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WS/T 558-2017 English PDF

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WS/T 558-2017: Dietary guide for stroke patients
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Basic data

Standard ID WS/T 558-2017 (WS/T558-2017)
Description (Translated English) Dietary guide for stroke patients
Sector / Industry Health Industry Standard (Recommended)
Classification of Chinese Standard C55
Word Count Estimation 14,119
Date of Issue 2017-08-01
Date of Implementation 2018-02-01
Regulation (derived from) State-Health-Communication (2017) 10
Issuing agency(ies) National Health and Family Planning Commission of the People's Republic of China

WS/T 558-2017: Dietary guide for stroke patients

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Dietary guide for stroke patients ICS 11.020 C 55 WS People's Republic of China Health Industry Standard Dietary guidance for stroke patients 2017-08-01 released 2018-02-01 implementation Issued by the National Health and Family Planning Commission of the People's Republic of China

Foreword

This standard was drafted in accordance with the rules given in GB/T 1.1-2009. Drafting organizations of this standard. First Hospital of Hebei Medical University, Institute of Nutrition and Health, Chinese Center for Disease Control and Prevention, Peking Union Medical College Hospital, Tianjin Third Central Hospital, Huashan Hospital Affiliated to Fudan University, West China Hospital of Sichuan University, Second Affiliated Hospital of Harbin Medical University, China Japan Friendship Hospital, the Second Hospital of Hebei Medical University. The main drafters of this standard. Li Zengning, Zhang Jian, Ma Fang, Yang Qinbing, Qi Yumei, Liu Jingfang, Jiao Guangyu, Chen Wei, Hu Wen, Zhang Xiang Jian, Zhou Chunling, Gu Ping, Luo Bin, Jia Shanshan. Dietary guidance for stroke patients

1 Scope

This standard stipulates the dietary guidelines, recommended intakes of energy and nutrients, food choices, and formulation of dietary prescriptions for stroke patients. This standard applies to dietary guidance for stroke patients.

2 Terms and definitions

The following terms and definitions apply to this document. 2.1 Stroke Cerebral blood vessel obstruction or rupture caused by cerebral blood circulation disorders and brain tissue function or structure damage disease. Can be divided into two categories, namely ischemia Cerebral stroke and hemorrhagic stroke, including cerebral hemorrhage, cerebral thrombosis, cerebral embolism, cerebral vasospasm, etc. 2.2 Medical Nutrition Therapy; MNT Nutritional treatment measures for specific diseases under clinical conditions, including individualized nutritional assessment, diagnosis, and nutritional therapy for patients The formulation, implementation and monitoring of treatment plans. 2.3 Pressure ulcers Part of the body is damaged by pressure, shear or friction, causing blood circulation disorders and causing necrosis of the skin and subcutaneous tissue. 2.4 Aspiration pneumonitis It is caused by inhalation of acidic substances, such as animal fat, food, stomach contents, volatile hydrocarbons or other irritating liquids Lung injury. In severe cases, respiratory failure or respiratory distress syndrome can occur. 2.5 Stress ulcer When the body suffers severe trauma (including major surgery), infection and other stress conditions, erosions and superficial ulcers of the stomach and duodenal mucosa appear Acute injuries such as ulcers and bleeding. 2.6 Hepatic encephalopathy; HE A syndrome of central nervous system dysfunction caused by severe liver disease or portal-systemic shunt based on metabolic disorders, clinical manifestations In mild cases, there may be only slight mental decline, in severe cases, disturbance of consciousness, behavioral disorders, and coma may occur. 2.7 Dysphagia Abnormal swallowing process. Dysphagia in stroke patients refers to the inability to safely deliver food or liquids from the mouth to the stomach without aspiration, and Including abnormalities in the oral preparation phase, such as abnormal chewing and tongue movements. 2.8 Body mass index; BMI body mass index An index for calculating weight for height. See formula (1) for calculation.  2)m(/)kg(BMI height and weight...(1)

3 Dietary guidelines for stroke patients

3.1 Balanced diet Choose a variety of foods to achieve reasonable nutrition to ensure adequate nutrition and suitable weight (18.5 kg/m2≤BMI＜24.0 kg/m2). The daily recommended intake of cereals and potatoes, vegetables, fruits, meat, poultry, fish, milk, eggs, beans, oils and fats are five categories of food. Be the staple food Match thickness. 3.2 Individualized dietary guidance According to the different populations of stroke, corresponding medical nutrition treatment is carried out to meet their nutritional needs in a specific period. For the young brain Stroke patients should develop good eating habits to reduce symptoms of hyperlipidemia, hypertension, and hyperglycemia. For elderly stroke patients, provide suitable Of energy and nutrients and consider its psychosocial factors. 3.3 Cooking method Use steaming, boiling, stewing, mixing, boiling, simmering, simmering, braising and other cooking methods with less salt and less oil. Reduce chewing, easy to digest and absorb. 3.4 Changes in food quality and traits For patients with dysphagia, change solid food into a puree or paste. Solid food is mechanically processed to make it softer and more uniform in texture It is not easy to loosen, thus reducing the difficulty of swallowing. Most patients with dysphagia after stroke are most likely to aspirate dilute liquid. Adding thickeners to increase viscosity can reduce aspiration and increase intake. Pay attention to fortifying the nutritional ingredients that may be lost in foods with structural changes Divide, try to make the food can arouse the patient's appetite.

4 Recommended intake of energy and nutrients for stroke patients

4.1 Energy The basic energy expenditure of stroke patients is about 30% higher than that of normal people (the Schofield modified formula is used to calculate the basic energy consumption of normal people). Thanks for consumption). The recommended energy intake is 83.68 kJ (20 kcal)/(kg·d) ~ 146.44 kJ (35 kcal)/(kg·d), then root The coefficient is adjusted according to the patient's height, weight, gender, age, activity level, and stress status. The energy supply of stable patients can be the same as that of normal people, and those who are overweight should reduce their energy supply. The energy requirement after the onset should be in accordance with The formula "BEE×Activity Coefficient" is calculated. 4.2 Protein The protein intake of stroke patients is at least 1 g/(kg·d), and if there is excessive catabolism (for pressure sores) The protein intake increased to 1.2 g/(kg·d) ~ 1.5 g/(kg·d). The ratio of animal protein to plant protein is about 1.1. 4.3 Fat Total fat energy accounts for no more than 30% of total energy intake in a day, and no more than 25% for patients with dyslipidemia. saturated fatty acid Energy accounts for no more than 7% of total energy intake in a day, and trans fatty acids no more than 1%. n-3 polyunsaturated fatty acid intake may account for total energy The amount of 0.5% to 2%, n-6 polyunsaturated fatty acid intake can account for 2.5% to 9% of total energy. 4.4 Carbohydrates On the basis of reasonable total energy control, carbohydrates in the diet of stroke patients should account for 50% to 65% of the total daily energy intake. 4.5 Vitamins and minerals A balanced supplement of foods containing multiple vitamins and minerals and formula foods for special medical purposes, especially those rich in vitamin B6 and vitamins B12, vitamin C, folic acid and other vitamin foods (see Appendix A to Appendix D), prevent the deficiency of trace elements and reduce the risk of patients risk. 4.6 Dietary Fiber The daily intake of dietary fiber for stroke patients can be 25 g/d ~ 30 g/d, and patients with bed rest or with constipation should increase their dietary fiber intake as appropriate 4.7 Cholesterol Limit cholesterol intake to no more than 300 mg per day, and no more than.200 mg for people with abnormal blood lipids. 4.8 Water Under the condition of unrestricted fluid intake, under mild weather conditions, stroke patients drink at least 1200 mL of water per day. For coma stroke Middle-aged patients can be supplemented several times through a small amount of nutrition tube to maintain water and electrolyte balance.

5 Food choices for stroke patients

5.1 Cereals and Tubers Ensure that the intake of grains, cereals and tubers is.200 g～300 g. Prefer low sugar and high dietary fiber types, such as naked oats, buckwheat, jade Rice noodles, millet, oats, wheat bran, brown rice, etc. 5.2 Animal food 5.2.1 Poultry meat It is recommended that the daily intake of poultry food is 50 g～75 g. Prefer low-fat and high-quality protein types, such as pigeon meat, turkey leg, chicken Brisket, beef tenderloin, pork tenderloin, etc. 5.2.2 Fish and shrimp The recommended daily intake of fish and shrimp foods is 75 g-100 g. Prefer low-fat, high-quality protein types, and rich in polyunsaturated Fatty acid foods, such as sea cucumber, silver carp, herring, carp, hairtail, eel, cod, etc. 5.2.3 Eggs The recommended daily egg intake is 25 g～50 g. For stroke patients with hypertension, dyslipidemia, and diabetes, eat less eggs Yellow, you can eat one for 2 to 3 days. 5.2.4 Milk and milk products It is recommended to drink 300 g of milk or an equivalent amount of milk products every day. Low-fat, skimmed milk and its products are preferred. 5.3 Beans and their products It is recommended to consume 30 g～50 g soybeans or equivalent amount of soy products every day. Preferred mung beans, black beans, adzuki beans, soybeans, soy milk, tofu, Soy sauce and so on. 5.4 Vegetables The daily vegetable intake of patients with brain tube disease is more than 500 g, mainly fresh green leafy vegetables, such as spinach, rape, water spinach, raw Vegetables, lettuce leaves, etc. 5.5 Fruit The daily fruit intake of patients with cerebrovascular disease without hyperglycemia is about 150 g. Watermelon, orange, grapefruit, lemon, Peach, apricot, kiwi, loquat, pineapple, strawberry, cherry, dragon fruit, etc. 5.6 Nuts Nuts are rich in protein, fat, vitamins, and minerals. It is recommended to consume about 50 g per week. Preferred pistachios, almonds, White melon seeds, walnuts, etc. 5.7 Grease Vegetable oil is the main ingredient. It is not advisable to eat high-fat and fried foods, such as fatty meat and animal oil. 5.8 Seasoning It is not advisable to eat high-salt dishes or pickled products, such as bacon, pickles, smoked sauces, etc. Table salt should not exceed 5 g per day, if combined high Blood pressure should not exceed 3 g per day. Do not eat spicy condiments and stimulating foods such as coffee and strong tea. 5.9 Wine Patients with stroke should limit alcohol consumption. If you want to drink after recovery, it is recommended that women drink no more than 15 g of alcohol a day and men a day The alcohol content of drinking wine does not exceed 25 g. 15 g of alcohol is equivalent to 450 mL of beer, 150 mL of wine or 50 mL of low-alcohol liquor. 5.10 Food without added sugar Such as aspartame, edible saccharin and other foods made from it.

6 other

6.1 For stroke patients with diabetes, vitamin B6, folic acid and vitamin B12 should be supplemented appropriately to reduce the patient's homocysteine level (see See appendix A, appendix C, appendix D), random blood glucose control is below 10 mmol/L. 6.2 Stroke patients with high blood pressure should have a low-salt and low-sodium diet, and nutritional management measures are the same as those of ordinary stroke patients. 6.3 For stroke patients with lipid metabolism disorders, it is recommended to give foods rich in n-3 polyunsaturated fatty acids. 6.4 For stroke patients with neuropathy, folic acid and vitamin B12 should be supplemented appropriately (see Appendix C and Appendix D). 6.5 Stroke with aspiration pneumonia, stress ulcer, dysphagia, hepatic encephalopathy, should follow the clinician and (or) nutritionist Guidance, give enteral or parenteral nutrition.

7 Formulation of dietary prescriptions for stroke patients

7.1 Established according to the food exchange portion law 7.1.1 Calculate daily nutrient requirements Calculate the daily protein, fat and carbohydrate requirements based on the metabolic status and the energy and nutrient requirements. 7.1.2 Calculate the number of food exchange servings per day Divide the calculated total energy by 90 to get the total number of exchanges required. Refer to the food exchange table (see Table E.1 in Appendix E for details) to allocate food, Distribute the number of foods to each meal reasonably. 7.1.3 Choose food based on dietary principles and exchange portions See Table E.2~Table E.7 in Appendix E for details. 7.2 Formulated according to the Food Composition Law 7.2.1 Calculate the nutrient requirements for each meal Calculate the protein, fat and carbohydrate requirements for each meal based on the energy and nutrient requirements according to the metabolic state. 7.2.2 Determine the variety and quantity of staple and non-staple food Check the food composition table (2002 or.2004 edition), and match the varieties and quantities of staple foods and non-staple foods reasonably according to dietary principles. AA

Appendix A

(Informative appendix) Common foods rich in vitamin B6 See Table A.1 for foods rich in vitamin B6. BB

Appendix B

(Informative appendix) Common foods rich in vitamin C Foods rich in vitamin C are shown in Table B.1. CC

Appendix C

(Informative appendix) Common foods rich in folic acid Foods rich in folic acid are shown in Table C.1. Note. This data is derived from "Chinese Food Composition Table.2002" and "Chinese Food Composition Table.2004". DD

Appendix D

(Informative appendix) Common foods rich in vitamin B12 See Table D.1 for foods rich in vitamin B12. Note. Quoted from the selection of the American "Encyclopedia of Food and Nutrition" (5) Food Ingredients. EE

Appendix E

(Informative appendix) Food exchange See Table E.1~Table E.7 for food exchange.

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