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Диета при инфаркте миокарда стол

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17 августа 2019

Описание актуально на 29.05.2017

Общие правила

Основными задачами реабилитации пациента после инфаркта и стентирования являются восстановление жизненных функций больного и снижение риска повторного приступа. Успешность реабилитационных мероприятий во многом определяется правильностью лечебного питания. Диета при инфаркте миокарда направлена на:

  • нормализацию функции сердечной мышцы и ускорение репаративных процессов в миокарде;
  • снижение нагрузки на сердечно-сосудистую систему и улучшение кровообращения в целом;
  • стабилизацию массы тела при наличии ожирения;
  • нормализацию двигательной функции ЖКТ.

Основными принципами питания постинфарктных больных являются:

  • сокращение потребления жиров (особенно продуктов, содержащих в больших количествах насыщенные жирные кислоты);
  • увеличение потребления полиненасыщенных жирных кислот, которые снижают уровень липидов в крови;
  • ограничение свободной жидкости;
  • увеличение употребления продуктов, содержащих сложные углеводы и клетчатку;
  • ограничение поваренной соли до 3-5 г в сутки;
  • снижение в рационе питания доли продуктов, богатых холестерином.

Лечебное питание после инфаркта миокарда строится на основе диетического Стола 10И и 10. Рацион питания содержит физиологически нормальное количество белка — 80-90 г (60 % животных), ограниченное содержание жиров — до 70 г жира (в основном животного) и 350-400 г углеводов (из них на долю простых углеводов приходится около 30 г), потребление поваренной соли не более 3-5 г в сутки. Энергетическая ценность рациона – 2300-2400 ккал. Количество свободной жидкости на уровне 1,2 л/сутки.

Рацион питания обогащен Витаминами А, С, Д и водорастворимыми витаминами, улучшающими метаболические процессы в миокарде, что достигается включением в рацион питания оптимального количества растительного жира, свежих овощей и фруктов, некоторых круп (гречневая, овсяная), некоторых мясных продуктов (телятина).

С целью нормализации электролитного состава внеклеточной/внутриклеточной жидкости, имеющего большое значение в нарушении метаболизма миокарда, в рацион питания вводятся продукты, содержащие повышенное количество калия. Это достигается путем включения в рацион больных фруктов и овощей, соков и отваров из них. Для улучшения сократительной функции сердца важен кальций, который поступает в организм с молочными продуктами и наличие которых в рационе является обязательным, особенно если инфаркт был обширный.

Другие микроэлементы (марганец, магний, калий, йод), необходимые для нормального функционирования сердечной мышцы, компенсируются наличием в рационе различных продуктов растительного и животного происхождения, в частности, различных морепродуктов (кальмары, мидии, креветки, морская капуста). Для снижения нагрузки на сердечно-сосудистую систему Стол 10И предусматривает дробное 5-6-разовое питание с последним приемом за 3 часа до ночного сна.

Из рациона исключают все продукты, обладающие возбуждающим действием (кофе, чай, шоколад, пряности, какао). Возрастает удельный вес продуктов, содержащих пищевые волокна (овощи, крупы, фрукты), употребляемых в виде салатов или самостоятельных блюд. Показано включать в рацион разные сорта «белой» рыбы, поскольку ненасыщенные жирные кислоты жиров рыб улучшают обмен холестерина. С целью нормализации функции ЖКТ из рациона исключаются трудно перевариваемые продукты, способствующие брожению в кишечнике и вызывающими метеоризм, а также экстрактивные вещества мясных и рыбных продуктов.

Диетическое питание после инфаркта для мужчин и для женщин строится в зависимости от этапа реабилитации:

  • I этап – острый период (первая неделя после инфаркта) — пища щадящая (готовится на пару или отваривается с протиранием), с полным исключением поваренной соли. Прием пищи 6-7 раз в день, небольшими порциями. Общий вес дневного рациона 1700 г. Энергетическая ценность рациона 1100-1300 ккал, с содержанием белков, жиров и углеводов в количестве — 60, 30 и 180 г; свободная жидкость — до 0, 8 л.В меню могут включаться: первые блюда на овощном отваре с протертыми овощами и крупами; паровые котлеты, фрикадели из нежирной говядины, протертый творог, омлет из белков, отварная нежирная рыба белых сортов, сухари (до 50 г), нежирный кефир; пюре из отварной свеклы, моркови, или картофеля, овсяная или гречневая каша, протертая на молоке; жидкие кисели, желе, морсы, отвар шиповника, настой из кураги, чернослива или изюм; некрепкий чай с добавлением молока, разбавленные водой фруктовые, морковный соки, щелочная негазированная минеральная вода (без газа). Все блюда должны быть теплыми, сливочное и рафинированное и растительное масло добавляться только в готовые блюда.
  • II этап — подострый период (2-3 неделя после инфаркта) — вес дневного рациона не более 2000 г. Энергетическая ценность 1600-1800 ккал с содержанием белков, жиров и углеводов в количестве — 80:50 и 200 г. Свободная жидкость на уровне 0,8 л, содержание соли — не выше 3 г. Блюда готовятся на пару, тушится или отваривается.Блюда подаются в измельченном виде дробно, до 6 раз в день. В меню могут включаться супы на овощном отваре с добавлением хорошо проваренных круп/овощей, рубленные отварные куски нежирных сортов мяса/рыбы, блюда из фарша, несоленый нежирный сыр, пюре из картофеля, моркови, свеклы, творожно-фруктовые пудинги; запеченные яблоки, кефир, вязкие не протертые каши (гречневая, манка), сухари или подсушенный пшеничный хлеб до 150 г; блюда из цветной капусты, фруктовый и молочный кисель, компоты и морсы, сырые мягкие фрукты без грубой клетчатки, сахар до 50 г, некрепкий чай. Растительное рафинированное и сливочное масло (до 5 г), молоко добавляется только в готовые блюда или соусы.
  • III этап – период рубцевания (4 неделя) — вес дневного рациона не более 2300 г. Энергетическая ценность 2100-2300 ккал с содержанием белков, жиров и углеводов в количестве — 90:70 и 320 г. Пища отваривается, тушится и подается куском или измельченной, 5 раз в день. Свободная жидкость на уровне 1 л, количество поваренной соли не более 5 г/сутки.В меню могут включаться сухари или подсушенный пшеничный хлеб до 150 г, первые блюда, на слабом обезжиренном мясном или овощном бульоне, нежирная ветчина, отварная рыба и мясо, отваренные макароны с творогом, спелые томаты, творожные пудинги с добавлением фруктов и круп, тушеная свекла с морковью, масло сливочное — только в блюда (до 10 г).
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Диета после инфаркта для мужчины/женщины с «лишним» весом предусматривает его снижение с целью уменьшения физической нагрузки на миокард и нормализации липидного обмена. Достигается это путем проведения разгрузочных дней в виде:

  • арбузного дня 1500 г спелого арбуза на 5 приемов;
  • рисово-компотного дня (1 л компота и 100 г рисовой каши);
  • 800 мл фруктового сока и 500 г овсяной каши на день;
  • яблочного дня (2 кг печеных или протертых яблок в сутки).

Сроки нахождения на том или ином этапе реабилитации могут удлиняться, особенно после обширного инфаркта миокарда, при наличии осложнений. Диета после этапа рубцевания должна соответствовать Столу №10 с минимальным содержанием жиров и соли.

Разновидности

При наличии у пациента, перенесшего инфаркт миокарда недостаточности кровообращения или артериальной гипертензии, может назначаться калиевая диета, которая оказывает мочегонный эффект, нормализует натриево-калиевый обмен, улучшает состояние миокарда, снижает артериальное давление. В рацион калиевой диеты включаются продукты, содержащие много калия и бедные натрием, (соотношение этих микронутриентов должно быть от 8:1 до 14:1).

В дневном рационе содержание калия должно варьировать в пределах 5-7 г, что обеспечивается включением в рацион печеного картофеля, кураги, изюма, шиповника, орехов, капусты; телятины, молока, нежирного творога, растительного масла, цитрусовых, овсяной, ячневой и пшеничной крупы; чернослива, крыжовника, черной смородины. Существует четыре варианта калиевой диеты, отличающиеся по химическому составу содержанию и калия. Учитывая, что диета является физиологически неполноценной, ее назначают кратковременно на 3-5 дней, а по мере улучшения состояния пациента переводят на Диету 10И.

Показания

Перенесенный инфаркт миокарда и другие проявления острой коронарной недостаточности в периоде реабилитации больного.

Разрешенные продукты

Для минимизации риска развития осложнений в рацион питания необходимо включить продукты, богатые полиненасыщенными жирными кислотами, клетчатку и сложные углеводы. В меню включаются супы на овощном бульоне с добавлением хорошо разваренных круп и картофеля (свекольник, щи, борщ). Для вторых блюд чрезвычайно полезны нежирные сорта белой рыбы (хек, треска, тунец, камбала) и морепродукты (креветки, мидии, кальмары, морская капуста), а также постные сорта красного мяса и диетическое мясо птицы (индюшина, курица), кролика в отварном или запеченном виде, рубленые или куском. В качестве жиров рекомендуются растительные рафинированные масла (подсолнечное, оливковое), а также жирная рыба: сардины, сельдь, тунец, лососевые (семга, кета, горбуша).

В рацион включаются несолёные сыры с низким содержанием жира, обезжиренные молокопродукты (кефир, ряженка). Хлебобулочные изделия в рационе присутствуют в виде изделий из цельных злаков, муки грубого помола, бездрожжевых хлебцов, овсяного печенья. Увеличивается объем потребляемых в любом виде и способах кулинарной обработки фруктов и овощей, а также свежевыжатые соки из ягод (ежевика, земляника, черника) и фруктов, грецкие орехи.

Крайне полезно употребление свежей зелени, блюд из злаков. Для улучшения кровообращения необходимо включать в рацион отвары из шиповника и пшеничных отрубей. На показатели липидного обмена благоприятно воздействует питье минеральных вод, преимущественно гидрокарбонатных натриевых, хлоридных, сульфатных или воды смешанного катионного состава («Боржоми», «Ессентуки» № 4, № 17, «Лужанская», «Смирновская»).

Таблица разрешенных продуктов

Овощи и зелень

Белки, г Жиры, г Углеводы, г Калории, ккал
баклажаны 1,2 0,1 4,5 24
бобы 6,0 0,1 8,5 57
кабачки 0,6 0,3 4,6 24
капуста 1,8 0,1 4,7 27
капуста брокколи 3,0 0,4 5,2 28
капуста брюссельская 4,8 0,0 8,0 43
лук зеленый 1,3 0,0 4,6 19
лук репчатый 1,4 0,0 10,4 41
огурцы 0,8 0,1 2,8 15
патиссоны 0,6 0,1 4,3 19
перец салатный 1,3 0,0 5,3 27
петрушка 3,7 0,4 7,6 47
свекла 1,5 0,1 8,8 40
сельдерей 0,9 0,1 2,1 12
соя 34,9 17,3 17,3 381
спаржа 1,9 0,1 3,1 20
помидоры 0,6 0,2 4,2 20
топинамбур 2,1 0,1 12,8 61
тыква 1,3 0,3 7,7 28
укроп 2,5 0,5 6,3 38
фасоль 7,8 0,5 21,5 123
чеснок 6,5 0,5 29,9 143
чечевица 24,0 1,5 42,7 284

Фрукты

авокадо 2,0 20,0 7,4 208
апельсины 0,9 0,2 8,1 36
грейпфрут 0,7 0,2 6,5 29
груши 0,4 0,3 10,9 42
лимоны 0,9 0,1 3,0 16
манго 0,5 0,3 11,5 67
мандарины 0,8 0,2 7,5 33
нектарин 0,9 0,2 11,8 48
персики 0,9 0,1 11,3 46
яблоки 0,4 0,4 9,8 47

Ягоды

крыжовник 0,7 0,2 12,0 43
смородина красная 0,6 0,2 7,7 43
смородина черная 1,0 0,4 7,3 44

Орехи и сухофрукты

орехи 15,0 40,0 20,0 500
семена льна 18,3 42,2 28,9 534
семена пажитника 23,0 6,4 58,3 323
семечки подсолнечника 20,7 52,9 3,4 578

Крупы и каши

гречневая крупа (ядрица) 12,6 3,3 62,1 313
овсяная крупа 12,3 6,1 59,5 342
овсяные хлопья 11,9 7,2 69,3 366
пшеничные отруби 15,1 3,8 53,6 296

Молочные продукты

кефир 0% 3,0 0,1 3,8 30
кефир 1% 2,8 1,0 4,0 40

Сыры и творог

творог 0.6% (маложирный) 18,0 0,6 1,8 88
творог тофу 8,1 4,2 0,6 73

Мясные продукты

говядина 18,9 19,4 0,0 187

Птица

куриное филе 23,1 1,2 0,0 110
индейка 19,2 0,7 0,0 84
яйца 12,7 10,9 0,7 157

Рыба и морепродукты

рыба 18,5 4,9 0,0 136
морская капуста 0,8 5,1 0,0 49

Масла и жиры

масло виноградных косточек 0,0 99,9 0,0 899
масло льняное 0,0 99,8 0,0 898
масло оливковое 0,0 99,8 0,0 898
масло подсолнечное 0,0 99,9 0,0 899

Напитки безалкогольные

вода минеральная 0,0 0,0 0,0
цикорий растворимый 0,1 0,0 2,8 11
чай зеленый 0,0 0,0 0,0

Соки и компоты

кисель из клюквы 0,0 0,0 13,0 53
шиповниковый сок 0,1 0,0 17,6 70

* данные указаны на 100 г продукта

Полностью или частично ограниченные продукты

Из рациона питания исключаются бульоны на мясе, грибах и рыбе, а также все виды жирного мяса, бекон с прослойками жира, сало, любые колбасы, яичница с мясом, паштеты и мясные пасты, гусь, утка, кожа домашней птицы, а также все виды субпродуктов — сердце, печень, мозги. Полностью исключаются любые жареные продукты, соления, копчёности, рыбные и мясные консервы, животные и кулинарные жиры, кокосовое масло, майонезы и маргарин.

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Ограничивается употребление сливочного масла, жирных молочных изделий (сметана, сливки), неснятого или сгущенного молока, жирного сыра. Потребление куриных яиц ограничивается до 3 штук в неделю. Не следует включать в рацион икру рыб и ракообразных. Ограничивается прием жаренного и тушеного картофеля, засахаренные фрукты, фрукты в сиропе, лесной орех, миндаль. Не рекомендуются включать в рацион виноградный сок, картофельные чипсы, шпинат, хрустящий картофель, щавель, грибы. Сладости рекомендуется заменить сухофруктами.

Из списка продуктов необходимо вычеркнуть кондитерские изделия, свежий белый хлеб, сахар и продукты его содержащие, мороженное, газированные напитки, мед. После инфаркта полностью запрещается потребление изделий из сдобного/слоеного теста, желтков куриных яиц, риса, макаронных изделий, а также кофеинсодержащих продуктов (крепкий чай, шоколад, кофе, какао), вызывающих спазм сосудов и усиливающих сердечную деятельность. Не допускается употребление газированных сладких напитков, изюма, различных пряностей и любых алкогольсодержащих напитков.

Диета №10и. Диета при инфаркте миокарда

Диета №10и назначается при инфаркте миокарда.

Диета №10и способствует восстановительным процессам в мышце сердца, улучшению кровообращения и обмена веществ, уменьшению нагрузки на сердечно-сосудистую систему, нормализация двигательной функции кишечника.

В рационе значительно снижают калорийность за счет уменьшения потребления белков, углеводов и особенно жиров, а также уменьшения объема пищи, ограничения количества натрия хлорида и свободной жидкости.

Исключают трудноперевариваемые, вызывающие брожение в кишечнике и метеоризм, богатые холестерином, животными жирами и сахаром продукты, экстрактивными веществами мясо и рыбу.

В диету включают продукты, богатые липотропными веществами, витаминами С и Р, калием, а также мягко стимулирующие двигательную функцию кишечника (для борьбы с запорами).

Диета № 10и при инфаркте миокарда состоит из 3 последовательно назначаемых рационов.

I рацион дают в остром периоде (1 -я неделя); II — в подостром периоде (2-3-я неделя); III — в период рубцевания (4-я неделя).

В I рационе блюда — протертые; в II — в основном измельченные; в III — измельченные и куском. Пищу готовят без соли, в отварном виде. Исключают холодные (ниже 15°С) блюда и напитки.

При I рационе организм получает 50 г белков, 30-40 г жиров, 150-200 г углеводов, 0,7-0,8 л жидкости. Масса рациона — 1,6-1,7 кг, его энергетическая ценность составляет 1100-1300 ккал.

При II рационе: 60-70 г белков, 50-60 г жиров, 230-250 г углеводов, 1600-1800 ккал, 0,9-1,0 л жидкости, 3 г натрия хлорида. Масса рациона — 2 кг.

При III рационе: 85-90 г белков, 70 г жиров, 300-350 г углеводов, 2200-2400 ккал, 1-1,1 л жидкости, 5-6 г натрия хлорида. Масса рациона — 2,2-2,3 кг.

Пищу принимают: I-II рационы — 6 раз, III — 5 раз в день, небольшими порциями.

При диете №10и при инфаркте миокарда разрешаются:

  • хлеб и мучные изделия. I рацион — 50 г сухарей или подсушенного хлеба без пшеничной муки высшего и 1-го сорта; II — 150 г пшеничного хлеба вчерашней выпечки: III — 250 г вчерашнего пшеничного хлеба с заменой 50 г его на ржаной хлеб из овсяной муки (при переносимости);
  • супы (150-200 мл) на овощном отваре с протертыми разрешенными крупой и овощами, яичными хлопьями. II-III рацион: супы (250 мл) с хорошо разваренными крупой и овощами (борщ, свекольник, морковный протертый и др.), допустим слабый обезжиренный мясной бульон;
  • нежирные виды и сорта мяса, птицы и рыбы. Мясо освобождают от фасций, сухожилий, кожи (птица) и жира;

I рацион: паровые котлеты, кнели, фрикадельки, суфле и др. отварная рыба (по 50 г);

II-III рационы: отварные куском, изделия из котлетной массы.

  • молоко — в блюда и чай. Нежирный кефир и другие кисломолочные и нитки. Творог протертый, паста, суфле (I рацион), а также пудинги с крупой, морковью, фруктами (II-III рационы). Сметана —для заправки супов. Сыр нежирный, несоленый — II-III рационы;
  • I-III рационы — белковые омлеты, яичные хлопья к овощным бульоном;
  • I рацион — 100-150 г манной каши, протертой гречневой, геркулеса на молоке; II — 150-200 г жидких, вязких непротертых каш, 100 г рассыпчатой гречневой, запеканки манной: III — 200 г каши, отварной вермишели с творогом, запеканки манной с яблоками, пудинга гречнево-творожного;
  • I рацион — 100 г пюре из картофеля, моркови, свеклы (отдельные блюда и гарниры), протертый морковно-творожный пудинг; II рацион дополняют цветной капустой, тертой сырой морковью; III — тушеной морковью и свеклой. Масса блюд — 150 г;
  • закуски при I-II рационах исключены; III — вымоченная сельдь, нежирная ветчина, отварные заливные мясо и рыба, спелые томаты;
  • I рацион — яблочное пюре, желе, муссы; чернослив, курага (разоченные, пюре); 30 г сахара или меда;
  • II-III рационы дополняют сырыми мягкими фруктами и ягодами, печеными яблоками, компотом, молочным киселем и желе, джемом, меренгами; до 50 г сахара, 10-20 г ксилита вместо сахара;

  • II-III рационы — для улучшения вкуса несоленой пищи — кисло-сладкие фруктовые, лимонный и томатный соки, лимонная кислота, ванилин, 3%-ный столовый уксус, соусы на овощном отваре и молоке, вываренный и слегка поджаренный репчатый лук; напитки;
  • I рацион — по 100-150 мл слабого чая с лимоном, молоком, кофейных напитков с молоком, отвара шиповника, настоя чернослива, морковного, свекольного, фруктовых соков;
  • II-III рационы — то же по 150-200 г.

  • сливочное масло и растительные рафинированные масла (в блюда). В III рационе — 10 г сливочного масла.
  • При диете №10и при инфаркте миокарда исключаются:

    • свежий хлеб, сдоба, мучные выпечные изделия;
    • жирные виды и сорта мяса, птицы, рыбы, печень, и другие субпродукты, колбасы, консервы, икра;
    • цельное молоко и сливки, яичные желтки;
    • пшено, перловая, ячневая крупа;
    • бобовые, белокочанная капуста, огурцы, редис, лук, чеснок, пряности;
    • животные и кулинарные жиры;
    • шоколад и другие кондитерские изделия, натуральный кофе и какао, виноградный сок.

    Диета №10и при инфаркте миокарда. Примерное меню дня I, II и III рационов

    I рацион

    Овсяная каша протертая

    50 г овсяной крупы, 120 мл молока, 5 г сахара.

    Крупу измельчить в кофемолке и просеять в кастрюлю. При постоянном помешивании влить молоко (с температурой 80°С) и довести до кипения. Добавить сахар и варить 10-15 мин.

    Читайте также:  Шум в ушах при всд

    Диета № 10и — показания: инфаркт миокарда.

    1. Показания к применению: инфаркт миокарда .

    2. Цель назначения. Диета призвана:

    — обеспечивать восстановительные процессы в очаге поражения сердечной мышцы;

    — уменьшить нагрузку на сердечно-сосудистую систему;

    — улучшать кровообращение в миокарде;

    — регулировать обмен веществ;

    — нормализовать двигательную функцию кишечника и массу тела;

    Врачи-диетологи и клиницисты в диете № 10и выделяют три последовательно назначаемых рациона. Рацион I рекомендуется один раз в неделю больным острым инфарктом миокарда, II — на 2—3 недели, то есть в подостром периоде, и III — на 4 недели — в периоде рубцевания (см. в табл.).

    Рацион диеты №10и при инфаркте миокарда.

    Лечебная диета при инфаркте миокарда, стол № 10и

    Эта диета рекомендована пациентам, страдающим инфарктом миокарда.

    Необходимо акцентировать внимание на том, что тщательно разработанная диета помогает сократить срок реабилитации пациентов после инфаркта. Кроме этого, диета может предотвратить сердечный приступ, поэтому здоровое питание можно использовать для профилактики инфаркта миокарда.

    Основными продуктами в диете должны быть свежие овощи и фрукты, цельнозерновой хлеб.

    Старайтесь есть фрукты и овощи именно свежими, чтобы сохранить все витамины и микроэлементы, которые исчезают при термической обработке.

    В течение первой недели после инфаркта, питание должно быть дробным, небольшие количество пищи принимаются 5-6 раз. Необходимо ограничить в рационе содержание соли. Также необходимо избегать употребление холодных жидкостей. В рационе в первые дни должна присутствовать капуста, спаржа и морковь, так как эти продукты содержат большое количество витаминов, минералов и микроэлементов. Незаменимы жирные кислоты, содержащиеся в нерафинированных маслах, полученных при холодном отжиме орехов. Также рекомендуется льняное масло, которое можно добавлять в салаты и другие блюда.

    Специалисты рекомендуют избегать употребления красного мяса, маргарина, копченостей, колбас и консервов. Очень важно полностью исключить из рациона транс-жиры. Насыщенные транс-жиры очень негативно влияют на сосуды и могут стать причиной развития сердечно-сосудистых заболеваний.

    Рекомендуется регулярное употребление рыбы, брокколи, картофеля, шпината. Все эти продукты помогают регулировать деятельность сердца.

    Некоторые специалисты советуют включать в диету чеснок, который снижает уровень холестерина и триглицеридов, а также препятствует образованию тромбов. Аналогичные советы есть и по употреблению гвоздики, миндаля, пивных дрожжей и семян кунжута.

    Необходимо добавлять в рацион морские водоросли, овощные и фруктовые соки.

    Через 7-10 дней пациента переводят на диету № 10с.

    Диета после инфаркта миокарда достаточно строга, особенно в первую неделю реабилитационно-восстановительного периода. Организм пациента после серьезной операции слишком ослаблен, поэтому важно оградить его от тех продуктов, которые плохо усваиваются. Из меню питания после инфаркта обязательно нужно исключить острую, пряную, жирную и копченую пищу, алкоголь, сладости, кофе и ещё целый ряд продуктов, перечисленных в расположенной ниже таблице.

    Какая диета назначается после перенесенного инфаркта миокарда?

    Данная диета показана после перенесенного инфаркта миокарда на время восстановительного периода пациента.

    Она состоит из трех рационов:

    • В первую неделю назначается рацион 1 (протертые блюда; питание 6 раз в день).
    • На второй и третьей неделе используется рацион 2 (измельченная пища; питание 6 раз в день).
    • На четвертой неделе показан рацион 3 (в меню этой диеты после инфаркта миокарда входят продукты, отваренные кусками; прием пищи 5 раз в день).

    Важно!

    Блюда для питания после перенесенного инфаркта в первую неделю следует готовить без соли.

    Такое меню после инфаркта улучшает кровообращение и обмен веществ, способствует восстановлению организма. Из рациона следует исключить сильно горячие и холодные блюда, жареные продукты. Количество жидкости и соли рекомендуется ограничить.

    Прежде чем узнать, какая диета назначается после перенесенного инфаркта, ознакомьтесь со списком продуктов и блюд, рекомендованных и запрещенных в реабилитационно-восстановительный период.

    Продукты питания после перенесенного инфаркта

    Питание после инфаркта должно быть сбалансированным, а пища – легко усваиваться. При диете после инфаркта миокарда в меню должны входить только те продукты, которые не принесут вреда ослабленному организму.

    В левой колонке таблицы «Питание после инфаркта миокарда» перечислены блюда, которые готовить рекомендуется, в правой – продукты, запрещенные к употреблению:

    Рекомендуется Не рекомендуется
    Сухари и подсушенный пшеничный хлеб (рационы 1 и 2) Хлебобулочные изделия и выпечка
    Пшеничный хлеб вчераш­ний, ржаной хлеб (рацион 3) Жирные, острые и соленые закуски, копчености
    Салаты из свеклы, морко­ви, помидоров и цветной капусты (рационы 2 и 3) Свинина, баранина, субпродукты, мясо утки и гуся, мясные консервы
    Овощные супы с протертой крупой (рацион 1) Копчености и колбасные изделия
    Вегетарианские супы с протертыми овощами; нежирный мясной бульон (рационы 2 и 3) Жирная, соленая, копченая, жареная рыба
    Паровые котлеты и фрикадельки из нежирно­го мяса (рацион 1) Консервированные рыба и морепродукты
    Тушеные и паровые котлеты; нежирное мясо, отваренное куском (рационы 2 и 3) Сливки, жирный творог
    Паровые котлеты и фрикадельки из нежирной рыбы (рацион 1) Жареные яйца, яйца вкрутую и всмятку
    Тушеное или вареное филе; вымоченная сельдь (рационы 2 и 3) Мясные жиры, топленое масло, маргарин, кулинар­ный жир
    Молоко, 1 % -й кефир
    Протертый творог, нежирный несоленый сыр (рацион 3)
    Редька, редис, чеснок, репчатый лук, белокочанная капуста, зеленый горошек, кабачки, огурцы, грибы, шпинат, щавель
    Белковый омлет на пару, яичные хлопья Блюда их соленых, квашеных и маринованных овощей
    Манная, протертая гречневая и геркулесовая каши на молоке (рацион 1) Фрукты с грубой клетчаткой, виноград
    Вязкая гречневая каша, манная запеканка (рацион 2) Пирожные
    Гречнево-творожный пудинг, манная запеканка с яблоками, отварная вермишель (рацион3) Шоколад, кремы
    Несоленое сливочное масло, растительное масло Рыбные, мясные и грибные соусы
    Картофельное, морковное, свекольное пюре (рацион 1) Горчица, хрен, перец
    Натуральный и растворимый кофе, какао, шоколадные напитки
    Цветная капуста, вареные овощи; свежая морковь (рацион 2) Алкогольные напитки
    Тушеные свекла и морковь; помидоры (рацион 3) Газированные напитки, квас
    Яблочные пюре, желе, муссы; пюре из чернослива и кураги(рацион 1)
    Спелые фрукты и ягоды; джем (рационы 2 и 3)
    Овощные, молочные и фруктовые соусы
    Некрепкий чай, напитки из заменителей кофе
    Овощные, фруктовые соки, компоты
    Отвар шиповника
    Минеральная вода без газа

    Составляя меню после инфаркта миокарда, обязательно учитывайте общее состояние пациента.

    Примерное меню на неделю после инфаркта (рацион 1)

    Здесь описано, какая диета после инфаркта назначается в первую неделю реабилитационного периода. Это примерное меню после инфаркта, рекомендованное медиками и диетологами.

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      คอมพิเตอร์ ทำให้ผู้คนรู้จักเกมไพ่อย่างมากขึ้นอย่างรวดเร็วและยังมีรูปแบบการเล่นที่ทันสมัยเข้าใจง่ายซึ่งฉีกกฏการเล่นไพ่ในอดีตด้วยรูปแบบการเล่นไพ่ออนไลน์

      เก็บกำไรเมื่อชนะ
      คือ การเล่นเดิมพันชนะและเก็บกำไรทันทีเป็นการเล่น ที่ควรมีลิมิตในการเล่นต่อวันโดยวันหนึ่งผู้เล่นจำเป็นต้องวางแผนจำนวนไม้/กี่ตา กำหนดไม้เล่นต่อวันโดยการเล่นจนครบไม้หากได้กำไรที่คิดว่าไม่เสมอตัวให้หยุดเล่นและกำไรไว้เหลือเงินทุนเดิมพันไว้เล่นพรุ่งนี้เพื่อเก็บกำไรใหม่
      หากขาดทุนและเล่นจนครบไม้ให้หยุดเล่นเพื่อพักเพื่อตั้งสติ

      สามารถเลือกได้ว่า จะเป็นผุ้เล่น
      หรือเจ้ามือ

      แค่เปลี่ยนรูปแบบมาเล่นบนโทรศัพท์มือถือ และคอมพิวเตอร์แทน แต่ที่ดีกว่าแน่นอน

      อย่าให้อารมณ์เข้ามาเกี่ยวข้อง
      การเล่นนี้เป็นการเล่นที่สนุกและทำเงินได้ดี แต่ในขณะเดียวกัน ก็มีความเสี่ยงที่จะเสียได้ ถ้าท่านไม่มีการศึกษาอย่างรอบคอบ และใช้เทคนิคอย่างมีประสิทธิภาพ นอกจากนี้ยังมีความเสี่ยง ที่จะสูญเสียเงินของท่านเป็นจำนวนมาก กรณีใช้อารมณ์ในการเล่น
      จะส่งผลเสียต่อการเล่นของท่าน เพราะการลงเงินอย่างไม่ระวัง
      จะอันตรายต่อการเล่นมาก ไม่ว่าท่านจะได้หรือเสีย ท่านต้องรู้จักควบคุมตัวเอง ให้มีสติในการเล่นอยู่ตลอดเวลา

      ขั้นตอนของการเล่นไพ่ป๊อก รูปแบบออนไลน์นั้น

      วิธีการเล่นไพ่ป๊อกเด้งออนไลน์ เล่นยังไงให้ถูกต้อง ทำเงินได้

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