NATIONAL UNIVERSITY OF

PHARMACY DEPARTMENT OF CHEMISRY OF NATURAL COMPOUNDS

AND NUTRICIOLOGY

LECTURE on NUTRICIOLOGY

Diets Therapeutical nutrition

Kharkov 2020 1

THERAPEUTICAL NUTRITION REFERS TO THE NUTRITION PRESCRIBED TO THE PATIENT IN ORDER TO TREAT A PARTICULAR DISEASE.

It is based on the physiological needs of a

healthy person in nutrients and energy,

which are corrected based on the

characteristics of pathogenesis, clinical

course, stage of the disease, severity of

metabolic disorders, risk factors for the

development of alimentary-dependent

diseases in each individual patient

CLINICAL NUTRITION CAN BE THE ONLY

TREATMENT FOR METABOLIC

DISORDERS, SOME GASTROINTESTINAL

DISEASES, KIDNEY DISEASE, ETC.

Clinical nutrition can be prescribed in

combination with other methods of treatment

(medication, surgical, physiotherapeutic) for

diseases of the cardiovascular system, nervous

system, skin, etc.

Properly organized and built on modern

scientific foundations, rational and dietary

nutrition ensures the normal course of the

processes of growth and development of the

body, preservation of human health and

working capacity

CLINICAL NUTRITION IS USED

DIFFERENTIALLY (INDIVIDUALLY)

DEPENDING ON THE FORM AND STAGE

OF THE DISEASE AND IS PRESCRIBED BY

THE DOCTOR IN THE FORM OF A DIET

There are 15 major diets (treatment tables).

Some diets are divided into subgroups (1a, 1b,

1c, etc.) for a gradual transition from strict

restrictions to expanded nutrition as the

patient recovers

Diet (buffet) № 1 used when remission or

exacerbation of ulcers of stomach and

duodenal ulcers, acute gastritis in the recovery

period, gastritis with high or normal acidity;

Diet (buffet) № 3 shown in chronic diseases of

intestines, accompanied by constipation when

the fading or нерезком exacerbation and

remission stage;

Diet (buffet) № 1a appointed by the sharp

worsening ulcers disease duodenal ulcers and

stomach sharp aggravation of chronic gastritis,

acute gastritis, a burn of the esophagus;

Diet (buffet) № 4 used for diseases and sudden

worsening of intestinal diseases, accompanied

by severe diarrhea;

Diet (buffet) № 1b indicated for duodenal

ulcers and stomach, as well as chronic gastritis

in the phase of remission after a sharp

deterioration. Is used, as a rule, after the diet №

1a after Pevzner

Diet (buffet) № 4a shows people suffering from

colitis, with a predominance of fermentation

processes;

Diet (buffet) № 2 can be set chronic gastritis

type, with secretory insufficiency in the

recovery stage or when exacerbation of acute

colitis, enteritis, gastritis outside and after

exacerbation, if the disease is not accompanied

by diseases of the kidneys, pancreas, biliary

tract, liver;

Diet (buffet) № 4b appointed by the acute

intestinal diseases in the period of improvement

of chronic diseases of intestines in нерезком

exacerbation or after;

The full list of therapeutic diets on Pevzner

• Diet (buffet) № 4c used as a

transition to a rational balanced ration in

the recovery period of acute intestinal

diseases, chronic diseases of intestines in

the exacerbation stage of attenuation;

• Diet (buffet) № 6 shown with

urolithiasis and gout;

Diet (buffet) № 5 shown in acute

gastritis, cholecystitis in the recovery

stage, chronic hepatitis in remission,

cirrhosis of the liver;

Diet (buffet) № 7 assigned for both

chronic and acute (in the stage of

recovery) nephritis, renal failure;

Diet (buffet) no 5a assigned for acute

cholecystitis and hepatitis,acute

cholelithiasis and cholecystitis, cirrhosis

in flocks compensation;

Diet (buffet) 7a shown in severe acute

glomerulonephritis with concomitant

renal insufficiency after unloading days,

disease of medium gravity from the first

days of the disease and in the form of

chronic;

Diet (buffet) no 5b is used in diet therapy

of patients with chronic pancreatitis

outside and after the aggravation and

convalescence;

Diet (buffet) № 7b used after a diet 7a of

acute glomerulonephritis, chronic

nephritis with moderate renal failure;

The full list of therapeutic diets on Pevsner

• Diet (buffet) № 7c chronic kidney

disease, nephrotic syndrome;

• Diet (buffet) № 10a is used in diseases

of the cardiovascular system with blood

circulation insufficiency pronounced (II B –

III degree);

Diet (buffet) № 8 indicated for obesity;

Diet (buffet) № 10b is prescribed to the

patients with myocardial infarct;

Diet (buffet) № 9 used in diabetes light and

average weight, patients with normal or

slightly overweight, who are not receiving

insulin or get it in a small dosage (up to 20-

30 UNITS). The power system can be

assigned to establish your endurance for

carbohydrates during the selection of

adequate doses of insulin;

Diet (buffet) no 10c shows people suffering

from atherosclerosis lesions of the brain,

heart and other organs, hypertension,

developed against the background of

atherosclerosis;

Diet (buffet) № 10 shows suffering from

cardiovascular diseases in expressed (I-II of

A degree) circulatory failure or in the stage

of compensation;

Diet (buffet) № 11 is used at a tuberculosis

of bones, lungs, lymph nodes, joints, and also

lowered body weight, exhaustion after

infectious diseases, and surgery, injuries;

The full list of therapeutic diets on Pevsner

• Diet (buffet) № 12 indicated for

diseases of the nervous system that

have functional nature;

• ;

Diet (buffet) № 13 is prescribed to

patients experiencing acute infectious

diseases;

Diet (buffet) № 14 used in the case of

phosphaturia Diet (buffet) № 15 can be used in

various болезных that do not require

special treatment tables and proceed

without violation of the conditions of

digestive system. This diet after

Pevzner is a transitional stage to a

normal diet in convalescence and after

passing diet.

The full list of therapeutic diets on Pevsner

Diets No. 1, 2, 5, 9, 10, 15 can be used for a

long time, as they are balanced in calories

and chemical composition and fully satisfy

the body's need for nutrients.

DIETS NO. 4, 5A, 8 HAVE AN UNBALANCED DIET AND ARE PRESCRIBED

FOR A SHORT TIME

A prerequisite for the effectiveness of medical

nutrition is a combination of mechanical,

chemical and thermal sparing of the organs of

sick people with complete diets in quantitative

and qualitative terms.

MECHANICAL SPARING IS ACHIEVED MAINLY

BY CHOPPING FOOD, AS WELL AS BY THE

APPROPRIATE METHOD OF HEAT TREATMENT

- CHOPPING FOOD IN BOILED FORM

(STEAMED OR IN WATER).

CHEMICAL SPARING IS ACHIEVED BY

ELIMINATING OR RESTRICTING THOSE

NUTRIENTS THAT CAN FURTHER

IMPAIR THE FUNCTION OF THE

DISEASED ORGAN, AS WELL AS BY

CHANGING THE METHOD OF COOKING.

Thermal sparing - the exclusion of strong

thermal stimuli from food, i.e. very cold or very

hot food. The temperature of the first and

second hot dishes should not be higher than 60

°, snacks and drinks - not lower than 15 °. This

must be taken into account, since hot dishes

have a juice-generating effect and weaken the

motility of the stomach, cold ones reduce the

secretion of the stomach, and increase motility.

Thermal sparing is used mainly for

gastrointestinal diseases.

PURPOSE:

gastric and duodenal ulcer, with

gastritis with increased secretion of

gastric juice.

TARGET:

mechanical, chemical and thermal

sparing of the mucous membrane

of the stomach and duodenum,

normalization of secretion and

motility of the stomach.

FORBIDDEN:

fried dishes,

meat,

fish,

mushroom broths,

savory foods,

marinades,

smoked meats,

sausages,

rye bread,

canned food,

cabbage,

turnips,

radishes,

radishes,

sorrel.

RECOMMEND:

yesterday’s wheat bread;

milk products;

low-fat meat and fish in the form of steam chopped products; eggs in the form of omelets;

vegetables (potatoes, carrots, cauliflower) in the form of mashed potatoes;

sweet berries in the form of mashed potatoes, juices, jelly;

cereals (semolina, oatmeal, rice);

milk and vegetarian soups, mashed soups;

milk and fruit sauces;

butter, sunflower oil;

tea, tea with milk, drink of dogrose.

PURPOSE:

chronic gastritis with secretory insufficiency, chronic colitis.

TARGET:

stimulate the secretory activity of the stomach and normalize the motor function of the gastrointestinal tract by mechanical, thermal sparing.

(Gastritis - inflammation of the gastric mucosa)

(Colitis is an inflammatory disease of the inner lining of the large intestine)

All food is prepared mashed or finely chopped

in boiled, steam, stewed form. Baked and

fried foods should be without a rough crust.

FORBIDDEN:

fried dishes with a rough crust,

spicy dishes,

vegetables with rough fiber,

smoked meats,

canned goods,

rye bread,

whole milk. Whole milk is considered to be natural milk, the components of

which have not undergone any changes.

RECOMMEND:

yesterday’s wheat bread;

inedible cookies,

dairy products - kefir, yogurt, cottage cheese;

low-fat fish, meat;

eggs - soft-boiled, scrambled eggs;

vegetables in the form of mashed potatoes, cutlets, puddings;

sweet fruits and berries in the form of jelly, stewed fruit, jelly, mousse; butter -

butter, sunflower, olive;

spicy grated cheese;

soups - on skimmed broths, mashed cereals and vegetables;

sauces - meat, fish, sour cream;

drinks - tea with milk, cocoa, coffee with milk and on the water, rosehip broth,

fruit and berry juices.

PURPOSE:

chronic bowel disease with

constipation with unsharp or

fading exacerbation and without

exacerbation.

TARGET:

normalization of impaired

intestinal functions and

associated metabolic disorders in

the body.

The diet is physiologically complete, includes foods and dishes that

enhance motor function and bowel movement (vegetables, fresh and

dried fruits, baked goods, cereals, fermented milk drinks, etc.).

Excluded foods and dishes that enhance fermentation and rot in the

intestine and adversely affect other digestive organs (rich in fats, fried

foods, etc.).

Food is cooked unmilled, in water, steamed or baked. Vegetables and

fruits are consumed raw and cooked. The diet includes cold first and

sweet dishes, drinks.

PURPOSE:

acute chronic intestinal diseases during

exacerbation with severe dysfunction

(diarrhea).

TARGET:

help reduce the inflammatory process and

normalize the intestines by limiting the

mechanical and chemical irritants of food.

RECOMMEND:

wheat bread crackers;

low-fat meat and poultry, (chopped chicken cooked in water or steamed);

low-fat fish in boiled chopped form;

soft-boiled eggs,

omelets;

cereals - rice, oat, semolina on the water;

butter in limitation;

soups - slimy,

mashed cereals on weak broths;

drinks - tea, black coffee on the water,

drink of dogrose,

blueberries,

bird cherry.

FORBIDDEN:

vegetables,

fruits,

berries,

milk and dishes from them,

fried dishes,

strong broths,

sauces and snacks.

All food is cooked in mashed boiled form.

PURPOSE:

liver and biliary tract disease (hepatitis,

cholecystitis, cholelithiasis).

TARGET:

normalize function

liver, gall bladder and

stimulate

bile secretion

FORBIDDEN:

radish,

radish,

sorrel,

mushrooms,

legumes,

onions,

broths,

fried foods,

fatty meats and

fish,

pastries,

canned goods,

smoked meats,

sour and spicy

dishes.

RECOMMEND:

yesterday’s wheat bread baking;

inedible cookies;

milk, yogurt, mild cheese;

low-fat cottage cheese and dishes from it;

lean meat, poultry, boiled or steamed fish;

eggs in the form of omelets;

vegetables in the form of boiled or baked dishes;

fruits, berries - sweet varieties in the form of compotes, jelly, jelly, mousse;

cereals in the form of milk porridges and puddings;

butter: butter and vegetable;

vegetable, fruit, dairy soups;

sweet drinks - tea and coffee with milk, juices, rosehip drink.

PURPOSE:

urolithiasis with the formation of stones from uric acid salts

TARGET:

a decrease in the formation of uric acid and its salts in the body.

The diet excludes foods containing a lot of oxalic acid; moderate restriction of salt, an increase in the number of dairy, vegetables and fruits.

Diet: 4 times a day, at intervals and on an empty stomach - drink.

PURPOSE:

kidney disease.

TARGET:

kidney sparing and excretion of nitrogenous

wastes and excess fluid from the body

Forbidden:

broths,

fried foods,

salted foods,

savory foods,

smoked meats,

canned food.

RECOMMEND:

saltless protein-free bread;

kefir, yogurt, sour cream;

low-fat boiled meat, poultry, fish or with subsequent frying;

no more than 1 egg per day, omelets;

boiled and raw vegetables (except radish and radish);

watermelons, melons, pumpkin dishes;

fruits and berries - fresh, juices, mashed potatoes, jelly, compotes;

butter: butter and vegetable;

vinaigrettes with fresh cucumbers, salads from fresh vegetables;

vegetarian, fruit soups;

sauces - milk, tomato, fruit;

rosehip broth, weak tea,

vegetable juice.

PURPOSE:

obesity.

TARGET:

reduce body weight by limiting the energy

value of the diet, carbohydrates, fats, liquid, salt

and the excitability of the food center.

FORBIDDEN:

strong broths;

fatty dishes;

wheat bread;

sweet dishes and berries;

confectionery;

hot sauces;

spices.

RECOMMEND:

rye bread (150g / day);

milk, kefir, low-fat cottage cheese and dishes from it, mild cheese;

low-fat beef, chicken, boiled rabbit;

low-fat fish in boiled, jellied form, seafood;

eggs (2pcs / day);

raw, boiled vegetables (200g / day);

unsweetened fruits and berries;

buckwheat, oatmeal;

salads, vinaigrettes;

tea, tea with milk, weak coffee,

tomato juice,

fruit and berry juices from sour fruits.

INDICATION:

Diabetes mellitus

TARGET:

normalize carbohydrate, fat and protein metabolism.

Diabetes mellitus is a group of diseases developing as a result of the absolute or relative insufficiency of the hormone insulin, resulting in an increase in blood glucose.

The disease is characterized by a violation of all types of metabolism: carbohydrate, fat, protein, mineral and water-salt.

FORBIDDEN:

sugar;

confectionery and

butter flour products;

dishes of rice, semolina;

sweet vegetables, fruits and berries;

fatty meat dishes,

smoked meats,

strong broths;

foods rich in cholesterol.

RECOMMEND:

.

rye bread, protein-wheat,

protein-bran (200g / day);

milk, yogurt, kefir, curd

dishes, cheese, sour cream;

low-fat beef, veal, fish,

chicken, boiled and aspic

rabbits, diabetic sausage;

soft-boiled eggs, omelets;

vegetables containing little

sugar (cabbage, cucumbers,

zucchini, lettuce, soaked

potatoes,);

unsweetened fresh berries;

butter and vegetable oil - 40g

/ day;

vegetarian and vegetable

soups;

tea, milk tea, weak coffee,

tomato juice,

fruit juices from sour fruits;

sweeteners

PURPOSE:

cardiovascular diseases and hypertension.

TARGET:

normalize functions of cardiovascular

systems ,

reduce blood pressure.

coronary heart disease - a disease of blood vessels supplying blood to the heart muscle;

cerebrovascular disease - a disease of blood vessels supplying blood to the brain;

peripheral artery disease - a disease of blood vessels supplying blood to the arms and legs;

rheumatic heart disease - damage to the heart muscle and heart valves as a result of a rheumatic attack caused by streptococcal bacteria;

congenital heart disease - deformations of the heart structure existing since birth;

deep vein thrombosis and pulmonary embolism - the formation of blood clots in the leg veins that can move and move to the heart and lungs.

FORBIDDEN:

salt,

broths,

fatty meat,

savory foods,

pastries, f

foods and drinks that stimulate the central nervous

system

carbonated drinks,

cabbage,

legumes,

whole milk

RECOMMEND:

wheat bread, yesterday's rye baking;

milk, kefir, yogurt, low-fat cottage cheese dishes, sour cream;

low-fat meat, boiled and baked fish;

soft-boiled eggs or steam omelettes;

vegetables (except for radish, radish, spinach, sorrel);

fruits and berries in any form (especially dried apricots,

apricots, raisins, figs - contain potassium);

cereals in the form of cereals, puddings, casseroles;

oils - creamy and vegetable;

soups - vegetarian, dairy, fruit;

sauces - milk, fruit, vegetable broth;

rosehip broth, tea, tea with milk, juices.

PURPOSE:

with tuberculosis of various organs, anemia,

exhaustion after infectious diseases.

TARGET:

strengthen and enhance

body resistance

in the fight against infection.

FORBIDDEN:

hot condiments,

savory foods,

refractory fats.

RECOMMEND:

wheat bread, rye, biscuit, cookies, crackers;

milk, cream, yogurt, kefir, sour cream, cottage cheese, cheese;

beef, veal, chickens, liver, fish;

soft-boiled eggs and omelettes;

various vegetables and berries;

oils - creamy and vegetable;

caviar, ham, low-fat sausage, light-salted fish, salads, vinaigrettes;

tea, coffee, cocoa, rosehip drink

PURPOSE:

diseases of the nervous system.

TARGET:

restoration of the normal functioning of the nervous system.

To reduce the load on the system in the diet, the amount of carbohydrates and fats, salt is cut, foods that excite the nervous system (coffee, alcohol, spicy and fried foods) are excluded, and the number of positively affecting foods saturated with phosphoric salts is increased (liver, beans, milk and dairy products).

PURPOSE:

acute infectious diseases.

TARGET:

maintaining the general strength of the body

and increasing its resistance to infection,

reducing intoxication.

Low-energy diet by reducing fats, carbohydrates and, to a lesser extent, proteins; with a high content of vitamins and fluids.

With a variety of food packages, easily digestible foods and dishes that do not contribute to flatulence and constipation are preferred.

Excluded sources of coarse fiber, fatty, salty, difficult to digest foods and dishes.

Food is prepared in minced and mashed form, boiled in water or steamed.

Dishes are served hot (not lower than 55-60 ° C) or cold (not lower than 12 ° C).

Diet: 5-6 times a day in small portions.

Purpose:

urolithiasis with alkaline pH of urine.

Target:

restoration of acid pH of urine.

in terms of energy, protein, fat and carbohydrate content, the diet complies with physiological norms;

diet restricts alkalizing foods and is rich in calcium (dairy, most vegetables and fruits);

products that change the reaction of urine to the acid side (bread and flour products, cereals, meat, fish) predominate.

Cooking and food temperature are common.

In the absence of contraindications, heavy drinking is recommended.

Diet: 4 times a day, at intervals and on an empty stomach - drink.

PURPOSE:

recovering patients and diseases that do not

require special diets.

TARGET:

to provide sick person

full food

FORBIDDEN:

dishes of ducks, geese, spicy seasonings, spices,

refractory fats, canned food.

RECOMMEND:

Wheat and rye bread, flour products.

Borsch, cabbage soup, beetroot soup, pickle; dairy vegetable and cereal soups on meat, fish broth, broth of mushrooms and vegetables; fruit.

Meat and fish dishes of various culinary preparations; sausages, sausages, boiled sausages.

Milk and dairy products in kind and in dishes. Mandatory inclusion of dairy products.

Boiled eggs and dishes.

Dishes from various cereals, pasta, legumes.

Vegetables and fruits in raw form and after heat treatment.

Greens.

Fruit and vegetable juices, broth of wild rose and wheat bran.

Tea, coffee, cocoa.

Butter, cow, ghee, vegetable oils; limited to margarines.

•Фармацевтическая броматология / под. ред. Георгиянц В.А. - Х.: Изд-во НФаУ, 2014. – 375 с.

•Pharmaceutical bromatology/ под. ред. Георгиянц В.А. - Х.: Golden Pages, 2015. – 368 p.

•Тексты лекций по фармацевтической броматологии / Авторы-составители: Попова Н.В., Безуглый П.А., Георгиянц В.А.,

Головченко О,С., Северина А.И., Казаков Г.П., Ковалёв С.В., Алфёрова Д.А., Очкур А. В.. - Х.: Изд-во НФаУ, 2014.– 160 с.

•Конспект лекций по нутрициологии для студентов фармацетических Вузов / Попова Н.В., Очкур А. В., Казаков Г.П.,

Ковалёв С.В., Алфёрова Д.А. – Харьков, 2014. – 140 с.

•Нутриціологія:навч.посібник/ Н.В.Дуденко [ та ін.]; під ред. Н.В.Дуденко. – Х.: Світ книг, 2013– 560с.

•Аналітична хімія/ навч. посіб. Для ВНЗ/ В.В. Болотов, О.М. Свєчнікова, С.В. Колісник та ін. – Х.: Вид-но НФаУ. – 2004.

•Базаров В. И. Исследование продовольственных товаров: учебное пособие. – М.: Экономика, 1986.

•Бутейкис Н.Г. Организация производства предприятий общественного питания. – М., 1985.

•Герасимова В.А., Белокурова Е.С., Вытовтов А.А.. Товароведение и экспертиза вкусовых товаров. – СПб: Питер Принт,

2003

•Гернатовская В.В. Дпнейдер Б.Л. Основы организации и экономики производства предприятий общественного питания.

– М., 2001.

•Дубов Г. Г. "Производство национальных хлебных изделий" Москва ВО "Агропромиздат" 1997г.

•Егоров Г.А. Технология переработки зерна. – М.: Колос, 1997.

•Елисеева Л. Г. Товароведение и экспертиза продовольственных товаров: Учебник. - М.: МЦФЭР, 2006.

•Жук Ю.Т., Журавлёва М.Н., Руш В.А., Федотова Т.К. Товароведение продовольственных товаров: Зерномучные, сахар,

кондитерские, молочные, вкусовые товары. – М.: Экономика, 1990.

• Казанцева Н. С. Товароведение продовольственных товаров. Учебник. - М.: Дашков и К, 2007.

•Ковальов В.М., Павлій О.І., Ісакова Т.І Фармакогнозія з основами біохімії рослин – Х.: Прапор, Видавництво НФАУ.–

2000.

•Козьмина Е.П. Технологические свойства крупяных и зернообразных культур. – М.: Прогресс, 2001.

•Козьмина Н.П. Биохимии зерна и продуктов его переработки. – М.: Колос, 2000.

•Козьмина Н.П. Зерно. – М.: Колос, 2003.

•Колесник А.А. и др. Товароведение продовольственных товаров. – М.: Экономика, 2007.

•Кондрашова Е.А., Коник Н.В., Пешкова Т.А. Товароведение продовольственных товаров: Учебное пособие. - М.: Альфа-

М: ИНФРА-М, 2007.

•Коровин Ф.Н. Зерно хлебных, бобовых и масличных культур. – М.: Пищевая промышленность, 1998.

•Кругляков Г.Н., Круглякова Г.В.Товароведение продовольственных товаров. 2008

•Л.А. Боровикова “Товароведение продовольственных товаров”. M.: Экономика 1988 г.

•Любарский Л.Н., Попова Е.П., Моисеева А.И. Товароведение сельскохозяйственных продуктов. – М.: Колос, 2000.

• Неверова Н. А. Товароведение и организация торговли продовольственными товарами. - М., 2005.

•Никифорова Н. С., Новикова А. М., Прокофьева С. А. Справочник по товароведению продовольственных товаров. - М.,

2007.

•Николаева М. А. Теоретические основы товароведения. Учебник для вузов. - М.: Норма, 2007.

• OK.. DONE, LET’S GO HOME!!

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