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Nutritional care for gout

Gout is a chronic disease associated with impaired purine (uric acid) metabolism. It is accompanied by the accumulation of uric acid in the body and the deposition of urates in the joints, tendons, skin, kidneys. The clinical manifestation of gout is inflammation of the joints (arthritis), the deposition of uric acid in the kidneys. The formation of urate (uric acid) stones is the final manifestation of a special type of uric acid metabolism disorders, referred to in clinical practice as urate diathesis.

The role of nutritional factors in the origin of gout is not leading, but it can not be underestimated. Consumption of foods rich in purines, within days increases in 2 times and more stocks of uric acid in the body.

Proper nutrition is an important method of treating gout in combination with other methods aimed at regulating the metabolism of uric acid, and primarily at reducing hyperuricemia (elevated levels of uric acid in the blood), by limiting the purines in the diet.

Foods that are rich in purines, especially brains, liver, kidneys, tongue, meat broths and extracts, are excluded from the diet. Many purines are found in fish, including sardines, horse mackerel, herring, sprats, pink salmon, and chum. For patients with gout choose low-fat varieties of meat, fish, and meat from low-fat chickens. These products are allowed to use no more than 1 — 2 once a week in the amount of 200 — 300 g, and only boiled. Preference should be given to dairy products - cottage cheese, sour cream, cheese, milk

Excluded from the supply of fresh bean pods, mushrooms. Vegetables and fruits are foods low in purines (see. Table. 11). The exception is spinach, Brussels sprouts and cauliflower.

Food should include purine-poor foods (bread, cereals, berries, eggs, and nuts). Every day it is recommended to use at least 1,5 — 2 liters of liquid: tea, juice, juice, alkaline mineral waters. Fasting days are useful, especially fruit, vegetable, kefir, cottage cheese. All types of alcoholic beverages must be excluded from the diet. Treatment with hunger and the appointment of hungry days are contraindicated. On the days when meat and fish are allowed, add 150 of boiled meat (beef) or 150 of boiled fish to the menu. You can combine fish with meat in equal quantities.

Gout is a disease of middle-aged people (40 — 50 years). To prevent it, in this period of life, it is advisable to treat with particular attention to your diet. It is desirable to somewhat limit the consumption of meat soups and meat dishes, replacing them with dairy ones. And, of course, you need to increase the number of raw vegetables in the diet.

Dietary treatment of anemia

Anemia (anemia) is characterized by a decrease in the hemoglobin content in red blood cells (erythrocytes), as well as the number of erythrocytes per unit volume of blood. Most often it occurs when there is a deficiency in the body of iron and certain vitamins (cyanocobalamin, folic acid). Normally, the human body contains about 5 g of iron, 60 — 70% of which is in hemoglobin. The function of hemoglobin is to transport oxygen from the lungs to the tissues.

With food for the day 10 — 15 mg of iron is ingested, but only 10% is absorbed.

A number of nutrients helps to reduce the absorption of iron. This is characteristic of tannin, phosphate and oxalate. At the same time, ascorbic, amber, pyruvic acid, fructose, sorbitol increase iron absorption.

Iron is found in many products of plant and animal origin (in meat, liver, beans, eggs, parsley, rice, peas, corn, spinach, apricots, prunes, raisins, bread). However, the amount of iron in foods is not proportional to the possibility of its use by the body. So, only about 1% of this trace element is absorbed from rice and spinach, from corn, beans, eggs - 3%, fruits and berries - 3%, fish - 11%. Iron is best absorbed from beef, especially veal (22%). The recommendations to eat raw or nearly raw liver in iron deficiency anemia are completely ungrounded, since the iron content in the liver does not change during cooking. Besides, the substance ferritin, which contains iron in the liver, is poorly absorbed. It is impossible to place great hopes on replenishing the iron deficiency due to the consumption of a large number of apples, buckwheat, pomegranates and other plant products containing a lot of iron. Patients with anemia are encouraged to include in the diet up to 130 — 150 g of proteins per day, mainly of animal origin (from beef, veal). Proteins are needed to build the basis of red blood cells and hemoglobin synthesis.

Since fats inhibit blood formation, their content in food should be limited to 70 — 80 g. It is necessary to give preference to easily digestible fats - milk, sunflower, and other vegetable oils.

The amount of carbohydrates in the diet of patients with anemia must meet the physiological norm. It is recommended to include honey, jam, legumes, vegetables, berries, fruits, cereals from various cereals, rye bread in the diet.

It is useful to use an increased amount of ascorbic acid contained in the gooseberry, oranges, raspberries, beets, color and Brussels sprouts, zucchini, onions, fresh peas, tomatoes, black currant, sweet and red peppers, kohlrabi cabbage, plums, horseradish, barberry, strawberry, cranberry, wild rose.

Limited in the diet should be tea, wheat flour, millet, oats, evaporated milk, cheese, sorrel, rhubarb, cocoa, chocolate.

Meals after suffering a viral hepatitis

Viral hepatitis is an infectious disease of a viral nature, which is characterized by primary damage to the liver and manifested by intoxication and jaundice.

The medical nutrition of people who have undergone viral hepatitis, is aimed at sparing the liver and improving its functions, stimulating bile secretion and preventing fatty regeneration of this organ. The diet in this case should correspond to the energy expenditures of the organism and its physiological needs for nutrients. Since the protein-deficient diet leads to severe liver damage, the food of patients with viral hepatitis must contain a sufficient amount of proteins, ensuring the functional usefulness of liver cells. The total amount of fat in the diet of this contingent of individuals is recommended within 100 g, mainly in the form of milk and vegetable oils. Sharply digestible refractory fats of animal origin, rich in saturated fatty acids, are sharply limited. Useful vegetable oil as a good stimulator of bile secretion. The food had been ill with viral hepatitis should be tosufficient amount of carbohydrates, especially easily digestible, which ensure the normal functioning of the liver cells.

From easily digestible carbohydrates it is advisable to use honey, jam, compotes, jellies, juices, fruit, berry, dietary fiber. However, be sure to include in the diet of food containing starch and plant fiber, which stimulate bile secretion. Vegetables and fruits provide the diet with vitamins and minerals. To reduce the stagnation of bile in the liver, food must be taken at least 4 — 5 once a day.

It is forbidden to consume alcoholic beverages, smoked meats, extractives, spicy, salty, fried, cold dishes and drinks, as well as products containing essential oils and organic acids that irritate the liver (mushrooms, mustard, horseradish, vinegar).

Recommended are white or wheat stale bread, dairy, vegetable soups, fruit with cereals, pasta; lean meat boiled (in limited quantities), lean fish boiled, vegetables, legumes, cereals, fruits in all forms. Milk and dairy dishes are allowed. Dairy products, salads and vinaigrettes with vegetable oil, fruit and vegetable juices, various fruits, berries, jams, and honey are especially useful.

Thus, the diet should be complete, varied, rich in vitamins and well digestible.

Feeding people who have had infectious diseases

The course and outcome of many diseases, including infectious diseases, as well as the effectiveness of the therapeutic effect of drugs, in which they largely depend on the rationality of nutrition.

The therapeutic nutrition of those who have had infectious diseases is aimed at covering the patient’s increased energy consumption, removing toxic substances from the body, increasing its defenses, stimulating the secretory activity of the digestive glands, and creating favorable conditions for the rapid normalization of the activity of the affected organs and systems.

After normalization of body temperature, the patient should establish a regular diet with frequent meals, in small portions, at certain times.

During the recovery period, it is necessary to prevent overloading the digestive system or the premature administration of difficult-to-digest food. Despite the increasing appetite, the volume of food intake should be increased gradually. The increase in body weight should not exceed 2 kg per month, if significant weight loss was noted during the illness.

To enhance the appetite, you can give in very small quantities lightly smoked fish and meat products, marinades.

To meet the body's daily need for vitamins (which is: in retinol - 2000 mcg, or carotene - 4000 mcg, ascorbic acid - 100 mg, thiamine - 4 mg, riboflavin - 4 mg and nicotinic acid - 30 mg) and mineral salts should be consumed a lot of vegetables, fruits, berries, herbs, broth hips.

During the period of recovery from severe infectious diseases (typhoid, dysentery, etc.), diet No. 2 is prescribed, which provides mechanical sparing of the digestive apparatus, and after some time, diet No. 11, which provides enhanced nutrition (with energy to 13 398 — 14 654 kJ, protein content - up to 130 — 140 g, fat - up to 100 g, carbohydrates - up to 450 — 500 g). At the same time, various products of animal and vegetable origin are recommended, and certainly raw vegetables, fruits, and greens.

In the absence of appetite or the presence of dyspeptic symptoms (belching, nausea, or even diarrhea), a half-starved regimen is administered on the 1 — 2 of the day — boiled fruits or vegetables without oil, then switch back to a full-fledged diet.

In order to remove toxic substances and metabolic products from the body, prevent salt deposition in the urinary tract when taking sulfanilamide preparations (etazol, norsulfazole, etc.), as well as to replace significant water losses, it is shown to consume it in an increased amount (up to 2 L)

The order of appointment of dietetic therapy in the conditions of production

Patients in need of diet therapy for various diseases are selected by attending physicians (local and department therapists, gastroenterologists, endocrinologists, and other specialists). Indications for use of clinical nutrition are: gastritis, gastric ulcer and duodenal ulcers, enteritis, pancreatitis, hepatitis, cholelithiasis, cholecystitis, ischemic heart disease, hypertension, chronic circulatory failure with heart defects, diseases infarction, glomerulonephritis, pyelonephritis, nephrotic syndrome , kidney disease, anemia of various etiologies, suppurative processes in the lungs, pulmonary tuberculosis, skin and bones, pneumoconiosis, complicated by tuberculosis, wasps eomielit the sudden exhaustion, diabetes, obesity. In addition, dietary therapy can be prescribed after severe operations, long-term diseases, dysentery, salmonellosis, typhoid fever, paratyphoid fever, viral hepatitis, occupational diseases and poisoning, in violation of chewing function, reduced nutrition in adolescents, pregnant women and nursing mothers.

After a thorough examination of the patient and clarification of the diagnosis, the attending physician fills in the exchange card, which is the official document for diet therapy. At the end of each year, medical institutions make lists of people in need of dietary treatment and submit them to trade union organizations at work to decide on the issue of preferential vouchers for diet food.

At the direction of the patient on a dietary food the attending physician carefully acquaints it with character assigned diet, explains the need to respect certain requirements with a combination of diet food in the dining room and the house.

Permits are issued on a diet food trade union committees of enterprises and institutions.

The duration of diet in the production environment is usually determined by the doctor for 1 — 2 months, but not more than 3 months per year. If a patient needs a diet for a longer period (in case of diabetes, obesity and other diseases), then it should be continued for the full cost.

At enterprises and institutions where the number of employees is small, diet food is organized on a contractual basis in the nearby diet canteens of the city. The selection of patients for the diet is carried out by the territorial health authorities.

Dietary canteens are used by people who need medical nutrition, also at full price. They can contribute money for meals by purchasing tickets for 2 or 4 weeks. The subscription payment system allows you to accurately plan the number of dishes made, reduces the distribution time of poor people and, last but not least, disciplines those who eat, contributes to their more precise compliance with the diet. Patients are provided with subscriptions for daily meals, and only for lunch, or for breakfast and lunch.

After the end of the course of treatment with nutrition, the dietary nurse sends the completed exchange card to the medical unit or territorial medical institution where the effectiveness of this treatment is analyzed.

Studies have shown that adequate dietary nutrition for workers significantly improves their health, reduces by 27,3% labor losses due to temporary disability, and increases labor productivity in various industries (on average by 6,2 — 11,1%).

General characteristic of the basic diets

All diets are conventionally divided into two groups. The first group includes those in which mainly takes into account only the quantitative content of certain components of the food, while the method of culinary processing does not play a significant role. They are diets characterized by increasing or limitingNo matter the content of protein, fat, carbohydrates or other constituents of food. In the second group of diets, on the contrary, culinary processing, giving new qualities to food, is of paramount importance. These include diets with a sparing dietary regimen, most commonly used for diseases of the digestive system.

Developed more than 15 different diets Consider the most commonly used ones.

Diet and number 1. It is used for gastric ulcer and duodenal ulcer in the period of exacerbation, acute gastritis, exacerbation of chronic gastritis, regardless of the secretory and acid-forming functions of the stomach. The energy value of the diet is somewhat reduced by reducing the carbohydrate content. In terms of food composition and cooking, the diet is mechanically, chemically and thermally sparing. It includes wiped boiled or steam products. All dishes are served to the patient in a liquid or mushy state. Proteins are used primarily of animal origin in the normal range. The amount of fat also corresponds to the physiological needs of the body (of which 25% should be vegetable oils), carbohydrates in the daily ration contain 200 g, salt - no more than 8 — 10 g, free fluid - 1,5 l. The daily ration energy value is 8792 — 9211 kJ. The temperature of food intake should not exceed 60 ° С, but should not be lower than 15 ° С. The number of meals - 6 per day. It is recommended to introduce into the diet mucous soups, dairy, cereal, meat and fish steam soufflé from low-fat meats and fish, milk, soft-boiled eggs, omelets, cottage cheese, butter, sweets, jelly, jelly, non-acidic juices. The diet is calculated on 7 — 12 days.

Diet № 1. It is used in case of peptic ulcer in the period of damped exacerbation process. Prepared pureed or non-rubbed, boiled or steam food. Low-fat varieties of meat, fish are allowed to serve a piece. The composition of the diet is fully valuable, characterized by moderate mechanical and chemical shchazheniem digestive apparatus. Contains 110 g of proteins, 100 g of fats and 400 — 450 g of carbohydrates. Its energy value 12 142— 12 979 kJ. Consists of a diet of vegetarian and dairy soups, vegetable purees, mashed porridge, low-fat steamed or boiled meat and fish, sausages, 2 — 3 soft-boiled eggs or in the form of omelettes, milk, yogurt, cottage cheese, sour cream and white stale bread, sweet fruit juices . Excluded from it are cabbage, turnips, radishes, cucumbers, strong meat and fish broths, all fried foods, smoked meats, canned food in oil and tomato, fresh bread, spices, beer, vodka, wine. The number of meals - 6.

Diet № 2. It is prescribed for gastritis with insufficient secretory and acid-forming function of the stomach, as well as for chronic diseases of the intestines - colitis and enteritis - in the stage of unsharp exacerbation. Diet helps to improve the function of the stomach and intestines. Inclusion of products with coarse growbody fiber is limited. The introduction of whole milk, as a rule, is not allowed. Meat is carefully separated from the veins, cartilage and bones are removed from the fish. Dishes are prepared mostly pureed or chopped. It is allowed to eat fried foods, but without breading products in flour or breadcrumbs. Salt is added to food in moderation (up to 15 g per day). Energy value of the diet— 12 560 — 13 398 kJ. The number of meals - 4 — 5.

Diet № 4. It is recommended for acute and chronic diseases of the intestines during acute exacerbations, accompanied by diarrhea and severe dyspeptic symptoms. All dishes are cleaned, cooked boiled or steamed. The diet contains 100 g of proteins, 70 g of fats and 250 g of carbohydrates. It consists of mucous soups in water or lean meat broth, mashed porridge on water, meat steam dishes, cottage cheese, three-day sour milk, stale white bread or crackers, berry juices, strong tea, cocoa on water, black coffee. Pure milk and black bread are excluded from the diet. The frequency of eating food - 5— 6 once a day.

Diet number 5. It is used in chronic cholecystitis, choleiitis, hepatitis, cirrhosis of the liver during the recovery period, but in the absence of inflammatory diseases of the stomach and intestines. The diet is limited to cholesterol, purine substances. Contains 100 g of proteins, 80 — 100 g of fats and 350 — 400 g of carbohydrates. The third part of the amount of fat is provided by vegetable oils. The diet consists of vegetarian and milk soups, low-fat varieties of boiled meat and fish, dairy and dairy products, butter, vegetable oils, cereals, vegetables and fruits, black and white bread. The use of alcoholic beverages, liver, kidneys, legumes, butter dough, fried foods, smoked meats, marinades, canned goods is not allowed. Salt is limited to 5 — 8 g per day. The number of meals - 6.

Diet number 7 indicated for kidney disease without marked impairment of function. It is characterized by a sharp restriction of table salt, a decrease in liquid, the elimination of nitrogenous extractive substances from meat, fish, mushrooms, as well as products containing cholesterol. The total amount of liquid contained in the diet is 1,5 l, free liquid 0,8 l. Boiled or cooked meat dishes are prepared from meat and fish. As seasonings use sour cream, vegetable and fruit gravy, boiled onions. Food is wiped or well boiled without salt. In the diet include salt-free bread. The number of meals - 4 — 5. The composition of dietary nutrients: 80 g of proteins, 85 g of fat and 450 g of carbohydrates, its energy value - 12 142 kJ.

Diet number 8. It is recommended for the treatment of obesity in the absence of diseases of the digestive and circulatory organs. The diet is characterized by reduced energy value of food. But in a normal work environment this reduction in energy value should not be abrupt (on 20 — 30%). The energy value of the diet decreases due to a significant restriction of foods rich in carbohydrates: sugar, honey, pasta, confectionery, jelly, jam, sweets, creams. It is also recommended to reduce the consumption of bread and potatoes, cereals. It is useful to include in the diet of protein-bran bread. Spices, strong broths are excluded. In the diet, you must enter a large number of cabbage, carrots, cucumbers containing fiber. The number of meals - 5. Sorbitol or xylitol are used instead of sugar.

Diet number 9. Recommended for the treatment of diabetes. This diet restricts carbohydrate intake and, in part, fat. Sugar and all sweets are excluded from it. Culinary processing of products is recommended ordinary. The nutritional composition of the diet is 100 g of proteins, 70 g of fats and 300 g of carbohydrates. The diet includes foods that contain little carbohydrates: meat, fish, cottage cheese, eggs, butter and vegetable oils, lactic acid products, cabbage, swede, greens, legumes, oatmeal and buckwheat, black bread in a metered amount, sour varieties of berries and fruits. Eating salt is allowed in the amount of 12 g per day. You need to avoid fried foods. Sugar should be replaced with sorbitol or xylitol.

Diet № 10. Recommended for patients with diseases of the cardiovascular system without pronounced circulatory disorders. Diet provides for the restriction of fluid (total - 1,5 l, free —0,8 l), salt, substances that stimulate the nervous system and heart, irritate the kidneys and liver. Contains 80 g of proteins, 70 g of fat, 350 — 400 g of carbohydrates. It consists of vegetarian soups, boiled meat and fish, milk and dairy products, semolina and rice porridge, fruit. It introduces products rich in potassium, lipotropic substances. The diet prohibits the use of alcohol, strong coffee, tea, cocoa, chocolate, spicy salty snacks, seasonings; restricts the use of foods that cause flatulence or bloating (legumes, carbonated drinks), as well as cholesterol-rich foods (internal organs of animals, brains, caviar, animal fats). The use of salt limits to 3 — 5 g per day. A meal intake provides 5 per day.

The methodology of clinical nutrition in the diet of table

Dietary canteens and departments (diet halls) are organized in the catering system to provide dietetic food to people who need it. Dietary canteens are independent specialized catering establishments with a seating capacity of at least 50 — 60. Dietary departments (dietary halls) are subdivisions of canteens, factories, kitchens or combi.natov catering. Dietary departments usually have a separate room for meals and their own production facilities in which cooking is carried out. Dietary halls are allocated in catering for the consumption of food by sick workers. Dietary dishes with this option are prepared in common production areas.

The numbered system of therapeutic diets is used in diet canteens, diet departments and diet rooms.

Medicinal mineral waters, decoctions and extracts of various medicinal herbs, vitamin drinks, and juices are widely used at dietary catering establishments. In diseases of the intestines, patients receive decoctions of immortelle, wormwood, cumin, dill; in case of gastric ulcer and duodenal ulcer - decoctions of elecampane, strawberry * plantain, celandine, marsh corpus; in diseases of the liver and gallbladder - decoctions of immortelle, St. John's wort, chamomile, centaury, tansy, corn stigmas, yarrow; with diseases of the kidneys and urinary tract - decoctions of Althea officinalis, peppermint, knotweed, horsetail, St. John's wort.

Additional intake of vitamins in the diet provides for the expense of the use of drinks from the hips, bran, yeast, black currant. The inclusion of fruit and berry juices in the diet is an important factor in replenishing it with vitamins and mineral salts. For the same purpose, mandatory fortification of dishes with ascorbic acid is provided.

Patients with diabetes and obesity are provided with sugar substitutes - sorbitol or xylitol. Preference should be given to xylitol, since the coefficient of its sweetness (compared to sugar) is 0,98, and sorbitol - 0,48. The daily amount of these sugar substitutes in the diet should not exceed 30 g.

For the diet should be allocated places 20% of the total number of seats in the catering.

Nutritional care in sanatoriums

In the prevention and treatment of various diseases of workers and employees in industrial enterprises, an important role is played by sanatoria-preventoria of trade unions. Workers without interruption of production in their free time are provided with comprehensive sanatorium treatment, rational, dietary, and, if necessary, therapeutic and prophylactic nutrition. Persons suffering from various chronic illnesses receive the necessary medical treatment. assistance, including preventive, scientifically based nutrition, aimed at preventing exacerbation. This ultimately leads to an improvement in the health of workers, a decrease in the number of days of disability and an increase in labor productivity.

The organization of effective work of sanatoriums in our country pays great attention. In particular, in the recommendations of the Commission on Health and Social Welfare of the Council of the Union and the Council of Nationalities of the Supreme Soviet of the USSR from March 14 “On the work of sanatoriums for the protection and promotion of the health of workers” and the resolution of the Presidium of the All-Union Central Council of Trade Unions 1980 June 20. additional measures to develop the network, improve the work and improve the effectiveness of sanatoriums and preventative cares in protecting and promoting the health of workers ”, emphasizes the need to further improve the protection of workers’ health, including the provision of rational and dietetic food in sanatoria-preventoriums.

Food for workers and employees in sanatoria-preventoriums is organized in accordance with established standards, within the limits of the provision.

Identification and consideration of persons in need of dietary nutrition, as well as the appointment of an appropriate diet in industrial enterprises are engaged in shop therapists. If the enterprise is serviced by a district (city) clinic, these issues are decided by district physicians. They need dietary treatment in a sanatorium-preventorium, first of all, patients with chronic diseases who are in the dispensary register, in the period of recovery or of a mildly pronounced exacerbation of the disease; recovered from serious illnesses and undergoing surgery. In addition, dietary food in a sanatorium-preventorium can receive weakened by illness adolescents, pregnant women and nursing mothers.

The number and range of diets sold in each sanatorium-preventorium is determined by the chief doctor together with the diet doctor (dietary nurse), depending on the profile of patients who come to treatment and who need dietary diets for a specific diet. However, the above-mentioned diets (No. 1, 2, 5, 7, 8, 9 and No. 10) are used more frequently in trade unions. In the conditions of sanatorium-preventorium, diets No. 7 and No. 10, as well as No. 8 and No. 9 are often prepared together, since they do not differ significantly in their composition and technology of cooking.

The group dietary system in sanatoria does not preclude some individualization of the nutrition of individual patients.

Taking into account the production loads, the energy value of the medical ration should be slightly increased depending on the volume and intensity of the physical labor performed.

However, in the presence of obesity, the energy value of food in a sanatorium can be reduced by 20 — 30% compared with the energy requirement of a particular person.

The missing amount of vitamins for diet therapy in a sanatorium can be replenished by artificial fortification of dishes, the introduction of beverages (from hips, rhubarb, prunes, wheat bran) and fruit and berry juices. Vitamin drinks and fruit and berry juices are given out instead of a sweet dish at the end of a meal, and a drink of wild rose and wheat bran is recommended to be taken before meals.

An integral part of clinical nutrition in the conditions sanatoriya- dispensary is reception of mineral water.

Treatment with mineral waters is carried out only on doctor's prescription.

Features dietolecheniya at home

In order to improve the care of people who need dietary food at home, production of food and convenience foods for dietary food has been launched.

Dietary foods are divided into two groups. The first includes mechanically and chemically sparing sick organ products. They contain little fiber in vegetable products and extractives in meat and fish. These are rice, oatmeal, buckwheat flour of fine grinding, homogenized canned food from vegetables, fruits and berries, butter, sour cream, cottage cheese, cream, dietary eggs.

The second group of dietary products includes products that contribute to the regulation of impaired metabolism. This is done by enriching some natural products with vitamins, polyunsaturated fatty acids, lipotropic substances, or restricting certain substances (simple carbohydrates, saturated fatty acids, extractives, spices, table salt, etc.). There are quite a few such dietary products produced by the industry: bakery products (bran buns and bread with lecithin, protein-wheat and protein-bran bread, protein-free and salt-free bread), xylitol confectionery (jams and preserves, sweets and canned fruit), dietary oil and Health oil, which contains 35% vegetable oil and 65% milk fat.

In large cities, products purchased from dietary stores are widely used for home therapeutic food. In cases where dietary products cannot be purchased in stores, medical cooking comes to the rescue, with the principles of which physicians usually acquaint in detail those who need diet therapy, their family members in conversation or through special non-fiction literature for patients on dietary nutrition at home.

In medical culinary, various technological methods are used for mechanical and chemical cleansing of the organs of the digestive apparatus. In order to reduce mechanical irritation of mucous membranes, food products are crushed: boiled meat is cut into small pieces or passed through a meat grinder, while preparing the cutlet mass, the raw products are passed twice through a small meat grinder grate, and water or milk is added to the finished mass. Cartilage, coarse connective and integumentary tissue (fish, birds) are pre-removed. Vegetables are cooked puree, from cereals - viscous porridge. For the preparation of mucous soups, the cereals are boiled until they are fully cooked, and then rubbed through a sieve and boiled again, or the grits are ground, for example, in a coffee grinder before cooking the soups.

Chemical schazhenie mucous membranes is provided by reducing the amount of extractives in the products (during cooking), mineral salts, excluding onions, garlic, spices from the dishes. Do not recommend fried dishes, meat and fish broths. The best way to cook foods to ensure chemical depletion of the body is such cooking, when the finely chopped product is immersed in cold water. Steaming leads to significantly less loss of extractives.

To limit carbohydrates in food, besides excluding sugar and foods containing it from the diet, it is recommended to soak potatoes in cold water for 12 hours. Diabetes and obesity often use drinks and sweet foods with sugar substitutes - sorbitol or xylitol.

In order to reduce revenues in the human body calcium in the diet to limit milk and dairy products, leafy greens, some varieties of apples.

If, for health reasons, the patient requires enhanced nutrition, for example, in case of tuberculosis, cooking methods should preserve the nutritional value of foods as much as possible and promote appetite stimulation. In this case, the meat and fish are fried; fruits and vegetables are consumed mostly raw; widely used spices, roots. In the diet include in high quantities simple carbohydrates, better honey and sweet fruit dishes.

Organizing health food at home, you should take care of the maximum variety of diet. In this case, it is necessary to periodically consult with your doctor or dietitian. Dietary nutrition, like other types of treatment carried out according to the type of self-treatment, does not lead to the desired result without appropriate medical monitoring and correction.

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