Nutrition of patients with tuberculosis. Tuberculosis. Approximate weekly menu

Behind last 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 treatment regimens is required. The key to success is A complex approach, which, in addition to drug therapy, involves maintaining a healthy lifestyle. 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 resistant to conditions external environment microorganism. 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 into the lung tissue, where they multiply and develop an inflammatory reaction.

With immunity, the body fights the infection and makes a full recovery. In the case of a weakened immune response, disease progression and hematogenous spread with damage to the kidneys, intestines, and nervous system are possible.

It is not easy to suspect the development of tuberculosis, since the initial manifestations are similar to the symptoms of a cold and acute 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. Additional studies may include CT, MRI, PCR, microscopic and bacteriological examination of sputum. The main treatment aimed at eradicating the pathogen is chemoprophylaxis and antibiotic therapy.

With tuberculosis, catabolic processes in the human body are activated 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. Drug therapy also has a large number of 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 the necessary elements. Necessity of use high-calorie foods due to 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 increased content squirrel. 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 plant proteins have a complete amino acid composition. Among them are soybeans, lentils, peas, beans, and 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. Among confectionery products, 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 (cakes, pastries).

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 microcirculatory vessels. With a deficiency, phosphorus-calcium metabolism is disrupted and bone density decreases.

Rich source of unsaturated fatty acids and vitamin D is fish fat. Omega-3 will help avoid many complications caused by tuberculosis. They have a protective effect on nerve fibers, reduce thrombus formation, promote the formation of muscle fibers, and 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 calorie content 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. In chronic cases, the daily need 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, 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. The daily requirement is 2-2.5 g per 1 kg of body weight.

Breakfast: steam omelette with a piece of boiled chicken, vegetable salad, sweet tea with long 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, vegetable stew, sweet tea.

Characteristics of table No. 11 for adults and children

If it is necessary to restore the body in case of infectious diseases, table No. 11 according to Pevzner is prescribed. 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 creating a children's menu, you should pay attention to heat treatment products. It is better for children to use stewed and boiled vegetables, baked meat. The diet should be rich in fresh fruits and vegetables.

Proper nutrition for tuberculosis is the basis of therapy for this disease. The patient’s diet is developed by the attending physician, as well as a nutritionist. This attention to nutrition is due to the fact that medications used to treat tuberculosis seriously impair the functioning of gastrointestinal tract person. In addition, during treatment, it is necessary to strengthen the immune system, which balanced diet directly provides assistance.

The main goal when organizing nutrition for a patient with pulmonary tuberculosis is to increase the calories entering the body by 20-30%, depending on the form and severity of the disease. In addition, the diet for the patient is selected in such a way that the person receives more vitamins groups A,B and C and essential minerals.

At the same time, such a diet is observed so that the accumulation of fatty tissue does not occur, since in this case the disease will begin to progress. In the course of proper nutrition, a person’s immunity is strengthened, weight remains normal, and intoxication of the body with tuberculosis microorganisms is reduced to zero.

Diet affects the stable functioning of the heart, since with tuberculosis, during an exacerbation, the depth and correctness of breathing is disrupted, which in turn negatively affects the functioning of the cardiovascular system. In other words, the patient’s diet includes foods rich in potassium, sodium and other minerals that strengthen the heart muscle.

How do products affect the body?

The human diet includes proteins, fats, carbohydrates, fiber and other substances that make up the diet. Each of them has its own special effect on the body:

Protein. Tuberculosis has the ability to destroy the protein that makes up the cells, and therefore it is necessary to increase its amount during therapy. In addition, protein in an organism affected by pulmonary tuberculosis is absorbed much worse than in healthy person. In light of this, the body must receive a large amount of easily digestible protein, such as, for example, found in abundance in dairy products. The protein necessary for a patient with tuberculosis can be found in yogurt, kefir, sour cream, cottage cheese, and cheeses. It is also found in chicken eggs, fish, chicken, veal, rabbit, and lean meats. At the same time, all protein foods should only be boiled, since such heat treatment rearranges the protein into a quickly digestible structure. For example, if you have tuberculosis you should not drink raw eggs, but when boiled they are necessary. It is strictly not recommended to eat smoked fish or fatty meat. Meat that has been smoked, for example in the form of sausage or frankfurters. Canned meat and fish are prohibited.
Fat. During treatment, fat is necessary for metabolism. But it can be different - plant and animal. During the treatment of tuberculosis, preference is given to vegetable fat contained in olive, sunflower or sesame oil. You can also consume the fat contained in butter or fish. It is strictly forbidden to include fat of animal origin in the diet, such as lard, interior fat, lamb, margarine. These substances are very difficult to dissolve by the body and clog the gastrointestinal tract. As for the amount of fat consumed, it should be such that excess fat does not accumulate in the body, but also does not lead to its depletion. That is, it is calculated individually, in each specific case.
Carbohydrates. The bottom substance is broken down by the digestive system very quickly and is found in many foods. This could be bread or any other flour product. There are many carbohydrates in cereals, legumes, and sugar.
Cellulose. This is a material necessary for digestion, found in fresh vegetables and fruits. The anti-tuberculosis diet must include apples, pears, and most importantly, berries. It is the berries that contain vitamin C and other useful material. It could be currants, blueberries, gooseberries or raspberries. You can not only eat the berries, but also make compotes and jams from them. Vegetables can also be eaten boiled, such as cabbage, bell peppers, and the usual potatoes. In order to get more vitamin C, the patient should eat fruits such as lemon, orange, tangerines and kiwi. You cannot eat fried vegetables; they must undergo heat treatment by boiling in water or steaming.

In order to get the required amount of carbohydrates, it is recommended to include porridge made from buckwheat, rice, semolina, beans or peas in your diet. You can also eat pasta and bread, preferably rye. Sugar can be consumed in the form of jam, honey or sweet baked goods. You should not overuse sugar-containing products, such as cakes and pastries containing cream. It is also not recommended to drink carbonated and sweet drinks. In this case, an excess of carbohydrates can lead to weight gain.

Table No. 11

The menu developed for table No. 11 includes a wide variety of dishes, with the exception of highly fatty and fried dishes. Nutrition for tuberculosis is carried out exactly according to table No. 11, while of course the doctor takes into account the individual characteristics of his patient’s body and calculates an individual diet.

And one more important aspect is to eat during tuberculosis treatment in small portions, but 4-5 times a day. Sometimes an apple or a glass of kefir is enough.

1 menu:

09:00 – sour cream or cottage cheese, you can mix both. Boiled egg. Sweet tea with a slice of lemon.
11:00 – oatmeal. Tea with jam or honey.
13:00 – meat broth with a piece of beef. Salad with vegetables and seafood. Fresh juice, tomato or orange.
16:00 – a glass of kefir. Bun.
19:00 – boiled fish, mashed potatoes. Dried fruits compote.

2 menus:

09:00 – buckwheat porridge. You can add milk and a little sugar to it. Sweet tea.
11:00 – 2 egg omelet with vegetables added to it, such as tomatoes and onions.
13:00 – vegetable salad such as Vinaigrette. Vegetable soup. Steamed beef cutlets. Mashed potatoes. Apple juice.
16:00 – zucchini pancakes. Tea.
19:00 – boiled pasta with minced beef – “Navy pasta” Sweet tea.

3 menus:

09:00 – cheesecakes, sour cream, berry jam. Sweet tea.
11:00 – boiled chicken.
13:00 – fresh salad with carrots and cabbage. Vegetable soup with chicken. Buckwheat porridge with meat gravy. Dried fruit compote.
16:00 – a plate of fresh berries.
19:00 – potato roll with mushrooms. Sour cream. Berry compote.

4 menus:

09:00 – semolina with butter. Tea with honey.
11:00 – rye barn. Dried fruits compote.
13:00 – cabbage salad. Pea soup. Pearl barley porridge with pieces of meat. Orange juice.
16:00 – berry jam, bun.
19:00 – boiled potatoes, cutlets. Green pea with lettuce leaves. Tea with lemon and sugar

5 menu:

09:00 – Sweet rice porridge, boiled until smooth. Sweet tea.
11:00 – Apple. A glass of kefir
13:00 – Crab salad. Daily cabbage soup. Boiled chicken with mashed potatoes. Dried fruit compote.
16:00 – Vegetable pancakes. Sweet tea
19:00 – Pasta. 2 boiled eggs. Curdled milk. Berry compote.

The menu can be made more varied. There should be no more than 2 hours interval between meals. Dinner should be at least 3 hours before going to bed. Before going to bed, you can drink a glass of kefir or warm fresh milk. It's soothing nervous system and promotes good sleep. This is recommended to be done, especially if the patient has symptoms of chronic stress - nervous tension, irritability, headache.

Prevention of tuberculosis

In order to reduce the risk of tuberculosis, you need to not only avoid contact with sick people, wash your hands before eating and avoid damp places. You can also include in your diet some foods that help increase the body's protective functions:

For tuberculosis, it is recommended to consume honey during treatment. It is also irreplaceable as a preventive measure. One tablespoon per day is enough.
None of dietary menus does not include propolis. And in vain, it helps very well to fight pulmonary tuberculosis, as it contains a strong and safe antibiotic. In the old days, propolis was used to seal festering wounds, knowing its anti-inflammatory effect. For the same reason, it can be taken 3 times a week as a preventative measure.
Decoctions of field chamomile, rose hips or fireweed tea, consumed at least once a day, will significantly reduce the risk of developing tuberculosis, even in an unfavorable environment.
Lemon, grapefruit or orange. You need to eat at least one of these fruits per day. This will satisfy daily requirement the body in vitamin C, which significantly strengthens the human immune system.

Diet for tuberculosis is a very important therapeutic aspect. It should not be neglected or taken lightly. It is prescribed by the attending physician, who must monitor its effect on the body and, if necessary, adjust it.

A proper diet promotes faster recovery.

The effectiveness of tuberculosis treatment is directly related to the ability of the patient’s immune system to resist the aggressive effects of infection. In order to increase its resistance, phthisiology provides a special diet for pulmonary tuberculosis, which, together with the intake, is a mandatory part of the entire therapeutic course.

The use of such a diet significantly speeds up the treatment process and promotes adequate rehabilitation after intensive chemotherapy.

Briefly about pulmonary tuberculosis

Tuberculosis (popularly “consumption”) occurs due to the high activity of a specific mycobacterium known as Koch’s bacillus. The path of spread of the bacillus is airborne, which is why the pathology is classified as infectious diseases. Incubation period The illness lasts from 1 to 3 months.

Koch's bacillus under a microscope.

Basic dietary principles for tuberculosis

Compliance with a high percentage of nutritional content of the patient’s diet.
The correct calculation of the protein norm is 1.2-2 g of protein x 1 kg of body weight, or an average of about 130 g per day.
Fractional and gentle nutrition for pulmonary tuberculosis during treatment. The frequency of meals should consist of 4-6 meals, evenly spaced in time.
Compliance with the optimal (according to M.I. Pevzner) ratio of B:F:U in grams in the diet is 120:100:450. Where B are proteins, F are fats, U are carbohydrates.
All food must undergo heat treatment and be stewed, baked, boiled or steamed.
Nutrition for pulmonary tuberculosis should not be limited only to food, but also include additional medications - multivitamins, nutritional supplements, minerals. They are good at stimulating the patient’s weak appetite, especially at the beginning of treatment.
If necessary, stabilize your weight - lose weight or, conversely, gain the missing kilograms.

Approximate weekly menu for pulmonary tuberculosis

Day weeks	Breakfast	Lunch	Dinner	Afternoon snack	Dinner	Before bedtime
Mon	Wheat porridge The vinaigrette	Assorted nuts	Borsch	Berry yogurt	Mashed potatoes Fresh vegetable salad Boiled egg	A glass of kefir
W	Oatmeal Dried fruits Rye bread	Fresh fruits	Vegetable soup Fish cutlets	Glass of tea Homemade apple pie	Cottage cheese	Glass of whey
Wed	Omelette Dutch cheese Whole grain toast	Green yogurt smoothie	Pea mash Stewed pickles	Fruit infusion Cottage cheese casserole	Buckwheat Seafood Linseed oil	Kefir
Thu	Wheat porridge Vegetable gravy	Fruit juice	Rassolnik Beet and carrot salad	Fresh Juice Oatmeal pumpkin cookies	Pancakes	Homemade yogurt
Fri	Pasta Chicken goulash	Jelly made from fruits and berries	Stuffed cabbage rolls Fresh vegetables	Glass of carrot juice Whole grain bread	Vegetable stew Boiled fish	Glass of whey
Sat	Porridge Steamed chicken cutlets Vegetable sauce	Natural dried fruits Raw nuts	Bean soup Dumplings with meat Fresh herbs	Fresh berries	Cheese	Ryazhenka
Sun	Fruit and berry pudding Bread toast made from rye flour Butter	Compote	Bean soup Cabbage and beet salad	Banana milkshake	Fish with vegetables	Curdled milk

The therapeutic diet for tuberculosis is so universal that even after recovery the patient can freely use it as his main diet.

The content of the article

The dietary regimen of patients with tuberculosis is made taking into account working conditions, living conditions, the nature and degree of damage to the organ, characteristics general condition the body, its reactivity, complications from other organs.
Therapeutic measures in these patients should be aimed at strengthening the regenerative capacity of the affected organ, improving interstitial metabolism, increasing the immunobiological properties of the body, which can largely be achieved by a balanced diet of a patient with tuberculosis. For this purpose, it is necessary to introduce an increased amount of protein with food (at least 120-140 g), the consumption of which is increased in this group of patients. Easily digestible protein products (milk, fish, eggs, meat) are prescribed. 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 1/3 - in the form of vegetable fat, which is a source of polyunsaturated fatty acids.
The amount of carbohydrates is within the physiological norm (450-500 g). In cases where, with tuberculosis, there is a violation of carbohydrate metabolism, allergization of the body (allergic diathesis, bronchial asthma, chronic eczema), overweight body, patients should limit carbohydrate intake to 300-400 g, mainly due to easily digestible ones (sugar, honey, jam, syrups, etc.).
With an exacerbation of the tuberculosis process, an increased release of mineral salts (calcium, potassium, phosphorus, sodium chloride) may be observed, so foods rich in them are introduced (milk, cheese, cottage cheese, eggs, figs, dried apricots, raisins, meat and fish products, nuts, etc.) .d.).
For exudative pleurisy, transudate, ascites, empyema, tuberculous meningitis, increased secretion into the bronchi, kidney damage leading to edema, a hyposodium diet is prescribed (food is prepared without adding table salt). This diet helps to increase diuresis, resolve fluid accumulated in cavities, reduce tissue hydrophilicity and reduce the inflammatory process. The liquid is administered in an amount of 800-1000 ml. In case of large blood loss, repeated vomiting, diarrhea, profuse sweating, the amount of table salt is increased to 20 g.
Patients with tuberculosis develop vitamin deficiency (especially ascorbic acid, vitamins A and group B). The introduction of 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, at high temperatures and tissue breakdown. Along with the introduction of a sufficient amount of vegetables and fruits into the diet, patients must be periodically prescribed up to 300 mg of ascorbic acid per day.
Individuals with tuberculosis of the lungs, larynx, intestines and skin need increased amounts of vitamin A (about 5 mg) to improve epithelial regeneration. They are recommended dairy products, fish oil, egg yolk, and also foods containing carotene (carrots, tomatoes, apricots, red peppers, etc.).
Particular importance should be attached to providing patients with B vitamins, which are directly related to protein metabolism, the need for which is increased in this group of patients. Along with the introduction into the diet of foods rich in B vitamins (fresh vegetables, meat, dishes made from bran, brewer's or baker's yeast), they should be periodically given in the form of preparations.
The calorie content of the diet is 2500-3500 kcal. Excessive consumption of fats and carbohydrates often leads to negative results: leads to an overload of interstitial and general metabolism, weakens the body's defenses and increases its allergenicity. In addition, with chronic tuberculosis intoxication, the functional activity of the digestive organs is hampered, therefore, only for certain indications, the calorie content of the diet can be increased by 1/3, and evenly at the expense of all food ingredients.
Basic principles of therapeutic nutrition for a patient with tuberculosis.
1. Diet should be varied, taking into account the dynamics of the tuberculosis process and the general condition of the body.
Strict regimens and dietary restrictions can be prescribed only for a short period of time (in case of complications and exacerbations of the disease).
At all stages of treatment (inpatient, sanatorium, outpatient), 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.
5 variants of diet No. 11 have been developed for patients with tuberculosis.
First diet option No. 11(Table) is prescribed to patients with reduced reactivity of the body, general hypotension, low-grade fever, and a sluggish course of the disease. Chemical composition this diet option: proteins 140 g, fats 100 g, carbohydrates 350-400 g (with a limit on easily digestible ones). Calorie content 2700-3000 kcal. Content of ascorbic acid up to 300 mg, vitamin B1 5 mg. Cooking is normal. Small meals (5-6 times a day).
Second diet option No. 11 (table) prescribed to patients with increased nervous excitability, body weight deficiency, elevated temperature (up to 38 ° C), without signs of increased tissue breakdown, during the attenuation of the process with tuberculosis of the lungs, bones, lymph nodes and joints. The chemical composition of this diet option: proteins 110-120 g, fats up to 120 g, carbohydrates 500-550 g. Ascorbic acid content up to 300 mg. Calorie content 3000-3500 kcal. Calcium-rich foods (milk and dairy products, eggs) are recommended. Culinary processing of products is normal. Eating 5 times a day.

Approximate one-day diet menu L5 11 (first option) (2990 kcal)

Name Mica	Output, G	Proteins, g	Fats, g	Carbohydrates, g.
First breakfast
Curd pudding	130	17.5	21,0	9,2
Buckwheat milk porridge	220	8,3	11,4	31,0
Tea
Lunch
Calcined cottage cheese	100	13,8	11,1	8,8
Dried apricot mousse	125	2,7	-	27,9
Dinner
Broth with dumplings	500	11,7	10,5	21,8
Fried steak with vegetables	70	14,0	16,76	1,43
Apple compote without sugar	180	0,2	-	9,2
Afternoon snack
Soft-boiled egg (1 pc.)	48	5,1	5.4	0,2
Rosehip decoction (1 glass)	200
Dinner
Boiled fish, baked with potatoes	250	23,8	6.8	30.5
Carrot puree	200	3,6	5,7	16,8
Tea with lemon without sugar	180
Nanoch
Kefir	200	5,6	7,0	9,0
All day
Wheat bread	200	14,5	1.3	94,0
Bran bread	150	15,0	6,8	54.4
Sugar	30			29,9
Total		135	102	365,9

Third diet option No. 11(Table) is prescribed to patients during the period of exacerbation of the process with pronounced tissue breakdown, significant inflammatory phenomena occurring with high temperature We are exhausted. In these cases, increased protein breakdown is usually observed. Chemical composition of the diet: proteins 120-140 g, fats 100 g, carbohydrates 400-500 g. Calorie content 3000-3500 kcal. Due to the presence of severe intoxication, decreased

Approximate one-day menu of diet No. 11 (second option) (3600 kcal)

Name of dishes	Output, G	Proteins, g	Fats, g	Carbohydrates, g
First breakfast
Soft-boiled egg (1 pc.)	48	5,1	5,4	0,2
Calcined cottage cheese	100	13,8	11,1	8,8
Oatmeal milk porridge	300	9,7	12,2	42,5
Tea with lemon
Lunch
Cheese	30	6,8	7,7	0,6
Tea
Dinner
Borscht with meat broth with sour cream	500	3,95	9,6	25,9
Fried chickens	115	17,6	20,1	3,5
boiled rice	135	3,2	8,3	36,3
Apple compote	180	0,2	-	28,3
Afternoon snack
Crackers	25	3,2	1,1	29
Rose hip decoction	200
Dinner
Meat zrazy, stuffed onion and egg	110	17,1	18,5	12,4
Stewed carrots	150	3,8	5,7	17,2
Lapshevnik with cottage cheese	215	14,7	25,3	49,1
For the night
Kefir	200	5,6	7,0	9,0
All day
Bran bread	150	15,1	6,8	54,4
White bread	200	15,8	3,8	105,4
Sugar	50			49,9
Total		120,0	123,0	461,9

oxidative processes require the introduction of 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 introduce a large number of different drinks, raw juices, vegetables and fruits rich in mineral salts and vitamins.
During the period of exacerbation of the process, patients' appetite decreases, and disorders of the gastrointestinal tract often occur, which should be taken into account when preparing a diet. All food is prepared pureed. Small meals every 2-3 hours.
List of recommended products and dishes. Bread and bakery products. White bread, crackers, savory cookies, biscuits:
Soups. Mashed in meat broth.
Meat and fish dishes. Beef, veal, chicken, turkey in the form of cutlets, souffle, pate. Fresh river fish, boiled.
Milk, dairy products and dishes made from them. Milk, curdled milk, kefir, sour cream, cheese, calcined cottage cheese, cottage cheese casserole.
Egg dishes. Omelettes, whole soft-boiled eggs.
Vegetable dishes and side dishes. Boiled and pureed vegetables (white cabbage is excluded).
Dishes and side dishes from cereals. Porridge with milk (oatmeal, buckwheat, rice, semolina).
Sweet dishes. Kissels, mousse, jelly, pureed compotes. Fruit and berry juices, rose hip and black currant decoction.
Fats. Butter and vegetable oil.
The fourth option of diet No. 11(Table) is prescribed to patients with pronounced allergic manifestations. Diet with a restriction of easily digestible carbohydrates. Chemical composition of the diet: proteins 120 g, fats 110 g, carbohydrates 250-300 g. Calorie content 2500-3000 kcal. The content of vitamins is within the physiological norm. Calcium content 2-5 g.
The fifth option of diet No. I (table) is prescribed for those with a tendency to exudates and transudates. The diet is prepared without adding table salt. Chemical composition of the diet: proteins 100-120 g, fats 120-130 g, carbohydrates 300-350 g. Calorie content 3000 kcal. Calcium content is less than 2 g. The amount of liquid is limited to 800-1000 ml.
Diet for patients with tuberculosis with concomitant disorders of the digestive system. Patients with tuberculosis often have concomitant diseases of the digestive system. Chronic gastritis and colitis often occur in connection with taking anti-tuberculosis drugs. Gastritis in this group of patients is usually with reduced secretion. Patients are recommended to take split meals with the obligatory exclusion of coarse plant fiber from the diet. Vegetables and fruits are given only in boiled and pureed form, tough meats in pureed or chopped form,

Approximate one-day menu of diet No. 11 (third option) (3090 kcal)

Name of dishes	Output, g	Proteins, g	Fats, g	Coal carriers, g
First breakfast
Boiled tongue	65	10,3	10,2	-
Our buckwheat milk rubbed	200	7,1	8,3	30,2
Cheese	50	11,3	12,8	1,0
Tea
Lunch
Calcined cottage cheese	100	13,8	11,1	8,8
Baked apples	120	0,36	-	13,8
Dinner
Soup from prefabricated vegetables (except cabbage) pureed in meat broth with sour cream	500	3,95	9,6	25,9
Beef Stroganoff	55/100	20,6	13,6	7,1
Mashed potatoes	130	2,3	5,0	20,3
Grape juice jelly	125	3,0	-	28,2
Afternoon snack
Steamed protein omelette	110	8,2	6,4	3,3
Rose hip decoction	200
Dinner
Meatloaf stuffed with omelette	125	21.1	9,4	10,4
Lapshevnik with cottage cheese	215	17,7	10,5	47,8
For the night
Kefir	180	5,0	6,3	8,1
All day
White bread	200	15,8	3,8	105,4
Sugar	50			49,9
Total		140,5	106,0	398,6

Approximate one-day menu of diet No. 11 (fourth option) (2580 kcal)

Name of dishes	Output, g	Proteins, g	Fats, g	Carbohydrates. G
First breakfast
Vegetable salad	200	3,5	13,6	14,2
Boiled meat	55	13,6	8,9	-
Boiled potatoes	160	2,9	8,1	30,5
Tea
Lunch
Dutch cheese	50	11,3	12,8	1,0
Tea
Dinner
Borscht with meat broth	500	3,95	9,6	25,9
Fried steak	70	14,0		1.4
Fried zucchini	200	5,6		29,9
Apple mousse with xylitol	125	2,3		4,6
Afternoon snack
Calcined cottage cheese	100	13,8	11,1	8,8
Rose hip decoction	200
Dinner
Meat cutlets	110	18,8	20,5	16,8
Mashed potatoes	130	2,3	5,0	20,3
Tea
For the night
Milk	180	5,0	6,3	8,1
All day
Wheat bread	200	14,5	1,3	94,4
Bran bread	150	15,1	6,8	54,4
Sugar	20	-	-	19,9
Total		122,0	115,0	320

In case of dysfunction of the liver and biliary system, foods that cause irritation are excluded from the diet. Extractive substances, fatty meats and fish, fried foods, butter dough, smoked foods, canned food, marinades, strong tea and coffee are prohibited.

Approximate one-day menu of diet No. 11 (fifth option) (3500 kcal)

Name of dishes	Output, g	Proteins, g	Fats, g	Carbohydrates, g
First breakfast
Boiled, baked meat in white sauce without salt	55	18,1	20,0	6,2
Mashed potatoes and carrots without salt	200	3,7	5,6	26,0
Oatmeal without salt	300	9,7	12,3	42,5
Tea with lemon
Lunch
Carrot puree with apples	200	3,2	5,6	19,1
Tea
Dinner
Milk noodle soup without salt	500	13,3	16,0	46,5
Boiled fish with sauce in Polish without salt	85	20,6	5,9	4,0
Potato shore without salt	130	2,3	5,0	20,3
Fresh fruit compote	180	0,3	-	11,5
Afternoon snack
Meat balls, baked in sour cream without salt	110	17,8	16,7	25,5
Rose hip decoction	200
Dinner
Omelet without salt	150	12,4	19,1	4.1
Buckwheat porridge without salt	200	6,6	8,2	29,8
Tea with milk	180	1,6	1,8	2,3
All day
White bread	200	15,8	3,8	105,4
Sugar	15	-	-	14,8
Total		125,0	126,0	346,8