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Nutrition of patients has received considerable attention during all periods

of human development. Hippocrates believed that treatment

should consist in the fact that at different stages of the disease to be

able to choose the right foods in the quantitative and

qualitative respects. The Roman physician Asclepiades (128-56 BC),

which is considered the founder of the Diet, at odds with the views of the

time rejected the pharmacotherapy and thetreatment is considered on

the basis of the diet. Together with his students, he has

developed detailed guidance on the use of nutrients in the treatment

of various diseases.

Nutrition of patients has received considerable attention during all periods

of human development. Hippocrates believed that treatment

should consist in the fact that at different stages of the disease to be

able to choose the right foods in the quantitative and

qualitative respects. The Roman physician Asclepiades (128-56 BC),

which is considered the founder of the Diet, at odds with the views of the

time rejected the pharmacotherapy and thetreatment is considered on

the basis of the diet. Together with his students, he has

developed detailed guidance on the use of nutrients in the treatment

of various diseases.

Historical background Historical background

Dietetics (from diet and ... ology), dietetics, the science of nutrition of

patients, studies, and validating the principles of nutrition in various

diseases. (Power healthy people engaged in food hygiene.) In the

past, the whole science of dietetics called on health

care, modern hygiene, since the beginning of the 19th century. limited

to questions of dietetics and nutrition rationalization of the 20th

century. almost become synonymous with nutrition.

Dietetics (from diet and ... ology), dietetics, the science of nutrition of

patients, studies, and validating the principles of nutrition in various

diseases. (Power healthy people engaged in food hygiene.) In the

past, the whole science of dietetics called on health

care, modern hygiene, since the beginning of the 19th century. limited

to questions of dietetics and nutrition rationalization of the 20th

century. almost become synonymous with nutrition.

Terminology Terminology

Therapeutic nutrition is an important part of the treatment.

The purpose of clinical nutrition is to ensure the body's physiological

needs for nutrients and the normalization of the functional state of

various organs and metabolic processes, disrupted due to illness.

Exacerbation of many diseases are associated with

various excesses in the diet: chronic pancreatitis after eating a

fatty cream, pancakes, alcoholic beverages, fried foods, violations of

the diet in diabetes lead to a sharp rise in blood sugar, dry mouth,

increased thirst, progressive fatty infiltration liver and

pancreas, increased blood pressure in patients with essential

hypertension is observed in the use of salty

foods, appointed withtreatment of low efficiency.

Therapeutic nutrition is an important part of the treatment.

The purpose of clinical nutrition is to ensure the body's physiological

needs for nutrients and the normalization of the functional state of

various organs and metabolic processes, disrupted due to illness.

Exacerbation of many diseases are associated with

various excesses in the diet: chronic pancreatitis after eating a

fatty cream, pancakes, alcoholic beverages, fried foods, violations of

the diet in diabetes lead to a sharp rise in blood sugar, dry mouth,

increased thirst, progressive fatty infiltration liver and

pancreas, increased blood pressure in patients with essential

hypertension is observed in the use of salty

foods, appointed withtreatment of low efficiency.

Nutritional care Nutritional care

-Nutritional care should contribute to directional effects on metabolism, and it

should heal, and prevent the worsening of many diseases.

Observe correct diet: eat regularly, at the same time. In this case, produced a

conditioned reflex in the time allocated the most active gastric juice and the

most conducive conditions for the digestion of food. For health care facilities

recommended by the four meals: breakfast at 8-9 h and 13-14 h lunch, dinner

in 17-18 hours, eating at night at 21 pm The choice of this time due to a

physiological feature of the human body, activity its enzyme systems.

Calorie meals: breakfast - 30%, lunch - 40%, Dinner - 25%, eating at night -

5%. It is desirable that the last meal was for 4-5 hours before bedtime.

- It is necessary to diversify the diet. If the food is varied, includes food and

animal (meat, fish, eggs, milk, cottage cheese), and plant origin (vegetables,

fruit, cereal, bread), you can be sure that the body receives all the necessary

for life.

-Nutritional care should contribute to directional effects on metabolism, and it

should heal, and prevent the worsening of many diseases.

Observe correct diet: eat regularly, at the same time. In this case, produced a

conditioned reflex in the time allocated the most active gastric juice and the

most conducive conditions for the digestion of food. For health care facilities

recommended by the four meals: breakfast at 8-9 h and 13-14 h lunch, dinner

in 17-18 hours, eating at night at 21 pm The choice of this time due to a

physiological feature of the human body, activity its enzyme systems.

Calorie meals: breakfast - 30%, lunch - 40%, Dinner - 25%, eating at night -

5%. It is desirable that the last meal was for 4-5 hours before bedtime.

- It is necessary to diversify the diet. If the food is varied, includes food and

animal (meat, fish, eggs, milk, cottage cheese), and plant origin (vegetables,

fruit, cereal, bread), you can be sure that the body receives all the necessary

for life.

Basic principles of nutrition Basic principles of nutrition

The first group - milk and dairy products (milk, yogurt, buttermilk,

cottage cheese, etc.).

The second group - vegetables, fruits, berries (fresh

cabbage andsauerkraut, potatoes, carrots, beets, tomatoes,

cucumbers, lettuce, pumpkins, apples, currants, strawberries, etc.).

The third group - meat, poultry, fish, eggs (animal protein sources).

The fourth group - bread, pasta, cereals.

The fifth group - fats (butter and vegetable oil).

The sixth group - sweet (sugar, honey, confectionery).

In cases of various diseases it is limited to use certain food groups. For

example, in the diets  used in obesity, diabetes, eating sweets is

severely limited or prohibited.

The first group - milk and dairy products (milk, yogurt, buttermilk,

cottage cheese, etc.).

The second group - vegetables, fruits, berries (fresh

cabbage andsauerkraut, potatoes, carrots, beets, tomatoes,

cucumbers, lettuce, pumpkins, apples, currants, strawberries, etc.).

The third group - meat, poultry, fish, eggs (animal protein sources).

The fourth group - bread, pasta, cereals.

The fifth group - fats (butter and vegetable oil).

The sixth group - sweet (sugar, honey, confectionery).

In cases of various diseases it is limited to use certain food groups. For

example, in the diets  used in obesity, diabetes, eating sweets is

severely limited or prohibited.

The main food groups The main food groups

Unloading (contrast) diet used periodically to partial starvation and unloading of the affected organs and body systems.

They are used with obesity, hypertension, heart failure, liver disease and kidney failure, gout, colitis, etc.

Assign contrasting diets occasionally 2-4 times a month for 1-2 days

Unloading (contrast) diet used periodically to partial starvation and unloading of the affected organs and body systems.

They are used with obesity, hypertension, heart failure, liver disease and kidney failure, gout, colitis, etc.

Assign contrasting diets occasionally 2-4 times a month for 1-2 days

Fasting diet Fasting diet

It is very popular all over the world to go on so-called

"fashion diet" proposed by various authors (doctors, artists,

writers, etc.) to achieve any important task.

"Trendy diets" are designed to reduce body

weight, longevity, better health.

Most of these diets non-physiological, deficient in

many nutrients and can not be recognized by official medicine.

It is very popular all over the world to go on so-called

"fashion diet" proposed by various authors (doctors, artists,

writers, etc.) to achieve any important task.

"Trendy diets" are designed to reduce body

weight, longevity, better health.

Most of these diets non-physiological, deficient in

many nutrients and can not be recognized by official medicine.

Clinical dietetics Clinical dietetics

Incorrect nutrition Incorrect nutrition

Anorexia affects mainly young women (only 10% of patients are male).Most often it is the result of compliance with various diets.Gradually the diet is becoming increasingly strict, she eats less and less until, finally, to recover the fear of not becoming intrusive. Psychologically, at this stage, the woman is still considered the weight excess, although in factit has been a lack of weight gain and begin to show signs of malnutrition.

Anorexia affects mainly young women (only 10% of patients are male).Most often it is the result of compliance with various diets.Gradually the diet is becoming increasingly strict, she eats less and less until, finally, to recover the fear of not becoming intrusive. Psychologically, at this stage, the woman is still considered the weight excess, although in factit has been a lack of weight gain and begin to show signs of malnutrition.

Among healthy individuals:

poor nutritionovereatingQuick meal "on the fly" in a stressful environmentAbuse of butter and fatty foodsDrinking large amounts of sweets and foods containing caffeine (coffee, tea, chocolate)Abuse of acute and spicy foodAlcohol abuse, smoking, stressSleep or rest lying down after mealsLack of exercise. Obesity. constipationWearing tight clothingIndividual sensitivity to foods - citrus fruits, onions, garlic, tomato products(juice, pasta, sauces)The first half of pregnancy

Among healthy individuals:

poor nutritionovereatingQuick meal "on the fly" in a stressful environmentAbuse of butter and fatty foodsDrinking large amounts of sweets and foods containing caffeine (coffee, tea, chocolate)Abuse of acute and spicy foodAlcohol abuse, smoking, stressSleep or rest lying down after mealsLack of exercise. Obesity. constipationWearing tight clothingIndividual sensitivity to foods - citrus fruits, onions, garlic, tomato products(juice, pasta, sauces)The first half of pregnancy

The most common causes of heartburn The most common causes of heartburn

IBW= kg/m2IBW= kg/m2

CLASSIFICATION OF BODY MASS IN TERMS OF IBW

CLASSIFICATION OF BODY MASS IN TERMS OF IBW

Body weight IBW stage of obesity Defective < 18,5

normal 18,5-24,9

excessive 25,0-29,9

obesity 30,0-34,9 I

35,0-39,9 II

extreme obesity 40 and more III

An assessment of liquid needsAn assessment of liquid needs

Human requires more and more liquid because of:

- Diarrhea, vomiting,

- Sweating,

- Fever - each C0 increases the fluid requirements by 13%

- Dehydration.

An assessment of liquid needsAn assessment of liquid needs

- are several methods to assess the basic needs of the organism in the fluid:

Adults:

1. 1500 ml/m22. 1500 ml for the first 20 kg body weight 20 ml/kg over 20 kg3. 30-35 ml/kg (18-65), 25 ml/kg (over 65)

4. 1 ml/kcal

ChildrenBody weight (kg) 1-1011-20

>20

Basic needs of fluid a day100-150 ml / kg1000 ml 50 ml for each kg over 10 kg1500 ml 20 ml for each kg over 20 kg