Diets - description

Dietotherapy in Belarusian health resorts

Medical foods - science-based system of nutrition organization and differential use of therapeutic purposes certain food combinations, types of cooking, including in health resorts of Belarus. The principles of therapeutic nutrition include: full body supply of proteins, fats, carbohydrates, as well as essential nutrition factors (essential amino acids, polyunsaturated fatty acids, vitamins, minerals) in different ratios; compliance of the chemical structure of food functional state of the enzyme systems of the human body.

By the Decree of the Ministry of Health of the Republic of Belarus of 29 August, 2008 N 135 was introduced Instructions on the organization of diet nutrition in state health organizations, amended and supplemented By the Decree of the Ministry of Health of the Republic of Belarus of 25 March, 2011 №22. Entered into force alphabetic classification of diets: B, P, H, H1, Т, О, D. Health resort organizations in Belarus have switched to a new system of classification of diets.
Sometimes you have to make changes to the basic diet. This can be caused by the following reasons: the presence of several diseases in patients; drug therapy, which has a side undesirable effect on the metabolism and the condition of organs and systems, or requiring appropriate nutrition for its effect; intolerance of individual products due to food allergies or insufficient enzymes in the intestine, necessary for digestion of food components; obesity as a comorbidity.
Different diets can be prescribed with the same disease, taking into account the nature of the course of the disease, concomitant diseases or complications.

Organization of medical nutrition of patients is carried out in accordance with the list of standard diets according to annex 1 to this Instruction. Description of each standard diet includes:

• general description of chemical composition and product set;
• purpose of assignment;
• basic indications for use;
• chemical composition and energy value;
• basic cooking methods;
• power mode.

Before using this or that diet, it's necessary to receive recommendations of the attending physician and consultation of the dietician or the dietitian's nurse.

Medical diet food in health-resort organizations supplemented by the introduction of elements of the "buffet": fresh fruits and vegetables, pastries, soups and salads.

Diet	Description	Indications
Diet B	the basic diet	diseases and conditions that do not require special therapeutic diets
Diet P	ration with mechanical and chemical protection	acute and exacerbation of chronic diseases of the gastrointestinal tract, liver, pancreas
Diet M	diet with high protein content	diseases and conditions requiring the introduction of an increased amount of protein (malabsorption, kidney disease with nephrotic syndrome without violation of azotovydelitelnoy function, diabetes mellitus type 1, sepsis and other severe bacterial diseases, severe anemia)
Diet H	low protein diet	chronic kidney disease with severe disorders of kidney azotovydelitelnoy function and expressed azotemia, liver cirrhosis with hepatic encephalopathy
Diet Т	diet with high protein content and high caloric content	pulmonary tuberculosis, burn disease.
Diet D	diet for diabetics	diabetes mellitus

Digital classification of diets before By the Decree of the Ministry of Health of the Republic of Belarus of 25 March, 2011 №22 before moving to the alphabetic classification of diets:

Diets	Analogue	Indications
№1		ulcers disease stomach and duodenal ulcer in the period of recovery after a sharp deterioration and mild aggravation; unsharp exacerbation of chronic gastritis with preserved or increased secretion; acute gastritis in the recovery period.
№1 а		acute exacerbation of gastric ulcer and duodenal ulcer in the first 6-8 days of treatment; acute exacerbation of chronic gastritis in the first days of treatment; acute gastritis on the 2nd - 4th day of treatment.
№1 b		gastric and duodenal ulcer or chronic gastritis (used after a diet № 1 а).
№2		chronic gastritis with secretory insufficiency with mild exacerbation, and in the stage of recovery after the exacerbation; acute gastritis, enteritis, colitis during the recovery period as a transition to rational nutrition, chronic enteritis and colitis after and without exacerbation without concomitant diseases of the liver, biliary tract, pancreas, or gastritis with preserved or increased secretion.
№3		chronic intestinal diseases with constipation with non-sharpened or damped exacerbation and without exacerbation.
№4		acute diseases and acute exacerbation of chronic intestinal diseases with severe diarrhea.
№4 b		acute intestinal diseases during the period of improvement; chronic intestinal diseases after a sharp exacerbation or with a sharp exacerbation, as well as in combination with the defeat of other digestive organs.
№4 v		acute intestinal diseases in the recovery period as a transition to a rational diet; chronic intestinal diseases in the period of exacerbation damping, as well as outside exacerbation with concomitant lesions of other digestive organs.
№5	Diet P, М	acute hepatitis and cholecystitis in the stage of recovery; chronic hepatitis out of exacerbation; cirrhosis of the liver without its insufficiency; chronic cholecystitis and cholelithiasis out of exacerbation (in all cases - without expressed diseases of the stomach and intestines).
№5 а	Diet M	acute hepatitis and cholecystitis, exacerbation of chronic hepatitis, cholecystitis and cholelithiasis, cirrhosis of the liver in the compensation stage, as well as other diseases in accordance with the purpose of the diet.
№5 p	Diet M	chronic pancreatitis in the recovery period after acute and non-acute
№6		gout and urolithiasis with formation of stones from uric acid salts (uraturia).
№7	Diet H, М	acute nephritis during recovery (from the 3rd - 4th week of treatment), chronic nephritis without exacerbation and kidney failure.
№7 а	Diet H, М	acute nephritis in severe form after discharge days and moderate severity from the first days of the disease, chronic nephritis with pronounced renal insufficiency.
№7 b	Diet H, М	acute nephritis after diet №7 a or immediately in mild form, chronic nephritis with moderate renal insufficiency.
№8		obesity as the main disease or concomitant with other diseases that do not require special diets.
№9	Diet D	diabetes mellitus of mild, moderate and severe forms without concomitant diseases in normal or slightly overweight.
№10	Diet M	disease of the cardiovascular system with circulatory failure I - IIA degree.
№10 а	Diet M	diseases of the cardiovascular system with circulatory failure of the IIB - III degree.
№10 i	Diet M	heart attack.
№11	Diet T	tuberculosis of lungs, bones, lymph nodes, joints in case of non-sharp aggravation or its attenuation, with reduced body weight (exhaustion after infectious diseases, operations, injuries), in all cases in the absence of lesions of the digestive system.
№12		functional diseases of the nervous system.
№13		acute infectious disease. Purpose: the maintenance of the general forces of the body and increase its resistance to infection, reduce intoxication, sparing the organ of digestion in terms of fever and bed rest.
№14		kidney stones with alkaline reaction of the urine with precipitation of phosphate-calcium salts (phosphaturia)
№15	Diet B	various diseases, not requiring special medical diets and without human digestive system; transition to a normal diet diet during the recovery period and after the use of therapeutic diets.