Abstract: Medical nutrition for various diseases. Healing nutrition: Organization, Principles, Diets Medical Nutrition for various diseases
Ministry of Education and Science of the Russian Federation
GOU SPO "Kirov Aviation Technical School"
Abstract on the discipline "Physical Culture"
"Therapeutic nutrition for various diseases"
Work completed
student 3 courses, gr. M-31
Kropacheva Veronica Aleksandrovna
Specialty: 080501 "Management"
Introduction ................................................................................. ... 3
Chapter I. Principles of rational nutrition for diseases of the musculoskeletal system ............................................................... ... 4
Chapter II. Healing nutrition for diseases of the respiratory organs ............ .... 6
Chapter III. Nutrition for diseases of the cardiovascular system ............ 10
Chapter IV. Diet therapy of patients with stomach diseases .................. .13
Chapter V. Products activating the immune system ..................... ... 16
Conclusion .............................................................................. ..19.
Bibliographic list ............................................................ 20
Introduction
People have long understood that it is necessary to avoid frills in food and drink, in order to preserve health. Food of our ancestors was more useful than now, and, undoubtedly, more natural. In the process of cooking, preservatives, thickeners, dyes and other chemicals have not been used to improve taste and storage time.
The modern person has much more difficult, because to choose environmentally friendly, natural products, especially the residents of the metropolis, has become almost impossible. However, over the number and quality of meals, it is vital. One wise person is not in vain said that "the knife and fork we swarm the grave," and this popular statement is quite fair.
Following the principles of rational nutrition will help more actively fight the body with ill and faster to achieve recovery. It will also be good prevention.
Chapter I. Principles of rational nutrition for diseases of the musculoskeletal system
Our food has an impact on the whole organism, the basis of which is the bone system. For patients suffering from inflammatory or degenerative diseases of the musculoskeletal system, proper nutrition is especially important.
Principles of rational nutrition for diseases of the musculoskeletal system:
1. Limit the intake of salt and sugar. It is no longer a secret that the salt and sugar actually act on the segments of the musculoskeletal system, so these nutritional supplements should be significantly limited, replacing sugar with honey or fructose to the maximum, and the salt is dried sea cabbage. Honey and fructose are much sweeter than sugar, but at the same time do not have in small quantities of negative impact on health. For example, honey removes harmful salts from the body, slags. Salt, people who have diseases of the musculoskeletal system are needed in the daily amount of 5-7 g., And in some cases there is also a residual diet (short courses in 14-21 days).
2. Refuse to preservatives. Persons suffering from diseases of the musculoskeletal system, it is better to completely abandon canned products. It is possible to maintain useful vegetables and fruits by deep freezing in the refrigeration chamber.
3. Exclude products that harm the joints. Fat sausages, smoked, sausage cheese, strong meat and fish broths preferably exclude from their diet. Preferences need to be given to dairy and vegetable soups, low-fat varieties of meat and fish, vegetables, bean, cereals, nuts.
4. Do not eat caffeine. Tea and coffee is advisable to replace freshly squeezed juices, champs and ribs, milk and dairy drinks.
5. Prepare as much as you can eat at a time. Food should be prepared for one reception, because When storing food loses its nutritional value.
6. Observe the drinking mode. It is advisable to drink at least 2 liters of water per day. It is necessary to drink 1-2 hours before meals or as much time after meals, because the excessive fluid flow dilutes the digestive juices and food is bad and long digends in the intestine, thereby loading all the body systems.
7. Do not interfere with many products in one meal. Supporters of separate nutrition successfully proved that combinations of some products (for example, meat and bread, meat and potatoes, sugar and flour, etc.) are well on the body. For example, it is not desirable to use desserts after the main meal - fruits and sweets eat as the main dish.
8. Experiment with the mind. In the nutrition, you can experiment, but it is better to do this under the guidance of your attending physician. One is suitable for separate meals, the other is vegetarianism, and the third will prefer raw food. We are all different, therefore it is not worth blindly following some systems or standards, and it is better to try to choose elements from different schools for themselves, most fully meet the needs of the body and mental preferences. No extremes in nutrition.
9. Apply diet with caution. Diets differ from the power supply systems by the fact that they are temporary in nature and are usually canceled during status normalization.
10. Use products that contribute to the restoration of cartilage, joint tissue and bones. For example, patients with degenerative-dystrophic diseases of the joints are recommended more often by jelly, cold, products containing chitin (crayfish, shrimp, etc.).
Chapter II. Healing nutrition for diseases of the respiratory organs
Currently, respiratory diseases are among the most common. Doctors around the world work on this problem, creating all new medicines. However, for successful recovery is not enough to take medicines. You still need to lead a healthy lifestyle and eat right. At the same time, it is the full and proper nutrition that does not only provide a person with all the necessary substances, but also gives forces to combat diseases.
Medical nutrition for diseases of the upper respiratory tract (sore throat, bronchitis, pharyngitis, ORVI and influenza):
As a rule, suffering from the diseases of the upper respiratory tract, in which inflammation of the nasopharmaceous mucous membranes is noted, it is difficult and painfully perform swallowing movements.
Food should not have traumatic action on one or another affected organ of the upper respiratory tract, be it almond, throat, soft sky, etc. It should not be very cold or very hot. From the edible diet should be eliminated by coarse food - black bread, meat of a piece, raw vegetables and fruits, crumbly cereals, fried dishes. All food prepare boiled or finely chopped.
Healing nutrition when inflammation of the lungs:
It is necessary to fully, calorie meals with an increased free liquid content. Frequent and fractional meals are recommended, including meat, fish, cottage cheese, eggs, fruit and vegetable juices, cranberry juice, fruits and berries, lemon tea, milk, kisyli, etc. When restricting the cook salt and refined carbohydrates.
The diet should consist of products with an increased amount of vitamins (especially groups B, C, P) and also include products with antifungal action, such as blueberries, oranges, tangerines, lemons, grapefruits.
During the recovery period, the need for abundant drink disappears, but the protein content in the diet should be increased.
Diet and therapy for bronchial asthma:
The main purpose of therapeutic nutrition becomes a decrease in the allergic mood of the patient, which is facilitated by the so-called hypoallergenic diets.
An important value for bronchial asthma also has a full and diverse nutrition, which should include a sufficient amount of proteins, mostly animals (meat, fish, milk, lactic acid drinks, cottage cheese, cheese, etc.). However, it should be remembered that it is protein structures most often cause allergic reactions capable of provoking the attack. Allergens can be fish, crabs, caviar, eggs, sometimes meat.
With regard to fats, restrictions primarily relate to ram, pork, beef and combined fat. Creamy oil, sour cream, cream, vegetable oil can be used without restrictions both in natural form and in dishes. It is necessary to restrict a few and carbohydrates, introducing more easily-friendly from them into the diet, that is, you should use vegetables, fruits, berries, juices. It should be limited to the use of a cook salt, and when edema appears, which indicates a circulatory impairment, it is necessary to reduce the amount of liquid from up to 1-1.5 liters per day and turn on the daily diet rich in calcium, potassium, since calcium salts have anti-inflammatory and Antiallergic action. These products include primarily milk and various lactic acid drinks, cottage cheese, unsheatteric cheese, etc. Patients suffering from bronchial asthma should be excluded from diet products containing a large amount of oxalic acid, since the latter contributes to the elimination of calcium from the body. In a large amount of oxalic acid, it contains sorrel, spinach, salad, cocoa and trouser. It is also necessary to limit the use of products that increase the excitability of the central nervous system: strong tea, coffee, cocoa, welded broths, sharp snacks, spices, marinades, herring, etc.
Medicinal nutrition with tuberculosis:
Diet therapy is aimed at improving the protective forces of the body, stimulation of reparative processes, normalization of exchange disorders, restoration of impaired functions and a decrease in hypergic reactions.
Therapeutic nutrition should be based on the localization, the nature of the process, the state of the digestive organs, the respancies and the lifestyle of the patient, concomitant diseases and complications, the functional state of the affected organs.
Due to the enhanced protein decay, an increased amount of protein was shown in the diet (during the exacerbation - up to 2.5 g and outside the exacerbation of the tuberculosis process - to 1.5-2 g per 1 kg of body weight), which helps to increase the resistance of the body of tuberculosis infection . Not less than half of the amount of proteins should be animal origin (meat, fish, eggs, milk, cottage cheese, etc.).
Outside the exacerbation of the tuberculosis process should provide the body with a normal amount of carbohydrates, and when the process is activated, it is recommended to reduce their content in the diet, which has an anti-inflammatory effect. Restricting carbohydrates, especially easily-friendly (sugar, honey, jam, etc.), also shown in impairment of nervous regulation.
Previously practiced use of a large amount of fat is not recommended, as it has a negative impact on the body. Excess fat in the diet contributes to an acidotic acid shift, it makes it difficult to the activity of digestive organs, causes diarrhea, liver body infiltration, inhibits the already often reduced secretion of the stomach and appetite. Currently, the feasibility of some limitation of the number of fats in the diet during the intensification of the tuberculosis process and the normal number of fats in the remission phase is substantiated.
It should be preferred to butter and vegetable fats. The latter are the main source of essential fatty acids.
It is prohibited annoying food (sharp, salted, pickled, sauer-food, mustard, pepper, vinegar, horseradish, cold and hot dishes). It is recommended that the use of mucous soups, fastening frozen broths, liquid dairy cas, non-crushed potato mashed potatoes, milk, fastening coffee, tea with milk.
Recommended in the cooled form of kisins, fruit and berry jelly, rubbed cottage cheese with milk, cream, egg skey, liquid semolina milk porridge, cool drink (tomato juice, acidic lemon water, etc.).
Chapter III. Nutrition for diseases of the cardiovascular system
With diseases of the cardiovascular system, therapeutic nutrition plays a significant role.
In one case, it is aimed at ensuring the heart muscle with energy and plastic material, in the other - it is capable of rendering an anti-inflammatory effect, in the third - anti-allergic.
In nutritional diseases, the amount of sodium and fluid consumption should be moderately limited, the content of substances exciting cardiovascular and nervous systems, internal organs should be moderately limited.
The purpose of this nutrition is to help improve blood circulation, cardiovascular system, liver, kidneys, metabolic normalization.
1. Bread and flour products . Wheat bread from the flour of the 1st and 2nd varieties of yesterday's baking or slightly dried, dietary baking bread. Not biscuits and biscuit.
Exclude fresh bread, products from a juice and puff pastry, pancakes, pancakes.
2. Soup 250-400 g . Vegetarian with different croups, potatoes, vegetables (better crushed), dairy, fruit, cold beetter. Soups are squeezed by sour cream, lemon acid, greens.
Exclude Soups from legumes, meat, fish, mushroom broths.
3. Meat. Non fatty varieties of beef, veal, meat pork, rabbit, chicken, turkey. After stripping from the tendons, the meat is boiled, and then rushing or roasted. Dishes made of chopped or lumpy boiled meat, filled with boiled meat. Limited: "Doctoral" and "dietary" sausages.
Eliminate greasy varieties of meat, goose, duck, liver, kidneys, brains, smoked, sausages, canned meat.
4. Fish . Not fatty and moderately fatty views, boiled or subsequent roasting, piece and chopped. Dishes from boiled non-fish products of the sea.
Solve fatty types of fish, salt, smoked, canned food.
5. Dairy products . Milk (with portability), fermented milk drinks, cottage cheese and dishes with croups, carrots, fruit. Limited: sour cream and cream (only in dishes), cheese.
Salt and fatty cheeses are excluded.
6. Eggs. 2-3 pieces per week - skeyka or in the form of protein omelets.
7. Circles . Dishes from various croup prepared on water or milk (porridge, baked puddings, etc.). Boiled pasta.
Exclude legumes.
8. Vegetables. Potatoes, cauliflower, carrots, beets, zucchini, pumpkin, tomatoes, salad, cucumbers. In boiled, baked, less rare form. White cabbage and green peas are limited, green onions, dill, parsley is added to the dishes.
Salted salty, pickled, quashed vegetables, spinach, sorrel. Radish, radishes, onions, mushrooms.
9. Snacks. Fresh vegetable salad (grated carrots, tomatoes, cucumbers), winegirls, with vegetable oil, vegetable caviar, fruit salads, with seafood. Boiled fish, fuel.
Exclude sharp, fatty and salty snacks, smoked, caviar.
10. Fruits, Sweet dishes, sweets . Soft, ripe fruit and berries in fresh form, dried fruits, compotes, kisins, mousses, samboys, jelly, dairy kisins and creams, honey, jam, chocolate candies, limited chocolate.
Fruits with coarse tissue, cream products, ice cream are excluded.
11. Sauces and spices. On vegetable brave, sour cream, dairy, tomato, onion made of dilated and roasted onions, fruit gravy. Bay leaf, vanillin, cinnamon, citric acid.
Exclude sauces on meat, fish and mushroom brave, mustard, pepper, sharp ketchup.
12. Drinks. Sustained tea with lemon or milk, fastening natural coffee, coffee drinks, vegetable, fruit and berry juices, decoction of rose and wheat bran. Limited - grape juice.
Exclude Strong tea and coffee, cocoa, alcoholic beverages, carbonated drinks.
13. Fats. Do not saline butter, non-salted soft margarine, vegetable oil in natural form.
Exclude meat and culinary fats.
Chapter IV. Diet therapy of patients with gastric diseases
With dietotherapy of patients with stomach diseases, it is necessary to take into account the influence of food products and methods of their culinary treatment on a secretory (selection of gastric juice, hydrochloric acid, pepsin) and motor (motor-evacuator) of the stomach.
The strength of the secretion of the stomach includes the following foods and dishes:
1) with extractive substances meat and fish broths, champs of mushrooms and vegetables;
2) all fried dishes;
3) stew meat and fish in their own juice;
4) meat, fish, mushroom, tomato sauces;
5) saline or smoked meat and fish products;
6) Salted, pickled and sauer vegetables and fruits;
7) meat snack bars, fish and vegetable canned food, especially with tomato fill;
8) boiled boiled eggs, especially yolk;
9) rye bread and products from a dough;
10) acidic and insufficiently ripe fruits and berries;
11) Spicy vegetables, spices and seasonings;
12) fermented dairy products with increased acidity, skimmed milk and dairy serum;
13) non-freight or superheated food fats;
14) coffee, especially black; All drinks containing carbon dioxide (kvass, carbonated water, etc.) and alcohol.
Weak stomach secretions include the following food and dishes:
1) mucous soups from cereals;
2) Milk soups with cropped rubbing;
3) rubbed vegetable soups on a weak branch of vegetables;
4) boiled chopped or rubbed meat and boiled fish;
5) puree of boiled vegetables (potatoes, carrots, cauliflower, zucchini, etc.);
6) Cooked egg sick, steam omelets and whipped egg whites;
7) whole milk and cream;
8) Fresh gentle witchcraft, especially fresh or calcined;
9) liquid dairy, semi-naked well-strained, as well as rubbed porridges;
10) Bread from wheat flour of the highest and first grade of yesterday's baking or drunk in the oven;
11) Kissels, mousses, jelly from sweet fruits or their juices, puree of sweet, ripe fruits;
12) alkaline mineral waters without carbon dioxide;
13) fastening tea, especially with milk;
14) Freshly creamy and refined vegetable oil in kind.
The most quickly digested and leaves the stomach liquid, jelly and puree, as well as cascidious food. These types of food have a minimal mechanical effect on the stomach compared with solid food, which is slowly digested and evacuated from the stomach. Dishes prepared by frying or baking with a crust are digested longer and have a greater mechanical impact than boiled in water or a pair. The mechanically irritant effect on the stomach is provided by products containing many dietary fibers rich in rough fiber (beans, bread from coarse grinding, croups of solid grain, nuts, some vegetables, fruits and berries), as well as rich connective tissue - meat with fascia and Tenders, skin of fish and birds.
The lowest impact on the gastric mucous membrane render dishes, the temperature of which is close to that in the stomach, - 37 o C. Dishes, the temperature of which is above 60 to 62 o C, can have an irritant effect on the gastric mucous membrane and delay food evacuation from it. Warm dishes and drinks leave the stomach faster than cold (below 15 o C). They negatively act on the secretory and motor functions of the stomach. Large volumes of fees taken, therefore, with sharp or exacerbation of chronic stomach diseases, food is obtained by frequent, fractional portions, distributing the daily mass of the diet to 5-6 receptions.
Chapter V. Products Activant Immunist System
1. Green tea.
Studies have shown that green tea (saturated with antioxidants) reduces the risk of majority of cancer types. "Fitoddavders in tea maintains the growth and development of intestinal bacteria," says Bowerman. "They delay the growth of bad bacteria (intestinal sticks, salmonella), and useful bacteria are left intact."
Why is it so important? "Up to 70% of the immune system is located in the digestive tract," says Susan Bowerman, Deputy Director of the Center for Food at the University of California in Los Angeles. "Four cups per day will support the immune system at the peak of its effective performance."
2. Chilean pepper.
"Chilean pepper stimulates the metabolic processes, works as a natural anticoagulant and helps free endorphins," says Gunnar Petersen, a certified specialist in hardening and strengthening the body. Plus Chilean pepper - a wonderful way to add a highlight to the dish, without fearing to increase the amount of extra calories or fat.
Chilean pepper is rich in beta-carotene, which in blood turns into vitamin A and struggles with infections, as well as capsaycin, overwhelming neuropeptides (elements that cause inflammatory processes).
A recent study that was published in the journal the study of cancer, showed that Chilean pepper has anti-staming properties. All this can be kept, eating a daily floor of red pepper (or one teaspoon of dried pepper).
3. Ginger.
Contrary to the emerging opinion that ginger, piquant seasoning to Asian dishes, is a root, but this is the basis containing the living elements that improve our health. The main element is a substance that is intensively struggling with cancer.
Studies have shown that this substance is particularly effectively in the fight against the colon cancer. Ginger can be added with pieces, and in crushed form in fish or chicken. The more ginger, the better.
4. Blueberry.
"This berry can help avoid many diseases, ranging from cancer and ending with heart disease," says Ryan Endruc, head of human nutrition research, Toronto, Canada.
In one portion (100 g) of antioxidants more than in any other fruit. Sprinkle with lemon juice and mix with strawberries - and the dish is ready. It climbs hunger, and will be prevented from many diseases.
5. Cinnamon.
It is added to sweet desserts and indian dishes. Cinnamon is rich in antioxidants, which delay blood clotting and the growth of bacteria (including those that cause abnormal breathing).
"Studies have shown that cinnamon helps stabilize blood sugar levels, by this reducing the likelihood of type 2 diabetes disease," says Nancy Clark's nutritionist, author of Nancy Clark's sports nutrition. "And cinnamon helps to reduce the level of poor cholesterol. Try daily to add a tea spoon to yogurt or porridge. "
6. Sweet potatoes (Batat).
It is often confused with a yams. This tuber is one of the most useful products on the planet. Also, this tuber struggles with the negative effect of passive smoking and is the prevention of diabetes, the batt contains glutathion, an antioxidant that improves the metabolic processes and the general state of the immune system.
It protects against diseases such as Alzheimer's disease, Parkinson, liver diseases, fibrosis, HIV, cancer, heart attack and stroke. "One batt per day is a good alternative to traditional prevention methods," Clark says.
7. Tomato.
"I think that tomatoes are an effective assistant in the fight against herpes," says Petersen. Contained in tomatoes, lycopene helps protect against degenerative diseases. "Cooked tomatoes and tomato paste work best," says Petersen. Take half tomato or 350-550 g of tomato juice per day.
It contains a large number of potassium, manganese and antioxidants. This fruit helps maintain the right pH body level, which makes it difficult to penetrate the pathogens inside the body.
Also, fibers in figs reduce the level of insulin and blood sugar, by this reducing the risk of diabetes and metabolic syndrome. It is better to choose a dark-color fig (in such fruits there are more nutrients) and is separate from other products or add to the dry mixture. Fig is a fast and easy way to strengthen the immune system. It is necessary to eat at least 4 pieces of figs per week.
9. Mushrooms (Schitaki, Mushroom Baran).
Very tasty, especially with brown rice or quinoa. In mushrooms, a large amount of Ergotioneen antioxidant, protecting cells from improper growth and development. "In short, they reduce the risk of cancer," - says Bowerman, which advises, there is a half-hour fungi one or twice a week.
10. Pomegranate.
The juice from this fruit with many seeds reduces the risk of developing many types of cancer due to the content of polyphenol, which is called ellagatinine (which gives juice such a unique color).
"Drink a glass of juice per day," recommends Bowerman.
Conclusion
In the treatment of various diseases, a large role is assigned to the correct nutrition of patients. It is with food that people get a majority of all the nutrients they need: proteins, fats, carbohydrates, vitamins and mineral salts.
It should also be borne in mind that the treatment of one disease often leads to various complications, violation of the functions of other organs. As a rule, attending physicians observing the patient are prescribed to the patient, along with therapeutic drugs, the corresponding diet.
Therapeutic nutrition not only helps to normalize a number of processes in the body, but also enhances the effect of treatment, reduces side effects from a number of drugs, improves metabolic processes and helps the body cope with the disease.
Of course, therapeutic nutrition is not the only way to combat the disease, but, most often, will be a necessary component for the treatment of the disease.
Thus, it is necessary to remove much attention to therapeutic nutrition. It is known that a properly compiled, balanced diet rich in all necessary substances is the basis of treatment as a whole.
Bibliographic list
- http://www.drdautov.ru/pitanie/1_1.htm
- http: //10diet.net.html
- http://www.inflora.ru/.html
- Mazne N.I. Encyclopedia of traditional medicine. Ed. 8th, copy. and add. - M.: Martin, 2004. - 416c.
- http://www.fictionbook.ru.
About the principal difference in the perception of the same things with men and women written entire treatises. However, the difference in duty nutrition has been practically not discussed. And in vain, because representatives of both sexes are distinguished not only by primary and secondary sexual signs, but also a hormonal system, and genetics. As a result, women suffer from one diseases, and men are others.
Food for men
Scientists spent not one dozen studies in the field of male food. As a result, they managed to establish that a competent approach to the choice of products allows men after 30 years to keep well-being, the vigor of the spirit and strength. And also to protect yourself from some diseases that are most often exposed. Among them: prostate cancer, hypertension, heart attacks and diseases of the cardiovascular system.
Food for a set of muscle mass
A beautiful, muscular body is the subject of dreams of many people. Days are spent in gym and fitness centers, constantly working on themselves and trying to finally embody all their dreams into reality. However, as not paradoxically, it sounds, but the miracle does not happen. Muscular weight is not just not increasing, but also decreases. About the causes of such phenomena, which most often lick in an incorrectly selected diet, are told in their publications scientists, nutritionists and coaches with world name.
Food for height
The problem of small growth complicates the lives of many people. The proof of this is not only the reports of psychologists, but also hundreds of new questions to those skilled in the arts left on forums and sites on medicine and sports. People of most different ages are interested in whether it is possible to "deceive" nature and increase their actual growth at least a couple of centimeters.
Products Energy
Are you experiencing an overwhelming sense of fatigue, drowsiness and decay of forces already to dinner or worse - immediately after awakening? You clearly lack energy. In order to get it, it is not necessary to drink an enyny cup of coffee or resort to the help of drink energy. Much more wisely, revise your diet and remove products from it, carrying vitality and vigor, and add those that give them.
Food for improving metabolism
Many of us are first faced with the concept of metabolism only when they appear sharp need to quickly and easily lose weight. Of course, this makes sense. But, do you know that not only the speed of weight loss, but also the quality of our life depends on metabolism.
Food to reduce cholesterol
Fashion for a healthy lifestyle is steadily growing every year. Increasingly, people are thinking about the benefits of regular physical exertion, and the quality of their food. An integral component of it is the consumption of special products capable of normalizing blood cholesterol.
Antibiotic food
The history of antibiotics takes its origins in the 1920s, when Penicillin was opened for the first time Alexander Fleming. It is with his appearance about natural antibiotics for some reason forgotten. And remembering just a few decid years ago, only when the public began to bravely discuss the detrimental effect of such medicines on the human body. And look for ways to replace them. As it turned out, it is not necessary to go far for them.
Food for thickening thirst
The strongest feeling of thirst at some point is experiencing every person. It can appear not only in summer, but also in winter, especially if it is preceded by intense physical exertion. As a rule, in order to get rid of it enough to drink a glass of water. It will make it possible to fill the lost fluid in the body, the lack of which causes such sensations. But what if it won't be at hand?
Food against headaches
What a new or pulsating headache, perhaps, knows every person. According to recently published statistical data, about 70 million people suffer from chronic headaches. At the same time, some try to get rid of it with the help of medicines, others - just survive, and the third - to find true ways to prevent and relieve in everyday life, for example, with the help of ordinary food.
Food for voice
Do you know that a beautiful voice presented to you by nature requires care and care? And they consist not only in the prevention and treatment of diseases of the throat and voice ligaments, but also in ensuring proper nutrition, especially if you are singing or often proclaim speeches in front of a huge audience. About how it should be, well-known physiologists and nutritionists write.
Food for calming nerves
The state of the nervous system has a direct effect of substances that enter the human body along with food. After carefully examining them, scientists presented a list of vitamins, microelements and organic compounds, the use of which will eliminate the nervous system as the safest and natural way.
Food with PMS.
Russian sociologists argue that with the concept of PMS, one way or another faces almost 90% of women aged 13 to 50 years. In this case, 10% of them observed especially pronounced symptoms. But, the most amazing thing is that most of them do not fight this condition, mistaken it naturally. But the doctors say that many SMITs of PMS can be easily delighted, simply by adjusting their diet.
Food for conception
Children are flowers of life. This is our joy and weakness. We immemberously love them and endlessly dreaming about them. But we can not always conceive. The most interesting thing is that the reasons for this often lick not so much in health problems that are in women or men, as in their diet. Moreover, in this case, it is necessary for the performance of the cherished dreams quite a bit: to remove some products from it, replacing them with others.
Food during pregnancy
The health of the future child is directly dependent on the quality and number of eaten during pregnancy. Remembering this, many future mothers try to make fundamental changes to their lifestyle and in food. And everything would be nothing, just in pursuit of perfection, they often fall into extremes. On how to avoid fatal errors, keep wonderful well-being and make an invaluable contribution to the health of the baby, simply by adjusting your diet, leading pediatricians and nutritionists are told in their publications.
Food for nursing mothers
It's no secret that everything eaten by a nursing mom falls into the child's body. On some products, it can react violently, for example, a rash or intestinal colic, to others is neutral. But they all, one way or another, affect its growth and development. That is why many pediatricians advise to revise their diet during feeding, especially if earlier it was far from the right one. And it is harmful or poor-quality products from it, replacing them with useful and secure.
Food for children
It is said that the profession of parents is the hardest in the world. And it is difficult to disagree with this. After all, on their shoulders, overnight, there are a number of problems, each of which seems terrible than the previous ones. The success of their solutions often depends on the experience and knowledge of medicine, nutrition, pedagogy, ethics and other sciences, and the result directly affects the future of the baby. To somehow facilitate this difficult work, we also collected the recommendations of famous practitioners from children's nutrition.
Food with sex maturation
We are interested in nutrition issues with sexual maturations, and their parents themselves are interested. Most often, this is due to the desire of the first to get rid of the problems with the figure, which may arise during this period, and the desire of the second sincerely help their children will slander him in painlessly.
Food to improve memory
The fact that human memory, whatever wonderful it, will deteriorate over time, everyone knows everything. And about what is happening for various reasons, most often physiological, absolutely everyone knows everything. However, not every person is ready to put up with such a state of affairs. This article is a kind of review of the most effective, from the point of view of leading nutritionists and physiologists of the planet, ways to improve memory.
Diuretic products (diuretics)
A good diuretik can not only save the swelling, but also to reduce pressure, and to get rid of excess weight, without causing harm to the body. And you do not need to go for him. The most efficient and widely demanded diuretics are most often waiting in our hour in our kitchen. Just not everyone knows about them.
Food for cleansing colon
It is said that a pure intestine is a pledge of strong immunity. And the key to health, excellent well-being, youth, beauty and good mood! That is why the methods of his cleansing, scientists dedicated not one scientific publication, painting the causes and consequences of a similar phenomenon. Meanwhile, nutritionists assure that, in fact, the colon cleansing can be performed independently. All that is needed for this is to introduce the right food in your diet.
Increase performance, improve memory and concentration, and can also be more intelligent and attentive in periods of large mental loads. To do this, it is enough to introduce a complex of special products responsible for the work of the brain. Interestingly, they will also help to establish sleep, get rid of irritability, stress and significantly improve the quality of your life.
It is difficult to believe, but large physical exertion is not a reason to abandon old good fats and carbohydrates in favor of protein food. On the contrary, this is the reason to seriously revise its diet, the most variety of it. And add healthy and right products to it. Those who will not just be able to give strength and energy, but also allow to do more and, as a result, achieve sports heights faster.
Food to improve sight
Recently, ophthalmologists of the whole world beat the alarm: more and more people of different ages face the problems of impaired view. Moreover, the diseases of the eye "younger", amazing even small citizens. The question arises - can food affect eye health and improve it?
Food for improving immunity
For our immunity, winter is a difficult reliability test. After all, the shortage of the Sun, a sharp cooling, air is cut inside the heated premises create favorable conditions for the growth of viruses and bacteria that cause seasonal diseases. They are infinitely "attacking" our organism and weaken the immune system. As a result, at some point she does not cope and the person gets ill. But this could be avoided by simply adding special products to its diet.
Food for weight loss
Some are sure that weight loss is impossible without a tight diet. Others are convinced that in order to achieve the desired results and forms, only a small restriction in food is sufficient. Nevertheless, our article is written specifically for third. Those who do not accept either the infringement of their own rights and freedoms, nor, even more so, no prohibitions in nutrition, but at the same time it always wants to remain the most slender, tightened and most attractive.
Food for weight gain
At the time when most of the world's population is looking for effective ways to deal with overweight, there are still people who dream to dial it. And there may be several reasons for any. For example, an excessive thinness of women who prevents them from getting pregnant or too small weight of the men who they want to increase to become more statutory and beautiful. And sometimes banal diseases that are frequent satellites of a depleted and weakened organism.
Aphrodisiac products for women
On the existence of special foods that are able to make the sex life of both sexes are brighter and rich, knew from time immemorial. These knowledge was kept carefully and passed from generation to generation. Despite the fact that they used to be available only to units - nobility and priests, in our time, everyone can familiar with their list.
Aphrodisiac products for men
Scientists argue that almost all men aged from 16 to 60 years are subject to problems with libido. This can be promoted by a number of factors, including diseases, and the negative impact of the environment. However, in any case, it is not necessary to despair. It is enough just to revise your diet. Perhaps the organism does not receive the necessary substances that support libido at the proper level.
Food down pressure
The key role of products is to ensure that such substances contribute to the body that would help him function correctly, including reducing pressure, if necessary, or, on the contrary, increasing it. Recently, many scientists have been developing a special menu for hypertensive.
Therapeutic food is part of the complex of all therapeutic procedures and manipulations applied to the patient with any disease. The power and menu mode is the base on which the patient's treatment plan is built. For a medical sister, it is important to know the principles of therapeutic nutrition for its proper organization and timely competent control.
The basic need of the body
Before talking about what kind of healing nutrition, remember the aza. For normal life, human body requires interaction with an external environment in the form of metabolism. To live, a person consumes oxygen, liquids and food products. Power is one of the basic needs of a person. The organism through food produces the necessary substances:
- proteins
- carbohydrates
- vitamins
- mineral compounds (micro and macroelements)
Proteins, fats, carbohydrates (BZH) with the participation in the metabolic processes of the body contribute to the release of energy, which is measured in calories.
1 calorie (1 channel) - the amount of heat (energy) required for heating 1 gram of water at 1 ° C (degrees Celsius)
1 Cylolaria (1 kcal) - the amount of heat required for heating 1 kilogram of water at 1 ° C (degrees Celsius)
The daily diet is based on the calorie content of food. A healthy person, depending on the lifestyle, is required from 1,700 to 4,000 kcal / day. Food is the basis of both "building material" to replace tissue cells and the source of energy to maintain the functioning of the body.
Diet Determines the multiplicity (numerical number) and the time of food intakes throughout the day, the duration of the intervals between them, the quantitative and qualitative distribution of the diet. The optimal break between the two meals - 4 hours, the big night break should be 10-11 hours. 2 hours before the deposit to sleep without special purpose, food should not be taken. 6-typosal food involves the following meals:
- Breakfast
- Lunch
- Afternoon person
- Late light dinner
Diet pattern
With deep antiquity, certain products and specially compiled rations were used as the treatment of patients. Since the beginning of the XIX century, Russian scientists began to approach nutrition issues from the point of view of the interaction of physiology, hygiene, chemical composition of food and its cooking technology.
Diet - diet, a certain set of dishes and products, selected, taking into account the condition of the patient's body.
Dietology - Science, learning the nutritional issues of a healthy and sick person. The principles of nutrition are based on knowledge about the causes of the occurrence, form and mechanism of the course of the disease, the peculiarities of digestive processes in healthy and sick people.
Medical nutrition (dietary) - component of complex treatment; Cooperating recovery nutrition organized taking into account the physiological needs of the patient.
Diet pattern - "Power Treatment", Power Application In order to therapeutic effects on a patient's body.
Manuel Isaakovich Pevzner, Russian therapist, one of the founders of nutrition and clinical gastroenterology, indicated that food for a sick person is the main background, on which the doctor can use other healing effects. Manuel Isaakovich founded a power system out of 15 healing tables (diets), which is used to this day.
To compile a healing diet, it is necessary to know the composition of food, its caloric content, the proportions of the components (proteins, fats, carbohydrates), the total number (daily diet). A specialist doctor who develops power and assigns a diet - nutritionist. Medical sister specializing in patient nutrition is a dietary dietary nurse ( nutritionist).
The principles of therapeutic nutrition
Conducting an important medical appointment - a diet, the doctor takes into account the mechanism for the development of the disease, the condition of the body, the work of exchange processes, the individual ability to absorb food. Some products and dishes are excluded due to poor digestibility, others - due to the ability to harm, but some products, on the contrary, are specifically prescribed for their useful influence (for example, to remove toxins from the body).
Volume, weight, consistency, food temperature is determined by a specific diet. The average mass of the daily diet is 3 kg. In therapeutic nutrition, the amount of food can often be increased or reduced due to liquid or plant fiber (non-spike carbohydrates).
- The diet must be directed to the exchange processes, contributing both to the treatment of the disease and the prevention of exacerbations of chronic processes.
- Strict adherence to the power mode: food intake is always at the same time, the multiplicity of food intake is compiled taking into account the disease and characteristics of the body.
- The diet should be diverse, satisfying the patient tastes within the diet. Monotonous nutrition contribute to a decrease in appetite and slowing the processes of digestion, which interferes with treatment.
- The diet is drawn up taking into account the individual characteristics of a particular patient, including accompanying diseases.
- When drafting a diet, calorie content and chemical composition of products and dishes taking into account the patient's energy consumption are taken into account.
- The use of the most appropriate culinary processing when cooking. Prepared dishes should be delicious, as well as - preserved the valuable properties of products.
- Each meal must end with the optimal filling of the stomach, causing a patient a sense of saturation without overcrowding.
If necessary, the principles of mechanical, chemical, thermal spurry apply during the preparation and supply of food. With mechanical genthes, dishes will be liquid, semi-liquid and masculine. Chemical spares implies an exception to hardly digestible and irritating dishes and products.
Food Organization in Medical Institutions
One of the most important segments of the provision of medical care in stationary medical institutions - in patients, or patients, should be rational food. The process of cooking, feeding, meal must be organized according to an existing regulatory framework. The main document at the same time - the order of the Ministry of Health of the Russian Federation of August 5, 2003 N 330 "On measures to improve therapeutic nutrition in therapeutic and preventive institutions of the Russian Federation". The norms are regulated by the document of the Ministry of Health of the Russian Federation of June 21, 2013 N 395n "On Approval of the Norms of Medical Power."
Responsible for diet food
Control over the organization of nutrition in medical institutions is a doctor on dietary nutrition, senior medical sister and dietistra. In the hospital departments, post-medical sisters each morning give the information of the senior nurse on the number of patients with diet numbers.
The eldest medical sister, in turn, reduces the data, summing up the number of tables. Then makes a portion requirement ("PORTEND"), which transfers the nurse on diet. A nutritionist, having received the portions from each branch, gives a general summary of the sophons. For newly received, especially in emergency testimony, information is transferred to the medical sister of the receiving department or the post nurse immediately after receiving the patient to the hospital.
Food in the department
In the kitchen of hospitals, a sanatorium or a preparing food on the basis of portion requirements. Employees of the buffet (distributors) or get food for separation on the food, or take the separations delivered directly to the buffet. Patients are fed in the dining room or in the wards. Before taking food, a medical sister must complete all manipulations with patients. If feeding occurs in the ward, you need to conduct ventilating. The patient needs to wash his hands.
For the optimal effect from therapeutic nutrition, external conditions for food intake are important. In the dining room should be clean, light, cozy. Tables are served neatly, employees involved in the process of feeding patients must have a neat-groomed appearance. Food is fed in warm form. Dishes should look appetizing and beautiful. During meals, patients should maintain a relaxed atmosphere.
After each meal is cleaning the tables and floor washing. Tables and chairs must have surfaces that can be wet cleaning and disinfecting with solutions. At the end of the working day, the tables need to be hot water in compliance with the rules of safety of labor. The dishes after use should be washed and disinteced according to Sanpin 2.1.3.2630-10 and SanPine 2.3.6.1079-01. Food waste is disposed of according to Sanpin 2.1.7.2790-10.
Therapeutic tables (diet)
For diseases of various organs and systems, as well as in a state after the operation, a specific diet is assigned (table). We present the number of dietary tables with testimony to the destination. In the future, consider each diet more.
- - postoperative period, precomath states
- , as well as No. 1A. and No. 1B - peptic disease such as the stomach and duodenal intestine; Exacerbation of chronic gastritis with stored secretory function
- Diet number 1 surgical - 4-5th day after surgery on the stomach, intestines; second day after appendectomy (the same as diet 0)
- and № 2A. - acute gastritis, colitis, enteritis during recovery period, chronic gastritis, colitis, enteritis without concomitant diseases of the digestive tract during remission period
- - chronic bowel diseases with propensions to constipation and in the presence of concomitant diseases of the digestive tract
- - Intestinal diseases are sharp and chronic during diarrhea
- - acute and chronic liver diseases, gallbladder and biliary tract
- - gout, the state of the bridge diathesis; Eritremia
- , № 7A, № 7B and № 7V. - acute jade, glomerulonephritis after strict discharge days and during recovery period; nephrotic syndrome and other chronic kidney disease
- - obesity in the absence of concomitant diseases of the digestive and cardiovascular system, requiring compliance with other diets
- - diabetes mellitus in the absence of concomitant diseases of internal organs and acidosis
-
Artificial nutrition
In some situations, the patient feeding naturally is impossible: with an unconscious state, mental diseases, injuries of the language, stenosis of the esophagus, states after surgery on the sip, esophagus and other problems. In such cases, food is carried out through the nasogastric probe or gastrostom. If it is impossible to introduce food in the stomach, nutrients are fed through the rectum or intravenous (parenteral nutrition).
During the day, the patient on artificial nutrition should get food with calorie content about 2000 kcal. At the same time, the relationship of BJV 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 prescribed in the form of injections (parenteral).
Through the probe or one is introduced only by liquid food: broth, milk, cream, melted butter, raw egg, vegetable soups (rubbed or mucous), liquid kisins, compotes, juices, fastening tea. Nutrient mixtures for artificial nutrition are prepared using standard recipes. There are also ready-made liquid mixtures, as well as dry, requiring dilution in the desired proportion.
Food distribution rules in hospital patients
- Food distributes the buffetric (distributor) together with a warded medical sister according to the portion of the requirement. Before the start of the distribution of food, they put the bathrobes labeled "for distribution of food", thoroughly wash their hands.
- Nonitars, occupied by the cleaning of premises, are not allowed to feed patients.
- Heavyly ill patients are obliged to feed a nurse. Feeding is carried out within the chamber, in the bed of the patient. Food for such patients delivers a buffet in a special table on wheels. Dirty utensils and food remnants immediately after feeding are taken out of the chamber in the washing buffet.
- Patients who are assigned the overall mode, take food in the dining room. Before taking food, all patients must wash their hands, and it controls the nurse.
We hope, after reading the article, readers have developed a picture of what the healing nutrition, as it is organized and what responsibility lies on the medical sister.
3. Therapeutic nutrition for diseases of the kidneys and urinary tract
4. Healing nutrition for diseases of the endocrine system
5. Therapeutic nutrition for metabolic diseases
6. Healing nutrition in rheumatic diseases
7. Medical nutrition in infectious diseases
8. Therapeutic nutrition of surgical patients
9. Medical nutrition
10. Rational and Medical Food
The basis of good well-being is healthy full nutrition.
Structure: Milk (4-5 glasses), mucous baking, such as manual, dairy or wheat bran soups with butter; Porridge liquid, rubbed, dairy; Eggs sick (2-3 times a day) or in the form of steam omelettes; steam souffle of skinny varieties of fish, meat; Creamless salted (70-80 g per day) or olive oil (add to dishes), cream; Berry's berry, fruit (non-acid) and dairy, carrot, fruit juice, wild rose, weak milk tea (sugar up to 50 g per day). Salt limit up to 5-8 g (remember that 3-5 g of salts are contained in products, 5-8 g - in bread), free fluid is not more than 1.5 liters. Additionally vitamins A, C, group B (B1, B2, PP). Feed meals under bed mode every 2-3 hours in a liquid and semi-liquid form, warm. With poor milk tolerance (teaching abdomen, diarrhea), it is recommended to give small amounts, diluting with weak tea.
Table N 1b. Shown when sinking aggravation of ulcerative disease and chronic gastritis with increased acidity
Structure: In addition to the dishes listed above, steam meat, fish dishes are allowed in the form of knives, steam cutlets, rubbed milk soups from rice, bias, pearl cereals with rubbed vegetables; porridge in the scarlet form on milk; Wheat crucks up to 100 g. Salt is limited to 8 g, additionally - vitamins A, C, Groups B. Power Six-colored in a semi-liquid and mature form.
Table number 22.
Table N 2. is shown in chronic gastritis with reduced acidity or in its absence, chronic colitis (outside the exacerbation).
Structure: soups from croup and vegetable, rubbed, on meat, mushroom, fish broths; low-fat meat (chopped, fried), boiled chicken, steam, stew, roasted cutlets without rough crust, low-fat ham, low boiled fish, well-dyed low-fat herring chopped, black caviar; Milk (if it does not cause diarrhea), butter creamy, kefir, prostromatic, cream, sour cream, nice, fresh nice cottage cheese, unshearch cheese wipe; Eggs sick, omeletted fried; porridge, well-strained or rubbed (buckwheat, semolina, rice); Flour dishes, (except for drowsing), bread stalk white, gray, non-propulsive breadcrumbs; Vegetables, boiled fruits, raw in grated form; fruit, vegetable juices (also sour); Tea, coffee, cocoa on water with milk, marmalade, sugar. Crop Salol until 12-15 add vitamins C, B1, B2, RR. POWER FIQUE, mainly in mature form.
Table number 3.
Table N 3. is shown in atonic constipation.
Structure: Products rich in vegetable fiber, such as raw or boiled vegetables and fruits in large quantities, apple and other compotes, prunes, figs (wine berries), vegetable, fruit juices, beet, carrot puree, puree from boiled dried fruits (prunes, Kuraga), black bread, prostrochush, milk, cream, one-day kefir, honey, buckwheat, pearl crumbly, meat, fried fish, butter creamy and vegetable, sugar. Abundant drink, including carbonated mineral waters. Excluded: strong tea, cocoa, mucous soups, kisins.
In spastic constipation associated with the increased motor excitability of the intestine, dramatically limit the products rich in plant tissue (permissible a few vegetables - boiled and raw wipes).
Table number 4.
Table N 4. is shown in acute intestinal diseases and exacerbations in the period of continuing diarrhea.
Structure: Strong tea, cocoa, strong coffee on the water, stale white crackers, fresh cottage cheese rubbed, one egg schiek per day, mucous soups on the water, rubbed rice, semolina on the water, meat, boiled fish, steam in chopped form with adding into mince Rice instead of bread, low-fat three-day kefir, decoction of dried black currant, blueberries, kissels, jelly from blueberries. Limit the core salt, add vitamins C, B1, B2, PP. Food 5-6 times a day.
Table n 4a. Shown when colitis with the predominance of fermentation processes.
The composition is the same as in the diet N4, but sharply limit the products and dishes containing in large quantities of carbohydrates (porridge; bread no more than 100 g per day; sugar no more than 20 g per day); Increase the content of proteins due to meat dishes, wiped cottage cheese and so on.
Table N 4b. Shown in chronic colitis in the stage of the fading exacerbation.
Structure: Bread white, yesterday's baking, non-propulsive cookies, dry biscuit; Millage soups on a weak fish or meat broth, broth with meatballs, rubbed porridges, except for millet, on the water with the addition of 1/3 of milk, boiled and steam and steam and steam vegetables, cheese, unscalated sour cream, kefir, sophistication, compotes, sweet berries , Fruits in the witch form, tea, coffee with milk, Malso butter (to add to finished dishes). The table salt is 8-10 g. Vitamins C, groups of B. Food is 4-6 times a day. Food is fed in warm form.
Table N 4B. Shown in acute intestinal diseases during recovery as a transition to rational nutrition; Chronic bowel diseases during the attenuation period of exacerbation, as well as out of exacerbation with the accompanying defeats of other digestive organs.
By Eppink "\u003e Diet is prescribed to ensure complete nutrition at some lack of intestinal function, which will contribute to the restoration of other digestive organs. This is a physiologically full-fledged diet with a slight increase in protein content and moderate restriction of cook salt, mechanical and chemical intestinal stimuli, eliminating food and dishes. which enhances fermentation and rotting in the intestine, sharply increase its secretory and motor functions, secretion of the stomach, pancreas, bile. The food is prepared in a non-aggravated form, steamed, boil in water or baked. Power mode: 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,
Craw salt - 10 g,
Free liquid - 1.5 liters.
Calorie - 2900-3000 kcal.
Table number 5.
Table N 5. is shown in the diseases of the liver, gallbladder, biliary tract outside the aggravation stage.
Structure: Vegetarian fruit, dairy soups, cereal soups on a vegetable brave, boiled meat, birds of low-fat varieties, boiled low-fat fish, milk, fresh prostrip, kefir, acidophilic milk, cottage cheese up to 200 g per day, cereal and flour dishes (except for the dying), Bread white, black worn, ripe fruit, berries (except acidic varieties) in cheese, baked, boiled form, vegetables and greens in boiled form and raw (especially carrots, beets), jam, honey, sugar (up to 70 g per day) , vegetable, fruit juices in significant quantities, slight tea with milk. Limit fats (cream, butter cream to 10 g, vegetable oil 20-30 g), egg (one per day). Cooking salt up to 10 g. Vitamins A, C, B1, B2, B12, folic acid, PP, K.
Meal 5 times a day in crushed form.
Excluded: Alcoholic beverages, liver, brains, spits, legumes, mushrooms, spinach, sorrel, bow, bump, fatty grade, fish, fried, sharp, smoked foods, meat extractive substances, fish, spices, vinegar, canned food, ice cream, cocoa, carbonated drinks, chocolate, creams (with chronic lesions of the gallbladder flowing with bile stagnation, the amount of fats is recommended to increase to 120-150 g, including 60% of plant fats).
Table N 5a. Shown in chronic pancreatitis.
It differs from the N5 diet with a high content of proteins (up to 150 g, of which 80-85% of animal origin), products rich in lipotropic factors with a limitation of carbohydrates with a moderate content of fats. All dishes are prepared in a vapor, rubbed, crushed form.
Table number 6.
Table N 6. It is shown for gout, renal disease with the disorder of stones consisting mainly of urates.
Structure: Milk, dairy products, bread white and black, sugar, honey, soups Vegetarian vegetable, dairy and fruit cereal products, all sweet fruits, jam, fruit and berry juices, carrots, salad, cucumbers. Of the seasonings - lemon, vinegar, bay leaf. Eggs, meat, low-fat fish - 2-3 times a week. The amount of table salt is reduced to 6-8 g; Large liquid (up to 2-3 liters) are introduced, vitamins C and B1 are added.
Excluded: spicy extractive substances, meat soups and champs, liver, kidneys, brains, fried, smoked meat, roasted fish, fish ear, fat, sledding, sardines, anchovies, springs, splashes, pies, mushrooms, legumes, sorrel, spinach, coffee, Cocoa, chocolate, alcoholic beverages.
Table number 7.
Table N 7. It is shown in chronic kidney diseases with the absence of phenomena of chronic renal failure.
Structure: Vegetarian soups, dairy, fruit, low-fat varieties of meat, poultry, boiled slices, chopped and rubbed, fish, low-fat boiled, chopped and rubbing, white bread, gray, cut without salt, one egg per day, cereals, macaroni in the form of cereals , Puddings, flour dishes, milk, lactic acid products, fats, except for refractory (carrying, pork, beef), cottage cheese, raw vegetables, boiled, greens (crooton of radish, celery, spinach), berries, fruits, especially uryuk, dried pumpkin, pumpkin , watermelons, melon, sugar, honey, jam.
Limit cream, sour cream. To improve taste, you can use cumin, dried dill, cinnamon, citric acid. Calculated salt 3-5 g (issued in hand, and food is prepared without salt). Add vitamins A, C, B1, B12, K. free fluid to 800-1000 ml per day. Food 6 times a day. Excluded: carbonated drinks, legumes, cakes and creams, meat, fish, mushroom broths, pickles, snacks, smoked, canned food.
Table N 7A. Shown in acute renal diseases (nephritis acute or exacerbation).
Structure: Mostly vegetables in boiled, fret, fruits, especially rich in potassium salts (Kuraga, Uryuk, raisins), cereal and flour dishes in moderate quantity (buckwheat porridge with milk), tea with milk, porridge white bread, sugar up to 70 g, oil Creamy up to 30 g. Add vitamins C, K, group V. Food fractional. Liquids up to 600-800 ml; Completely excluded salt salt.
With a developing uremia, the daily amount of proteins decrease to 20-25 g (first of all, the content of plant proteins should be reduced - legumes, cereals, products from flour, like bread, etc., since they are inferior to animal proteins in biological value and only overload the body with harmful products. protein metabolism; prescribe in large amounts of glucose or sugar (up to 150 g per day).
Table N 7b. Shown when calming the acute inflammatory process in the kidneys.
It is the transition from the table N7A to the table N7 (white abolhead bread, skinny varieties of meat, fishes in boiled form 1-3 times a week, table salt up to 2 g per hand, liquid up to 800-1000 ml; in products used for cooking contain 2-4 g salts).
Table number 8.
Table N 8. Obesity as the main disease or associated with other diseases that do not require special diets.
General characteristics: - Reducing the energy value of the diet due to carbohydrates, especially easily-friendly, partially fats, with normal protein content, is the limitation of free fluid, sodium chloride and food and dishes exciting appetite.
(daily diet):
- Proteins - 90-110 g
- Fats - 80 g
- Carbohydrates - 150 g
- Energy value - 1700-1800 kcal
rye, protein-wheat and protein-cut bread (100-150 g per day);
Vegetable soups with a small addition of cereals, soup, borshs, okroshka, beetroot;
2-3 times a week soups on a weak meat or fish broth with meatballs (up to 250-300g per reception);
low-fat varieties of meat, birds, fish - in boiled, baked or stew, beef sausages or jelly;
Sea Products (Pasta<Океан>, mussels, shrimps, etc.) - up to 150-200 g per day;
Milk and fermented milk products, cottage cheese, cheese - low-fat species and varieties.
Vegetables and fruits are used widely, in all kinds, part of necessarily raw.
Products from wheat flour of the highest and 1st grade, a dough;
potato, cereal, legumes, pasta soups;
Fatty grade meat, birds, fish;
sausages, smoked, meat and canned fish;
bold cottage cheese, cheeses, cream, rice, semolina and oatmeal, pasta, legumes, sweet varieties of fruits and berries;
sugar, pastry, jam, honey, sweet juices, cocoa;
meat and culinary fats;
Fat and sharp snacks, sauces, mayonnaise, all spices and spices.
Table number 9.
Table N 9. By Eppink "\u003e Sugar diabetes medium and light gravity.
General characteristics: - by Eppink "\u003e Diet with energy value, moderately reduced due to easily digestible carbohydrates and animal fats, with the exception 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 products and dishes:
rye, wheat, protein-cut bread, not busty flour products;
any vegetable soups, low-fat meat and fish broths;
low-fat varieties of meat, birds and fish;
Milk, fermented milk products, low-fat cottage cheese and cheeses;
Crupes, buckwheat, bunch, millet, oat, pearl; bean, potatoes and vegetables;
Fresh fruits and berries of sour-sweet varieties
Excluded products and dishes:
Products from a duple test;
strong and fat broths;
non-fat varieties of meat, fish, birds, sausages, salt fish;
Salted cheeses, cream, sweet curd cheese;
rice, semolina, pasta;
salted and pickled vegetables;
Grapes, raisins, sugar, jam, candy, sweet juices, lemonades on sugar;
Meat and culinary fats
Table number 10.
Table N 10. Diseases of the cardiovascular system with insufficiency of blood circulation degree I-IIA.
General characteristics: - a slight decrease in energy efficiency due to fats and carbohydrates, limitation of chloride and substances exciting 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 products and dishes:
Bread yesterday's baking, not bicked cookies and biscuit;
any vegetarian soups;
low-fat varieties of meat, fish, birds;
milk, fermented milk drinks and cottage cheese;
dishes from various croup; boiled pasta;
Vegetables in boiled and baked form;
Soft ripe fruits and berries, honey, jam.
Excluded products and dishes:
Fresh bread, products from a dough test;
Soups from legumes, meat, fish and mushroom broths;
fatty varieties of meat, fish, birds;
kidneys, smoked, sausages;
Salted fish, salt and fatty cheeses;
legumes;
Salted, pickled and sauer vegetables; fruits with coarse tissue;
Chocolate, strong tea, coffee and cocoa.
Table number 11.
Table N 11. Tuberculosis of the lungs, bones, lymph nodes, joints with a blurred exacerbation or attenuation, exhaustion after infectious diseases, operations, injuries.
General characteristics:
- by Eppink "\u003e a 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 products and dishes:
Virtually any food and dishes are used with the exception of very fat varieties of meat and birds, raggy, beef and culinary fats, as well as cakes and cakes with plenty of cream
Table number 12.
Table N 12. Shown in functional diseases of the nervous system.
Table diverse; Sharp seasonings are excluded, strong welded soups, smoked meats, fatty, fried dishes, especially meat, acting exciting to the nervous system, alcohol, strong tea, coffee, somewhat limit meat and salt. Recommended dishes from liver, language, dairy products and beans containing phosphorus salts.
Table number 13.
Table N 13. Shown in acute infectious diseases.
General characteristics: - by Eppink "\u003e diet with energy value reduced to a large extent due to fats and carbohydrates, with 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 products and dishes:
Wheat dried bread;
Degreased meat and fish broths, soups on a vegetable brave, mucous boars from croup;
low-fat varieties of meat, birds, fish;
lactic acid drinks, cottage cheese;
rubbed porridges from rice, manna and buckwheat;
potatoes, carrots, beets, cauliflower, ripe tomatoes;
ripe soft fruits and berries, rosy rose; Sugar, honey, jam, jam, marmalade.
Excluded products and dishes:
rye and any fresh bread, snob;
Fat broths, soup, borsch;
fatty varieties of meat, birds, fish, sausage, smoked, salted fish, canned food;
whole milk and cream, fatty sour cream, cheeses;
millet, pearl and barley cereals, pasta;
white cabbage, radishes, radish, onions, garlic, cucumbers, legumes;
fruits rich in fiber;
Chocolate, cakes, cocoa.
Table number 14.
Table N 14. Urolithiasis (phosphatia).
General characteristics: - physiologically full nutrition with restriction of leaning and rich in calcium products
Chemical composition and energy value (daily diet): - proteins - 90 g - fats - 100 g - Carbohydrates - 400 g - Energy value - 2800 kcal
Recommended products and dishes:
various types of bread and flour products;
Soups and broths (meat, fish, cereal);
meat and fish;
any cereals;
Green peas, pumpkin;
Mushrooms;
Sour varieties of apples and berries
Sugar, honey, pastry
Excluded products and dishes:
dairy, vegetable, fruit soups;
smoked, salted fish;
milk products;
potatoes, vegetables and fruits, except those named above, fruit, berry and vegetable juices;
Meat and culinary fats.
Table number 17.
Table N 15. Various diseases that do not require special medicinal diets.
General characteristics:
- Physiologically full nutrition with the exception of difficult and sharp products.
Chemical composition and energy value (daily diet):
- Proteins - 90-95 g
- Fat - 100-105 g
- Carbohydrates - 400 g
- Energy value - 2800-2900 kcal
Diabetes
What is diabetes?
Diabetes is a disease caused by metabolic disorders. At the moment it is one of the leading medical and social problems. According to world statistics, 2-3% of the earth's population suffers from diabetes. In diabetes mellitus, there is insufficient absorption by the body of the sugar due to the fact that the pancreas produces a reduced amount of insulin hormone, and a chronic level of sugar is determined in the blood. All complications that are associated with diabetes mellitus occur due to this reason. If a person who is sick with diabetes, learn how to manage well-being so good that the blood sugar level will remain at a normal level, then diabetes of the disease will turn into a special lifestyle, leading which can be avoided by many complications.
Diabaino translated from the Greek means "pass". Hence the name of the disease: diabetes mellitus literally means "losing sugar". This determines the main symptom of the disease - the loss of sugar with urine. For another 1.5 thousand years BC. In ancient Egypt, symptoms of diabetes were described in the Medical Treatment "Papyrus Ebers".
The famous Greek doctor Arethaius, who lived in ancient times, said: "Diabetes is a mysterious disease. This is a terrible suffering, not very frequent among men dissolving flesh and limbs in the urine. Patients without ceasing, excrete water with a continuous flow, as through open tap pipes. Life is short, unpleasant and painful, thirst for the neatolima, the reception of the liquid is excessive and disproportized with a huge amount of urine due to even greater diabetes. Nothing can keep them from taking fluid and urine selection. If they are briefly refused to receive fluid, they dry into the mouth, the skin and mucous membranes becomes dry. Patients have nausea, they are excited and die for a short period of time. " This statement did not lose its relevance, because many questions about the course of the disease remain unexplained. Antique doctor A.K. Celsius believed that the development of diabetes was caused by the indentation of the stomach, and the father of classical medicine Hippocrates was diagnosed, trying the patient's urine to taste. The wise men of the Ancient China also knew that with diabetes mellitus it becomes sweet. But invented a more original diagnostic method - with the help of flies. If the fly sits on a saucer with urine, then urine is sweet, and the patient is sick.
The reason for the occurrence of this ailment was found only at the end of the XIX century. After conducting a scientific experiment to remove the pancreas in the dog. After this operation, the animal marked the main symptoms of diabetes. The reason has become clear, but for a long time, artificial insulin could not be synthesized. Finally, in 1921, in the city of Toronto, two young scientists (F. Banting, Ch. Best) were able to single out a substance that reduces blood sugar from the pancreas. This substance was called insulin. In January 1922, the first patient with diabetes began to receive the first injections, which helped to extend his life. In 1923, the Portuguese scientist E. Roma found out that to reduce the manifestation of symptoms, improving the quality of life, a completely defined image of behavior was needed. And he formed the world's first school for patients with diabetes mellitus. Then the German doctor M. Berger noted: "Diabetes is not a disease, but a lifestyle. To hurt diabetes - I don't care what to drive the car along the busy track: you need to know the rules of movement. " Now such schools for patients with diabetes have many. Worldwide, patients with diabetes and their relatives have the opportunity to receive knowledge of the disease and not feel deprived of fate.
There are several hypotheses about the possible reason for the development of diabetes. The essence of the disease is the insufficient secretion of the pancreas hormone insulin, which regulates the sugar content (glucose) in the blood. When it is exposed to excess glucose turns into glycogen. If the amount of insulin is not enough, then the excess sugar coming from the outside is not processed, its content increases in the blood, and also begins the release of sugar with urine (if blood glucose rises above 10 mmol / l). At the same time, the cells begin to experience an acute deficit of energy. The fact is that glucose is the main energy source for the cells of the whole organism, but it can only get into the cage only with insulin.
A healthy person in the blood constantly arrives an adequate amount of insulin. Upon receipt of the excess sugar in the body, the pancreas increases the production of this hormone, and with a decrease, it reduces. Therefore, people who do not suffer from diabetes mellitus, the content of glucose in the blood is maintained in a strictly defined framework and is approximately an empty stomach 3.3-5.5 mmol / l, and after eating - up to 7.8 mmol / l.
In addition, with a further uncontrolled course of the disease in the blood and urine, acetone appears. This is dangerous, since the ketone bodies (acetone) cause ketoacidosis. This condition can lead to loss of consciousness (coma) and even death.
Diabetes Classification
There are two main types of diabetes:
first-type diabetes (insulin-dependent);
second-type diabetes (insulin-dependent).
In diabetes of the first type (insulin-dependent), a person must constantly introduce insulin. Most often, the disease is developing in people up to 40 years, at an early age - in children, adolescents, young people. The main cause of the diabetes of the first type is the death of cells responsible for insulin synthesis. These are the so-called beta cells. As a result, the generation of insulin is reduced or stopped at all. This occurs under the action of various factors - autoimmune process, viral infections, etc.
When the virus enters the human body, the body identifies a foreign material and begins to produce antibodies that destroy these viruses. But with the individual peculiarities of immunity after the destruction of these alien agents, the synthesis of antibodies does not stop. Their attack begins on the cells of their own organism, while the beta cells of the pancreas are destroyed.
The diabetes of the second type (insulin-dependent) is marked four times more often than the first (in 80-85% of cases). It is usually found in patients with obesity and older people (over 40 years old). There are evidence that every 20% of overweight increases the risk of sampling with diabetes of the second type. It is worth noting that not every person, even suffering from obesity in severe, is subject to this disease.
As a rule, the sugar diabetes of the second type proceeds more easily. In this case, beta cells first synthesize insulin in the usual and even excessive amounts. But its activity is sharply reduced. This is due to the large tissue content, the sensitivity of which is reduced to insulin. In the future, there is a decrease in the formation of insulin. With a diabete of a second type of weight loss and adequate physical exertion allow normalize blood sugar levels.
Causes of sugar diabetes
Modern studies allowed to highlight a number of predisposing factors that can lead to the development of diabetes.
It is mistaken to assume that if scientists can not yet determine exactly which causes lead to diabetes, then in general, all their observations of the frequency of diabetes in different groups of people do not have scientific value and practical application. On the contrary, these data revealed certain predisposing factors, which allow today to register people today, warn them from indifferent, and sometimes even barbaric attitudes towards their health.
The main of the predisposing factors is heredity. The risk of damage to sugar diabetes is high, if a person has some of the close relatives (father, mother, brother, sister) is sick of this disease. There are scientific evidence that the diabetes of the first type is inherited, as a rule, with a probability of 3-7% on the mother line and 10% along the father's line. If both parents are sick, the possibility of the occurrence of the disease increases to 70%. The second type diabetes is inherited with a probability of 80% both by the maternal and by the father's line, and if insulin-independent diabetes mellitus is noted in both parents, the probability of its appearance in children reaches 100%.
These numbers are not a sentence. From the small years, the child needs to be explained that there is a certain risk of the disease, but if he eliminates the effect of other predisposing factors, it will be carefully followed by its health, it will be able to avoid the development of diabetes mellitus. Also, the hereditary factor should be taken into account when marriage and family planning.
Very important is such a predisposing factor as obesity. Therefore, it is necessary to carefully monitor your weight throughout life, conscious of the good hazard.
As a result of certain diseases (pancreatitis, pancreatic cancer, diseases of other glands of internal secretion) occur damage to the pancreas and the death of beta cells. The provoking factor in this case may be a dull injury of the abdominal organs.
To the death of cells producing insulin, and consequently, some viral infections, such as rubella, chickenpox, epidemic hepatitis, influenza, etc., can lead to the development of diabetes mellitus, and others. These infections play the role of the trigger, as if a tricking disease. In a healthy person, these diseases will not cause diabetes. But when combined with other factors, especially such as heredity and obesity, the development of diabetes is quite likely. Therefore, it should be especially closely related to its state in the period from November to March, because most cases of diabetes occur during this period due to the influence of viral infection. The situation is complicated by the fact that during this period the condition of harsh diabetes can be taken as a viral infection. Install the accurate diagnosis is only based on the analysis of blood glucose content.
Another predisposing factor is chronic stressful states. At the same time, a combination of stress with hereditary heredity and excess kilograms is particularly dangerous.
When a person aging increases the risk of developing diabetes. The data of some studies indicate that with an increase in age for every 10 years, the probability of diabetes is rising by about twice. But, on the other hand, such a predisposing factor, as heredity, with age loses its meaning. Scientists came to the conclusion that if one of the parents sick diabetes, the probability of the disease is 30% aged 40 to 55 years, and after 60 years - only about 10%.
It should be noted that some of the reasons mentioned very rarely leads to the development of diabetes. Usually the disease occurs under the influence of several predisposing factors. Also, in rare cases, such reasons as hormonal disorders, some drugs or long-term abuse of alcohol can lead to the affix of the pancreas and the development of diabetes mellitus.
From the foregoing, it should be concluded that all people entering groups of risk should be very vigilant.
With the development of diabetes of the first type, the symptoms appear, as a rule, quickly, the diagnosis is not a special difficulty. The diabetes of the second type flows imperceptibly, the doctor can detect it by chance. So, the oculist when inspecting the eye bottom can see characteristic signs. For diabetes characteristic typical, long-known clinical signs. A person begins to disturb the general deterioration of well-being, weakness, fatigue, insomnia. Excess glucose is removed with urine, which leads to frequent urination with an increase in total urine to 3-7 liters per day. Loss of fluid causes increased thirst and consumption of a large amount of water, as well as dry mouth. For diabetes, it is characterized by the appearance of the skin and mucous membranes, poor healing of wounds, weight loss in diabetes of the first type, with a second type diabete, as a rule, an overweight is observed. Pathological changes in cardiovascular, nervous systems and other organs are developing again.
The diabetes mellitus of the first type is sometimes manifested by a sharp deterioration in the state, when pronounced weakness occurs, abdominal pain appears, vomiting, the smell of acetone from the mouth (ketoacidosis). The second type diabetes is usually developing gradually for a long time.
Diagnostics
The main diagnostic sign, on the basis of which you can make a diagnosis, is to increase the concentration of glucose in the blood of an empty stomach, as well as the appearance of sugar in the urine.
Depending on clinical manifestations and the level of blood sugar concentration and urine, three stages of diabetes are distinguished.
1. With a light form diabetes, the blood glucose indicators do not exceed 9.99-11.1 mmol / l, while the release of sugar with urine is no more than 15-20 g per day. All signs of the disease appear nonresko.
2. In diabetes mellitus, the blood glucose indicators in an empty stomach fluctuate in the range of 11.1-22.2 mmol / l, while the release of sugar with urine does not exceed 10% of the sugar value of the daily diode. This stage is characterized by violation of metabolism, pathological changes in the gastrointestinal tract, etc.
3. With severe diabetes, blood glucose indicators reaches 22.2-33 mmol / l, while the release of sugar with urine significantly exceeds 10% of the sugar value of the daily diet. For the heavy stage of diabetes, it is characterized by the development of complications from the nervous system, the eye dna, heart, kidney and other organs.
People suffering from diabetes mellitus, it is necessary to constantly monitor blood sugar levels. This can be done with the help of jet strips immediately before insulin injection. Most often, patients check blood sugar levels before taking food (breakfast, lunch and dinner). Additionally, it is possible to control the content of glucose in the blood before bedtime and with a deterioration of well-being. Daily multiple control of blood sugar levels - the basic condition for correction of the insulin dose, respectively, individual lifestyle and power regime.
Complications of diabetes
1. Acute states
Special attention deserves the issue of the development of complications of diabetes. Usually, almost all complications in diabetes are developing due to the increased blood glucose content.
One of the most dangerous complications of diabetes mellitus is ketoacidosis. Glucose is the main source of energy for the human body. But in order to get into the cage, it is necessary for insulin. In humans, the need for insulin is very variable. It changes from stress, diet disorders, reduce or increase physical activity, accession of various infections. If the amount of insulin has decreased sharply due to the action of these reasons, the energy starvation of cells is developing. As a result, unfit for this substance, for example, fats are beginning to be disposed. At the same time, acetone appears in the blood and urine (the so-called ketone bodies, which are a product of adhesion of fats), develops ketoacidosis. The patient begins to disturb the strong thirst, dry mouth, it is sluggish, a large amount of urine is distinguished, weight is reduced. As the disease progressing, the characteristic smell of acetone in exhaled air appears. In the future, the development is possible, and then coma.
A man suffering from ketoacidosis should carefully monitor the content of glucose in the blood and urine. With a deterioration in the health of the patient, it is necessary to find out the content of glucose in the blood. If the amount of sugar exceeds 16 mmol / l, urine analysis is necessary for acetone. When acetone is detected, it should be immediately administered once 20% of the daily dose of a short action insulin. Recommended after 3 hours re-identify the amount of blood sugar. If the blood sugar level has not decreased, it should be reused 20% of the short action insulin and urgently turn to the endocrinologist to determine the cause of the appearance of acetone and further correction.
If a person suffering from diabetes is concerned about the increase in body temperature, it is necessary to measure the amount of glucose in the blood as soon as possible and introduce 10% of the daily dose of the short action insulin. Such recommendations are valid in the absence of acetone in the urine. If the sugar level is so high that acetone appeared in the urine, should act according to the first rule. But in any case, it is necessary to urgently consult a doctor.
Hypooglycemia is also a threat to health, while there is a sharp decrease in the amount of glucose in the blood (below 3.3 mmol / l). This occurs due to excess insulin. As a rule, it occurs with such states as the passage of food intake after the injection, with inadequate, excessive physical exertion, after alcohol abuse.
The characteristic signs of the development of the hypoglycemic state are a sharp deterioration in state of health, the darkening in the eyes, expressed sweating, the appearance of trembling in the body, an increase in appetite. With the appearance of these symptoms, in the shortest possible time, it is necessary to eat something sweet (easily handed carbohydrates - at least 2 bread units). If you do not eliminate hypoglycemia on time, a person loses consciousness, then he can fall into the hypoglycemic to whom. Unlike hyperglycemic coma, it develops rapidly, literally within a few minutes. Therefore, a person suffering from diabetes is necessary to have something sweet with him. With the loss of patients of consciousness, if he is in a fainting condition surrounding in the shortest possible time to cause ambulance. The first medical care is to introduce a 40% glucose solution intravenously or glucagon intramuscularly, which contributes to the emission from the liver of its own glucose.
With frequent hypoglycemic states that occur at a certain time, it is necessary to reduce the dose of insulin administered at this time, after which it is possible to determine the amount of blood sugar. It is necessary to pre-discuss with your doctor.
Certain interest has an insulin dose correction during exercise. The need for the body in insulin decreases with physical activity. When ignoring this factor, hypoglycemia may occur. In physical load, the dose of prolonged and short action insulins can be reduced by about 10-50%. The percentage of reduction of the insulin dose, as a rule, depends on the duration and intensity of the load. This can only be done under blood glucose control before and after load. With short-term exercise, it is not worth changing the insulin dose. Before physical activity and every half hour during it, you must eat approximately 1 grain unit.
2. Late complications of diabetes
Late complications of diabetes mellitus include lesions of many organs and organism systems. First amazed, as a rule, small vessels - capillaries and nerve endings. In diabetes mellitus, the walls of the vessels lose their elastic qualities characteristic. They become brittle, fragile, very easily traumatized. At the same time, there is a violation of blood circulation, local minor hemorrhages occur. In those places where there were similar microtraums, connecting tissue grows. The vessel walls thickening due to excess connective tissue, as a result of which permeability for nutrients decreases. Given the fact that the vessels and nerves are present in any organ, the entire body suffers in diabetes. Typically, the vessels and nerves of the eyes, kidneys and lower extremities are affected.
Angioretinopathy is a diabetic lesion of the eye vessels. Due to the long-term increase in blood sugar levels, circulatory disorders may appear and the retina hemorrhage. As a result, visual impairment occurs, sometimes blindness. This disease is revealed in the eye study. Only an oculist during inspection using the eye mirror can determine the presence and stage of angiohetinopathy. In angiohetinopathy, hemorrhages, newly formed retinal vessels and other changes will be visible on the eye day. To prevent the appearance or stop changing the eye bottom, it is required to adjust insulin therapy. Directly for the treatment of angiohetinopathy, there are drugs, with the inefficiency of which they resort to a surgical method of therapy - laserophorthoagulation. In a planned manner, an oculist has a sugar diabetes, twice a year should be examined. If you suddenly have any violations of vision, bone, vagueness of objects, then you should turn to the eyepiece outside the plan.
Patients with diabetes often develop closet of eye lens (cataract). One of the first signs of cataract is the appearance of brownish glare on all subjects. Often, the cause of headaches and impairment of vision in the elderly, there is an increased intraocular pressure - glaucoma.
The diabetic lesion of the vessels of the lower extremities also refers to quite frequent late complications of diabetes. First, as in any other organ, the capillaries and nerves are affected here. With a predominant damage to vessels, the an angiopathic form of limb damage is isolated, with a predominant damage to nerve endings - neuropathic. There is also a mixed form at which minor vessels and nerves are suffering. With neuropathic form, cutting and burning pains in the legs arise, especially at night.
With long-term diabetes mellitus, the so-called diabetic foot is possible. At the same time, a person is worried about the excess form of corns, thickening and changing the shape of the nails of the foot, fungal defeat of the nails and the skin, the feeling of numbness stop, the feeling of "goosebumps" and other skin sensitivity disorders, a change in the shape of the foot.
In diabetes mellitus, as a rule, a reduced skin sensitivity is noted to the effects of various external stimuli. Therefore, small cuts and other microtraums remain ignore. The skin in patients with diabetes is thin, dry, easily plenty. In the future, these wounds are often infected, which leads to the emergence of non-healing ulcers for a long time, and sometimes gangrene. In some elderly patients, this leads to the amputation of the foot or legs.
To prevent these possible complications, it is necessary to care for their legs and follow the rules below.
If a person has a feet of her legs, it should not use hot baths, heating, various electrical appliances to warm them. With a violation of the temperature sensitivity of the legs of the legs, the likelihood of burns is high. To make the legs warm, you just need to wear woolen socks.
Wash legs are recommended warm water daily, but long-term foot baths, which contribute to severe skin softening. After washing, you must carefully wipe my legs, special attention to the space between your fingers. At the same time, it is necessary to carefully inspect the legs for damage detection. When the wound is detected, it must be cleaned with a 3% solution of hydrogen peroxide, rinse with furaticiline with aqueous solution and impose a sterile bandage. With the appearance of redness, swelling around the wrecks are recommended to ensure the foot full of peace and urgently consult a doctor.
During pedicure, the use of sharp items is prohibited. Nails on the legs can not be cut, they need to be simply chopped in a straight line. It should be done because with a reduced sensitivity of the skin stop there is a danger of imperceptible damage to scissors and skin. Nails do not need to be poured very short. If you need to remove the corn, it is recommended to use PEMZA. Application for these purposes of corn liquid or patcher, as they contain caustic substances, as well as cutting tools, such as blade or razor.
In diabetic damage, stop vessels in no case can we wear close, undiscovered shoes, high-heeled shoes. All this can lead to a deterioration of blood circulation. Shoes should be leather and free. When choosing a shoe, it is recommended to remove and wear several times, carefully examine whether the insole is smooth and there is no such thing in the shoes that it can grasp or anticipate the leg. You should buy only soft, elastic shoes. New shoes are first recommended to wear no more than 1 hour. Due to the danger of increased injury, it is strictly forbidden to walk barefoot. On the beach you need to shift in bathing slippers.
Diabetic nephropathy is the defeat of kidney vessels in diabetes mellitus, which is considered to be very serious complication. It is customary to allocate five stages of diabetic nephropathy. In the study of urine on the microalbumin (small mass protein), you can reveal the first three stages that are reversible. If a protein appears in the overall analysis of urine, this indicates the transition of the disease in the fourth, irreversible, stage. In the future, chronic renal failure is developing. The main features of this disease are a sharp decrease in the excretory function of the kidneys, the appearance of edema, increased blood pressure and the rise in the blood of creatinine and urea. When maintaining blood glucose indicators at the level as close as possible to normal, it is possible to prevent the development of diabetic nephropathy or braking the further development of the complication already arising. Each man suffering from diabetes should take the urine analysis to determine the albumin protein in her quarterly.
Atherosclerosis and diabetes mellitus are two interrelated diseases. With diabetes, atherosclerosis progresses very quickly. Because of this, people who have diabetes mellitus, myocardial infarction meets much more often and arises much earlier than everyone else. It should be noted that, since during diabetes, there is a damage to nerve endings, heart attacks almost always proceed without pronounced pain. From this it is necessary to conclude that when unpleasant sensations in the heart of the heart, it is recommended to urgently consult a doctor and make an ECG. In addition, arterial pressure should be regularly followed.
In conclusion, it should be noted that when performing all the necessary recommendations on self-control and stabilization of the level of sugar in the blood, you can suspend the development of even those complications that have already arisen.
Dispensarization
People suffering from diabetes are under the dispensary observation of the endocrinologist or diabetologist. Other specialists are also involved in the dispensarization, the Okulist, therapist, neuropathologist. Patients with a light degree of disease The correction of insulin therapy is carried out on outpatient conditions under the supervision of an endocrinologist, with diabetes mellitus of medium and severe degrees, patients require hospitalization to the Endocrinological department of the hospital. In the development of the diabetic coma of humans, they are emergency to be hospitalized into the therapeutic endocrinological separation of the hospital.
For the treatment of insulin-dependent diabetes mellitus, artificially synthesized insulin is used. Insulin is a protein hormone, it is possible to enter it only with the help of injections, since when it is in the stomach, it is destroyed and cannot realize its biological significance. The drug is produced in special syringe knobs, with which it is easy to make injections. Usually, at the beginning of the disease in the body there are still cells that produce insulin, but their number is very small and cannot meet the needs of the body. With the beginning of insulin receipt from outside from these cells, an additional load is removed, they begin to produce more insulin after a while. During this period, the dose of injected insulin can decrease. This venterity process occurs in patients in the first year of the disease is the so-called honeymoon. Unfortunately, this period does not last forever. After his dose insulin increase again.
Now the so-called alternative methods of treatment are becoming popular. It should be noted that they not only can not help the patient, but are usually harmful to its body and worsen the state.
Features of the treatment of the diabetes of the second type depend on the age of the patient. If diabetes manifested itself after 40 years, then blood glucose indicators should be maintained as close as possible to a normal level using medicines. Usually an endocrinologist prescribes tablets that contribute to a decrease in blood sugar levels. When progressing the disease, the assignment of insulin becomes necessary. This will help further avoid the development of late complications. If diabetes was first revealed in a person at the age of about 75 years, this, as a rule, does not lead to a decrease in life expectancy, even if glucose indicators will be somewhat increased. Applying drug drugs appropriate only if the patient with diabetes appears clinical signs of improving sugar levels: frequent urination, a large amount of urine, skin or bladder infection, a sharp decline in working capacity, poor wound healing.
Healing Nutrition for Diabetes
In diabetes, therapeutic nutrition has a determining value, especially with diabetes of the second type. With a light (and even moderate severity), the form of the disease diet food will help reduce doses of drugs.
In wide masses, there is an opinion based, apparently on the name of the disease, which is the main reason for diabetes in food, which diabetes is mostly sweet. The share of truth in this is, at least in the sense that a person with such habits in nutrition will definitely be overweight. We should not forget that the number of patients with diabetes is growing and diabetes are valid to the diseases of civilization, i.e. The cause of diabetes in many cases is redundant, rich in easily-friendly carbohydrates, "civilized" food.
In the presence of overweight persons suffering from a second type diabetes, it is necessary to lose weight. In this case, there is a chance in the abolition of sugar drugs and even more so without insulin. The ideal weight for a person can be calculated according to the following formula: human growth in centimeters minus 100. It should be noted that weight loss even by 10 kg significantly improves blood glucose indicators in the patient.
Diets number 8 and No. 9 recommended by the Ministry of Health of Russia are similar to each other. So, diet number 8 is aimed to prevent or eliminate the accumulation of adipose tissue in the body, and No. 9 is to normalize all types of metabolism and is primarily a carbohydrate exchange. All other diets are modifications of the above diets and can be resolved only by the doctors-diabetologists or endocrinologists, taking into account age, gender, the nature of the work of the patient and the energy consumption of the body.
All diet uses uniform principles:
fractional nutrition allowing the level of blood sugar to the maximum to stabilize during the day;
spots (unloading) of the pancreas, i.e. reduction of carbohydrate and fats;
exception of sugar and products cooked on sugar;
satisfaction of physiological age needs (primarily in proteins, vitamins, mineral components and calorie);
correction depending on the phase of the diabetic process and the development stage of the disease;
the appropriate cooking processing of food, determined by exclusive complications of diabetes or accompanying diseases.
Diet
Sick diabetes mellitus power mode should include 5-6 meals. Increasing the number of food meals has several goals: first, the amount of food for each reception is reduced, and therefore the degree of food hyperglycemia; Secondly, frequent meals (every 2-3 hours) prevent the possibility of hypoglycemic states. The main calorie food techniques are distributed as follows: breakfast - 30%, lunch - 40%, afternooner - 10% and dinner - 20%.
The first breakfast is recommended to be taken 20-30 minutes after insulin injection. The second breakfast is 2-3 hours after the first breakfast, which reduces the possibility of the development of hypoglycemia. If it is not possible to take food exactly at the appointed time, then the patient is better feeding 15-20 minutes earlier than to stay at the same time. An individual diet can be recommended by the doctor.
Squirrels and fats
Proteins are rich in nitrogen complex chemical compounds contained in animal products and to a lesser degree of plant origin. They are necessary for the body to build and restore fabrics, the growth process, the formation of hormones, resistance to infections, maintaining performance. The body's assimilation of 1 g of proteins is accompanied by the formation of 4 kcal of thermal energy, which allows them, while in the daily diet, along with its main function, provide 10-15% of the daily energy needs of the body.
Fats - complex compounds containing glycerin and fatty acids that contribute to the absorption of vitamins, part of the cells of the body and participate in the exchange processes of proteins and carbohydrates. Excess fat is postponed in adipose tissue. Excessive use of animal fat helps to increase the content of cholesterol in the blood and atherosclerosis, while plant fat (sunflower, corn oil) has an antisclerotic effect. 1 g of fat, absorbed with food, forms 9 kcal of thermal energy. The physiological need for fats is 30-35% of the daily diet, and the animal fat (butter, the biskir, fat) should be no more than 25-30% of the total amount of fat consumed, and the remaining 70-75% should consist of vegetable fats. Daily cholesterol consumption should not exceed 300 mg.
In 100 g of boiled fish, there is about 50 mg of cholesterol, and in 100 g of boiled poultry meat - 40 mg, in one yolk egg (20 g) - 300 mg.
In diabetes mellitus shown:
meat, bird, fish (boiled, stewed or roasted after digestion), bay (cold), beef sausages, chicken sausage;
milk (from fermented milk products - kefir and prokurba low-fat), sour cream as adding into dishes;
eggs (1-2 pieces per day in any form, except scrambled eggs);
fats (butter and vegetable oil).
Contraindicated:
goose meat, duck, smoked, salted fish;
milk, cream, ripple, sweet yogurt, Ayran.
Carbohydrates
Carbohydrates - chemical compounds providing normal proteins and fats, as well as the energy needs of the body, mainly brain and muscles. For simple carbohydrates include glucose and fructose, which are quickly absorbed in the intestine and cause an increase in blood sugar levels. Complex carbohydrates (starch, fiber) are absorbed slowly, without causing a quick increase in blood sugar levels. Carbohydrates are mainly contained in products of plant origin (bread, croups, potatoes, vegetables, fruits). The absorption of 1 g of carbohydrates causes an education in the body of 4 kcal of thermal energy. The physiological need of the body in carbohydrates is 50-60% daily diet.
With diabetes, use is allowed:
croup (crumbling casters from buckwheat and pearl cereals, rice only after soaking for 10 hours with water change every 2-3 h);
vegetables (any, except marinated and salty; beets after preheating, and potatoes after pre-pulp (as well as rice) so that starch comes off).
Contraindicated:
manna cereal, pasta, noodles;
marinated and sauerkraut.
Approximate diet menu number 9
Breakfast: buckwheat porridge (cereals - 40 g, oil - 10 g), meat (or fish) Pate (meat - 60 g, oil - 5 g), tea with milk (milk - 50 g).
11 h: a glass of kefir.
Lunch: Vegetable soup (vegetable oil - 5 g, Potatoes - 50 g, Cabbage - 100 g, Carrot - 25 g, sour cream - 5 g, Tomato - 20 g), boiled meat - 100 g, Potatoes Exhaled - 150 g, Oil - 5 g, Apple - 200 g.
17 h: yeast drink.
Dinner: Zrazy from carrots with cottage cheese (carrots - 75 g, cottage cheese - 50 g, semolina - 8 g, Rye crackers - 5 g, egg - 1 thing). Boiled fish - 100 g, cabbage - 150 g, vegetable oil - 10 g, tea with xylitol.
At night: a glass of kefir.
Bread for day - 250 g (mostly rye).
borsch, soup, okroshka, beetter, low-fat and non-concentrated broths;
sweet-sweet varieties of fruits, compotes, candy, cookies and waffles on xylitol; Sweets can be replaced with nuts in limited quantities.
Contraindicated:
dairy soups and soups with croups and noodles;
grapes, raisins, dates, sugar, honey, candy, figs, bananas;
sweet fruit and berry juices, sweet kvass, cocoa.
Carbohydrates vegetables in raw form are absorbed slower than in boa, therefore it is recommended to use vegetables in raw form, especially since vitamins are preserved.
Carrot contains a lot of carotene, which turns into the body in vitamin A, and therefore improves the condition of the vision in patients with diabetes, it also contains a lot of potassium and vitamin B12.
Eggplants have the ability to reduce cholesterol levels, contain many vitamins (groups B, C, PR) and potassium, improve the work of the heart muscle.
The cucumbers are rich in mineral salts, dissolve and remove urinary acid, normalize the work of the heart, liver, kidneys, help reduce obesity.
It should be noted that the number of vegetables, with the exception of potatoes and beets, in the daily diet can be practically not taken into account, since the content of carbohydrates is insignificant.
Substitutes of sugar
The need to exclude or dramatically limit the use of sugar in nutrition creates in patients with diabetes mellitus the state of discomfort. Children and adolescents are especially difficult to endure the exclusion of sweets, so the sugar substitutes obtained from plants or a chemical method created are widely used. As substitutes of sugar, patients can use sorbitol, xylitis, fructose, saccharin and aspartame.
Sorbitol is a sweet, well-soluble in water powder made from vegetable raw materials. In small quantities, contains in berries and fruits, most of all in Ryabin. By participating in the metabolic processes of the body, 1 g of sorbitol forms 4 kcal of energy.
Increasing the consumption of sorbitol over 30 g per day can cause a relaxing effect and discomfort in the abdomen. Sorbitol can be added to dishes subjected to hot culinary processing.
Xylitis is a sweet crystalline substance, well-soluble in water, which is obtained from corn kerges and cotton husks. To assimage xylitis, insulin is not required. Daily consumption of xylitis should not exceed 30 g, as it can contribute to the intestinal disorder. 1 g of xylitis when absorbed by the body forms 4 kcal of energy. Xylitis can be used with heat treatment.
Fructose is a sweet substance that is part of berries, fruits and sugar. But in contrast to glucose, also included in the sugar, her assimilation occurs without insulin. Fructose is two times sweeter than sugar. Its daily consumption should not exceed 30 g. The energy value of fructose is 3.8 kcal / g. Suitable for hot cooking.
Aspartame (Slavlin ") is a substance consisting of two amino acids (asparaginic and phenylalanine), which is 200 times sweeter than sugar, does not have energy value and does not have a side effect. When boiling loses its properties.
Sakharin is a crystalline powder, which is 500 times sweeter than sugar, well soluble in water. Energy value does not possess. It should not be boiled due to the acquired unpleasant bitter taste. Daily consumption should not exceed 1-1.5 tablets. It is not recommended to use saccharine to children, pregnant women, as well as in the diseases of the liver, kidneys.
Interchangeable products
1. Bakery and grain products. Equalities: 40 g (slice) of wheat bread, 50 g of rye bread, 40 g of bakery products, 100 g of protein-wheat bread, 140 g of protein-cut bread, 30 g of superstars (2 pieces), 20 g of pea (beans).
2. Products containing animal protein. Equalities: 30 g of boiled beef, 50 g of veal, 65 g of lean pork, 48 g of chicken, 46 g of turkey, 46 g of rabbit, 77 g boiled sausage, 85 g of sausages (Sardelka), 54 g of fish, 35 g of Dutch cheese, 53 G low-fat curd, 1.5 eggs.
3. Fats. Equal: 5 g of butter, 4 g of grained oil, 4 g of vegetable oil, 40 g of cream 10% fat, 16 g sour cream, 6 g mayonnaise.
4. Dairy products. Equalities: 200 g kefir, 200 g of milk, 200 g of sources.
5. Vegetables. Equalities: 50 g of potatoes, 90 g beets, 140 g of carrots, 170 g of turnips, 75 g of green peas.
6. Fruits and berries. Equalities: 100 g of apples, 110 g of apricots, 100 g of cherries, 105 g of pears, 115 g of plums, 90 g of cherries, 135 g of orange, 140 g of strawberries gardening, 115 g of gooseberry, 125 g of raspberries, 130 g currant.
The number of lemons and cranberries can be practically not limited in the diet of diabetes patients.
Vitamins
When appointing a diet, the daily need for vitamins should be taken into account. The physiological diet usually contains a sufficient number of vitamins, however, given the increased need for them in diabetes, it is necessary to increase their content in a diabetic diet. Showing drinks, champs and infusions made of rosehip fruits, blueberries, black currant, black and red rowan, lemon.
For the prevention and treatment of diabetes mellitus, teas are recommended from the following berries and plants: strawberries, nettle of dwarfish, large, oats, dandelion, the plantain, yarrow, beans, chicory, blueberries, rosehip.
Positive action is noted when applying tea of \u200b\u200bthe following composition: Blueberry leaves - 4 parts, beans pods - 4 parts, Ordinary strawberry leaves - 3 parts, yarrow grass - 1 part, Breeding root - 3 parts, nettle leaves Dwarm - 4 parts, root Ordinary dandelion - 2 parts, blurring oats pan - 4 pieces, leaves of bones - 4 parts, Rosehip fruits - 4 parts.
The diet is recommended to include salads from dandelion leaves, nettles, chicory, wild mountain, meduse drugs. These plants are rich in tocopherol, ascorbic acid, phosphorus, iron, calcium, aluminum, manganese, organic compounds (inuline, magnesium, inosite, flavoxantine, wax, etc.).
Vegetable facilities are facilitated, increasing the body's alkaline reserve (potatoes, onions, beets, beans, beans, blueberries). Enrichment of the body with alkaline radicals contributes to the improvement of the tissue use of glucose and reduce the level of glycemia.
ginseng (pharmacy tincture) - 15-20 drops in the morning and afternoon; Extract (pharmacy) - 5-10 drops in the morning and at lunch;
eleutherococcus (extract) - 1 / 4-1 / 2 l. morning and afternoon;
golden root (rhodium pink) (pharmacy extract) - 1 / 4-1 / 2 l. on the reception in the morning and during the day;
the nettle nettle (7 g of dry crushed herbs on a glass of boiling water, fervent for 15-20 minutes, drink 1 tbsp. l. 3 times a day);
dandelion (roots, grass). 6 g of dry crushed raw materials on a glass of water, boil for 10 minutes, insist for 30 minutes, take 1 tbsp. l. 4 times a day before meals;
chicory (grass - in food in the form of salads, and roots (dried and ground) - as a substitute for coffee).
Sugar Diabeteste products include fruits, seeds and berries of black elderberry, blueberries, strawberries, goats, cannabis, rowan, mulberries, raspberries, blackberries, citrus, lentils, celery roots, barley extract, cabbage, chestnut, alfalfa, oats, Spinach and others.
Unloading Days
In the presence of insulin-dependent diabetes mellitus and obesity, unloading days (600-800 kcal) are recommended two or three times a week. These days should cancel suarrangeing pills. Unloading days are carried out for the purpose of weight loss and maximum discharge of the pancreas.
Curd-kefir day: cottage cheese - 200 g, kefir - 400 g. Calorie - 690 kcal.
Meat day: boiled beef - 400 g, white-baked raw and boiled cabbage - 400 g (or carrot salad, cucumbers, tomatoes, cauliflower). Calorie - 675 kcal.
Apple day: 1.5 kg of apples. Calorie - 690 kcal.
Oatmeal: 250 g of oat colts cooked in water. Calorie - 860 kcal.
Fruit and egg day: 5 times a day for one egg and 10 g of apples with a cup of bravery branch (without sugar). Calorie - 650 kcal. It is carried out at normal liver function.
Kefirday: 1.5 l kefir. Calorie - 800 kcal.
Recipes of dietary dishes
First meal
1. Broth transparent.
Required: 1 kg of beef with bones, 200 g beef (pulp), 1 egg squirrel, 1 carrot, 1/2 beam parsley, 1/2 celery beam, 1 bulb, 4 peas of fragrant pepper, 1 bay leaf, 3 l of water, salt.
Cooking. Put in a pan washed and blurred bones, meat, pour water and boil. Then the broth drain and pour meat hot boiled water.
When the water boils, remove the foam, salt and cook on low heat for at least 3 hours. In the middle of the cooking, put a sliced \u200b\u200bgreens. At the end of the cooking put pepper, bay leaf. When the broth cooks, remove the saucepan from the fire, remove the bones and meat, give the broth to stand. Then strain through the metal frequent sieve. If the cooked broth is not transparent enough, it can be lit with the help of egg protein. Use this broth as a basis for cooking soups. For broth, you can use veal, low-fat beef.
2. Rollers dietary.
Required: 200 g of weak broth, 20 g onion, 10 g of oil, 20 g of carrots, 20 g of greenery to taste, 50 g of salted cucumbers, 50 g of potatoes, 20 g of pearl cereals, 30 g sour cream.
Cooking. Cut the carrots and onions in small slices and slightly extinguish. Clear cucumbers from the peel, cut into thin slices and, pour a bit of broth, cook for 10-15 minutes. With the rest of the broth, boil the cereal with potatoes and put there cucumbers and carrots with greens. Soup let boil and fill sour cream.
3. Summer dietary soup.
Required: 300 g of broth, 15 g of oil, 20 g onion, 40 g of carrots, 120 g of cabbage, 60 g of potatoes, 40 g of tomatoes, 30 g sour cream, parsley greens.
Cooking. A finely chopped onion put out in a small amount of oil with the addition of water. Then add chicted with slices carrots and put out to half-preparation. Cabbage with potatoes cut into small cubes and put in boiling broth, there to put stew vegetables and cook until readiness. When filing to the table, put in the soup sour cream and finely chopped parsley greenery.
4. Coupling.
Requires: 200 g of weak broth, 10 g of oil, 20 g of carrots, 10 g of tomato puree, 50 g of beets, 20 g of onion, 60 g of cabbage, 60 g of potatoes, 3 g of flour, 30 g sour cream, bay leaf.
Cooking. Sliced \u200b\u200bcarrots and beets put in a saucepan, add oil, tomato puree, salt and stew, closing the lid, until soft vegetables. Onions fry in oil and mix with stewed vegetables. Then pour the broth and add finely chopped cabbage and potatoes, put a bay leaf. Soup boil until vegetables are ready. Then wipe the soup through the sieve, to fasten the roasted flour, salt to taste and bring it to a boil. When submitting to the table, add to the SCO-SCOW.
5. Soup with meatballs.
Required: 300 g of broth, 10 g of oil, 70 g of low-fat beef or veal, 200 g of potatoes, 1/2 eggs, 20 g onion, parsley greens.
Cooking. Skip meat through a meat grinder, add half of all the finely chopped onion, egg, salt and mix thoroughly. Rock out minced small meatballs and cook them in broth. The rest of the broth boils, put into it potatoes and the remaining pre-spices on the oil onions. When the soup is welded, put meatballs into it and sprinkle a finely chopped parsley.
6. Fish soup with rubbed meatballs.
Required: 250 g of fish broth, 20 g onions, 100 g of fish, 10 g of bells, 20 g of milk, 5 g of egg protein, 200 g of potatoes, 30 g sour cream, 5 g of oil, greens.
Cooking. Onions fry in oil, put in fish broth, add chopped potatoes and cook. Skip the fish through the meat grinder together with a mumbled bun, add an egg, salt and mix the fish stuffing well. Make meatballs and weld them separately in broth. Then put meatballs into the soup and add sour cream. Feeding to the table, sprinkle with greens.
7. Vegetable puree soup on rice brave.
Required: 150 g of potatoes, 70 g of carrots, 30 g rice, 1 cup of milk, 1 tbsp. l. Oil, 1/2 egg yolk.
Cooking. Rice rinse and boil until readiness. Then wipe, mix with boiled and rubbed potatoes and carrots, breed with boiling milk, fill with yolk and butter. Feeding to the table, decorated with chopped greens.
Second dishes
1. Cutlets from veal steam.
Required: 200 g of veal, 20 g of bells, 30 g of milk, 5 g of oil.
Cooking. Rinse meat, cut into small pieces and skip through a meat grinder. Add a biller wet in milk and skip minced meat grinder again. Pour the rest of the milk and melted oil, salt, mix. Make the cutlets and put them on the lattice pairing lid. Put a double boiler on fire and cook cutlets at least 15 minutes. Cutlets serve with butter.
2. Steam memers.
Requires: 200 g of low-fat beef, 30 g rice, 20 g of oil.
Cooking. Meat Skip through a meat grinder, rice to boil in the water until ready, then drain and mix with meat, missing again through the meat grinder, add a little water and salt to the mince. Mass mix well and make several bikes. Boil meatballs for a couple. When submitting to pour sour cream.
3. Chicken steam bokings.
Required: 300 g of chicken meat, 20 g of a stalk of bread, 20 g of milk, 15 g of oil.
Cooking. A chicken meat to skip through the meat grinder, add a bug wet in milk, to skip and put a little oil, mix well and modify the backs. Cook for a couple. To the table of backs feeding with a vegetable side dish.
4. Fish baked in the oven.
Required: 1 kg of sturgeon or pike perch, 2 tbsp. l. Sour creams, 1 tbsp. l. Oils, salt, parsley greens.
Cooking. Purified fish put the skin down on a lubricated oil baking sheet. To lubricate sour cream from above, salt and pour into melted creamy oil. Put in the oven and bake at least 30 minutes. Before feeding to the table, cut into pieces and decorate the parsley greens.
5. Boiled meat baked in sauce.
Required: 150 g of low-fat beef, 70 g of milk, 5 g of flour, 100 g of apples, 1 tbsp. l. Butter.
Cooking. Boil meat and cut into small slices, then prepare sauce from milk and flour. Clear apples from the skin and core and cut into thin circles. After that, lubricate the frying pan with oil, put on the bottom of the apples, put meat with apples on the apples. Top pour sauce and bake.
6. Pudding dietary.
Required: 130 g of zucchini, 70 g of apples, 30 g of milk, 1 tbsp. l. Creamy oil, 15 g semolina, 1/2 eggs, 40 g sour cream.
Cooking. Zucchini cleaned, chopping and stew with milk to half-year. Then add sliced \u200b\u200bapples and grieved for another 3-4 min, after which you pour the semolina and hold the saucepan under the lid on the edge of the plate for 5 minutes, then cool. Add yolk and separately whipped protein, mix the mass, lay out in the mold, lubricated with oil, and bake. To the table is served with sour cream.
7. Potato zrazy "Surprise".
Required: 100 g of veal, 250 g potatoes, greens.
Cooking. Meat boil and skip through a meat grinder. Potatoes boil, wipe and add crushed greenery. Prepared potato mass to form circles and put mince in the middle. Put on a steam bath and bake.
8. Lazy dumplings.
Required: 100 g of cottage cheese, 10 g of wheat flour, 20 g sour cream, 10 g of sugar, 1 egg.
Cooking. Cottage cheese, mix with egg and add flour and sugar. From this mass form a roller and cut into small pieces. Put dumplings in boiling water and bring to a boil. As soon as the dumplings will pop up, remove them and file to the table with sour cream.
Third dishes
Berry kissel
Required: 50 g of fresh berries, 15 g of sugar, 6 g of potato starch.
Cooking. Berries to be confused and move the juice through the gauze. Legged to boil in water, strain and cook from the beam kissel. When Kissel cools, pour berry juice into it.
Diet and therapy for complications of diabetes
The development of ketoacidotic decompensation of diabetes requires both a decrease in the overall caloric content of nutrition and a sharp limitation of fat in the diet. During this period, creamy oil, cheese, sour cream are completely excluded from the diet, they need to be replaced by products containing carbohydrates. At the time of the ketoacidosis of the patient, it is necessary to provide sufficient number of full-fledged carbohydrates (sugar, sweet fruits, bread, bun, and potatoes without restrictions).
Only vegetable or fruit juices and mashed potatoes are prescribed in a heavy pre-or post-comatic condition, kissels containing carbohydrates, calcium salts and having an alkaline reaction. The use of alkaline mineral waters (type of borodom) is shown. Gradually (from the second day of post-comatic state), the bread is prescribed, from the third day - meat, the oil is administered only after the disappearance of ketosis. In the treatment of hypoglycemic states, it is necessary to observe a certain sequence of use of carbohydrate products, taking into account the severity of hypoglycemia and its development time. If the light hypoglycemic state occurs immediately 15-20 minutes before the next meal, then additional carbohydrates should not be introduced: you need to immediately feed the patient (starting meals from bread or bread, since the carbohydrates of these products are absorbed faster and easier than porporates, potatoes, etc.). If hypoglycemia develops between meals, the patient should additionally introduce carbohydrates.
If there are harbinger of hypoglycemia (feelings of hunger, weakness, heat, sweating), it is possible to limit ourselves to one or two slices of bread or bread (25-50 g). With more pronounced manifestations of hypoglycemia (headache and dizziness, sharp pallor, paresthesia, muscle tremors), it is necessary to give sweet warm tea (2-3 hours l. Sugar on a glass of tea). If the patient is close to loss of consciousness, it is necessary to immediately appoint 100% sugar syrup (2-3 hours l.). Finally, with the development of hypoglycemic shock or coma, the effect can be obtained only from the inkjet intravenous maintenance of a concentrated (20-40%) glucose solution. After receiving the bread or the twist of hypoglycemia, it should be eliminated after 10-15 minutes, after a sweet tea, the improvement occurs after 5-7 minutes, the use of sugar syrup improves the patient's condition in a few minutes, and with intravenous administration of glucose, the patient comes into consciousness "on the needle's edge" . Directly during injection.
Description of the disease
Gout - this is a disruption of metabolism, in which a sharp increase in the content of uric acid in the blood is noted (hyperuricemia). The consequence of this is the deposition of crystals of this acid or its salt, sodium urates, in the body tissues. These processes arise due to a violation of the exchange of purine bases and uric acid. During deposits in the joints of uric acid salts, severe inflammation occurs, which is characterized by severe soreness and limiting limb mobility. As a rule, the joints of the fingers and legs are affected. Gout meets much more often in men (up to 95%). The disease of the gout of women and children is extremely rare.
Increasing the number of patients with gout over the past decades is probably due to the increase in the material welfare of the population and the improvement of nutrition, a sedentary way of life, alcohol use, as well as with improved diagnosis of the disease. Most often, the gout is detected in countries with a high life level. Often the gout proceeds against the background of general obesity.
It should be noted that the gap is not synonymous with the elevated content of uric acid in the blood, since this symptom may be observed in many diseases (psoriasis, blood disease, etc.), as well as in healthy faces.
Gout is known from ancient times. Greek doctor Hippocrat mentioned it about 2400 years ago. The term itself comes from the Greek word Podagra - "drone feet." A classic description of this disease was given about 1660 by an English doctor T. Sidenchem, who himself hurt her. Many famous people suffered from gout (B. Michelangelo, O. Cromwell, J. Mazarini, Standal, G. de Maupassan, I.S. Turgenev, I.V. Goethe, O. Vista S. Bismark, A.V. Suvorov and Dr.).
In order to consider the cause of the disease, it is necessary to mention the role of uric acid in the body. The finite products of the exchange of purine bases are urinary acid and its salts (mainly sodium urates). Eating a large number of certain products, especially meat and meat products, which contain a large amount of purine bases, leads to a noticeable increase in the content of uric acid and its salts in the blood. In the body, urine acid is also constantly synthesized. In the blood of a healthy person, even without food products containing purine bases, contain a certain amount of uric acid.
Causes of gout
The main cause of gout is heredity. But that the disease develops, it is necessary to effect and other factors (such as excess nutrition, alcohol, etc.). The best proof of this is that in those areas of the globe, where the diet consists mainly of carbohydrate products (China, India, Africa), poor poubine grounds, gout occurs extremely rarely.
The gout is a consequence of urinary accumulation in the body. Its excess can occur in two ways. With one form, the kidney gage is not able to output the urinary acid produced in normal quantities. With a second form, the amount of uric acid sampled in the body significantly exceeds the ability of healthy kidney to withdraw it. In some patients with the second form of gout, as a rule, congenital metabolic defects are identified - most often the lack of a key enzyme that reduces the formation in the uric acid body. Its excess can also be an indirect consequence of many states associated with metabolic disorders, such as anemia, starvation or reception of some drugs. Gout, developing in such cases, is called secondary.
The deposition of uricular salts predisposes the accompanying urine reaction, which in healthy people is weakly acidic. If the acidity of urine increases, the salts of uric acid begin to accumulate in the body, which form conglomerates. When the acidity of urine acidity is shifted in an alkaline side due to a large amount of phosphoric acid salts, other kinds of phosphates can be formed. The appearance of stones, which include salts of oxalate, are oxalates depends on the urine reaction shifts. One of the most important causes of changes in acidity indicators in the urine is considered a violation of water-salt metabolic metabolism in the body, in the regulation of which kidneys participate.
Diseases or situations are also known when the gout is only a symptom (for example, with a myelolomicosis, congenital and acquired heart defects, lead poisoning, the use of diuretics, riboxin, etc.).
Of the predisposing factors, the abuse of a number of food products (meat, bean and other products, rich purin bases) and beverages (mainly red wine, coffee, cocoa) should be distinguished. It can only cause gout attacks, but is not the main cause of the disease.
Aspirin's action is also very interesting: low doses reduce the release of uric acid, and high - increase the allocation of urates. Thus, those prophylactic doses of aspirin, which are prescribed to patients to prevent myocardial infarction and stroke, can contribute to the emergence of gout attacks.
A combination of gouts with a number of serious diseases such as obesity and hypertensive disease is very important. Hypertensive disease is interconnected with the gout of several paths. On the one hand, hypertension reduces the removal of ultrasters, on the other hand, the formation of the kidney tissue of urinary acid deposition (microtofus) can contribute to the development of secondary renal hypertension. When goug is often developing increased blood fats and atherosclerosis, and naturally, one of the most unpleasant consequences of gout is a frequent development of vascular complications.
Often there is a combination with diabetes mellitus, which is associated with the presence of a diuretic effect with an elevated sugar content in the urine during diabetes mellitus. There is an influence of urates on pathological immunity to insulin (resistance). This resistance may, in turn, contribute to the development of hypertension and coronary failure. Thus, the violation of purine, carbohydrate and lipid exchanges is the complex that is characteristic of a patient gout.
But at the same time, there are effective relationships - the gout is usually not developing after the rheumatoid arthritis arose (due to the ability of proteins of the synovial fluid to destroy the crystals of ultrasons).
The main manifestations of gout
The main manifestations of gout are gouty nodes, gouty arthritis, as well as a urolithiasis at which stones consist of uric acid salts or crystals of the urinary acid itself. Gouty nodes (tufasi) are crystals of uric acid salts, interconnected into small conglomerates, they can be postponed almost in any part of the body. When such deposits occur in the joints or eyelace tissues, they cause the body's reaction as an alien body, in which acute inflammation develops. This condition is called gout arthritis.
A typical attack of gout arthritis, the most characteristic manifestation of the gout, arises in one joint, usually the thumb, ankle or knee joint. The attack is most often evolving in the early morning in the form of a sudden strong gulp of pain in the scratched joint. The skin above it becomes a bugmer and slow. In the afternoon, the pain weakens somewhat, but by night it is intensified again. So continues for several weeks. When the process is repeated, other joints can be involved in it, which leads to partial damage to the bones.
With excessive content in the blood of uric acid salts, they are postponed in the kidneys, forming uranium stones. In other cases, such stones consist mainly of crystals of the urinary acid itself, and not its salts. The kidney stones arising when gazing can cause renal failure and death.
Power treatment
Power treatment is reduced to a decrease in the content of uric acid and its salts in the body by limiting the introduction of nucleoproteins with food and the use of drugs that depress the formation of uric acid and its salts in the body and reinforcing them with kidneys.
Medicinal nutrition for gout
For the treatment of gout outside the exacerbation, diet No. 6 is applied on Pevznera. The essence of this diet is that from the diet, products rich in nucleoproteins, oxalic acid, and introduce products, poor nucleoproteins.
A comparative analysis of the content of purine bases in various products is shown in Table 5. It is very important with the help of therapeutic nutrition to affect the acid reaction of urine, shifting it into the alkaline side. This will lead to an increase in the solubility of uric acid and thereby preventing the occurrence or progression of the gouty urolithiasis.
Table 5. The content of purine bases in 100 g of food (on G. Levin)
For diet number 6, a certain limitation of proteins, fats (especially refractory). In the presence of concomitant obesity, it is necessary to limit and easily durable carbohydrates. The chemical composition and energy value of the daily diet are: proteins - 70-80 g, fats - 80-90 g, carbohydrates - 400 g; Energy value - 2700-2800 kcal.
The power mode with this diet is fractional, 4 times a day, in between and on an empty stomach, be sure to additionally take the fluid. Food temperature is ordinary.
With diet number 6, the table salt (up to 5-7 g along with the products contained in products) is moderately limited, the percentage in the daily diet of vegetables, fruits and dairy products, which lead to the sheath of urine indicators in the alkaline side. To correct the disorders of the water and salt metabolism, it is recommended to use a large amount of fluid (in the absence of contraindications from the cardiovascular system). The amount of free fluid should reach 1.5-2 liters per day.
The list of allowed and prohibited products is presented in Table 6.
Culinary processing of food ordinary. The exception is the culinary processing of meat, birds and fish, which consists in binding pre-bias. This is done, because during cooking up to 50% of the purines contained in the product go into broth. After boiling meat, bird, fish can be used to prepare various dishes (stew, baked, fried, chopped products. You can combine meat and fish about equal amounts. In the diet, meat and fish dishes include no more than 2-3 times a week. A piece of meat should not be more than 150 g (proteins - 17.7, fats - 3.6 g, calorie content - 106 kcal). Fish is allowed to be used to 170 g (proteins - 14.9 g, fat - 0.4 g, calorie content - 65 kcal).
It is recommended to limit the use of animal refractory fats rich in rich fats in food, since there is a direct relationship between them in food, an increase in the level of uric acid in plasma and a decrease in its selection with urine.
Use of products rich in alkaline valences (vegetables, fruits, berries), contributes to urine sick. Their positive effect is also due to the presence of potassium, which has a pronounced diuretic effect and thereby favors the removal of uricular compounds from the body.
For gouting, it is necessary to provide the body with an adequate amount of vitamins C (ascorbic acid), B1 (riboflavin) and niacin.
Before a man suffering from gout, it is necessary to drink 1 cup of liquid. It can be stonentious tea, coffee, tea with milk or lemon, kefir, decoction of wheat bran, juices. It should be limited to products that excite the nervous system (coffee, cocoa, strong tea, sharp snacks, spices, etc.). The use of alcoholic beverages can provoke gouty attacks, as alcohol worsens the breadth of uric acid kidney.
When goug is recommended once a week, unloading days are curd, kefir, dairy and fruit. When conducting unloading days, the patient should receive at least 1.5-2 liters per day. But the treatment of hunger and the appointment of "hungry" days, on the contrary, is strictly contraindicated. Fasting already in the first days leads to a sharp increase in the content of uric acid in the blood, with the subsequent occurrence of an attack of gout.
If the gout is combined with obesity, prescribe diet No. 8 using unloading days. With all the treatment options, it is necessary to introduce 1.5-2 liters of fluids per day.
Table 6. Characteristics of permitted and prohibited products for diet No. 6 by Pevznera
Approximate diet menu number 6 for a week
First breakfast: vegetable salad with vegetable oil, tea with milk.
Breakfast: Omelet Natural Steam, Robber Hip.
Lunch: milk noodles, potatoes fried potatoes, kissel.
Afternoon school: fresh apples.
Dinner: Boiled fish, Pudding steam from low-fat curd, tea.
First breakfast: buckwheat porridge, Egg Ski, Pudding from carrots with apples and a militant, fastening coffee.
Second breakfast: Robbing decoction.
Lunch: Vegetarian borsch, potato baked, baked in sour cream, peid carrots, fresh apples.
Afternoon school: fruit juice.
Dinner: carrot casserole with prunes, soy bun, faint tea with lemon.
At night: tea with milk.
First breakfast: vegetable salad with paste "ocean" on vegetable oil, protein omelet, tea with milk.
Second breakfast: dried fruit machined.
Lunch: Vegetarian vegetarian soup from prefabricated vegetables, pudding curd steam, compote fruit.
Afternoon snack: Rube Hip.
Dinner: baked cheese, cabbage rolls, stuffed with vegetables with rice, tea.
At night: kefir.
First breakfast: beet and apples salad with sour cream, fastening coffee.
The second breakfast: fruit with tomatoes, fresh fruit.
Lunch: Okroshka, stew vegetable with boiled beef, tea with lemon.
Afternoon person: compote from berries.
Dinner: Potato salad with fresh vegetables, cabbage casserole with sour cream sauce, tea with milk.
For the night: decoction of wheat bran.
First breakfast: beet and prunes salad, roshovnik decoction.
Second breakfast: Egg Ski, faint coffee.
Lunch: oat milk soup, pasta with cheese, carrot cutlets with sour cream, tea with lemon.
Alpan: a glass of fruit juice.
Dinner: Dumplings with cottage cheese, prunes, baked with cottage cheese, ripping rosehip.
At night: kefir.
Unloading cottage cheese day: 100 g of cottage cheese of low-fat or 9% grease 5 times a day.
At night: kefir.
First breakfast: winecraft with vegetable oil, oatmeal porridge, coffee with milk.
The second breakfast: omelet with apples, compote berry.
Lunch: beetter, beequer beef beefstroogan, stew cabbage, fruit kissel.
Sferdnik: Fresh fruits.
Dinner: Curd cheese, beets, stuffed with rice and apples, ripping rosehip.
At night: Cranberry Morse.
Fitotherapy for gout
When pressing, it is recommended to include the following fruits and berries in its diet: a lingonberry, cherry, strawberry, red and black currant, apples. Fruits and berries need to eat twice a day, in the morning and in the evening, 40-60 minutes before meals or 2-3 hours after meals.
Brushing tea is very useful. For this it is necessary to 1 tbsp. l. Leaf lingonberries brew a glass of water. Drink 1 tbsp. l. 3-4 times a day.
In traditional medicine, since ancient times, the following fee was used as ancient for the treatment of gout: take the flowers of elderberry black, lime color, hormour grass, daisy flowers - 1 tbsp. l., Mix everything thoroughly. Place the mixture into porcelain dishes, boiled boiling water, close the lid tightly and put for 15 minutes on a water bath. Then cool at room temperature, strain, and residues of raw materials. After that, bring it to it with boiled water to the desired volume in the ratio of 1:10 or 1:20. Take 3-4 glasses 4 times a day 15 minutes before meals. Store in a dark cool place or in the refrigerator no more than 3 days.
The miraculous properties have a tincture of garlic with a lemon, which is needed to drink in the morning on an empty stomach. Take 1/4 cup 3 times a day before meals for three weeks.
All means of phytotherapy should be alternating in approximately 1 month.
Medicinal nutrition when aggravating gout
In the occurrence of an acute gage attack, the patient needs to provide a strict bed mode with a complete shutdown from the movement of the affected limb. These days it is very important to observe a strict diet and adequate drug therapy.
For the period of exacerbation of gouts, any meat and fish products are categorically prohibited. The main products are predominantly liquid dishes (milk, lactic acid products, kisins, compotes, vegetable and fruit juices, faint tea with milk or lemon, vegetable soups, liquid porridges). It is necessary to ensure that the patient does not suffer from hunger and consumed up to 2 liters of fluid per day. Especially useful on such days the use of alkaline mineral waters.
During the exacerbation of gouts, digestive disorders are often noted, which are often aggravated by drugs annoyingly acting on the gastrointestinal tract, and therefore it is necessary to respect the gentle diet. During the grown of exacerbation, a limited number of meat dishes is allowed (one or twice a week of 100-150 g of boiled meat). Other days, dairy products, eggs, cereals, potatoes, vegetables and fruits are recommended. Such a diet is scheduled for 1-2 weeks.
Dishes for diet number 8
Cold snacks and salads
1. Fried eggplants.
Required: 1 large eggplant, salt in taste, flour, 2 glasses of vegetable oil.
Cooking. Eggplant cut into pieces with a thickness of up to 5 mm, decompose them on a tray and sprinkle with salt. Leave at least 30 minutes to remove excess moisture. Then wash the salt and dry eggplants with paper napkins. Next, the pieces of eggplant are placed in a plastic bag or a paper bag, which is puffed flour. The bag should be carefully shaken, then remove one pieces of eggplant and, shaking off the extra flour, lay out pieces on the tray. To fill the french oil (or vegetable) oil in such a quantity so that its layer was 5-8 cm. Heat the oil up to 190 ° C and lowered so many eggplant circles into it, how much can fit on the oil surface. Fry every side until he is twisted and will not become crunchy. Finished pieces to remove noise and lay out on paper napkins. The finished dish sprinkle with greens.
2. Pickles.
Required: 10 Bulgarian peppers, 5 tomatoes, 6-7 garlic cloves, salt to taste.
Cooking. People wash, do not remove the core, do not squeeze, put on a preheated pan in sunflower oil and fry to the darkening of their skin without closing the lid. It is important to turn the pennants all the time so that they roar evenly from all sides.
Prepare Sauce: Take tomatoes and omit in boiling water, cook 2-3 minutes. Remove, remove the skin, cut the core, renovate fork. Add garlic, salt, pepper and mix everything thoroughly. Sick pecifications on a dish with sauce. Eating pechers along with the core.
First meal
Vegetarian borsch with pampushki.
Required: 1 cup of dark beans, 1 medium size beets, 2 carrots, 1 fresh or frozen Bulgarian sweet pepper (seasonal), 4-5 medium tomatoes or tomato paste, 4-5 potato tubers, 1/2 Kochana cabbage, 2 st . l. Sunflower oil, greens, salt to taste.
Cooking. Pushed and washing beans put in a saucepan, pour water (approximately half of half) and cook depending on the variety for 1-2 hours. While the beans are boiled, make a grip. Clean beets, carrots, sweet peppers, tomatoes and cut into straws. Sliced \u200b\u200bstraw beets to sprinkle with salt, slightly mix and put it in a deep frying pan (or a skeleton), lubricated with oil. Salt is needed so that the beets let juice and borsch have a bright color and a pleasant fragrance. In such a state, give beets to stand a little, so that it becomes softer, and then put sweet pepper into it, sliced \u200b\u200btomatoes or tomato juice and extinguish everything. In the welded bean, put the potatoes, sliced \u200b\u200bby cubes, which you need to cook until ready, then chopped cabbage and carrots. After the cabbage copied, you can add a prepared roaster. Mix well, let boost boil for another 5 minutes on low heat. At the end, salute to taste and put greens.
Pampushki, which are prepared as follows. To do this, take 500 g of flour, 1 cup of water, 10 g of yeast, 1 tbsp. l. vegetable oil and as much sugar, 0.5 h. Salt and knead the dough. Modify small balls, put them on a lubricated oil bastard and put in a warm place. Then bake for 30 minutes.
Second dishes
Oatmeal cutlets.
Required: 1 cup of oat flakes, 1/2 raw potatoes, 1 vegetable bouillon cube, 1 egg, flour for slaughter, 3 tbsp. l. vegetable oil.
Cooking. Glass of Hercules Flakes Pour 0.5 cups of steep boiling water, in which 1 Vegetable Bouillon Cube was dissolved. All this is stirred to a thick consistency. In the resulting mass add an egg, to lose raw potatoes. To let stand until it cools, so that the mixture can be taken in hand, cut down the cutlets, cut into flour, fry in a large number of boiling vegetable oil to a golden crust.
1. Strawberry pudding.
Required: 0.5 cup of milk, 2 h. Sugar, 1/2 Package Vanillina, 2 h. Corn starch, 1 cup of strawberry, 1 protein or whipped cream.
Cooking. Milk with sugar and vaniline boil and brew in it stirred with cold milk corn starch. Cook with constant stirring to thick mass. When the mixture is cooled, add to it rubbed through a strawberry sieve, mixed with sugar. Then combine with whipped protein. Place in glass dishes. Decorate with strawberries, whipped cream.
2. Apple casserole.
Requires: 1 cup of sugar, lemon juice 1, 1 cup of sugar, 100 g of butter, 100 g of groundwash (hazelnut), 100 g of rum-sulfur, citric acid, sugar powder.
Cooking. Apples thoroughly clean the skin, cut into 4 parts, extract seeds. Peel to softness in a mixture of water, sugar and lemon juice. Shift to sieve and give a track. Cooking puree from apples. Melt 30 g of butter. Carefully mix the crumbs, nuts, raisins and citric acid. Preheat oven to 200 ° C, layers lay a dried mass and apple puree. Finish with a layer of cracked mass. From above, distribute pieces of the remaining butter and bake for 15 minutes. Before serving, sprinkle with powdered sugar.
Obesity
Description of the disease
Obesity is a violation of the metabolism of the body characterized by the presence of an excessive amount of adipose tissue. At the same time, so much kilocalorium comes into the body that it exceeds the required level. In obesity in cells, excessive conversion of carbohydrates into fats is observed. As a result, an approximately adequate energy excess accumulation of body mass is noted. In the quantitative measurement, it is equal to the private from dividing the excess of the resulting calories by 9. More often, obesity occurs after 40 years, mainly in women.
Causes of obesity development
The reasons for the development of obesity and manifestations of arising from this consequences are quite complex and diverse. In the blood, a long time remains a high level of lipids (fat), which adversely affects the state and functioning of the central nervous system. This leads to a violation of the work of centers regulating metabolism, and, as a result, a pathological change in fat metment throughout the body.
In obesity, it is difficult to work with almost all organs and systems. First of all, the activity of the cardiovascular system is violated. Due to the impairment of cholesterol, atherosclerotic changes of the aorta and coronary heart vessels are formed. Fat sediments in the heart bag are constrained by the heart, interfere with its work. The deposition of fat between its muscle fibers reduces the power of heart abbreviations. There is gradually insufficient blood circulation.
The provision of oxygen tissues is reduced, which is aggravated by the difficulty of breathing, gradually decreasing the lungs life tank. People suffering from obesity are to a greater extent than people with a normal mass of the body are subject to hypertension, angina, myocardial infarction and brain hemorrhages.
A significant deposition of fat in the abdominal cavity leads to the intestinal displacement down, the abdomen. The activity of the gastrointestinal tract is broken. Emptying of the intestine slows down, constipation arise, flatulence, venous hemorrhoids are formed.
The appearance of a person suffers. Increased sweating, diameters in the folds of the skin, are parts of multiple minerals, seborrhea (intensive dandruff formation) of the scalp.
The mental state of man is disturbed. This is manifested by drowsiness, dispellation, weakening of memory, increased fatigue. Dizziness and emotional instability with rapid mood changes are possible. But chronic stress, which often experiences a person, can also contribute to weight gain. The causes of stress may be dissatisfaction with material and social status, concern for the future, instability of the political situation and a number of other factors. In the conditions of a shortage of positive emotions, a person subconsciously seeks to enjoy to protect against stress, and "hire problems."
The following factors play a role in the development of obesity: a constitutional predisposition, a decrease in physical activity, age-related, sex, professional factors, some physiological conditions (pregnancy, lactation, climax).
Due to the emergence of obesity, it is divided into three large groups:
alimentary-constitutional;
caused by violations of the central nervous system;
hormonal (obesity in endocrine diseases).
Combines all types of obesity. The presence of overweight body.
Alica and constitutional obesity is the most common view. Alimentary-constitutional obesity is often detected from members of one family or close relatives. Based on the name it is clear that this obesity group has two main reasons. The first part of the word denotes that the food diet has an increased calorie content. This is especially dangerous with a sedentary lifestyle, in which reduced calorie consumption, systematic overeating, violation of the food regime.
But people who already suffer obesity may have changes in hormonal status, distinguishing them from people of normal and asthenic buildings. It should be noted that not these changes are the cause of obesity, but on the contrary.
The second part of the term suggests that there is a certain individual predisposition, which determines the food habits, the level of feeling of hunger, motor activity, as well as energy consumption during human physical activity.
When developing obesity due to various violations of the central nervous system, the leading role is played by expressed pathological changes in the work of hypothalamus, causing a change in behavioral reactions, especially food behavior, and various hormonal disorders. At the same time, the activity of the hypothalamic-pituitary-adrenal sound system increases: the secretion of adrenal hormones increases, the secretion of the hormone, having a fat-making effect, is reduced, the secretion of female and male genital hormones is disturbed. It is characterized by improving the level of insulin in the blood, reducing the effectiveness of its action. The effect of thyroid hormones and sensitivity to them organs and systems are disturbed.
Endocrine obesity is the most rare obesity group. Obesity can manifest themselves with such diseases of the hormonal system, as an Itsenko-Cushing disease, hypothyroidism, hypogonadism in men, a shortage of growth hormone, and some other diseases. At the same time, obesity is not a major sign, it does not care for a person first.
Measurements
In order to objectively assess the degree of obesity, there is a body mass index (BMI). With it, it is possible not only to calculate the excessive body weight, but also to predict the risk of angina, myocardial infarction, hypertension, diabetes mellitus.
The formula for calculating this indicator is as follows:
BMI \u003d body weight (kg) / height (m) 2
For example, a woman has a growing 167 cm and weighing 85 kg of BMI is 30.5.
There are four degrees of obesity.
1. When BMI< 18,5 отмечается дефицит веса.
2. With BMI 18.5-24.9, the weight is normal.
3. Excessive is the weight of NAM 25.0-29.9.
4. With CMT 30.0-34.9, the diagnosis of obesity I degree is made: the actual body weight exceeds the ideal no more than 29%.
5. With BMI 35.0-39.9 - obesity of the II degree: an excess of body weight is 30-40%.
If CMT\u003e 40, then there is a sharply pronounced obesity. With III degree of obesity, the actual mass of the body exceeds ideal by 50-99%, with IV degree of obesity - 100% or more.
In addition, other anthropometric indicators are used to determine the risk of disease with cardiovascular diseases during obesity. For example, measuring the circle of the waist. The risk of disease increases significantly when the waist circle in men\u003e 102 cm, in women\u003e 88 cm.
When a person appears, the I-II degrees of obesity appear such complaints as weakness, fast fatigue, drowsiness, reduction, sweating, nervousness, irritability. The gastrointestinal tract is beginning to disturb the nausea, the appearance of bitterness in the mouth, as well as flatulence, chronic constipation. With physical work, shortness of breath appears. At the II degree, the lower limbs begged, bolted pain in the joints, especially in the spine due to an increase in the load on it. It is worth noting that if at the I degree of obesity, the patient's performance does not change, although such signs are beginning to appear as shortness of breath, fast fatigue in the physical exertion of the average intensity, then at the II degree performance is noticeably declining.
For III degree of obesity, the development of ugly disproportionality of the physique is characterized. Disability is actually lost due to constant shortness of breath even alone. The patient has a pronounced circulatory disorder, swelling does not disappear during the day. Attention is drawn to a sharply increased appetite of a person against the background of general lethargy and drowsiness.
With IV degree, a person becomes a complete disabled person, this is because the body weight exceeds normal twice. A mental state is disturbed by obese, he loses its connection with the world around, it does not care except food.
In obesity, the cause of which is violations of the functions of the central nervous system, specific features are noted. An incredible appetite appears that appears usually in the afternoon and at night with a strong thirst. Women appear certain gynecological problems, such as disorders of the menstrual cycle, increased hairiness (girsutism), infertility. Men, in turn, suffer impotence. The skin appears acne (acne) and trophic disorders, on the hips, abdomen, shoulders, axillary depressions - small pink stria (stretch marks). Characterized by increased pigmentation, especially in the area of \u200b\u200bthe neck, elbows, friction places. In the hypothalamic type of obesity, hypertensive disease is very rapidly developing.
Why with obesity should be struggling
Convincing recommendations of doctors to people suffering from obesity, have good reasons. Obesity is often complicated by a second-type diabetes (80% of cases). It should be emphasized that not diabetes is the cause of obesity, but, on the contrary, obesity is the cause of diabetes mellitus. Women develop heavy endocrine disorders (hyperandrogenation), which are expressed in the extinction and termination of the menstrual function, the development of male genital signs, such as hair appearance, chest, back (at the same time on the scalp, on the contrary, there are signs of baldness), hoarseness Voices, reduction of the size of the mammary glands, infertility. With a large mass of the body, arthritis (inflammation of one or more joints of one or more joints, including intervertebral joints), is manifested by frequent, almost familiar radiculites, followed by the deformation of the articular surfaces of the vertebrae and the spinal curvature.
Treatment of obesity
Qualified struggle with obesity problems are engaged in nutritionists and endocrinologists.
A complex of obesity treatment measures includes a certain diet, an increase in physical activity, psychotraining for changing attitudes towards food. Against the background of body weight loss, the main exchange is reduced, which helps to preserve the energy received from food and reduce the effectiveness of dietary treatment. This requires in the process of treating the recalculation of daily caloric content of food and increase engine activity. In the endocrine forms of obesity, the main disease is carried out. Among the various groups of specialists, endocrinologists are engaged in the treatment of obesity. Now medicine has developed medicinal drugs that reduce appetite ("Meridia") or inhibitable suction of fats in the intestine. In obesity of IV degree, surgical operations are performed to reduce the size of the stomach (vertical gastroplasting) and removing excess adequate tissue (liposuction).
People suffering from an alimentary-constitutional obesity, have a tendency to long sleep, as well as sleep after eating. To reduce weight, it is not recommended after lunch, neither go to bed or sit down, it is better to take a long time for 10-15 minutes.
Therapeutic nutrition
With obesity, diet No. 8 on Pevznera is recommended. A feature of all therapeutic diets is their absolute harmlessness for the human body. In each case, the doctor can adjust the standard diet depending on the patient's condition.
The essence of this diet is to reduce the calorie content of the diet mainly due to easily digestible carbohydrates, as well as animal fat while maintaining a normal or slightly increased protein content (with a long stay on diets with a reduced amount of protein, disorders occur in the liver, cardiovascular system). Due to this, a decrease in body weight is achieved, restoring impaired fat metabolism and water-electrolyte balance.
The chemical composition of the diet is the following: proteins - 100-110 g, fats - 80-90 g (of which 50% vegetable), carbohydrates - 120-150 g, cyloaloria - 1600-1800. Only in hospital conditions with a severe degree of obesity are prescribed a diet with an energy value of 1200 kcal.
For this diet, a fractional power supply is characterized (5-6 times a day) with a volume sufficient for saturation. A sufficient volume is formed by low-calorie food (raw vegetables, fruits), while there is no sense of hunger. This avoids stress and comply with the proposed diet for a long time.
Culinary processing of dishes - capacity, quenching, baking. It should be limited to the consumption of fried, rubbed and chopped products.
With diet number 8, it should also limit the amount of free fluid to 1-1.2 liters (soup to 1 reception not more than half a plate and 3-4 glasses of liquid in the form of milk, tea, compote, only about 5-6 glasses of free fluid per day ), Salts up to 3-5 g and exciting food appetite and dishes (pepper, mustard, garlic). Alcohol must be completely excluded from the diet.
In the daily diet, it is necessary to content up to 400-500 g of protein products in the form of fish, meat, cottage cheese, etc. It is recommended to include seafood in the diet.
The meat before roasting is necessarily dried.
It is necessary to enrich its diet with a large number of vegetables in order to increase the content of fiber in food required for the optimal functioning of the gastrointestinal tract. Part of vegetables must be presented in the raw form.
The low-calorie plow of the watermelon is especially useful from fruit, in 100 g of which is about 38 kcal. When obesity, watermelons can be consumed in large quantities to suppress the feeling of hunger.
The amount of vegetable fat should reach 50%, because it has the ability to activate the grain splitting process.
Sugar is prohibited, instead of it uses substitutes (for example, xylitol, sorbitol) for the preparation of sweet dishes and drinks.
A certain meaning is the quality of fat: it is best to use vegetable and butter, which are faster oxidized and used by the body to replenish energy costs.
The list of permitted and prohibited dishes is presented in Table 7.
Table 7. Characteristics of permitted and prohibited products for diet number 8 by Pevznera
Unloading days are assigned to ensure the gentle mode of operation of organs and systems, facilitate and improve their function, contribute to the normalization of metabolism. These days are needed to remove the exchange products from the body, increasing the efficiency of the main diets. Unloading days are prescribed according to the nature of the disease and tolerance by 1-2 days and no more often 1-2 times a week. Products used in a unloading day are accepted with equal portions 5-6 times a day.
In addition to the unloading days presented in the chapter "Therapeutic diet with diabetes", a few more options are offered below.
Salad day. During the day, there should be fresh raw vegetables and fruits (5 times a day 250-300 g without salt with the addition of vegetable oil). Also, this type of discharge diet is useful in diseases such as atherosclerosis, hypertensive disease, diabetes of second type, jade, liver disease and biliary tract, gout, urolithiasis without phosphaturia.
Floor day. During the day, it is necessary to drink 600 ml of the juice of vegetables or fruits, pre-diluted with 200 ml of water or 800 ml of risk rosehip. Juice is divided into 4 reception. This type of discharge diet is also useful in diseases such as atherosclerosis, hypertensive disease, diabetes of second type, diseases of the kidneys, liver and biliary tract, gout, urolithiasis without phosphaturia.
Cucar day. During the day, it is necessary to eat 1.5 kg of fresh cucumbers and 1 egg welded by splitting this amount of food on 5 receptions.
Phytotherapy in obesity
In folk medicine for the treatment of obesity uses bee honey. 1 tbsp. l. Bee honey stir in 0.5 glasses of warm water of room temperature. Drink on an empty stomach. After that, it is not within 2 hours. 2 hours before sleep, overnight, again drink on an empty stomach of 0.5 glasses of water with 1 Article dissolved in it. l. Honey. Honey should be drunk for 1 month. After a 1-2 week break, the treatment is recommended to repeat.
For the treatment of obesity apply the following two collection:
1) White Birch Kidney - 1 tbsp. l., daisy flowers pharmacy - 1 tbsp. l., Grass of the Hypericum Different, Grass Immorteur Sandy - 1 Art. l. All ingredients gently mix and exterminate into powder. Take 1 tbsp. l. Gathering, brew in porcelain kettle 500 ml of boiling water, let it stand for 12-15 minutes. Drink tea twice a day: in the morning and in the evening 1 cup, having stirred in it 1 tsp. Honey. After the evening reception of herbal tea is not recommended;
2) the root of chicory of ordinary - 1 tbsp. l., Coray crust breaking - 1 dec. l, fruits parsley kudryavoy - 1 dec. l., Dandelion dandelion leaves - 1 dec. l, corn springs - 1 dec. l., The grass of mint is a list - 1 t. l., The grass of the yarrow of an ordinary one - 1 tsp. Take 2 tbsp. l. This medicinal collection, brew 500 ml of boiling water overnight in a thermos, to strain and drink 0.5 cup 3 times a day 30 minutes before meals for 1.5-2 months.
Approximate diet menu number 8 for a week
First breakfast: Boiled meat with green peas, cheesecakes with sour cream, tea with lemon.
Second breakfast: fresh apples.
Lunch: vegetable soup, boiled fish with potatoes, pineapple juice.
Halfoon: Cottage cheese is low-fat with milk.
Dinner: Fish boiled, stew from vegetables, tea.
At night: kefir is low-fat.
First breakfast: meat salad, omelette, faint coffee.
Second breakfast: jelly from cranberries.
Lunch: Vegetarian borsch with sour cream, boiled meat, stewed cabbage with vegetable oil, compote from dried fruits without sugar.
Afternoon person: Pudding from carrots and apples.
Dinner: stew meat, carrots, stewed under the sauce of Beshamel, compote with a sugar substitute.
For the night: Rubbernik's decoction.
First breakfast: vegetable salad with vegetable oil, cottage cheese, low-fat, tea.
Lunch: Okroshka with kvass, boiled beef beefstrokes with a garnish of fresh vegetables, dairy jelly.
Afternoon school: kefir.
Dinner: Vinaigrette, marinade fish with potatoes, faint coffee.
At night: tea with lemon.
First breakfast: seafood salad, buckwheat porridge, fruit compote.
Second breakfast: fresh apples.
Lunch: soup cooked on the secondary meat broth, fisher fill, stewed cabbage, lemon tea.
Sferdnik: Cheesecakes with sour cream.
Dinner: Cucumbers stuffed with egg, stew meat with vegetables, Morse.
For the night: Rubbernik's decoction.
First breakfast: fresh cabbage salad with green peas, scrambled eggs, tea with milk.
The second breakfast: the flesh of the watermelon.
Lunch: beetroot, fried fish with boiled potatoes, lemon jelly, compote from unsweetened fruits.
Sferdnik: Cheesecakes with sour cream.
Dinner: boiled meat with ham and cucumber, pudding from apples, tea with lemon.
At night: low-fat kefir.
Unloading kefficer day.
First breakfast: Salad of sauerkraut with apples, egg skey, Morse.
Second breakfast: Fresh fruit.
Lunch: Borsch on the secondary meat broth, boiled chicken with a vegetable side dish, orange juice.
Afternoon school: low-fat cottage cheese with milk.
Dinner: Fried fish with boiled potatoes, stewed cabbage, compote from unsweetened fruits with a sugar substitute.
For the night: Rubbernik's decoction.
Dishes for diet number 8
Recipes are given per 1 portion.
Cold snacks and salads
1. Vinaigrette.
Required: 1 potato tuber, 1 small beet, 1 Salted cucumber, 1 fresh apple, 1 carrot, half of the bulbs, 1 tbsp. l. vegetable oil, sour cream or mayonnaise.
Cooking. Boiled potatoes, beets and carrots clean from the peel and cut into small cubes. Salted cucumbers, apples and onions cleaned and cut the same. All ingredients of the vinegar mix, fill with vegetable oil and pour mayonnaise or sour cream.
2. Salad of sauerkraut with cucumber.
Required: 100 g of sauerkraut, 1 salty cucumber, 1 tbsp. l. Luke and vegetable oil.
Cooking. Washed in boiled water sauer cabbage squeeze. Salted cucumbers cut in half, remove the seeds, cut into cubes. Onions chopping onions. Fix with vegetable oil and mix.
3. Cucumbers stuffed with eggs.
Required: 2 fresh cucumber, 1 egg, 2 tbsp. l. sour cream, greens.
Cooking. The washed small thin cucumbers to cut in half, cleaned grain from them. Finely chopped boiled eggs mix with greens and sour cream, salt to taste. Farming the cucumbers obtained by the mixture.
4. Meat salad.
Required: 100 g meat, 1 potato tube, 3 tbsp. l. Cabbage, 1 tomato, 2 tbsp. l. Canned green peas, 1 tbsp. l. sour cream, greens.
Cooking. Boiled meat cut into slices. Boiled potatoes cut into cubes. Washed and launching cabbage to put out. All mix and put on a plate. Then add fresh or canned tomatoes, canned green peas, stewed cabbage. Salad fill sour cream. Sprinkle finely chopped with greens from above.
5. Boiled meat with ham and cucumber.
Required: 100 g of meat, 50 g of ham, 1 cucumber, 1 tsp. Sliced \u200b\u200bgreenery.
Cooking. Boiled and chilled meat cut into slices of the same size. Also cut the ham. Fresh cucumber cut into circles. Beautifully lay out meat, ham, cucumber on a plate and sprinkle finely chopped with greens.
6. Boiled meat with green peas.
Required: 100 g of meat, 1 canned green peas.
Cooking. Sliced \u200b\u200bwith slices meat boil to half-year. The resulting broth to merge, pour the meat with juice from canned green peas and cook until readiness. Cool Pleep meat put on a plate, attach green peas and deliver juice obtained during cooking meat.
7. Herring with boiled potatoes.
Required: herring fillet, 2 potato tuber, 1 tbsp. l. vegetable oil, greens, vinegar, rings of a bunk.
Cooking. From herring to remove the bones, soak in water for 10-12 hours. Boiled potatoes to clean the peel in the mundire and cut into circles. Herring prepared by fillet put together with potatoes on a plate, to fill with vegetable oil and vinegar, divorced in half with water. Decorate the dish with rings of the onion and chopped greens.
First meal
1. Borsch on the secondary meat broth.
Required: 200 g beef, 2 potato tuber, half of a small cabbage, 1 Tomato, 1 small zucchini, 1 carrot, 1 parsley root, 1 tbsp. l. sour cream, 1 tsp. Oil, 1 tsp. greenery.
Cooking. A piece of lean beef put in a saucepan, pour cold water and bring to a boil. Drain the broth, re-pour water and cook for 1-1.5 hours. In the resulting broth, put the chopped vegetables and cook under the lid until readiness. Before serving to the table, fill the sour cream and sprinkle finely chopped with greens.
2. Sing acid on the secondary meat broth.
It is required: 200 g of cabbage, 10 g of butter, 15 g sour cream, 10 g of flour and bow, 35 g of carrots, 10 g of parsley and tomato paste.
Cooking. Onions, carrots and root cleaned, chopping and spruce. Flour to dry, mix with tomato-paste and fry, stirring constantly. Press the sauer cabbage, put in a pan, pour secondary meat broth and cook until readiness. Shortly before the end of the cooking, introduce prepared roots and flour with tomato-paste and give it to boil. Serve with sour cream.
3. Soup from prefabricated vegetables.
Required: 2 potato tuber, half of a small Kochana cabbage, 1 tomato, 1 small zucchini, 1 carrot, 1 parsley root, 1 tbsp. l. Canned green peas, 1 tbsp. l. sour cream, 1 h. l oil, 1 tsp. greenery.
Cooking. Clean and chopping carrots and parsley root, then allow them with butter under the lid. Shift to pre-sliced \u200b\u200bvegetables, peas and potatoes. Put the whole mixture in a saucepan with boiling vegetable broth. Cook under the lid on a weak heat until ready. Fill sour cream, before serving to the table, sprinkle finely chopped with greens.
4. Tomato soup with vegetables.
Required: 200 ml of secondary meat broth, 1 small carrot, 1/2 bulbs, 2 h. Tomato paste, 1 tomato, 1 tsp. Sunflower oil, sugar substitute, salt, dill.
Cooking. Onions finely chop and slightly fry on the oil, add pre-boiled vegetables or ice cream vegetable mixture, tomato paste, peeled and sliced \u200b\u200btomato and put everything together. Pour meat broth, some cook, salute, add a sugar substitute, spices and cut-out dill.
5. Okroshka with kvass.
Required: 100 g of meat, 4 cucumber, 2 glasses of kvass, 1 tbsp. l. sour cream, sugar substitute, greens.
Cooking. Boiled meat cut into small cubes. Fresh cucumbers wash and cut. Sour cream in a small amount of kvass. Pour meat and cucumbers with the resulting mixture. Mix everything, add the remaining part of the kvass, mix again, add a sugar substitute. Sprinkle before serving to the table a finely chopped greenery of dill and parsley.
6. Okroshka on the fruit brave.
Required: 1 potato tube, 2 cucumber, 1 egg, 1 fresh apple or 2 tbsp. l. dried apples, 2 tbsp. l. sour cream, greens.
Cooking. A chopped apple to pour boiling water, boil and leave it to be for 2-3 hours. After strain. Cucumbers cut into cubes. Potatoes cooked in uniforms clean and cut the same as cucumbers. Washed greens in finely chop. The protein of the boiled egg is crushed, and the yolk is confused with sour cream. Connect in a saucepan all components of the okroshka and pour the fruit decoction, add some lemon acid or vinegar, as well as a sugar substitute (to taste). Serve with sour cream.
Meat dishes
1. Beefstroods from boiled meat with stewed cabbage.
Required: 150 g meat, 1 tbsp. l. Butter, 1/2 Kochana Cabbage, Half of the Reflore Luke, 1 h. Tomato paste, chopping flour.
Cooking. Boiled to half-preparation meat chopping straw. Chopping cabbage, put out with the addition of a small amount of water. Pour meat to pour the cabbage to the cabbage and extinguish further until readiness. At this time, prepare a flour sauce, a finely disturbed onion and tomato paste, roasted on creamy oil. Pleep the meat and cabbage to the pan with a cooked sauce and remove after boiling.
2. Boiled meat with stewed beet.
Required: 120 g of meat, 1 beet, 1 tsp. Cream oil, 2 tbsp. l. Sour cream, chopping of greenery.
Cooking. Prepare meat broth. Then boiled up to half-preparation meat cut into pieces, a broth to merge. Also cut the beet, which, bay with a small amount of water, acidified by vinegar, to extinguish until readiness. Put the chopped meat and beets on the pan, pour sour cream sauce, add a fluid that remains after extinguishing beets, and extinguish until readiness. Serve with finely chopped greens.
3. Boiled meat stewed with green peas.
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