Therapeutic diet. Table No. 7 according to Pevzner. Menu for the week

General rules

As you know, a therapeutic diet is prescribed for various diseases and is a prerequisite for their treatment. Nephritis is a group of kidney diseases of an inflammatory (or autoimmune) nature. This includes glomerulonephritis (the process involves the glomeruli of the kidneys), interstitial nephritis (or tubulointerstitial nephritis - the pathological process affects the interstitial tissue of the kidney), pyelonephritis (inflammation of the pelvis and calyx of the kidney). All of these diseases can be acute or occur in a chronic form, which more often causes renal failure .
Table diet number 7 according to Pevzner is designed for patients with kidney disease in the recovery stage - usually 3 weeks after an acute illness and discharge from the hospital. The diet has several varieties, which are prescribed at different stages of the disease (exacerbation, subacute course or persistent remission) and taking into account renal function (absence or presence of renal failure). With these diseases, the kidneys are affected to varying degrees and their function is impaired, and the severity of symptoms also differs. These are increased pressure, frequent urination, changes in urine ( red blood cells , casts, protein) and edema syndrome. All this is taken into account when prescribing different types of diet.

Basic Diet 7 table provides moderate sparing of the kidneys, nutrition is aimed at reducing edema and blood pressure . In addition, it helps improve the excretion of nitrogenous metabolic products from the body. It is distinguished by the restriction of proteins, and fats and carbohydrates are contained within the physiological norm. The daily calorie content of this diet is 2700-2900 kcal. The patient is allowed 80 g of proteins per day (mainly from dairy products), 90-100 g of fats and 400-450 g of carbohydrates (in terms of sugar - 80-90 g). Food is prepared without salt.

Thus, Diet No. 7 for kidney disease has the following features:

• Limitation of salt - food is prepared without salt, but it is allowed to consume a certain amount of it (3-6 g per day) - this depends on the severity of the disease and the severity of renal failure and is provided for in the varieties of the main table. For example, in acute nephritis it is completely excluded, and in chronic tubulointerstitial nephritis in remission and without impaired renal function, up to 7-8 g per day is allowed and only in the presence of arterial hypertension makes it necessary to reduce it to 5 g.
• 80 g of protein is allowed. Milk proteins and egg whites (more easily digestible) are preferred over meat or fish. Plant proteins have less nutritional value than animal proteins.
• When preparing all dishes, meat and fish (they are allowed in quantities of 150 g) are first boiled and then baked, stewed or fried. This technological technique significantly reduces the amount of extractive substances in the finished dish.
• Avoid foods rich in essential oils (celery, fresh dill, parsley, basil, garlic and fresh onions) and sources of oxalic acid (spinach and sorrel).
• In case of kidney disease, the amount of fluid consumed is limited - from 0.9 to 1.1 liters. More accurately, it is calculated by the amount of urine excreted over the past day and should not exceed diuresis by 300–400 ml. In end-stage renal failure, fluid is significantly limited to 0.7-0.8 liters.
• Products that have a diuretic effect are required: pumpkin, cucumbers, zucchini, beets, green salads, fresh apricots, raisins, dried apricots, apricots, prunes, watermelon and melon.
• 5 meals a day are provided.
• The daily diet should not exceed 3 kg by weight.
• Mandatory inclusion of vitamins A , C , B1 , B12 , K .
• Any alcoholic drinks, strong tea and coffee, cocoa, chocolate, spicy and salty snacks that irritate the kidneys are excluded.
• The intake of sodium mineral waters is prohibited.

General characteristics of dietary table No. 7

Diet No. 7 satisfies a person’s physiological needs for nutrients and energy, and is enriched with plant fiber. Nitrogenous extractives (purines), oxalic acid, and foods rich in essential oils are sharply limited. The amount of proteins is slightly reduced, table salt is completely eliminated. Food is prepared steamed, boiled and baked; fried foods are allowed. Dishes are not chopped. Diet No. 7 provides for fractional meals 4-6 times a day. The amount of liquid is limited. The diet is an intermediate stage in transferring the patient to a normal diet. Used after diet 7B or after 3-4 days of fasting (for acute diffuse glomerulonephritis).

Varieties

Treatment Table No. 7A is prescribed for nephritis with severe renal failure. This is a completely salt-free, plant-based diet with a significant protein limit of up to 20 g.

The amount of fluid you drink depends on your urine output in the previous day. It is usually prescribed for 20 days. When the acute process subsides and azotemia Diet 7B is recommended , in which, compared to the previous one, the amount of protein (40 g) and liquid 1-1.2 liters is doubled. It is seen as a transition to Diet No. 7.

Table 7B is recommended for nephrotic syndrome (edema, loss of protein in the urine) and is aimed at replenishing protein, so its daily content in the diet reaches 125 g. Liquid (0.8 l) and salt are significantly limited.

Table 7G is indicated for patients on hemodialysis when they have renal failure . The therapeutic diet is characterized by a protein content of up to 60 g, 2-3 g of salt and 0.7 liters of liquid are allowed.

Chemical composition and energy value of dietary table No. 7

Proteins: 80–85 g (including 40 g animal proteins). Fats: 70–80 g (including 30 g vegetable fats). Carbohydrates: 300–330 g (including no more than 30–40 g of simple carbohydrates). Daily calorie content: 2,200 – 2,400 kcal. Free liquid: no more than 1.5 l. Table salt: excluded or given to the patient in quantities of up to 5 g per day. Vitamins: retinol (A) – 0.3 mg, riboflavin (B2) – 2.5 mg, thiamine (B1) – 1.7 mg, nicotinic acid (B3) – 20 mg, ascorbic acid (C) – 150 mg. Macroelements: sodium – 2.3 g, potassium – 4.5 g, calcium – 1 g, magnesium – 0.5 g, phosphorus – 1.6 g. Microelements: iron – 6 mg. Optimal food temperature: from 15 to 65 degrees Celsius.

Authorized Products

The dietary table provides for limiting salt, so the patient should eat only home-baked salt-free bread, pancakes or pancakes also without salt. All food is prepared without salt, but it is allowed to add salt to ready-made dishes, using 3-5 g per day.

Soups are prepared in vegetable broth with the addition of vegetables, cereals, and vermicelli. Borscht, cabbage soup and beetroot soup are allowed. Season them with sour cream, butter, dill, parsley, caraway seeds, and, if desired, citric acid. Onions can be added to first courses after preliminary boiling and sautéing.

Main courses are prepared from lean meat (chicken, beef, lamb, turkey, tongue). It must be remembered that all meat and fish products must first be boiled, and then, if you want to get a crust, lightly fried or baked.

Therefore, it is better to serve all protein dishes in pieces, and from boiled minced meat you can make cabbage rolls, stuffed vegetables, and pancakes with meat. The fish is also chosen to be low-fat, boiled in pieces and baked if desired; you can prepare a jellied dish from it. You can use sauces in dishes: tomato, sour cream, milk, any vegetable, onion (from boiled and sauteed onions), sweet gravy. Allowed dried herbs are added to them.

All cereals and pasta can be used as a side dish and in soups. Porridge is boiled in water, cereals are used to make puddings and cutlets with the addition of vegetables. Allowed are casseroles with noodles (pasta) and cottage cheese, fruit pilaf, cereals and pasta with the addition of prunes, dried apricots, raisins and jam.

The following dairy products are allowed: milk, cream, curdled milk, yogurt, cottage cheese and dishes made from it with apples, carrots and rice. Sour cream is added to dishes in limited quantities. 2 eggs per day are allowed, provided that proteins (cottage cheese, meat and fish) are reduced. Eggs are added to dishes, made into an omelet or soft-boiled.

Many vegetables are allowed (except radishes, radishes, celery, garlic, fresh onions). They can be boiled, stewed, added to casseroles and made into vegetable cutlets, salads from boiled and fresh vegetables and boiled meat. Do not add onions, sauerkraut and pickles. You can add cumin and dried dill to stewed vegetables.

All ripe fruits and berries are allowed in fresh and processed form: puree, jelly, jelly, baked, compotes, jam. You can add cinnamon to desserts. Candies (except chocolate), honey and fruit ice cream are also allowed as desserts. Drinks include any juices, weak coffee, tea with lemon, rosehip infusion.

Table of permitted products

Permitted and prohibited products

The following products are prohibited:

• rich and puff pastry products;
• pickles, marinades and smoked meats;
• mushrooms, beans;
• sorrel;
• radish;
• salted cheese;
• semi-finished products;
• chocolate and cocoa;
• ice cream;
• garlic;
• cauliflower.

Permitted products include:

• most vegetables;
• parsley, dill;
• low-fat fermented milk products;
• eggs;
• pasta in limited quantities;
• sugar;
• tea;
• melted butter;
• butter;
• jelly, mousse, jelly;
• compote;
• tea with rosehip;
• dried fruits.

It is better to choose chicken and veal from meat. You can prepare dishes from rabbit, lean pork, turkey, and beef.

Unsalted foods seem tasteless. To get used to such food, you can use some tricks. Salt, for example, can be replaced with seasonings. Dishes are seasoned with herbs, lemon juice, cinnamon, etc.

To improve the taste, buckwheat is seasoned with butter. Pilaf with fruits or milk porridge are prepared from rice. Cabbage can be supplemented with cranberries or carrots.

Prohibited products.

Fully or partially limited products

You cannot salt food. It is also not allowed to eat regular bread, and add salt to homemade flour products. Meat, fish, and mushroom broths, legume broths, pea and bean soups are excluded. Fatty varieties (pork, duck and goose), sausages, smoked meats, and canned food are excluded from meat products. You should not eat fried foods or stewed meats without first boiling them.

Fatty types of fish, salted and smoked, canned fish and fish caviar are not allowed. Any cheese should be excluded due to its high salt content. It is expected to exclude legumes, onions, garlic, radishes, sorrel, spinach, radishes, as well as all salted and pickled vegetables and mushrooms from the diet. Pepper, mustard, and horseradish should be excluded from seasonings and sauces. Any pickled or pickled vegetables are not allowed. Animal fats are prohibited. Strong coffee, mineral waters with sodium, and cocoa should be excluded from drinks.

Cream, sour cream, milk soups, lard are limited.

Table of prohibited products

Strictly contraindicated products

Therapeutic nutrition within the framework of table No. 7 according to Pevzner implies the exclusion of the following products from their diet:

• bakery products of traditional baking (that is, with table salt and soda);
• confectionery products;
• peas and beans;
• fish, meat and mushroom broths;
• meat and fish of fatty varieties;
• sausages;
• canned products;
• cheeses;
• salted, pickled and pickled vegetables;
• radish and radish;
• mushrooms;
• ice cream and chocolate products;
• strong coffee and tea, cocoa, mineral and sweet waters.

Menu (Power Mode)

Now that we have found out the main points and products that the therapeutic Diet No. 7 includes, the menu for the week can be developed without much difficulty. You need to try to make your diet varied, since all cereals, cottage cheese, meat and all (with minor exceptions) vegetables are allowed. Dried herbs can be added to dishes, and all sauces can be prepared.

The only limitation is salt. The amount of it in ready-made dishes is discussed with the doctor. To diversify the menu, try to master bread baking - bake unsalted bread with different seasonings (carrots, pumpkin, cumin, dried dill, parsley) and sweet bread (muffin) with raisins, dried apricots, prunes, apples, enhancing the taste with cinnamon. Any homemade pastry is also available, but not salty.

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Diet 7A is the strictest of all varieties. It is prescribed to a patient in a hospital with acute severe kidney disease. Meals are 5-6 times a day and consist mainly of vegetables, fruits and cereals. Proteins are allowed in quantities of only 20 g-25 g - this means that a piece of meat or chicken is allowed only for lunch and a little milk with cereals. An approximate calculation of the amount of protein in products is carried out by protein “units”. One unit corresponds to 6 g of protein and is contained in: 25 g of cooked meat (or poultry), 30 g of boiled fish, 45 g of cutlets (meat or chicken), 1 egg, 25 g of hard cheese, 1 cup of milk, 30 g of cottage cheese , 200 g sour cream.

Specialized products containing little protein (artificial sago, protein-free bread, salt-free bread made from maize starch, amylopectin starch) are widely used. You can consume 300-400 g of such bread per day, in the absence of bran bread - 200 g. The amount of fats and carbohydrates is moderately reduced. Sugar - 75 g for the whole day. Salt is completely excluded, the amount of liquid is with the doctor's permission.

Table 7A diet menu looks like this:

What does following a diet give and reviews

Conscientious adherence to nutritional recommendations will reduce the load on the filtration apparatus of the kidneys, improve their structural and functional state and gradually get rid of the signs of the disease that led to the deterioration of the general condition. The duration of compliance with dietary recommendations is determined individually, depending on the nature and severity of the pathological process.

People who follow the seventh table diet notice improvement in kidney function, reduction in swelling, restoration of blood pressure and other positive aspects in the body after just a few days. The diet is varied and nutritious. But many note that eating without salt, which is provided by diet No. 7, quickly gets boring and makes the food bland.

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Ilona Ganshina

02.10.2018

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Recipes

First meal

Brussels sprouts soup

Potatoes, carrots, onions, tomatoes, vegetable oil, Brussels sprouts (or broccoli).

Place the chopped potatoes into boiling water. Lightly saute chopped carrots, tomatoes and onions in vegetable oil (they must first be boiled for 1 minute). When the potatoes are almost done, add the dressing and cabbage. Boil for another five minutes.

Vegetarian borscht with prunes and sour cream

Beets, white cabbage, potatoes, tomato paste, onions, prunes, vegetable oil, sour cream.

Place the chopped potatoes in a saucepan with water. Finely chopped beets and onions simmer over low heat under a lid. Add vegetable oil and tomato paste. Boil prunes separately in a small amount of water. When the potatoes are almost ready, add the dressing to it, add the prune broth and at the end add shredded cabbage and boil. Add prunes to the prepared borscht and serve with sour cream.

Second courses

Pilaf with fruits

Pilaf with fruits

A glass of rice, carrots, 7 pcs. dried apricots and prunes, 50 g raisins, dried apples, apple (grape) juice 2 cups, vegetable oil.

Cut the carrots into strips and fry in vegetable oil. Wash the rice, cut the dried fruits. Place carrots, rice and dried fruits in a thick-bottomed cauldron. Pour the juice over everything and cook over low heat for 30-40 minutes with the lid closed until the rice is cooked. You can add walnut oil to the finished pilaf and mix.

Lapshevnik with cottage cheese

200 g noodles, 200 g cottage cheese, one egg, 1 tbsp. l. sugar, 50 g butter, 2-3 tbsp. l. sour cream.

Boil the noodles, grate the cottage cheese and add to the noodles. Add melted butter and egg, mashed with sugar. Place the mixture in the mold and brush with sour cream. Bake until golden brown. Serve with sour cream, honey or jam.

Dessert

Pumpkin with apples, cinnamon and nuts

0.5 kg pumpkin, 2-3 apples, 40 g butter, cinnamon, 1 tbsp. l. honey, any nuts.

Cut the peeled pumpkin and apples into pieces. They can be baked in the oven in a suitable form with a little water or stewed in a pan. Sprinkle the finished dish with cinnamon, add butter and honey. Decorate with nuts.

Carrot-apple cutlets

200 g apples, 200 g carrots, 1 tbsp. l. butter, 2 chicken whites, 1-2 tbsp. l. semolina, sugar, sour cream or honey for serving.

Stew the grated carrots in butter, add grated apples, and a little water if necessary. Add whipped egg whites, sugar and semolina to the warm carrot-apple mixture. Mix well, form into cutlets, fry in a pan or bake in the oven. Serve with honey or sour cream.

During pregnancy and lactation

A form of late toxicosis is nephropathy of pregnancy. It includes characteristic symptoms that appear in the third trimester of pregnancy : edema , hypertension and the presence of protein. Primary nephropathy develops in healthy women with no history, and secondary nephropathy develops against the background of pre-existing diseases ( glomerulonephritis , pyelonephritis , heart defects, diabetes mellitus ). A constant sign of it is progressive hypertension , after a while proteinuria (protein in the urine) joins and increases. The severity of edema can vary - from mild pastiness of the hands and face to swelling of the entire body.

In such cases, in addition to medication prescriptions for pregnant women, therapeutic nutrition is simply necessary. Inpatient treatment is required for constant monitoring of blood pressure, renal function and blood electrolytes. The diet consists of limiting salt consumption to 1.5-2.5 g, as well as liquid to 1 liter. A sufficient amount of protein, plenty of vegetables, fruits and foods high in potassium are recommended. Fasting days (curd, kefir, fruit) are prescribed weekly.

After discharge from the hospital, a pregnant woman is recommended to take the main Table No. 7, which has an increased salt content, before giving birth. Women who have kidney disease should follow this diet after childbirth.

Table 7 for pyelonephritis and kidney disease

Diet number 7 is prescribed for a diagnosis of acute or chronic nephritis (in remission), for kidney failure, pyelonephritis, hypertension, metabolic disorders, a tendency to edema, as well as during situations where a salt-free, sparing diet is necessary. Thanks to such a diet, the risk of edema is reduced, as a result of the inability to completely remove waste products from the body.

The table shows the main diseases for which diet number 7 and its derivatives are indicated:

Expert opinion

For different diseases, different nutritional systems are recommended.

1. Diet table 7 (7a) and 7b are the most common for any kidney disease. For example, for acute forms of glomerulonephritis in moderate or severe form, diet number 7a is recommended, which is considered the most strict, since it contains only 20 g of protein per day, and only 15 g of which is of animal origin. It is recommended to eat food in 5-6 meals while lying in bed.
2. Diet 7b already contains 40g of protein. Salt in these subtypes of the diet is contained only in the composition of the products. Diet 7a is prescribed for a short period of up to 20 days, after which the patient is transferred to diet No. 7b. Then, as you recover, diet No. 7 is prescribed. In mild stages of the disease, diet 7b or 7 is immediately prescribed.
3. Chronic glomerulonephritis in the acute stage begins to be treated with diet No. 7B until a marked improvement in the condition. Then they move on to diet No. 7.
4. In case of renal failure, it is recommended to start with diet No. 7a.

Reviews and results

This therapeutic food cannot be called monotonous, since almost all products and various technological methods of cooking are allowed. You can diversify it with many new dishes. The only drawback, according to many patients, is the unsalted and tasteless dishes. It is very difficult for some to get used to this, but high blood pressure and the presence of edema require salt restriction. Reviews note the effectiveness of this therapeutic nutrition: after 3-5 days, swelling of the face and hands decreases, blood pressure normalizes, and general condition improves.

• “... I was prescribed a kidney test during pregnancy because edema appeared and protein was found in the urine. The pressure was normal. I kept a diet with limited salt until the birth. It was hard, but for the sake of the child, anything can be endured. The doctor said that there could be premature birth, placental abruption and even eclampsia during childbirth. I followed all the recommendations and was hospitalized twice”;
• “... After acute glomerulonephritis (there was a severe sore throat), this diet was prescribed for six months. I checked my tests all the time. Only six months later, the doctor allowed me to increase the amount of salt and slightly expand my diet. The hardest thing is to get used to eating without salt. This was difficult for me, sometimes I just took a crystal of salt and dissolved it”;
• “... There was swelling and high blood pressure with acute glomerulonephritis. Allowed 5 g of salt - this is a level teaspoon. It was hard to bear, but I strictly measured the prescribed amount and did not violate the recommendations. Of course, it was impossible to eat ready-made store-bought products that contain salt. I excluded sausages, pickles, and smoked foods for almost a year. It was difficult, since I had to cook myself and take lunch to work - I canceled snacks in a cafe with my girlfriends.”

Kidney Diet No. 7

Diet table No. 7 can be prescribed for acute nephritis in the recovery stage, hypertension, pyelonephritis and in other situations when there is a need for a salt-free diet. This nutritional system helps reduce edema, maintain renal function, and accelerate the removal of metabolic products from the human body. Diet table No. 7 is characterized by a somewhat limited protein content in the diet, and carbohydrates and fats are present within the physiological norm.

The amount of salt is regulated by the attending physician. The daily volume of free fluid is reduced to approximately one liter. Extractive substances from mushrooms, fish, meat, as well as sources of essential oils and oxalic acid are excluded. Fish and meat should be boiled. The food temperature is normal. The diet is split, about six times a day.

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