Therapeutic table or diet No. 4 according to Pevzner is a fairly frequently prescribed type of nutritional therapy. Doctors use it to treat many chronic diseases of the digestive system in children. Following the main principles of such therapeutic nutrition allows you to achieve stable remission and prevent exacerbations of many diseases.
Who is it shown to?
This therapeutic food is specially designed to treat exacerbations of many diseases of the digestive system:
- Exacerbations of chronic intestinal diseases. These include various enteritis, colitis, gastroenterocolitis.
- It is used in complex therapy for intestinal tuberculosis, dysentery, and typhoid fever. Can be used after surgical interventions on the intestine.
- After infectious inflammatory bowel diseases.
- With intestinal dysbiosis, resulting from the proliferation of infectious microorganisms.
- For irritable bowel syndrome, as well as for constipation and diarrhea.
Description
A medical nutrition system consisting of several tables was created by the famous scientist I. Pevzner. It should be noted that it has existed for more than a hundred years. This system is quite successfully used in the treatment of many chronic diseases in children.
Diet No. 4 prohibits the consumption of fatty, fried, smoked and salty foods. They can damage the intestinal wall and increase pain. All pickled foods with a high content of spices and vinegar should also be excluded.
Food is prescribed 4-5 times a day. For babies of the first year of life - up to six times throughout the day. All dishes must be prepared using gentle methods.
It is allowed to boil, bake, use a slow cooker or double boiler.
Before eating, the dish must be cooled to a temperature of 40-45 degrees. Giving your child too hot tea or soup is prohibited! The consistency of the dishes should be liquid or puree. In the first days of an exacerbation, only pureed dishes are allowed. For babies under one year old, food should be ground through a sieve. For older children, you can already use a blender.
The following foods should be completely excluded from the child’s diet:
- All canned food and marinated products, including sauerkraut.
- Freshly baked products, as well as baked goods. They are also contraindicated in pancreatitis.
- Soups, cooked in strong meat or chicken broth, as well as dairy.
- Meat and poultry with fat: pork, lamb, duck.
- Deli meats and sausages. This also includes sausages, sausages and all other semi-finished meat products.
- Whole cow's milk, cheese, sour cream. Fatty fermented milk products. Adding them to the diet is possible only when the inflammatory process subsides.
- Scrambled eggs or eggs, with hard boiled.
- Pork lard and fat. Margarine.
- All spices and seasonings. Ketchup, spicy tomato sauce, mayonnaise.
- Coffee and cocoa, as well as all sweet sodas.
If a child has a tendency to experience allergic reactions, in such cases it is worth turning to a hypoallergenic diet.
It completely excludes the introduction of allergenic products into the menu. Compliance with a hypoallergenic diet is also indicated for children with frequent exacerbations of diathesis or intestinal dysbiosis.
According to the chemical composition of products, diet No. 4 should include:
- Up to 60-70% proteins, predominantly of animal origin. This amounts to approximately 70-80 g per day.
- Up to 60-70 g of healthy fats.
- 220-240 g carbohydrates, Of these, glucose accounts for up to 50 g.
- Table salt - 7-8 g per day.
- Water and other drinks - at least 1.5-1.8 liters per day.
Daily calorie content is 1550-1750 kcal.
Options
Treatment table No. 4 includes several options:
- 4A. It is used for diseases associated with intolerance to cereal products, chronic pancreatitis with steatorrhea, and various colitis. This option excludes all cereal products. There is a strong emphasis on protein foods and calcium. All baked goods made from flour, buckwheat and oatmeal are prohibited.
Products should not contain gluten, which can increase inflammation in the intestines.
- 4B. Prescribed after the exacerbation of the disease has subsided. At this time, the intestines should begin to recover. This option is often used for exacerbation of liver and gallbladder diseases. The diet at such a table is already expanding. Crackers, boiled pasta, jam and preserves, boiled and pureed vegetables (cauliflower and carrots) are allowed.
- 4B. It is a transitional option from 4B to a regular table. It is usually prescribed for 1-2 weeks (to consolidate the results obtained). Can be used during the recovery period of treatment of chronic intestinal diseases.
Sample menu for the week
When choosing recipes for your child, remember that food should be varied and nutritious.. There is no need to include the same foods in the diet every day, arguing that the baby is on a diet! It is only a systematization of products, the use of which will contribute to a rapid recovery.
Every week, when creating a sample menu, try to alternate meat products.
Don't forget to include low-fat fish in your diet.
Let's consider what dishes you should choose to feed your baby.
Monday
Breakfast: Boiled slimy flakes. Oatmeal is perfect. Unsweetened jelly.
Breakfast No. 2: Mashed apple.
Dinner: Vegetable broth with chicken meatballs. Non-acidic berry juice.
Afternoon snack: Dry biscuits with a glass of tea.
Dinner: Poached fish meatballs with boiled rice on the side. Lingonberry juice.
Tuesday
Breakfast: Boiled buckwheat flakes. Compote of dried apricots.
Breakfast No. 2: Pear pudding.
Dinner: Puree cauliflower soup. Blueberry juice.
Afternoon snack: Rice biscuits with tea.
Dinner: Vegetable puree and steamed fish dumplings. Sea buckthorn fruit drink.
Wednesday
Breakfast: Mashed rolled oats with dried fruits. Berry juice.
Breakfast No. 2: Banana souffle.
Dinner: Rice soup with fish. Oatmeal jelly.
Afternoon snack: Crackers with tea.
Dinner: Braised chicken meatballs with steamed rice flakes. Tea.
Thursday
Breakfast: Rice pudding with dried apricots. Compote with raisins.
Breakfast No. 2: Baked plums.
Dinner: Uha. A decoction of raisins and dried apricots.
Afternoon snack: Biscuit crackers with tea.
Dinner: Steamed beef dumplings with vegetable puree. Berry juice.
Friday
Breakfast: Cereal pudding. Kissel.
Breakfast No. 2: Pear souffle.
Dinner: Broth with vegetables, wheat biscuits. Berry juice.
Afternoon snack: Crackers and tea.
Dinner: Hake soufflé with vegetables.
Saturday
Breakfast: Pear balls. Morse.
Breakfast No. 2: Banana.
Dinner: Chicken broth with well-cooked oatmeal. Seasonal fruit compote.
Afternoon snack: Biscuits with tea.
Dinner: Stewed fish quenelles with boiled rice.
Sunday
Breakfast: Steamed rice casserole. Warm sea buckthorn juice.
Breakfast No. 2: Baked pear.
Dinner: Turkey meatballs with rice cereal.
Afternoon snack: Biscuits with tea.
Dinner: Meatballs with rice. Compote of dried apricots.
Delicious recipes for children's menus
Rice pudding with dried fruits
- Take 100 g dry round rice. Rinse well. Pour in two glasses of water and cook until the cereal is completely softened. Cool. Add 1.5 tablespoons of sugar and one egg. Stir.
- Rinse dried fruits thoroughly. Check that there are no rotten or old fruits among them. Dry them with a paper towel. Grind the dried fruits. This can be done through a meat grinder or blender. Mix dried fruits with rice mixture.
- Grease a baking dish with butter. Spoon the rice mixture into the pan. Bake it in an oven preheated to 180 degrees (for 15 minutes). Cool. Serve with any fruit puree.
Homemade fruit puree
Take one ripe pear and one apple. Wash the fruits, remove skins and stems. Place them on parchment and bake in an oven preheated to 150-160 degrees until completely soft. Cool and grind through a sieve. Add a little sugar or powdered sugar. This will be a good alternative to store-bought puree from jars. This food goes well with puddings or boiled porridge.
Following diet No. 4 helps to significantly reduce the number of exacerbations of chronic diseases of the digestive system.
Prescribing such a diet for various intestinal diseases helps normalize its functioning and relieve inflammation.
For information about healthy and unhealthy foods for a child, see Dr. Komarovsky’s program.
Table No. 4 is indicated for acute intestinal diseases and exacerbations during the period of ongoing diarrhea. The goal of the diet is to provide the body with the necessary nutrients without irritating the intestines or causing fermentation in it. Table No. 4 refers to strict medical diets. It is prescribed for 2-5 days during periods of exacerbation of dyspeptic disorders, chronic intestinal diseases and after operations.
Table No. 4 assumes a sufficient amount of protein in the diet, but a reduction in carbohydrates and fats to the lower limits in order to reduce intestinal inflammation and prevent damage to its mucosa. To do this you need:
- Reduce portion sizes.
- Eat 5-6 times a day.
- Boil or steam all foods.
- Take food in liquid, semi-liquid, or ground form.
- Exclude foods that cause fermentation in the intestines (fresh vegetables and fruits, sweets, legumes and coarse cereals, milk).
- Avoid foods that stimulate bile secretion (spices, sauces, snacks).
- Avoid cold and hot foods (calorizer). The food should be warm.
On diet No. 4 they limit, add,. According to new WHO rules, the amount of salt in the average person's diet should not exceed 5 g.
Restrictions on diet No. 4 apply to all foods that can mechanically, thermally or chemically damage the intestinal mucosa, cause fermentation processes and increase inflammation. This:
- All flour and bakery products, except those permitted;
- Soups with fatty broth, with vegetables or cereals;
- All types of fatty meat, fish and poultry;
- Ready meals: snacks, semi-finished products, canned food, smoked meats;
- Coarse cereals: pearl barley, barley, millet and all types of legumes;
- All fresh vegetables, fruits, berries;
- All types of sweets, confectionery, carbonated drinks.
- Flour products: stale white bread, white bread crackers.
- Meat and fish: Lean parts of veal, beef, chicken or turkey, minced and cooked into steamed cutlets, soufflés or meatballs. Low-fat varieties of fresh fish, steamed or boiled in water.
- Eggs: 1-2 eggs per day, soft-boiled or steamed into an omelet.
- Dairy products: pureed cottage cheese, fresh calcined cottage cheese.
- Cereals: rice, buckwheat or oatmeal, boiled and ground.
- Vegetables and fruits: in the form of purees or decoctions.
- Oil: vegetable, butter for dishes.
- Drinks: tea, cocoa, water coffee, diluted juices, jelly, decoction of rose hips, currants, blueberries.
Table No. 4a
Table No. 4a is indicated for colitis with a predominance of fermentation processes.
The composition is the same as in diet No. 4, but they sharply limit foods and dishes containing large quantities of carbohydrates (porridge; bread no more than 100 g per day; sugar no more than 20 g per day); increase the protein content through meat dishes, pureed cottage cheese, etc.
Meals on diet No. 4a are fractional, but the portion size is smaller and the calorie content is lower than on No. 4. Table No. 4a is prescribed for the period of exacerbation of colitis, so the duration of such nutrition is 2-5 days, and then the patient is transferred to another medical diet.
Table No. 4b
Table No. 4b is indicated for chronic colitis in the stage of fading exacerbation. It is prescribed to patients whose intestinal diseases are accompanied by disorders of the stomach, biliary tract, liver or pancreas. The goal of the diet is to restore intestinal functions and the digestive process in case of non-acute disorders.
- The nutritional rules are the same as on diet No. 4, but the following products are added to the composition:
- Flour products: white bread, yesterday’s baked goods, savory cookies, dry biscuits.
- Soups: cereal soups with weak fish or meat broth, broth with meatballs.
- Cereals: heavily boiled or pureed porridge, except millet, barley, pearl barley, in water with the addition of 1/3 milk.
- Vegetables and fruits: boiled and steamed vegetables, pureed. Boiled and chopped cauliflower, carrots, and potatoes are recommended. Ripe sweet fruits without peel are allowed. If the dynamics are positive, you can include a small amount of ripe tomatoes.
- Dairy products: mild cheese, kefir, yogurt. You can add milk, cream, sour cream to food, and also prepare sauces based on sour cream. Béchamel sauce and dairy desserts with grated fruit are allowed.
The basis for the diet is the composition of table No. 4. Add , . Meals 4-6 times a day. Food is served warm.
Table No. 4b
Table No. 4c is indicated for acute intestinal diseases during the recovery period as a transition to a balanced diet; chronic intestinal diseases during the period of attenuation of exacerbation, as well as outside exacerbation with concomitant lesions of other digestive organs.
The diet is prescribed to provide adequate nutrition in case of some insufficiency of intestinal function, which will help restore the activity of other digestive organs. This is a physiologically complete diet with a slight increase in protein content and moderate limitation of mechanical and chemical irritants of the intestines, excluding foods and dishes that increase fermentation and putrefaction in the intestines, sharply increase its secretory and motor functions, secretion of the stomach, pancreas, and bile secretion.
The basis of the table consists of products from diet No. 4 and 4b, but now it is allowed:
- There is slightly dried or yesterday's bread.
- Add finely shredded cabbage, green peas, beets, young beans, chopped vegetables and well-boiled cereal to soups.
- Cook meat and poultry chopped, not minced, and bake fish.
- There are crumbly porridges and small pasta.
- Prepare sauces using fish or weak meat broth.
- Add oranges and tangerines, sweet fruits and berries within 200 g per day, and finely chopped greens to your diet.
- Marshmallows, marmalade, marshmallows.
Food is prepared uncut, steamed, boiled in water or baked. You need to eat small portions 5-6 times a day.
In addition to following the rules of nutrition for intestinal disorders, you need to drink - an average of 1.5 liters per day (calorizator). You should also promptly adjust your diet in case of intolerance to certain foods. A doctor should prescribe a diet and vitamins based on the patient’s tests and diagnosis.
Table 4 – dietary food prescribed in cases of intoxication of the body, combined with severe diarrhea, dysfunction of the gastrointestinal tract, and problems with intestinal function.
Description of the diet, to whom it is indicated
The essence of diet No. 4 is to eat foods that do not irritate the gastrointestinal tract.
The essence of the diet:
- Fractional consumption of food in small portions (no more than a handful) every 4-5 hours.
- The basis of the diet is slimy, puree-like soups with a semi-liquid consistency.
- Food is prepared by boiling, simmering, baking, with minimal use of fat.
- Exclusion from the diet of fried, smoked, cholesterol-rich foods, products containing carcinogens and dyes that cause fermentation and putrefactive processes in the intestines, irritating the liver and pancreas.
- Predominance of protein foods. Reducing carbohydrate foods to a minimum.
- Almost complete absence of salt in prepared dishes.
Before consumption, food is pureed, crushed, pureed, the basis of the 4th table is the mucous semi-liquid consistency of the prepared food. Only warm foods (15-650) are allowed. Errors in temperature conditions cause gastrointestinal spasms.
The 4th table is prescribed when:
- dysentery;
- acute colitis, accompanied by severe cramps and pain in the abdomen;
- enterocolitis;
- severe diarrhea;
- recovery of the body after surgical treatment;
- damage and trauma to the gastrointestinal tract;
- intestinal tuberculosis;
- typhoid fever;
- relapses of chronic pathologies of the liver, gall bladder, pancreas;
- severe intoxication of the body by microbes that cause hepatitis C;
- poisoning accompanied by vomiting and diarrhea.
Daily norm of BZHU in numbers
Daily consumption rate:
- proteins – up to 90 g;
- fats – up to 75 g;
- carbohydrates – up to 270 g;
- salt – from 8 to 10 g;
- sugar – 50-70 gr.
- clean drinking water without gas content – 1.5-2 l.
The daily norm of calories consumed daily is 2000 - 2500.
Varieties
Types of therapeutic nutrition: 4a – the diet is indicated for exacerbation of pathologies of the stomach and intestines, accompanied by a putrefactive process, increased formation of gases in the body, and fermentation.
Characterized by:
- 6 meals a day;
- daily norm 2000 cal;
- warm, puree-like consistency of food;
- maximum exclusion of salt.
Prescribed when:
4B – used for chronic gastrointestinal pathologies in the attenuation stage after the disappearance of diarrhea, vomiting, and painful symptoms. It has a wide variety of products, aimed at stimulating the secretory function of the intestines and the discharge of bile.
Characterized by:
- a greater abundance of acceptable products compared to the first type;
- in the consumption of food in warm, ground form;
- daily energy 3000 cal;
- salt up to 9 g;
Allowed during:
- chronic diseases of the abdominal organs after relieving severe inflammation;
- to normalize the condition during infectious processes accompanied by diarrhea;
- colitis, enterocolitis in the chronic phase.
4B is an intermediate stage, considered as a transition to normal nutrition. Prescribed during the recovery period after stomach infections, intoxications, and gastrointestinal pathologies.
Characteristics of nutrition:
Appointed:
- at the stage of recovery after enterocolitis, colitis, viral gastric infection;
- stages of remission of chronic gastrointestinal pathologies.
4G – dietary nutrition indicated for exacerbation of chronic dysfunctions of the gastrointestinal tract. Indicated after the disappearance of pain, diarrhea, nausea, vomiting if it is impossible to transfer the patient to the 5th table. The principles of nutrition and purpose are similar to the previous form.
Advantages and disadvantages
Nutrition benefits:
Minuses:
- Low-calorie diet, the range of permitted foods is strictly limited. With prolonged use, a deficiency of nutrients occurs in the human body.
- Strict calculation of the energy value of dishes. The danger of overeating, causing a load on the gastrointestinal tract.
- Special conditions for preparing and serving food. Only pureed, warm dishes can be eaten. Prohibition of the use of the diet for persons suffering from cardiovascular pathologies and weight deficiency.
Allowed foods and dishes
During the period of dietary nutrition, gentle dishes and products are allowed, designed to eliminate the inflammatory process, start intestinal function, and normalize the functions of the gastrointestinal tract. The list of recommended products includes:
Beverages
Options for liquids allowed during treatment:
Avoid drinking milk. Tea and cocoa are served weakly brewed and sweetened with sugar.
Soups
The first courses must be cooked in a third chicken, beef, or vegetable broth. You can add crushed, well-cooked cereal porridges and vegetable decoctions. The meat must be chopped before serving. Temperature no higher than 65 degrees.
Porridges and cereals
Cereal dishes need to be boiled in water; you can use milk (25 g) and butter (4 g). Semolina, rice, oatmeal and buckwheat porridge are allowed for consumption. Large grains should be ground after cooking.
Meat and fish products
For second courses use:
- a rabbit;
- veal;
- chicken;
- cod;
- hake;
- pollock.
It is acceptable to eat ground steamed meatballs, homemade pate, and minced meat stewed with water. Before cooking, the fillet must be cleaned of veins and ground in a meat grinder.
Bakery and pasta products
Diets 4b, c, d allow the consumption of dry cookies soaked in tea, up to 300 g. in a day.
Pasta is allowed at any stage of the disease. Before serving, they should be boiled until smooth.
Milk products
During intestinal infections, lactose intolerance occurs, prompting a medical ban on milk consumption. You can use lactose-containing products during cooking (20 ml). Shown is grated low-fat cottage cheese. Acidolact and kefir are not prohibited.
Vegetables
Root vegetables are consumed in boiled, pureed form. A vegetable decoction is shown. In diet menu 4b, c, d, vegetables are used that are prepared in a double boiler, by stewing or baking. Salads made from fresh root vegetables, peeled, are consumed.
Fruits and berries
Berries and fruits are added to purees, juices, fruit drinks, jellies, and mousses.
You can eat:
- currants (except black);
- dogwood;
- quince;
- pears;
- apples.
Apple and pear puree are served daily to improve intestinal motility.
Oils
The 4th table diet allows the consumption of only butter fat (4-5 grams).
Eggs
Egg whites need to be served 1-2 pcs. per day. It is advisable to use it as a steam omelette, boil soft-boiled.
Snacks
Lenten cheese is allowed as a snack (diet 4c).
Seasonings and sauces
The use of seasonings is not encouraged during the treatment process. Salt – 7-10 gr., sugar – 50-70 gr. per day. Diet menu 4c allows sour cream as a sauce to improve the taste of first and second courses.
Sweet
Desserts are made from berries and fruits, and are offered in the form of mousses, purees, and soufflés. Table 4c allows the consumption of pies, one-day-old rolls, and marmalade (no more than 1 slice every 3-4 days).
Prohibited foods and dishes
The diet of the 4th table has a large list of restrictions. During treatment, it is necessary to exclude from the diet any foods that injure the intestines, causing fermentation, rotting of food, and increased formation of gases.
You should not eat fried, spicy, salty, fatty foods.
These foods irritate internal organs, provoke pain, spasms, and cause nausea and vomiting.
Beverages
The following are necessarily excluded:
Soups
First courses should not be prepared with concentrated chicken, meat, or mushroom broths. The addition of sauteed vegetables, onions, garlic, and smoked meats is excluded. Do not use industrially produced soup dressing or bouillon cubes. Milk noodle soup will cause severe vomiting.
Cereals
Barley, pearl barley, and millet cereals are excluded from the diet. You should not cook porridge in milk with butter, dried fruits, raisins; use packaged oatmeal that does not require cooking.
Fish and meat
The deterioration of the general condition and the occurrence of spasms of the abdominal organs are promoted by food made from fatty meats (pork, beef), fish (butter pink salmon, trout, mackerel).
Need to remove:
Protein dishes must be chopped before serving.
Bread
Bread made from rye flour slows down intestinal motility.
Excluded:
- pancakes;
- pancakes;
- shortbread,
- puff pastries,
- pies.
Milk products
Milk causes vomiting. During treatment, the consumption of dairy products (except for cottage cheese and acidolact) is excluded. Porridges and drinks are made strictly with water.
Vegetables and mushrooms
They injure the intestines and provoke increased formation of gases:
Fruits and berries
Should not be eaten raw if there are painful symptoms or diarrhea. Tables 4c, d allow peeled fruits. Juices and concentrated fruit drinks are prohibited.
Throughout the treatment the following are canceled:
- plums;
- apricots;
- grape.
Eggs
Eggs should not be consumed more than 2 pieces. per day. Fresh, hard-boiled eggs are prohibited.
Oils and fats
During treatment, any vegetable, animal fat, sunflower, olive, and soy fats are removed from food. Butter is added to cooked dishes (4-5 g). Margarine is not allowed.
Snacks
Any snacks provoke stagnation in the intestines, spasms, and deterioration of the condition.
Sauces and seasonings
During therapy, the gastrointestinal tract is excluded from the diet:
- mayonnaise;
- ketchup;
- sour cream;
- spices;
- pepper;
- leafy greens
- the use of salt is reduced (up to 7-10 g).
Desserts and sweets
Industrial confectionery products are confiscated:
Partially permitted products
Restricted Products:
- salt – 7-10 gr. to improve the taste of dishes;
- sugar – 50-70 gr.
- butter – 4-5 gr.
- cottage cheese – only grated, low-fat (1 time every 3 days);
- eggs – 1-2 pcs. per day, soft-boiled.
- pureed vegetables - at the acute stage should not be consumed more than 3 times every 7 days;
- fresh fruits and berries – peeled and used after the pain and bowel movements disappear.
- loaf, croutons - 200 gr.
Features of the diet for gastritis
Diet table 4, what is possible, what is not, is determined by a gastroenterologist during the therapeutic treatment of gastritis of the stomach, aimed at stabilizing the secretion of hydrochloric acid.
For the first time, gastroenterocolitis is detected as a side effect after food intoxication of the gastrointestinal tract.
During treatment, medications and fasting are prescribed for the first day. From the 2nd day the patient is transferred to diet 4a until the pain disappears. Next, diet 4c, d is prescribed.
Features of nutrition in acute gastroenterocolitis:
Features of the diet for cholecystitis
Diet table 4, what can and cannot be consumed during an exacerbation of cholecystitis, is monitored by a gastroenterologist. Inflammation of the bile ducts occurs due to errors in nutrition, large consumption of carbonated lemonade, chocolate products, and fried foods.
On the 1st day you should fast. From 2 tea, low-fat broth, water are indicated. On the 3rd you can eat warm pureed vegetables, boiled cereals, shredded chicken meat.
Nutrition principles:
- 5-6 times a day.
- Warm food.
- Mucus-like, boiled dishes, chopped boiled meat,
- Use only freshly prepared food.
- In addition to boiled and steamed food, prohibited foods are allowed.
- Strict refusal of eggs, milk, butter, rich in cholesterol. Application will cause vomiting and pain.
From 6-7 days, switch to a 4 g diet. If you are feeling well, sweets are allowed in moderation.
Features of the diet for gallstone disease
Diet 4 table, what is possible, what is not - controlled by a doctor at the stage of exacerbation of cholelithiasis. Therapeutic nutrition is focused on improving the outflow of bile, reducing pain, stabilizing intestinal functions and cholesterol metabolism.
The formation of stones causes girdling spasms, stagnation of bile, and stool disturbances. To maintain the condition, the 5th table is prescribed, for severe pain - the 4th.
Meal order:
- Food is taken 5-6 times a day.
- Compliance with food temperature (from 15-65 degrees). Cold or hot causes increased pain symptoms.
- Preparation of slimy soups, crushed porridges without milk.
- Selection of lean meat and fish products. Any fried foods rich in cholesterol are prohibited.
- Mandatory consumption of 2 liters of clean drinking water. Exclusion of lime, drinks containing gas, concentrated juices, coffee, milk.
- Cooking food with or without vegetable oil. The use of butter fat is not allowed.
- Eliminating eggs, sweets, salty and pickled foods from food.
Features of the diet after gallbladder removal
The goal of nutrition after surgical removal of the gallbladder is to normalize intestinal function, prevent bile stagnation, and make defecation easier. Surgery is carried out using the laparoscopic or traditional (strip) method.
You cannot eat for 1 day after anesthesia. On the 2nd day, warm broth, water, and weakly brewed tea are dissolved. From 3-4 days the patient is transferred to the 4th table.
Power characteristics:
The duration of the diet is up to 5-9 days. On the 10-11th day, the sutures are removed and the 5th table is prescribed.
Features of the diet for pancreatitis
Diet 4 table (what is possible and what is not is chosen by the gastroenterologist at the stage of attenuation of the acute form of chronic pancreatitis) is an intermediate stage to good nutrition.
The 4G option menu is characterized by:
The duration of the diet is up to 14 days.
Features of the diet for hepatitis C
The permitted and prohibited dietary rules of the 4th table during the treatment of hepatitis C are aimed at minimizing intoxication of the body and liver and stabilizing the outflow of bile. Diet 4B, D is prescribed throughout the entire period of treatment, if it is impossible to transfer the patient to the 5th table.
Characteristic:
- The main part of the daily diet is liquid soups and decoctions mixed with ground lean meat, poultry, and vegetables.
- Separate 5-time snacks are strictly recommended. You should eat only when you feel signs of hunger.
- All food is consumed warm.
- It is allowed to use boiled cereal porridges, pasta, baked, or made in a slow cooker.
- If you are feeling well, sweets and raw vegetables and fruits are allowed.
- Milk (25 ml), cottage cheese, egg white are allowed. Butter fat is excluded.
In severe cases, food should be chopped. As you recover, you are allowed to add vegetable salads, creamy sour cream sauce, chopped herbs, cinnamon, and vanilla to your daily menu.
Features of diet during pregnancy
The purpose of the 4th table diets during the period of waiting for a child is aimed at normalizing the function of the colon, improving absorption qualities, and preventing constipation. It is highly undesirable for expectant mothers to push during bowel movements. Consumption of food from the vein can stabilize the stool.
Diet features:
Allowed to eat:
- Veal, rabbit, turkey, chicken, cod, pollock;
- Milk, kefir, sour cream, cottage cheese (daily);
- Boiled cereal porridge in water
- Tea, herbal infusions, fruit drinks, uzvar with pulp;
- Loaf, dried bread crackers, no more than 400 g.
- Raw vegetables, peeled fruits, salads seasoned with vegetable fat.
- Honey, homemade brew.
Removed from the diet:
- Fatty, fried foods containing carcinogens, dyes, food additives;
- Industrial sweets, chocolate, ice cream, cakes, pastries.
- Coffee, cocoa, alcohol;
- Sausage, frankfurters, fatty varieties of sora;
- Pickles, marinades;
- Seasonings, with the exception of fresh chopped herbs.
- Large quantities of baked goods;
- Ketchup, mayonnaise, vinegar.
Sample menu for every day
The daily diet is no more than 2500-3000 calories. You need to eat in small portions when you feel hungry. The size of one snack is no more than 2 handfuls.
Sample daily menu:
Menu for the week
Diet menu for 7 days.
1st day:
- Breakfast— manna with blueberries, raspberries, dogwood, tea with mint.
- 2nd breakfast: - pureed apple.
- Dinner– carrot soup, steamed rabbit hedgehogs with rice, diluted uzvar.
- Afternoon snack– biscuits with jelly.
- Dinner– buckwheat, boiled chicken breast, green tea with sugar.
- For the night- quince jelly.
Day 2:
- Breakfast– rice casserole with pears, tea.
- 2nd breakfast- curd soufflé.
- Dinner– beef broth, 200 gr. loaf, stewed veal, herbal rosehip decoction.
- Afternoon snack– poached egg, fruit drink.
- Dinner– steamed cod with carrot puree, apple soup.
- For the night– acidolact.
3rd day:
- Breakfast- oatmeal, tea.
- 2nd breakfast– berry soufflé with yogurt, diluted apple juice.
- Dinner– broth with white croutons, ground chicken drumstick with vermicelli, blueberry infusion.
- Afternoon snack– pear-apple juice with water, dogwood jelly.
- Dinner– boiled skinless turkey with pureed zucchini, mint tea.
- For the night– phyto-decoction of rose hips.
4th day:
Day 5:
- Breakfast– curd cheesecakes, tea.
- 2nd breakfast- manna with berries, fruit drink.
- Dinner– soup with a decoction of vegetables and ground veal, baked vegetables with minced meat, pear uzvar.
- Afternoon snack– egg mousse with pear, blueberry juice with water.
- For the night- jelly.
Day 6:
- Breakfast– buckwheat casserole with vegetables, mint tea.
- 2nd breakfast– semolina mousse with pears, chamomile herbal infusion
- Dinner– squash puree soup, chicken breast with cauliflower, peach uzvar.
- Afternoon snack– blueberry jelly with biscuits.
- Dinner– baked pollock with potato and carrot puree, tea with mint.
- For the night– acidolact.
Day 7:
First course recipes
Puree soup with turkey and rice cereal:
- Wash the cereal (1 tbsp.), boil it, grind it with the broth.
- Cook the turkey (75 gr.), add to the rice.
- Grind the substance with a blender. Bring the dish to a boil. Remove from the stove, cool to 65 degrees.
Vegetable soup ingredients:
- Potatoes, carrots – 2 pcs.
- Zucchini – 1.5 pcs.
- Broccoli – 3-4 inflorescences.
Peel, wash the vegetables, cut into squares, cook for 25-30 minutes. Remove half of the broth. Puree with a blender.
Second courses
Meatballs with rice and veal:
- Grind meat fillet (80 g).
- Cook rice (1 tbsp.).
- Combine the ingredients, add salt, and form into circles 2-3 cm in size.
- Place in a steamer and cook for 10-15 minutes.
Pollock soufflé with white sauce:
- Grind the fish (300 g) in a meat grinder 3 times.
- Add the yolk. Knead the minced meat.
- Heat milk (25 ml), add flour (1 tsp), simmer until bubbles appear, remove from heat, cool, pour into minced meat.
- Mix all ingredients, fill the multicooker bowl, set the “Stew” mode for 20 minutes. Season the finished dish with sour cream.
Salads
Vegetable salads are allowed in menu 4 B, D.
Cucumber-tomato salad:
Vegetable salad:
- Potatoes, beets, carrots 2 pcs. each.
- Olive oil 4 gr.
- Peel the root vegetables, boil, cool, and chop.
- Combine with ground dill, salt and season with oil.
Recipes for children
Cottage cheese casserole
Components:
- 150 gr. low-fat cottage cheese;
- 1 tsp granulated sugar, semolina;
- egg.
Mix the ingredients. Grease the multicooker bowl and distribute the substance evenly. Close the device and set the “Steamer” mode for 15 minutes.
Apple-carrot soufflé
Mounting parts:
- 60 gr. apples, carrots, cauliflower;
- egg white;
- semolina (8 gr.)
- sugar (15 gr.);
- 4 gr. butter.
Stew the cauliflower. Add carrots and apples, simmer for 5 minutes. Stir in sugar and semolina, stirring and bring to a boil. Remove from heat and grind with a blender. Foam the protein and add it to the mixture. Distribute the mixture in a multicooker and cook in the “Baking” mode for 15 minutes.
Contraindications
Therapeutic food of the 4th table is not allowed:
- People suffering from pathologies of the heart and blood vessels.
- If you are underweight due to low calorie content.
- For small children, table 4a is prescribed for up to 4 days. Next is the mandatory transfer of the child to 4v.
Precautions while dieting
During treatment it is necessary to monitor your well-being. Compliance with your doctor's recommendations is of particular importance. You should not prescribe meals yourself, or follow a diet for more than the prescribed period (especially table 4a). With prolonged restriction, the condition may worsen, the appearance of dizziness, fainting caused by a lack of nutrients in the body.
Consequences of not following the diet
With spontaneous refusal of therapeutic nutrition, especially at the acute stage of the disease, the following appear:
Errors in diet cause relapse of chronic gastrointestinal pathology.
Diet 4 table for children from a famous nutritionist is intended for the prevention and treatment of diseases of the small intestine. The 2019 nutrition system is aimed at reducing fermentation processes; dishes high in carbohydrates are sharply limited.
How diet number 4 works for children
The most basic rule is to reduce carbohydrate foods while maintaining the daily protein requirement. The diet prevents the formation and reproduction of pathogenic microflora in the intestines, which contributes to the active recovery of the body.
The treatment table guarantees a gentle menu, which is distinguished by the following indicators:
- eating cottage cheese and meat dishes to increase the amount of protein per day;
- for each dish there is a strict heat treatment regime - steamed or boiled;
- to prepare various dishes, you need to use grated products, and only after the stool has normalized - crushed;
- eat small meals, 5-6 times a day, the duration of diet 4 for children is no more than a week.
What foods can you eat during diet number 4?
- Wholemeal bread, rye bread crackers, bran bread.
- Vegetable and meat soups, with the addition of rice, buckwheat, and ground low-fat meat.
- When preparing meat and fish products, it is necessary to cut off the skin from them, remove the film and excess fat, and try to ensure that the ingredient turns out fat-free.
- Instead of bread soaked in milk, add boiled rice to the minced meat and grind it to a puree.
- Dairy products include freshly prepared mashed cottage cheese and steam soufflé.
- As for eggs, they should be consumed in the form of a steamed or soft-boiled omelet, for preparing various dishes and desserts.
- Vegetables and fruits are only boiled, raw are prohibited.
- Cereals only in ground form, in the form of porridges or broths in low-fat broth, you can consume rice, oatmeal, buckwheat, semolina.
- For sweets, you can make jelly and jelly, prepare steamed apples with a little honey, without sugar.
- For drinks you can choose cocoa with skim milk, green and black tea, decoctions of medicinal plants, rose hips, currants, bird cherry, clean water at room temperature.
What foods are prohibited during diet 4 for children?
The chemical daily ration is:
- fats up to 70 g;
- carbohydrates – up to 250 g;
- proteins not less than 100 g;
- calorie intake – 2000 kcal;
- liquid about 2 liters;
- salt up to 10 g.
During diet table No. 4, painful symptoms are reduced, the inflammatory process is reduced, fermentation in the body is eliminated, and the patient is slowly but surely on the mend.
Table 4 diet - weekly menu for children
The diet menu contains many different foods, which should be consumed in small portions, avoiding overeating. Foods and dishes that can enhance fermentation processes in the intestines are completely prohibited.
Diet 4 results for children
As for the results when using diet No. 4, they are mostly positive; within a week, inflammation of the walls of the gastrointestinal tract is significantly reduced, and the intestines are cleansed of waste and toxins.
Complete recovery occurs after 10 days, depending on the initial condition of the patient. You need to leave the diet carefully so that the disease does not return again, which means that you need to continue to eat according to the proposed menu, but at the same time carefully add carbohydrates and other high-calorie dishes.
Simple table diet recipes No. 4
Steamed fish balls
To prepare the dish, you need to take 2 eggs, 20 g of wheat bread, 80 g of fish fillet, grind with a blender or meat grinder, add other ingredients. Steam the meatballs. This dish is perfect with buckwheat or rice porridge.
Liquid semolina porridge on water
Semolina porridge is made very simply, you need to gradually pour the cereal into boiling water, gradually stir until completely cooked, add granulated sugar, salt, and before serving add a piece of butter. A great treat for breakfast or dinner.
Dried blueberry drink
Rinse the blueberries, pour boiling water, keep on low heat for 15 minutes, leave for 4 hours, and before serving, strain and mix the drink with sugar or add a teaspoon of honey.
- For diseases of the intestines and gastric tract, you need to do fasting days, during which time you drink green tea and Borjomi mineral water.
- Meals should be frequent, but in small portions.
- More liquid, this applies to low-fat broths and liquid mucous porridges. The diet requires: decoctions of rose hips, medicinal plants, cocoa in water, tea.
- The child should eat cottage cheese in pureed form; the child should not be given milk, sour cream, or cheese.
- A few days after your condition improves, you can add some vegetables to your diet, such as pumpkin, cauliflower, potatoes, and carrots.
- Porridge can be prepared with a small amount of milk, in rare cases adding a spoonful of sour cream.
- It is allowed to eat ripe watermelons, seedless and peeled grapes, and puddings with added fruit.
Therapeutic diet 4 (table 4) is prescribed for acute and chronic colitis, enterocolitis, in the initial stage of acute gastroenterocolitis, as well as for dysentery, typhoid fever and intestinal tuberculosis. The diet helps reduce fermentation and putrefactive processes in the intestines, stop the inflammatory process and restore impaired functions of the digestive tract, as well as transfer its functioning to a more gentle mode. Diet 4 is prescribed by doctors in order to reduce the amount of fats and carbohydrates in the patient’s diet. The diet is designed to ensure the supply of food that will not cause thermal or mechanical irritation of the digestive organs, and will not increase the secretion of bile. In Diet 4, food is boiled or steamed. To make food easier to digest and digest faster, it is ground or pureed.
The energy value of the diet at table 4 should be about 8583 kJ (no more than 2050 kcal). Of these, fats should be no more than 70 grams (50 g butter), proteins - 100 grams (about 70% animal proteins), carbohydrates - 250 grams (40-50 g sugar). Sodium chloride should be no more than 8-10 grams in the diet, and free liquid should be no less than 1.5 liters. During the diet, it is very important to maintain bed rest. Food on diet 4 should be taken warm up to five to six times a day.
With diet 4, it is allowed to eat thinly sliced and not toasted crackers from two hundred grams of wheat bread and savory cookies. Fresh and rye bread, pastry products, pancakes, and pancakes are prohibited.
It is allowed to eat boiled vermicelli, rice, semolina, oatmeal, pureed buckwheat porridge, cooked in low-fat broth or water, as well as in the form of steam puddings. During diet 4, you cannot eat pearl barley, barley porridge, legumes, or pasta casseroles.
It is allowed to consume lean varieties of veal, beef, rabbit meat, turkey, and chicken. The meat is first degreased, tendons and fascia are removed. The meat is used to prepare meatballs, quenelles, and cutlets boiled in water or steamed. Instead of bread, add boiled rice to the minced meat for cutlets, and then pass it through a fine grinder three to four times. A soufflé is prepared from boiled meat. During diet 4 (table 4), it is prohibited to use fatty types and varieties of meat, fried and stewed meat in pieces, smoked meats, and sausages in cooking.
Soups on diet 4 are cooked in a weak low-fat fish or meat broth with rice or semolina, pureed or boiled meat, meatballs and steamed quenelles, and egg flakes. During this diet, you should not consume milk soups, as well as soups made with fatty and strong broths with vegetables and pasta.
Diet 4 menu may include dishes from low-fat fish (in the form of quenelles, meatballs, cutlets). Fish dishes can be boiled in water or steamed. You cannot eat salted fish, fatty fish, canned food, or caviar. You are allowed to eat one or two eggs daily. Eggs can be soft-boiled, steamed omelettes prepared from them, and added to various dishes.
You can add a small piece of butter (5 g) to ready-made dishes. Cooking and animal fats should not be used for cooking.
Diet 4 is prohibited from including dairy products. You can only eat freshly prepared pureed unleavened or calcined cottage cheese.
During therapeutic diet 4, you cannot eat berries and fruits in their natural form, as well as compotes, dried fruits, jam, honey and other sweets. You can make jelly and jelly from dogwood, blueberries, quince, pears, and bird cherry. Sugar can be added to dishes in limited quantities (no more than 50 grams per day). Vegetables can only be consumed in the form of decoctions added to soups. Snacks, spices and sauces are excluded from the diet.
You are allowed to drink tea, cocoa with water, coffee, juices of non-acidic fruits and berries diluted with water. It is allowed to use decoctions of dried blueberries, dogwood, rose hips, quince, and black currants. You cannot drink cocoa and coffee with milk, cold and carbonated drinks, grape juice, kvass.
Diet 4 menu might look like this:
- first breakfast: oatmeal cooked in water, freshly prepared grated cottage cheese, tea with one teaspoon of sugar;
- second breakfast: applesauce;
- lunch: meat broth with rice cereal, steamed meatballs, semolina porridge, jelly.
- afternoon snack: unsweetened blackcurrant decoction;
- dinner: steam omelette, buckwheat porridge cooked in water (mashed), tea.
- jelly before bed.
General characteristics of the therapeutic diet 4b
Therapeutic diet 4b is prescribed for exacerbation of chronic intestinal diseases, as well as for acute intestinal diseases at the stage of improvement. Diet 4b helps reduce inflammation and normalize the functioning of the digestive system. With this type of diet, foods that aggravate fermentation and putrefaction in the intestinal area, irritate the liver and sharply stimulate the secretion of the pancreas and stomach are prohibited. Diet 4b involves eating five or six meals a day. The energy value of diet 4b should be no more than 2600 kcal. Of these, proteins should account for 100-110 grams, fats - 80-90 grams, carbohydrates - 350-400 grams, 8-10 grams of salt and one and a half liters of free liquid. In terms of chemical content and energy value, therapeutic diet 4b is not complete, but the amount of protein is slightly increased.
With diet 4b, it is allowed to eat dried or day-old wheat bread made from first- or highest-grade flour, dry biscuits, and dry cookies. Rye bread, puff pastry or pastry products, and wheat bread made from wholemeal flour are prohibited.
Low-fat and low-fat types and varieties of meat are allowed. Therapeutic diet 4b prohibits fatty varieties and types of meat. It is not allowed to eat goose or duck meat, various sausages, smoked products, and canned food. You can add cutlets, dumplings, and meatballs from low-fat fish to your diet. The consumption of salted, smoked, fatty fish and canned food is prohibited. You can add milk, cream, and sour cream to dishes. You can eat acidophilus, kefir and other fermented milk drinks. It is allowed to eat curd paste, fresh cottage cheese, puddings, and mild cheese. Well-cooked porridge is allowed. When preparing porridge, you can add a third of the milk to the water. With diet 4b, you are allowed to eat fresh and ripe tomatoes (50-100 g per day). Sweet and ripe fruits, previously peeled, are recommended for food (up to 100 g per day). Sauces based on vegetable broth or weak meat broth are recommended. Fruit sauces and milk sauces are allowed. You can add dill, parsley, cinnamon, vanillin, and bay leaf to dishes.
