Diet In Diseases Of The Heart. Part 2

Description

This section is from the book "Food And Feeding In Health And Disease", by Chalmers Watson. Also available from Amazon: Food and Feeding in Health and Disease.

Diet In Diseases Of The Heart. Part 2

Chronic Heart Disease

The diet for patients with chronic organic heart disease usually requires more or less careful regulation, even before compensation is lost, for digestion is always more or less handicapped by the heart lesion, with its resulting venous stasis in the liver and other parts of the alimentary tract. After compensation is lost the question of diet certainly becomes one of the most important factors in the treatment. The gaseously distended abdomen may press up the diaphragm and impede the already embarrassed respiration, thus occasioning great discomfort and restlessness. These symptoms can be greatly lessened and often entirely relieved by a carefully restricted and judiciously arranged dietary. The diet must be regulated to suit the condition of the patient and his special circumstances. General principles applicable to all cases are as follows: -

General Directions

1. The meals should be small in amount. More should never be taken than the patient can easily digest. Over-distension of the stomach from food mechanically pushes up the diaphragm and displaces the heart, causing palpitation and dyspnoea. In addition, if the meals are too large, the residue of the digested food in the intestine ferments and causes flatulence.

2. The meals should be simple, and well cooked. A simple diet (i.e. not too large a variety of courses) throws less strain on the digestive functions, and also greatly diminishes the risk of eating to excess. Improperly prepared food is a cause of indigestion, and may itself produce flatulence and discomfort.

3. Long intervals between the meals should be ordered, and eating between meals should be strictly prohibited, as even a small portion of food taken while digestion is in progress may give rise to flatulence. The object of this restriction is to permit the stomach to have time to enabie it to completely get rid of one meal before it is again filled.

4. Three meeds of about equal size should be taken in the twenty-four hours. The midday meal can be the richest, but the total bulk should be about the same in each.

5. The meals should be taken as dry as possible. This lessens the distension of the stomach and does not over-dilute the gastric juice; further, fluid ingested tends to dilate the vessels, to raise arterial tension, and to increase the work of the heart. Fluid need not be restricted to a very small amount unless special indications arise, but it should be taken mainly between meals and sipped slowly. Weak tea or coffee can be taken in small amount with breakfast, and alone for afternoon tea.

In a general way, it may be said that, in all cases in which compensation is satisfactorily established, a diet of plainly prepared food, unencumbered by too many detailed restrictions, is best, but a few hints may be here given as to foodstuffs.

All highly seasoned food and condiments are better omitted, as they tempt the appetite more than is necessary. Stews and badly fried foods are apt to cause derangement of the digestion.

It will also be found advisable to restrict the carbohydrates, especially the starches and sugars; they need not be strictly cut off, unless causing fermentation and flatulence. Toast, dry bread, rolls, biscuits, may be taken, but should never be eaten warm. Lightly made and well-cooked milk puddings can be taken, but pastry and suet puddings are not suitable. Of the vegetables, potatoes (not new), cauliflower, spinach, vegetable marrow and cucumber, stewed tomatoes (the pulp only), boiled onions, stewed celery, asparagus tops, are all easily digested. The root vegetables and stalks of the green vegetables above mentioned should be avoided.

Alcohol is not necessary in the early stages of heart disease, and if later indicated on account of marked failure of compensation, small doses of good whisky or good old brandy may be given in measured quantity twice daily. Wine and beer are better withheld.