Therapeutic Diet №14

Urolithiasis (phosphaturia) is a disease of the urinary system, in which stones form in the kidneys, urinary tract. This happens if the acid-base balance of urine shifts towards alkali. To restore this balance and alleviate the patient’s condition, a special nutrition system is called upon – diet No. 14.

Scope of the diet

The fourteenth diet, or table number 14, was compiled by the scientist and nutritionist Manuil Pevzner^[1]. The professor revealed that nutritional correction is necessary for any disease. He compiled fifteen diets based on scientific and clinical observations. They are an additional method of treatment to drug therapy of various diseases.

Table No. 14 is necessary for the precipitation of urine salts and the formation of stones (phosphates, oxalates and urates). This condition can be caused by a violation of calcium and phosphorus metabolism. Often, such a disease can be the result of other diseases: tuberculosis, epilepsy, cystitis, prostatitis. Improper nutrition can also cause the development of phosphaturia.

The purpose of the diet is to restore the normal pH balance of urine and its acid reaction. With the help of a special treatment menu in patients with urolithiasis, the level of alkali in the urine is reduced, which prevents the formation of sediment.

In addition to the main fourteenth diet, table 14a is prescribed. It is indicated after surgical interventions, in particular, with extensive operations on bones and soft tissues.

Rules of treatment methods

The patient’s nutrition should remain within normal limits. Daily put into the diet proteins of animal and vegetable origin, carbohydrates, healthy fats. Diet number 14 is considered complete in terms of calories, per day the patient is supposed to gain as many calories as the body needs. Starving and overeating is not recommended, as the first and second weaken the body.

In the diet, foods that increase the level of alkali in the urine are limited. These include most fruits and vegetables, milk. Also, the consumption of calcium, which is a component in precipitation during phosphaturia, is minimized. Preference is given to those nutrition ingredients that oxidize urine. These include meat and fish dishes, bread, cereals.

Culinary processing of dishes is not regulated. Following a diet, you can boil the components, bake, fry, stew, steam or grill. There are no special temperature requirements for food. For additional sparing of the digestive tract, it is recommended to consume only warm food.

Particular attention is paid to the drinking regimen. On a day, the patient is supposed to drink up to 3 liters of fluid. Recommended ordinary purified and enriched water.

An enhanced drinking regime is established for a short period, after which the patient switches to a normal one. Long-term intake of large amounts of water shifts the pH to the alkaline side. In addition to the usual liquid, you can add oxidizing drinks: fruit drinks, compotes, apple and grape juice. Sweet and sour drinks should also not be carried away, as they provoke the release of calcium.

Disturbances in the functioning of the nervous system can also be causes of a malfunction in phosphate metabolism. Given this fact, it is recommended to exclude drinks and dishes that excite the central nervous system. These include: spicy, oily, coffee, green tea, energy, chocolate. The amount of salt should be reduced to 10 g per day. Excess sodium chloride provokes the withdrawal of calcium and increases the level of phosphorus. In addition to salt, sharp spices and herbs should be excluded.

Phosphaturia is usually observed in peptic ulcer disease, inflammatory diseases of the bronchopulmonary system, and diabetes mellitus. If urolithiasis is combined with other pathologies, then the final dietary recommendations should be made by the attending physician.

Nutrition on a diet

Depending on the causes of phosphaturia, a course of treatment is prescribed, which will consist of medications and a diet. Such a diet is designed to reduce pain, speed up recovery, and in some cases allows you to do without surgery.

When compiling the menu is prohibited to use

• sausages, smoked meats and canned goods;
• salted fish – allowed in macerated form;
• pure dairy products (allowed in small quantities in dishes);
• almost all vegetables;
• coffee, strong tea, cocoa;
• chocolate, cream pastry;
• berries and fruits, except for permitted;
• horseradish, pepper, mustard;
• berry and vegetable juices;
• alcohol, kvass, sweet soda.

The hardest thing, according to patients, is to limit the consumption of vegetables. This must be done for the entire period of the diet, since most plant foods alkalize the urine.

Recommend to include in the menu:

1. Meat and fish – all types and varieties are allowed, and it is allowed to cook in any way.
2. Seafood, fish caviar.
3. Kashi – you can use all kinds of cereals. It is forbidden to add milk to them.
4. Green peas, asparagus, all kinds of mushrooms, pumpkin.
5. Eggs are allowed in limited quantities. It is recommended to consume no more than 1 eggs per day.
6. Sour apples: Greni Smith, Antonovka, Semerenko, Jonagold.
7. Lingonberries, cranberries, red currants – you can prepare desserts from them or use for compote.
8. Weak black tea, light coffee without milk and cream, decoctions of wild rose and herbs.

Food can be prepared in vegetable or butter, all types of processing are allowed. To give the taste of dishes, you can use mild spices and herbs: dill, parsley, rosemary, bay leaf, curry (limited). Soups can be cooked in fish, mushroom or meat broth; potatoes are not allowed. For the first dishes, you can use pasta, cereals, allowed vegetables.

Since nutrition excludes a number of useful components, it is recommended to add bran bread, fish oil, and yeast baked goods to the menu. Calcined food is included in the diet once or twice a week, as the body needs it. Additionally, you can use vitamin complexes, but without the content of vitamin D. Hypervitaminosis of this component can cause primary phosphaturia.

Diet menu

When compiling a diet, it is important to take into account the presence of concomitant diseases, as dietary restrictions may expand. It is recommended to draw up a menu for the week ahead in order to properly plan the diet.

Monday

Breakfast: pearl barley porridge with chicken chop, white bread, tea.

Snack: apple juice.

Lunch: broth with noodles, bread, pilaf, redcurrant compote.

Snack: green apples.

Dinner: fish cakes with rice, a decoction of barberry.

Tuesday

Breakfast: semolina on the water, toast with jam, tea.

Snack: decoction of wild rose.

Lunch: veal and green pea soup, buckwheat, bread.

Snack: cranberry jelly.

Dinner: boiled meat, roasted pumpkin, chamomile tea.

Wednesday

Breakfast: boiled egg, baked apples, tea.

Snack: kefir.

Lunch: mushroom cream soup (without potatoes), crackers from white bread.

Snack: pumpkin fresh, drying.

Dinner: fried hake, rice with green peas, linden broth.

Thursday

Breakfast: barley porridge on the water with mushrooms, tea.

Snack: red currant jelly.

Lunch: noodle soup with meat, sponge cake, apple juice.

Snack: semolina and pumpkin pudding.

Dinner: roast beef and green peas, a decoction of barberry.

Friday

Breakfast: omelette of two proteins, bran bread, tea.

Snack: compote of lingonberries.

Lunch: meat soup, bread croutons.

Snack: drying, half a cup of milk.

Dinner: stuffed mushrooms, boiled rice, lingonberry compote.

Saturday

Breakfast: pumpkin porridge with millet, tea.

Snack: jelly from apples.

Lunch: broth with meatballs, buckwheat, bran bread.

Snack: apples are green.

Dinner: aspic from pork and boiled egg, broth of wild rose.

Sunday

Breakfast: wheat cereal with cutlet, tea.

Snack: grape juice, biscuits.

Lunch: pumpkin cream soup, bread crumbs.

Snack: lime tea, dried fruit jelly.

Dinner: a rabbit in sour cream, boiled bulgur, grape juice.

In the sample menu, periodically calcined foods are introduced to prevent critical reduction in calcium content. Berry and fruit juices help to reduce the alkaline reaction in the urine, but in small quantities, so you should not get too carried away. Recipes without the use of vegetables is easy to find on the Internet or simply change the recipe of familiar dishes.

Roasted pumpkin is suitable as a side dish for meat or instead of breakfast. To prepare it, you will need to clean the pumpkin from seeds and skin, slightly salt it and roll in flour. For the 14 diet, any grade of flour except rye is suitable: bran, wheat, oat. Fry pumpkin in vegetable oil until half ready. Then place the fried pieces on a baking sheet covered with parchment. Bake the dish for another 15-20 minutes. If you do not salt it before frying, you can eat baked pumpkin with honey as a dessert.

Stuffed zrazy will eliminate the need to cook a side dish, so they contain both meat and rice inside. For them, boil 50 g of dry rice separately and cool it, add oil and salt to taste. 300 g veal or beef should be several times grind through a meat grinder. Fillet should be without fat, bone particles, fascia. Add minced loaf of bread soaked in water to the mince, mix everything well.

From the meat mass to form flat cakes, in the middle of each place a little rice filling. Blanks need to carefully pin and give them a round or oval shape. Better to do it with wet hands. Place zrazy in a double boiler and cook under the lid 20 minutes.

Fish dumplings are a great way to diversify the diet menu and replenish the supply of useful components. Any lean type of fish is suitable for them. It is better to use hake, it is easily separated from the bones, which makes it easier to process. 300 g of pure fillet must be passed several times through a meat grinder. Add 100 g of bread soaked in water (also ground) to it. Beat the whole mass well, salt a little.

Separately in a cauldron mix sour cream with water and bay leaf. Place the dumplings in a boiling sour cream mixture and boil the 20-30 minutes for a minimum of fire. You can cook them in a double boiler.

14 Diet

Table No. 14a, as a rule, is prescribed for patients with a complicated postoperative period after injuries of bones and soft tissues. This is a simplified form of the basic diet.

As a rule, the 14 diet is applied intermittently to other tables according to Pevzner. The nutrition scheme looks like this: a week on the 14 diet, then a week on the diet No. 11 or No. 15, then again No. 14, and so on.

The rules of nutrition remain the same: the amount of alkaline food decreases and the level of acid valences increases. Drinking mode – enhanced, up to 3 liters per day. Food can be processed in any way, if there are no additional restrictions. Recommend separate meals, on 4-5 small meals.

The amount of vegetables should be reduced to 100 g per day, mainly in the first dishes. Soups can be prepared with meat and mushrooms, with fish, noodles, cereals. For side dishes, it is recommended to cook cereals, pasta, beans, pumpkin. The number of eggs can be increased to 2 pieces per day. Dairy products are very limited, periodically a little cottage cheese and hard cheese are allowed. Otherwise, all prohibited products for the table number 14 remain characteristic of the table 14.

The diet is applied “zigzag” and lasts until the patient’s health is restored.

In conclusion

For phosphaturia and other disorders of the urogenital system, it is recommended to drink broths of hips and barberries. It is necessary to prepare drinks from these berries, using fruits, but not leaves. Find them the easiest on the markets, there are packaged fees in pharmacies and shops eco products. Both barberry and wild rose have a good effect on digestion, heart work, normalize liver and kidney functions.

For a speedy recovery, it is recommended to increase the consumption of millet. Useful and porridge from it, and decoctions. For decoctions, the groats are washed, filled with water and boiled for 5 minutes. The resulting water is drained and drunk in small portions throughout the day.

After recovery, it is important to continue to adhere to proper nutrition, to prevent infectious diseases, to avoid hypothermia. It is important sometimes to be examined by a doctor, since phosphaturia can return, and its initial stages pass unnoticed.

Sources of