Protein in urine 300 what does it mean. High protein in the urine is a signal of poor health. Parsley Seed Infusion

The presence in the urine of such an element as protein signals a malfunction in the body. It can be caused by a number of reasons - from banal hypothermia to serious pathologies of the urinary system. If you have detected an increased protein content (), you should not postpone a visit to the doctor so as not to miss a possible disease.

The process of protein formation in urine

Urine is formed in the process of filtering the blood by capturing unnecessary substances from it and passing them through the kidney membranes. Thus, the body is freed from salts and toxins.

Failures in the functioning of the components of the kidneys lead to the detection of elements in the urine that should not be found there. The blood plasma contains a large amount of proteins, of which small ones easily pass through the renal tubules and are reabsorbed into the blood.

Entry into the urine of larger protein molecules becomes possible when the filtration system of the kidneys is damaged. The more severe the damage to the renal tissue, the more large molecular proteins will be found in the urine.

The appearance of protein in urine is not always associated with pathologies of the kidneys and urinary organs, sometimes disorders in other body systems lead to the release of protein into the urine. , burns, frostbite strike at tissue proteins, which is why their concentration in urine will be higher than normal.

Causes of protein formation in urine

Proteinuria is physiological and pathological, depending on what it is caused by. The physiological increase in protein is a transient condition that does not require treatment.

Main reasons:

• excessive physical and nervous tension;
• excessive consumption of proteins;
• prolonged vertical position that prevents blood flow;
• hypothermia, overheating;
• the last months of pregnancy;
• increased adrenaline and norepinephrine in the blood;
• examination of the kidneys by palpation;
• diseases accompanied by fever;
• taking certain medications.

Pathological causes:

• damage to the renal tubules;
• inflammatory processes in the urinary organs;
• hypertension, heart failure;
• , multiple myeloma;
• diabetes mellitus, epilepsy;
• kidney failure;
• , pyelonephritis, glomerulonephritis;
• tumors of the urinary organs.

Only a comprehensive examination will help determine which disease caused the deviation from normal.

Symptoms that may be associated with proteinuria

A temporary (physiological) increase in protein in urine does not manifest itself in any way. A mild form of the disease at an early stage also does not present a clear clinical picture. Pathological proteinuria disappears with symptoms of the disease that provoked it.

Long-term high protein levels cause:

• pain in muscles, joints, bones;
• night cramps, sleep disturbances;
• weakness, anemia, dizziness;
• swelling, palpitations;
• turbidity, white bloom and;
• fever, nausea.

The amount of protein in urine

Protein norm for men

A slight excess of these indicators in the male is not a deviation, especially with increased training, physical or standing work, frequent hypothermia, and the abuse of meat food. An increase in protein can also occur when it enters the urine from the prostate or urethra.

The norm of protein in women

For female representatives, the upper permissible limit of protein content is 0.03 g / l. Its physiological increase is the result of infections of the genital area, pregnancy, and the postpartum period.

During pregnancy, an indicator of 0.033-0.3 g / l is considered acceptable. In this case, the protein may increase due to the mechanical pressure of the fetus on the kidneys. Exceeding the figure of 0.5 g / l in pregnant women in the last trimester often indicates. Its other symptoms - in combination with high blood pressure. Systematic urinalysis and monitoring of the work of the kidneys of a pregnant woman will help to distinguish the physiological growth of indicators from the pathological one.

The norm of protein in children

Maximum concentration of protein in urine healthy child- 0.025 g / l. Exceeding this indicator does not always indicate pathology. It can be caused by allergies, fever, colds, stress, and in infants, overfeeding. Often the protein content increases in the urine of adolescent boys, which is due to the specifics of the functioning of the kidneys at this age.

Protein in the urine. What to do? Tips for parents. Tells the pediatrician, candidate of medical sciences Kostyushina I.S., Scientific Center:

Rules for collecting urine for analysis

The reliability of the results of the analysis depends on compliance with the rules on the eve of its delivery:

1. Do not take drugs that affect protein levels (colistin, acetazolamide, lithium, oxacillin).
2. Refrain from eating meat, cottage cheese, salt, sour, spicy, smoked foods.
3. Give up alcohol and 3 days before the analysis.
4. To carry out the toilet of the external urinary organs.
5. Collect urine immediately after waking up according to this scheme: start in the toilet, continue into the jar, then back into the toilet.
6. Avoid hypothermia and stress the day before.

How to decipher a urine test

General analysis allows you to evaluate physical indicators (color, transparency, density, weight, acidity) and chemical composition urine and its sediment. The research should include the following:

On a note! Urinalysis is indicative for assessing the state of health, but for an accurate diagnosis of the disease, the doctor directs for further examination.

AT general analysis urine must have an item - protein. A person begins to worry when he receives results with an increased content of it. Why is protein present, what does it mean, what norms of protein in urine are acceptable? In order to deal with this issue, you will have to go to the doctor.

Where does it come from?

This component is constituent of enzymes, and takes part in almost all cellular processes occurring in the body. Therefore, in some quantities, its formation in urine is quite acceptable, as well as its absence.

Even drinking a large number protein products can affect. But the concentration of protein at the same time quickly disappears.

Important! Although about 15 percent healthy people sometimes a protein is detected in the urine, but a negative result in the study is considered the absolute norm.

The body is protected from protein entering the urethra by the so-called renal pelvis, which serve as a "wall". Therefore, damage to this protection can serve as a reason for protein formation.

In medicine, the increase in concentration is called proteinuria.

How much protein should be in the urine - acceptable norms

This is the first indicator that the doctor turns to when interpreting the results of the patient's examination. It is impossible to visually determine the presence of protein in the urine. One can only guess from the presence of whitish impurities.

The analysis is carried out by various methods: a sample with boiling, test strips, the Brandberg-Roberts-Stolnikov study, as well as quantitative methods. Take the morning portion of the material or daily.

If a protein is detected, a second screening is carried out. in two weeks, due to existing provoking factors such as nervous strain, protein foods in the diet, hypothermia.

The norms of protein in the urine in women and men:

morning analysis - 0.033 g / l
daily analysis - 0.06 g / l

Norms of protein in the urine in children:

morning analysis - 0.037 g / l
daily analysis - 0.07 g / l

The norms of protein in the urine in pregnant women:

morning analysis - 0.033 g / l
daily analysis - 0.3 g / l

How to lower the level of protein in the urine, read our article.

Why the norm is increased - the causes of proteinuria

The reasons for the increase in protein are varied. In addition to physiological reasons, including just transferred SARS, pregnancy, prolonged exposure to the sun, improper hygiene, etc., if there is a lot of protein in the urine, then this may be due to diseases:

• urinary system;
• Complications of SARS: influenza, pneumonia;
• Allergy;
• Pyelonephritis;
• Diabetes;
• Systemic diseases;
• Nephropathy;
• Malignant neoplasms.

In newborns, immediately after birth, there is a slight increase in protein in the urine. And it's completely fine.

Even protein addiction, lack of water in the body, taking high doses of vitamin C leads to the fact that the protein can “jump” to significant numbers.

Symptoms of pathology

Proteinuria is divided according to severity: traces of protein - up to 0.033; light - up to 1; moderate - up to 2 and severe - more than 3.

If the excess is insignificant, then an adult does not notice any signs. But the following symptoms may appear:

Among the symptoms of severe proteinuria: increased pressure, migraines, sweating. If arose bad smell in the urine, then this indicates the progression of pathology, for example, urethritis.

Protein in the urine 0,066 - such indicators are a frequent occurrence during pregnancy, and is called gestational proteinuria. If there are no others, and the rest of the values ​​​​in the analyzes are normal, then you should not worry.

Protein in the urine 0,033 - experts mark in the analysis - traces of protein in the urine, or trace proteinuria. A failure can also occur in healthy people and does not mean kidney disease at all, especially if there are no additional signs of the disease. The reasons:

• Improper nutrition;
• Stress;
• The use of certain types of antibiotics.

The result is distorted by incorrect collection of urine, that is, a violation of hygiene and so on.

It is necessary to retake the analysis again.

Protein in the urine 0,1 - shows that there is a moderate proteinuria. For pregnant women, it can be regarded as the norm.

But the doctor must evaluate all indicators and prescribe additional studies in order to early detection of kidney problems: complete blood count (in it, elevated leukocytes and ESR will “show themselves”), creatinine, urea, C-reactive protein. If necessary, ultrasound of the kidneys, in women additional ultrasound of the pelvic organs.

Protein in various diseases

Increased protein in the urine is a constant companion of such pathologies as cystitis, diabetes mellitus and pyelonephritis.

Acute cystitis affects people of almost all ages, but most often "loves" the fair sex. Diagnosis is based on proteinuria above 1 g/l and detection of elevated leukocytes in the urine.

Plus, the patient's complaints about the pungent smell of urine, painful urination and general symptoms of malaise. The patient is prescribed antibiotics and a diet. Do not consume foods that may induce more protein: it is meat, oily fish, foods excessively rich in vitamin C.

Diabetics are at high risk of getting a complication of their underlying disease: kidney dysfunction. Therefore, they need to control the protein in the urine at least once every six months. Experts sound the alarm already at the indicator above 0.3 g/l. Albumin protein is determined. Its norms for patients with diabetes mellitus:

• Less than 20 mg/l is normal;
• 20-200 mg / l - a slight excess;
• Above 200 - proteinuria.

For the diagnosis of pyelonephritis, each analysis value is not evaluated separately. But the characteristic picture of urine: a pale shade, and if pus appears, then it looks cloudy. Leukocytes are high - more than 6 (in children, the norm is up to 6). Protein is usually above 1 g/l. But the density and acidity can be within the normal range.

The clinical picture of the patient's complaints: heat, back pain, urination, weakness.

Why is proteinuria dangerous?

This pathology is fraught with the loss of the body various kinds protein essential for its life. As a result, for a person, this will be expressed in constant edema, problems in blood clotting, which means that the risk of bleeding is high. In addition, there may be problems with the thyroid gland and, in fact, with any organ or system of the body.

Find out what the unpleasant smell of urine says from the video:

The presence of protein in urine is called proteinuria. The norm is the complete absence of protein molecules or their singular presence.

For a person, they are very important, because they take part in the construction of cells of muscle and bone tissues, epithelium. Protein is indispensable in the course of chemical reactions within systems and organs. It is necessary for the normal implementation of self-regulation of the body.

They lie in the list of certain diseases and pathological conditions:

• connective tissue damage due to lupus erythematosus;
• consequences of chemotherapy;
• formation specific type of protein– M-protein;
• kidney infection or inflammation;
• intoxication of the body;
• malignant tumor Bladder, kidney;
• diabetes;
• frostbite or burns of the skin;
• development of arterial hypertension;
• mechanical damage to the kidneys.

In addition to the above reasons for detecting protein in the urine, there are also typical ones for a certain gender and age.

What does it mean?

When protein molecules are more than normal, this signals the development of a pathological process in an adult or child. If the analysis confirms the presence of protein in the urine, you need further diagnostics to make an accurate diagnosis and start treatment.

Puberty is an exception. At this time, adolescents show an excess of the norm, but the reason here is not in the disease, but in physiology. The body is in a stage of changes, the hormonal background is unstable. At the final stage of growing up, the protein level is normalized.

When only the initial stage is observed, with timely intervention recovery is coming soon. Moderate and severe pathology requires additional examination to identify the cause and prevent the development of the disease.

During pregnancy, proteinuria is considered harmless until its levels reach the level of 500 mg / l.

What to do if proteinuria is found?

If an excess of the norm of protein molecules in urine is diagnosed, it is necessary to re-analyze after a week or two. During this time, the protein concentration should decrease naturally. If there are no changes, a detailed examination will be required.

The reason for the deviation may be problems with kidney function. It is advisable to do another blood test to get a more detailed clinical picture illness. Further actions will depend on what is the true cause of proteinuria.

When an excess of protein is caused by diabetes, a special menu is needed in combination with taking medications prescribed by a doctor. With arterial hypertension, you will need to monitor the pressure so that it is normal - within 140 to 80. It is advisable to control how much protein and glucose are present in the diet.

Why is protein elevated?

Its concentration can increase as a result of excessive physical activity or from the abuse of foods rich in protein.

If you stay in a standing position for a long time, overheat under the influence sun rays, the blood circulation process may be disturbed. This will definitely affect the test results. In women in the last trimester of pregnancy, such deviations are often observed.

When the body suffers from hypothermia, severe stress, epileptic seizure or increased palpation of the kidneys, proteinuria will be observed. It also causes a concussion. All these reasons are considered to be physiological.

Proteinuria in women

Sometimes protein molecules end up in the urine of perfectly healthy people. Then their concentration will not be higher than 0.033 g/l.

Factors unrelated to disease

When the patient does not have any complaints, the increased protein level can be considered the result of a violation of the diet and the predominance of dishes in the menu, which include products, saturated with proteins. It's about meat raw eggs, milk.

Depression, mood swings and temperature, hard physical labor and medication cause a similar reaction of the body.

Pathological causes

Among them, in the first place are cystitis and pyelonephritis. This is followed by inflammatory processes in the ureters, kidneys and bladder.

The third reason is the presence of stones in the organs of the urinary system. Pathology can develop against the background of diabetes, ovarian cysts, renal tuberculosis or cancer, leukemia.

Sometimes it's about hypertension, infection pathogenic microorganisms or mechanical deformation of organs. Chemotherapy and brain concussion also affect protein levels.

Exceeding the norm in men

When it is associated with pathological processes, they have a different origin. Some problems are localized in the glomerular structures, while others - in the renal tubules. There is a third subgroup of reasons - physiological.

Glomerular proteinuria

It develops against the background of nephrotic syndrome, which is manifested by a disorder in the functioning of the kidneys, a decrease in the concentration of protein in the blood and its excretion with urine. Accompanied excess cholesterol. In the worst cases, tumor foci are considered the cause of the pathology.

Often, damage to the glomerular part of the kidneys is observed in inflammatory processes caused by pathogenic microorganisms, toxins, poisons, medicines or drugs.

Damage to the renal tubules

It progresses due to a genetic predisposition to pathology, frequent drug intoxication, with a lack of potassium and an excess of D vitamins.

Long-term use of antibiotics, accumulation of salts in the body heavy metals lead to the deformation of the tubules of the kidneys and proteinuria.

The reason may be in the formation of nodular growths that affect the internal organs and tissues, or in their inflammation.

Physiological reasons

These include fever, overload of the body after exhausting physical labor or sports. This is the most common cause of proteinuria in men.

What is the norm?

There is no single criterion, it depends on gender and age. In children and in the representatives of the stronger and fairer sex, the protein norm will differ significantly.

Limits in men

For them, the normal concentration of protein is considered to be value from 0 to 0.3 g/l. The maximum value is found at large physical activity, depression, frostbite or hypothermia.

Norm in a child

In newborns, protein molecules are present in the urine, but gradually their level stabilizes. This is due to the attempt of the urinary system to establish its functioning in a new environment - outside the womb.

In children preschool age there should be no protein in urine at all, or it is desirable that the indicator be no higher than 0.025 g / l. normal orthostatic protein in adolescence a value of 0.7-0.9 g / l is considered. With repeated tests, its concentration is always less.

Healthy value in women

The level of protein molecules in the urine is equal to normal if it fluctuates between 0-0.1 g / l. for women in position, up to 30 mg / l is considered the norm.

Excess protein in children

Detection of excess protein in children's urine can be both a harmless phenomenon and a symptom of the disease. In a child that has just been born, the content of protein molecules in the urine is the norm. Infants are characterized by the appearance of proteinuria after overfeeding.

In adolescents, excess protein is observed within the orthostatic period. It has nothing to do with pathology. In the interval from 6 to 14 years, the concentration of protein in males reaches 0.9 g / l.

This is due to the fact that the urinary system, under the influence of the hormonal background and the active growth of the body, is modified and finally formed. This happens during the period of physical activity - from morning to evening. Night urine is not distinguished by an excess of protein molecules.

For girls, deviations from the norm are characteristic in the case of development inflammatory processes into the vagina. Then you should limit the use of salt, undergo a course of treatment.

During late pregnancy

For women in position in the last trimester, excess protein is a common occurrence. On baby and condition expectant mother this does not affect until the level of proteinuria exceeds 500 mg / l. Then further testing is required. Perhaps an excess of protein molecules is caused by an inflammatory process.

Non-pathological causes

AT frequent cases proteinuria on later dates due to the presence in the menu of products that are saturated with protein vegetable or animal origin. An excess of it can be explained by active physical labor, experienced depression or nervousness, the use of medicines or vitamins before collecting urine.

Causes of a pathological nature

Toxicosis in the last term often worries pregnant women, causing proteinuria. Malfunctions in the functioning of the kidneys, diabetes mellitus, traumatic factor, nephropathy, infection internal organs also leads to excess protein.

The reason may be in connective tissue deformities, problems with blood pressure, the formation of tumors or cysts, burns or intoxication of the body, allergic reactions or heart disease.

Index 0.2 g/l

In the composition of urine, protein molecules are always present.

If there is a slight deviation from the norm, this will not necessarily indicate the development of the disease and health problems.

The concentration of protein increases during exercise, sports or dancing, from dehydration, under the influence of cold or extreme heat, from allergens, after nervous strain, under the influence of stress factors. Then the repeated analysis of a proteinuria does not reveal.

If the protein in urine is 0.033 g/l

In this case, there may be several reasons for its excess:

• allergic reaction;
• angina disease or infection with staphylococci;
• burn skin lesions;
• fever;
• a malignant tumor affecting the kidneys;
• traumatic experience;
• blockage of the renal arteries;
• stones in the kidneys;
• various kinds of jade;
• low immunity;
• diabetes;
• pressure problems.

If you have been diagnosed with proteinuria, go re-examination and don't jump to conclusions.

03.08.2017

There should be no protein in the urine, or it can be detected by analysis in trace amounts - up to 0.033 g / l.

If traces of protein are found in the urine or the amount of protein slightly exceeding the trace indicators, a reanalysis is done.

Insignificant indicators of protein in the results of the analysis may be due to insufficient hygiene of the patient before collecting urine, taking certain medications, eating protein foods. Why is this value, 0.033 g / l, considered the limit of the norm? Smaller concentrations of protein are difficult to determine by the existing methods of laboratory analysis.

The norm of protein in urine in men is up to 0.033 g / l, up to a maximum of 0.05 g / l. Protein in the urine can occasionally appear during stress, muscle strain, eating a large amount of meat or eggs (protein food), sometimes the protein can get into the urine with sperm. If there is a persistent excess of the protein norm, this indicates the presence of a pathological factor.

The rate of protein in the urine in women is no more than 0.033 g / l. When collecting urine for analysis, it is necessary to exclude the ingress of discharge from the vagina or menstrual blood into it - this gives a false positive result. During pregnancy, the protein content in the urine can increase to 0.14 g / l (according to other sources up to 0.3 g / l), this concentration is not yet considered abnormal and is usually explained by mechanical compression of the kidneys by an enlarged uterus.

If the protein content in the urine is higher, it may be a symptom of kidney disease or preeclampsia (toxicosis of the second half of pregnancy)With preeclampsia, the permeability of the blood vessels increases, and the fluid leaves the bloodstream into the edema. The mechanism of increasing blood pressure is turned on to maintain its level in the vessels; fluid goes into edema, pressure rises. This vicious circle is extremely dangerous for mother and child.

The probable cause of the appearance of protein in the urine is cystitis, a common disease in pregnant women.

In normal children, the protein should not be detected in the results of the analysis, although pediatricians allow its episodic appearance at a concentration of up to 0.036 g / l. Protein in the range of 0.7 - 0.9 g / l can be observed in boys aged 6 - 14 with high physical activity, and only in the daytime (orthostatic proteinuria). Morning analysis of the boy's urine immediately after sleep does not reveal the protein.

This condition is not considered pathological. Sometimes protein is detected in infants with the onset of complementary foods with cottage cheese, meat, in children who are ill or have just had SARS. 7 to 10 days after recovery, the protein should return to trace levels.

Causes of protein in the urine

High protein in the urine is caused by:

• kidney diseases (acute and chronic glomerulonephritis, nephrosis, nephropathy of pregnant women, pyelonephritis, tuberculosis);
• poisoning with a number of toxic substances;
• degenerative changes in the kidneys with hypertension, atherosclerosis of the renal arteries, diabetes mellitus;
• inflammatory processes in the bladder and urethra (cystitis, urethritis), urolithiasis, prostatitis;
• oncological diseases;
• chemotherapy of oncological diseases;
• allergic and autoimmune reactions;
• significant injuries of muscle tissue, extensive burns;
• severe stress;
• hypothermia;
• functional reasons associated with the acceleration of blood flow in the renal arteries. The kidneys receive a larger volume of blood per unit of time than usual, and therefore more protein is filtered. This explains the increase in the concentration of protein in the urine with a significant motor load.

As already mentioned, an increased content of protein in the urine can appear in healthy people after a significant physical overstrain, including with profuse sweating, with dehydration.

An important diagnostic indicator isdaily protein in the urine (the amount of protein excreted in the urine per day).

A study of daily urine for protein is carried out after a repeated general urine test again confirmed its presence. The allowable amount of protein in the daily volume of urine is 0.08 - 0.24 g / day. The urine excreted by the patient during the day is collected in a 2.7-liter container (sold in pharmacies), or in a well-washed and dry, better sterilized 3-liter jar. The day before urine collection, it is necessary to exclude the use of diuretics, acetylsalicylic acid. Before each urination, you need to thoroughly wash yourself, both women and men.

If a woman is menstruating, it is best to wait until it is over. When urinating, it is better for women to cover the entrance of the vagina with a sterile cotton swab. The first portion of morning urine is not collected, starting with the average, but the time of the first trip to the toilet is noted in order to complete the collection of urine for analysis after about 24 hours. The urine collected per day is thoroughly shaken and about 100 ml is poured into prepared dishes, preferably in a sterile pharmacy container. However, when instructed by the doctor, bring everything that you have collected.

Normally, protein excretion (protein in daily urine) should not exceed 50–80 mg (0.05–0.08 g) per day. With extreme physical exertion (athletes, loaders, etc.), the physiological maximum is 250 mg / day. In pregnant women, the physiological maximum is 300 mg / day, in the later stages up to 500 mg / day (if edema and arterial hypertension are not observed).

An increase in protein in the urine, what does it mean

Proteinuria - a persistent increase in protein in the urine, excretion of protein in the urine. First of all, it can signal a violation of the filtration function of the kidneys and is most likely caused by:

• an increase in the permeability of the membranes of the renal glomeruli for plasma proteins;
• elevated above the normal amount of proteins in the blood plasma;
• impaired reabsorption (reabsorption) of plasma proteins in the tubules of the kidneys;
• the ingestion of kidney tissue proteins into the urine during inflammation or traumatic injury.

Diagnostic value is the daily loss of protein, or the degree of proteinuria:

• up to 0.5 g / day - moderate. Occurs in chronic pyelonephritis;
• from 0.5 to 4 g / day - high. It is characteristic of acute pyelonephritis, glomerulonephritis, kidney amyloidosis (protein metabolism disorders, in some cases associated with an autoimmune reaction - an insufficiently studied disease with severe consequences), toxic nephropathy (when poisoned by a number of toxins), as well as kidney damage due to diabetes or heart failure;
• more than 4 g / day - typical for the degradation of the glomerular apparatus of the kidneys.

The combination of proteinuria with an increased content of leukocytes indicates inflammation, infection in the urinary tract, the presence of blood - the possible presence of ulceration of the mucous membrane or an increase in the permeability of the walls of the blood vessels of the mucosa, an injury. Attention is also drawn to the molecular weight of the detected protein.

The low molecular weight of proteins indicates that their filtration by the kidneys is impaired to a small extent. A high molecular weight of proteins is a sign of severe pathological changes in the kidneys.

Diagnostics

Urinalysis is an initial study, the results of which determine the need for further diagnosis. If a protein is detected in a repeated general analysis, a daily urine test is prescribed first of all. If he confirmed proteinuria, then carry out:

• complete blood count (primarily the number of leukocytes and the ESR index);
• blood sugar test;
• enzyme-linked immunosorbent assay (possibly);
• blood test for lipid spectrum (possibly);
• Ultrasound of the kidneys, bladder and urinary tract (mandatory).

Ultrasound with an increased concentration of protein in the urine is very informative.

If pathological changes in the kidneys, bladder and urinary tract are not found, further searches for the cause of proteinuria continue.

We remind you that proteinuria can signal a developing oncological disease (leukemia, myeloma).

How to get rid of protein in the urine, including folk remedies

The question is fundamentally wrong.

Proteinuria is not a disease, but a symptom of possible diseases. It is necessary to undergo a medical examination to determine the causes of proteinuria.

Treatment is prescribed depending on the causes. Having identified the cause, it is necessary to act on it, including, possibly, folk remedies.

In any case, when an increased protein in the urine is detected, it is necessary to facilitate the work of the kidneys as much as possible:

• limit salt intake;
• refuse spices, pickles and canned food with vinegar, sausages, smoked meats, meat and fish broths;
• exclude alcoholic beverages, including beer;
• refrain from physical activity.