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Diet Table No. 10: list of allowed and prohibited foods, recipes of dishes
Last reviewed: 03.07.2025

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The diet, called diet No. 10, is intended for patients with cardiovascular problems, in particular, with circulatory failure of the I-IIIA degree. It does not have too many restrictions; in fact, diet table No. 10 is a healthy eating plan that is useful for all people. Less salt, liquid, irritants and stimulating substances, moderate cooking of products, exclusion of heavy food - not such a big price to pay if in return you get a healthy heart and blood vessels, and at the same time - a slim figure.
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Indications
Dietary table options No. 10 are intended for patients with heart and blood vessel problems. Indications for use are as follows:
- hypertension;
- circulatory disorder (ischemia);
- arrhythmia, heart defects;
- recovery after a heart attack;
- high cholesterol;
- accumulation of fluid in tissues associated with heart and kidney failure;
- atherosclerosis of blood vessels.
Diet No. 10 is characterized by the following features:
- reduced calorie content due to the reduction of fats and carbohydrates;
- significant restriction of table salt and coarse fiber;
- reducing the drinking rate to 1.1 liters;
- excluding spicy, irritating, difficult to digest foods that cause flatulence;
- by increasing the amount of potassium and magnesium, alkalizing foods.
During the cooking process, gentle processing is recommended, that is, boiling meat and fish, without salt, eating warm but not hot dishes, eating five meals a day, in equal portions.
The energy value of the diet is determined depending on the stage and symptoms of the pathology, age and weight of the person. The optimal proportion of proteins, fats and carbohydrates is 80:70:350 g.
The daily food portion should be divided into at least five meals, the last of which should be taken approximately three hours before bedtime. After that, you are allowed to drink only a glass of kefir.
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Diet #10 for heart disease
It is unlikely that anyone is unaware of the exceptional importance of the heart as a physiological organ. Accordingly, it requires exceptionally careful and considerate treatment. After all, unfortunately, the main cause of death in developed countries is still heart disease.
Food products affect cardiac activity in different ways, therefore special recommendations have been developed for the nutrition of heart patients, which are the basis of diet No. 10 for heart diseases. Since there are many heart pathologies, and they are caused by different reasons, diet table No. 10 is specified depending on them. If we consider such diseases as angina pectoris, heart attack, arrhythmia, heart failure to be the most popular, then diet No. 10 for patients with such diagnoses differs in some accents.
- Angina is caused by spasms or narrowing of the coronary vessels through which blood enters the myocardium. To prevent it, a sufficient amount of potassium and magnesium is necessary. These microelements are supplied to the body by nuts, cereals, potatoes, pumpkin, strawberries, mango, barley. In this case, all high-fat dairy and meat products, fast food, salty dishes, alcoholic beverages are considered harmful.
In myocardial infarction, part of the heart muscle, due to blockage of the coronary artery, irreversibly dies. To restore it, it is necessary to reduce the food load on the heart and blood vessels. For this purpose, eat fruits, nuts, vegetables, potatoes, bran, olive oil, fish. Forbidden fruits include animal fats in all forms, all types of sausages, fried and fast food, sweets, alcohol, salty foods.
- Arrhythmia is a disturbance of the heart rhythm. In case of severe failures, this leads to insufficiency and subsequent cardiac arrest. The best preventive products are those enriched with potassium, as well as magnesium and calcium. These are dried fruits, currants, bananas, potatoes, parsley, seeds, honey, cabbage. Alcohol, energy drinks, and too fatty foods are prohibited.
The essence of heart failure is that the main muscle of the body is unable to pump a sufficient amount of blood. To correct the situation, the body needs products containing vitamin B1, as well as a set of "heart" microelements: potassium, calcium, magnesium. At the same time, the diet should help eliminate excess fluid. To stimulate cardiac activity, dried fruits, rose hips, citrus fruits, cabbage, cereals, currants, cherries, raspberries, and fermented milk products are introduced into the diet. It is necessary to minimize the consumption of salt and sugar, and completely give up alcohol.
Diet #10 for hypertension
For hypertensive patients, diet table No. 10 is recommended with a significant restriction on drinking: up to 800 ml. The patient has to give up soups, and their liquid products should be consumed as tea with milk, rosehip drink, juices, and clean water.
The diet is vegetarian. It is not a very strict nutrition system, combining plant and lean meat products in a reasonable ratio. Not so healthy, but patient-favorite dishes are allowed from time to time. The daily menu for diet No. 10 includes 5 meals a day: first and second breakfasts, lunch, afternoon snack, dinner and kefir at night. An approximate version of the daily diet:
- 1. Pureed oatmeal or buckwheat porridge, egg white omelette (or soft cottage cheese), tea with milk.
- 2. Yogurt and cookies or baked apple.
- 3. Steamed chicken cutlets, boiled cauliflower, zucchini or other vegetables, fresh berry compote.
- 4. Casserole of cottage cheese, apples and carrots, jelly.
- 5. Fish (boiled or baked), vegetable stew, rosehip broth.
- 100 g of kefir (shortly before bed).
The steam omelette, a favourite of many, recommended by diet No. 10 for hypertension and other cardiovascular pathologies, is prepared from two eggs and 120 ml of milk. The whipped mixture with the addition of a teaspoon of oil is placed in a steamer or a steam bath, that is, the frying pan is placed on a saucepan with boiling water. In about 15 minutes, the omelette is ready. For variety, pieces of vegetables or greens are added to the dish.
In case of a hypertensive crisis, the first days after the critical condition should be made unloading, eating only vegetables, cereals, fruits. Ignore salt as much as possible and do not use it during cooking, adding salt to the dish immediately before eating. Further nutrition after the crisis should include healthy fatty acids, which are rich in seafood. Limit liquid to 1 liter.
Diet No. 10 for atherosclerosis
Diet No. 10 for atherosclerosis is aimed at normalizing metabolism, in particular, in the myocardium, reducing hemocoagulation, strengthening the vascular and nervous systems. From the healthy products recommended for diet table No. 10, you can prepare food for the whole family, which will bring pleasure and benefit to both children and adults.
An important aspect of the anti-sclerotic diet No. 10 is the adjustment and optimal ratio of all nutritional and vital components. The basic rules are as follows:
- Eating according to a schedule, with short breaks between meals.
- Balanced across all criteria.
- Stewing and boiling instead of frying and smoking.
- Priority is given to bland and non-spicy dishes.
- Instead of rich broths – vegetable broths.
- Green light for vegetable and dairy products.
- Unloading days, subject to agreement with the doctor.
Atherosclerosis "does not like" many things that healthy people like. For example, all sweets, sausages and other smoked meats, offal, fruits with a lot of sugar, mushroom and bean soups, semolina and rice, industrial sauces, sea fish, caviar, canned products are excluded from the diet. With atherosclerosis, carbonated and hot drinks, including cocoa, are especially harmful.
A separate issue is alcohol and tobacco products, which are a common cause of diseases in men. Smoking, abuse of strong drinks, a sedentary lifestyle, stress aggravate the course of the disease and lead to irreparable consequences. Therefore, in the presence of cardiovascular disorders, each person is obliged to give up bad habits, control their diet and physical activity.
Diet #10 after a heart attack
Diet No. 10 with the letter "I" helps restore health after a myocardial infarction. The diet of a patient who has suffered a heart attack depends on the recovery period and the physical regime. The goal of diet No. 10 after a heart attack is to reduce calories, the amount of salt and liquid, fats and sugar, to exclude foods that provoke flatulence, excite the nervous system and blood vessels, to organize a regime of fractional meals with easily digestible food.
Diet table No. 10 in the first day or two of the acute period consists mainly of drinks. Suitable are semi-sweet tea with lemon, diluted orange or currant juice, fruit drink, jelly, compote, non-carbonated alkaline water. Drinks should be warm, since cold ones can cause pain in the heart. The patient should not be forced to eat until he wants it himself.
After this time, 1 diet is prescribed. It consists of the following components:
- pureed first courses of vegetables and cereals;
- steamed cutlets, meatballs, omelettes;
- boiled fish, milk porridge;
- vegetable purees, puddings, soufflés;
- fermented milk products;
- dried fruits, juices, other drinks.
Vegetable oil, butter and milk are added directly to the dishes. The food should be pureed and should not be consumed too hot.
2 post-infarction diet is prescribed in the subacute period, that is, in the second or third week of the disease. 150 g of dried white bread, viscous porridges, casseroles, cauliflower puree, raw berries, grated fresh carrots, baked apples are added to the previous diet. Soups with boiled ingredients, meat and fish - in pieces or minced, vegetable and milk sauces are recommended. You can improve the taste of unsalted food with juices, boiled and slightly fried onions. Drinks and fats - as in option 1.
During the scarring period, option 3 is suggested. This is an enriched diet, compared to the previous two, including stewed carrots and beets, lean ham, jellied dishes, pasta with homemade cheese, casseroles with semolina and buckwheat porridge. Bread deserves special mention. Diet 3 suggests eating 250 g of wheat or 200 g of wheat plus 50 rye bread.
After three rations, the diet is expanded, and in case of excess weight, additional fasting days are prescribed. If the patient's condition improves, but the appetite remains reduced, it is permissible to include high-calorie foods in the menu - eggs, cream.
Diet #10 for angina
Angina pectoris is called a clinical manifestation of coronary heart disease (CHD). Diet No. 10, along with a healthy lifestyle and giving up unhealthy habits, helps improve the patient's condition and quality of life. After all, properly selected and prepared food normalizes metabolism, strengthens vascular walls, and helps nerves withstand stressful situations.
An attack of angina develops due to a lack of nutrition for the myocardium. Diet table No. 10 is designed to prevent an attack, ensure fat metabolism and normal blood clotting. After all, with increased clotting, there is a risk of thrombosis, and as a result, blood flow and nutrition of the heart are difficult.
- Diet No. 10 for angina contains products enriched with minerals and vitamins. An important place in the treatment of coronary heart disease is occupied by vitamin C, which strengthens blood vessels, prevents their lumen from narrowing, and also has antioxidant properties.
Table salt is practically excluded from the diet; the body needs its natural amount contained in permitted products. The patient should forget about such dishes as concentrated broths, offal, sweet flour products, lard and other animal fats, all salted-smoked-canned products, fatty whole milk products.
Excess weight is reduced by regulating the caloric content of the diet, but only after consultation with doctors. Approximate figures for the caloric content of the dietary ration are as follows: for normal weight - up to 2900 kcal, for increased weight - up to 2100.
Fractional nutrition, recommended for all people, is mandatory for angina. Food is taken up to six times a day, in small portions. Fresh vegetables, unsweetened and dried fruits, eggs, nuts, legumes, vegetable oils, whole grain bread, fatty fish, lean meat (rabbit, turkey), seafood - the list of permitted foods is quite extensive, which allows the recovering person to eat tasty, complete and rationally.
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Diet #10 for renal colic
Acute pain in the lumbar region is provoked by the so-called renal colic. It can be a precursor to urolithiasis. According to statistics, the disease is much more common in men, presumably because women are more attentive to their health and diet.
If attacks are repeated periodically, then after examination, in addition to treatment, the patient is prescribed diet No. 10 for renal colic. This is a set of products that can normalize metabolic processes. In order to avoid overeating and overloading the digestive organs, it is recommended to adhere to a fractional diet, eating every four hours. Another principle of diet No. 10 is the minimum amount of carbohydrates, fatty and hard-to-digest foods.
- By and large, diet table No. 10 advocates a regime that is beneficial in all cases, since proper nutrition minimizes the risk of any disease.
Fish and meat are cooked by boiling and stewing, fried and smoked foods are completely removed from the menu - along with baked goods and flour products. Porridges, vegetable broths and juices with water, fermented milk dishes, tea with milk, fruit salads are welcome. It is preferable to stew and boil plant foods, and also to use them according to the season, when vegetables and fruits contain the maximum amount of vitamins.
- Diet table No. 10 for colic depends on what kind of stones cause it. During examination, oxalate, phosphate or urate stones are most often diagnosed.
With oxalates, the emphasis is on limiting protein foods and leaching urine. Plant products with a high content of vitamin C and oxalic acid, confectionery, sour berries and fruits are prohibited. Vitamins B, sweet fruits, cereals (except semolina), lean fish and meat, butter, jelly and compotes are recommended.
With urates, the diet is not very different. Proteins, salty foods and smoked foods are also limited. Porridges (except buckwheat), wholemeal bread products, sweet berries, vegetables, and various types of dairy products are included.
In the presence of phosphates, in addition to salted and smoked dishes, fish, milk, potatoes, sweet fruits, and curd dishes are prohibited. The list of permitted foods includes egg whites, legumes, poultry, lard, butter, sugar, honey, the entire fruit and vegetable group, pumpkin, and rosehip infusion.
General information of diet #10
There are 15 diets developed by scientists under the guidance of therapist Pevzner. They serve to correct the health of patients with certain diseases. Diet table No. 10 is a nutrition system designed for people with cardiovascular disorders, in particular, with circulatory insufficiency.
The essence of the diet is to correct the diet in order to improve blood circulation and other functions of the cardiovascular system. At the same time, the body is provided with complete and tasty nutrition.
- Healthy foods help to normalize metabolism, improve health and strengthen the body's defenses.
- Avoiding unhealthy foods protects the digestive organs, liver and kidneys from irritation and accumulation of toxins.
The diet is an important part of a complex of therapeutic measures and is prescribed in hospitals, sanatoriums, and at home for patients suffering from problems with the heart and blood vessels. The diet proposed by diet No. 10 reduces the load on the heart, so it is useful for hypertensive patients, heart patients, people with high cholesterol in the blood, and also during the recovery period after a heart attack. The diet helps remove excess fluid accumulated in the tissues and improves kidney function. As a result, a person's quality of life is significantly improved.
Hypocholesterol, hypolipidemic diet No. 10
Nutrition according to Pevzner, called hypocholesterol, hypolipidemic diet No. 10, is prescribed for cardiac pathologies - in order to stabilize blood circulation and restore normal heart rhythm. The hypocholesterol diet significantly limits animal fats, yolks and other fatty foods.
Diet table No. 10 has modifications "a", "b", "g", "i", "r", "c", which are used depending on the specific disease. That is, the principles and tasks of these modifications are the same, but each has its own characteristics.
Diet No. 10 is designed to relieve the vessels and myocardium, stimulate renal activity and cleanse tissues from excess fluid. Thus, it slows down the spread of pathological processes in the vessels and heart muscle. The energy value of the tenth table satisfies the physiological need of the body for energy and nutritional components. The menu is made individually, taking into account the nature of the pathology, the severity of the condition, and the taste preferences of the patient.
During the therapeutic diet, it is permitted to consume:
- dry biscuits, black bread;
- cereals, except rice and semolina, pasta made from durum wheat flour;
- lean fish and meat, bologna;
- proteins, up to 10 per week;
- light soups – vegetable, milk, mushroom and meat;
- low-fat dairy products;
- soft or peeled fruits;
- every other day – preserves or jellies;
- a little butter;
- herbal teas, compotes, jelly, still water.
Foods rich in cholesterol, stimulating the nervous system, blood vessels and heart muscle are prohibited. The following products belong to this category:
- white bread and sweet pastries;
- all legumes;
- egg yolks;
- pickled and smoked products;
- radish, sorrel, onion, garlic, spinach;
- salty high-fat cheeses;
- berries and fruits rich in coarse fiber;
- chocolate, ice cream;
- carbonated drinks, alcohol;
- coffee, tea, sour juices.
As in other cases, to avoid overloading the stomach, food is taken frequently, but little by little. It is recommended to finish the day with rosehip decoction or kefir. Usually, after a week, a positive result is observed: stabilization of the heart and kidneys, weight loss, normalization of sleep and mood.
Salt-free diet #10
It is known that salt retains water in tissues and slows down metabolic processes. However, it is impossible to live without salt: its deficiency in the body causes nervous and mental disorders, anorexia, osteoporosis. Therefore, salt-free diet No. 10 is not a complete rejection of salt, as it may seem at first glance.
Diet No. 10 salt-free implies the use of salted ingredients in home cooking in minimal quantities and excludes industrial products that initially contain a lot of salt. This way of eating cannot last long. There are options for 4, 7, 14, 15 days. With proper adherence to diet table No. 10, the body loses excess weight and cellulite, restores water-salt balance.
One of the popular salt-free diets is called Japanese. Lots of rice, sea fish, green tea, everything without sweet and spicy components is the basis of such a diet. All dishes are steamed or boiled. Mandatory refusal of long-term storage products, since the guarantee of their safety is precisely the high concentration of salt. One good thing: you can drink your favorite drinks, including coffee, without restrictions (though without sugar).
- Unsalted food is useful for hypertension and edema. People who are used to it say that over time, food without salt stops seeming tasteless. And that natural saltiness is felt most in protein dishes – meat, fish, dairy products.
However, this way of eating is not suitable for everyone. The lack of sodium, which is a component of table salt, has an adverse effect on the cardiovascular system, so heart patients should not use risky methods of losing weight.
And not all nutritionists are enthusiastic about the salt-free diet; some believe that losing weight solely by removing excess water is not “real” weight loss. And that methods that help burn fat, rather than just remove excess fluid, are more effective.
Menu for a week of diet #10
When prescribing therapeutic diet No. 10, it is recommended to make a list of dishes calculated for a week at once. Practical people borrow ready-made examples of a menu for a week of diet No. 10 and, based on them, create their own therapeutic nutrition schemes.
Diet table No. 10 with six meals a day may include the following dishes:
- Breakfast: millet porridge with milk, egg white omelette, berry drink.
- 2nd breakfast – baked apple or pear, possibly with honey.
- Lunch: half a portion of borscht seasoned with vegetable oil; turkey fillet with vegetable puree, fruit jelly.
- Afternoon snack – acidophilus 200 g, rice pudding.
- Dinner: homemade cheese casserole with sour cream and jam, pike fillet with milk sauce, vegetable stew, rosehip drink.
- Before bed – chicory drink and dry biscuits.
The following menu option for diet No. 10 offers a five-meal regimen:
- Breakfast: milk porridge made from pumpkin and millet, biscuit, tea (green).
- Lunch – steamed omelette, plum juice mixed with water.
- Lunch: rice and vegetable soup, zucchini caviar, cauliflower, rabbit stewed in milk, uzvar.
- Afternoon snack: dried apricots with rosehip drink.
- Dinner: mackerel baked in foil, lean mashed potatoes, chicory drink.
If desired, a light drink is allowed before bed – kefir, yogurt, milk with honey.
Recipes for Diet No. 10
Diet table No. 10 is capable of not only reducing the intensity of cardiac pathologies, but is also considered an effective preventive measure against angina, myocardial infarction, atherosclerosis, coronary heart disease, stroke, coronary disease. The effectiveness of diet No. 10 has been tested by time and several generations of patients combining drug treatment with healthy nutrition.
In addition to the positive effect on blood vessels, heart, and other vital organs, dietary nutrition has a beneficial effect on appearance and the entire body, normalizes metabolism and body weight. Recipes for diet #10 are available on the Internet, and the products for healthy dishes are no more expensive than the rest. It is not a sin to eat such food without waiting for special recommendations from doctors. Simple recipes for healthy dishes:
- Cauliflower stewed in sauce
Boil the head, separated into florets, in water without salt, put into a separately prepared milk sauce. For the sauce you need 200 ml of milk, a spoon of flour and parsley. Simmer the cabbage in the sauce for about five minutes. Add minimal salt when serving.
- Meatballs with rice and sauce
The mince is prepared from 0.5 kg of fillet (chicken or turkey). The minced meat is mixed with 3 spoons of cooked rice and an egg. After adding a little salt, small balls are formed, placed on a mold and covered with foil. Bake in a preheated oven for about 40 minutes. Serve with milk or sour cream sauce.
- Apple and Pumpkin Casserole
For 200 g of apples, take 600 g of pumpkin. Coarsely grate the peeled fruit, simmer in a frying pan with butter for several minutes, rub until smooth. Pour in 100 g of milk and add 60 g of semolina, stirring for about 10 minutes. Beat an egg into the mixture cooled to 60 degrees, place on a baking sheet greased and sprinkled with breadcrumbs. Grease the top with sour cream and melted butter. Pour butter or sour cream over the casserole taken out of the oven.
Benefits
Therapeutic diet No. 10 has several variants. They are designated by letters: A, B, C, P, G, I. The benefit of the diet is that instead of useless or obviously harmful food, the body is offered healthy food, saturated with components necessary for the myocardium, central and peripheral vessels. Dietary nutrition limits fats and salt, caloric content, instead, it is proposed to enrich the diet with vitamins, Omega3 fatty acids, microelements.
The dietary table regimen No. 10 provides for fractional consumption. The entire daily dose is divided into approximately equal parts, which should be consumed at the same time, in five to six meals. The first breakfast should be light, and the last meal should be taken no later than two to three hours before going to bed. The number of healthy drinks is limited, harmful ones are completely excluded.
- Following this diet reduces cholesterol levels and body weight, which eases the load on the myocardium and reduces the risk of atherosclerosis.
What can and what can not?
Some people who do not particularly follow a healthy diet, after reading the recommendations for diet No. 10, ask in surprise: how and what can you eat, cooked without salt and spices? It is not tasty! And only after the results obtained during the forced adherence to diet table No. 10, do they give credit to this way of eating. Many are especially pleased with the side effect - weight loss.
Healthy foods and dishes for diet number 10:
- vegetarian and milk soups;
- dried white bread;
- unsweetened baked goods, biscuits, sweets (non-chocolate);
- lean meats, poultry - baked or fried after preliminary cooking;
- fish, seafood;
- soft-boiled eggs, omelettes;
- puddings, porridges with water or milk;
- fresh, boiled, baked vegetables;
- jellied dishes, kissels, jelly;
- fruit salads, vegetable caviar;
- pasta;
- unsalted cheeses, low-fat dairy products;
- gravies made from vegetable broths, sour cream, and tomato;
- soft fruits, jam, honey, dried fruits;
- light tea, coffee drink with milk, juices, rosehip infusion;
- vegetable oils, butter and low-fat ghee;
- vanillin, cinnamon, citric acid.
Recommended in limited quantities: sour cream and cream, green peas, cabbage, sausages such as Doctor's sausage, raw vegetables, dill, parsley, grape juice.
The short answer to the question of what you can't eat on diet #10 is that you can't eat unhealthy food. This advice should be taken into account not only by people with circulatory disorders, but also by everyone who considers themselves healthy.
When prescribing diet table No. 10, the patient must be prepared to give up the following products:
- fresh bread, pastry and puff pastry products, pancakes, fritters;
- broths from mushrooms, fish, meat;
- fatty poultry, canned food, smoked meats, liver;
- smoked, salted, canned fish, caviar;
- sharp and fatty varieties of hard cheese;
- fried and hard-boiled eggs;
- decoctions and main courses from legumes;
- salted, pickled, marinated vegetables;
- spinach, garlic, radish, onion, sorrel;
- fruits containing coarse fiber;
- chocolate, cakes, cooking fats;
- pepper, horseradish, sauces prepared with meat and fish broths;
- lard, fast food;
- coffee, cocoa;
- alcoholic, energy, carbonated drinks.
It is impossible to list absolutely all prohibited products. It is easier to focus on the permitted ones, and what is not on the list is considered prohibited. You should not be afraid that the diet will be meager and tasteless; in fact, from the products of diet No. 10 you can cook varied and nutritious food every day. It is important to use gentle cooking methods and stick to the regime - eat fresh dishes at the same hours.
Possible risks
Hypertensive patients will undoubtedly benefit from reducing the saltiness of their food. However, salt-free diet No. 10, which consumes less than 3 g of salt per day, can cause heart attacks, strokes, and other pathological conditions associated with blood vessels and the heart.
The risks associated with the diet can be minimized if you resort to it only on the recommendation of a competent specialist, and not for independent reasons. And follow the recommendations of diet table No. 10 occasionally, and not constantly.
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Complications
Due to the loss of a large amount of salt, salt-free diet No. 10 causes weakness, apathy, headache, and reluctance to move actively.
Possible complications do not allow pregnant and nursing mothers to independently resort to diet table No. 10.
Complete rejection of salt is fraught with cardiovascular pathologies. When using a salt-free diet for weight loss, returning to the previous way of eating causes the return of lost kilograms.
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Reviews
Olga, who had a heart attack, claims that with the help of diet #10 she lost as much as 35 kg in 10 days. She combined diet table #10 with physical activity. She feels great and does not feel hungry.
Natalia followed the diet for two years. She started with difficulty, but after the first results she felt a second wind. She got rid of swelling and pressure surges.
Most of the reviews are in the same vein. However, some patients cannot stand bland food for long, as all dishes without salt seem the same to them.
Diet table No. 10 is quite varied and balanced. For simple disorders, a soft diet option is offered, for complex ones - a more strict diet option. And although following diet No. 10 does not replace medications prescribed by doctors, but in combination with them it helps restore the body and prevent complications of pathologies. The only condition is that it can only be prescribed by a cardiologist or nutritionist, and not the patient himself.