Diets

Diet number 4A

General rules

Diet No. 4A according to Pevzner is prescribed for bowel diseases that occur with diarrhea and the predominance of fermentation processes. Fermentation dyspepsia characterized by increased gas formation, loss of appetite, rapid fatigue and abdominal pain. A plentiful discharge of gases, usually not offensive, is characteristic. The increased gas content stretches the intestines, stimulates peristalsis and thereby causes discomfort and pain. At the same time, unexpressed diarrhea.

Fermentation in the intestine is due to the predominance of digestible carbohydrates in food. They inhibit the normal intestinal flora and contribute to the growth of aerobic microorganisms (conditionally pathogenic). Fermentation of sugars produces a large amount of gas, vinegar and butyric acid.

The purpose of the diet in such conditions is to sparing the intestines, suppressing fermentation processes and normalizing digestion with complete and high-quality assimilation of food. The composition of the table is slightly different from the main Diets №4, but a distinctive feature is the restriction in the diet of products that enhance fermentation - these are simple carbohydrates. The therapeutic nutrition of this table is high-protein (120 g) and low-carb (150-140 g), it contains 50 g of fat, which is also below the physiological norm. In this regard, its calorie content is 1600 kcal. Porridge is excluded (except for buckwheat and oatmeal), it is allowed to take 20 g of sugar per day and 100-150 g of bread.

The diet has a meager trace element, a fairly small amount of carbohydrates and fats. This diet option is not balanced, so it is prescribed for no more than a week with the transfer of the patient to Diet number 2 or No. 5A.

In the period of exacerbation and the presence of diarrhea, it is necessary to exclude any intestinal irritants: mechanical, chemical and thermal. Therefore, dishes are steamed and wiped. When restoring stool, you can not wipe it, but serve them in a semi-liquid state in a warm form. Water regimen is 1.5-2 liters in laziness. Food is organized up to 6 times a day, fractional.

The main points of the diet are:

  • reduction in the amount of carbohydrates to 150 g-140 g. Easily digestible carbohydrates (white cereals, mashed potatoes, sweet fruits, honey, preserves, muffins, sweets, butter biscuits) are excluded;
  • proteins are represented in the diet by cottage cheese and fermented milk products, meat and fish dishes, eggs and soy protein isolate;
  • restrict the intake of fiber (whole ground flour, bran, nuts, legumes, dried fruits, cabbage, vegetables and fruits in raw form) to reduce peristalsis with diarrhea;
  • exclude products that stimulate gas formation (brown bread, bananas, grapes, sweet apples, legumes, all varieties of cabbage, cucumbers, whole milk, carbonated drinks);
  • products with a high content of essential oils (radishes, turnips, radishes, sorrel, onions, spinach, garlic, mushrooms) are excluded;
  • as in the main diet, heat treatment - steaming or food is cooked;
  • You can use spices: bay leaf, cloves;
  • the implementation of the drinking regime (up to 2 liters of liquid), which contributes to a good evacuation of feces and prevents stagnation and fermentation;
  • it is advisable to introduce into the diet decoctions of plants that suppress fermentation in the intestines (mint, chamomile, cornel, dogrose, lingonberry, barberry, calendula, sage, raspberry, strawberry).

It is also necessary to restore intestinal microflora (reception probiotics) Since fermentation and flatulence caused by many reasons (ranging from malnutrition and ending with chronic diseases of the digestive tract) it is important to establish the reason why you should be examined.

Indications

Colitis acute stage with diarrhea and the predominance of fermentation processes.

Allowed Products

  • Table No. 4A involves the use of dried wheat bread or crackers. On the day you can eat 100-150 g of crackers (or gluten-free). You can use soy flour products.
  • The basis of the diet is protein products. The use of low-fat varieties of beef, chicken, turkey, veal is recommended. The meat is additionally degreased, the skin of the bird is removed. Steam cutlets, paste (from boiled), souffle or meatballs are prepared from meat. These products can be boiled. When cooking meatballs, put a little boiled rice in the minced meat.
  • Low-fat fish (pollock, blue whiting, hake, pike perch) are prepared in a piece or in the form of knels, cutlets and meatballs.
  • Allowed eggs 1-2 per day, which cook soft-boiled or steam omelet.
  • Soups are prepared on low-fat secondary fish or meat broth, adding a small amount of cereals, a minimum of vegetables, mashed meat, meatballs or egg flakes.
  • Mashed porridge from buckwheat and oatmeal. They are prepared on water or low-fat broth. Butter is added in an amount of 5 g per serving, and vegetable oil is excluded.
  • You can eat fresh (non-acidic) cottage cheese, which is better to wipe, casseroles can also be prepared from it.
  • Vegetables (pumpkin, zucchini, carrots) are eaten only as a pureed supplement in soups. In the absence of diarrhea - can be stewed.
  • Wiped raw apples, applesauce, jelly from blueberries, cornel, quince, bird cherry, pears are allowed. With good tolerance, you can use diluted fresh juices from berries. Exclude worth grape and plum juice.
  • Allowed herbal teas, rosehip broth, cherry infusion, blueberries, dried dogwood, green and black tea, still water.

Approved Product Table

Proteins, gFats, gCarbohydrates, gCalories, kcal
quince0,60,59,840
sweet and sour apples0,50,512,359
dried pears2,30,662,6249
buckwheat groats (kernel)12,63,362,1313
oat groats12,36,159,5342
cereals11,97,269,3366
white bread crackers11,21,472,2331
kefir 1%2,81,04,040
curdled milk 1%3,01,04,140
acidophilus2,83,23,857
cottage cheese 0.6% (low fat)18,00,61,888
cooked beef25,816,80,0254
boiled veal30,70,90,0131
rabbit21,08,00,0156
boiled chicken25,27,40,0170
turkey19,20,70,084
butter0,582,50,8748
mineral water0,00,00,0-
green tea0,00,00,0-
black tea20,05,16,9152
* data are per 100 g of product

Fully or partially restricted products

  • Foods containing simple carbohydrates are completely excluded: white cereals, mashed potatoes, pasta, sweet fruits, honey, jam, muffins, sweets, butter biscuits. Sugar is limited to 20 g per day.
  • Fresh bread, pastries, flour products (pancakes, dumplings, pancakes) cause fermentation in the intestines, therefore, are also excluded.
  • Fermented foods are excluded: bananas, grapes, sweet apples, cabbage of all kinds, legumes, cucumbers, sodas, whole milk. Diluted milk is acceptable as an additive in cereal.
  • Porridge from difficult to digest cereals (millet, barley, pearl barley) is excluded during the period of exacerbation.
  • Coarse fiber, wheat and rye bran, whole grain, rye and bran bread are excluded.
  • Fatty meat and fish, rich fatty broths that enhance intestinal motility, sausages, canned foods are prohibited.
  • Sour cream, cream and cheese can trigger increased diarrhea.
  • Kvass and carbonated drinks increase peristalsis and gas formation, so they are unacceptable in this disease.
  • You can not use sauces and marinades.

Prohibited Products Table

Proteins, gFats, gCarbohydrates, gCalories, kcal

Vegetables and greens

legumes vegetables9,11,627,0168
cabbage1,80,14,727
Brussels sprouts4,80,08,043
cauliflower2,50,35,430
potatoes2,00,418,180
cucumbers0,80,12,815
radish1,20,13,419
white radish1,40,04,121
turnip1,50,16,230
horseradish3,20,410,556
garlic6,50,529,9143
spinach2,90,32,022
sorrel1,50,32,919

Berries

grape0,60,216,865

Mushrooms

mushrooms3,52,02,530

Nuts and dried fruits

nuts15,040,020,0500
dried fruits2,30,668,2286

Cereals and cereals

semolina10,31,073,3328
pearl barley9,31,173,7320
Wheat groats11,51,362,0316
millet groats11,53,369,3348
white rice6,70,778,9344
barley grits10,41,366,3324

Flour and Pasta

pasta10,41,169,7337

Bakery products

bread high9,02,236,0217
Old Russian grain bread9,62,747,1252
Rye bread6,61,234,2165

Confectionery

jam0,30,263,0263
jam0,30,156,0238
candies4,319,867,5453
biscuits7,511,874,9417
cake3,822,647,0397
raisin crackers8,44,978,5395
crackers with sugar9,54,272,1368
dough7,91,450,6234

Ice cream

ice cream3,76,922,1189

Cakes

cake4,423,445,2407

Raw materials and seasonings

seasonings7,01,926,0149
mustard5,76,422,0162

Meat products

pork16,021,60,0259
ham22,620,90,0279

Sausages

cooked sausage13,722,80,0260
cured / dried sausage24,138,31,0455
sausages10,131,61,9332
sausages12,325,30,0277

Bird

duck16,561,20,0346
goose16,133,30,0364

Fish and seafood

smoked fish26,89,90,0196
canned fish17,52,00,088

Oils and Fats

vegetable oil0,099,00,0899
animal fat0,099,70,0897
cooking fat0,099,70,0897

Soft Drinks

kvass bread0,20,05,227

Juices and compotes

juice0,30,19,240
* data are per 100 g of product

Menu for the week of Diet No. 4A (Diet)

With six meals a day, you can create a varied menu, which will include the alternation of different protein products and allowed cereal dishes. You need to organize your diet in such a way that the week of food contains dishes of beef (meatballs, dumplings, meatballs, pastes), cottage cheese (natural, steam casserole, souffle), chicken (dumplings, souffle), fish (meatballs, meatballs, souffle) and eggs then food will not seem monotonous and devoid of taste. Keep in mind that all day it’s fashionable to eat 100-150 g of dried bread, 10 g of butter and 20 g of sugar.

Monday

Breakfast
  • buckwheat porridge with the addition of butter;
  • omelette;
  • green tea.
Lunch
  • calcined cottage cheese;
  • stewed apple puree.
Dinner
  • meatball soup;
  • crackers;
  • oatmeal porridge;
  • steam chicken dumplings;
  • compote of dried pears.
High tea
  • boiled meat;
  • rosehip infusion.
Dinner
  • boiled fish;
  • buckwheat and cottage cheese pudding;
  • tea.
For the night
  • kefir.

Tuesday

Breakfast
  • mashed oatmeal;
  • fish souffle;
  • tea.
Lunch
  • skim cheese.
Dinner
  • meat broth with mashed meat;
  • beef steam patties;
  • crackers;
  • jelly.
High tea
  • omelette;
  • compote.
Dinner
  • boiled buckwheat porridge puree;
  • boiled chicken;
  • tea.
For the night
  • yogurt.

Wednesday

 Breakfast
  • oatmeal;
  • chopped meat;
  • coffee;
  • cracker.
Lunch
  • cottage cheese;
  • stewed apple.
Dinner
  • urine broth with egg flakes;
  • buckwheat;
  • meatballs from rabbit meat;
  • compote.
High tea
  • quince jelly;
  • cracker.
Dinner
  • hake steam meatballs;
  • tea with sugar.
For the night
  • kefir.

Thursday

Breakfast
  • buckwheat porridge;
  • soft-boiled egg;
  • tea.
Lunch
  • cherry cherry, cracker.
Dinner
  • meatball soup;
  • crackers;
  • boiled oatmeal;
  • fish steamers;
  • jelly.
High tea
  • cottage cheese;
  • rosehip infusion.
Dinner
  • beef paste;
  • buckwheat pudding;
  • tea.
For the night
  • kefir.

Friday

 Breakfast
  • rice pudding;
  • cottage cheese;
  • crackers;
  • tea.
Lunch
  • mashed cottage cheese;
  • dogwood broth.
Dinner
  • meat broth with meatballs;
  • crackers;
  • buckwheat;
  • chicken souffle;
  • quince broth.
High tea
  • hips of rose hips;
  • crackers.
Dinner
  • omelette;
  • oatmeal porridge;
  • tea.
For the night
  • acidophilus.

Saturday

Breakfast
  • buckwheat;
  • cottage cheese;
  • apple puree;
  • tea.
Lunch
  • stewed pears and apples;
  • cracker.
Dinner
  • egg flakes broth;
  • steam chicken cutlets;
  • mashed porridge;
  • stewed bird cherry.
High tea
  • rosehip infusion, crackers.
Dinner
  • oatmeal, butter;
  • steam fish;
  • tea.
For the night
  • yogurt.

Sunday

Breakfast
  • oatmeal;
  • steam cutlets;
  • cracker;
  • tea.
Lunch
  • cottage cheese;
  • blueberry broth.
Dinner
  • beef broth with minced meat;
  • cracker;
  • pike perch meatballs;
  • jelly.
High tea
  • cornelian decoction;
  • crackers.
Dinner
  • omelette;
  • boiled buckwheat porridge;
  • tea.
For the night
  • kefir.

Advantages and disadvantages

prosMinuses
  • Affordable and not expensive.
  • Provides gastrointestinal tract sparing, which is important in the presence of diarrhea.
  • Contains the required amount of protein.
  • Eliminates fermentation in the intestines, bloating and increased motility.
  • Significantly reduced the amount of carbohydrates and fats - is not balanced.
  • No fiber (fresh vegetables and fruits).
  • Not suitable for prolonged use.

Nutritionist Comments

  • Diet therapy will be effective only in case of diagnosis and in the treatment of the underlying disease. Lactase deficiency or celiac enteropathy also accompanied by fermentation processes in the intestine and increased flatulencebut diet food will be different.
  • The first three days it is better to completely eliminate carbohydrates, then cereals on water, mashed potatoes, mousses and jellies from berries and fruits are gradually introduced and only after 3 weeks - fresh vegetables and fruits. In the future, it is necessary to gradually increase the intake of carbohydrates with food, mainly due to easily digestible ones. You need to remember about a possible relapse, so it is not recommended to eat brown bread, unripe fruits, fermented drinks.
  • Do not use soups and cereals concentrates, frozen meat and fish for cooking. Only fresh and natural products without preservatives.
  • Perhaps forever (depending on well-being), sweet curds, yoghurts, dumplings, pizza, all pastries and pasta, which aggravate fermentation processes, will have to be excluded from the diet.
  • The use of carbonated drinks and fermented drinks (kvass, young beer) enhances the fermentation processes in the intestines, so give up these products.
  • Make sure that the mutually exclusive foods are present in the constant diet as little as possible: milk and fiber, salty and sweet foods, proteins and carbohydrates. Fruits can be consumed only an hour after eating (for snacks).
  • Clinical nutrition should be accompanied by correction of intestinal microbiocenosis (prescribing probiotics and prebiotics), and digestive disorders are corrected by taking pancreatic enzymes. Carbohydrate digestion suffers when pancreatic amylase secretion is reduced. All this in combination increases the effectiveness of treatment.
  • Treatment is fixed by the appointment of low-mineralized, slightly alkaline mineral waters (Berezovskaya, Borzhom, Mirgorodskaya, Naftusya, Izhevskaya), which are taken warm 15 to 20 minutes before meals.

Feedback and Results

It must be remembered that this diet is therapeutic and is prescribed by a doctor. This is a rather complicated diet food, which has many limitations, but is designed for a week and this period can be sustained, several days of such nutrition are enough to restore normal bowel function. Compliance with recommendations is a guarantee of rapid improvement. This is evidenced by the reviews of patients.

  • "... I suffer from chronic pancreatitis and often in the summer, when I eat a lot of vegetables and fruits, it happens. Intestinal pain and frequent stools with undigested food are intensified. In such cases, I sit on this diet and strictly adhere to it for a week, and after 2 weeks I begin to introduce sweet dishes and stewed vegetables. The condition immediately improves";
  • "... After treatment of severe pneumonia with antibiotics, a terrible bloating, gas formation and unstable stool appeared and this lasted about a month - worse and worse. I had to see a doctor because I myself could not cope with this problem. I did feces and culture, put dysbacteriosis (there were very few lactobacilli). In addition to Acipol, a strict diet was prescribed. And only after two weeks did it get better";
  • "... In the summer on vacation, I felt what it was. Apparently affected by heat, heavy drinking and plenty of poorly washed fruit. The rest was spoiled, though it didn’t take me very much, but for a whole week I had to strictly follow a diet - there was no question of any fruits, sweet soda water and sweets. I noticed that it was worth eating a sweet bun or soda, it was again deteriorating. Upon returning home, she took up nutrition more seriously.".

Diet price

The diet is not very expensive, despite the fact that the main products are fish, beef, chicken and cottage cheese. Grains and vegetables are practically excluded. According to the menu, the cost of weekly food has been calculated - it is 1250-1300 rubles.

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