Diet 4 on the table - do's and don'ts. Diet “4 table” - features, nutritional recommendations, menu

Therapeutic diet 4 (table 4) is prescribed for acute and chronic colitis, enterocolitis, in the initial stage of acute gastroenterocolitis, as well as for dysentery, typhoid fever and intestinal tuberculosis. The diet helps reduce fermentation and putrefactive processes in the intestines, stop the inflammatory process and restore impaired functions of the digestive tract, as well as transfer its functioning to a more gentle mode. Diet 4 is prescribed by doctors in order to reduce the amount of fats and carbohydrates in the patient’s diet. The diet is designed to ensure the supply of food that will not cause thermal or mechanical irritation of the digestive organs, and will not increase the secretion of bile. In Diet 4, food is boiled or steamed. To make food easier to digest and digest faster, it is ground or pureed.

The energy value of the diet at table 4 should be about 8583 kJ (no more than 2050 kcal). Of these, fats should be no more than 70 grams (50 g butter), proteins - 100 grams (about 70% animal proteins), carbohydrates - 250 grams (40-50 g sugar). Sodium chloride should be no more than 8-10 grams in the diet, and free liquid should be no less than 1.5 liters. During the diet, it is very important to maintain bed rest. Food on diet 4 should be taken warm up to five to six times a day.

With diet 4, it is allowed to eat thinly sliced ​​and not toasted crackers from two hundred grams of wheat bread and savory cookies. Fresh and Rye bread, products from butter dough, pancakes, pancakes.

It is allowed to eat boiled vermicelli, rice, semolina, oatmeal, pureed buckwheat porridge, cooked in low-fat broth or water, as well as in the form of steam puddings. During diet 4, you cannot eat pearl barley, barley porridge, legumes, or pasta casseroles.

It is allowed to consume lean varieties of veal, beef, rabbit meat, turkey, and chicken. The meat is first degreased, tendons and fascia are removed. Meat is prepared boiled in water or steamed meatballs, dumplings, cutlets. Instead of bread, add boiled rice to the minced meat for cutlets, and then pass it through a fine grinder three to four times. A soufflé is prepared from boiled meat. During diet 4 (table 4), it is prohibited to use fatty types and varieties of meat, fried and stewed meat in pieces, smoked meats, sausages.

Soups on diet 4 are cooked in a weak low-fat fish or meat broth with rice or semolina, pureed or boiled meat, meatballs and steamed quenelles, and egg flakes. During this diet, you should not consume milk soups, as well as soups made with fatty and strong broths with vegetables and pasta.

Diet 4 menu may include dishes from low-fat fish (in the form of quenelles, meatballs, cutlets). Fish dishes can be boiled in water or steamed. You cannot eat salted fish, fatty fish, canned food, or caviar. You are allowed to eat one or two eggs daily. Eggs can be soft-boiled and cooked steam omelette, add to various dishes.

You can add a small piece of butter (5 g) to ready-made dishes. Cooking and animal fats should not be used for cooking.

Diet 4 is prohibited from including dairy products. You can only eat freshly prepared pureed unleavened or calcined cottage cheese.

During therapeutic diet 4, you cannot eat berries and fruits in their natural form, as well as compotes, dried fruits, jam, honey and other sweets. You can make jelly and jelly from dogwood, blueberries, quince, pears, and bird cherry. Sugar can be added to dishes in limited quantities (no more than 50 grams per day). Vegetables can only be consumed in the form of decoctions added to soups. Snacks, spices and sauces are excluded from the diet.

You are allowed to drink tea, cocoa with water, coffee, juices of non-acidic fruits and berries diluted with water. It is allowed to use decoctions of dried blueberries, dogwood, rose hips, quince, and black currants. You cannot drink cocoa and coffee with milk, cold and carbonated drinks, grape juice, kvass.

Diet 4 menu might look like this:

• first breakfast: oatmeal cooked in water, freshly prepared grated cottage cheese, tea with one teaspoon of sugar;
• second breakfast: applesauce;
• lunch: meat broth with rice cereal, steamed meatballs, semolina porridge, jelly.
• afternoon snack: unsweetened blackcurrant decoction;
• dinner: steam omelette, buckwheat porridge cooked in water (mashed), tea.
• jelly before bed.

General characteristics of the therapeutic diet 4b

Therapeutic diet 4b is prescribed for exacerbation of chronic intestinal diseases, as well as for acute intestinal diseases at the stage of improvement. Diet 4b helps reduce inflammation and normalize the functioning of the digestive system. With this type of diet, foods that aggravate fermentation and putrefaction in the intestinal area, irritate the liver and sharply stimulate the secretion of the pancreas and stomach are prohibited. Diet 4b involves eating five or six meals a day. The energy value of diet 4b should be no more than 2600 kcal. Of these, proteins should account for 100-110 grams, fats - 80-90 grams, carbohydrates - 350-400 grams, 8-10 grams of salt and one and a half liters of free liquid. By chemical content and size energy value Therapeutic diet 4b is not complete, but the amount of protein is slightly increased.

With diet 4b, it is allowed to eat dried or day-old wheat bread made from first- or highest-grade flour, dry biscuits, and dry cookies. Rye bread, puff pastry or pastry products, and wheat bread made from wholemeal flour are prohibited.

Low-fat and low-fat types and varieties of meat are allowed. Therapeutic diet 4b prohibits fatty varieties and types of meat. It is not allowed to eat goose or duck meat, various sausages, smoked products, and canned food. You can add cutlets, dumplings, and meatballs from low-fat fish to your diet. The consumption of salted, smoked, fatty fish and canned food is prohibited. You can add milk, cream, and sour cream to dishes. You can eat acidophilus, kefir and other fermented milk drinks. It is allowed to eat curd paste, fresh cottage cheese, puddings, and mild cheese. Well-cooked porridge is allowed. When preparing porridge, you can add a third of the milk to the water. With diet 4b, you are allowed to eat fresh and ripe tomatoes (50-100 g per day). Sweet and ripe fruits, previously peeled, are recommended for food (up to 100 g per day). Sauces based on vegetable broth or weak meat broth are recommended. Fruit sauces and milk sauces are allowed. You can add dill, parsley, cinnamon, vanillin, and bay leaf to dishes.

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Developed by the Soviet scientist M.I. Pevzner, the therapeutic diet table 4 helps to cope with acute intestinal diseases accompanied by diarrhea, in particular, colitis, enterocolitis, dysentery, intestinal tuberculosis, typhoid fever, food poisoning. Table 4 diet menu is prescribed by gastroenterologists during periods of exacerbation of gastrointestinal pathologies.

Varieties of diet No. 4:

• table 4a - therapeutic nutrition is intended to restore the functionality of the intestines in case of colitis with pronounced processes of putrefaction, increased gas formation and fermentation;
• Table 4b – a diet that helps the body cope with chronic colitis in the subsiding stage of exacerbation (prescribed after table No. 4a).

The 4-table diet for intestinal diseases relieves inflammation, reduces fermentation and putrefactive processes, restores the functioning of the entire gastrointestinal tract, and reduces the load on the digestive system through a gentle diet.

Characteristics and features of diet table 4

A decrease in the calorie content of the daily diet when following table 4 occurs due to a decrease in the amount of fats (up to 70 g) and carbohydrates (up to 250 g) supplied with food, while the protein norm remains unchanged (about 90 g, of which 2/3 comes from animals) .

• Daily portion table salt– from 8 to 10 g, volume of free liquid – from 1.5 to 2 liters. The total calorie content of the menu is 2000 kcal (8584 kJ).

Meals are provided in fractional meals, five to six times a day, in small portions. All products should be boiled, steamed or in a slow cooker and then chopped.

It is unacceptable to fry and bake foods, as well as consume any canned food, pickled foods, pickles, or smoked foods. Warm dishes are served only with liquid, pureed or pureed consistency.

In this way, thermal and chemical irritation of the gastric and intestinal mucosa is minimized.

What is possible and what is not allowed on the 4 table diet (TABLE 1)

The list of permitted and prohibited products is presented in the table below; for convenience, the products are divided into menu categories for the day.

Name of dishes and products	What is possible	What not to do
First meal	Soups with water and low-fat, always weak, broth with the addition of mucous cereal decoctions	Milk soups, products made with strong meat, fish, vegetable and mushroom broth, soups with cereals, pasta, ungrinded and prohibited vegetables
Meat and fish dishes	Steam cutlets, meatballs, meatballs, soufflé, quenelles. Lean varieties of meat and fish with tendons and fascia removed are boiled (steamed) and ground, passing through a meat grinder with a minimum hole diameter. Bird carcasses must be skinned and fat removed.	Any smoked meat and fish, fatty fish and meats, canned food, fish roe, fish oil, sausages, offal, meat and fish served in pieces, semi-finished products, fast food
Side dishes	Puree vegetables (limited), ground porridge (rice, oatmeal, buckwheat, semolina) in water with the addition of a small amount of milk, cereal flour dishes in water	Millet, pearl barley, barley porridge, pasta, vermicelli
Dessert	Sugar is added to prepared dishes in limited quantities (no more than 50 g/day), mousses, jellies and jelly from permitted fruits	Confectionery, sweets, butter cookies, cakes, pastries, chocolate, cocoa with milk, compotes, honey, jam, other sweets
Vegetables	Use all vegetables with caution, adding them grated to soups. Potatoes, zucchini, carrots, pumpkin are healthy	Legumes, cabbage, except cauliflower, garlic, onions, leafy greens, peppers, tomatoes, any mushrooms
Fruits and berries	You should only eat fruits with astringent properties: dogwood, pear, bird cherry, quince, blueberry, black currant. They are used to make jelly and jelly for dessert. Baked apples are healthy.	Any fresh fruits and juices squeezed from them are not allowed in the diet.
Beverages	Herbal, weak black and green teas, cocoa in water, natural weak coffee, decoctions of dried rose hips, blueberries, bird cherry, black currant, still mineral water (as prescribed by the treating doctor)	Carbonated drinks, energy drinks, lemonade, cold drinks, alcohol
Milk products	Fresh cottage cheese, acidophilus, milk only as an additive to dishes (porridge, soups, puddings, omelettes), but not more than 70-100 ml per day	Cream, sour cream, kefir, fermented baked milk, cheese
Fats	Vegetable oils: soybean, corn, sunflower, grape seed, sea buckthorn, rose hips, flaxseed, pumpkin, nut, etc. for greasing molds and adding to purees (no more than 5 ml per day), natural unsalted fresh butter, it is added only to ready-made meals (about 5 g per serving)	Margarine, cooking and animal fats
Eggs	Eat no more than 2 pieces per day. soft-boiled chicken eggs. It is best to cook a steamed protein omelet	Fried, raw, hard-boiled eggs
Bread	The daily norm should not exceed 0.2 kg of dried wheat bread or shortbread cookies	Rye, fresh bread, pastries, butter and puff pastry products, long and pancakes, pancakes
Seasonings for food	It is acceptable to use dried parsley and dill in small quantities, white milk sauce	Sauces, ketchups, mayonnaise, spices, seasonings, aromatic herbs with a high content of esters

Table 4 The diet for children is similar to the adult diet, only the portions are reduced depending on the age of the child.

Diet 4 table - menu for the week + recipes

Breakfast

• Option #1. Oatmeal on water: boil 40 grams of rolled oats flakes in 0.4 liters of water for 10 minutes, grind through a sieve, add a pinch of salt and ½ teaspoon of butter.
• Option #2. Protein omelet: Beat 2 egg whites, a pinch of salt and ¼ cup of water with a whisk or fork, pour into a glass bowl, greased with oil, steam in a saucepan or double boiler.

As a drink, choose from: green or chamomile tea, black coffee with a drop of whole milk, or a drink made from chicory root powder.

Lunch

• Option No. 1: Boil a tablespoon of dried blueberries in 0.25 liters of water over low heat (about a quarter of an hour), strain, cool to a temperature of 25-30°C.
• Option No. 2: bake a medium apple in the oven or microwave until soft, remove the skin, eat the pulp.

Dinner

First

• Option #1. Broth with semolina: boil 0.35 liters of weak chicken broth, add in a thin stream, stirring constantly, 15 grams of semolina and a pinch of dried dill, boil for about 20 minutes, serve warm with cubes of wheat bread croutons soaked in a plate.
• Option #2. Turkey meat puree soup with rice: 2 tbsp. Rinse spoons of rice in cold water, boil in 0.6 liters of water until tender, wipe with liquid, puree boiled turkey fillet (70 g) in a blender, combine with rice porridge and bring the dish to a boil. Before serving, add 5 grams of butter to a plate.

Garnish

• Option #1. Liquid mashed potatoes: boil 200 grams of peeled and cut into pieces tubers in a liter of water, drain the broth, leaving at least 100 ml, add a pinch of salt and 5 grams of butter, puree with a masher.
• Option #2. Buckwheat porridge: 2 tbsp. Boil tablespoons of cereal for 15 minutes in a glass of water (300 ml) with salt added (at the tip of a teaspoon), grind through a sieve or pass through a food processor, add a teaspoon of butter.

Meat or fish

• Option #1. Veal meatballs: grind 100 grams of boiled lean veal to puree in a blender, combine with 20 grams of rice boiled in salted water, add 1/5 teaspoon of table salt, beat out the minced meat, form it into balls 2-3 cm in diameter, boil in water or in a special steamer form.
• Option #2. Fish soufflé from hake fillet: mince 100 grams of raw fillet at least 3 times, beat in the egg yolk, dilute 5 grams of wheat flour in 30 ml of milk, boil the white sauce for about 3 minutes, add to the cutlet mixture, mix, place in greased vegetable oil the mold and place in a double boiler.

Beverages

• Option #1. Bird cherry jelly: pour boiling water (1/4 liter) over 15 grams of dried berries, simmer for a quarter of an hour, leave covered for about 45 minutes, filter, add 15 grams of granulated sugar, put on the stove, add 10 grams of potato or corn starch, diluted in a small portion of cold water, stirring constantly with a wooden spatula/spoon, bring to a boil, pour into a glass.
• Option #2. Decoction of wild rose hips: about 20 grams of dry berries crushed with a knife, pour hot water (1/4 liter), bring to a boil, pour into a thermos or wrap a container, leave for at least 4-5 hours, sweeten with a teaspoon of sugar if desired.

Afternoon snack

• Option No. 1: 100 grams of calcined fresh cottage cheese with sugar and biscuits.
• Option #2. Cottage cheese casserole steamed: mix 150 grams of cottage cheese with a teaspoon of sugar and one egg, add 5 grams of semolina, knead, transfer to a greased mold and place in a multicooker, turning on the “steam” mode.

Dinner

• Option #1. Steamed potato croquettes with fish: puree 120 g of boiled potatoes, combine with the egg mixture (beat 1/3 with a fork chicken egg or 1 quail), 10 grams of butter, knead, roll in flour and form flat cakes with your hands, place ground and salted pollock fillet in the middle, pinch the ends, form into balls, place them in a steamer mold, previously greased with vegetable oil, steam 20 minutes.
• Option #2. Carrot-apple soufflé: 60 grams of cauliflower stalks, simmer in water, add diced carrots and apples (60 grams each), boil in ½ cup of water for 10 minutes, add 15 grams of semolina and 5 grams of granulated sugar, bring to a boil, cool , grind through a sieve, add a third of a beaten egg and 5 grams of butter, mix thoroughly, place in a mold greased with oil and cook in a slow cooker, setting to “casserole” mode.

An experienced nutritionist will help you create a menu for the week. You can independently plan your meals for several days in advance, based on the table provided and using our recipes.

Let digestive system never lets you down. Be young and healthy!

Medical diet 4b according to Pevzner, as a rule, is prescribed to patients with chronic or acute intestinal diseases during the recovery period. With this diet, you should eat small meals five times a day.

Table 4c is a diet in which the protein content increases and the consumption of salt, as well as other foods that irritate the intestines, decreases. The menu reduces the consumption of dishes that contribute to fermentation and rotting in the intestines and active bile secretion.

Diet 4c: weekly menu, recipes

Soups.
You can eat soups prepared with light, low-fat fish and meat broth, as well as vegetable broth. Add meatballs to soups minced meat, dumplings, various cereals (except millet), noodles, vermicelli, potatoes, carrots, zucchini, cauliflower and white cabbage, beets and green peas. All fatty broths, borscht, cabbage soup, milk soups, rassolnik, okroshka, mushroom soup and bean soup.

Flour products.
You can eat wheat bread made from higher grades of flour, as well as slightly dried or yesterday's bread. Biscuits and dry cookies are allowed, and a couple of times a week you can indulge in savory buns, apple pies, cheesecakes, etc. You cannot eat rye and fresh bread, butter and puff pastry.

Poultry and meat.
Lean beef, veal, rabbit, chicken and turkey are allowed. Meat should be without tendons, and poultry should be without skin. They need to be steamed or boiled. Smoked meats, canned food, fatty meats, almost all sausages and goose meat are prohibited.

Fish.
Preference should be given to low-fat varieties of fish, steamed or boiled. In small quantities you can eat baked or slightly fried fish. Canned food, fatty, salted and smoked fish are prohibited.

Dairy products.
If there is no intolerance, you can consume milk by adding it to different dishes. Fermented milk drinks, natural cottage cheese, cream and sour cream (added to dishes) and mild cheese are allowed. Salty and spicy cheeses, as well as foods with high acidity, are excluded.

Eggs.
You can eat no more than two eggs per day, steamed, soft-boiled or added to dishes. Prohibited fried eggs and hard-boiled.

Cereals.
You can eat different porridges, except pearl barley, millet and barley. Cook them mainly in water (no more than 1/3 milk). Any legumes are prohibited.

Vegetables.
Allowed are zucchini, potatoes, cauliflower, carrots, pumpkin, if there is no intolerance - beets, white cabbage, green peas, up to 100 grams of tomatoes per day. You cannot eat radishes, onions, garlic, radishes, spinach, sorrel, mushrooms, cucumbers and rutabaga.

Sweets, fruits.
Berries and fruits can be eaten in limited quantities - up to 150 grams per day. Fudge, marshmallows, jam, marmalade, preserves, and honey are allowed. Apricots, figs, plums, cakes, chocolate and ice cream are prohibited.

Spices and sauces.
You can prepare sauces using meat broths, vegetable broths, as well as fruit and milk sauces. Spices allowed are cinnamon, vanilla, bay leaf, dill and parsley. You should avoid mustard, fatty and hot sauces, pepper and horseradish.

Beverages.
Tea, coffee and cocoa can be drunk with or without milk. Rosehip decoctions will also be useful. Tomato, berry and fruit juice should be diluted with water. You will have to exclude apricot, grape and plum juice.

Fats.
You can use butter in dishes in an amount of no more than 15 grams (for one meal). You can also add up to 5 grams of vegetable oil to salads, sauces, fish and meat dishes. All other fats are strictly prohibited.

Diet “4 in the table”: what is possible, what is not, table

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  Table 1: diet for gastritis and ulcers. Table 1a and 1b: menu…
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  Table 10a medical diet: nutrition rules, menu...

Indications:

acute diseases and a sharp exacerbation of chronic intestinal diseases with severe diarrhea.

Diet Goal #4: provide nutrition for indigestion, reduce inflammation, fermentation and putrefactive processes in the intestines, help normalize the functions of the intestines and other digestive organs.

general characteristics diet number 4: a diet of reduced calorie content due to fats and carbohydrates with a normal protein content. Mechanical, chemical and thermal irritants of the gastrointestinal tract are sharply limited. Foods and dishes excluded. enhancing the secretion of the digestive organs, the processes of fermentation and putrefaction in the intestines. Dishes are liquid, semi-liquid, pureed, boiled in water or steamed. Very hot and cold dishes are excluded.

Chemical composition and calorie content of dietary table No. 4: carbohydrates - 250 g (40-50 g sugar); proteins - 90 g (60-65% animals), fats - 70 g, calories - 2000 kcal; sodium chloride - 8-10 g, free liquid - 1.5-2 l.

Diet No. 4: 5-6 times a day in small portions.

Soups. In low-fat, weak meat or fish broth with the addition of mucous decoctions of cereals, semolina, rice, boiled and pureed meat, steamed quenelles and meatballs, egg flakes. And they include: soups with cereals, vegetables, pasta, dairy, strong and fatty broths;

Bread and flour products. Rusks from 200 g of premium wheat bread, thinly sliced ​​and not crispy. And they include: other bakery and flour products;

Meat and poultry. Lean and lean varieties of beef, veal, chicken, turkey, rabbit. The meat is degreased, fascia and tendons are removed, and in birds, the skin is removed. Steamed or boiled cutlets, quenelles, meatballs. Minced meat with boiled rice instead of bread is passed through a fine grinder 3-4 times. Boiled meat soufflé. And they include: fatty types and varieties of meat, piece meat, sausages and other meat products;

Fish. Low-fat types of fresh fish, cut into pieces and chopped (quenelles, meatballs, cutlets), steamed or boiled in water. And they include: fatty species, salted fish, caviar, canned food;

Dairy products. Freshly prepared calcined or unleavened mashed cottage cheese, steam soufflé. And they include: whole milk and other dairy products;

Eggs. Up to 1-2 per day. Soft-boiled, steamed omelet and in dishes. And they include: hard-boiled, raw, fried eggs:

Cereals. Puree porridges in water or low-fat broth - rice, oatmeal, buckwheat, cereal flour. And they include: millet, pearl barley, barley, pasta, legumes;

Vegetables. Only in the form of decoctions added to soups;

Snacks. And they include;

Fruits, sweet dishes, sweets. Jelly and jelly from blueberries, dogwoods, bird cherry, quince, pears. Mashed raw apples. Sugar - limited. And they include: fruits and berries in their natural form, dried fruits, compotes, honey, jam and other sweets;

Sauces and spices. Only low-fat broth and butter in dishes;

Beverages. Tea, especially green, black coffee and cocoa with water. Decoctions of rose hips, dried blueberries, black currants, bird cherry, quince. If tolerated, diluted fresh juices from berries and fruits, except grapes, plums, and apricots. And they include: coffee and cocoa with milk, carbonated and cold drinks;

Fats. Only very fresh butter, 5 g per serving of the finished dish.

Sample diet menu No. 4.

First breakfast: oatmeal porridge mashed in water, freshly mashed cottage cheese, tea.

Second breakfast: decoction of dried blueberries.

Lunch: meat broth with semolina, steamed meatballs, mashed rice porridge in water, jelly.

Afternoon snack: warm, unsweetened rose hip decoction.

Dinner: steam omelette, mashed buckwheat porridge in water, tea.

At night: jelly.

Table No. 4B

Indications:

1) acute intestinal diseases during the period of improvement;

2) chronic intestinal diseases after a sharp exacerbation or with a mild exacerbation. and also when combined with damage to other digestive organs.

Purpose of diet No. 4B: provide adequate nutrition in conditions of moderately impaired digestion, help reduce inflammation and normalize intestinal functions. as well as other digestive organs.

General characteristics of diet No. 4B: in terms of caloric content and chemical composition, a complete diet with a slight increase in protein content. A diet with moderate restriction of mechanical and chemical irritants of the gastrointestinal mucosa. Products and dishes that increase rotting and fermentation in the intestines, as well as sharply stimulating the secretion of the stomach, pancreas, bile secretion and irritating the liver are excluded. Dishes are pureed and chopped, boiled in water or steamed. Hot and cold dishes are excluded.

Chemical composition and calorie content of dietary table No. 4B: carbohydrates - 400-420 g (50-70 g sugar), proteins - 100-110 g (60-65% animal), fats - 100 g (mainly butter), calories - 2900-3000 kcal, sodium chloride - 8- 10 g, free liquid - 1.5 l.

Nutrition regimen for diet No. 4B: 5-6 times a day.

Soups. In a weak low-fat meat and fish broth and vegetable broth with well-boiled or pureed cereals, vermicelli, noodles or finely chopped vegetables (potatoes, carrots, zucchini, cauliflower), meatballs, quenelles. And they include: bean soup, milk soup, cabbage soup, borscht, rassolnik, cold (okroshka, beetroot pancakes);

Bread and flour products. Wheat bread made from premium and 1st grade flour, yesterday's or dried. Dry cookies and biscuits. If tolerated - 1-2 times a week in small quantities of well-baked products with cottage cheese, boiled meat, apples, jam. And they include: rye bread, wholemeal wheat bread, fresh bread, products made from butter and puff pastry;

Meat and poultry. Low-fat types and varieties or low-fat. Beef, chicken, chopped turkey (cutlets, meatballs, dumplings, etc.), steamed and boiled. A bird without skin. Veal, chicken, rabbit - in pieces, boiled. And they include: fatty types and varieties of meat, duck, goose, smoked meats, sausages, canned food;

Fish. Low-fat types in pieces and chopped (quenelles, cutlets, etc.), boiled and steamed. And they include: fatty types, salty, smoked fish, canned food;

Dairy products. Milk, cream, and sour cream are added to dishes. Acidophilus, kefir and other fermented milk drinks. Freshly prepared cottage cheese, curd paste, steamed and baked puddings, etc. Mild cheese. And they include: milk in its natural form, all dairy products with increased acidity, sharp, salty cheeses;

Eggs. 1-2 pieces per day. Soft-boiled, steamed omelets, protein omelettes, in dishes. And they include: hard-boiled, fried.

Cereals. Various well-cooked porridges (except millet, barley, pearl barley) in water with the addition of 1/3 milk; buckwheat and oatmeal are pureed; steam puddings from pureed porridge, casserole from rice, semolina, boiled noodles. And they include: legumes, porridge from pearl barley, barley, millet;

Vegetables. Potatoes, carrots, cauliflower - boiled and pureed, early zucchini and pumpkin - boiled; steam soufflé of pureed vegetables. Ripe fresh tomatoes up to 50-100 g per day. And includes: white cabbage, beets, radishes, radishes, onions, garlic, cucumbers, rutabaga, turnips, sorrel, spinach, mushrooms;

Snacks. Jellied fish, mild cheese, sturgeon caviar;

Fruits, sweet dishes, sweets. Sweet, ripe berries and fruits (without skin) in raw form with a tolerance of up to 100 g per day. Mashed apples, baked apples, pears. Jelly and mashed compotes, jellies, mousses from sweet fruits. Meringues, snowballs. Marmalade, marshmallows, marshmallows, preserves and jams. And they include: grapes, apricots, plums, dried fruits, ice cream, chocolate, cakes;

Sauces and spices. In a weak meat broth, vegetable broth, milk bechamel, fruit. Parsley, dill, bay leaf; vanillin, cinnamon. And they include: hot, fatty sauces, mustard, horseradish, pepper;

Beverages. Tea, coffee and cocoa on water go with milk. Decoctions of rosehip and wheat bran. Apple, cherry, tangerine, orange, strawberry juices mixed with hot water. And they include: grape, plum, apricot juices, kvass, fruit drink;

Fats. Butter - with bread and added to dishes from 5 to 15 g per meal, taking into account tolerance. And they include: other fats.

Sample diet menu No. 4B.

First breakfast: steam omelette, semolina milk porridge, tea.

Second breakfast: baked apples.

Lunch: meat broth with egg flakes, steamed meat dumplings with carrot puree, jelly.

Afternoon snack: rosehip decoction.

Dinner: boiled fish with mashed potatoes, rice pudding with fruit sauce, tea.

At night: jelly.

Table No. 4B

Indications:

1) acute intestinal diseases during the recovery period as a transition to a balanced diet;

2) chronic intestinal diseases during the period of recovery after an exacerbation, as well as outside of an exacerbation with concomitant lesions of other digestive organs.

Diet goal number 4B: provide adequate nutrition with some insufficiency of intestinal functions, promote the restoration of the latter and the activity of other digestive organs.

General characteristics of diet No. 4B: a physiologically complete diet with a slight increase in protein content and a moderate limitation of table salt, mechanical and chemical irritants of the intestines, with the exception of foods and dishes that increase fermentation and putrefaction in the intestines, sharply increasing its secretory and motor functions, the secretion of the stomach, pancreas, and bile secretion. Food is given unground, steamed, boiled in water or baked. The food temperature is normal.

Chemical composition and calorie content of dietary table No. 4B : carbohydrates - 400-420 g, proteins - 100-120 g (60% animal), fats - 100 g (15-20% vegetable), calories - 2900-3000 kcal; sodium chloride - 10 g, free liquid - 1.5 l.

Nutrition regimen for diet No. 4B: 5 times a day.

Soups. In a weak low-fat meat and fish broth, vegetable broth with meatballs, quenelles, various cereals (except millet), vermicelli, noodles, potatoes, finely chopped carrots, cauliflower, zucchini; if tolerated - with white cabbage, beets, green peas. And they include: strong, fatty broths, milk broths, cabbage soup, borscht, rassolnik, okroshka, bean and mushroom soup;

Bread and flour products. Wheat bread made from premium and 1st grade flour, yesterday's bread or slightly dried. Dry cookies and biscuits. 2-3 times a week in small quantities I bury baked, not warm, insipid buns, pies with apples, meat, jam, cheesecakes with cottage cheese. And they include: fresh rye bread, products made from butter and puff pastry;

Meat and poultry. Lean or low-fat beef, veal, chicken, turkey, rabbit. Meat without tendons, poultry without skin. Piece and chopped, boiled in water or steamed. Boiled tongue. Milk sausages. And they include: fatty varieties, fish soup, goose, most sausages, smoked meats, canned food;

Fish. Low-fat types, in pieces and chopped, boiled in water or steamed. Limited baked and lightly fried without breading. And they include: fatty types, salted, smoked, canned;

Dairy products. Milk - if tolerated, mainly in dishes. Various fermented milk drinks. Fresh natural cottage cheese, in the form of paste, steamed and baked puddings and cheesecakes. Sour cream, cream - in dishes. Mild cheese. And they include: sharp, salty cheeses, dairy products with high acidity;

Eggs. 1-2 pieces per day. Soft-boiled, steamed natural and protein omelettes, in dishes. And they include: hard-boiled, fried;

Cereals. Various porridges (except millet, pearl barley, barley), including crumbly ones. On water, with the addition of 1/3 milk. Steamed and baked puddings, casserole and semolina balls, steamed rice cutlets, pilaf with fruit, boiled vermicelli, finely chopped pasta. And they include: legumes;

Vegetables. Potatoes, carrots, cauliflower, pumpkin, boiled or steamed ungrated zucchini, in the form of purees, casseroles; if tolerated - white cabbage, beets, boiled green peas. Soufflé from beets or carrots with cottage cheese. Leaf salad with sour cream. Raw ripe tomatoes up to 100 g. And they include: radishes, radishes, onions, garlic, cucumbers, rutabaga, turnips, sorrel, spinach, mushrooms;

Snacks. Salad of boiled vegetables, with boiled meat and fish. Jellied fish, boiled tongue, mild cheese, sturgeon caviar, doctor's sausage, diet, dairy, low-fat ham. And they include: spicy and fatty snacks, smoked meats, canned food;

Fruits, sweet dishes, sweets. Sweet ripe fruits and berries in raw form in limited quantities (100-150 g); if tolerated - apples, pears, oranges, tangerines, watermelon, strawberries, raspberries, peeled grapes. Mashed fresh and baked apples. Kissels, mousses, jellies; compotes, including dried fruits. Meringues, snowballs, marmalade, marshmallows, fudge, jam, jam; if tolerated, use honey instead of sugar. And they include: apricots, plums, figs, dates, berries with rough skin, ice cream, chocolate, cakes;

Sauces and spices. With meat broth, vegetable broth, milk bechamel, fruit bechamel, and occasionally sour cream; vanillin, cinnamon, bay leaf, parsley, dill. And they include: hot and fatty sauces, mustard, horseradish, pepper;

Beverages. Tea, coffee and cocoa without milk and with milk. Decoctions of rosehip and wheat bran. Diluted fruit, berry and tomato juices. And they include: grape, plum, apricot juices;

Fats. Butter for bread and dishes 10-15 g per serving; if tolerated - refined vegetable oils up to 5 g per dish. And they include: other fats.

Sample diet menu No. 4B.

First breakfast: soft-boiled eggs, oatmeal porridge, tea.

Second breakfast: fresh apples.

Lunch: peasant soup with meat broth, boiled meat pilaf, jelly.

Afternoon snack: rosehip decoction. Dinner: boiled fish, mashed potatoes, baked curd pudding, tea.

With the help of this diet, chemical, mechanical and thermal irritations to the intestines are limited in the diet. The diet is indicated for intestinal diseases that occur with diarrhea: dysentery, gastroenteritis during an exacerbation, chronic colitis during an exacerbation.

• General characteristics of diet No. 4

  A diet with a normal amount of protein, limiting fats and carbohydrates to the lower limit of normal. The goal of this diet is to reduce inflammatory changes in the intestinal mucosa by maximizing mechanical and chemical smoothing of the intestinal mucosa.

  All dishes are boiled or steamed and pureed. Avoid foods and dishes that enhance the processes of fermentation and putrefaction in the intestines, in particular milk, sweets, legumes, coarse fiber ( fresh vegetables, greens, fruits and berries), all dishes that stimulate bile secretion, secretion of the stomach and pancreas (sauces, spices, snacks).

  The diet is split - 5-6 times a day.

• Chemical composition and energy value of diet No. 4

  Proteins 90 g, fats 70 g, carbohydrates 250 g, table salt 6 g; calorie content 2000 kcal; retinol 2 mg, thiamine 4 mg, riboflavin 4 mg, ascorbic acid 100 mg, nicotinic acid 30 mg; calcium 0.8 g, phosphorus 1.6 g, magnesium 0.5 g, iron 0.015 g. Reduce the content of table salt in the diet to 6–8 g per day. Free liquid 1.5 l.

• Recommended dishes and products for diet No. 4
  • Bread in the form of croutons from 200 g of wheat bread from premium flour; stale white bread.
  • Soups based on low-fat weak meat and fish broth with the addition of mucous decoctions of cereals (barley, semolina, rice), boiled and pureed meat, steamed dumplings, meatballs, egg flakes.
  • Meat and poultry - lean and lean varieties of beef, veal, turkey in the form of water-boiled cutlets, quenelles, meatballs; boiled meat soufflé.
  • Fish – low-fat varieties of fresh fish, boiled in water or steamed, in the form of meatballs, cutlets or pieces.
  • Dairy products – freshly prepared calcined cottage cheese or unleavened pureed cottage cheese.
  • Butter, fresh, is added to dishes.
  • Eggs – 1-2 soft-boiled or as a steam omelet.
  • Cereals – pureed porridge in water (rice, oatmeal, buckwheat).
  • Vegetables - only in the form of decoctions added to soups.
  • Drinks – tea, especially green, black coffee and cocoa with water; diluted fruit juices from berries and fruits, except grapes, plums, apricots, blueberry jelly, quince, pears, rose hip decoctions, dried blueberries, black currants. A decoction of dried black currants, blueberries, bird cherry.
  • Mashed raw apples.

• Excluded foods and diet dishes for No. 4
  • Snacks are excluded.
  • Milk and dairy products.

• Diet options No. 4

  Specialized versions of diet No. 4 have been developed.

• Diet No. 4a

  Diet No. 4a is used for any intestinal diseases that occur with a predominance of fermentation processes.

  Diet No. 4a sharply limits the content in the diet of all substances that irritate the intestines and enhance fermentation processes in it.

  The calorie content of this table is 1600 kcal, the chemical composition of the diet: 120 g of proteins, 50 g of fats, 140 g of carbohydrates.

  • This diet option is physiologically inferior and monotonous, so it is prescribed for 2–5 days with subsequent transfer to table No. 2 or No. 5a.
    • Approximate one-day diet menu No. 4a (for severe exacerbation of intestinal diseases, with diarrhea)
    • 1st breakfast: steamed protein omelette, semolina porridge with water, tea.
    • Lunch: pureed meat soup, steamed meatballs, blueberry jelly.
    • Afternoon snack: rosehip decoction (1 glass).
    • Dinner: jellied fish, boiled vermicelli, tea.
    • At night: kefir (1 glass).

• For the whole day: bread (crackers) – 200 g, sugar – 30 g, butter – 10 g.

  Diet No. 4b

  Diet No. 4b is used during periods of exacerbation of chronic and acute intestinal diseases, when intestinal diseases are combined with diseases of the pancreas, stomach, liver and biliary tract.

  • This diet slightly limits the content of mechanical and chemical irritants of the receptor apparatus of the gastrointestinal tract in the diet. Purpose of diet No. 4b
  • Providing adequate nutrition for moderately severe inflammatory processes in the gastrointestinal tract and indigestion.

    General characteristics of diet No. 4b

    The diet is physiologically complete with a moderate limitation of mechanical and chemical irritants of the gastrointestinal tract, a moderate limitation of table salt, with the exclusion of foods that enhance fermentation processes, as well as strong stimulants of gastric secretion and bile secretion. All dishes are boiled or steamed, pureed, slimy, served warm and hot. Meals are split - 5-6 times a day. Use foods rich in tannin (blueberries, strong black tea, cocoa, natural red wines) containing simple carbohydrates to delay bowel movements.

  • The diet is split, 6 times a day. All foods should be steamed or boiled, vegetables should be pureed, fruits should be pureed.

    Proteins 100 g, fats 100 g, carbohydrates 350-400 g; calorie content 2700-2900 kcal; retinol 2 mg, thiamine 4 mg, riboflavin 4 mg, nicotinic acid 30 mg, ascorbic acid 100 mg; calcium 0.8 g, phosphorus 1.2 g, magnesium 0.5 g, iron 0.015 g. It is necessary to limit the amount of salt consumed to 8 g per day. The amount of free fluid consumed should be 1.5 liters per day.

  • Recommended dishes and products for diet No. 4b
    • Wheat bread made from premium or first grade flour, yesterday baked or dried. Total bakery products no more than 200 g/day.
    • Lean varieties of meat and fish are allowed (beef, veal, rabbit, chicken, pike perch, bream, cod, perch) in the form of boiled cutlets, quenelles, soufflé (if well tolerated in the form of a whole piece).
    • Various cereals in the form of well-cooked porridges, in water or with the addition of 1/3 milk.
    • Vegetables – potatoes, carrots, cauliflower, boiled and pureed; fruits are ripe and sweet varieties of berries without peel. If tolerated well, ripe tomatoes are allowed (up to 100 g/day).
    • Unsalted butter is added to ready-made dishes or in its natural form with bread, up to 15 g per meal.
    • It is possible to eat soft-boiled eggs (up to 2 eggs per day) or as additives to dishes, egg white omelettes, meringues, snowballs.
    • In contrast to diet No. 4 and No. 4a, snacks are allowed (mild cheese, doctor's sausage, pate, veal, soaked herring, jellied meat, jellied tongue) and sauces (meat, vegetable and fish weak broth with dill, parsley leaves, milk sauce bechamel with the addition of a small amount of sour cream, fruit sauces, cinnamon can be used).
    • Jelly, jellies, mousses, pureed compotes of sweet berries and fruits (except melons, watermelons, apricots and plums), baked apples, raw berries (strawberries, raspberries up to 100 g), pureed peeled ripe sweet apples are used as sources of vitamins. and pears. Fruit juices diluted in a 1:1 ratio with water are allowed. Their intake begins with 50 ml, gradually increasing to 100–150 ml per day.
    • Drinks – tea, coffee, cocoa with water or milk.
  • Excluded foods and dishes for diet No. 4b
    • From the daily diet it is necessary to exclude all products that stimulate bile secretion, secretory activity of the stomach and pancreas, and enhance putrefactive and fermentative processes in the intestines.
    • Bakery and flour products other than those listed above are excluded.
    • Soups with cereals and vegetables, strong and fatty broths are excluded.
    • Fatty meats, fish, poultry; smoked meats, canned meat and fish.
    • Millet, pearl barley, barley cereals.
    • Legumes; vegetables, fruits and berries in their natural form.
    • All sweets, coffee and cocoa with milk, carbonated and cold drinks.
  • An approximate one-day diet menu No. 4b with mechanical and chemical sparing (for patients with acute or chronic intestinal diseases in the phase of subsiding exacerbation).
    • 1st breakfast: boiled fish, mashed potatoes, pureed rice porridge, tea.
    • 2nd breakfast: calcined cottage cheese (100 g).
    • Lunch: cheese (30 g), pearl barley soup in meat broth with pureed carrots, meatloaf with pureed buckwheat porridge, apple jelly.
    • Afternoon snack: rosehip decoction (1/2 cup), white omelette.
    • Dinner: boiled tongue with carrot puree, calcined cottage cheese.
    • Dinner: jellied fish, boiled vermicelli, tea.
    • For the whole day: white bread – 300 g, sugar – 50 g, butter – 10 g, fruits, berries – 300 g.

• Diet No. 4c

  Diet No. 4c is prescribed during the period of recovery after acute intestinal diseases as a transition table to general nutrition, as well as during the period of remission of intestinal diseases, when intestinal diseases are combined with diseases of the pancreas, stomach, liver and biliary tract.

  Diet No. 4c, compared to diet No. 4b, is more varied and less sparing, so it is prescribed after 2-4 weeks of using diet No. 4b.

  • Purpose of diet No. 4c

    Providing adequate nutrition and compensation for digestion in case of chronic intestinal diseases in remission, and in acute intestinal diseases in the recovery stage.

  • General characteristics of diet No. 4b

    Diet No. 4c is physiologically complete, with a normal content of proteins, fats and carbohydrates, with some limitation of table salt, chemical irritants, with the exception of foods and dishes that enhance the processes of fermentation and putrefaction in the intestines. All dishes are cooked with water or steam, and also baked in the oven; food is predominantly uncut. The diet is split, 6 times a day.

  • Chemical composition and energy value of diet No. 4b

    Proteins 100-110 g, fats 90-100 g, carbohydrates 400-450 g; calorie content 2900-3140 kcal; retinol 2 mg, thiamine 4 mg, riboflavin 4 mg, nicotinic acid 30 mg, ascorbic acid 100 mg; calcium 1.2 g, phosphorus 1.6 g, magnesium 0.5 g, iron 0.015 g. It is necessary to limit the amount of salt consumed to 8 g per day. The amount of freely consumed liquid should be 1.5 liters per day.

  • Recommended dishes and products for diet No. 4b
    • Wheat bread made from premium or first grade flour, yesterday baked or dried.
    • Soups with weak meat, fish broth and vegetable broth with well-boiled and mashed cereals or finely chopped and well-boiled vegetables, as well as meatballs and quenelles.
    • Meat and poultry – minced meat, chicken, turkey, steamed or boiled.
    • Fish – low-fat varieties, cut into pieces, chopped, boiled or steamed; Individual baked dishes are allowed, without a rough crust.
    • Allowed are crumbly porridges (except millet and pearl barley) in water, in meat broth, with the addition of milk or a third of 10% cream, zrazy, dumplings, pancakes, boiled vermicelli, finely chopped pasta, milk noodles in the form of side dishes, casseroles, puddings.
    • Dairy products - milk, cream, sour cream added to the dish, kefir, acidophilus, yogurt, freshly prepared cottage cheese.
    • Butter is added to prepared dishes and given in its natural form (no more than 10 g per serving).
    • Eggs – 1-2 eggs per day in the form of an omelet or soft-boiled.
    • Sauces based on weak meat, fish broth, dairy.
    • Vegetables – potatoes, carrots, cauliflower, boiled and pureed; fruits are ripe and sweet varieties of berries without peel. If tolerated well, it is allowed to add white cabbage, green peas, young beans, and beets to soups. Young finely chopped greens, tangerines and oranges are introduced into the diet.
    • Drinks – tea, coffee, cocoa with water or milk. The amount of raw sweet fruits and berries (apples, pears, strawberries) is increased to 200 g/day. Fruit juices (except grape), berry, vegetable (except cabbage) juices diluted 1/3 with water are shown.
    • Marmalade, marshmallows, marshmallows, and sugar are allowed.
  • Excluded foods and dishes for diet No. 4b
    • Bakery and flour products other than those listed above are excluded.
    • Soups with cereals and vegetables, strong and fatty broths.
    • Fatty meats, fish, poultry; smoked meats, canned meat and fish.
    • Legumes; vegetables, fruits and berries in their natural form.
    • Coffee and cocoa, carbonated and cold drinks.
  • Sample diet menu No. 4c for patients with acute or chronic intestinal diseases that occur with diarrhea during the recovery period or in remission
    • 1st breakfast: rice porridge with milk, steamed protein omelette (2 eggs), tea with milk.
    • 2nd breakfast: calcined cottage cheese (150 g).
    • Lunch: meat broth soup with cauliflower, boiled meat with boiled rice, fresh apples.
    • Afternoon snack: boiled meat, rosehip decoction (200 g).
    • Dinner: baked curd pudding, steamed meatloaf with stewed carrots and green peas, tea with milk, fresh fruits (or berries).
    • Dinner: jellied fish, boiled vermicelli, tea.
    • For the whole day: white bread – 300 g, sugar – 40 g, butter – 10 g.

• Diet No. 4ag - gluten-free diet

  A special version of diet No. 4 is diet No. 4ag, intended for patients with celiac enteropathy, in whom the body loses the ability to digest gluten ( component grain proteins) due to the absence of specific peptidase in the epithelium of the intestinal mucosa, as a result of which the breakdown of gliadin, which is part of gluten, does not occur.

  • General characteristics of diet No. 4ag

    Diet No. 4ag contains an increased amount of protein, a physiological norm of fat, and is enriched with vitamins and calcium salts. Boiled or steamed food.

  • Chemical composition and energy value of diet No. 4ag

    Proteins 120 g, fats 100 g, carbohydrates 400-450 g, table salt 8 g; calorie content 2980-3180 kcal.

  • Diet therapy tactics for celiac disease (gluten enteropathy)

    In extremely severe cases of dystrophy, treatment of celiac disease begins with parenteral nutrition in the intensive care unit. See parenteral nutrition.

    The body's minimum requirement for protein, which is necessary for the body to avoid the destruction of its own structural proteins, is 0.6-0.9 g/kg per day.

    Parenteral nutrition begins with the lower limit of the daily protein requirement (0.6 g/kg), taking into account poor protein tolerance in severe depletion.

    The next day, the amount of protein is prescribed at the rate of 1 g/kg, gradually increasing to 2-3 g/kg. Basically, the protein requirement during parenteral nutrition is met through special amino acid mixtures.

    As diarrhea is eliminated and the required amount of fluid is replenished, the dose of protein increases to 4 g/kg, while the amount of protein administered with food increases, and in the form of amino acid preparations decreases.

    Another component of therapy carried out for severe conditions are fat emulsions, administered separately from other solutions (3-4 times). When the condition improves, fats are administered in the form of nutrition using special preparations for enteral nutrition.

    The need for carbohydrates during parenteral nutrition is covered by intravenous administration of glucose and fructose in 5, 10 and 20% solutions under the control of blood sugar levels.

    In the first 2-3 days of parenteral nutrition, patients may experience weight loss due to the disappearance of edema; in the next 2-3 days, stabilization occurs, and by the end of the week, patients’ body weight begins to increase. Lethargy and reluctance to move disappear after 3-4 days; by the end of the second week, patients get up and move independently. Vomiting stops from the first day of treatment, the number of bowel movements is reduced to 3 times a day.

    The prognosis for continued adherence to a gluten-free diet is favorable. It is believed that a strict gluten-free diet should be followed for at least 8-10 months. After this, it is allowed to carefully introduce foods containing gluten. But if, at the same time, increased bowel movements reappear, you should immediately return to your previous diet.

  • General dietary recommendations for celiac disease
    • For children, food should be age appropriate and pureed (gentle). The volumes of one serving are small, and the number of feedings can be increased. The child can drink at will, without restrictions.
    • Culinary processing of products in the initial period of treatment - stewing, cooking, and a little more than usual. Pass the products through a meat grinder, grate or rub through a sieve. Peel vegetables and fruits. From grapes and grape juice At the beginning of treatment, it is better to refuse, since the berries have a hard skin, and the juice can cause fermentation in the intestines and bloating.
    • During the first few months of the diet, it is not recommended to include mushrooms, legumes, nuts, raw cabbage, or apples in the menu, as they contain coarse fiber, which can slow down intestinal recovery. Limit garlic, onions, spices.
    • Whole milk should be limited. This limitation especially applies to factory-made milk, to which flour can often be added.
    • Homemade milk and non-industrial dairy products can be used in the absence of lactase deficiency.
    • Don't limit sweets. Simple carbohydrates will partially compensate for energy metabolism disorders and improve brain nutrition. As you recover, your need for sweets will decrease.
    • Main sources of food ingredients:
      • Protein: meat, fish, natural dairy products, eggs.
      • Fat: vegetable oil and fat found in meat, homemade milk and fish.
      • Carbohydrates: rice, corn, buckwheat (limitedly allowed), potato starch, rice, corn, vegetables, fruits, jam, honey, sugar.
    • Biological preparations (bifidumbacterin, lactobacterin), constantly, 5-10 doses daily, on an empty stomach or before bedtime, 2 hours after meals.
    • Sea buckthorn oil and honey. 1-2 tsp. daily, but not together.
  • Criteria for the effectiveness of diet therapy for celiac disease

    Excluding foods containing gluten from the diet first leads to the rapid disappearance of symptoms, and then to the normalization of all biochemical parameters. The first sign of recovery is the elimination of frequent and heavy bowel movements. Then there is an increase in body weight and the disappearance of all symptoms of deficiency in the body. Osteoporosis is the slowest to eliminate, therefore, in addition to diet therapy, it is necessary to take calcium supplements and vitamin D. Over the course of 3-8 months of treatment, well-being, performance and mood improve.

  • Dosage forms approved for celiac disease
    • All those dosage forms, which do not contain wheat starch.
    • It is better to use only ampoule preparations, using them like tablets, dissolving them in water; suppositories and transparent gelatin capsules.
    • Can only be taken in tablets Activated carbon- it contains potato starch.
  • Recommended dishes and products for diet No. 4ag
    • Children under 3-4 months are allowed only human milk.
    • Adults include gluten-free foods - rice, corn, starch, soy, tree nuts, vegetables, fruits.
    • Corn and rice flour, potatoes, meat, and fish are allowed.
    • Buckwheat porridge is shown in limited quantities.
    • Vegetable butter, butter made from pure cow's cream.
    • Fresh sour cream, fresh cream (loose, non-industrial).
    • Cottage cheese, cheeses, fermented milk products made from bottled milk at home.
    • Meat (all varieties), eggs, fish, canned fish in own juice, oil.
    • Caviar.
    • All types of fruits in their natural form (except bananas and dates), all vegetables.
    • Sugar, honey, whole coffee beans (to be ground), loose leaf tea.
    • Homemade canned food (meat, jam, jam).
    • Industrial canned food (sprats, seaweed, canned corn).
  • Excluded foods and dishes of diet No. 4ag
    • Prohibited Products
      • The introduction of mixtures with decoctions of oats, barley, and wheat is contraindicated for children. For older children, bread, cookies, semolina and oatmeal, and crackers are excluded.
      • Wheat, rye, barley, oats, as well as all products containing them, are completely excluded from the diet. (Millet is produced from millet, oatmeal is made from oats, oatmeal is made from wheat, semolina and wheat cereal, Wheat flour. From barley - pearl barley and barley grains, from rye - rye flour.)
      • Milk mixtures with oat and wheat decoctions and flour, fermented milk mixtures with oat and wheat decoctions and flour are prohibited.
      • Canned meat, homogenized canned meat containing flour, ham. All products (semi-finished products, cutlets and cheesecakes), breaded in breadcrumbs or with the addition of bread. Sausages, frankfurters, sausages.
      • Breaded fish, canned fish with added flour.
      • Vegetables and canned vegetables to which wheat or oatmeal or barley are added.
      • Products made from wheat, barley, biscuits, cookies, gingerbread.
      • Canned fruit compotes.
      • All confectionery, sweets, caramel, dragees, chocolate. All home and industrial baked goods made from wheat, rye and buckwheat flour (bread, rolls, crackers, crackers, cakes, pastries).
      • Cornflakes.
      • Sauces, mustard.
      • Bouillon cubes.
      • Beer, vodka.
      • Carbonated drinks.
      • Bananas, dates.
    • Products that are not recommended for consumption
      • Puffed bread, corn sticks, cereal, chips.
      • Ice cream, yoghurts, all types of cheese curds, cheese and curd mass, packaged cottage cheese, powdered or condensed milk, cream, margarine and industrial butter, cheeses and mayonnaise.
      • Ketchups, tomato paste.
      • Cocoa, Pepsi-Cola, Coca-Cola, instant coffee, granulated tea. Marshmallows, jams, marshmallows, Turkish delight, halva.
      • All tablet forms of medications, dragees, opaque capsules, syrups, peas.
      • Chewing gum, toothpaste.
      • Cosmetics ( lipstick and mascara).
  • Gluten-free diet menu No. 4ag

  • • Homemade cheese.
    • Required: 200 g cottage cheese, sour milk, 1 egg, 1 tbsp. l. gluten-free butter or cream, 1 tsp. soda, salt.
    • Preparation. Pour sour milk over the cottage cheese 3 cm above the level of the cottage cheese, boil for 10 minutes over low heat, drain in a colander, and allow to drain. Mix thoroughly with egg, cream, soda (salt to taste), cook for 5 minutes in a boiling water bath while stirring. Place in a bowl greased with vegetable oil and cool.
    • Hominy. Required: 1 cup corn grits, 4 cups milk (water), 50 g gluten-free butter, salt.
    • Preparation. Boil milk with butter (25 g), add salt and corn grits and cook, stirring, until the porridge begins to pull away from the walls of the pan. Stir hot hominy with melted gluten-free butter (25 g) before removing from heat.
    • Cut cold hominy into thin slices, dip in beaten eggs or roll in corn flour, fry in oil and serve with meat dishes.
    • Cheesecakes made from corn flour.
    • Required: 0.5 kg of cottage cheese, 1 egg, 3 tbsp. l. sugar, corn flour, loose raisins or apples.
    • Preparation. Beat eggs with sugar, add cottage cheese, stir, add flour until a stable dough is obtained, add raisins (apples), form cheesecakes, bake over medium heat until done.
    • Mayonnaise. Required: 2 yolks, salt, sugar, 0.5 cups vegetable oil, 1 tsp. vinegar. Preparation. Mix the ingredients and beat with a mixer. Whipped cream with sugar.
    • Required: 1 glass of cream, 2-3 tsp. Sahara. Preparation. Cool the cream, add sugar, beat. Ice cream. Required: 700 ml milk, 300 ml homemade cream, 3 yolks, 150 g sugar, 5 g gelatin., 1 egg, 1 clove of garlic, 2-3 tbsp. l. corn flour, salt, red pepper, soda.
    • Preparation. Grind the cottage cheese with the egg, chop the onion and garlic, mix everything. Bake in vegetable oil, cover the pan with a lid.
    • Carrot cake. Required: 2 cups finely grated carrots, 1 cup granulated sugar, 2 eggs, 2 cups corn flour, 1 tsp. soda Preparation. Mix carrots with sugar and leave for 30 minutes. Beat the eggs and mix everything. Knead the dough. Divide into 2-3 parts (cakes). Bake on tracing paper, coating the cakes with jam.
    • Meatloaf with buckwheat porridge and mushrooms. Required: 100 g meat, 60 g buckwheat, 1-2 dried mushroom , 1 onion, 1 tbsp. l. vegetable oil, 1 tbsp. l. corn flour, 1 egg, salt, pepper. Preparation. Carefully sort the grains, leaving only whole grains, and rinse several times in cold water. Grind the meat, mix with 1/2 egg. Soak the mushrooms, cook, finely chop. Finely chop the onion and sauté. Cook the buckwheat. Connect everything. Make a roll, grease the surface with sour cream or milk with the rest of the egg. Bake on low heat.
    • Omelette with buckwheat porridge.
    • Required: 2 eggs, 1 tbsp. l. vegetable oil, 100 g buckwheat porridge, 1/4 cup milk. Preparation. Beat the eggs with a mixer and pour onto hot frying pan . Place in the middle of the omelette buckwheat porridge , wrap the edges of the omelette into a pie shape and place on a plate. Sprinkle with dill and serve. Grated pie.
    • Lazy meat pie.
    • Required: 300 g minced meat, 1 onion, 4 eggs, soda, 5 tbsp. l. corn flour, 5 tbsp. l. a mixture of corn starch and rice flour, 200 ml of mineral water.
    • Preparation. Mix everything, pour into a greased pan, and bake.
    • Cookie. Required: 8 tbsp. l. sugar, 8 tbsp. l. vegetable oil, 1/2 tsp. soda, corn flour.
    • Preparation. Mix everything, add enough corn flour to make a thick dough. Use a spoon to form cookies and place on a baking sheet. Let stand for 20 minutes, bake in a hot oven. Okroshka. Required: 50 g boiled meat, 50 g boiled tongue, 60 g cucumbers, 30 g green onions, 1/4 egg, 1 tbsp. l. sour cream, 1 tsp. sugar, 350 ml whey, salt. Preparation. Finely chop everything, mix with whey, cool. Before serving, add dill and sour cream.
    • Cornmeal pancakes.
    • Required: 1 egg, 250 g bottled milk, 3 tsp. sugar, 0.3 tsp. soda, corn flour.
    • Layered pie with sour cream.
    • Required: for the dough: 400 g sour cream, 2 eggs, 200 g corn flour, 1 tsp. soda; for cream: 250 g sour cream, 1/2 cup sugar.
    • Preparation. Beat the eggs, adding sour cream in portions. Put in soda. Add corn flour in parts until the mixture becomes creamy. Pour the dough into two wide and low forms, greased with vegetable oil, let stand for 15-20 minutes, bake over medium heat. Cool the cakes, cut them, coat them with jam, sour cream, whipped with sugar. Keep refrigerated.
    • Meringue.