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Basic principles of therapeutic nutrition in case of myocardial infarction


In nutrition, the caloric content and volume of food are significantly limited, which then gradually increases. Excludes foods rich in animal fats and cholesterol (fatty meats, internal organs of animals, brains, caviar, egg yolk, animal fats, fatty fish, etc.), products that cause fermentation in the intestines and flatulence (black bread, cabbage, beans , milk in kind, etc.). In the diet include products such as cottage cheese, pike perch, cod, oatmeal, as well as foods rich in vitamins C and P, potassium salts. Limit the salt and free liquid, taking into account the period of the disease, the state of blood circulation and blood pressure.



The food consists of three consecutive rations. The first diet is given in the acute period of myocardial infarction (the first 7-8 days), the second - in the subacute period (2-3 weeks), the third - during the scarring (starting from the 4th week).
In the first two days of severe myocardial infarction, give 7-8 times 50-75 grams of semi-sweet tea with lemon, slightly warm and diluted with water juices of fruits and berries, broth of wild rose, liquid from compote, liquid jelly, cranberry juice, mineral alkaline water without gas.
In the future, easily digestible food is given in small portions 5-6 times a day, thus preventing the cardiac arrest of the diaphragm that makes it difficult to work. Exclude very hot and cold food; to improve the taste of unsalted dishes and appetite, give tomato juice, use table vinegar, citric acid, sweet and sour fruit juices, etc.
In the first days of illness, if the patient does not want to, it is not necessary to coerce him. After some improvement, it should not be denied to those who have an appetite lowered in a small number of foods rich in fats and cholesterol (eggs, caviar, cream, etc.). During the recovery period with excess body weight, unloading days are necessary.
CULINARY TREATMENT
All dishes are prepared without salt. Low-fat varieties of meat and fish give in boiled form, exclude fried and baked dishes. On the first diet, dishes are cooked in a grated kind, on the second - mostly crushed, on the third - crushed and chunk. Exclude cold (below 15 degrees) food and drinks.

CALORILITY OF FOOD
The first diet: 1200-1300 kcal. Proteins 50 g, fats 60-70 g, carbohydrates 170-200 g. The content of vitamins: A - 2 mg, B1 - 2 mg, B2 - 2 mg, PP - 15 mg, ascorbic acid - 100 mg. Amount of free liquid 800 g. Table salt 1,5-2 g (in products). The total weight of the ration is 1700 g. The sample menu of the diet is given below.
Second ration: calorie content of 1600-1800 kcal. Proteins 60-70 g, fats 60-70 grams, carbohydrates 230-250 g. The content of vitamins is the same as in the first diet. The amount of free liquid is 1 liter. Table salt 1,5-2 g (in products, in addition 3 g are given out on hands). The total weight of the diet is 2 kg. An approximate menu of the diet is given below.
The third diet: calorie 2300-2400 kcal. Proteins 90 g, fats 80 grams, carbohydrates 300-350 g. The content of vitamins is the same as in the first diet. The amount of free liquid is 1 liter. Table salt 1.5-2 g (in products, in addition, 5 g are given to the hands). The total weight of the ration is 2300 g. The approximate menu of the diet is given below.
DIET
The first and second rations - 6 times; the third - 5 times a day in small portions. The temperature of food is normal.
RECOMMENDED FOODS AND MEALS
Bread and flour products: the first ration - 50 g of rusks from wheat flour of the highest and 1st grade; second ration - 150 g of wheat bread of yesterday's baking; third ration - 250 g of yesterday's wheat bread with the replacement of 50 g of it with rye bread (with tolerability).

Soups: the first ration - 150-200 g, on a vegetable broth with
rubbed with allowed croup and vegetables, egg flakes; second-third rations - 250 g with well-boiled croutons and vegetables (borsch, beetroot, carrots, etc.), let's say weak, low-fat meat broth.

Meat, poultry, fish: only low-fat species and varieties. Meat
free from films, tendons, skin (poultry), fat. The first ration - steam cutlets, knels, meatballs, souffle, etc., boiled fish for 50 g; the second and third rations - meat boiled with a piece, products from a cutlet mass.
Dairy products: milk - in dishes and tea. Low-fat kefir and other sour-milk products, drinks. Curd cheese, soufflé (first ration), as well as puddings with croup, carrots, fruits (second-third rations). Sour cream - for filling soups. Cheese is low-fat, unsalted - second-third rations.
Eggs: first, second and third rations - protein omelets, egg flakes to vegetable broths.
Cereals: the first ration - 100-150 g of semolina porridge, wiped buckwheat, oat on milk; second ration - 150-200 g of liquid, viscous uneatened cereals, 100 g of crumbly buckwheat, casserole of manna; third ration - 200 grams of porridges, boiled vermicelli with cottage cheese, casserole of manna with apples, pudding of buckwheat and curd.
Snacks: first and second rations - excluded; third ration - soaked herring, low-fat ham, boiled pouring meat and fish, ripe tomatoes.
Vegetables: the first ration - 100 g of puree from potatoes, carrots, beets (separate dishes and side dishes), wiped carrot-curd pudding; the second diet is supplemented with cauliflower, grated raw carrots; third diet - stewed carrots and beets. The mass of dishes is 150 g.
Fruits, sweet dishes, sweets: the first diet - apple puree, jelly, mousse, prunes, dried apricots - soaked, mashed potatoes, 30 g of sugar or honey; the second and third diets are supplemented with raw soft fruits and berries, baked apples, compote, milk jelly, jelly, jam, meringues; up to 50 g of sugar, 15 g of xylitol instead of sugar.
Sauces and spices: second and third rations - to improve the taste of unsalted food - sweet and sour fruit juices, tomato juice, citric acid, vanillin, 3% table vinegar, sauces on vegetable broth and milk, boiled and lightly toasted onions.
Drinks: the first diet - for 100-150 grams of weak tea with lemon, milk, coffee drinks with milk, broth of wild rose, infusion of prunes, carrot, beet, fruit juices; second and third rations - the same for 150-200 g.
Fats: butter and vegetable refined oils - in dishes; on the third diet 10 g of butter on the hands.
EXCLUDED PRODUCTS AND DISHES
From the diet of patients with myocardial infarction is excluded:
fresh bread, buns, flour baked products, fatty species and varieties of meat, poultry, fish, liver, brains and other meat by-products,

sausages, canned goods, caviar, whole milk and cream, egg yolks, millet, barley, barley, legumes, cabbage, cucumbers, radish, onions, garlic, spices, animals and culinary fats, chocolate and other confectionery products, cocoa, grape juice.
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