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PATHOLOGIES AND DIETS
Diabetes and related pathologies
Gastroduodenitis and Peptic Ulcer
High cholesterol, Hypertriglyceridemia
Hypertension
Constipation
Pathology of chronic inflammatory intestinal diseasesOverweight and obesity
The protein diet
Supplements
AMIN 21K
Diabetes and related pathologies
Eating correctly can help prevent diabetes in people at risk.
Following a diet is important to keep the glucose metabolism well-balanced, avoid becoming overweight, and prevent hyperlipidemia.
Foods to use in moderation
Whole grain cereal and related products
Legumes, raw and cooked vegetables
Lean meat: veal, chicken, turkey, rabbit, beef, grilled, roasted, baked, or steamed
Eggs: no more than two per week
Fish: Frozen or fresh; steamed, boiled, roasted, grilled, baked.
Parma ham, cooked ham, without fat, bresaola
Fresh fruits in season
Fat free milk, low fat or fat free yogurts
Foods to avoid
Sugar, honey, jam, sweets, ice-cream, syrups, chocolate, desserts, biscuits, candy, pudding
Drinks: wine, beer, liquor
Carbonated drinks: Coke, orange juice, Seven up, etc.
Sweet fruits: bananas, persimmons, figs, grapes, plums, fruit juice
Dried fruits, chestnuts, fruit in syrup, candied fruit, pickled fruit relishes
Sausages, salami, smoked food, pickled food
Fatty meat: ham, lamb, goat, goose, wild game, giblets
High fat cheese
Whole milk
Butter, margarine
Salt, gravy, and sauces can be used in moderation
Recommended dressing: olive oil, sweet corn oil, maize oil, sunflower oil
It is better to use artificial sweetener instead of sugar
Foods to be used in doctor-prescribed quantities
White bread, crackers, breadsticks, melba toast, pasta, rice
Low fat cheese: mozzarella, cottage cheese, certosino, fontina, bel paese, taleggio, robiola.
Low fat milk
Some advice for diabetics
It is very important that the diabetic is well informed about his/her illness since he is the most responsible for maintaining his own health.
Each diabetic should have a personalized diet, prescribed by his doctor, which regulates not only quality, but also quantity of foods used. Food portions should be weighed at least for the first few days to establish the correct quantities.
Continually weighing foods can be avoided using kitchen utensils such as measuring spoons, cups, etc. until the size of a correct portion is well understood. To keep diabetes under control it is necessary to eat the assigned quantity of food given in each meal without transferring some part of it to the next meal.
Gastroduodenitis and Peptic Ulcer
DIET FOR PEPTIC ACID ILLNESS AFTER ACUTE STAGE
Food advisories
Eat small, frequent meals, (four or five times per day), but no more, to avoid increased acid secretion.
Use simple methods of food preparation, making sure that the food is well cooked.
Dressings and sauces are to be used with moderation, giving preference to those which are vegetable based.
Avoid acidic foods such as lemons and spices.
Salt should be added with moderation.
Vegetables and legumes must be very well cooked.
Wheat bread should be toasted, rendering it more digestible.
Eat fruits, preferably cooked, for a snack.
Avoid coffee, even decaffeinated.
Avoid wine, liquor, beer, aperitifs, liqueurs, as they stimulate gastric secretion.
Food to be avoided or reduced and not to be taken on an empty stomach
Cooked fat or stock soup; roasted, salted, or smoked meat; salami, sausages, meat extract.
High fat and aged cheeses.
Spices, vinegar, spicy sauces and lemon juice.
Mushrooms, tomatoes.
Bread crumbs.
Dried or unripe fruits, dates, chestnuts.
Citrus foods.
Chocolate.
Bran with raw fiber.
Carbonated drinks.
Recommendations
Avoid foods that stimulate gastric secretion. This includes milk, especially fat free milk, although it seems to provide temporary relief.
Do not excessively reduce the use of fiber, as recent studies have shown that fiber can reduce acidity and prevent relapse.
Eat small portions of food when planning to have more than three meals per day.
High cholesterol, hypertriglyceridemia
Instructions to correct poor dietary habits.
Recommendations
Fish, rich in fatty acids with high levels of unsaturated fats, which can reduce the level of triglycerides and platelet aggregation (anti-clotting effect)
Vegetables; rich in complex carbohydrates
Cereal, whole grains, (bread, pasta, rice, etc.)
Legumes, which are almost fat-free and a source of vegetable protein, especially if they are with carbohydrates
Fiber: all plants contain fiber and are free of cholesterol, both soluble fibers (fruits, vegetables, bread, pasta) and insoluble fibers (whole grain cereals, bran). Fiber performs beneficial functions inside our intestine by absorbing water and slowing down the rate at which different nutrients, as well as fat, are absorbed.
Use in moderation
Meat products, which contain some invisible fats which are dangerous to our health
Dressings and sauces. Use olive oil, rather than butter or vegetable oil, as it has proven to be more metabolically beneficial than other unsaturated fats and better able to control blood cholesterol levels.
Fatty foods such as some cheeses and whole milk.
Fruits, for patients suffering from high triglyceride levels only.
To be avoided
Foods high in cholesterol: eggs, giblets, (brain, liver)
Excessive amounts of sugar, which cause an excessive consumption of calories and an increase in the number of circulating triglycerides. Also, in patients genetically predisposed, there is the danger of glucose tolerance alteration. Our taste for sweets can be satisfied by natural sugars which are contained in fruits, which are better tolerated by our bodies.
It is important to control the use of salt. In fact, excessive amounts of salt contribute to arterial hypertension. Meats and industrially produced foods contain high quantities of sodium, while sodium levels in cereals, legumes, fresh vegetables and fruits are much lower.
Do not consume excessive amounts of alcohol, not only because it is high in calories, but also because it can slow down fat metabolism and cause an over-production of triglycerides at the liver level, which are then enter the bloodstream. If there are no other conflicting health problems, a moderate use of wine is allowed for those suffering from high cholesterol. However, for those suffering from high triglyceride levels even a small amount of alcohol can
be dangerous.
Try to keep your weight within reasonable limits.
The daily diet should include a variety of foods so that the body receives all the substances it needs without abusing any in particular.
Studies have shown that in some western countries, where information on the risk factors of arteriosclerosis has been widely dispersed, the incidences of the disease have decreased, even with the rise in average life-expectancy. This is encouraging in that it demonstrates that arteriosclerosis is not a disease related to aging, but that lifestyle and correct diet play fundamental roles in increasing or decreasing the incidence of the illness.
LOW SODIUM DIET
To be avoided
Stock cubes (contain monosodium glutamate) and clear soups (contain sodium extracted from meat and vegetables).
Salted bread, crackers and salted breadsticks.
Fatty, salted, smoked, and canned meats.
Sausages
Giblets
Salted and smoked fish: herring, anchovies, dried salt cod, sardine, shellfish, caviar, salted and dried cod, tuna and salmon in brine, smoked salmon.
Cheese and milk products, with the exceptions of yogurt, mozzarella, and cottage cheese.
Canned fruits and vegetables.
Olives, cucumbers, and capers in brine.
Dried celery, parsley and onion powders.
Potato chips, popcorn, salty snack foods, industrially prepared foods.
Ketchup, Worchestershire sauce, soy and mustard extracts.
Snacks such as peanuts, almonds, pistachios, and some types of biscuits.
Remember
Sodium is also found in some food additives such as:
Sodium alginate - present in ice cream and chocolate drinks
Sodium benzoate - present in jellies
Sodium sulfate - present in dried fruits
Some types of medicines can contain notable amounts of sodium; for example, alkalinized medications for cough and headaches, laxatives, and others. It is therefore advisable to consult a doctor before taking any medication.
Prolonged use of some diuretics, in the treatment of hypertension and water retention, can cause an excessive loss of potassium.
Most fruits (especially oranges and bananas), fresh vegetables, legumes, and meats are good sources of potassium.
Those who suffer from high blood pressure should never use table salt and should use only a minimal amount of salt in food preparation.
Low sodium seasonings can be substituted for salt: basil, garlic, oregano, rosemary, fennel, vinegar, mint, red pepper, marjoram.
The use of coffee and alcoholic drinks should be reduced.
DIET RICH IN ROUGHAGE
Foods rich in roughage
Raw vegetables: celeries, cucumbers, chicories, carrots, lettuces, tomatoes, and salads.
Cooked vegetables: swiss chards, leeks, cabbages, chicories, spinach, string beans, turnips, peppers, zucchini, artichokes, legumes (preferably puréed).
Vegetable soups and purées
Fresh fruits: peaches, apricots, pears, honey, plums, figs, dates, oranges
Whole grain breads and cereals
Bran: a few spoonfuls with milk or clear soup
Foods which provide little roughage:
All types of meat
High fat, spicy, and aged cheeses
Sausages, salami
Sauces and dressings
It is very important to drink plenty of liquids; water can be consumed alone or as part of soups, broths, juice drinks, etc.
Include daily portions of yogurt and prunes (dried or cooked).
Avoid excessive amounts of cocoa, chocolates, rice, fried foods, seasoning, coffee, tea, ice cream, and cold drinks.
It is also a good habit to use olive oil instead of elaborate dressings.
Pathology of chronic inflammatory intestinal diseases
Ulcerative Colitis and Crohn's Disease
LOW SCORIAE DIET
Recommended
White bread, preferably toasted, breadsticks, crackers, melba toast.
Small pasta
Rice, semolina, rice cream.
White meat, low fat meat, roasted or boiled
Low fat fish, fresh or frozen, boiled or grilled
Parma ham, cooked ham, bresaola
Fresh, soft cheese: cottage cheese, mozzarella,
crescenza, bel paese, certosino, fontina, robiola, quartirolo
Oil, butter, if possible raw with little cooking oil
Soft boiled eggs, poached eggs
Cooked and strained vegetables: starting with carrots and potatoes, then asparagus, beets, greens, string beans, spinach, zucchini
Fruit: apples, bananas, peaches
Jellies, fruit jams
Biscuits, puff pastry, sugar
Water, tea, non-carbonated drinks
To be avoided
Milk and milk products during acute stages of the illness and after surgery. Take in small portions only after the above case, according to individual tolerance.
High fat meats: pork, wild game
Sausages
High fat and fermented cheeses
High fat fishes
Brown bread, whole wheat bread and food made of whole wheat flour (whole wheat cereal)
Fried and boiled eggs
Lard, bacon
Spicy sauces, mustard, spices, olives
Fresh and dry legumes, artichokes, cabbages and tomatoes
Persimmons, strawberries, raspberries, blueberries, blackberries, currants, figs, pears, nuts, dried fruits
Chocolate, sweets
Alcoholic drinks
Carbonated and cold drinks
Strong coffee and tea
This diet is recommended as long as intestinal trouble persists. Upon the absence of symptoms, return gradually to a normal diet.
Introduce raw vegetables only after significant improvement.
LOW CALORIE DIET
Use in moderation
Lean meat: beef, veal, chicken, rabbit, turkey (without skin, which is very fatty)
Low fat fish: hake, turbot, bass, sole, dab, angler, octopus, dogfish, trout.
Vegetables: they contain few calories, but be careful with potatoes and legumes as they have a higher caloric content.
Fresh fruits: except for figs, persimmons, bananas, grapes, plums, and chestnuts, as they are rich in sugar.
Eggs (few): poached or boiled.
Parma ham, cooked ham, bresaola, remove the fat before eating.
Low fat milk, fat free yogurt.
White bread, whole wheat bread, crackers, breadsticks, pasta, rice, semolina and whole grain cereal.
Low fat cheese: cottage cheese, mozzarella, provolone, tomino, quartirolo, scamorza.
Tea or coffee with very little sugar or sweetener
To be avoided
Fatty meats: pork, goat, lamb.
Fatty fish: tuna in olive oil, eel.
Sausages, salami, bacon, bologna, wurstel.
All cheeses except those already mentioned above.
Cooking oils: cream, lard, butter, excessive vegetable oil.
Sweets in general: bonbons, sugar, honey, jams, chocolates, syrups, candies.
Fresh fruits: bananas, persimmons, figs, chestnuts, plums, dried fruits or those in syrup.
Salty snack foods.
Sauces, mayonnaise
Alcoholic drinks: wine, liqueurs, beer, aperitifs.
Carbonated drinks: cola, orange soda, Seven-Up, etc.
Recommended
As condiments: olive oil, sunflower oil, corn oil, and soy oil, in small quantities (two tablespoons per day).
Plum tomatoes, lemons, vinegar, spices, basil, herbs, oregano, garlic, parsley, celery, pickles.
The use of salt must be limited.
Meat and fish should be grilled, roasted, steamed, or boiled without adding sauce.
Vegetables should be cooked in little water, steamed, baked, or braised (cooked at low temperature in a small amount of water or clear soup, uncovered).
Each meal should be planned in advance; do not eat between meals and do not skip meals.
If there are no other health problems, for short distances walk instead of driving, take the stairs, and get regular exercise. For more rigorous exercise programs you should always consult a doctor.
The best diet is to eat less. However, scientific research has shown the low-calorie diet to be almost a complete failure, having a success rate of only eight percent. Only patients with fewer than 10 kg to lose have any chance of success. It is true that a low calorie diet, when well-balanced, is a sure way to lose weight, but it is also the most difficult and uncomfortable for the following reasons:
--- It does not eliminate hunger; few people can resist this discomfort and thus abandon the diet after two or three weeks
--- It is too long-term; losing only 500 gr per week is demotivating for a patient who needs to lose more than 10 kg.
--- It favors temptation; the continual hunger causes the patient to binge, exceeding food quantity limitations.
Beyond this, the doctor must remember when administering this type of diet that reducing the number of calories is often accompanied by a reduction in other metabolic needs.
An alternative is absolute fasting. Under this method, only water is consumed, which promotes less fat loss and more loss of striated muscle mass, including cardiac muscle fibers, the loss of which can have fatal consequences. Nitrogen balance studies have shown that with an absolute fast an adult who weighs 70 kg loses 3.7 kg of nitrogen per day. Calculating that 1 g of nitrogen corresponds to 6.25 g of protein and that about 20% of these are found in muscle, the loss is 32 g of muscle per day. Also, considering that protein requirements become greater as calorie intake is reduced, the patient will lose about 2kg of muscle fiber after 10 days of fasting.
Taking this into consideration, several authors began searching for a diet which would promote a negative caloric balance while minimizing the loss of muscle mass. To achieve this, it was necessary to modify the absolute fast with the introduction of a protein supplement.
Bollinger tried to introduce albumin in 1966.
Apfelbaum added casein in 1970.
Geunth and Verter added glucose to casein in 1974.
Baird and Howard mixed glucose and amino acids in 1975.
However, it was Blackburn who discovered that the body needs amino acids during fasting. He demonstrated that a deprivation of calories, with the complete absence of carbohydrates, can neutralize the anabolic effect of insulin on fat metabolism. In fact, lithogenesis is impossible without insulin.
Blackburn proved that small quantities of amino acids caused small changes in the metabolic reaction during fasting and could neutralize the negative nitrogenous balance. Therefore, the danger of fasting could be eliminated by taking protein without carbohydrates. Blackburn codified the exact amount of protein to be taken during fasting to protect the noble mass of the human body, which is from 1.2 g to 1.5 g per kg of ideal weight. This was the beginning of the protein diet. It protects the nitrogenous balance and eliminates hunger thanks to the accompanying state of ketosis.
In fact, during the protein fast glucose levels drop, resulting in the activation of catabolism of adipose triglycerides. The lipoprotein lipase hydrolyzes the triglycerides into fatty acids and glycerol, the latter of which is then oxidized into glucose at the liver level. Forty percent of the fatty acids produced are utilized for muscle work, while the remaining 60% undergo beta-oxidation at the hepatic level, with formation of acetyl-CoA.
In the successive condensation of two molecules of acetyl-Coa, acetic acid is formed.
Most of this acid is then transformed into acetone and betahydroxibutyric acid.
These three compositions are called ketone bodies.
Correct pancreatic functioning, typical in non-diabetic patients, will allowed the subsequent reconversion, in the presence of low insulin concentrations, of the ketone bodies into acteyl-CoA which is then metabolized.
The formation of ketone bodies during protein fasting has many advantages:
--- Supplying 25% of the energy the body needs during a protein fast.
--- Aiding the utilization of free fatty acids by the brain which transforms its energy source using ketone bodies for 80% of its metabolism.
--- The ketone bodies travel freely throughout the body supplying energy. In fact, as they do not need protein windows, they easily penetrate cell membranes.
From this we can conclude that the protein fast allows the use of all of the energy from the adipose tissue, reducing it without damaging muscle mass.
Dr. Giuseppe Castaldo, responsible for the department of Nutrizione clinica dell'azienda ospedaliera Moscati in Avellino, has experimented extensively with this type of diet for surgery patients. The diet, reported below, includes the use of natural and dietetic food with vitamin and mineral supplements.
The patients were studied under the aspects of anthropometry, cardiology, and hematology before and during the diet. In all of the cases reported to date, (more than 500 patients), Dr. Castaldos' studies have shown a loss of adipose tissue without any loss of muscle mass.
All of the haematomic levels remained normal and there were no variations in the levels of either uricosuric agents (one of the risks
while fasting is tubular necrosis caused by uric acid), haematic PH (the possible initial acidosis of the ketone bodies was readily blocked), or hepatic enzymes (lack of steatosis). There were also no variations in the ECG graph.
Of particular interest was the discovery that the loss of fat was located mainly at the areas of excess adipose tissue.
Even though this process is not yet completely understood, it suggests a specific action of the GH, a hormone that increases during this diet.
The success of the protein diet has prompted food supplement outlets to supply a variety of freeze-dried protein products suitable for replacing natural food, often accepted with some difficulty by patients.
Without entering into a comparison of the different products on the market, but reminding each of us to verify, according to medical science, what we are suggested and, above all, that compositions do not exceed daily requirements of amino acids, here are the guidelines we used in our choices.
A dietetic food protein to be used in the diet treatment must:
Respect or come near to the percentage of essential amino acids suggested by Meister in "Biochemistry of Amino Acid" in 1965.
Respect the lysine/tryptophan ratio of 4 (L²HEWx4)
Not be subjected to acid hydrolysis in its treatment, as this technique destroys the tryptophan.
Come as close as possible to the amino acid compositions characteristic of the food which is principle for human growth: a woman's milk.
Reported below are the percentages of essential amino acids in a woman's milk and those established by Meister:
AMINOACIDS |
WOMAN |
MEISTER |
|---|---|---|
Istidine |
7% |
|
Isoleucine |
12% |
15% |
Leucine |
22% |
20% |
Lysine |
18% |
16% |
Methionine |
4% |
7% |
Phenylalanine |
10% |
10% |
Threonine |
12% |
10% |
Tryptophan |
4% |
5% |
Valine |
11% |
20% |
Protein supplement made of milk proteins and enriched with isoleucine, ornithine, tryptophan, taurine, citrulline, and potassium aspartate.
AMIN 21 K, containing 21 aminoacids, is a complete protein supplement, and not only: the resulting proportions of essential amino acids is as close as possible to the international recommendation.
In AMIN 21 K the ratio, in percentage, between essential aminoacids is as follows:
Protein content: Milk protein 78% + 12% added aminoacid = 0.025% Content of Na+
THE 21 AMINOACIDS OF AMIN 21 K
ESSENTIAL |
SEMIESSENTIAL |
NON-ESSENTIAL |
Isoleucine |
Tyrosine |
Alanine |
Leucine |
Cystine |
Aspartic acid |
Lysine |
Arginine |
Glutamic acid |
Methionine |
|
Glycine |
Phenylalanine |
Proline |
|
Threonine |
Serine |
|
Tryptophan |
Taurine |
|
Valine |
Ornithine |
|
Istidine |
Citrulline |