A diet for gout and high uric acid is necessary to treat and prevent exacerbation of the disease. The expert told us which products should be included in the daily menu and which should be completely excluded.
Gout: symptoms and treatment
Gout is the most common form of arthritis and has been known for several thousand years. Gout is caused by the deposition of uric acid crystals in the joints and various tissues and is associated with chronic hyperuricemia (increased levels of uric acid in the blood).
Uric acid is usually broken down and excreted by the kidneys. However, if the body produces too much of it or the kidneys cannot properly remove it from the body, uric acid builds up in the joints.
Gout is more common in men than women because estrogen increases the excretion of uric acid through the kidneys.
The main causative factors for gout appear to be diet and genetic predisposition.
Throughout history, gout has typically been associated with the diet of the rich (a sign of wealth! ) and excessive alcohol consumption, and dietary guidelines for gout have been around for a long time.
In 1876, A. B. Gerrod was one of the first to recommend reducing the consumption of foods high in purines, such as meat and seafood. A little later, Professor Ebstein recommended moderate food consumption with muchwater, fruits like cherries and strawberries and avoid alcohol.
Causes of gout
To understand how purines can affect someone with gout, you first need to understand how gout occurs.
Gout develops when uric acid builds up in the body. Normally, uric acid dissolves in the blood, is filtered by the kidneys, and then excreted from the body in urine. When this process is disrupted, excess uric acid can build up in the joints to form sharp crystals, which can cause severe joint pain and also trigger the formation of kidney stones.
The role of purines in the development of gout
Purines are chemical compounds found in certain foods that break down into uric acid when metabolized.
Uric acid, however, which comes from foods rich in purines, only represents about 15% of the uric acid present in the body. The rest is found naturally in body tissues, and genes play an important role in determining how much uric acid is synthesized in the body.
According to a Boston University study of more than 600 people, people on a high-purine diet had a five times higher risk of developing gout than people on a low-purine diet. Consumption of purine bases was associated with an increase in gout attacks, regardless of whether they drank alcohol or took medication.
Diet and lifestyle modifications are the main aspects of non-pharmacological treatment of gout.
Dietary principles of treatment should vary depending on the severity of the process, the frequency of exacerbations, the level of uric acid in blood plasma and body weight.
The basic principles of dietary therapy for gout are the complete satisfaction of the body's physiological needs for energy, macro- and microelements, dietary fiber, vitamins and minerals. We usually talk about the "Table Number 6" diet.
The diet should include an optimal amount of protein with a balanced amino acid composition, a reduction in the total amount of animal fats (the ratio of animal and vegetable fats is 1. 2: 1) with an adequate content of acidspolyunsaturated fats of ω -6 and ω-3, as well as a reduction in the carbohydrate portion of the diet by reducing the amount of refined and easily digestible sugars.
During the period of exacerbation of gout, it is recommended to exclude meat and fish products from the diet, using mainly liquid foods (jelly, compotes, milk, lactic acid products, vegetable and fruit juices, liquid cereals) and drinking up to 2 liters. of fluid per day.
It is recommended to limit the consumption of table salt and ensure that the body receives an adequate amount of vitamins, especially antioxidant vitamins (vitamins C, A, B-carotene).
The main goal of a diet for gout in men and women is to reduce purine bases in the body, which is achieved in several ways:
- Limit foods rich in purine bases (meat, fish).
- Include foods in your diet that can control uric acid levels (cereals, milk).
- Drink enough fluids.
- Lose weight, achieve a healthy weight and adopt good eating habits.
A good rule of thumb is to eat moderate portions of healthy foods, this will be the best treatment.
Antipurine diet
It is recommended to exclude from the diet foods containing large amounts of purines (more than 150 mg per 100 g of product).
These products include: beef by-products (brains, kidneys, liver), meat extracts, sardines, anchovies, small shrimps, mackerel, fried legumes.
Limit the consumption of foods containing 50 to 150 mg of purines per 100 g - meat products (beef, lamb), poultry, fish, shellfish, vegetables (peas, beans, lentils).
Since meat from young animals is higher in purines than meat from adults, it should also be avoided.
If you want to include animal proteins in your diet, it is recommended to consume them only in moderation. It is recommended to avoid large portions of meats rich in purines. A typical serving of meat is 85 grams and that of fish is 110 to 115 grams.
When cooking meat, up to half the amount of purines enters the broth, so it is advisable to eat boiled meat. In any case, meat and fish dishes, if it is impossible to completely refuse them, are included in the diet no more than 2-3 times a week.
It is also recommended to significantly reduce the consumption of saturated fats, because with increasing cholesterol levels in the blood, the excretion of uric acid through the kidneys worsens. It is believed that the daily diet should contain no more than 200 mg of purine bases.
Foods high in purines to avoid if you have gout:
- By-products
It is recommended to avoid dishes like chopped liver, as well as other organ meats like kidneys, hearts, as they contain a lot of purines.
Alternative:You can eat other types of meats, such as poultry and beef, which contain fewer purines. For example, you can try a vegetarian recipe for mushroom and walnut pâté, which mimics the flavor of liver but contains ingredients that won't worsen gout symptoms.
- Cold drinks
Although soft drinks made with fructose and sugar do not contain high levels of purines, they have been shown to increase the risk of developing gout. This happens because uric acid is one of the byproducts of fructose metabolism.
Evidence has shown that consuming large amounts of fructose can increase uric acid levels in the blood.
Drinking soda containing high fructose corn syrup has been linked to an increased risk of developing gout. According to a study published in the journal BMJ, men who drank two or more servings of sparkling water per day had an 85% higher risk of gout than those who drank less than one serving per month.
Alternative:You can drink diet soda, which does not cause gout and can help you give up sweets. For example, you can try water with lemon and lime slices.
- Seafood
Certain types of seafood – anchovies, mussels, crab, shrimp, sardines, herring, trout, mackerel and others – contain moderate to high levels of purines. Men who ate the most seafood were more than 50% more likely to have high uric acid levels compared to those who ate the least, according to a study conducted at Vanderbilt University Medical Center inNashville.
Alternative:Since fish is good for the heart and blood vessels, it makes sense to keep it in the diet. One option is low-purine cod. You can also eat small, palm-sized portions of purine-rich fish balanced with large portions of vegetables, such as roasted zucchini or broccoli in lemon juice, as lemon juice helps neutralizeuric acid.
- Alcohol
According to a 2014 study by the Boston University School of Medicine, drinking wine, beer, or alcohol was associated with an increased risk of gout attacks. The more alcohol a person drinks, the greater their risk, researchers found.
Alternative:The truth is that avoiding alcohol is the best way to prevent gout attacks. But since quantity really matters, the less alcohol the better – no more than one (women) or two (men) drinks per day.
Foods to avoid:
- smoked meats, canned foods, frozen meat, fish;
- meat extracts, broths;
- dried beans (lima beans), lentils, peas, asparagus, frozen and canned vegetables;
- alcoholic beverages;
- dried cereals, excluding husked rice, husked wheat and ground wheat;
- dried fruits, except prunes;
- biscuits, confectionery products prepared with salt and powdered sugar;
- salt, hot sauces, sauces, mustard, marinades, seasonings, olives, ketchup and pickles.
Patients are advised to use foods and dishes low in purines, or even without purines. The diet for gout during an exacerbation should be especially strict.
The general principles of the gout diet correspond to typical recommendations for a healthy diet.
Weightloss
Being overweight increases the risk of developing gout and losing weight reduces the risk of gout. Research shows that cutting calories and losing weight, even without a low-purine diet, lowers uric acid levels and reduces the number of gout attacks. Losing weight also reduces overall stress on your joints and also reduces your risk of diabetes.
Eat complex carbohydrates
Eat more fruits, vegetables and whole grains, which provide complex carbohydrates. Avoid foods and drinks containing high-fructose corn syrup and limit your intake of naturally sweetened fruit juices.
Drinking regime
Maintain an adequate water regime. To accelerate the elimination of purine bases from the body in the diet, the total amount of fluid is increased to 2. 5 l / day (if there are no contraindications from the cardiovascular system). You can drink weak tea, fruits, berries, vegetable juices, milk, alkaline mineral water. It is advisable to avoid strong tea and strong coffee: frequent consumption can lead to aggravation.
Reduce fat
Reduce your intake of saturated fats from red meat, fatty poultry and full-fat dairy products.
Choose lean meats and poultry, low-fat dairy products, and lentils as your protein sources.
Product specific recommendations
- Waste.Avoid meats like liver and kidney, which contain high levels of purines and help increase uric acid levels in the blood.
- Red meat.Medium portions for beef, lamb and pork.
- Seafood.Certain types of seafood, such as anchovies, clams, sardines and tuna, contain more purines than others. But the overall health benefits of eating fish may outweigh the risks for gout sufferers. Moderate portions of fish are an essential part of the gout diet.
- Vegetables high in purines.Research has shown that vegetables high in purines, such as asparagus and spinach, do not increase the risk of gout or recurrent gout attacks.
- Alcohol.Beer and alcoholic beverages are associated with an increased risk of gout and recurrent attacks. Moderate wine consumption does not increase the risk of gout. Avoid alcohol during gout attacks and limit alcohol consumption, especially beer, between attacks.
- Sweet foods and drinks.Limit or avoid foods containing sugar such as sugary cereals, pastries and candy. Limit your intake of naturally sweetened fruit juices.
- Vitamin C.Vitamin C can help reduce uric acid levels.
- Coffee.Some studies suggest that drinking coffee in moderation may be associated with a reduced risk of gout. However, the presence of concomitant diseases must be taken into account.
- Cherry.Some data suggests that cherry consumption is associated with a reduced risk of gout attacks.
Foods and drinks recommended for daily consumption
- beans and lentils;
- legumes;
- low-fat dairy products;
- whole grains like oats, brown rice, and barley;
- fruits and vegetables.
Beans and legumes are excellent sources of protein. Consuming these plant-based sources can help meet your daily protein needs while reducing the amount of saturated fat found in purine-rich animal proteins.
So, for gout, a vegetarian diet is recommended. In countries where the traditional lifestyle is to eat mainly plant foods, gout is rare.
It is important to understand that diet for gout is not the only treatment. Rather, it is a lifestyle change that can help reduce or eliminate gout symptoms.
Following a diet, combined with calorie restriction and regular physical activity, can also improve your overall health and quality of life.