Gout is a painful and potentially debilitating condition that develops in some people with a chronically high level of urate in the blood (usually called uric acid). Not everyone with a high level of urate in the blood (called hyperuricemia) develops gout; up to two-thirds of people with hyperuricemia never develop symptoms. It is not clear why some people with hyperuricemia develop gout, while others do not, but the symptoms of gout are the result of the body’s reaction to deposits of urate crystals in the tissues. In this article, consider the diet for gout.
Although joints are the most commonly affected part of the body, urate crystals can form in the kidneys or other parts of the urinary tract, where they can sometimes impair kidney function or cause urinary tract stones. Kidney stones caused by uric acid crystals are found in about 15% of people with gout. This compares with an 8 percent risk of kidney stones in people without gout.
Gout is different from another disease called calcium pyrophosphate precipitation disease (formerly called “ pseudogout ”). This develops in some people in response to the presence of another type of crystal, known as a calcium pyrophosphate crystal.
What causes gout
Gout develops when there is too much uric acid in the blood. This excessive amount may be the result of a diet high in purines. Or, your body produces too much uric acid. In some cases, uric acid levels in the blood may remain normal, but gout (as set by your doctor) is still the correct diagnosis. This is due to the fact that the body secretes an excess of uric acid in the urine and inflammatory factors.
What are purines
Purines are chemical compounds that, when metabolized, break down into uric acid. Purines are either made by your body or taken into your body through the foods you eat.
In a normal process, purines break down into uric acid. Then, uric acid dissolves in the blood, passes through the kidneys into the urine, and is excreted from the body.
However, this does not always happen with gout. Complications arise when the kidneys do not get rid of uric acid quickly enough or if there is an increased number of uric acid. These high levels accumulate in the blood, which leads to the so-called hyperuricemia. Although hyperuricemia is not classified as a disease, it can be dangerous if it leads to the formation of uric acid crystals. Gout can develop when these crystals grow around the joints.
What helps a diet with gout
The diet for gout is aimed at alleviating painful swelling (inflammation) and preventing future attacks. Depending on many factors — your age, general health, medical history, and severity — your treatment options may vary.
The good news is that gout can be controlled. In addition to taking the prescribed medications (which may include anti-inflammatory drugs or medications to reduce uric acid levels), acute attacks of gout can be used to manage proper nutrition, a healthy lifestyle, weight management, and an active approach to signs and symptoms.
What should be avoided completely
A diet with gout or proper nutrition will help control uric acid levels in the body while improving overall health. According to the American College of Rheumatology, a diet with an excess of the following foods can lead to gout (outbreaks):
- Red meat.
- Sweet drinks.
All of these foods are high in purine. With this in mind, a diet (proper nutrition) for gout should avoid or limit these foods:
- Meat offal.
- A heart.
- The kidneys.
- Beer, wine and liquor.
- Fruit juices.
If you want to include some kind of animal protein in your diet, it is recommended that no more than 100 – 170 grams per day. Gouty diets do not contain any of these animal proteins, or only in quantities small enough to help you stay under this restriction.
Animal proteins are high in purines. Since the accumulation of purines can lead to an increase in uric acid levels, which in turn can lead to gout, it is best to avoid or strictly limit these foods in your diet.
Caution, food moderately high in purines.
These foods are quite high in purines, eat in moderation:
Although these proteins are lower than purines than those on the earlier list, you should still try to limit your intake of whole animal protein to 100 – 170 grams per day.
Alcohol disrupts the excretion of uric acid from the body. It is believed that high levels of purine in alcoholic beverages lead to this violation. While cleavage of purines into uric acid is usually washed out of the body through urine, this process is interrupted when uric acid levels become too high. Crystals form around the joints, and gout develops. To prevent further attacks of gout, follow these guidelines:
- Avoid drinking alcohol during seizures.
- Limit your intake of wine.
- Avoid beer.
Keep in mind that you should avoid alcohol altogether unless your doctor says otherwise.
Fructose and sweet foods.
There is a discussion about the effect of fructose and sugary foods on the level of uric acid in the body. However, sugar and sweets are known to be higher in calories and are associated with obesity, a known risk factor for gout. Fructose-rich drinks, such as soft drinks, have been shown to increase the risk of gout. Although these types of drinks do not have a large amount of purines, they contain significant amounts of fructose, which increases the level of uric acid.
Increasing your daily water intake and reducing your consumption of soft drinks and soda will help cleanse your body of uric acid and prevent the formation of kidney stones.
Avoid refined carbohydrates.
Refined carbohydrates include:
- White bread.
- Macaroni (except whole grains).
All proper nutrition, useful for gout, either do not contain refined carbohydrates or include them only in very small quantities.
What to include in the diet?
A low-purine gout diet can help lower uric acid levels and prevent symptoms. Beans and legumes are excellent sources of protein. Eating these plant sources can help meet your daily protein needs, while saturated fats are high in purines, animal proteins.
Products to be included in the diet daily:
- Beans and lentils.
- Liquids, especially water.
- Low fat or non-fat dairy products (450 – 700 ml per day, maximum).
- Whole grains (e.g. oats, brown rice, and barley).
- Sweet potato.
- Fruits and vegetables.
Some people believe that dairy products may increase the symptoms of gout, while others experience a decrease in low-fat uric acid levels in dairy products. Fortunately, many plant-based alternatives are available if you need to avoid dairy products. Foods rich in vitamin C and cherries show some signs of a potential reduction in gout attacks. Interestingly, high-purine vegetables did not detect an increase in gout attacks. In addition, high-fiber, low-calorie vegetables can help you manage your weight. You can safely use these high purine vegetables:
- Spinach and other dark, leafy greens.
Lifestyle changes can help with gout.
It is important to understand that a diet for gout is not a cure. Rather, it is a lifestyle change that can help reduce or eliminate gout symptoms. In addition to the diet, your doctor will likely recommend regular exercise and weight loss, which in frequent cases will help to control gout more than eating a diet that is low in purine. Unlike other types of arthritis, gout can be cured. Most of your success depends on your eating habits and lifestyle. Be sure to discuss all nutrition problems with your doctor and nutritionist before starting work.