{"id":21200,"date":"2021-03-13T20:40:41","date_gmt":"2021-03-13T19:40:41","guid":{"rendered":"https:\/\/acva.sk\/odpovede\/"},"modified":"2021-03-13T20:40:41","modified_gmt":"2021-03-13T19:40:41","slug":"odpovede","status":"publish","type":"page","link":"https:\/\/acva.sk\/en\/odpovede\/","title":{"rendered":"Odpovede"},"content":{"rendered":"[vc_row][vc_column][vc_nested_accordion active_tab=”false”][vc_nested_accordion_tab title=”Do\u010d\u00edtali sme sa, \u017ee u det\u00ed s PAS mo\u017eno dosiahnu\u0165 zmiernenie pr\u00edznakov di\u00e9tou alebo doplnkami v\u00fd\u017eivy. Spom\u00ednaj\u00fa sa viacer\u00e9 di\u00e9ty aj doplnky v\u00fd\u017eivy. Ktor\u00e9 s\u00fa najvhodnej\u0161ie?” tab_id=”1616410287-1-47″][vc_column_text]\n

Ak sa u\u00a0die\u0165a\u0165a preuk\u00e1\u017ee potravinov\u00e1 alergia alebo intolerancia, lek\u00e1r odporu\u010d\u00ed die\u0165a\u0165u tzv. elimina\u010dn\u00fa di\u00e9tu, v\u00a0r\u00e1mci ktorej sa vylu\u010duj\u00fa potraviny, ktor\u00e9 die\u0165a\u0165u sp\u00f4sobuj\u00fa probl\u00e9m (bezlakt\u00f3zov\u00e1, bezlepkov\u00e1 di\u00e9ta, ap.).<\/span><\/p>\n

U\u00a0det\u00ed s\u00a0PAS sa v\u0161ak \u010dasto stret\u00e1vame s\u00a0pod\u00e1van\u00edm r\u00f4znych elimina\u010dn\u00fdch di\u00e9t bez toho, aby u\u00a0die\u0165a\u0165a bola preuk\u00e1zan\u00e1 alergia alebo intolerancia potrav\u00edn. Di\u00e9tny re\u017eim zav\u00e1dza zv\u00e4\u010d\u0161a rodina die\u0165a\u0165a z\u00a0vlastnej iniciat\u00edvy. Najbe\u017enej\u0161ou je di\u00e9ta s\u00a0vyl\u00fa\u010den\u00edm lepku a\u00a0kaze\u00ednu (GFCF, gluten-free\/casein-free). Medzi \u010fal\u0161ie patr\u00ed GAPS di\u00e9ta s\u00a0obmedzen\u00edm sacharidov a\u00a0priemyselne spracovan\u00fdch potrav\u00edn (m\u00e4sov\u00e9 v\u00fdrobky, syry), di\u00e9ta s\u00a0obmedzen\u00edm potravinov\u00fdch adit\u00edv, ketog\u00e9nna di\u00e9ta\u00a0a\u00a0pod.<\/span><\/p>\n

Uskuto\u010dnili sa a\u00a0na\u010falej prebiehaj\u00fa v\u00fdskumn\u00e9 \u0161t\u00fadie, sleduj\u00face \u00fa\u010dinky di\u00e9t na behavior\u00e1lne prejavy i\u00a0GI \u0165a\u017ekosti u det\u00ed s\u00a0PAS. Hoci niektor\u00e9 v\u00fdsledky nazna\u010duj\u00fa, \u017ee \u00faprava stravy by mohla by\u0165 pre niektor\u00fdch jedincov pr\u00ednosn\u00e1, napr\u00edklad GFCF alebo bezlepkov\u00e1 di\u00e9ta, doteraj\u0161ie v\u00fdsledky nepriniesli dostato\u010dn\u00e9 d\u00f4kazy o\u00a0\u00fa\u010dinnosti di\u00e9tnych postupov. Di\u00e9ty sa tak zara\u010fuj\u00fa medzi komplement\u00e1rne a alternat\u00edvne formy intervenci\u00ed pri PAS, ktor\u00fdch efekt\u00edvnos\u0165 nie je potvrden\u00e1. \u010eal\u0161\u00edm uhlom poh\u013eadu je i\u00a0bezpe\u010dnos\u0165 elimina\u010dn\u00fdch di\u00e9t. Hoci niektor\u00e9 z\u00a0di\u00e9tnych odpor\u00fa\u010dan\u00ed sa daj\u00fa vn\u00edma\u0165 ako racion\u00e1lne a\u00a0prospe\u0161n\u00e9 (napr. obmedzenie cukru, odpor\u00fa\u010danie \u010derstvo pripravovanej stravy), ochudob\u0148ovanie jed\u00e1lni\u010dka o\u00a0z\u00e1kladn\u00e9 potraviny (mlie\u010dne v\u00fdrobky, obilniny, strukoviny a\u00a0pod.), a\u00a0to mnohokr\u00e1t u\u00a0det\u00ed, ktor\u00fdch strava je u\u017e i\u00a0tak limitovan\u00e1 ich selektivitou, m\u00f4\u017ee predstavova\u0165 nezanedbate\u013en\u00e9 riziko.\u00a0<\/span><\/p>\n

U\u00a0det\u00ed s\u00a0PAS je sa stret\u00e1vame aj pod\u00e1vanie doplnkov v\u00fd\u017eivy so z\u00e1merom zlep\u0161i\u0165 behavior\u00e1lne prejavy PAS. \u010casto sa pod\u00e1va i\u00a0viacero doplnkov s\u00fa\u010dasne, bez konzult\u00e1cie s\u00a0odborn\u00edkom. Je v\u0161ak iba mal\u00fd po\u010det doplnkov v\u00fd\u017eivy, kde sa benefit preuk\u00e1zal (napr. melaton\u00edn pri poruch\u00e1ch sp\u00e1nku, multivitam\u00edny pri selektivite). Podobne, ako v\u00a0pr\u00edpade di\u00e9t, aj pri zara\u010fovan\u00e1 doplnkov treba zv\u00e1\u017ei\u0165 ich potenci\u00e1lne rizik\u00e1.\u00a0<\/span><\/p>\n[\/vc_column_text][\/vc_nested_accordion_tab][vc_nested_accordion_tab title=”Pros\u00edm o radu, kto a na z\u00e1klade \u010doho m\u00f4\u017ee ur\u010di\u0165, \u010di je pre moje die\u0165a vhodn\u00e1 di\u00e9ta GFCF.” tab_id=”1616410287-2-73″][vc_column_text]\n

Niektor\u00e9 rodi\u010dia det\u00ed s\u00a0autizmom pri\u00a0pod\u00e1van\u00ed GFCF di\u00e9ty spozorovali u\u00a0svojho die\u0165a\u0165a ist\u00e9 zlep\u0161enie. \u00da\u010dinnos\u0165 GFCF di\u00e9ty sa v\u0161ak vo vedeck\u00fdch \u0161t\u00fadi\u00e1ch zatia\u013e spo\u013eahlivo nepotvrdila, preto nie s\u00fa zn\u00e1me ani objekt\u00edvne krit\u00e9ri\u00e1, ktor\u00e9 by n\u00e1m u\u013eah\u010dili rozhodovanie o\u00a0tom, \u010di je di\u00e9ta pre konkr\u00e9tne die\u0165a vhodn\u00e1 alebo nie.\u00a0 Odborn\u00edci tie\u017e uv\u00e1dzaj\u00fa, \u017ee di\u00e9ta priniesla zlep\u0161enie hlavne u\u00a0det\u00ed, ktor\u00e9 mali tr\u00e1viace \u0165a\u017ekosti a\u00a0alergick\u00e9 prejavy.<\/span><\/p>\n[\/vc_column_text][\/vc_nested_accordion_tab][vc_nested_accordion_tab title=”Radi by sme vysk\u00fa\u0161ali n\u00e1\u0161mu die\u0165a\u0165u s PAS pod\u00e1va\u0165 GFCF di\u00e9tu. Na \u010do by sme si mali d\u00e1va\u0165 pozor?”][vc_column_text]\n

Pri GFCF (gluten free\/casein free) sa z\u00a0v\u00fd\u017eivy vylu\u010duj\u00fa potraviny s\u00a0obsahom lepku (glut\u00e9nu) a kaze\u00ednu.\u00a0<\/span><\/p>\n

Lepok sa nach\u00e1dza v\u00a0obilnin\u00e1ch – p\u0161enici, ra\u017ei, ja\u010dmeni, teda aj vo v\u0161etk\u00fdch potravin\u00e1ch (pe\u010divo, krupica, ka\u0161e) a\u00a0jedl\u00e1ch (kol\u00e1\u010de, om\u00e1\u010dky, knedle), ktor\u00fdch zlo\u017ekou s\u00fa tieto obilniny<\/span><\/p>\n

Be\u017en\u00e9 druhy v\u00fdrobkov z\u00a0obiln\u00edn sa v\u00a0di\u00e9te nahr\u00e1dzaj\u00fa \u0161peci\u00e1lnymi bezlepkov\u00fdmi druhmi (bezlepkov\u00fd chlieb, cestoviny a\u00a0pod.) Vhodnou s\u00fa\u010das\u0165ou di\u00e9ty s\u00fa plodiny, ktor\u00e9 prirodzene lepok neobsahuj\u00fa, ako napr. kukurica, zemiaky, proso, amarant, poh\u00e1nka, fazu\u013ea, ry\u017ea (niekedy rob\u00ed probl\u00e9m pri \u0165a\u017e\u0161\u00edch form\u00e1ch ochorenia), s\u00f3ja a\u00a0v\u00fdrobky z\u00a0nich (m\u00faky, ka\u0161e, \u0161kroby at\u010f.). \u010cist\u00fd ovos v\u00a0men\u0161\u00edch mno\u017estv\u00e1ch pacienti dobre zn\u00e1\u0161aj\u00fa. Mnoh\u00e9 v\u00fdrobky s\u00a0n\u00e1zvom \u201eovsen\u00fd\u201c v\u0161ak obsahuj\u00fa pr\u00edmesi in\u00fdch obiln\u00edn, tak\u017ee lepok sa v\u00a0nich nakoniec nach\u00e1dza, preto sa nepova\u017euj\u00fa za vhodn\u00fa s\u00fa\u010das\u0165 di\u00e9ty.\u00a0<\/span><\/p>\n

Kaze\u00edn sa nach\u00e1dza v\u00a0mlieku, v mlie\u010dnych v\u00fdrobkoch a\u00a0syroch, ktor\u00e9 sa teda zo stravy \u00faplne vylu\u010duj\u00fa (v\u0161etky \u2013 jogurty, cmar, srv\u00e1tka, \u0161\u013eaha\u010dka, smotana, at\u010f.). Nevhodn\u00e9 s\u00fa v\u0161etky druhy \u017eivo\u010d\u00ed\u0161neho mlieka (kravsk\u00e9, kozie, ov\u010die a\u00a0pod.), ako aj v\u00fdrobky z\u00a0nich.\u00a0<\/span><\/p>\n

Lepok a\u00a0kaze\u00edn s\u00fa s\u00fa\u010das\u0165ou mnoh\u00fdch potravin\u00e1rskych pr\u00edsad, taktie\u017e i polotovarov a\u00a0hotov\u00fdch pokrmov. Nevhodn\u00e9 s\u00fa napr\u00edklad potraviny, ktor\u00e9 obsahuj\u00fa kazein\u00e1t, slad alebo hydrolyzovan\u00fd rastlinn\u00fd prote\u00edn, preto\u017ee obsahuj\u00fa lepok. Nevhodn\u00e9 pr\u00edsady m\u00f4\u017eu obsahova\u0165 potraviny ako instantn\u00e9 polievky, hotov\u00e9 om\u00e1\u010dky, sladkosti, keks\u00edky, \u00fadeniny. Glut\u00e9n sa \u010dasto nach\u00e1dza vo vypr\u00e1\u017ean\u00fdch jedl\u00e1ch a\u00a0do chrumkava upraven\u00fdch potravin\u00e1ch. Pred podan\u00edm nezn\u00e1mych v\u00fdrobkov sa odpor\u00fa\u010da d\u00f4kladne pre\u0161tudova\u0165 inform\u00e1cie pre spotrebite\u013ea na etikete v\u00fdrobku, v\u00a0pr\u00edpade neistoty obr\u00e1ti\u0165 sa v\u00fdrobcu. Ist\u00fdm vod\u00edtkom m\u00f4\u017ee by\u0165 ozna\u010denie \u201eV\u00fdrobok vhodn\u00fd pre bezlepkov\u00fa di\u00e9tu\u201c. Nevhodn\u00e9 pr\u00edsady m\u00f4\u017eu by\u0165 aj s\u00fa\u010das\u0165ou liekov.<\/span><\/p>\n

Obilniny a\u00a0mlieko\/mlie\u010dne v\u00fdrobky patria vo v\u00fd\u017eive \u010dloveka medzi z\u00e1kladn\u00e9 potraviny\u00a0 a\u00a0s\u00fa v\u00fdznamn\u00fdm zdrojom \u017eiv\u00edn. Pri obmedzen\u00ed obiln\u00edn s\u00a0obsahom lepku je treba do stravy zara\u010fova\u0165 in\u00e9 alternat\u00edvy. V s\u00fa\u010dasnosti to nie je a\u017e tak\u00e9 zlo\u017eit\u00e9, preto\u017ee jestvuje slu\u0161n\u00fd sortiment bezlepkov\u00fdch obiln\u00edn.\u00a0<\/span><\/p>\n

Mlieko je zasa hlavn\u00fdm zdrojom v\u00e1pnika a\u00a0vitam\u00ednu D, ktor\u00e9 treba taktie\u017e nahr\u00e1dza\u0165 z\u00a0in\u00fdch zdrojov. Do v\u00fd\u017eivy die\u0165a\u0165a treba zara\u010fova\u0165 vo v\u00e4\u010d\u0161om mno\u017estve i\u00a0nemlie\u010dne zdroje v\u00e1pnika: v\u00fdrobky zo s\u00f3je (tofu, s\u00f3jov\u00e9 m\u00e4so, s\u00f3jov\u00e1 m\u00faka), ostatn\u00e9 strukoviny, zeleninu bohat\u00fa na v\u00e1pnik (brokolica, kel, p\u00f3r, petr\u017elen, \u0161pen\u00e1t, \u0161al\u00e1t, kaler\u00e1b, karfiol), v\u0148ate. Dobr\u00fdm zdrojom v\u00e1pnika s\u00fa sardinky. Pod\u00e1va\u0165 m\u00f4\u017eete miner\u00e1lne vody bohat\u00e9 na v\u00e1pnik. Vitam\u00edn D sa nach\u00e1dza v\u00a0rybom oleji.<\/span><\/p>\n

Aby sa mohli \u00fa\u010dinky di\u00e9ty prejavi\u0165, je d\u00f4le\u017eit\u00e9 di\u00e9tu starostlivo dodr\u017eiava\u0165 a\u00a0d\u00f4sledne vylu\u010dova\u0165 potraviny s\u00a0obsahom lepku a\u00a0kaze\u00ednu. Ak die\u0165a hor\u0161ie jed\u00e1va a\u00a0jeho strava nie je dostato\u010dne pestr\u00e1, treba zv\u00e1\u017ei\u0165 pod\u00e1vanie doplnkov v\u00fd\u017eivy.\u00a0\u00a0<\/span><\/p>\n[\/vc_column_text][\/vc_nested_accordion_tab][vc_nested_accordion_tab title=”Na\u0161e die\u0165a m\u00e1 autizmus a ve\u013emi \u010dasto m\u00e1va z\u00e1pchu. Ako by sme mu mali upravi\u0165 stravu?”][vc_column_text]\n

Pri z\u00e1pche sa odpor\u00fa\u010da zara\u010fova\u0165 do stavy potraviny bohat\u00e9 na vl\u00e1kninu. T\u00e1to zlo\u017eka stravy podporuje pr\u00e1cu \u010driev. Jej dobr\u00fdm zdrojom je najm\u00e4 zelenina a\u00a0ovocie, taktie\u017e celozrnn\u00e9 druhy chleba a\u00a0pe\u010diva, ako aj strukoviny. Ve\u013ea vl\u00e1kniny obsahuj\u00fa ovsen\u00e9 vlo\u010dky, ktor\u00e9 mo\u017eno konzumova\u0165 napr\u00edklad v\u00a0podobe polievky, ka\u0161e alebo ich prid\u00e1va\u0165 do pokrmov. Vhodn\u00e9 s\u00fa i\u00a0\u010fal\u0161ie potraviny s mierne preh\u00e1\u0148av\u00fdm \u00fa\u010dinkom: figy, su\u0161en\u00e9 ovocie, alebo kyslomlie\u010dne v\u00fdrobky (jogurt, acidko). Z\u00e1rove\u0148 je potrebn\u00e9, aby die\u0165a vypilo dostatok tekut\u00edn, vhodn\u00e1 je voda alebo aj \u010derstv\u00e9 \u0161\u0165avy z\u00a0mixovan\u00e9ho ovocia.\u00a0 V\u00a0strave je dobr\u00e9 obmedzi\u0165 mrkvu, ry\u017eu, \u010dokol\u00e1du, ban\u00e1ny a \u010dierny \u010daj.\u00a0<\/span><\/p>\n[\/vc_column_text][\/vc_nested_accordion_tab][vc_nested_accordion_tab title=”Chcela by som poprosi\u0165 o pomoc pri rie\u0161en\u00ed probl\u00e9mu s opioidn\u00fdmi peptidmi v mo\u010di u m\u00f4jho syna.”][vc_column_text]\n

V\u00a0r\u00e1mci v\u00fdskumu autizmu a\u00a0probl\u00e9mov, ktor\u00e9 tr\u00e1pia deti s\u00a0autizmom (vr\u00e1tane probl\u00e9mu s\u00a0re\u010dou), sa sk\u00fama i\u00a0\u00fa\u010dinok GFCF di\u00e9ty.\u00a0 O\u010dak\u00e1valo sa, \u017ee di\u00e9ta s\u00a0vyl\u00fa\u010den\u00edm lepku a\u00a0kaze\u00ednu (GFCF di\u00e9ta), ktor\u00e9 s\u00fa hlavn\u00fdm zdrojom opioidn\u00fdch peptidov navod\u00ed ich pokles v\u00a0krvi a\u00a0zlep\u0161enie stavu die\u0165a\u0165a. Ani najnov\u0161ie v\u00fdskumn\u00e9 \u0161t\u00fadie nepreuk\u00e1zali jednozna\u010dne priazniv\u00e9 \u00fa\u010dinky di\u00e9ty na hladiny opioidn\u00fdch peptidov, \u010di na spr\u00e1vanie det\u00ed s\u00a0autizmom. In\u00fdmi slovami, napriek dodr\u017eiavaniu di\u00e9ty, u\u00a0mnoh\u00fdch det\u00ed hladiny opioidn\u00fdch peptidov nepoklesli a spr\u00e1vanie sa neupravilo. Aj mnoh\u00e9 zdrav\u00e9 deti maj\u00fa vysok\u00e9 hladiny opioidn\u00fdch peptidov a\u00a0s\u00fa bez ak\u00fdchko\u013evek probl\u00e9mov.<\/span><\/p>\n[\/vc_column_text][\/vc_nested_accordion_tab][vc_nested_accordion_tab title=”Na\u0161a dc\u00e9ra nejed\u00e1va \u017eiadne mlie\u010dne v\u00fdrobky, ani nepije mlieko, ob\u00e1vame sa, \u010di m\u00e1 dos\u0165 v\u00e1pnika. Z ktor\u00fdch potrav\u00edn m\u00f4\u017ee z\u00edska\u0165 v\u00e1pnik?”][vc_column_text]\n

Pri v\u00fd\u017eive bez mlieka, mlie\u010dnych v\u00fdrobkov alebo syrov treba do stravy zara\u010fova\u0165 vo v\u00e4\u010d\u0161om mno\u017estve nemlie\u010dne zdroje v\u00e1pnika: v\u00fdrobky zo s\u00f3je (tofu, s\u00f3jov\u00e9 m\u00e4so, s\u00f3jov\u00e1 m\u00faka), ostatn\u00e9 strukoviny, zeleninu bohat\u00fa na v\u00e1pnik (brokolica, kel, p\u00f3r, petr\u017elen, \u0161pen\u00e1t, \u0161al\u00e1t, kaler\u00e1b, karfiol), v\u0148ate. Dobr\u00fdm zdrojom v\u00e1pnika s\u00fa sardinky i mak. Pod\u00e1va\u0165 mo\u017eno miner\u00e1lne vody bohat\u00e9 na v\u00e1pnik.\u00a0<\/span><\/p>\n[\/vc_column_text][\/vc_nested_accordion_tab][vc_nested_accordion_tab title=”N\u00e1\u0161 syn s PAS m\u00e1 probl\u00e9m so sp\u00e1nkom, v noci sa opakovane bud\u00ed a vst\u00e1va\u0165 chce u\u017e nad r\u00e1nom.”][vc_column_text]\n

Pri poruch\u00e1ch so sp\u00e1nkom m\u00f4\u017ee by\u0165 n\u00e1pomocn\u00e1 \u00faprava \u017eivotospr\u00e1vy a nasleduj\u00face opatrenia:\u00a0<\/span><\/p>\n