Contents
The text is for informational purposes only. We urge you not to use diets, do not resort to any medical menus and fasting without medical supervision. Recommended reading: “Why you can not go on a diet on your own.” Nutrition for tuberculosis is an important component of the successful treatment of this infectious pathology.
The main tasks of diet therapy are to supply the body with nutrients, increase the activity of immune system cells, normalize metabolism, accelerate the regeneration of damaged tissues, and reduce the toxic load on the liver (endogenous and exogenous).
clinical picture
Tuberculosis is an infectious disease caused by gram-positive mycobacteria (Koch’s bacillus). These bacilli are extremely resistant to negative temperatures, acids, alcohols and alkalis. To reproduce successfully, pathogens “populate” tissues with a rich supply of oxygenated blood. For this reason, the infection often affects the human respiratory tract, causing pulmonary tuberculosis. In addition, invasion can affect the lymphatic system, joints, urinary organs, bones, brain, and skin. At the same time, a persistent inflammatory process develops in the places of subsidence of the stick (due to the intensive reproduction of pathogens). Then, protective capsules are formed around the places of introduction of the pathogen, where the body “seals” the suppressed bacteria.
With strong immunity and proper treatment, damaged tissues gradually scar. However, even proper therapy cannot give a XNUMX% guarantee of recovery, since some bacilli remain in the body in a dormant state. As soon as favorable conditions are created for the activation of Koch’s bacillus (decreased immunity, the development of hypovitaminosis, an increase in the toxic load on the liver), the protective capsule melts at the site of the focus of infection. At this moment, mycobacteria leave the granulomatous focus, and a cavity is formed at the site of tissue scarring – a cavity (secondary tuberculosis).
As the infection progresses, local destruction of the upper and lower respiratory tract occurs. With a large number of cavities, hemoptysis or pulmonary hemorrhage occurs.
The first symptoms of tuberculosis:
- weakness;
- fatigue;
- pallor of the skin;
- low-grade fever (37,2 degrees);
- sweating (especially at night);
- weight loss;
- swollen lymph nodes;
- insomnia;
- dry cough.
Remember, primary pulmonary tuberculosis can be asymptomatic for a long time. Every citizen must be examined at least once a year. Naturally, if there are complaints of coughing, shortness of breath, weakness, the patient should be examined immediately. For those who are in contact with a person with an open form of tuberculosis, fluorography should be done once every six months.
A group of increased risk of tuberculosis – patients with chronic respiratory diseases, gastric ulcer, chronic gastritis, diabetes mellitus, patients with chronic alcoholism, heavy smokers should undergo fluorography at least 2 times a year.
Tuberculosis Nutrition
The calorie content of the daily diet of patients should be 10% higher than the energy value of the daily menu of healthy people (3000-3500 kilocalories).
Features of nutritional components in tuberculosis:
- Squirrels. A lot of protein should be present in the diet, because under the influence of bacterial intoxication, the consumption of this substance increases by 2 times.
For infected patients, the daily rate is calculated based on the ratio of 2 grams of protein per kilogram of body weight (this is 120-130 grams per day for an adult weighing 60-70 kilograms). In severe cases, the daily portion of the nutrient is increased to 140-150 grams. These components are necessary for the body to scar the focus of inflammation, restore tissue proteins, and accelerate the development of anti-tuberculosis immunity.
The best sources of easily digestible protein: dairy products (whey, cottage cheese, kefir, sour cream, cheese), poultry (turkey, chicken), rabbit meat, eggs (chicken, quail), seafood (mussels, fish, oysters, shrimps), cereals (pearl barley) , buckwheat, oat), legumes (lentils, peas, soy).
The digestibility of animal proteins is 94%, vegetable – 70%.
- Fats. Toxins secreted by mycobacteria cause profound changes in the structure of cell membranes, which lead to the activation of lipid peroxidation, and, as a result, a violation of fat metabolism. Against the background of these processes, a person loses his appetite and rapidly loses weight. In addition, in 50% of cases, dysfunctions of internal organs occur, in which many lipoproteins are concentrated (liver, adrenal glands, brain).
To compensate for the lack of body weight, the daily menu of tuberculosis patients is enriched with fats based on the calculation: 1,2 grams of triglycerides should be per kilogram of weight (this is 100-110 grams). However, the excess of the daily portion of lipids has the opposite effect: digestive disorders occur, appetite decreases, detoxification functions of the liver worsen. In addition, during exacerbations of pathology, it is important to consume no more than 70 – 80 grams of the element per day.
The replenishment of lipid reserves is carried out due to the consumption of unsaturated fatty acids, which are part of vegetable oils (linseed, camelina, cedar), seafood, fish oil.
- Carbohydrates. In active forms of tuberculosis (accompanied by a febrile state), the function of the insular apparatus of the pancreas is inhibited, which leads to a decrease in glycogen synthesis in the liver. To prevent metabolic disorders, the patient’s body should receive at least 500 grams of carbohydrates per day. In severe forms of pathology (exudative pleurisy, fibro-cavernous tuberculosis, caseous pneumonia, meningitis), the daily portion of saccharides is reduced to 350 grams.
Fresh bread, unrefined cereals, honey, and cane sugar are used to replenish glucose reserves. At the same time, it is better to refuse to use confectionery, sugary drinks and refined pastries (from white flour).
- Mineral salts. With active tuberculosis, the need for micro- and macrocells doubles (due to tissue breakdown, high temperature, sweating). Deviations in mineral metabolism result from impaired synthetic and metabolic functions of the liver.
A key role in the diet therapy of tuberculosis is played by macronutrients: phosphorus and calcium. These nutrients are involved in almost all energy and metabolic reactions in the body. In addition, they accelerate tissue scarring in infectious foci, normalize the process of blood clotting, reduce the manifestations of allergic reactions, and reduce the permeability of lymphatic and blood vessels.
With tuberculosis, the daily need for calcium increases to 2-3 grams, in phosphorus – to 3-6 grams. These substances are contained in cottage cheese, cheese, sour cream, kefir, parsley, cauliflower.
- Vitamins. Patients with tuberculosis (especially the cavernous form), in 90% of cases, suffer from a deficiency of vitamins B, C and A. The introduction of 2-3 grams of L-ascorbic acid into the patient’s diet increases the protective functions of the blood (including the synthesis of T-killers, destroying the infection), neutralizes the decay products of mycobacteria, stimulates natural anti-infective immunity. Natural sources of the nutrient: sauerkraut, parsley, cranberries, rose hips. In addition, an increased amount of vitamin A (4-5 milligrams per day) should be present in the diet of tuberculosis patients.
Retinol (provitamin A) is found in dairy products (butter, sour cream), fish oil, egg yolks, red-orange vegetables and fruits (carrots, apricots, pumpkins, persimmons, oranges). This substance accelerates the regeneration of damaged tissues (including mucosal epithelium), reduces the concentration of cholesterol in cells (which feed on mycobacteria), increases the patient’s immune status, and participates in the formation of visual purple. Along with this, B vitamins are included in the diet for tuberculosis, as they accelerate the healing of tissue wounds, improve protein-carbohydrate metabolism, and stabilize the psycho-emotional background. Whole grain bread, cereals, legumes, vegetable oils, nuts, seeds, eggs, dairy products will help to compensate for the lack of these nutrients.
Remember, only a well-designed diet (with the correct ratio of food components) helps to speed up the rehabilitation of the patient after intensive antibiotic therapy.
Bee products on guard health
In the “fight” against tuberculosis, wax moth larvae, propolis, royal jelly, pollen and honey are used as an additional therapy for drug treatment. These products improve metabolic processes in the liver and increase the patient’s immune status.
Beneficial features:
- Wax moth larvae. Despite the fact that the moth is the main parasite of honeycombs, anti-tuberculosis tinctures are made on the basis of its eggs. The Russian immunologist I. I. Mechnikov experimentally established that the digestive enzymes of wax moth larvae are able to dissolve the films that cover mycobacteria. As a result, the infection becomes vulnerable to the effects of the main anti-TB drugs.
- Propolis. Due to the presence of aromatic resins, flavonoids, benzoic and cinnamic acids, the product has pronounced antiseptic, bactericidal properties (especially against tuberculosis bacteria). Along with this, propolis enhances natural anti-infection immunity, accelerates the elimination of harmful cholesterol, improves appetite and reduces the frequency of coughing attacks. In addition, the substance counteracts the formation of blood clots, stimulates the process of hematopoiesis, eliminates vascular spasm.
Interestingly, propolis increases in 10-100 times the action of antibiotics (polymyxin, tetracycline, neomycin, streptomycin). In the acute course of the disease, oil and water extracts of the product of beekeeping are used, during the period of remission it is permissible to use alcohol solutions.
- Royal jelly. The nutritional value of this product is superior to whole cow’s milk: 4-5 times in protein content, 3-4 times in carbohydrate concentration, 2-3 times in fat component. In addition, it has a powerful detoxification and anabolic effect on the body (due to the content of flavonoids, immunoglobulins, phytoncides, amino acids, phytohormones, antioxidants, enzymes).
In pulmonary tuberculosis, royal jelly is advisable to use as part of phytocompositions with linden honey, propolis (to enhance the biological properties).
- Pollen (bee pollen). The natural concentrate of amino acids, which increases the immune status of the patient. In addition, the product accelerates the recovery of tissue proteins, improves metabolic processes in the liver, stimulates the production of red blood cells, reduces the number of relapses, stabilizes cell membranes, neutralizes toxins and slags.
- Honey. Restorative product that increases the vitality of the patient. Honey improves the enzymatic function of the digestive tract, stimulates the synthesis of red blood cells, increases the phagocytic activity of leukocytes, increases glycogen stores in the liver, and accelerates the clearance of decomposition products of mycobacteria.
Remember, it is advisable to use bee products for both treatment and prevention of tuberculosis, especially in tubules where patients with tuberculin turns are observed.
Features of food
With the active form of tuberculosis, the consumption of essential structures (proteins, vitamins, fats, minerals) increases, which leads to a decrease in natural anti-infective immunity. In view of this, the main goals of therapeutic nutrition are: replenishing the deficiency of nutrients, increasing the body’s defenses and reducing the toxic load on the liver. To solve these tasks, the Russian therapist M. I. Pevzner has developed a special food for tuberculosis patients, called “Diet number 11”.
Basic table characteristics:
- The energy value of the daily menu – 3500-4000 kilocalories.
- The optimal ratio of B: W: Y in the diet is 120 grams: 100 grams: 450 grams.
- Acceptable methods of heat treatment of food – stewing, baking, boiling, steaming.
- The nature of the food is fractional (5-6 once a day), gentle, plentiful (especially during remission).
- Limitations for concomitant diseases: in case of iron deficiency anemia, the daily dose of fats is reduced to 80-90 grams and the portion of proteins is increased to 140 grams. If the patient has diabetes, the daily volume of carbohydrates is reduced to 300 grams, and the protein rate is increased to 130 grams. During periods of attenuation of the pathological process, the daily dose of fats and saccharides is reduced to a minimum (70 grams and 300 grams, respectively). For pathologies of the digestive tract, the feasibility of following “diet No. 11” should be discussed with a TB specialist.
- Prohibited foods: spicy dishes, spices, coffee, black tea, strong meat broths, offal, semi-finished products, confectionery, white sugar.
Given that patients with tuberculosis have a reduced appetite, cooked food should be as tasty and fragrant as possible.
List of recommended products
- Bakery products. To stimulate the evacuation function of the intestine, it is better to use whole-grain pastries (made from rye or whole-wheat flour). In addition, in the daily diet of the patient it is permissible to include products from puff pastry.
- First meal. Soups should be cooked exclusively on the second broth (to reduce the amount of easily extractable food additives in the liquid). At the same time, it is recommended to put a large amount of carrots, beets, potatoes, greens, cereals or dark pasta in dishes.
- Meat. To reduce the load on the liver, it is better to use foods that do not accumulate toxic substances in muscle tissues (lean lamb, turkey, chicken, rabbit meat). Store-bought “meat” (sausages, balyks, pates, stews, sausages, liver, tongue) is prohibited.
- Dairy products. It is important to include homemade kefir, yogurt, sour cream, cottage cheese, whey and cheese in the “anti-tuberculosis” menu. When using store products, it is better to give preference to the product marked “Thermostat”. This food accelerates the scarring of tuberculosis foci (due to saturation of the body with calcium and protein), and also enhances the patient’s natural anti-infective immunity (by “supplying” the intestines with beneficial strains of bacteria).
- Cereals. Essential components of the “diet number 11”, supplying the body with dietary fiber, amino acids, vitamins and minerals. The best cereals for medical nutrition – green buckwheat, unpolished rice, flattened oats.
- Fish. To improve appetite, herring, pink salmon, pikeperch or trout are introduced into the menu of infected people 2-3 times a week. Use of canned fish or semi-finished products (in oil or tomato) is strictly prohibited.
- Vegetables. For “diet number 11” it is important to choose foods with a high glycemic index: carrots, sweet potatoes, beets, potatoes, corn, legumes. To accelerate the withdrawal of feces and improve the detoxification function of the liver, the patient’s diet should contain at least 500 grams of vegetables per day (baked, boiled, steamed, pickled).
- Fruits and berries. To replenish the daily requirement for vitamins (especially in ascorbic acid), the patient’s daily diet is enriched with lemons, oranges, rose hips (in the form of a decoction), gooseberries, cranberries, kiwi, black currants, strawberries, strawberries, blackberries. When choosing fruits and berries, preference is given to seasonal fruits with a juicy ripe pulp and a sour-sweet taste. If, against the background of anti-tuberculosis therapy, the mucous membrane of the digestive tract becomes inflamed, coarse plant fiber is excluded from the daily menu. In such cases, it is permissible to use fruits and berries only in boiled form (together with a side dish).
To improve the barrier functions of the body, it is recommended to use seeds, nuts, unrefined oils, herbs, herbal decoctions.
Menu for the week
Monday
Breakfast: 200 grams of wheat porridge, 150 grams of vinaigrette, 30 grams of slightly salted herring (previously soaked in water), 10 grams of camelina oil.
Lunch: 50 grams of assorted nuts (almonds, cashews, walnuts).
Lunch: 300 grams of borscht, 100 grams of chicken steak, 30 grams of sour cream.
Lunch: 200 milliliters berry-yogurt cocktail.
Dinner: 200 grams of mashed potatoes, 150 grams of fresh vegetable salad (tomato, cucumber, onion, leafy greens), 1 egg (soft-boiled).
An hour before bedtime: 200 milliliters of kefir.
Tuesday
Breakfast: 200 grams of oatmeal, 100 grams of dried fruits (cranberries, dried apricots, raisins), 20 grams of rye bread.
Lunch: 200 grams of seasonal fruits (apples, pears, oranges, peaches, plums, bananas).
Lunch: 300 grams of vegetable soup, mashed potatoes, 150 grams of fish cutlets, 50 grams of leafy greens.
Lunch: 200 milliliters of chamomile tea, 150 grams of apple charlotte (homemade).
Dinner: 150 grams of cottage cheese, 100 grams of seasonal berries (raspberries, strawberries, cranberries, blackberries), 30 milliliters of sour cream.
An hour before bedtime: 200 milliliters serum.
Wednesday
Breakfast: 100 grams of omelet (from 2 eggs), 50 grams of Dutch cheese, 30 grams of whole-grain toasts.
Lunch: 250 milliliters of green cocktail (100 milliliters of yogurt, 100 grams of fruit or berries, 50 grams of greens).
Lunch: 300 grams of pea soup, 150 grams of stewed vegetables (beets, carrots, cabbage), 15 milliliters of sour cream.
Lunch: 200 milliliters of compote, 150 grams of cottage cheese and cranberry pudding.
Dinner: 250 grams of green buckwheat, 150 grams of jellied fish with vegetables, 15 milliliters of flaxseed oil.
An hour before bedtime: 200 milliliters of kefir.
Thursday
Breakfast: 200 g of wheat porridge, 150 g of vegetable gravy (zucchini, carrots, eggplant, tomato), 20 milliliters of flaxseed oil.
Lunch: 200 g of fruit mix (avocado, apples, peaches, banana, pears).
Lunch: 300 g of rice pickle, 150 g of beetroot-carrot salad, 100 g of meat goulash.
Afternoon snack: 150 g of freshly squeezed juice (orange, apple, grape, strawberry), 100 g of pumpkin-oatmeal cookies.
Dinner: 250 of pancakes with cottage cheese, 150 milliliters of herbal tea (jasmine, rose, linden).
An hour before bedtime: 150 milliliters of homemade yogurt, 7 milliliters of honey.
Friday
Breakfast: 150 grams of pasta (brown), 50 grams of chicken goulash,
Lunch: 200 milliliters of fruit and berry jelly (lingonberry, blackcurrant, kiwi, banana, rosehip, apple), 50 grams of nuts (forest, walnut, almond).
Lunch: 300 grams of cabbage rolls with meat, 150 grams of fresh vegetable sliced, 30 grams of thermostatic cream.
Snack: 200 milliliters of carrot juice, 70 grams of whole grain breads.
Dinner: 200 grams of vegetable stew, 100 grams of boiled fish, 15 milliliters of sea buckthorn oil.
An hour before bedtime: 250 milliliters serum.
Saturday
Breakfast: 200 g of buckwheat, 100 g of chicken cutlets (steam), 50 milliliters of vegetable gravy (stew).
Lunch: 100 g of natural dried fruits (dried apricots, figs, prunes, cranberries, raisins), 50 g of raw nuts (cashews, almonds, walnuts, hazelnuts).
Lunch: 300 g of lentil soup, 100 g of meat dumplings, 50 g of leafy greens (cilantro, dill, basil, parsley), 30 milliliters of homemade sour cream.
Afternoon snack: 200 g of seasonal berries (strawberries, raspberries, blueberries, blackberries), 30 milliliters of cream.
Dinner: 150 g of cottage cheese, 50 g of bananas, 30 g of raisins, 30 g of dates, 20 milliliters of sour cream.
An hour before bedtime: 25 milliliters ryazhenka.
Sunday
Breakfast: 150 g of apple and rice pudding, 50 g of Dutch cheese, 30 g of rye toast, 10 g of butter.
Lunch: 200 milliliters of berry compote, 100 g of biscuits, 15 milliliters of may honey.
Lunch: 200 g of bean puree soup, 150 g of beetroot-cabbage salad, 30 g of leafy greens.
Afternoon snack: 200 g banana milkshake.
Dinner: 200 grams of fish with vegetables (baked), 20 milliliters of sea buckthorn oil.
An hour before bedtime: 250 milliliters of sour milk.
Conclusion
Nutrition for tuberculosis is the most important component of therapeutic therapy aimed at suppressing a bacterial infection caused by Koch’s bacillus. When infected, a large amount of toxic poisons (waste products of microorganisms) are released into the blood. As a result, oxidative processes in tissues slow down, the exchange of essential structures is disrupted, the enzymatic secretion of the pancreas decreases, and blood circulation worsens. To minimize these problems, the diet of tuberculosis patients is enriched with nutritional components that have detoxifying activity.
Useful products for tuberculosis patients: whole grain and dairy products, unpolished cereals, nuts, seeds, vegetable oils, vegetables, fruits, berries. These ingredients, in addition to improving liver function, saturate the body with nutrients (amino acids, vitamins, minerals), increase the natural anti-infective immunity.
- Sources of
- State Budgetary Institution of Healthcare “Tuberculosis Dispensary No. 23” of the Ministry of Health of the Krasnodar Territory – Clinical nutrition for tuberculosis.
- State budgetary health care institution “Orsk TB dispensary” (GBUZ “OPTD”) – Principles of catering for tuberculosis.