium).
