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The basic principles of clinical nutrition in myocardial infarction


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



Food consists of three consistently appointed rations. The first diet is given in the acute period of myocardial infarction (the first 7-8 days), the second - in the subacute period (the 2-3rd week), the third - during the scarring period (starting from the 4th week).
In the first two days of severe myocardial infarction, they give 7–8 times 50–75 g of an infrequent semi-sweet tea with lemon, slightly warm fruit juices and berries diluted with water, rosehip decoction, liquid compote, liquid kissels, cranberry juice, alkaline mineral waters without gas.
In the future, easily digestible food is given in small portions 5-6 times a day, thus preventing the heart from raising the diaphragm. Eliminate very hot and cold foods; To improve the taste of unsalted dishes and appetite they give tomato juice, they use table vinegar, citric acid, sour-sweet fruit juices, etc.
In the first days of the disease, if the patient does not want to eat, it is not necessary to force him. After some improvement, one should not refuse those with reduced appetite in a small amount of foods rich in fats and cholesterol (eggs, caviar, cream, etc.). During the recovery period with overweight, fasting days are needed.
CULINARY PROCESSING
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 ration, dishes are prepared in shabby form, on the second - mostly ground, on the third - ground and in a piece. Exclude cold (below 15 degrees) dishes and drinks.

FOOD CALORIES
The first diet: 1200-1300 kcal. Proteins 50 g, fats 60-70 g, carbohydrates 170-200 g. Vitamins content: A - 2 mg, B1 - 2 mg, B2 - 2 mg, PP - 15 mg, ascorbic acid - 100 mg. The amount of free liquid is 800 g. Cooked salt 1.5-2 g (in products). The total weight of the diet is 1700 g. An exemplary diet menu is given below.
The second diet: calorie 1600-1800 kcal. Proteins 60-70 g, fat 60-70 g, carbohydrates 230-250 g. The content of vitamins is the same as in the first diet. The amount of free fluid - 1 l. Table salt 1.5-2 g (in products, in addition, 3 g are given on the hands). The total weight of the diet 2 kg. A sample ration menu is provided below.
The third diet: calorie 2300-2400 kcal. Proteins 90 g, fat 80 g, carbohydrates 300-350 g. The content of vitamins is the same as in the first diet. The amount of free fluid - 1 l. Table salt 1.5-2 g (in products, in addition, 5 g are given on the hands). The total weight of the ration is 2300 g. A sample ration menu is given below.
DIET
The first and second rations - 6 times; the third - 5 times a day in small portions. Food temperature is normal.
RECOMMENDED PRODUCTS AND DISHES
Bread and flour products: first ration - 50 g of bread crumbs from wheat flour of the highest and 1st grade; second ration - 150 grams of yesterday's wheat bread pastries; the third ration is 250 grams of yesterday's wheat bread, replacing 50 grams of it with rye bread (with tolerance).

Soups: the first ration - 150-200 g, on vegetable broth with
grated permitted grains and vegetables, egg flakes; the second and third rations - 250 g with well-cooked cereals and vegetables (borscht, beetroot soup, carrot grated, etc.), suppose weak fat-free meat broth.

Meat, poultry, fish: only low-fat species and varieties. Meat
free from films, tendons, skin (bird), fat. The first diet - steam cutlets, dumplings, meatballs, souffles, etc., boiled fish, 50 g each; the second and third rations are boiled meat in a piece, products made from the cutlet mass.
Dairy products: milk - in dishes and tea. Low-fat kefir and other dairy products, drinks. Mashed cottage cheese, soufflé (first ration), as well as puddings with cereals, carrots, fruits (second and third rations). Sour cream - for refueling soups. Cheese low-fat, unsalted - the second and third rations.
Eggs: first, second and third rations - protein omelets, egg flakes to vegetable broths.
Cereals: the first ration - 100-150 g of semolina, grated buckwheat, rolled oats on milk; the second ration - 150-200 g of liquid, viscous, non-rubbed porridge, 100 g of crumbly buckwheat, manna casseroles; the third ration - 200 g of porridge, boiled vermicelli with cottage cheese, casseroles with semolina with apples, buckwheat-curd pudding
Snacks: the first and second rations are excluded; the third diet - soaked herring, lean ham, boiled meat and fish, ripe tomatoes.
Vegetables: the first ration - 100 g mashed potatoes, carrots, beets (separate dishes and side dishes), mashed carrot curd pudding; the second ration is supplemented with cauliflower, grated raw carrots; The third diet - stewed carrots and beets. A lot of dishes - 150 g.
Fruits, sweet dishes, sweets: the first diet - applesauce, jelly, mousses, prunes, dried apricots - soaked, mashed, 30 g of sugar or honey; the second and third rations are supplemented with raw soft fruits and berries, baked apples, stewed fruit, milk kissel, 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 fried onions.
Drinks: the first diet - 100-150 g of weak tea with lemon, milk, coffee drinks with milk, rosehip broth, infusion of prunes, carrot, beetroot, fruit juices; second and third rations - the same for 150-200 g.
Fats: butter and refined vegetable oils - in dishes; on the third diet 10 g of butter on hand.
EXCLUDED PRODUCTS AND DISHES
From the diet of patients with myocardial infarction is excluded:
fresh bread, pastries, flour baked goods, fatty types and varieties of meat, poultry, fish, liver, brains and other meat by-products,

sausages, canned food, caviar, whole milk and cream, egg yolks, millet, barley, barley, legumes, cabbage, cucumbers, radishes, onions, garlic, spices, animal and cooking oils, chocolate and other confectionery, natural coffee, cocoa, grape juice.
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