What do they feed in the hospital menu. Medical nutrition: the whole truth about how they feed in Belarusian hospitals

The editorial office receives many letters complaining about poor nutrition in hospitals. It's no secret that often the product does not reach the patient, settling in the kitchen. It happens that food does not seem to cause even a semblance of appetite, and sometimes it is simply tasteless. Instead of five times a day, they can feed at best three. We decided to check how things really are. Our correspondent went to read the "hospital" menu in Moscow hospitals, choosing three of them at random.

Written one - give another

FIRST on the list is the Road Hospital. Semashko.

The object of my attention is the purulent department. Upon entering the floor, immediately in front of me is a neat dining room. Above the issuance window hangs the coveted menu sheet - the purpose of my visit. But then it turns out that the joy is in vain: one thing is written, but they give something completely different. It is difficult to print the names of different dishes every day, especially since each patient has his own diet. For example, table 15 eats one thing today, while table 9 eats something completely different. The food turned out to be very tasty and interesting. For example, the menu of the 9th table includes a variety of meat products. On Monday they are given cutlets or sausages, on Tuesday - sausages, on Wednesday - chickens, and on Thursday they put fish. In addition to all this, soup is a must every day. Oil is given only in the morning. "For breakfast, eggs or scrambled eggs, that's all, nothing else," says the canteen worker. Without porridge in any hospital - nowhere. Therefore, rice, millet, semolina, oatmeal are always available. More dishes from the menu: apple soufflé, vegetable soup with sour cream, compote, etc., etc. that we don’t need anything, and so we overeat here, ”they tell me. Indeed, patients do not complain about food. Pyotr Nikolaevich says that he ate "some kind of soup for lunch today. They feed more or less, you can eat. And there are very tasty dinners, I eat with pleasure." As Sergei put it: “They don’t feed, of course, but it’s necessary for the sick, we have a diet. Otherwise, everything is fine. If you don’t eat enough, you always get a supplement.”

It is good when everything is good

In the CITY clinical hospital N 1 them. Pirogov I go straight to the dining room of the cardiovascular department. And here the menu strikes my imagination. There are dishes that you don’t often cook at home, not like in a hospital. The menu is different every day. Recurrence can be only in a week. The chefs list to me what patients usually eat. For breakfast - cereals, cheese, sausage, cottage cheese, cottage cheese casserole. Lunch is not complete without soup: borscht, cabbage soup, chicken, noodles, rice, pickle, beans, peas. Second courses are no less varied: meat goulash, cutlets, boiled chickens, Stroganoff liver, steamed chicken soufflé, pilaf, pasta with meat. In the evening, they usually give a potato casserole, boiled fish, hodgepodge, stew, lazy cabbage rolls with meat, etc. They drink kissel, kefir, compote. Every day the patient is given either an orange or an apple. The 10th and 15th tables are fed 4 times, and the 9th - as many as 5 times a day. Patients benefit from vegetables and lean meat, so there are no pork dishes on the menu. Unfortunately, it is not possible to talk with patients, but the canteen workers assure that no one has yet complained about food in their presence.

Gynecological hospital N 1 is designed for a little more than 100 beds. Therefore, cooks have the opportunity to cook even what in large hospitals will seem too troublesome. For example, they bake pies with meat, and in the summer they stuff peppers and eggplants. “It’s supposed to feed for 39 rubles, and we feed for 53, the hospital adds. And then, after all, our cooks cook with soul. Patients, for example, ask what we add to an omelet, and does it become so airy? And the secret is simple: you need beat it well, with love," says Olga Sergeevna, a dietitian. The menu here is also seven-day, that is, it is not repeated. And they give both meat and fish, sausage, cheese, eggs, fruits, cereals, vermicelli. Even in winter, they try to include tomatoes and cucumbers in the diet every day. They indulge in a sweet and such signature dish as meatloaf. They definitely have an afternoon snack with fruits, and a glass of kefir is put at night. For lunch today, a fragrant mushroom soup and the aforementioned meatloaf are prepared. It's really delicious and homemade. I read the book of reviews and suggestions. In addition to sincere gratitude to doctors, a separate “thank you” to the kitchen and chefs often flashes. They even asked to have a separate book for the dining room.

"We express special gratitude to the catering staff for their loving attitude to their work. All dishes are very tasty, satisfying and varied. Thank you very much!"

Chamber N 11

"Thank you so much for the wonderful food. Everything is so delicious in the hospital, just like at home..."

16th ward

It turns out that this also happens in our hospitals: the doctors are good and the food is excellent.

Homemade crust tastes better than hospital pie

I have come across some fairly well-off hospitals that feed their patients fairly well. But this is rather an exception to the rule. Many of us know firsthand that sometimes it is impossible to eat what is given. Floating sausage in semolina for breakfast, soup from one cabbage leaf and a piece of incomprehensible meat for lunch - a very real picture.

Despite everything, in all hospitals, patients have one distinguishing feature. No matter how tasty the food is, they will still ask you to bring something from home. Apparently, the point here is that you want something native, from the hands of home. It's also important to feel the support of a loved one. About how to diversify the diet of the patient, tells doctor of the clinical nutrition clinic Valentina Nikitichna MATUSHEVSKAYA:

Each patient has his own treatment table. In turn, the tables have an approved diet and nutritional habits, each has its own diet. It happens that formally all the rules are observed: both the calorie content and the ratio of products. But there are certain dependencies. For example, in winter and spring there is a traditional shortage of vegetables and fruits. The social factor plays a role, sometimes there is not enough money for medicines, not to mention a varied diet. Again, the hospital is tied to a specific food base. Well, if there is what you need. And if not, you have to get out, replace the potatoes with pasta and vice versa. Not the last role is played by the human factor: how the chef prepares the dish, how well he succeeds. Due to the geographical location of vegetables, cabbage, carrots and beets are very popular with us. They are definitely helpful. But someone may not tolerate the same cabbage. If possible, you can introduce cauliflower, zucchini, green beans, greens into the diet. It is quite possible to introduce salads, which are rarely found on the menu of hospitals. You can make healthy vegetable casseroles from carrots and beets. All this, of course, in accordance with the diet. If someone can’t do something, then it’s necessary.

Ideally, hospitals should have 5 meals a day in order to restore an exhausted body. In practice, 3 meals a day is common. This, of course, is not enough. Therefore, the relatives of the patient can consult with the attending physician, ask what additional to bring to the patient. Fermented milk products (cottage cheese, milk, yogurt, cheese) will be very useful. If you are allowed to bring homemade products, make vegetable stew, cook boiled chicken. A good way out is children's vegetable and fruit mixtures. They contain many nutrients and can be eaten even by people who have difficulty chewing. Do not pamper the patient with various goodies. For example, if he likes everything salty, peppery, spicy, do not forget that this does not fit into a healthy diet. Excessive sweets are extra carbohydrates, and they are not always needed.

There is an opinion that the broth is the best thing you can bring to the hospital. Much more useful for the patient as additional nutrition will be polysubstrate nutrient mixtures. They are a balanced amount of proteins, fats, carbohydrates. These mixtures are more easily absorbed by the body, the patient spends less energy on digesting food. Polysubstrate mixtures are usually sold in specialized stores in powder form. It must be dissolved in water and drunk, or the drug is sold ready-made. There are so-called modular mixtures, the property of which is to enhance any component of nutrition (proteins, fats or carbohydrates). But few people know about them, and therefore not all doctors can advise them. Remember to talk to your doctor about all dietary changes. Depending on the type of treatment, drink mineral water. Diluted fruit drinks, juices, dried fruit compote are useful.

During the time that a person is in the hospital, he has to rebuild the body in a new way. And all because the food in the hospital is not at all like homemade, and the regimen is not the same. Nevertheless, not so little depends on porridge and compote: if the food is full and tasty, then we will recover much faster.

In general, the state allocates 39 rubles for the nutrition of the patient. per day. With this money, you don’t even go to the store once. Nevertheless, this amount is supposed to be fed 4-5 times a day, moreover, satisfying and varied.

The hospital diet is low-calorie, its duration is 14 days.
Weekly weight is reduced by 2 - 3 kg.

Probably everyone who has ever been in a hospital with any disease has come across this diet, but no one has a desire to use a hospital diet for weight loss.

It would seem that the hospital diet is the usual common table number 15 for recovering patients, but in fact it is not.

A menu compiled by nutritionists is one thing, and its practical implementation is quite another. We will not delve into vicious schemes for the purchase, delivery and bookmarking of products in medical institutions. But everyone who has been in hospital for their own experience has experienced how many calories are contained in such a diet. In addition, recently there is no division into therapeutic diets in /tables/ in many hospitals. The main role in nursing patients, according to the hospital authorities, should be played by relatives.

Therefore, if you use this diet for weight loss, you get a very good result.

Detailed description and application of the hospital diet

So, the basic rules of the hospital diet

The volume of food should correspond to hospital norms, and this is 0.5 liters of soup / in fact 0.4 liters, because in the hospital canteen no one will pour you a full plate and give you an additive / exactly the same volume and the second dinner dish;

Products for cooking should be low-fat, meat for soups should be lean and in a minimum amount; cutlets, meatballs should also be cooked with a minimum amount of meat; porridge on the water;

Tea, coffee, compote sweeten to a minimum;

Black bread is better, no more than two thin slices for each meal;

The number of meals should be 3-4 times a day;

The last meal, as in a hospital, no later than 18.00;

Snacking between main meals is not allowed;

If the feeling of hunger is unbearable, you can increase the portion of morning porridge, and in the evening eat some fruit, apple, orange, pear.

Drinking regimen is not limited

Sample hospital diet menu for the day:

Breakfast : porridge / barley, semolina, rice / boiled in skim milk; bun with butter, liquid coffee, tea /not very sweet/

Dinner : any light soup with leftover meat / cabbage soup with sauerkraut, pea, borscht, pickle, soup with canned food, etc. / For the second - garnish / rice, buckwheat, cabbage, mashed potatoes, pasta, vermicelli / with a cutlet , meatballs, sausage, a piece of cheap doctor's sausage / with gravy; dried fruit compote, two slices of bread.

Dinner : carrot casserole, cottage cheese, egg, pancakes, scrambled eggs and porridge /save the morning diet/, a slice of bread.

The calorie content of such food is extremely small, in addition, such a diet stimulates appetite and improves metabolic processes. And if you exclude snacks, then the process of losing weight will accelerate, and if all this is still combined with sufficient physical activity, then you can achieve outstanding results.

The hospital diet is quite effective for weight loss and is well tolerated, but you should not be on such a diet for a long time.

Dangerous properties and contraindications of the hospital diet

Before using this diet, be sure to consult a dietitian. The site administration does not guarantee that the specified diet will help and will not harm you personally. Do not forget that you use any diet at your own peril and risk. Be prudent!

Nutrition for clinics is justified balanced and partly dietary food for people suffering from a variety of ailments that may be accompanied by certain eating habits.

What kind of food do patients need?

The issue of dietary prescriptions, taking into account the medical process, is fully resolved by doctors. Although to unify this process, diet numbers in the amount of 15 pieces are used. That is why companies, including ours, which provides food preparation and delivery services for clinics, must adhere to the developed programs, taking into account the profile of the healthcare institution.

Since the absence of certain groups of patients is the basis for excluding the provision of food on a specific dietary table. All this requires the chef and his team, when fulfilling the order of medical institutions, to prepare food:

• taking into account the sanitary mode of preparation;
• using fresh and natural ingredients;
• with diversity
• delicious food.

The latter aspect is important for compliance with treatment prescriptions, as well as for the patient to receive a full range of useful vitamins and necessary amino acids - substances that contribute to the speedy recovery of strength. It is very important to take into account the individual characteristics of the patient.

Overweight people, even if they have a prescribed diet, say, according to the kidneys or liver, should eat in such a way that the food contributes to both recovery and the absence of progress in diseases associated with obesity. Therefore, the delivery of food for hospitals and other institutions where there is a day hospital should be carried out with monitoring of the category of patients placed in them.

How to organize meals?

Usually, the issue of nutrition of patients and staff is carried out by the Deputy Chief Physician for Logistics. If the health department for veterans is on the balance sheet of any military unit or enterprise, then meals for the hospital are ordered through the main organization, even if the point of preparation or delivery is located at the address of the health care institution itself. At the same time, in an agreement with a company that will organize meals for patients, it is important to stipulate:

• the daily number of servings, taking into account the people lying in the hospital;
• adherence to certain diets;
• Delivery time;
• prices.

These are obligatory conditions of the agreement, allowing to consider the contract valid. Separately, you can take care of the nutrition of the clinic staff. We have been providing this service for 7 years. High-quality and healthy food at the place of work will increase the efficiency of the team, eliminate lateness to work.

We will not stand behind the price of health

We will be able to order food for hospitals in Moscow, which is seasoned with the professionalism of our chefs and laudatory reviews from patients, but the real advantages of our work are:

• fair prices;
• discounts for large orders;
• reducing the cost of the order while helping to find new customers.

We are open for cooperation!

If we look back centuries, we will see that clinical nutrition arose simultaneously with the first knowledge in the field of medicine. The ancient Greek healer Hippocrates said: we are what we eat.

Let me remind readers of how the concept of modern medical, dietary nutrition arose. At the dawn of Soviet power, when the civil war ended, the question arose of how to restore the health of the revolutionaries. By a government decree, an institute of balneology was established, one of the leaders of which was a physiologist and gastroenterologist Manuil Pevzner. It was to him that a simple but brilliant idea belongs - to sort all the nosological forms of diseases known at that time into groups. For each group, he and his colleagues developed an effective therapeutic nutrition system that lasted almost until the beginning of the 21st century. These are the most famous tables. There were 15 of them in total with subgroups. Each table was characterized by a certain calorie content, the energy balance of proteins, fats and carbohydrates, the composition of minerals and vitamins.

What is a therapeutic diet?

This is a diet that allows you to replenish energy expenditure in various diseases, fully eat and maintain strength. When a person enters the hospital, sometimes he does not realize that from the very first minute he begins to receive medical prescriptions (in addition to medicines, procedures, laboratory tests), namely: the doctor of the admission department, taking into account the anamnesis, prescribes therapeutic nutrition. Previously, these were number tables. Currently, in accordance with the regulations of the Ministry of Health on the organization of therapeutic nutrition, dietary nutrition has a letter designation.

"B" - basic nutrition. It is prescribed for patients who do not require any restrictions. The diet is characterized by a complete
caloric content, moderate content of proteins, fats, carbohydrates, minerals and vitamins.

"P" - nutrition for patients with pathology of the digestive system. Caloric content, biochemical composition correspond to the basic nutrition, but differ in the mode of cooking - steamed.

"M" - a diet with a slight increase in the protein component and moderate salt restriction. This food is intended for people with diseases of the cardiovascular system.

"H" is the most rigid dietary option. Sharp restriction of protein intake (up to complete exclusion) and salt. This diet is used in the pathology of the renal excretory system.

"T" - food for tuberculosis patients. A characteristic feature is an increase in the daily calorie content of the diet.

After the patient is assigned a meal, the information is transmitted to the catering department three times a day and corrected. And already the task of the workers is to prepare dishes according to the requirements of dietology. Often one has to read in the comments complaints about food in hospitals: they say that it is not salty, and the appearance does not cause pleasant emotions, and there are no fruits, and not enough vegetables. But it is worth noting that the nutritional norms in the hospital are calculated based on the physiological needs of the patient. There are approved “natural nutritional standards”, where the amount of a particular product and methods of cooking are indicated in grams.

Thus, the norms have established a mandatory list - this is meat, fish, sausages, cereals, vegetables, dairy and sour-milk products, bread, pasta. Indeed, the list does not include fruits, juices, confectionery. But there are exceptions here too. Children, pregnant women and women in childbirth, patients with diabetes and some other categories receive additional nutrition, which includes juices and fruits.

Nutritionists are developing a promising seven-day menu separately for the spring-summer and autumn-winter period, where each calorie is calculated. Supervises the correctness of the bookmarking of products marriage commission, which includes doctors, representatives of the administration. The output of finished products is controlled both in production and in departments. The Nutrition Council meets monthly to decide on the organization of therapeutic nutrition.

The quality of products supplied for the preparation of medical nutrition is strictly controlled. Meat, fish, dairy products are delivered to the catering unit directly from the manufacturer almost the same day. So the receipt of low-quality products is excluded. Only the highest quality raw materials are used in production.

Approximate diet in the hospital:

I do not think that at home, many can afford such a diet. This is what distinguishes medical nutrition from everyday nutrition. It is saturation and variety, although patients are not always satisfied. However, cereals are carbohydrates and fiber that are easily digested and do not have a harmful effect on the digestive system.

Hospital catering units are equipped with modern equipment(hot ovens, combi steamers, steam boilers), which allows you to cook meals with the least loss of energy value, vitamins and minerals. Yes, the look of a steamed meatball cooked in a combi oven and a steak baked on the grill are radically different. But the benefits of a meatball are much higher than those of a steak or barbecue.

The main method of preparing portioned dishes is steaming. Meatballs, quenelles, meatballs are cooked in combi steamers, fish is boiled or baked. For the basic diet, fried culinary products are allowed, but not more than two to three times a week. Meat dishes are prepared mainly from beef, or minced meat for making meatballs and meatballs, or from the shoulder or hip part for beef stroganoff, goulash, dumplings. Two or three times a week, patients should receive the bird in boiled form or in the form of meatballs.

Turkey dishes are often prepared for children and patients with food allergies. Cottage cheese is used to make casseroles and puddings. Omelet, which is cooked in a combi steamer, is very popular. Breakfast cereals (oatmeal, semolina, millet) are prepared with a mixture of milk and water. Buckwheat and pearl barley are used for making side dishes. Most patients like barley porridge cooked in a steam boiler, they say, as if from an oven.

About dishes in canteens

Many patients are frustrated that they have to eat from stainless steel utensils. This makes practical sense. Stainless steel cookware is easy to process and does not break - this is a plus. Minus - the aesthetic component. Earthenware dishes are in every pantry in the departments. But such dishes often break, do not withstand thermal disinfection for a long time, because they are processed in dry-heat cabinets at high temperatures. It is possible that a decision will be made to use disposable tableware, but even here many questions may arise. The main one is recycling. We already use a lot of plastic in our lives, which does not decompose for thousands of years. So, maybe, in order to save nature from toxic waste, it is worth sacrificing aesthetics while being treated in a hospital?

After patients are discharged from the hospital, the attending physicians recommend that certain dietary guidelines be followed (depending on the disease). Use only fresh and high quality products. If possible, exclude fried, smoked, pickled dishes. Limit the amount of salt and sugar. And don't forget: we are what we eat.

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Despite the fact that I am a fairly well-known food blogger and culinary specialist, few people know that I am quite picky about food. In the sense that I can eat almost everything and in any form, well, probably with the exception of worms, cockroaches and the like, although I do not rule out that I can eat this when I get to such places.

To my great regret, I have not preserved photos of breakfasts, lunch, dinner from GKB 81, where I lay for about 10 days. But I hope you take my word for it, they fed there with dignity, cereals, soups, potatoes in various forms and pasta, not expensive, but angrily, did not die of hunger. They kept bringing fruit.
In Burdenko it was a little richer in this regard, but they gave less soup.

For a week, they did not give anything the same (except mashed potatoes).

In the morning, constantly milk or kefir, and sometimes both dairy products + porridge at once.

Everything was delicious + you need to take into account that each patient has his own diet.

In general, the myth of a terrible feeder in Moscow hospitals has almost been debunked, I really hope that in all hospitals in Moscow (and I hope the country even more) they feed like this.