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1) Principle of mechanical safety.
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1) Principle of mechanical safety.
It is used restriction or exception of the difficult absorbing foodstuff, rich by cellulose (black bread, cabbage, a string bean etc. ), application during preparation of food methods of crushing, wiping, beatings etc., and also uses of special methods of the processing directed on reduction of the contents cellulose, dissolution pectines and softenings of products.
2) Principle of chemical safety - by exception of products, rich by extractive substances, and restrictions of the dishes having stimulating action on secretory and motor functions of a stomach (strong broth, rich soups, fried dishes, smoked products etc. ). Stimulating action of dishes on intestines can be lowered at steam processing, cooking.
Principles of safety are usually used at the initial stage of treatment by purpose of strict diets, further it is necessary to pass to a principle " training". Thus step systems with gradual transition, or systems of " zigzags" with rather sharp, but short-term changes of diets as loading (plus of " zigzags" ) or unloading (a minus of " zigzags" ) are used.
The Mode of dietetic therapy provides uniform within day receipt of a small amount of food with more often receptions (5-6 times per day). A fractional feed (meal) (a small amount peep everyone 1, 5 - 2 hours) in some cases is applied.
Hygienic bases of alimentary regulation exchange infringements and prevention of adiposity
Techniques of definition of normal (ideal) weight of a body:
1) Index Broka.
Ideal weight of a body = Growth (sm)-100 (growth of 155-165 sm)
- 105 (growth of 166-175 sm)
- 110 (growth more than 175 sm)
2) Parameter Bongard:
Normal weight of a body (kg) = Circle of a chest cell (sm)
240
(It is designed for men of 25-30 years with normostenical constitution)
3)Index Кetle:
weight of a body (kg) / (growth, m) 2
The ideal weight for men 20-25, women - 19-23, 8, less 15-20 - lack of weight of a body, 26-30 - excessive weight of a body, 31-40 - moderate adiposity, more than 40 - pathological adiposity
4) Index Breitman:
Ideal weight (kg) = _______ weight (kg) ____
(growth, sm х 0, 7) - 50
Technique of definition of a degree of adiposity:
Allocate 4 degrees of adiposity:
1-surplus of weight of a body of 10-29 %,
2-30-49 %,
3 - 50-99 %,
4 - more than 100 %.
Excess of normal weight of a body on 5-10 % testifies to presence of excessive weight of a body, instead of about adiposity as illnesses.
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Hygienic principles of the organization of dietetic therapy at adiposity:
1) Decrease (reduction) of power value of a feed (on 30-50 % from norm).
2) Restriction of carbohydrates, is especial not protected.
3) Restriction of fats of animal origin due to increase of vegetative fats (up to 50 %)
4) Optimal amount of protein (60 % - animal protein).
5) Eating 5-6 times a day - decrease of feeling of famine.
6) Restriction of water and salt.
7) Use of special unloading diets and days.
8) Estimation of efficiency of dietetic therapy and its correction on a basis of studying current of illness and the biochemical status of an organism.
Hygienic principles of alimentary prevention of atherosclerosis:
1) General prevention of adiposity (see above).
2) Increase antysclerotic alimentary factors: irreplaceble aminoacid methyonin, poly-unsaturated fatty acids families omega-3 and omega-6, phospholipids.
3) Increase of consumption of high-grade protein (especially vegetative), vegetative fats, pectins, celullose, vitamins C, B, A, D, РР.
4) Increase in a diet mineral substances - Са, Mg, microelements Cr, Cu.
5) Decrease salt, sharp and fried dishes.
Hygienic bases of alimentary prevention of presenilation:
1) Maintenance of equation level of caloricity of a feed with energy losses in view that 60-65 % of daily caloric content is provided due to carbohydrates, basically polysassarides (optimal caloric content for the persons who have been not occupied with physical work - 2600 Kcal / day).
2) Antisclerotical orientation of a diet.
3) Optimal maintenance of a diet by the substances stimulating activity of fermental systems of an organism.
4) The greatest possible variety of a feed and its equation under the basic irreplaceable factors of a feed.
5) Decrease of the use of fats to 20-25 % of daily caloric content, thus vegetative fats should make 50 % from all amount of fats.
6) Decrease of cholesterol in a diet up to 300 mg / day.
7) Decrease of consumption of sugar and confectionery products, replacement with their dried fruits.
8) Restriction salt (5-7 g/day).
9) Reception feed not less often 4 once a day.
KINDS OF DIETETIC THERAPY.
IT IS DEVELOPED 16 DIETS (TABLES).
They are subdivided into diets with a choice of dishes - realization of custom-made system (a diet 1, 2, 5, 9, 10, 15, ). These diets can be used long time, completely providing needs of an organism.
The second kind of diets - strict without a choice of dishes (0, 0a, 1a, 1b. 1c, 4, 5a, 5b, 8). They concern to unbalanced kinds of a feed and can be appointed only to short time. Transition (more often gradual) from strict diets to expanded is provided. Excessively long time of a presence the same diet is supposed only in unusual cases.
DIET 0 (LIQUID) - is appointed after operations on a stomach and intestines (after hungry days; at a heavy unconsciousness). The purpose of it is maintenance of an organism with a minimum quantity of food substances, maximal unloading gastric ways. Low caloric content (1000 Kcal. ), the amount of salt (5g), fibers (15g), carbohydrates (200g) is limited. Consists from easy absorbed liquid dishes. It is applied through 2, 5 - 3 hours of 6 times per days. Exist a little less strict variants of diet: 0 a and 0 b.
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DIET 1 - at a stomach ulcer in a phase of an aggravation (the first 8-12 days), sharp gastritises, aggravation of chronic gastritises and enteritis, after operations and at gastroenteric haemorrhages (after a diet 0). The purpose – maximal safety to promote a reparation mucous of stomach, to decrease its reflex excitability.
DIET 2 - at chronic gastritises with infringement secretory activity outside of an aggravation, chronic colitis, infringement of function of the chewing device. The purpose of a diet - stimulation of secretion and normalization of impellent function of a stomach and intestines, reduction of fermentive processes in intestines.
DIET 3 - at alimentary habitual locks without the expressed symptoms of irritation of intestines. The purpose - stimulation of impellent functions of intestines by inclusion in a diet mechanical, thermal and chemical irritations.
DIET 4 - at chronic colitis and enterocolitis in a phase of aggravation, sharp gastroenterocolitis and operations on intestines (after hungry days), dysentery, belly typhus, tuberculosis of intestines (within the first 5-7 days). The purpose - maximal mechanical, thermal and chemical safety of intestines, creation of conditions for liquidation of inflammatory process, restoration of infringements of functions, reduction of fermentive and putrefactive processes in intestines.
DIET 5 - at sharp hepatites (illness Botkin) in a phase of recovery, chronic hepatites, cholecystitis, bilious - stone illness with infringements of function of a liver and bilious ways without accompanying inflammatory processes in a stomach and intestines, moderate atherosclerotic cardiosclerosis. The purpose - normalization function of a liver and bilious ways, regulation of a cholesteric and fatty exchange, accumulation glicogen in liver, stimulation impellent function of intestines.
DIET 5a - at chronic pancreatitis in a stage of aggravation. The purpose - to promote braking exo-secretoric function of a pancreas, the synthesis of fiber necessary for construction of pancreatic enzymes, chemical safety of the food channel, the prevention fatty infiltration and dystrophies of a pancreas and a liver, to decrease of reflex excitability of a bilious bubble.
DIET 6 - at a gout and urine-acid diathesis. The purpose - to promote reduction endogenic formation of a uric acid, its removing from an organism and normalization pyrinic exchange.
DIET 7 - at a sharp kidney-stone illness in initial stage and a chronic kidney-stone illness during aggravation. The purpose - maximal safety functions of kidneys, unloading of an albuminous exchange, increase diuresis, liquidations of hypostases, sharp restriction of fibers (25-35g) and moderate decrease of fats (up to 60g) and carbohydrates (350g). Enrichment of a diet by vitamins. The liquid (up to 400-450 ml), salt in products (1-2 d) is sharply limited.
DIET 8 - adiposity at absence of infringement of bodies of digestion. The prevention and elimination of accumulation fatty cells.
DIET 9 - at diabetes, in the easy form (9a) without insylin therapy. Main principle - restriction of caloric content (2300 - 1700 Kcal) due to carbohydrates (300-200g), basically, not protected, and partial restriction of fats (70-50g), the normal contents of fibers (100-120g). Reception peep - 5-8 times with exact distribution of carbohydrates. Products with the high contents of carbohydrates are excluded.
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DIET 9 b - at diabetes heavy and average forms with application insylin therapy. Normal caloric content and chemical compound of diet, close to a diet 15. Are limited only not protected carbohydrates (sugar 30 g per day).
DIET 10 - unites a number of the diets used at disease of cardiovascular system, an atherosclerosis, hypertonic illness of different forms, insufficiency of coronary blood circulation. The general requirements - restriction of caloric content due to fats and carbohydrates, restriction of a liquid and salt, exception of products, rich cholesterol, the fat products containing a lot of saturated fatty acids.
DIET 10 a - one of variants of a diet 10 - at cardiovascular diseases with sharply expressed insufficiency. The purpose - simplification of cardiac activity, safety bodies of digestion and function of kidneys, increase diuresis and unloading of exchange. Sharp restriction salt (1-2 g) and a free liquid (600 ml), vegetative celullose, the products promoting meteorism and rich cholesterol, irritating a liver and kidneys.
DIET 11 - at tuberculosis of lungs and bones, during recovery after infectious diseases, traumas, operations, at anemia. The purpose - increase of the general feed and reactance of an organism, resistancy to chronic infections. The increased caloric content (3500 - 3900 Kcal), increase of the contents of fibers first of all due to fibers of an animal origin.
DIET 12 - at diseases of central nervous system with hypererethism or transitive from diet 10 to a balanced diet. The purpose - decrease of excitability of central nervous system.
DIET 13 - at sharp infectious diseases, after operation in a lungs cavity (except for operations on the food channel). The purpose - strengthening of removing of toxins, increase of protective forces of an organism, safety bodies of digestion in conditions of a confinement to bed.
DIET 14 - at phosphaturia. The purpose - to reduce phosphaturia and to interfere with loss phosporous-calcium salts in urine ways with formation stones. Moderate decrease of the contents of salt (10-12g). Restriction of calcium (0, 4g). Increase of amount of a free liquid (up to 200 ml).
DIET 15 - Is recommended to recovering and to people with various diseases at absence of indications to assignment of medical diets. The purpose - maintenance of a high-grade various feed in conditions of a hospital. Physiologically high-grade and various diet which has been intended for person, not carrying out physical work.
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