Nutrition for fractures: the importance of a therapeutic diet, the nuances of menu planning, the importance of a balanced diet

Basic principles of creating a menu for a fracture

Many people are interested in what the diet number for fractures is. However, a special dietary table for this disease was not developed by the Soviet nutritionist, Professor M.I. Pevzner.

The fact is that nutrition for bone fractures should be the subject of discussion with your doctor. Moreover, separate recommendations from a specialist are necessary if the patient has concomitant metabolic, endocrine or gastrointestinal diseases. We are talking about diabetes mellitus, malabsorption (poor intestinal absorption of substances due to inflammation or other problems in the gastrointestinal tract), gallbladder and kidney diseases, hypertension, hypogonadism and severe hormonal deficiency during menopause.

These conditions themselves can contribute to the development of osteoporosis, that is, a decrease in bone mineral density, acting as an indirect cause of fracture. Therefore, when drawing up a menu, it is necessary to strive for their correction through diet therapy at the same time as strengthening bone tissue.

In the absence of serious concomitant health problems, the standard diet for fractures is based on the following principles.

• Including foods rich in calcium, vitamin D and other nutrients involved in bone formation and mineral metabolism in the diet.
• Refusal of foods and drinks that increase the excretion of calcium from the body and inhibit the process of the birth of bone cells.
• Eating food without deep cooking, which allows you to preserve maximum vitamins and other nutrients in foods. Instead of frying, you should use short cooking or quick stewing, or delicate baking in the oven. It is better to eat vegetables, fruits, berries, and herbs mainly fresh.
• Inclusion of mineral water and vitamin and mineral supplements in the diet.
• The presence in the daily menu of light soups (not with strong broth), lean meat and fish, medium-fat dairy products, fresh vegetables and fruits, berries, nuts. Variety and easy digestibility of food are key.

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Authorized Products

• Wheat or rye bread, any flour products.
• Soups are prepared with weak broths. The choice of first courses is wide: borscht, beetroot soup, cabbage soup, vegetable, cereal and mushroom soups, rassolnik.
• You can eat any fish, including fatty varieties, containing vitamin D. The culinary processing is varied (according to preference).
• It is better to choose low-fat varieties of meat and poultry and cook them in any way.
• Be sure to daily consume fermented milk drinks (yogurt, yogurt, kefir, acidophilus), milk, cottage cheese, cheeses, sour cream.
• Eggs in any preparation up to 3 times a week.
• Any cereals (it is better to alternate), pasta.
• Any vegetables (as tolerated), greens, legumes. It is recommended to add sesame seeds to vegetable salads. Considering that it has a hard shell, which is poorly digested and thereby reduces the benefits of this product, the seed must be ground in a coffee grinder and consumed in this form. Recommended 1-2 tbsp. in a day.
• Butter, vegetable oils high in vitamin E (soybean, corn, flaxseed).
• It is better to eat fresh fruits and berries, since after heat treatment they lose some of their vitamins.
• Among the drinks, rosehip infusion, compotes, and herbal decoctions are recommended; you should limit the consumption of cocoa with milk and weak tea with milk.
• Use sugar, jam, jam, honey, marmalade without overdoing it.

Table of permitted products

The main mistakes in nutrition for bone fractures

Most patients with fractures make the same gastronomic mistakes that prevent prompt and complete healing of the injury. Let's name the most typical mistakes in diet.

• Excess dietary fiber

Although fruits, vegetables and other plant foods are a source of microelements and vitamins, overeating them reduces the absorption of bone mineral from the gastrointestinal tract into the blood. For example, you shouldn't completely replace regular white bread with whole grain bread, which has twice the fiber that binds calcium in the intestines. For this reason, calcium absorption is difficult for vegetarians. However, a lack of vegetables and fruits is even more detrimental to overall health. WHO recommends consuming at least 400 g per day , and our Ministry of Health recommends at least 600 g .

• Overeating foods with oxalic and phytic acids

They impair the absorption of calcium in the gastrointestinal tract. sorrel, spinach, and rhubarb rich in oxalic acid in the diet for bone fractures . It is advisable not to overeat grain products, legumes, bran, brown rice, and nuts . True, soaking and sprouting followed by boiling help neutralize the second of these insidious acids by 97%.

• Excess in the menu of foods that acidify the body

The fact is that bone mineral from bones and teeth is actively used to restore acid-base balance, since it has an alkalizing effect. Therefore, the menu should be formed in such a way that it does not contain a predominance of products that acidify the internal environment. These include meat, fats and confectionery products, sugar, chocolate, black tea, coffee, cocoa, tobacco products, potassium and nitrate preservatives, peanuts, wheat flour, pasta, rice .

• High content of animal fats in the diet

Fatty acids hinder the functioning of the digestive system and impair intestinal absorption of calcium.

• Excess of phosphorus-rich foods in the menu

Although this element, together with calcium, is included in the structure of bones, an imbalance between them in favor of phosphorus leads to the displacement of calcium from bone tissue. Ideally, for 1 share of Ca there should be 1.5 shares of P. Meat and fish contribute to an increase in phosphorus levels , in which this ratio is 1 to 10. And in various sausages, frankfurters phosphate additives are also added . Therefore, it is better to avoid them and consume animal protein in recommended quantities. For an adult, this is about 200 grams of meat and 50 grams of fish per day . On purely fish days, of course, you can eat more fish. In addition, excess phosphates threaten lovers of sweet sodas, biscuits, condensed milk, frozen foods and other products with the addition of orthophosphoric acid (E338).

• Lack of protein foods

It is dangerous because the body no longer has enough amino acids contained in the protein, which are used to build a collagen matrix in the bone tissue, into which calcium and phosphorus salts are embedded.

• Increased salt intake

A love of over-salted food results in additional loss of calcium in the urine.

• Excess sugar and sweets in the diet

Fast carbohydrates can lead to diabetes, which provokes the development of osteoporosis. The fact is that insulin is needed not only for the processing of sugar, but also for full bone formation.

• Coffee abuse

More than two cups of coffee per day can cause a negative calcium balance. However, 1-2 small portions of an invigorating drink per day will not do any harm. It is also worth limiting other caffeine-containing foods and drinks: chocolate, cola, cocoa .

• Insufficient water consumption

Dehydration prevents fracture healing, since bones are 22% water. Proper drinking regimen (about 2 liters per day) helps to activate metabolism, on which the speed of recovery processes depends.

• Alcohol addiction

In addition to general metabolic and hormonal disorders, ethanol directly affects bone tissue, causing the death of its cells - osteocytes. It also impairs the absorption of calcium in the intestines and the formation of vitamin D.

• Smoking

Although tobacco smoke can hardly be called nutrition, in the medical sense, it, like junk food, supplies the body with substances that are by no means beneficial for bones. Its toxins impair the functioning of the endocrine system, in particular the production of sex hormones that control bone anabolism. Nicotine also impairs the functioning of blood vessels, and hence the nutrition of bone tissue, which slows down its recovery.

Fully or partially limited products

• Alcohol, which can disrupt processes in the cells that form bone.
• Fatty concentrated broths, refractory fats, fatty meat, poultry (duck goose). Fats interfere with the absorption of calcium - they bind it to the formation of salts, which the intestines are not able to absorb, and are removed from the body.
• Coffee and caffeinated drinks, since caffeine promotes calcium loss in urine. In this regard, chocolate and strong tea should also be excluded.
• Calcium is lost when eating too many sugary foods.

Table of prohibited products

Specifics of calcium absorption from different foods

In order for a calcium-enriched diet for bone fractures to promote rapid healing of the injury, the conditions for the absorption of calcium by the human body should be taken into account. Bone mineral is absorbed differently from different foods. It is important what other substances it enters the gastrointestinal tract with.

• Milk and milk-based products

They supply the human body with calcium by 30–80%, so they are rightfully considered the most important sources of this mineral. Scientists have established a direct relationship between the strength of bone tissue and how much milk a person consumes. Milk has the advantage that it has a well-balanced balance of several substances that are important for bone health. These are calcium, phosphorus, magnesium, zinc, potassium, vitamin D. In addition, milk protein is used to build the bone matrix. Thus, in the absence of lactose intolerance or allergy to casein, milk should definitely be included in the menu. At the same time, low-fat dairy products are not recommended, since from them we do not absorb fat-soluble vitamin D, which increases the bioavailability of calcium.

• Fish

Fish, especially canned fish with softened bones, is also rich in bone minerals. However, unlike milk, it is high in phosphorus, which competes with calcium, making it difficult to absorb. But there is also an undoubted plus: fish is the main food source of vitamin D, as well as omega-3 unsaturated fatty acids, which activate bone tissue renewal. So it should definitely be included in the diet for bone fractures in the recommended quantities. According to WHO, you should consume at least 3 servings of fish per week. 1 serving is 100 grams. True, in order not to harm the pancreas, you should not eat only fatty varieties, and it is also not better to get carried away with salted and smoked fish.

• Plant food

Plant sources of calcium are not as high in calcium. In addition, its bioavailability is lower due to the presence of absorbent dietary fiber in plants, and in some, also oxalic and phytic acids. However, there are exceptions. For example, from cabbage, sesame, dried apricots, prunes, raisins, seaweed, the bone macronutrient is absorbed very well.

Vitamin C

It is imperative that the diet and dietary menu of a patient with a fractured hand bones contain foods rich in vitamin C. It stops the process of leaching minerals from the body and accelerates the process of its production in problem areas.

There is a lot of this vitamin in:

• red bell pepper;
• lemons:
• oranges:
• cabbage;
• beets;
• cucumbers;
• onion.

The patient can drink freshly squeezed juices and rosehip tea.

Vitamin D in food

It activates the absorption of calcium in the intestines and its penetration into the bloodstream. We can get this vitamin in the summer by exposing our body to the midday sun, as a result of which it is produced in the skin. But when we are rarely in the sun, and also from October to March, the production of vitamin D stops. And we need to get it from food or drugs. The inclusion of this nutrient in the diet for bone fractures is mandatory. Good sources of it are salmon, tuna, salmon, herring, cod and its liver, sardines, and fish oil. In smaller quantities we get the “sunshine” vitamin from dairy products, eggs, liver, meat, and mushrooms.

What not to eat

But a patient with a broken arm should completely avoid the following products.

You will have to give up:

• semi-finished products;
• smoked, spicy, salty foods;
• coffee and tea;
• fatty foods;
• alcohol;
• sweet lemonades.

Such products slow down the process of calcium absorption, remove it from the body, and disrupt the functioning of the gastrointestinal tract. They also retain fluid in the body, provoke the occurrence of edema, and increase the patient’s rehabilitation period.

Other minerals and vitamins in the diet for fractures

• Phosphorus , together with calcium, serves to strengthen bone structures. Fish, shrimp and squid, meat, eggs, milk and its derivatives, buckwheat, beans, grains and nuts will help compensate for its deficiency. You should remember about the competition of this macronutrient with calcium and consume foods containing phosphorus without exceeding the recommended norms.
• Magnesium is involved in the exchange of phosphorus and calcium. With its deficiency, bone tissue becomes thinner, bone-building cells (osteoblasts) become less active, and the number of destructive cells (osteoclasts) increases. It is more difficult for calcium to remain in the cells, and hypocalcemia develops. Acidification of the body increases, which also contributes to the consumption of calcium for alkalization. Most modern people, especially older people, are deficient in magnesium. You can get this valuable macronutrient from nuts, sunflower seeds, seaweed, buckwheat, millet, oatmeal, pearl barley and barley, legumes, milk, rye bread, dried fruits, bananas.
• Zinc affects enzymes involved in the synthesis of bone matrix. Supports the functioning of the thyroid and sex glands, the hormones of which determine bone remodeling. Its deficiency is one of the significant factors in reducing bone strength, especially in postmenopausal women and elderly men. To increase its level, it is recommended to include in the diet for bone fractures all types of shellfish, meat and eggs, flax seeds, sunflowers, sesame seeds, pumpkins, nuts, sprouted wheat, legumes, mushrooms, and milk.
• B vitamins are participants in numerous metabolic processes that affect the restoration of bone tissue. B6, B9, B12 are especially important for its renewal and strengthening. The first two are involved in the formation of collagen matrix structures, and B12 is necessary for the creative activity of building cells - osteoblasts. To compensate for their deficiency, you should eat sea fish and shellfish, eggs, meat and offal, peas, beans, soybeans, buckwheat, bananas, yeast, cabbage.
• Vitamin C is necessary for the building of bone collagen. With its deficiency, bone fragility is inevitable. Food sources of ascorbic acid are kiwi, rose hips, citrus fruits, red peppers, currants, cabbage and many other fruits, vegetables, and herbs.

In addition to vitamins and minerals, do not forget about the importance of consuming enough protein foods . It serves not only as a source of vitamins and minerals, but also amino acids necessary for bone renewal at the level of collagen fibers and cells.

The importance of protein

To speed up the healing process of broken bones, you need to eat foods rich in protein. This is a building material that is part of cells and is rich in beneficial vitamins and microelements. A lot of protein is found in dairy products and eggs.

There is also a lot of protein in:

• meat (beef, pork);
• poultry, fish, seafood;
• legumes, nuts;
• cereals (buckwheat, rice, oatmeal);
• wholemeal bread;
• vegetables. So the victim is recommended to eat Brussels sprouts, potatoes, zucchini, cucumbers, avocados, and figs.

And it is best to combine healthy foods that are included in the diet of a patient with a fracture of the bones of the arms, legs, and ankles. For example, the victim may eat porridge with meat or poultry. He can also have scrambled eggs and beans for breakfast. This breakfast will be very useful.

Nutrition for various types of fractures

Does nutrition for bone fractures depend on the location of the injury? Undoubtedly. Because the general condition of the body will be very different if the integrity of, for example, a finger and spine is violated.

• Nutrition for broken leg bones in adults and children involves reducing calories due to the fact that the person moves less. And since less energy is spent, then less energy should also be supplied with food. Otherwise, rapid weight gain is inevitable, which will increase the load on the lower limbs, and this will complicate recovery at the rehabilitation stage.

When cutting back on the diet, it should be taken into account that nutrition for a broken leg must correspond to the patient’s increased need for minerals, vitamins and sufficient protein intake. But the amount of carbohydrates with a high glycemic index (sweets, confectionery, white bread, fast food, fried potatoes) and saturated fats (lard, fatty meat, butter) should be kept to a minimum.

• Nutrition for a compression fracture of the spine , as well as for fractures of the legs, should be complete and less caloric than with an active lifestyle. The patient is prescribed bed rest in the first two weeks after the injury, which can lead to fluid retention in the tissues. Therefore, salt consumption should be limited and smoked meats and marinades should be avoided. Due to the inability to be in direct sunlight, pay special attention to the presence of vitamin D in your diet.

In addition, a fracture of the spine can damage not only the vertebrae, but also the intervertebral discs, joints, ligaments and muscles. Compression of the spinal cord and pinching of nerve roots is possible, which makes itself felt by pain and other neurological symptoms. To improve neuromuscular transmission and restore neural structures, increased consumption of foods rich in B vitamins is recommended.

Also, the diet for a spinal fracture should contain foods that are beneficial for cartilage tissue. These are collagen-rich jellies, jellied meat, jellied fish, etc. Dandelion root, from which today a drug for joint health is produced, has a powerful chondroprotective effect. Its compounds taraxacin and taraxacerin promote the synthesis in the liver of substances that activate the birth of bone cells.

• The diet for fractured ribs is similar to that recommended after a spinal injury. Indeed, with this type of injury, the costovertebral joints can also be damaged with the development of subsequent intercostal neuralgia. In addition, complications such as bruise of internal organs and respiratory failure, developing into pneumonia, are possible. Therefore, the heart and lungs require special support. A special role in this situation is played by sufficient dietary intake of protein, magnesium, zinc, copper, vitamins C, A, group B, especially B3. The amount of salt is no more than 6 g per day. Also, do not drink too much, as liquid increases the load on the heart. It is advisable to grind the food until it becomes a homogeneous mass.
• Nutrition for fractures of the arm bones limits physical activity only partially. The patient can walk and do exercises without the use of a broken limb. Therefore, you should not reduce the calorie content of your daily diet. Nutrition for a broken arm in old age should be especially rich in vitamin D, since after 60 years both intestinal absorption and the production of this vitamin in the skin deteriorate.
• Nutrition for a hip fracture requires a particularly careful approach due to prolonged immobilization and bed rest for many months if endoprosthetics is not performed. Important points are the ease of digestibility of food (it is advisable to grind the food and serve it to the patient in a puree form) and its intake 5-6 times a day. Due to immobility, intestinal motility often deteriorates, which causes constipation. To prevent them, it is necessary to observe the correct drinking regime (at least 1.5 liters of water per day), include fermented milk and foods rich in plant fibers in the diet.

Menu (Power Mode)

The range of products is varied and based on them you can organize a complete meal. However, you need to consider your physical activity. If it is minimized due to bed rest, it is worth sharply limiting the consumption of baked goods, sugar, and jam. But when creating a menu, you need to monitor the distribution of caloric content of food. There is no need to consume fatty dairy products (this will not increase the calcium content), and do not include porridge and potatoes for dinner. Vegetables should be a healthy addition to meat or fish.

In fresh vegetable salads, try to constantly add different vegetable oils and sunflower seeds, sesame seeds, pumpkin seeds, which contain several essential vitamins and microelements. For snacks, make fruit salads, enriching them with peanuts or walnuts. Sprouted wheat can be a useful addition to salads and porridge.

Nutrition for fractures in children and the elderly

A child’s diet during a fracture is based on the same principles and patterns as for adults. Detailed recommendations should be obtained from your pediatrician. It is important that all food is easily digestible and hypoallergenic. For most young patients, eggs (especially yolks) and cottage cheese should be the first-line products during the period of treatment and rehabilitation. And fresh fruits and berries will replace carbonated lemonades and sweets.

Features of the diet during a fracture for many older people are:

• replacing milk with fermented milk products due to age-related deterioration of milk protein tolerance;
• increased dietary intake or use of vitamin D supplements, the level of which is reduced in most elderly patients;
• inclusion in the menu of products that are beneficial for the endocrine system, compensating for the deficiency or stimulating the production of sex hormones, on which bone formation depends. These include bee products, especially bee pollen and drone homogenate; herbs ginseng, leuzea, eleutherococcus, golden root (for both sexes); hogweed, chamomile, licorice, sage, clover (for women).

Phosphorus

If a person often breaks his limbs, this indicates that there is little phosphorus in his body.

Red fish helps increase its quantity.

There is also a lot of it in:

• dairy products;
• buckwheat;
• beans;
• shrimp;
• squid

If a patient with a bone fracture has very little phosphorus in the body, then he is put on a fish diet and a special diet is developed for him. Such a patient is recommended to eat mackerel, sturgeon, tuna, flounder, and sardines.

Vitamin-mineral complexes for fractures

Proper nutrition for bone fractures does not negate the additional intake of vitamin and mineral complexes. Typically, your doctor will prescribe supplements that include a wide range of vitamins and microelements, or calcium supplements with vitamin D.

The disadvantage of the former is that the full absorption of nutrients is impaired due to the incompatibility of many of them when taken together. In addition, such multicomplexes often cause allergies, and it is problematic to determine which of the components a reaction develops to.

As for the “Ca + D3” formula, it really works, but most often it is not for the benefit of the body. The “sunshine” vitamin requires high doses of bone mineral to enter the blood. However, they cannot be instantly absorbed in bone tissue. Bone mineralization is especially difficult in older people due to a deficiency of bone cells due to hormonal deficiency.

As a result, calcium is deposited on the walls of blood vessels, in the kidneys and other organs. The result is cardiovascular attacks, kidney stones and other health problems, and not at all rapid healing of the fracture.

The solution to the problem of channeling calcium into bone tissue was found by a Russian specialist in osteoarticular diseases, Professor V.I. Strukov. To do this, he included an anabolic component of natural origin, HDBA organic complex, in the Ca + D3 duet.

This component helps restore and strengthen bones in several ways:

• stimulation of the birth of young bone cells through hormonal regulation: HDBA safely increases the level of its own sex hormones thanks to the bee prohormones it contains;
• supplying bone cells with free amino acids (more than 20, including all essential ones!) for the construction of collagen bone structures;
• nutrition of bone tissue: HDBA contains vitamins A, B, C, D, E, minerals: phosphorus, zinc, manganese, iron, magnesium, copper, potassium, etc.

In addition, it was decided to add vitamin B6 to the new drug, since it plays a big role in mineral metabolism, helping the absorption of magnesium and the direction of calcium into the bones. It is also necessary for the formation of the collagen matrix of bone.

The drug was named Osteomed Forte . During clinical trials, it was found that its use accelerates the healing of fractures and reduces rehabilitation time to two weeks.

Due to its effectiveness and high safety profile, it was included in the Rospatent list of “100 Best Inventions of Russia” and was awarded the main pharmaceutical award “Green Cross” in the category “Drug of choice for the prevention and complex therapy of bone diseases.”

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Reviews and results

Optimal caloric content and a high vitamin and mineral composition of the diet, which focuses on calcium, magnesium and zinc, helps in the process of restoring bone tissue after injury. Many patients indicate that they followed exactly this diet on the doctor’s recommendation and additionally took vitamin and mineral complexes.

• “... After a fracture of the tibia, I had to rely heavily on dairy products and sesame for 2 months. True, for the first month I took a special supplement (calcium, vitamin D, zinc and magnesium). The plaster was removed after a month, the doctor said the results were good. I don’t know whether the diet helped or not, but I noticed that I began to sleep better (magnesium probably helped). Thus, I discovered another missing element. After the cast was removed, I walked on crutches for another 2 weeks, and then on my own”;
• “... Everyone knows that calcium is necessary for bones, but I always thought that only dairy products contain it. It was a revelation for me when the traumatologist said to eat ground sesame seeds. I studied the calcium content in it, it turned out that it was higher than in milk. During these two months, everything went into use: dairy products, sesame seeds, and salted fish, ground together with bones. I don’t know what helped, but I recovered in 2 months and went back to work”;
• “... I was on this diet in a sanatorium after a fracture for three whole weeks. The food was good, but given the diagnosis, I additionally bought dairy products, bananas and some fruits, and there were enough vegetable dishes. The rehabilitation was at the highest level - massage, physical therapy and physiotherapy. They still told me not to put any weight on my leg and the health path was cancelled. I am satisfied with the treatment and its results.”

Menu to accelerate bone tissue regeneration

Water is the primary source of life

The specific proportion of water in the cells of the human body is 70%

As the body ages, a person’s sense of thirst significantly weakens. At the same time, many specifically sharply limit the intake of pure water, not contained in drinks, first courses, vegetables and fruits, in order not to overload fading kidneys and avoid swelling.

However, during the treatment of a fracture, first of all, you need to think not about what to eat for arm fractures, but to restore the daily drinking balance to the norm corresponding to age, taking into account, of course, existing problems with the kidneys.

Today it is easy to calculate the exact amount of water consumed per day. On the Internet you can find links to several calculators that take into account:

• level of physical activity;
• number of kilocalories;
• age;
• weight.

Let's give a few examples.

A 60-year-old woman, weighing 60 kg, in the absence of physical activity and consuming 2500 kcal per day, needs to consume 2.3 liters of liquid or 2 liters of clean water per day. A man with similar indicators will need 2.7 liters of liquid or 2.4 liters of clean water.

For the sake of reliability, it is worth noting that the formula, compiled taking into account leading international medical institutes, correlates mainly with the load and energy component. Therefore, elderly people treating fractures should consume clean water (including mineral water):

• women – 2 l
• men – 2.4 l

Normalizing the drinking balance will improve the processes of digestion, metabolism and make it easier for the body to restore bone integrity.