Gout diet: What works and what patients shouldn’t eat

A gout and high uric acid diet is necessary to treat and prevent progression of the disease. Experts tell us which products should be included in your daily menu and which should be excluded entirely.

Gout: Symptoms and Treatment

Gout is the most common form of arthritis and has been around for thousands of years. Gout is caused by the deposition of uric acid crystals in joints and various tissues and is associated with chronic hyperuricemia (elevated levels of uric acid in the blood).Uric acid is normally broken down by the kidneys and excreted from the body. However, if the body produces too much uric acid or the kidneys cannot adequately remove it from the body, uric acid can accumulate in the joints.Gout is more common in men than women because estrogen increases the excretion of uric acid by the kidneys.The main causative factors for gout appear to be diet and genetic predisposition.Throughout history, gout has been commonly associated with a rich diet (a sign of affluence! ) and excessive alcohol consumption, and dietary guidelines for gout have been around for a long time.In 1876, A. B. Jerrod was one of the first to recommend reducing the consumption of purine-rich foods, such as meat and seafood. Soon after, Professor Ebstein recommended eating food in moderation, drinking plenty of water, fruits such as cherries and strawberries, and avoiding alcohol.

Causes of gout

To understand how purines affect people with gout, you first need to understand how gout occurs.Gout occurs when uric acid builds up in the body. Normally, uric acid dissolves in the blood, is filtered out by the kidneys, and is then excreted from the body through urine. When this process is disrupted, excess uric acid can accumulate in the joints to form sharp crystals, which can cause severe joint discomfort and trigger the formation of kidney stones.

The role of purines in the development of gout

Purines are compounds found in certain foods that break down into uric acid when metabolized.However, uric acid from high-purine foods only accounts for about 15% of the uric acid in the body. The rest occurs naturally in human tissue, and genes play an important role in determining how much uric acid is synthesized in the body.A Boston University study of more than 600 people showed that people who ate a high-purine diet were five times more likely to develop gout than those who ate a low-purine diet. Purine base intake is associated with an increase in gout attacks, regardless of whether they drink alcohol or take medications.Diet and lifestyle changes are the main aspects of non-drug treatment for gout.Dietary principles in treatment should vary depending on the severity of the condition, frequency of exacerbations, uric acid levels in the plasma and body weight.The basic principle of dietary treatment for gout is to fully supply the body’s physiological needs for energy, macro and trace elements, dietary fiber, vitamins and minerals. Usually we talk about the "Chart 6" diet.The diet must include an optimal amount of protein and a balanced amino acid composition, reduce the total amount of animal fat (the ratio of animal and vegetable fats is 1. 2: 1) and contain sufficient amounts of polyunsaturated fatty acids of the -6 and omega-3 families, as well asReduce the carbohydrate portion of your diet by reducing the amount of digestible and refined sugars.During a gout attack, it is recommended to exclude meat and fish products from the diet, focus on liquid foods (jelly, preserves, milk, lactic acid products, vegetables and juices, liquid cereals), and drink no more than 2 liters of liquid per day. It is recommended to limit salt intake and ensure that the body gets enough vitamins, especially antioxidant vitamins (vitamins C, A, B-carotene).The main goal of the gout diet in men and women is to reduce purine bases in the body, which can be accomplished 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 eat right.

A good rule of thumb is to eat healthy foods in moderation, which will be the best treatment.

antipurine diet

It is recommended to exclude from diet foods foods containing high 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, shrimp, mackerel, fried beans.Limit the intake of foods containing 50-150 mg of purines per 100 g - meat products (beef, lamb), poultry, fish, crustaceans, vegetables (peas, broad beans, lentils).Meat from young animals should also be avoided, given that its purine content is higher than that from adult animals.If you want to add animal protein to your diet, it is recommended to consume it in moderation. It is recommended to avoid large amounts of purine-rich meats. A typical serving of meat is 85 grams and of fish 110-115 grams.When meat is cooked, up to half of the purines can pass into the broth, so it is recommended to eat cooked meat. In any case, if meat and fish dishes cannot be completely avoided, they should be included in the diet no more than 2-3 times a week.It is also recommended to significantly reduce the intake of saturated fat, since the excretion of uric acid by the kidneys worsens as cholesterol levels in the blood increase. It is believed that the purine base content in the daily diet should not exceed 200 mg.If you have gout, you should avoid foods high in purines:

1. by-productIt is recommended to avoid dishes such as chopped liver, as well as other internal organs such as kidneys, heart, etc. , as they contain high amounts of purine.choose:You can eat other types of meat, such as poultry and beef, which contain less purines. For example, you could try a vegetarian recipe for mushroom and walnut sauce, which mimics the taste of liver but contains ingredients that won't aggravate gout symptoms.
2. cold drinkAlthough fructose and sugary soft drinks are not high in purines, they have been shown to increase the risk of gout. This happens because uric acid is one of the by-products of fructose metabolism.There is evidence that consuming large amounts of fructose can increase uric acid levels in the blood.Drinking soda containing high fructose corn syrup increases your risk of gout. According to a study published in the journal BMJ, men who drank two or more sodas per day had an 85 percent higher risk of developing gout than men who drank less than one soda per month. choose:You can drink diet soda, which does not cause gout and may help you quit sweets. For example, you could try infusing water with lemon and lime slices.
3. seafoodCertain types of seafood (anchovies, mussels, crabs, shrimp, sardines, herring, trout, mackerel, etc. ) contain moderate to high levels of purines. Men who ate the most seafood were more than 50 percent more likely to have high uric acid levels compared to men who ate the least, according to a study conducted at Vanderbilt University Medical Center in Nashville.choose:Since fish is good for your heart and blood vessels, it makes sense to keep it in your diet. One option is low-purine cod. You can also eat small, palm-sized portions of high-purine fish with plenty of vegetables, such as grilled zucchini or broccoli in lemon juice, as lemon juice helps neutralize uric acid.
4. AlcoholAccording to a 2014 study from Boston University School of Medicine, drinking wine, beer, or spirits increases your risk of a gout attack. Researchers found that the more alcohol a person drank, the greater the risk of developing the disease.choose:The truth is, avoiding alcohol is the best way to prevent gout attacks. But since quantity does matter, the less alcohol the better—no more than one drink (for women) or two (for men) a day.

Foods to avoid:

• Bacon, canned goods, frozen meat, fish;
• Meat extracts, broths;
• Dried beans (lima beans), lentils, peas, asparagus, frozen and canned vegetables;
• alcoholic beverages;
• Dry grains, excluding husked rice, husked wheat, and milled wheat;
• Dried fruits, except plums;
• Biscuits and confectionary products made with salt and powdered sugar;
• Salt, hot sauce, gravy, mustard, marinades, relish, olives, ketchup and pickles.

Patients are advised to use foods and dishes that are low in purine or contain no purine at all. Your diet should be particularly strict during a gout attack.The general principles of the gout diet correspond to typical recommendations for a healthy diet.

lose weight

Being overweight increases your risk of gout, while losing weight reduces your risk. Research shows that reducing caloric intake and losing weight—even without a purine-restrictive diet—can lower uric acid levels and reduce the number of gout attacks. Losing weight can also reduce overall stress on your joints and reduce 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 habits

Maintain adequate water conditions. To speed up the elimination of dietary purine bases from the body, the total amount of fluids is increased to 2. 5 liters / day (if there are no contraindications to the cardiovascular system). You can drink light tea, fruits, berries, vegetable juices, milk, and alkaline mineral water. It is recommended to avoid strong tea and coffee: frequent use can aggravate the condition.

reduce 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 protein sources.

Product specific recommendations

1. Offal.Avoid eating meats such as liver and kidney. These meats contain high purine content, which can increase uric acid levels in the blood.
2. red meat.Medium serving, suitable for beef, lamb and pork.
3. seafood.Certain types of seafood, such as anchovies, clams, sardines, and tuna, contain more purines than other types of seafood. But for people with gout, the overall health benefits of eating fish may outweigh the risks. Moderate amounts of fish are an integral part of a gout diet.
4. Vegetables high in purine.Studies show that purine-rich vegetables like asparagus and spinach do not increase the risk of gout or gout recurrence.
5. Alcohol.Beer and alcoholic drinks increase the risk of gout and recurring attacks. Moderate drinking does not increase the risk of gout. Avoid drinking alcohol during a gout attack and limit alcohol consumption, especially beer, during an attack.
6. Sweets and drinks.Limit or avoid sugary foods such as sweetened cereals, baked goods, and candies. Limit intake of naturally sweetened fruit juices.
7. Vitamin C.Vitamin C may help lower uric acid levels.
8. coffee.Some studies suggest that moderate coffee drinking may be associated with a lower risk of gout. However, it is necessary to consider the presence of concomitant diseases.
9. cherry.There is some evidence that eating cherries may reduce the risk of gout attacks.

Recommended foods and drinks for daily consumption

• beans and lentils;
• legumes;
• low-fat dairy products;
• whole grains such as oats, brown rice, and barley;
• fruits and vegetables.

Beans and pulses are an excellent source of protein. Eating these plant sources can help meet your daily protein needs while also reducing the saturated fat content of high-purine animal proteins.Therefore, for gout, a vegetarian diet is recommended. Gout is rare in countries with a traditional plant-based lifestyle.It's important to understand that diet is not the only treatment for gout. Rather, it is a lifestyle change that can help reduce or eliminate gout symptoms.Dieting, calorie restriction, and regular exercise can also improve your overall health and quality of life.