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Role of diet in control of ascites

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The first step in the management of cirrhotic patients having ascites is ... Cucumber (medium size = 80 g = 4 mg Na ). Tomato (small size = 70 g = 7 mg Na ... – PowerPoint PPT presentation

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Title: Role of diet in control of ascites


1
Role of diet in control of ascites
Presented by Rabab Maamoun
Salama
2
  • The first step in the management of cirrhotic
    patients having ascites is sodium restriction.
  • The amount of fluid retained in the body depends
    on the balance between sodium injested in the
    diet and sodium excreted in urine.
  • If Na excretion in urine is greater than intake
    , ascites and or Oedema will decrease.

3
  • In patients with mild Na retention , reduction
    of Na content in the diet to 40-60 mmol / day
    (1-1.5 g of salt) without any therapeutic
    intervention will result in negative Na balance
    and loss of ascites.
  • In patients with moderate or severe Na
    retention , more severe restriction of Na to 20
    mmol/ day is indicated , however such intense Na
    restriction is difficult to accomplish and may
    impair nutritional status.
  • Failure to adhere to a low Na diet is the usual
    reason for ascites to be termed Resistant or
    Refractory.

4
General Remarks for diet control in ascites
  • I) Cereal and Cereal products
  • Bread
  • Avoid French bread , and white bread as they have
    high sodium content. Each one contains nearly 530
    mg Na.
  • ¾ of Balady bread 90 g contains 125 mg Na. So
    the patient can eat per day ¼ balady bread each
    meal.

5
  • Rice
  • 1/2 cup of boiled rice 65 g contains nearly
    7.15mg of Na.
  • Rice can be boiled or cooked with unsalted butter
    oil (low Na content every 100g 5 mg Na) or
    with corn oil or olive oil (no Na content at all
    ).
  • Macaroni
  • 3/4 cup of macaroni 60 g contains 4.8mg of Na
    can be eaten boiled with a small piece of
    unsalted butter.
  • Wheat flour
  • One cup 100g contains 22 mg Na.
  • Wheat
  • One cup of wheat 142 g contains 14.2 mg Na.

6
  • II)Legumes
  • Broad Beans
  • One cup of cooked unsalted broad beans 200 g
    contains 70 mg Na.
  • Germinated broad beans
  • One cup of boiled unsalted germinated broad beans
    200 g contains 28 mg of Na.
  • Lentils
  • ½ cup of boiled lentils 100g contains 30 mg
    Na.
  • Cow pea
  • ½ cup of cooked cow pea 100g contains 20 mg
    Na.
  • Lentils , peeled
  • ½ cup of boiled peeled lentils 72.5 g contains
    30 mg Na.

7
  • III) Starchy roots and Tubers
  • Potatoes
  • White potato has a low Na content . Every 100 g
    contains 8 mg Na.
  • One cup of fried potatoes 75 g contains 6 mg
    Na.
  • Sweet potatoes
  • One cup of boiled and minced sweet potatoes 125
    g contains 28 . 75 mg Na.
  • Colcasia tuber One cup of Colcasia 200 g
  • ½ of it colcasia and ½ of it chard swiss contains
    nearly 198 mg Na

8
  • IV) Vegetables
  • Most of vegetables are of low to average sodium
    content ranging from 7 100 mg / 100 g.
  • Examples of vegetables with low to average sodium
    content
  • Cucumber (medium size 80 g 4 mg Na).
  • Tomato (small size 70 g 7 mg Na).
  • Lettuce (6 leafs 70 g 7 mg Na).
  • Egg plant Radish white artichokes Squash
    Cauliflower Spinach.
  • Examples of vegetables with gt 100 mg Na content
    / 100 g
  • Chard swiss 164mg.
  • Jews Mallow 180 mg .
  • Water cress 116 mg.

9
  • V) Eggs
  • Hens eggs one small egg 32 g contains 50 mg
    Na.
  • Egg white Every 100 g contains 172 mg Na.
  • Egg yolk Every 100 g contains 44 mg Na.
  • VI) Milk and its products
  • ½ cup of milk 99 g contains 50-60 mg Na.
  • One cup of yoghurt 70 g contains 35 mg Na.
  • ½ cup of Cheese skim milk 80 g contains 36 mg
    Na.
  • Avoid Cow milk powder Cheese Camembert
    processed cheese- Salted cheese and Roquefort
    cheese.

10
  • VII) Meat and Poultry
  • 1 peice of cooked meat 30 g contains nearly
    30.9 mg of Na.
  • 1 slice of liver 50 g contains 40 mg Na.
  • ¼ of cooked chicken 30 g contains 23.1 mg of
    Na.
  • Avoid Canned corned beef (880 mg Na/ 100g).
  • Dried meat (5200 mg Na/ 100g).
  • Sausaged meat and salami .

11
  • VIII) Fish and Sea foods
  • One small Mullet fried 125 g contains 120 mg
    Na.
  • One small Mullet roasted 125 g contains 125 mg
    Na.
  • Avoid salted fish , and salted sardine.
  • IX) Fruits
  • All fruits of medium size as apple , apricots ,
    Banana , dates , grapes , lemon, Guava , pears,
    orange , mandarin , water melon and strawberry
    ,are of low Na content . Dried fruits as raisins
    , figs contain 30 mg Na/100 g.

12
  • X) Nuts
  • All nuts as Almonds , peanuts , hazelnuts and
    coconuts are of low Na content in the range of
    7-15 mgNa/100 g.
  • XI) Condiments
  • Avoid Mustard (240 mg/100g).
  • Clove and Cumin should be used in small amounts .
  • Clove (300 mg/100g).
  • Cumin ( 145 mg/100g).
  • Rest of condiments are of low Na content.

13
  • The ascitic patient can drink coffee , tea , ½
    glass of Seven up (14 mg / 100g).
  • He can also eat
  • Jam (2 tb spoon ) 40 g contains 5.6 mg of Na.
  • 1 piece of Halawah Tehiniah 40 g contains 2 mg
    Na.
  • Molasses (3 tb spoon) 20 g contains 8.2 mg Na.
  • Honey (2 tb spoon) 20 g contains 1.2 mg Na.
  • All patients should be individualized , weighted
    , clinically assessed and then menu according to
    the condition of nutrition and the amount of
    ascites is prescribed.

14
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