Therapeutic nutrition according to Pevzner. The principles of the main types of therapeutic diets

For almost a hundred years in medicine, when prescribing this or that type of nutrition to patients, the principle developed by the Soviet scientist M.I. Pevzner. According to him, each group of diseases, in addition to specialized treatment, requires a certain diet. There are 16 main treatment tables according to Pevzner (including zero). Table No. 0, postoperative, is appointed in the first days after surgery and implies the exclusion of any solid food from the diet, even in the form of mashed potatoes. Milk is also contraindicated. The diet consists of jelly, jelly, weak broths and juices diluted with water. It is necessary to limit the consumption of salt. At the same time, at least 2 liters of fluid per day is used, the optimal total daily calorie content of dishes is 1000 kcal. 

Tables 1 through 5 are therapeutic diets that are prescribed for various diseases of the gastrointestinal tract, tables 6, 7, and 14 compensate for dysfunction of the excretory system, and table 8 helps fight obesity 9th prevents the development of complications of diabetes, 10th reduces the risk of exacerbations of cardiovascular diseases, 11th table helps maintain energy balance in tuberculosis, blood diseases and other pathologies leading to general exhaustion; The 12th table is necessary for diseases of the nervous system, the 13th – for acute infections. Table No. 15 is the so-called general table, a healthy diet that does not have a specific specificity.  

Diabetes Nutrition

Diabetes mellitus is a chronic disease that requires constant strict adherence to a certain diet. Its main principles are described in the description of table No. 9 according to Pevzner. Diet implies the complete exclusion of sugar and sweets. Xylitol or sorbitol can be used to improve the taste of food and drinks. Foods containing easily digestible carbohydrates are replaced with foods rich in fiber and dietary fiber (vegetables, fruits, wholemeal products). The total calorie content of dishes is approximately 3360 kcal per day. 

Diet for diseases of the stomach and duodenum

With exacerbation of a stomach ulcer and duodenal ulcer, with the development of acute gastritis, condition after gastric bleeding, table No. 1a is assigned. The purpose of such a diet is to exclude everything that can increase irritation of the walls of the gastrointestinal tract. Food is served only in mashed and crushed form. Basically, the diet consists of juices, mucous soups, jelly, dairy products, soufflĂ©. Food should not be too cold or hot.  

Food is carried out fractionally, in small portions. Recommended energy value of consumed products is 2600 kcal per day. At the stage of calming down the acute process, transition to table No. 1b is possible, that is, adding steamed meat dishes, wheat crackers, cereals to the diet. In chronic gastritis, gastroduodenitis, peptic ulcer disease without exacerbation, the social activity of a person almost does not decrease, therefore, nutrition should be complete. Therefore, table number 1 implies only the limitation of table salt, spices, the exclusion of fried foods, coarse plant foods, concentrated broths, fresh bread. 

Diet for bowel diseases

To improve intestinal motility , food containing certain irritating substances is needed. Table 3 is based on the use of fiber-rich foods – vegetables, fruits, black bread, carbonated drinks, hard-boiled eggs. It is important not to grind food before eating. With dysentery and other acute bowel diseases, accompanied by diarrhea, table No. 4 is prescribed. The consumption of fats and carbohydrates is limited to the lower limit of the norm, fruits and vegetables, fresh milk, pastry, fried, spicy and fatty foods, cold drinks are excluded. All food should be mashed, boiled or steamed. After the acute process subsides, the daily calorie content gradually increases to normal, dishes can not be crushed, however, products that activate the processes of fermentation and decay in the intestine are still excluded. 

Diet for pathology of the biliary tract

In diseases of the liver , gall bladder and pathology of the biliary tract, table No. 5 is prescribed. Its main principle is the normalization of fat metabolism and the prevention of congestive processes in the liver. Fat, butter, fatty meat, and rich flour products are excluded from the diet. To improve the excretion of cholesterol with feces, it is recommended to enrich the diet with vegetables and fruits. 

Nutrition for urolithiasis

Urolithiasis is a consequence of a failure in metabolic processes in the body. Depending on the metabolism of which substance is impaired, an appropriate diet is prescribed. In case of violation of uric acid excretion, table No. 6 is recommended – an increase in the consumption of dairy products, vegetables and fruits and limited use of salt. Table No. 14 is prescribed for urolithiasis due to phosphaturia. The purpose of the diet is to increase the acidity of urine and reduce its alkalization. Dairy products, smoked meats, legumes, potatoes, juices, alcoholic drinks are excluded. It is recommended to reduce the consumption of animal fats, egg yolks. Mineral water, birch sap, fish oil, vegetable oil contribute greatly to acidity. 

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