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Power TB patients

Diet therapy of patients with tuberculosis is aimed at increasing the body's defenses. It is based on the nature of the disease, the state of the digestive system, associated diseases. In this case, nutritional therapy should provide the body with the nutrients needed to cover the increased breakdown of proteins, vitamins, excessive consumption of minerals, and restore the metabolism of fats and carbohydrates.

Over a long period in the treatment of tuberculosis dominated the principle of excess nutrition. The crucial role in this was assigned to food rich in heat. However, scientists have concluded that obesity, which develops from overnutrition, not only does not improve health, but, on the contrary, can aggravate the tuberculosis process.

The energy value of the daily diet with exacerbation of tuberculosis and patient compliance with bed rest should be 10 467 — 10 886 kJ; the amount of proteins in it is 90 — 100 g (of which b (the best half are animal proteins). Fats during exacerbation of tuberculosis and high body temperature are limited to 90 g per day. Their sources should be butter, dairy products and natural vegetable fats The carbohydrate content in the diet should be reduced to 250 — 350 g per day, of which the share of sugar and honey should be 80 — 100 g. Fresh fruits and vegetables, juices, dogrose are recommended to replenish the diet with vitamins. 2,5 — 3 h ne In large portions. Food should be cleaned. To stimulate appetite, it should be diversified to the maximum. For this purpose, they use gastric secretion stimulants (broth food, herring, caviar, etc.) * Drink water with lemon, diluted juices, fruit drinks, broth dog rose, table mineral water.

The need for minerals, especially calcium, phosphorus, as well as iron is satisfied with the use of milk, cottage cheese, cheese, meat products, eggs, honey, raisins. Table salt is usually not limited in the diet, andFor persistent sweating, diarrhea, or vomiting, it is recommended to increase its content to 20 g per day. However, with fluid retention in the body, as evidenced by the appearance of edema or a rapid increase in body weight in seriously ill patients, the amount of salt in food is sharply limited. The amount of fluid consumed depends on its excretion from the body. With significant sweating and the absence of edema, it is allowed to drink during the day to 2 — 2,5 l of free fluid, and when the above signs of fluid retention appear in the body, its use is limited to 1 liters per day.

During attenuation of exacerbation of tuberculosis, the energy value of food is increased to 12 560 — 14 235 kJ by increasing the protein content (to 120 — 140 g), fats (to 100 — 120 g) and carbohydrates (to 400 — 500 g). At the same time, the amount of simple carbohydrates in the form of fruit sweet products, honey and sugar is brought to 110 — 120. Young patients with chronic tuberculosis with reduced nutrition are recommended to increase the energy value of their daily ration to 13 816 — 15 072 kJ.

A more significant increase in the energy value of food does not contribute to improving the course of the disease. With concomitant obesity, the amount of carbohydrates in the diet is reduced to 300 — 350 g per day.

In case of uncomplicated tuberculosis during the process attenuation, culinary processing of products is recommended as usual. Eat 5 once a day. To improve the appetite, it is necessary to stimulate gastric secretion. This is facilitated by the beautiful design of the dishes, the variety of the menu, and the relaxed atmosphere during the meal. It is also necessary, as in the period of exacerbation of the disease, to monitor the intake of sufficient amounts of vitamins and minerals from food.

Tuberculosis of the intestines due to impaired absorption of proteins, vitamins, calcium, phosphorus, iron is accompanied by a deficiency of these substances in the patient's body. Diet therapy in this case is aimed at replenishing them. Food should be wiped, in small portions, 5 — 6 once a day (during an exacerbation).

Excluded from the diet spicy, fried, trudnopere- soldered products, sources of roughage.

Mucous and pureed soups, low-fat broths, boiled fish and meat, meat souffle, steam cutlets, meatballs, meatballs are allowed. Vegetables and fruits are consumed only boiled and pureed, fruit juices are diluted with half boiled water. Use white bread or crackers, well boiled porridge, steam omelette, puddings, sour cottage cheese, grated non-sharp cheese.

fat content in the diet of patients with tuberculosis of guts is limited because they are poorly tolerated and can cause diarrhea.

The amount of simple carbohydrates that cause fermentation in the intestines also decreases. Restrictions in the diet are carried out for the period of exacerbation (5 — 7 days), and then the diet expands.

Diet therapy of patients with closed tuberculosis in the conditions of production should be carried out according to the same principles as patients with attenuation of the tuberculosis process. At enterprises, these patients usually receive vouchers for diet food organized in separate dining rooms with special washing utensils. Dishes, which are used by patients with tuberculosis, is marked and does not fall into the common rooms. After degreasing, this dish is sterilized by boiling in 2% soda ash solution for 15 min. Glasses are replaced with cups that do not burst when boiled. Cutlery is sterilized by boiling for 15 — 20 min. Such preventive measures are carried out at home in order to prevent infection of healthy family members.

Nutrition of patients with nephritis

Nephritis impairs the ability of the kidneys to excrete toxic metabolic products from the body with urine. This leads to poisoning of the body, increased blood pressure, edema, the appearance of red blood cells and protein in the urine.

In the acute period of the disease in hospital treatment, the patient is prescribed a very strict diet. After discharge from the hospital at home, the patient's menu expands. Diet № 7 is assigned. In this case, from the diet excluded broths, gravies with extractives.

The amount of protein in the diet is limited to 75 — 80 g per day. Of animal proteins, milk proteins (rather than meat), fish, and eggs are preferred. The total weight of a daily ration should not exceed 3 kg, and the amount of free fluid in it is reduced to 1 liters per day. All food, including bread, is cooked without salt. For salting individual ready-made dishes you can use no more 3 g salt per day.

Products and dishes used in the nutrition of patients with jade.

Beverages: Tea is weak, tea with milk.

Bread products: Wheat bread (white and gray), biscuits, salt-free bread (achloride, as directed by a doctor).

Snacks: eggplant or squash caviar, cooked without salt with the addition of boiled, and then fried onions.

Milk, dairy products: whole milk, condensed milk, dried, kefir, yogurt, acidophilus milk, cream, sour cream, cottage cheese and various cheese dishes.

F and p s: creamy (fresh and baked) unsalted butter, olive, soybean, and sunflower oils.

Eggs, egg dishes (it is allowed to use no more than one egg per day, mostly eggs are added to culinary products).

Soups: dairy, fruit, vegetables with cereals on vegetable broth with sour cream, with boiled, and then toasted onions, borscht, beetroot soup, cabbage soup with apples, citric acid and natural vinegar.

Meat, fish: beef dishes, beef, lean pork, lamb, poultry, fish (food pre-boiled and then baked or fried).

Cereals, pasta: various

dish with raisins, prunes, dried apricots, jams and so on. n.

Vegetables, greens, except sorrel, spinach, radishes: raw, boiled, baked or fried in combination with fruits and berries.

Fruits, berries, sweet dishes and sugary foods: fruits, berries - raw, boiled, baked, compotes, jelly and jelly from them; sweet dough; sugar, honey, jam.

Sauces, spices: milk and cream sauce, onion sauce of digested and then roasted onions, vegetable sauce with the addition of natural vinegar or citric acid, butter, sour cream.

Sources of vitamins: a decoction of rose hips, fresh vegetables, fruits and berries.

Eating should not be less than 4 times a day.

When exacerbations of jade prescribed so-called fasting days in the form of sugar, compote, fruit and berry and vegetable diets.

Sugar diet is that the patient receives 5 once a day every 2,5 — 3 — one cup of sweet tea (with 15 — 20 g of sugar). To reduce the sweet ^, use 2 — 3 crackers.

Kompotnaya diet. 1,5 kg of ripe raw fruits or berries (you can use 400 g of dried fruit) prepare 1 l compote with the addition of 100 — 150 g of sugar. The finished compote is divided into 5 parts, and the patient drinks it every 3 h.

The fruit (berry) diet consists of giving the patient 5 once a day 300 g of watermelon or raw fruits (berries): apples, grapes, strawberries, etc. It is especially useful to use watermelon days.

Vegetable diet consists of 1,5 kg of various vegetables: prepare salads. The patient was given every hour on the 3 300 grams of salad. For salads, you can add a little sour cream or vegetable oil. Salads do not salt, to taste of the vegetables can be replaced with apples.

When there is a disturbance of purine metabolism, when urates, uric acid salts, predominate in the urine, foods rich in purines should be excluded from the diet: legumes, sprats, sardines, herring: internal organs of animals (tongue, kidney, liver, brain, lungs); mushrooms, meat and fish broth, jelly; some vegetables (sorrel, spinach, radishes, asparagus, cauliflower); fried and smoked meat; sausages (especially liverwurst); meat, fish, mushroom sauces. In tab. And lists foods containing purines. Since the latter, when cooked, pass into the water, their content can be significantly reduced by boiling these products. When cooking meat in broth 50% of purines pass.

Therapeutic nourishment with urolithiasis

The main cause of urolithiasis is the change in the chemical composition of urine and its reaction. These indicators are taken into account when organizing medical nutrition of patients.

11 table. The content of purine substances in 100 g of food (according to G. L. Levin), mg

Products,

rich

Purine

Substances

Soder

content of

Purine

substances

If

honors

uric

acid

Products,

poor

Purine

Substances

Soder

content of

Purine

substances

Soder

content of

uric

acid

Meat beef

37,5

11,1

Milk

Veal

38,5

114,0

Swiss

Mutton

26,5

78,0

cheese

Pork

41,2

123,0

Chicken eggs

Smoked vet

Caviar

Ranks

17,6

51,0

Potatoes

2,6

6,0

Meat broth,

Carrots

Cooked in

Salad

3,0

9,0

Current 2 h

15,9

'45,0

Bread white

Language

176,0

61,0

Bread Black Traces

Tracks

Brain

830,0

990,0

Groats greek

Beef liver

93,5

279,0

Vai

beef kidney

80,4

240,0

Croup perlovaya

Chicken

29,0

87,0

rice

Goose

33,8

990,0

Millet

Cod

28,7

114,0

Oat flour

Zander

45,8

135,0

Apples

Pike

48,5

144,0

G crashes

Herring

69,0

207,0

plums

sprat

82,9

248,0

Apricots

Sardinы

118,2

354,0

oranges

FRESH pods

27,0

81,0

Grapes

legumes

hazelnuts

Peas

18,0

54,0

Walnuts

White mushrooms

18,4

54,0

Color capus

and

8,4

24,0

Spinach

24,4

72,0


It is forbidden to consume alcoholic beverages, pickles, smoked meats, canned foods, spicy snacks, spices (mustard, pepper, horseradish).

Thus, in case of urolithiasis, a mainly milk-vegetable diet is recommended (No. 6). Allowed milk and dairy products, vegetables (except for the above), fruit; flour and cereals, jam, honey, sugar, butter and vegetable oils, weak tea; from spices - vinegar, bay leaf. It is allowed to eat boiled meat and fish 2 — 3 times a week.

In the presence of phosphate stones (urine is alkaline, a large amount of calcium is removed), patients need a diet aimed at acidifying the urine. Assign predominantly meat food. Milk is excluded from the diet. In addition to meat, it is recommended to use boiled fish, lard, flour dishes, vegetable fats. In limited quantities, it is allowed to use vegetables that are poor in calcium and alkaline substances (pumpkin, legumes, Brussels sprouts, asparagus), as well as berries and fruits containing acidic substances (red currants, lingonberries, cranberries, sour apples). The set of recommended products in this case corresponds to the medical diet number 14.

With oxalate stones, dietary treatment consists in limiting the administration of oxalic acid. Foods rich in shavey acid (sorrel, lettuce, spinach, rhubarb, legumes, radishes, beets, gooseberries, cranberries, apples Antonovka, figs, red currants, blueberries, parsley, cocoa, strong tea, chocolate) are excluded from use. The introduction of salts of oxalic acid from the body contributes to the introduction into the diet of pears, yayvah, apples, cornel, infusion of black currant leaves, grapes, pear tree, fruit peel. Allowed to use: black and white bread (without a crust), animal fats and vegetable oils, cereals, dough, sugar, honey, vegetables (potatoes, colored and white cabbage, carrots, cucumbers, turnips, mushrooms, tomatoes, green peas, watermelons, melons), vegetarian soups, fruits (apricots, peaches, grapes, wild rose, cherries, black currants, etc.), in limited quantities - boiled meat, fish, poultry, eggs, bay leaf, onion, garlic.

For all types of stone formation, it is advisable to reduce the use of edible salt, as it increases the saturation of urine and reduces the solubility of other salts. The introduction of fluid reduces the concentration of salts in the urine, contributes to a better solubility of substances forming stones. In the absence of disturbances in the functional activity of the cardiovascular system and kidneys, it is recommended to use a lot of fluids: boiled water, low-mineralized mineral waters. The diuretic effect of bearberry broths ("bear ears"), horsetail, corn stigmas, watermelons have a diuretic effect.

Increase urine excretion and change its reaction mineral waters. Alkaline mineral waters are recommended for urine acid diathesis (Essentuki No. 4 and No. 17, Smirnovskaya, Slavyanovskaya, Borjomi). Low-mineralized waters are shown to patients with oxalate stones (Essentuki No. 20, Naftusia, Sairme). When phosphate stones, it is advisable to use mineral waters that promote acidification of urine (Dolomitic narzan, Naftusi, Arzni). For all types of urinary stones, spa treatment is shown in Truskavets and Sairme.

Diet treatment of chronic renal failure

In chronic renal failure in the stage when excretion of the products of protein metabolism is not disturbed, the principle of nutrition is reduced to those basic provisions that are provided for by diet No. 7.

The amount of protein in the diet should be limited depending on the severity of renal failure (up to 0,4 — 0,6 g per 1 kg of body weight per day). It is recommended to use mainly plant-derived proteins, whose metabolic products are easily excreted. In addition, plant products contribute to alkalization of the body. Sufficient energy value of the daily diet is provided by increasing the content of carbohydrates and fats in it.

In the absence of edema, the use of 4 — 5 g daily of edible salt is permitted. Fluid intake is not limited, and with increased urine output even increases - to the volume corresponding to the daily excretion, plus 500 ml. For the prevention of anemia, often associated with this disease, recommend the inclusion in the diet of salads, potatoes, apples, tomatoes, oatmeal and pearl barley.

The diet of Giordano-Giovanetti modified by V.N. Petrov deserves attention:

1. breakfast. Boiled potatoes - 200 g. Egg - 1 pcs. Tea with sugar. Jam (honey) - 50 g.

2 breakfast. Sour cream - 100 g. Tea with sugar.

Lunch. Rice soup - 300 g (butter - 5 g, sour cream - 20 g, potatoes - 100 g, carrots - 20 g, rice - 30 g, onion - 5 g). Vegetable stew - 5 g (butter - 200 g, carrots - 10 g, beet - 70 g, rutabagas - 100 g). Fresh apple jelly - 100

Dinner. Rice porridge - 200 g (rice - 50 g, sugar - 5 g, milk - 100 g, butter - 5 g) Tea with sugar. Jam (honey) - 50 g.

Every morning the patient receives on hands: 70 g butter, 100 g sugar, 1 grams of tea, 1 egg.


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