Patient dietary taboos

There is no uniform list of taboos that applies to all patients. All dietary restrictions must be dynamically adjusted based on the three core factors of disease type, treatment stage, and individual allergy history/basic physical constitution. One-size-fits-all statements such as "all patients cannot eat hairy foods, cannot touch raw or cold foods, and cannot eat seafood" are spread online, and most of them have no scientific basis.

Don't tell me, this misunderstanding has really deceived many people. A few years ago, when I was rotating in the gastroenterology department, I met an aunt in her sixties who had minimally invasive surgery for a gastric ulcer. When she was discharged from the hospital, the doctor clearly said that she could gradually add some lean meat, fish and shrimp to supplement protein. However, she heard from neighbors in the community that "seafood is fat, and the wound will rot after eating it." So she only drank white porridge with pickles for half a month at home. When she came back for a follow-up check-up, her foot was so swollen that it pressed into a hole. The albumin was found to be extremely low, which delayed the wound healing.

When it comes to the most common controversial point of "fawu", the understanding of different systems is actually quite different. According to traditional Chinese medicine, the essence of hair food is "food that conflicts with the attributes of the disease syndrome." For example, for people who have heat syndrome and are suffering from fever and carbuncle, eating spicy, warm and tonic mutton and lychee may aggravate the symptoms. ； People with spleen and stomach deficiency and frequent diarrhea may easily feel uncomfortable when exposed to cold foods such as ice drinks and crabs. This depends on the individual's disease syndrome and not all patients should avoid it. Modern medicine does not have the concept of "hair growth" at all. It is more concerned about whether food will cause allergies, increase the burden on digestion, and whether it will react with the medicines you are taking. As long as you are not allergic to fish and shrimps if you eat them regularly, eating them after surgery can supplement high-quality protein, which is much more useful than drinking plain porridge.

Of course, this does not mean that patients have no dietary taboos. There are a few hard red lines that cannot be touched. For example, people who are taking drugs such as cephalosporin, metronidazole, and ketoconazole must not touch anything containing alcohol within 7 days. Don’t think that only liquor and beer are included. Fermented glutinous rice, wine-centered chocolate, even Dongpo pork made with rice wine, and alcohol-containing Huoxiang Zhengqi water are all included. If it really triggers a disulfiram reaction, serious cases will be sent to the emergency room. There are also people who are clearly allergic to certain foods, such as mango or peanut allergies. No matter what illness you have, don’t touch them. There is no room for negotiation on this.

Apart from this absolute taboo, most of the rest are relative restrictions that need to be flexibly adjusted. There is really no need to be too strict. Take the often-asked question of whether soy products can be eaten with kidney disease. Ten years ago, the old view was that soy protein was a non-high-quality protein and should not be eaten by patients with kidney disease. Clinical studies in recent years have long overturned this conclusion: as long as patients have stable renal function, eating a small amount of soy products such as tofu and soy milk will have a smaller metabolic burden than eating red meat. Only in the decompensated stage of renal insufficiency do plant protein intake need to be strictly limited. There are also gout patients who must strictly avoid high-purine broths, animal offal, and shelled seafood during the attack period. However, during the remission period, it is perfectly fine to eat a small amount of chicken and freshwater fish. They cannot just eat cabbage and radishes all their lives. By then, their nutrition will not be able to keep up, and the gout will not be cured but they will get other diseases first.

I met an old man with diabetes a while ago. I heard people say that "pumpkin lowers blood sugar". He skipped the staple food at every meal and ate half a steamed pumpkin first. The result was that his blood sugar soared to 12mmol/L. He even complained that he was eating according to folk prescriptions. In fact, there are no "foods that lower blood sugar". The only difference is the speed of raising blood sugar. The glycemic index of pumpkin is not low to begin with. It can only be eaten in small amounts to replace part of the polished rice and white flour. If it is really eaten as a treatment, it would be strange if it does not raise blood sugar.

To put it bluntly, there is no standard answer to a patient’s dietary taboos that is universally applicable. Just like you can’t wear the same down jacket regardless of spring, summer, autumn or winter, height, short, fat or thin, it must be measured accordingly. I have been in the clinic for almost ten years, and I have seen too many people who have been ruined by blind food taboos, and I have also seen people who have relapsed due to eating and drinking. If there is any general advice, don't speculate on your own, and don't listen to random advice from relatives and neighbors. Take your examination report to the nutrition department or bedside doctor and ask, it will be more effective than searching for ten "patient food taboo lists" on the Internet.