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Nutrition for pulmonary tuberculosis. Nutrition for pulmonary tuberculosis - therapeutic diet, permitted and prohibited foods

GENERAL CHARACTERISTICS

Tuberculosis is predominantly chronic infection, in which the lungs are most often affected. Tuberculosis of the larynx, intestines, kidneys, bones and joints, and skin is less common. With tuberculosis, changes in the affected organs, intoxication of the body are possible, metabolism and the functioning of various organs and systems, in particular the digestive organs, are disrupted.

The nutritional regimen is based on the nature and extent of damage to the organ, the general condition of the body, and complications from other organs. The calorie content of the diet depends on the characteristics of the course of the disease, body weight and concomitant diseases. For exacerbation of tuberculosis and bed rest, 2500–2600 kcal per day is sufficient. With semi-bed rest – 2700 kcal; when the exacerbation subsides – 3000–3400 kcal. For chronic pulmonary tuberculosis, especially in humans young, a high-calorie diet of 3600 kcal is recommended. Eating more calories is not healthy. A rapid and large increase in body weight may not improve, but rather worsen the patient's condition.

OBJECTIVES OF THERAPEUTIC NUTRITION

The main objectives of therapeutic nutrition for pulmonary tuberculosis are:

1. Providing the body with adequate nutrition in conditions of protein breakdown, deterioration of fat and carbohydrate metabolism, and increased consumption of vitamins and minerals.

2. Increasing the body's resistance to infection and intoxication.

3. Promoting normalization of metabolism.

4. Promoting the restoration of tissues affected by tuberculosis infection.

Must be administered with food to perform these tasks. increased amount protein (at least 120–140 g), the consumption of which is increased in patients with tuberculosis. Easily digestible protein products(milk, fish, eggs, meat). The amount of fat is recommended within the physiological norm (100–120 g). Fats should be easily digestible, rich in vitamin A (butter, cream, sour cream), about a third - in the form of vegetable fat.

The amount of carbohydrates is within the physiological norm (450–500 g). In cases where tuberculosis causes a disturbance in carbohydrate metabolism, allergization of the body ( allergic diathesis, bronchial asthma, chronic eczema), excess body weight, patients need to limit carbohydrate intake to 300–400 g, mainly due to easily digestible ones (sugar, honey, jam, syrup, etc.).

With exacerbation of the tuberculosis process, there may be increased secretion mineral salts (calcium, potassium, phosphorus, sodium chloride), so foods rich in them are introduced (milk, cheese, cottage cheese, eggs, figs, dried apricots, raisins, meat and fish products, nuts, etc.).

In case of exudative pleurisy, transudate, tuberculous meningitis, with increased secretions into the bronchi, kidney damage leading to edema, a hyposodium diet is prescribed, i.e. food is prepared without adding table salt. This diet helps to increase diuresis, resorption of fluid accumulated in the cavities, and subsidence of the inflammatory process. The liquid is administered in an amount of 900-1000 ml. With large blood loss, repeated vomiting, diarrhea, excess sweat the amount of table salt is increased to 20 g.

Patients with tuberculosis develop vitamin deficiency (especially ascorbic acid, vitamins A and group B). Consuming a sufficient amount of ascorbic acid increases the bactericidal properties of blood serum, increases the formation of antibodies, and reduces intoxication. The need for vitamin C is especially high in patients with fibro-cavernous process, with high temperature and tissue breakdown. Products recommended in this case sufficient quantity vegetables and fruits, and also need to periodically take up to 300 mg of ascorbic acid per day.

Patients with tuberculosis of the lungs, larynx, intestines and skin also need an increased amount of vitamin A - about 5 mg. To meet the need for vitamin A, dairy products are recommended, fish oil, egg yolk, as well as products containing carotene - carrots, tomatoes, apricots, red peppers, etc.

Special attention should be given to providing patients with B vitamins. They are directly related to protein metabolism, the need for which is increased in this group of patients. It is necessary to include foods rich in B vitamins in the diet - fresh vegetables, meat, dishes made from bran, brewer's or baker's yeast.

Calorie intake – 2500–3600 kcal.

BASIC PRINCIPLES OF THERAPEUTIC NUTRITION

1. The diet should be varied, taking into account the development of the tuberculosis process and the general condition of the body.

2. Strict modes and limited nutrition can only be prescribed for short term(for complications and exacerbations of the disease).

3. At all stages of treatment, nutrition should be differentiated.

It is necessary to observe the basic principles of qualitative and quantitative construction of the diet, depending on the nature and stage of the tuberculosis process, the state of the digestive organs, the presence of complications and concomitant diseases.

There are several therapeutic nutrition options available for people with tuberculosis.

SOME HEALTH FOOD OPTIONS

First food option.

It is prescribed to patients with reduced reactivity of the body, general hypotension, low-grade fever, and a sluggish course of the disease.

The chemical composition of this diet: proteins 140 g, fats 100 g, carbohydrates 400 g, limiting easily digestible ones.

Calorie content 2700–3000 kcal. Content of ascorbic acid up to 350 mg, vitamin B1 5 g.

Cooking is normal.

Second option.

Prescribed to patients with increased nervous excitability, reduced body weight, elevated temperature - up to 30 degrees, without signs of increased tissue breakdown, during the period of attenuation of the process with tuberculosis of the lungs, bones and joints.

Chemical composition of the diet: proteins 110–120 g, fats up to 120 g, carbohydrates 500–550 g. Ascorbic acid content up to 300 mg.

Cooking is normal.

Meals are fractional - 5 times a day.

Third food option.

This option is prescribed during the period of exacerbation of the process with pronounced tissue breakdown, significant inflammatory phenomena occurring with high temperature and exhaustion. In these cases, there is usually increased protein breakdown.

Chemical composition of the diet: proteins 120–140 g, fats 100 g, carbohydrates 400–500 g.

Calorie content 3000–3500 kcal.

It is necessary to introduce an excess amount of ascorbic acid. The remaining vitamins are recommended within the physiological norm. Calcium up to 2 mg per day. Table salt 8 g. It is advisable to consume a large number of different drinks, raw juices, vegetables and fruits rich in mineral salts and vitamins.

During the period of exacerbation of the disease, appetite often decreases, disorders of the gastrointestinal tract often occur, which must be taken into account when preparing food ration.

Culinary processing: all food is prepared pureed.

The diet is split, every 2–3 hours.

NUTRITION FOR PATIENTS WITH TUBERCULOSIS WITH ASSOCIATED DISORDERS OF THE DIGESTIVE ORGANS

Patients with tuberculosis often experience concomitant diseases from the digestive organs. Chronic gastritis and colitis often occur in connection with the use of anti-tuberculosis drugs. Gastritis is usually with low acidity. In this case, split meals are recommended with the obligatory exclusion of coarse plant fiber from the diet. Vegetables and fruits are given only in boiled and pureed forms; tough varieties of meat are also given in pureed or minced forms.

If the activity of the liver and biliary system is impaired, foods that cause irritation are excluded from the diet. Prohibited fatty varieties meat and fish, fried foods, pastry, smoked meats, canned food, marinades, strong tea and coffee.

SAMPLE ONE-DAY MENU FOR TUBERCULOSIS

First option

First breakfast: curd pudding, buckwheat porridge with milk, tea.

Second breakfast: calcined cottage cheese, fruit mousse.

Lunch: broth with dumplings, fried steak with vegetables, apple compote without sugar.

Afternoon snack: soft-boiled egg (1 piece), rosehip decoction.

Dinner: boiled fish, baked with potatoes, carrot puree, tea with lemon without sugar.

Tuberculosis is an infectious and inflammatory disease caused by Koch's bacillus. It can affect different organs, but most often affects the lungs, as the disease is transmitted by airborne droplets. Early tuberculosis was known as consumption, from the word to waste away; the disease received this name due to the fact that during the period of illness a person is exhausted and seems to waste away. The main reason for this is the development of the inflammatory process and deficiency nutrients. Adequate nutrition for tuberculosis during treatment helps to avoid exhaustion and improve the patient’s well-being.

What is nutritional therapy and why is it important?

Everyone knows that work human body completely depends on nutrition. Vitamins and microelements supplied with food are involved in many metabolic processes. A few decades ago, it was believed that only people who had poor nutrition could get tuberculosis, but this is not entirely true. Not only the quantity of food is important, but also its quality. Daily diet must be balanced and contain all groups of nutrients: proteins, fats and carbohydrates.

Therapeutic nutrition for tuberculosis should be high in calories, but main task do not overfeed the patient, but provide the body with useful substances without overloading digestive system. Depending on the age and weight of the patient, daily norm calories should be 15-20% higher than physiological. Treatment for tuberculosis involves simultaneous administration several drugs, which puts a huge burden on the liver. In this regard, therapeutic nutrition is aimed at solving the following problems:

increasing the body's defenses;
normalization of metabolism;
acceleration of tissue regeneration at the site of inflammation;
reducing the load on the liver;
providing the body with proteins, fats, carbohydrates, vitamins and microelements in conditions of their increased consumption.

The main goal of a balanced diet is to help the patient cope with the disease. At the same time, the energy value of food should not exceed the norm in order to prevent obesity in the patient. Dietary nutrition for pulmonary tuberculosis during treatment largely depends on the stage of the disease:

bed rest and exacerbation period – 2200-2400 kcal/day;
semi-bed rest – 2500-2700 kcal/day;
attenuation of the acute period – 2800-3100 kcal/day.

In order to avoid overeating and obesity, during the period of improvement, the patient must perform moderate physical activity.

What foods should you eat if you have tuberculosis?

The diet for tuberculosis is high in calories, so there are no sharp restrictions on foods. The main thing is that the food is healthy and can fully compensate for the deficiency in proteins, fats and carbohydrates. The amount of nutrients should be as follows:

proteins – 100-110 g (60% of animal origin);
fats – 100-110 g (25% of vegetable origin);
carbohydrates – 400-450 gr.

The daily volume of liquid should be at least 1.5 liters, and the amount of salt allowed for consumption depends on the patient’s condition. During the period when the patient is prone to swelling and exudate formation, the amount of salt is limited. If large fluid losses are observed ( increased sweating, diarrhea), then the permissible amount of salt is 15 grams.

Protein products

Proteins occupy a key place in the diet of patients with tuberculosis, since during illness they break down faster than usual and are poorly absorbed. Therefore, it is necessary to eat foods high in easily digestible proteins to provide the body with building material to restore damaged tissues. These include:

Dairy products: milk, kefir, sour cream, cottage cheese and cheese. Recommended use fermented milk products with probiotics, this will help improve the functioning of the digestive tract.
Meat, poultry, fish. All types of meat and fish are allowed, except fatty varieties. Boiling, stewing and baking are the preferred processing methods; frying can only be done in small quantity oils It is allowed to eat liver, seafood, sausage, balyk, and caviar. Canned fish, herring, and smoked foods should be limited.
Eggs can be eaten in any form.

Dairy products contain a large amount of easily digestible proteins, so patients with tuberculosis are recommended to drink 1 liter of milk per day.

Products containing fats

The amount of fat should be higher than usual, but the food should not be too fatty. Excessive use fat puts additional stress on the liver, which is already heavily loaded during illness. It is allowed to eat vegetable, olive and butter. It is prohibited to eat processed foods and products containing trans fats, cakes and pastries with a large number butter cream. It is not recommended to cook food using pork or lamb fat.

Carbohydrate foods

The carbohydrate diet of patients with tuberculosis is the same as that of healthy person: various cereals, pasta and pasta, beans, bread and wheat bran. Sweets are allowed in limited quantities: honey, jam, light biscuits and cookies.

The diet must include vegetables and fruits, both fresh and processed. Particular attention should be paid to foods high in vitamins B1, B6 and C. Treatment for tuberculosis requires the use of isoniazid and streptomycin, and they are direct antagonists of B vitamins. To compensate for the deficiency, vitamin supplements are prescribed medicines and consumption of foods that contain them: nuts, eggs, liver and offal, asparagus, cabbage and wholemeal bread. The amount of vitamin C for patients should be twice the usual amount. It is found in citrus fruits, currants, kiwi, strawberries, onions and bell peppers.

Table No. 11. Sample menu

Diet No. 11 is a diet with a high calorie content, with an increased amount of protein and a moderate amount of fat and carbohydrates. Approximate menu for the day:

Breakfast. Buckwheat or oatmeal milk porridge, omelette, tea with milk.
Lunch. Cottage cheese with dried apricot mousse.
Dinner. Borscht or soup with meat broth, fried chicken with vegetables or steak with rice, dried fruit compote.
Afternoon snack. Soft-boiled egg, rosehip infusion.
Dinner. Steamed fish and potatoes, carrot puree, cottage cheese casserole, tea with lemon.
For the night. Kefir or unsweetened yogurt.
The daily norm of wheat bread is no more than 300g.

Dietary nutrition for tuberculosis is part of the treatment and helps speed up recovery. The correct ratio of nutrients in the diet can improve the functioning of the body and restore it after intensive therapy.

The essence of the diet for pulmonary tuberculosis

Tuberculosis is an infectious disease characterized by a cough with sputum (sometimes there may be blood streaks), increased sweating, weakness and severe weight loss. And in order to prevent the development of anorexia, the patient is prescribed a special plan of enhanced nutrition.

The diet for tuberculosis is aimed at providing a person with everything he needs throughout the day so that his body can continue to fight the disease.

Basic diet rules

With the development of pulmonary tuberculosis, diet number 11 (Pevzdner diet) is prescribed. It is based on products with increased content fats and carbohydrates. This allows you to avoid severe weight loss.

The daily carbohydrate intake for tuberculosis patients is 400 - 500 g. This is a lot for ordinary person, but it is quite acceptable for a patient with such a disease. However, these carbohydrates should be obtained not only by consuming cereals (bread, porridge, flour products) and sugar with honey. The patient’s diet should contain other equally important foods that also contain a sufficient amount of carbohydrates.

The daily intake of fat for a person with tuberculosis is 100–120 g. Moreover, most of these fats should be of animal origin.

The daily protein requirement is 100 g, while vegetable protein should not exceed 50 g per day. That is, the diet for pulmonary tuberculosis involves the consumption of cottage cheese, eggs, meat, fish and milk.

In addition, the diet of a sick person should be rich in vitamins and minerals. So, in daily ration There should be about 5 mg of vitamin A, 4 mg of vitamin B1, and vitamin C up to 180 mg.

Principles of nutrition for tuberculosis

Organizing proper nutrition during the treatment of pulmonary tuberculosis is the key successful treatment diseases. The goal of the “anti-tuberculosis diet” is to provide the body with adequate nutrition, ensure that patients achieve a normal weight, increase the body’s resistance to infection, and reduce the intoxication associated with tuberculosis.

The nutrition of a patient with pulmonary tuberculosis, first of all, should be high in calories, but this does not mean at all that it is necessary to strive to overfeed the patient. The opinion about the need for super-enhanced nutrition for a patient with pulmonary tuberculosis is a relic: only when the patient is exhausted is a diet prescribed that exceeds the daily calorie requirement by 20-25%. In other cases, it is enough to give preference to a nutritious diet rich in vitamins C, B and A, as well as minerals.

Overfeeding only leads to obesity and overload of the digestive system. Despite great variety factors characterizing the course of tuberculosis in each specific case (nature of the disease, complications, age, degree of exhaustion, occupation, concomitant diseases), there are general principles organizations dietary nutrition for patients with pulmonary tuberculosis.

About the role of tasty and healthy food in daily nutrition for pulmonary tuberculosis

Most patients with tuberculosis have a complete lack of appetite, and correct mode Nutrition for tuberculosis requires eating at least 4-5 times a day. The conclusion suggests itself: food should be as tasty as possible and have an appetizing look and smell. Of course, for its preparation it is recommended to use exclusively fresh products.

Nutrition for patients with pulmonary tuberculosis also involves serving food to the table immediately after its preparation. Moreover, stale and heated food, in principle, is generally nonsense for dietary nutrition.

A separate secret of healing nutrition for pulmonary tuberculosis can be considered the satisfaction of “food whims,” i.e. following the rule: “Let better person“, who needs to eat, will, at will, eat a dish that is not entirely ideal from a nutritional point of view, which is why he stubbornly refuses the food prescribed to him by doctors (and impeccably prepared!).”

Nutrition for pulmonary tuberculosis: proteins

Due to the fact that in patients with pulmonary tuberculosis, the breakdown of proteins occurs faster than in a healthy person, and they are absorbed worse, it is necessary to include an increased amount of protein foods in the diet for tuberculosis. And since the proteins obtained with food should be as easily digestible as possible, the nutrition of tuberculosis patients is characterized as “a diet with an increase in the amount of proteins due to easily digestible proteins contained in dairy products.”

In other words, when organizing nutrition for tuberculosis patients, milk, yogurt, acidophilus milk, kefir, sour cream, cottage cheese, and cheese are recommended as optimal sources of protein. Equally necessary are eggs, fish, seafood, poultry, veal, rabbit, and soups made with low-fat meat broths. And remember that it is advisable to serve meat, fish and poultry boiled, baked, stewed, and also in the form of jellied dishes.

Less desirable sources of proteins are fatty meats and poultry, meat products (sausage, frankfurters, ham) and some fish products (herring, smoked meats, canned food).

Nutrition for pulmonary tuberculosis: fats

There should be little fat in the diet of a patient with tuberculosis. more than normal. It must be remembered that an excess of fat leads to indigestion, liver disease, quickly satiates, and the patient no longer wants to eat food rich in essential proteins, vitamins and minerals. Therefore, “more” does not mean “a lot”.

Nutrition for pulmonary tuberculosis: carbohydrates

When organizing nutrition for tuberculosis, carbohydrates are given within the age norms of a healthy person, and in any form: porridge (including those cooked with milk), flour products, bread, sugar.

As for contraindications, there are practically no contraindications against carbohydrates. The only exceptions are cakes with a high content of butter or custard. But this is due solely to reasonable restrictions on excesses: after all, the nutrition of patients with pulmonary tuberculosis is considered dietary!

Nutrition for pulmonary tuberculosis: vegetables, fruits and berries

Of course, nutrition for pulmonary tuberculosis involves eating fruits, vegetables and berries raw, but there is no objection to their culinary processing. Which vegetables and fruits to include in a patient’s diet can be decided individually, depending on taste preferences and the amount of vitamins contained in certain products.

Remember: vitamin C at proper organization A patient with pulmonary tuberculosis should receive twice as much nutrition as a healthy person. Vitamin C (ascorbic acid) is found in large quantities in lemons, oranges, tangerines, kiwis, strawberries, gooseberries, and black currants. From vegetables - in cabbage, onions, bell peppers, etc.

So, the diet of patients with pulmonary tuberculosis (and all other forms of tuberculosis) can and should include fruit drinks, mousses, jellies, juices, decoctions of rose hips and other “dried” fruits and berries. Don’t forget about casseroles, stews, purees containing vegetables, fruits and berries, as well as vegetable soups and various salads (including leafy greens), vinaigrettes. And vegetables in general! Pickled, boiled, stewed and steamed vegetables.

Healthy Products

High Protein Foods. In the body of a patient, proteins break down faster than in a healthy person, so it is necessary to include a higher protein content in the diet. These are: dairy products, eggs, fish, poultry, veal.
Products containing fats. The fat content in the patient's diet should be slightly higher than normal, but do not forget that excess fat in the diet can lead to digestive upset and liver disease. Sufficient amounts of fat are contained in olive oil, fish oil, butter. It is not recommended to consume pork, beef and lamb fat.
Carbohydrate-rich foods. Carbohydrates are found in cereals, various flour products, and sugar. It is recommended to include buckwheat, rice, semolina in your diet, wheat bread, honey, jam.
Vegetables, fruits, berries. During illness, the patient's body needs vitamin C in large quantities. Vitamin C is found in lemons, kiwi, oranges, and strawberries. Vegetables rich in vitamin C include: cabbage, onions, bell peppers, etc. Vegetables can be consumed either fresh or in the form of stews, purees, soups, etc. Vegetables do not have any contraindications.

Products that are prohibited

The diet of patients with tuberculosis practically does not limit anything. The list of prohibited products is not too long and includes the following:

fatty fish;
duck, goose;
pork;
mutton;
alcohol.

Otherwise, the nutrition of tuberculosis patients is not limited in any way. They can eat whenever they want and whatever they want. The main thing is that their diet complied with the above-mentioned standards for the content of fats, proteins, carbohydrates and vitamins.

Following a diet gives people with tuberculosis a chance to prolong their lives and hope for successful outcome. After all, today this disease has already been sufficiently studied and is being treated. The main thing is to believe in yourself and modern medicine.

Therapeutic diet No. 11 is indicated

at the stage of mild exacerbation of tuberculosis of the lungs, lymph nodes, bones and joints;
at the stage of attenuation of tuberculosis of the lungs, lymph nodes, bones and joints;
with exhaustion after infectious diseases, injuries and operations, accompanied by low body weight.

Therapeutic diet No. 11 is prescribed for the purpose of:

improving the body's nutrition;
increasing his protective powers;
enhancing recovery processes in the affected organ.

The therapeutic diet for tuberculosis is high in calories. It increases the content of animal proteins in the diet, especially dairy, vitamins, microelements, and also moderately increases the amount of fats and carbohydrates. Standard cooking and normal temperatures of food consumed are permitted. A 5-time food intake regimen is recommended.

Chemical composition of a therapeutic diet for tuberculosis

100-110 g of proteins, 60% of which are animal;
100-110 g of fats, 20-25% of which are vegetable;
400-450 g carbohydrates;
12-15 g salt;
1.5 liters of liquid.

Therapeutic diet No. 11 has an energy value of 2900-3100 calories.

Bread, flour products

It is allowed to eat wheat, rye bread, various flour products (pies, cookies, biscuits, muffins, etc.).

Soups of any kind are allowed.

Meat, poultry, fish

Allowed for food different types meat, poultry and fish, with the exception of very fatty ones. Any culinary processing is allowed. You can eat liver, sausage, ham, sausages, fish products such as herring, balyki, caviar, sprats, canned sardines, etc., and non-fish seafood.

Dairy products

Consumption of a full range of dairy products is allowed, with the obligatory inclusion of cottage cheese and cottage cheese in the diet.

Eggs can be eaten in any preparation.

Cereals

Vegetables, fruits, berries Can be eaten in any culinary preparation. However, some of them must be represented by raw fruits.

Snacks

Various snacks are allowed. Particular preference is given to leafy and vegetable salads.

Sweet dishes, sweets

You can eat a variety of sweet dishes, jam, honey, etc.

Sauces, spices

Consumption of red meat, milk bechamel, sour cream, egg-milk and other sauces and spices in moderate quantities is allowed.

Any drinks are allowed. IN mandatory It is recommended to consume vegetable and fruit juices, rosehip decoction and wheat bran.

Fats

Butter and vegetable oils can be eaten in their natural form, ghee can be used in cooking.

Consumption of very fatty meats and poultry, lamb, beef and cooking fats, hot and fatty sauces, cakes and pastries with a lot of cream is prohibited.

Example of a therapeutic diet menu No. 11

For second breakfast you can afford cheese and tea.

Dinner consists of borscht in meat broth with the addition of sour cream, fried chicken with boiled rice, compote.

Afternoon snack includes rosehip decoction.

Meat samples are allowed for dinner, stuffed with egg and onions, carrot puree, buckwheat casserole with cottage cheese, tea.

Composition and calorie content of the diet

Nutrition of tuberculosis patients with a sluggish course of the disease

Patients have decreased body reactivity, general hypotension, low-grade fever. The diet is limited to easily digestible carbohydrates. Calorie content 2700-3000 kcal: proteins - 140 g; fats - 100 g; carbohydrates - 400 g; ascorbic acid up to 350 mg; vitamin B 1 to 5 g. Culinary food processing is normal. Meals are fractional (5 times a day).

Nutrition for tuberculosis patients with increased nervous excitability

Patients have low body weight, elevated temperature, without signs of increased tissue breakdown, during the period of attenuation of the process in tuberculosis of the lungs, bones and joints. Calorie content of the diet is 3000-3500 kcal: proteins - 110-120 g; fats - 120 g; carbohydrates 500-550 g; ascorbic acid content up to 300 mg. Cooking is normal. Calcium-rich foods are recommended. Meals are fractional (5 times a day).

Nutrition of tuberculosis patients during exacerbation

Patients experience pronounced tissue breakdown, significant inflammatory phenomena, accompanied by high fever, exhaustion, and high protein breakdown. Calorie content of the diet is 3000-3500 kcal: proteins - 120-140 g; fats - 100 g; carbohydrates - 400-500 g. Be sure to consume excess amounts of ascorbic acid. It is advisable to use large quantity various drinks, raw juices, vegetables, fruits rich in mineral salts and vitamins. During an exacerbation of tuberculosis, appetite often decreases and gastrointestinal disorders occur. All food is prepared pureed. Diet: every 2-3 hours.

Besides the list necessary products There are also some components that can cause harm. It is important to avoid sweet, fatty and heavy foods, as they only take energy away from the body. In addition, salt is limited to 5 g per day so that calcium is not washed out too actively.

At the same time, do not forget that nutrition for tuberculosis should be balanced; you should not focus only on proteins or carbohydrates. There should be more carbohydrates than protein, but this is achieved due to its complex variants, which are contained in whole grain, cereals ( brown rice, buckwheat, oats, etc.).

Therapeutic nutrition for tuberculosis must certainly include plenty of fluids, but it should be taken no earlier than an hour after eating. We are talking not only about water, but about all drinks in general.

Composition and calorie content of the diet

Due to the characteristics of the disease associated with weight loss, the diet has a higher calorie content compared to normal nutrition and is about 3000-3500 kcal per day. Basically, this amount of calories is achieved by increasing protein foods of animal origin. The amount of fats and carbohydrates increases slightly. Also included in the diet are additional minerals and vitamins, especially the daily calcium intake increases.

There are no special requirements for heat treatment of food. Use free liquid, as with proper nutrition, is 1.5 liters. You need to eat at least 5 times a day.

Tuberculosis is an infectious disease with a predominantly chronic course. IN childhood During primary infection, the infection spreads through the lymphatic tract, affecting mainly lymph nodes. This form of tuberculosis often goes unnoticed. Adults are more likely to suffer from pulmonary tuberculosis; this is the most common form of the disease. The tuberculosis process can affect different organs - the larynx, intestines, kidneys, osteoarticular system, skin and other organs - this is organ tuberculosis, which is less common.

Tuberculosis causes not only local changes in organs, but also general phenomena characteristic of an infectious disease. Tuberculosis bacilli, entering the body, ultimately cause tissue destruction. Tuberculosis toxins and tissue breakdown products lead to intoxication of the body. Intoxication negatively affects the functions of organs and systems of the body and causes serious violations metabolism. The degree of intoxication depends on the severity of the tuberculosis process.

When intoxicated, the function of the digestive glands is inhibited, the secretion of digestive juices decreases, and appetite decreases. Under the influence of intoxication and oxygen deficiency, oxidative processes in tissues decrease. Violated protein metabolism- protein breakdown increases and tissue protein recovery decreases; in severely ill patients, the protein content in the blood decreases. Profound changes are occurring in fat metabolism: exhaustion sets in, fatty infiltration of the liver develops, products of incomplete combustion of fats - acetone - accumulate in the blood. Carbohydrate metabolism reduced, little glycogen is deposited in the liver and muscles. Violated mineral metabolism, the body loses calcium, phosphorus and sodium chloride. The consumption of vitamins A, B and C increases, and the reserves of vitamins in the body are depleted.

As the condition of tuberculosis patients improves under the influence of treatment, intoxication phenomena decrease, metabolic processes gradually normalize, and organ functions are restored.

For a long time, nutrition for tuberculosis patients has been the most important therapeutic factor. In the past, the principle of excess nutrition with a lot of fat prevailed for a long time.

Over the past decades, the understanding of the role of nutrition in the treatment of tuberculosis patients has changed significantly.

The objectives of diet therapy are as follows:

help increase the body's resistance
provide the body with the substances necessary for tissue repair and scarring of tissue defects caused by tuberculosis bacilli
promote normalization metabolic processes
restore vitamin and mineral balance in the body

Proteins are the most important integral part diets:

they are necessary for the restoration of tissue proteins and scarring of the lesion
they contribute to the development of anti-tuberculosis immunity
B vitamins and lipotropic factors are introduced with complete protein products

It is believed that with increased protein breakdown, introducing them in sufficient quantities enhances the utilization of protein substances. Therefore, tuberculosis patients require an increased amount of protein (up to 120-140 g). Only for severely ill patients with high fever and severe intoxication, proteins are limited to 80 g, but are given mainly in the form of complete proteins (meat, fish, eggs, dairy products). Milk proteins are the best for absorption. Even in the last century, doctors treated severe tuberculosis patients with baked milk and oats.

Recently, it has been found that excess fat in the diet has a negative effect on tuberculosis patients:

Weight gain occurs due to the deposition of fat in adipose tissue
fatty infiltration of the liver increases
Appetite decreases and the patient does not eat healthy protein foods
digestive disorders occur

The average amount of fat in the diet should not exceed 100-120 g, and in more severe patients 80-100 g. Tuberculosis patients should be given fats mainly in the form of easily digestible butter rich in vitamin A, as well as dairy products (sour cream, cream, milk ), which, in addition, contain a lipotropic factor - lecithin. The daily diet includes vegetable oil in its natural form as a source of polyunsaturated fatty acids, which normalize metabolism in the body.

Overfeeding with carbohydrates also causes obesity, so the diet of tuberculosis patients moderate severity the amount of carbohydrates should be no higher than 500-550 g. More severe patients should reduce carbohydrate intake to 300-350 g. The same restriction is carried out for obese patients and with tuberculosis processes occurring with allergic reactions. But a more drastic restriction of carbohydrates in tuberculosis is not indicated, since protein metabolism is disrupted (the breakdown of proteins increases) and fat metabolism (the acetone content in the blood increases). Some carbohydrates are given in the form of vegetables, fruits and berries, which are sources of mineral elements (potassium, phosphorus, iron) and vitamins (C, P, folic acid), and also have an alkalizing effect.

Mineral salts are an important part of the diet of a tuberculosis patient. With pulmonary tuberculosis with tissue breakdown and high temperature, the body loses calcium, phosphorus and sodium chloride.

Calcium plays big role in the body of a tuberculosis patient - compacts the wall of blood vessels, which is important when inflammatory processes, participates in blood clotting. Calcium is necessary for the calcification of tuberculous foci. For better absorption of calcium and phosphorus, vitamin D is needed. The main source of calcium is dairy products: milk, cottage cheese, cheese; other foods contain calcium in extremely small quantities. Dairy products are rich in vitamin D egg yolks, fish oil, fish.

At frequent vomiting and diarrhea, as well as after large blood losses, patients are administered with food a slightly increased amount of table salt (up to 15-20 g). In other cases, there are often indications for limiting table salt: with exudative pleurisy, peritonitis, meningitis, skin tuberculosis and kidney damage.

Tuberculosis is accompanied by an increased consumption of vitamins and depletion of their reserves in the body; phenomena of hypovitaminosis develop.

The diet of patients with pulmonary tuberculosis should contain an increased amount of vitamin A (3-4 mg), which is administered in the form of milk fat (butter, sour cream), egg yolks and fish oil (cod liver, fatty herring), as well as plant products containing provitamin A - carotene (carrots, apricots, tomatoes, greens). Vitamin A is necessary for the restoration of the epithelium of the mucous membranes, with lesions of the larynx, intestines and skin.

The increased need for B vitamins is not fully satisfied through food; some is added in the form vitamin preparations. Only adding brewer's or baker's yeast to food can to some extent compensate for the lack of B vitamins.

Vitamin C has a great influence on the course of the tuberculosis process:

it increases anti-tuberculosis immunity
improves oxidative processes in the body
reduces intoxication symptoms
in combination with vitamin P, it reduces increased capillary permeability, which is important for hemoptysis and bleeding, as well as for inflammatory processes in tissues. When prescribing ascorbic acid in an amount of 200-300 mg per day to an adult patient, improvement occurs

Considering that the body of a patient with tuberculosis is constantly deficient in vitamin C, the diet should contain a sufficient amount of vegetables, berries and fruits, some of them raw. In addition, rosehip infusion and ascorbic acid are systematically added. Severe tuberculosis patients should be given rosehip infusion, blackcurrant juice and other juices of fresh berries and fruits.

When conducting diet therapy for patients with pulmonary tuberculosis, the stage of the disease and the prescribed regimen (bed, sanatorium, with walks), as well as the presence of damage to other organs, are taken into account.

Dietary regimen prescribed to patients with chronic pulmonary tuberculosis who are in a sanatorium regime (walks on fresh air), in the absence of dyspeptic symptoms, contains 3000-4000 kcal/day, depending on age and fatness. This diet contains on average 100-140 g of protein, 100-120 g of fat, 500-550 g of carbohydrates, about 200 mg of ascorbic acid (until saturation). The calcium content in the products is 2-3 g, table salt 8 g.

This diet regimen is known as the 11 diet.

Another dietary regimen is used in patients with pulmonary tuberculosis during an exacerbation at high temperature and severe intoxication. The diet consists of 80-100 g of proteins, 80-100 g of fats, 300-350 g of carbohydrates, which is 2500-3000 kcal. The content of vitamin C is 250-300 mg, vitamin B1 3-5 mg. The amount of calcium and sodium chloride is the same as in the first diet regimen.

Dietary regimen prescribed for patients with pulmonary tuberculosis complicated exudative pleurisy, peritonitis, pericarditis, polyarthritis, the composition and calorie content is the same as the previous one. But the calcium content in food should be increased (up to 5 g) and sodium chloride should be sharply limited (up to 2 g). Food is prepared without salt, and salt-free bread is prescribed.

If there is damage to other organs (larynx, intestines, kidneys), appropriate diets are prescribed, but enriched with proteins, mineral salts and vitamins.

Kumis, as a medicinal and nutritious drink, has long been used in the treatment of patients with pulmonary tuberculosis. Kumis is obtained from mare's milk by fermentation. One liter of kumys contains: proteins 22 g, fat 17 g, milk sugar 32 g, vitamin C 200-300 mg, as well as vitamins A, B1, B2, lactic acid, carbon dioxide and up to 30 g of alcohol. Average daily dose kumis 1-1.5 l, and for severely ill patients 0.5 l. Under the influence of kumys, appetite increases and the absorption of food proteins and fats improves. Treatment with kumiss increases the tone of the body.

Kumiss treatment is contraindicated:

patients with increased excitability of the nervous system and liver diseases due to the presence of alcohol in kumiss
at gastrointestinal diseases
for obesity, as it increases the calorie content of food
for cardiovascular diseases and kidney diseases

Treatment with grapes is also prescribed for patients with pulmonary tuberculosis. One kilogram of grapes contains an average of 180 g of glucose, thus the patient receives additional nutrition in an easily digestible form. Initially, the patient is allowed to eat no more than 0.5 kg, and subsequently up to 1.5-2 kg of grapes per day.

Treatment with grapes is contraindicated for gastrointestinal diseases, diabetes mellitus and obesity.

For recent years The number of people infected with tuberculosis has increased significantly. Mycobacteria have become resistant to standard antibiotic therapy, so the development of new, more effective schemes treatment. The key to success is integrated approach, which, in addition to drug therapy, provides for compliance healthy image life. An important component is diet, so you need to know what you can eat if you have pulmonary tuberculosis.

The causative agent of tuberculosis is Koch's bacillus. It is a microorganism resistant to environmental conditions. It has a thick cell membrane that is not destroyed by acids, alkalis, peroxide compounds, alcohol, and acetone. Mycobacteria remain viable in dry dust for up to 3-4 years, when exposed to ultraviolet radiation for more than a year, and when boiled for up to 10 minutes.

Under unfavorable conditions, they turn into L-forms (non-enveloped form, has reduced metabolic activity and virulence). Infection occurs by airborne droplets. Bacteria penetrate through the upper respiratory tract V lung tissue where they multiply, an inflammatory reaction develops.

With immunity, the body fights the infection and makes a full recovery. If the immune response is weakened, the disease may progress and hematogenous spread with damage to the kidneys, intestines, and nervous system.

It is not easy to suspect the development of tuberculosis, since initial manifestations similar to cold and acute symptoms respiratory diseases. From the moment of infection to the appearance of the first complaints, it takes from 2-3 months to 1 year. The main symptoms of tuberculosis are:

poor health (fatigue, weakness, drowsiness, irritability);
decreased appetite and weight loss;
unreasonable increase in temperature to a subfebrile level;
the appearance of a cough with sputum discharge;
increased sweating at night;
shortness of breath and a feeling of heaviness in the chest.

To diagnose the disease for persons under 14 years of age, the Mantoux test is used - a subcutaneous injection of tuberculin. Chest x-rays and fluorography are used as screening for adults. As additional research can use CT, MRI, PCR, microscopic and bacteriological examination sputum. The main treatment aimed at eradicating the pathogen is chemoprophylaxis and antibiotic therapy.

With tuberculosis, catabolic processes are activated in the human body and energy costs increase. With the development of intoxication, all types of metabolism are disrupted: carbohydrate, protein, fat, mineral. To increase the body's resistance to infections, accelerate repair processes, and normalize digestion, you should adhere to proper nutrition.

It should be noted that some antibiotics destroy the cell membrane of the microorganism, which provokes the release of toxins contained inside the cell into the blood. This increases the manifestations of intoxication and significantly worsens well-being. Also drug therapy has a large number side effects. Proper nutrition helps reduce their intensity and duration.

Features of the diet during treatment

Nutrition for pulmonary tuberculosis during treatment should provide the body with all necessary elements. The need to consume high-calorie foods is explained by increased energy costs for catabolic processes. With tuberculosis, increased breakdown of proteins occurs, carbohydrate and fat metabolism is disrupted.

Authorized Products

In case of tuberculosis, the diet should be based on foods with a high protein content. They promote the healing of affected areas, are used in the synthesis of immunoglobulins, and take part in the absorption of B vitamins. Protein is the most easily absorbed from the following products:

Some have a complete amino acid composition vegetable proteins. Among them are soybeans, lentils, peas, beans, buckwheat. Permitted products also include:

milk;
butter and vegetable oils;
walnuts;
peanut;
garlic.

Nutrition for tuberculosis should satisfy the body's need for carbohydrates, since they are the main source of energy. Recommended consumption rye bread, raw vegetables and fruits, cereals. Patients with tuberculosis are recommended to eat fruits - apricots, oranges, lemons, pears, apples, plums, bananas. From confectionery preference should be given to marshmallows, marshmallows and marmalade.

It is worth adding honey to your diet. It has immunostimulating properties and helps thin mucus. The amount of salt is usually not limited, but its excessive consumption makes it difficult to clear sputum and retains fluid in the body.

What should you give up?

You should limit your consumption of waterfowl poultry(ducks, geese). From meat products Fatty pork and beef are not recommended. It is also necessary to reduce the consumption of confectionery products containing large amounts of cream (pastry, pies).

When treating tuberculosis, the use of irritating foods - pepper, mustard, horseradish, radish - is prohibited. You should also completely abandon:

kvass;
sweet carbonated drinks;
alcohol;
smoked meats;
canned meat and fish;
fermented and pickled products.

Essential Vitamins and Minerals

In the body of a person suffering from tuberculosis, a deficiency of vitamins and minerals occurs to one degree or another, since these substances help strengthen the immune system, normalize the repair processes of affected tissues, and also reduce intoxication. When the infection worsens, the excretion of micro and macroelements from the body increases and the acid-base balance is disturbed.

The following substances are of particular importance for tuberculosis:

In the chronic course of pulmonary tuberculosis, the amount of vitamins B12 (cyanocobalamin) and B15 (calcium pangamate) decreases. This can cause the development of anemia and hypoxia.

Important! Lack of vitamin K leads to coagulopathic disorders and increased hemoptysis.

Vitamin D (calciferol) promotes the activation of lymphocytes and strengthens the walls of blood vessels microvasculature. If there is a deficiency, it is disrupted phosphorus-calcium metabolism, bone density decreases.

Fish oil is a rich source of unsaturated fatty acids and vitamin D. Omega-3 will help avoid many complications caused by tuberculosis. They have a protective effect on nerve fibers, reduce thrombus formation, promote the formation muscle fibers, have immunostimulating and anti-inflammatory properties.

With tuberculosis, the removal of salts from the body increases, so it is necessary to ensure sufficient intake of calcium, phosphorus, magnesium and iron into the body. In cases of severe deficiency, when it is impossible to replenish vitamins and minerals with food, it is rational to use vitamin-mineral complexes.

Daily diet: ratio of fats, proteins and carbohydrates

To prevent weight loss and eliminate protein-energy malnutrition, certain rules should be followed when preparing a diet for a patient with tuberculosis. When calculating daily caloric intake, it is necessary to take into account the energy consumption to fight the infectious agent and the increase in metabolism during fever. On average, 2900-3500 kcal/day is required.

The main source of energy is simple carbohydrates and animal fats. At chronic course the daily requirement for carbohydrates is 8 g per 1 kg of the patient’s weight, in acute cases - 5-6 g. The amount of fat should not exceed 1.5 g per 1 kg of body weight, since their excess contributes to the development of acidosis, reduces appetite, and causes digestive disorders .

Patients with tuberculosis need to eat large amounts of protein. This is due to increased catabolism and an increased need for amino acids for the synthesis of antibodies and repair of damaged tissues. Daily requirement– 2-2.5 g per 1 kg of body weight.

Breakfast: steam omelette with a piece of boiled chicken, vegetable salad, sweet tea with lingering cookies.
Second breakfast: fresh fruit or berries.
Lunch: borscht with sour cream, buckwheat porridge with beans, compote.
Afternoon snack: cheesecakes with jam, tea.
Dinner: steam cutlet, stewed vegetables, sweet tea.

Characteristics of table No. 11 for adults and children

If it is necessary to restore the body when infectious diseases Table No. 11 according to Pevzner is assigned. A feature of this diet for tuberculosis is the increase in calories due to increased consumption of protein and fast carbohydrates.

The following products are allowed:

Lean meat.
Soups.
Bakery products.
Cereals.
Dairy products.
Fresh fruits and vegetables.

Fatty meats (lamb, domestic ducks and geese), margarine, smoked sausage, canned fish and meat, carbonated drinks, and kvass are prohibited.

When compiling children's menu You should pay attention to the heat treatment of products. It is better for children to use stewed and boiled vegetables and baked meat. The diet should be rich in fresh fruits and vegetables.