A gout and high uric acid diet is necessary to treat and prevent the disease from getting worse. The expert told us which products should be included in the daily menu and which should be completely eliminated.
Gout: symptoms and treatment
Gout is the most common form of arthritis and has been known for thousands of years. Gout is caused by the deposition of uric acid crystals in joints and various tissues and occurs with chronic hyperuricemia (increased levels of uric acid in the blood).
Uric acid is normally broken down and eliminated from the body through the kidneys. However, if the body produces too much or the kidneys cannot adequately remove it from the body, uric acid builds up in the joints.
Gout is more common in men than women because estrogen increases uric acid excretion through the kidneys.
The main causative factors for gout appear to be diet and genetic predisposition.
Throughout history, gout has been associated with the diet of the rich (a sign of affluence! ) and excessive alcohol consumption, and dietary guidelines for gout have existed for a long time. long.
In 1876 A. B. Gerrod was one of the first to recommend reducing consumption of purine-rich foods, such as meat and seafood. A little later, Professor Ebstein recommends eating in moderation with plenty of water, fruits like cherries and strawberries, and avoiding alcohol.
Causes of gout
To understand how purines can affect people 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 out by the kidneys, and eliminated from the body through urine. When this process is disrupted, excess uric acid can accumulate in the joints forming sharp crystals, which can cause severe joint discomfort and can also cause the formation of kidney stones.
The role of purines in the development of gout
Purines are chemical compounds found in some foods that are broken down into uric acid when metabolized.
However, uric acid derived from purine-rich foods only accounts for about 15% of uric acid in the body. The remainder is found naturally in the body's tissues, and genes play a large role in determining how much uric acid is synthesized in the body.
According to a Boston University study of more than 600 people, people with high-purine diets were five times more likely to develop gout than people with low-purine diets. Intake of purines has been linked to an increase in gout attacks, regardless of whether people drink alcohol or take medication.
Dietary and lifestyle modifications are key aspects of non-pharmacological treatment for gout.
Dietary principles in treatment should vary depending on the severity of the process, frequency of exacerbations, plasma uric acid concentration and body weight.
The basic principle of dietary therapy for gout is to fully provide the body's physiological needs for energy, macro and microelements, fiber, vitamins and minerals. Most often we are talking about the diet "Table number 6".
The diet must include an optimal amount of protein with a balanced amino acid composition, a reduced total amount of fat from animals (ratio of animal and vegetable fats is 1. 2: 1) with an adequate content of fatty acids. polyunsaturated fats ω -6 and ω-3, as well as reducing the carbohydrate portion of the diet by reducing the amount of refined and easily digestible sugars.
During the period of exacerbation of gout, meat and fish products should be excluded from the diet, using mainly liquid foods (jelly, juices, milk, lactic acid products, vegetable and fruit juices). plants, liquid cereals) and drink up to 2 liters of liquid per day.
You should limit your consumption of table salt, as well as ensure your body receives enough vitamins, especially antioxidant vitamins (vitamins C, A, B-carotene).
The main goal of a gout diet in men and women is to reduce purine levels in the body, which is achieved in several ways:
- Limit foods rich in purine (meat, fish).
- Include foods in your diet that can control uric acid levels (cereals, dairy).
- Drink enough fluids.
- Lose weight, achieve a healthy body weight and proper eating habits.
A good rule of thumb is to eat moderate amounts of healthy foods, which will be the best treatment.
Anti-purine 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 (brain, kidney, liver), meat extracts, sardines, anchovies, small shrimp, mackerel, refried beans.
Limit consumption of foods containing 50-150 mg of purines per 100 g - meat products (beef, lamb), poultry, fish, crustaceans, vegetables (peas, beans, lentils).
Because meat from young animals has a higher purine content than meat from adults, it should also be avoided.
If you want to add animal protein to your diet, you should only consume it in moderation. Avoid eating a lot of purine-rich meat. A typical serving of meat is 85 grams and fish is 110-115 grams.
When cooking meat, up to half of the purines go into the broth, so it is recommended to eat boiled meat. In any case, meat and fish dishes, if it is impossible to completely refuse, should be included in the diet no more than 2-3 times a week.
One should also significantly reduce the consumption of saturated fats, because as blood cholesterol levels increase, renal excretion of uric acid worsens. It is believed that the daily diet should contain no more than 200 mg of purine base.
Foods high in purine to avoid if you have gout:
- Byproduct
Foods such as chopped liver as well as other internal organs such as kidneys and hearts should be avoided because they contain a lot of purines.
Replace:You can eat other meats, such as poultry and beef, which contain fewer purines. For example, you could try a vegetarian mushroom and walnut pâté recipe, which tastes like liver but contains ingredients that don't aggravate gout symptoms.
- Cold drinks
Although sugar- and fructose-sweetened soft drinks 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 with high fructose corn syrup may increase your risk of developing gout. According to a study published in the journal BMJ, men who drank two or more servings of carbonated water per day were 85% more likely to develop gout than those who drank less than one serving per month.
Replace:You can drink diet soda, which doesn't cause gout and can help you give up sweets. For example, you can try water with lemon and lime slices.
- Seafood
Some types of seafood—anchovies, clams, crab, shrimp, sardines, herring, salmon, mackerel, and others—contain moderate to high levels of purines. According to a study conducted at Vanderbilt University Medical Center in Nashville, men who ate the most seafood were 50 percent more likely to have high uric acid levels than those who ate the least seafood.
Replace:Since fish is good for the heart and blood vessels, it makes sense to include it in the diet. One option is low-purine cod. You can also eat palm-sized portions of high-purine fish balanced with large portions of vegetables, such as grilled zucchini or broccoli in lemon juice, as lemon juice helps neutralize uric acid.
- Wine
According to a 2014 study from the Boston University School of Medicine, drinking wine, beer or spirits is associated with an increased risk of gout attacks. Researchers found that the more alcohol a person drinks, the higher their risk of developing the disease.
Replace:The truth is that avoiding alcohol is the best way to prevent gout attacks. But because quantity really matters, the less alcohol the better - no more than one (women) or two (men) drinks a day.
Foods to avoid:
- smoked meat, canned food, frozen meat and fish;
- meat extract, broth;
- dried beans (lima beans), lentils, peas, asparagus, frozen and canned vegetables;
- acoholic drink;
- dry cereals, other than hulled rice, hulled wheat and milled wheat;
- dried fruits, except prunes;
- cookies and candies made with salt and powdered sugar;
- salt, hot sauce, gravy, mustard, dressings, spices, olives, ketchup and pickles.
Patients should use foods and dishes that are low in purines or do not contain this substance. Diet for gout during an exacerbation should be especially strict.
The general principles of a gout diet correspond to typical recommendations for a healthy diet.
Losing weight
Being overweight increases your risk of developing gout, and losing weight will reduce your risk of gout. Research shows that cutting calories and losing weight—even without a purine-restricted diet—lowers uric acid levels and reduces the number of gout attacks. Weight loss also reduces overall stress on the joints and also reduces the risk of diabetes.
Eat complex carbohydrates
Eat plenty of fruits, vegetables and whole grains for complex carbohydrates. Avoid foods and drinks with high fructose corn syrup and limit your intake of naturally sweetened fruit juices.
Drinking regimen
Maintain adequate hydration. 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 for the cardiovascular system). You can drink weak tea, fruits, berries, vegetable juices, milk, alkaline mineral water. Strong tea and strong coffee should be avoided: frequent use can lead to aggravation of the condition.
Lose fat
Reduce your intake of saturated fat from red meat, fatty poultry, and full-fat dairy products.
Choose lean meats and poultry, low-fat dairy products and lentils as sources of protein.
Specific product recommendations
- Viscera.Avoid meats such as liver and kidney that are high in purines and contribute to increased uric acid levels in the blood.
- Red meat.Moderate serving sizes for beef, lamb and pork.
- Seafood.Some 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 people with gout. Moderate portions of fish are an integral part of a gout diet.
- Vegetables are 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.
- Wine.Beer and alcoholic beverages are associated with an increased risk of gout and recurring attacks. Moderate alcohol consumption does not increase the risk of gout. Avoid drinking alcohol during gout attacks and limit alcohol intake, especially beer, between attacks.
- Sweet foods and drinks.Limit or avoid foods containing sugar such as sugary cereals, baked goods, and candy. Limit your consumption of naturally sweet fruit juices.
- Vitamin C.Vitamin C can help reduce uric acid levels.
- Coffee.Some studies show that drinking coffee in moderation can reduce the risk of gout. However, the presence of comorbidities must be taken into account.
- Cherry.There is some evidence that eating cherries is associated with a reduced risk of gout attacks.
Foods and drinks recommended daily
- beans and lentils;
- pea's tree;
- low-fat dairy products;
- whole grains like oats, brown rice and barley;
- Fruits and vegetables.
Beans and legumes are excellent sources of protein. Eating these plant sources can help meet your daily protein needs while reducing the amount of saturated fat found in high-purine animal proteins.
Therefore, for gout, a vegetarian diet is recommended. In countries with a traditional lifestyle that mainly eats plant foods, gout is very rare.
It is important to understand that a gout diet is not the only treatment. Rather, making lifestyle changes can help reduce or eliminate gout symptoms.
Following the diet, along with calorie restriction and regular exercise, can also improve your overall health and quality of life.