Patients with gout should always monitor their purine levels, otherwise an acute attack may follow, accompanied by terrible and unpleasant symptoms. To understand why a diet is needed, you need to know the whole process.

How is uric acid formed, released, and accumulated?

1. Purines are vital in the body. They are part of the chromosomes in the cell nuclei and therefore carry genetic information. When purines break down, a product called uric acid is formed.
2. Excreted in urine.
3. When a person eats too much food containing purines, the level of uric acid in the blood rises. The body does not remove all the acid, it begins to accumulate.
4. High levels of uric acid lead to an increased risk of gout; it begins to accumulate in the joints and soft tissues, causing corresponding symptoms.

From the above, remember that high purine levels are the cause of high uric acid concentrations. This means that it is necessary to eat foods containing low amounts of purines.

Is dietary nutrition really that necessary?

All doctors will answer “yes” to this question. Of course, following dietary recommendations is the patient’s choice, but following a special diet will only have a positive effect on the patient’s general condition. A gout diet will help prevent acute attacks of the disease.

Thanks to the diet, many patients then do not require drug treatment or their use is reduced several times. What allows the patient to continue life without any restrictions, the main thing is to follow a diet, eating only healthy foods.

Especially a diet for gout is an integral part of treatment if the patient is obese. A too strict diet will only contribute to a new acute outbreak of an attack of the disease. In this case, the diet is regulated individually, since it is aimed not only at restoring and reducing purines, but also at reducing weight.

By adhering to the following rules, you can protect yourself from gout. Dietary food is required. Without it, treatment will be useless.

Empirical rules for gout patients:

1. Avoid offal and asparagus, because they contain a large amount of purines, which are quickly converted by the body into uric acid.
2. Avoid alcoholic drinks. Alcohol increases the concentration of uric acid in the blood. Regular consumption of alcohol causes the recurrence of an acute attack of gout.
3. Hydration. Increasing fluid intake during gout is of course advisable, as more uric acid may be released. It is necessary to take diuretics of folk origin, for example, decoctions based on nettle and sage with a small amount of honey. In addition, a special drink made from flaxseed can effectively flush out uric acid from the blood.
4. Coffee, tea and cocoa are harmless. There are no restrictions on the consumption of these drinks. This is due to the fact that the purines contained in them are not converted by the body into uric acid.
5. Avoid large portions of meat. Eating food of animal origin is allowed, but it is advisable to consume them in moderation.
6. High-fat foods negatively affect uric acid levels, so fatty foods should be removed from the diet. It is recommended to steam food.

What products are strictly prohibited?

Many foods containing high levels of purines should be eliminated from the diet. Reducing their consumption will normalize their levels and uric acid in the blood, which will lead to a gradual reduction in the symptoms of the disease. In addition to meat products, many types of fish also contain high amounts of purines. To better understand what you're up against, Table 1 has been created to describe the amount of purines in foods and the level of uric acid in the body after eating a purine-rich food.

Table No. 1. Foods rich in purines

Products	Purines mg per 100 g	Uric acid mg per 100 g
Meat extract	1400 -1500	3360 — 3600
Offal (calf, lamb pancreas)	500 — 615	1200 — 1476
Sprats	335	802
Yeast	285	684
Pork	250	600
Beef liver	230	552
Canned food	200	480
Mackerel with skin	150	360
Trout	144	345
Sardine	140	336
Veal liver	120	288
Pork shoulder with skin	115	276
Tuna	106	254
Goose meat	106	254
Pork cutlet	88	211,2
Ham	85	204

If the patient cannot deny himself any product, he needs to consume more vitamins, such as folic acid and vitamin C. Folic acid and vitamin C help reduce crystal deposition in the joints. Sometimes the use of high doses of dietary supplements is reasonable, especially if they are not included in sufficient quantities in the patient's diet. However, the agents do not replace a balanced and healthy diet, so products containing these components should be chosen first.

Meat and fish products with medium purine content

Humans need meat and fish products; they contain many vitamins. Many types of meat and fish are not advisable to consume, but they can be replaced with another type containing less purines. For example, you can replace red meat with white. Despite the fact that the products (Table No. 2) contain lower amounts of purines, you should not consume them in large quantities.

Table No. 2. Foods with medium purine content

Products	Purines mg per 100 g	Uric acid mg per 100 g
Peas (boiled)	71	170, 4
Beef tongue	66	158
Mackerel	66	158
Fillet of beef	64	153,5
Pork chop	50	120
Pork stew	46	110
Cod	45	108
Chicken legs	45	108
Hare	45	108
Pork belly	40	96
Flounder	40	96
Chicken breast	38	91
Smoked meat	33	80
Cancer	24	58
Meat pudding	24	58

Low purine foods

If the purine content is high, you should follow a strict diet. The maximum amount of purines consumed should not exceed 170 mg per day. These are mainly products of plant origin and most dairy products (Table No. 3).

Since the indicators are too low, individuals prescribed such a diet should be under the supervision of medical personnel. It is advisable to use such restrictions for a short period. In the future their number should be increased.

Table No. 3. Low purine foods

Products	Purines mg per 100 g	Uric acid mg per 100 g
Wheat flour	13	31
Onion	4	9,6
Tomatoes	4	9,6
Radish	4	9,6
Semolina	4	9,6
Hard cheese	4	9,6
Cucumber	3	7,2
Egg	2	4,8
Yogurt	(0)	(0)
Milk	(0)	(0)

There are products that work against gout. They include cherries, sweet cherries, strawberries, carrots, plums, celery, and cranberries. These ingredients can be consumed daily. Cranberry juice has a positive effect on the body, in particular on the urinary tract.

Remember to drink 2-3 liters of water or herbal tea throughout the day. Drinking plenty of fluids has a detoxifying effect on the kidneys, removes uric acid, and improves overall well-being.

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Gout (gouty arthritis) is an inflammation of one or more joints caused by the deposition of uric acid salts in the joint tissues. Gout affects those who have high levels of uric acid in the blood.
More often, middle-aged and elderly men suffer from gout, but recently there has been an increase in the incidence in women. In Russia, 0.1% of the Russian population suffers from gout. In the USA and Europe, 2% of people suffer from gout; among men aged 55-65 years, 4-6% suffer from gout.
Primary gout occurs as a result of a congenital metabolic disorder and poor nutrition, secondary gout occurs due to lead poisoning, certain blood diseases, etc. (less common).
Pain in the joints is caused by the accumulation of uric acid in the blood due to its formation from purine bases, delayed excretion by the kidneys, and a change in tissue pH to the acidic side. However, attacks are often triggered by consumption of foods rich in purines, fatty foods and alcoholic beverages. At the same time, microcrystals of uric acid are deposited in the joints, which lead to an acute inflammatory process with sharp pain. Despite the fact that the role of nutritional factors in the development of gout is not decisive, patients with gout should pay attention to foods that contain a lot of purine bases. It has been proven that consuming foods rich in purines increases the level of uric acid in a person’s blood by two times or more.

Purine diet

Purine grounds are directly related to metabolic processes, the disruption of which is manifested by the retention of uric acid in the body and the deposition of its salts in tissues. In particular, gout is almost always a consequence of a disorder in the metabolism of purine substances.
Drink 4 times a day, in between and on an empty stomach.

Recommended dishes:
soups
Vegetarian: borscht, cabbage soup, vegetable, potato, with the addition of cereals, cold (okroshka, beetroot soup), dairy, fruit.
Excludes: meat, fish and mushroom broths, sorrel, spinach, legumes;

bread and flour products
Wheat and rye bread, made from 1st and 2nd grade flour. Various baked goods, including those containing ground bran.
Restricted: products made from butter dough;

meat, poultry, fish
Low-fat types and varieties. Up to 3 times a week, 150 g of boiled meat or 160-170 g of boiled fish. After boiling, they are used for various dishes - stewed, baked, fried, products made from cutlet mass. You can combine meat and fish in approximately equal quantities.
Excludes: liver, kidneys, tongue, brains, meat of young animals and birds, sausages, smoked meats, salted fish, canned meat and fish, caviar

dairy
Milk, fermented milk drinks, cottage cheese and dishes made from it, sour cream, cheese.
Excludes: salted cheeses;

eggs
1 egg per day in any culinary preparation;

cereals
In moderation, any food.
Excludes: legumes;

vegetables
In increased quantities, raw and in any culinary processing. Potato dishes.
Limit: salted and pickled;
Excludes: mushrooms, fresh legumes, spinach, sorrel, rhubarb, cauliflower;

snacks
Salads from fresh and pickled vegetables, from fruits, vinaigrettes, vegetable caviar, squash, eggplant.
Exclude: salty snacks, smoked meats, canned food, fish caviar;

fruits, sweet dishes and sweets
Increased quantities of fruits and berries. Fresh and for any culinary processing. Dried fruits. Milk creams and jelly. Marmalade, marshmallows, non-chocolate candies, jam, honey, meringues.
Excludes: chocolate, figs, raspberries, cranberries;

sauces and spices
With vegetable broth, tomato, sour cream, milk. Citric acid, vanillin, cinnamon, bay leaf. Dill, parsley.
Excludes: sauces based on meat, fish, mushroom broths, pepper, mustard, horseradish;

beverages
Tea with lemon, milk, weak coffee with milk. Juices of fruits, berries and vegetables, fruit drinks, water with juices, kvass. Decoctions of rose hips, wheat bran, dried fruits.
Excludes: cocoa, strong tea and coffee;

fats
Butter, cow's ghee and vegetable oils. Limit pork fat.
Excludes: beef, lamb, cooking fats.

Sample diet menu No. 6.
First breakfast: vegetable salad with vegetable oil, soft-boiled egg, carrot pudding with apples and millet, tea.
Second breakfast: rosehip decoction.
Lunch: milk noodle soup, fried potato cutlets, jelly.
Afternoon snack: fresh apples.
Dinner: baked cheesecakes, cabbage rolls stuffed with vegetables and rice, tea.
At night: decoction of wheat bran.

Foods containing purine bases

Brain,
kidneys,
liver of slaughter cattle,
sorrel,
spinach,
cocoa,
coffee,
asparagus,
Brussels sprouts,
ripe peas,
beans,
lentils,
black long tea.

In animal products, purines are often present along with fairly large amounts of cholesterol.

Fruits and berries, most juices, as well as nuts can be consumed without special restrictions. It is useful to carry out fruit, vegetable, kefir, cottage cheese or dairy fasting days once a week. The only berries not recommended for gout are cranberries and lingonberries, the consumption of which leads to an increase in the acidity of urine, which contributes to the formation of stones in the urinary tract in case of uraturia.

Liquid in the diet for gout

The amount of liquid in the daily diet of a gout patient should be at least 1.5-2 liters. It is healthy to drink tea, milk, fruit juice, fruit and vegetable juices, and bicarbonate mineral waters. The amount of kitchen salt per day should be limited to 6-8 g. Treatment of gout by fasting is contraindicated, because already on the first day of fasting the amount of purine bases and uric acid in the patient’s blood increases significantly. This occurs due to increased breakdown of proteins, which can provoke an attack of gout pain already in the first days of fasting. During gout attacks, the therapeutic diet should be especially careful. Until the end of the attack, meat and fish, mushrooms and legumes, Brussels sprouts and cauliflower, as well as dishes from these products, are completely excluded from the patient’s diet. It is advisable to consume up to 2 liters of various drinks and alkaline mineral waters per day to avoid the precipitation of uric acid salts in the form of crystals in the urinary tract, as well as their microcrystallization in other tissues. Patients with gout are strictly prohibited from consuming even small doses of alcoholic beverages, since alcohol can provoke an attack.

Daily diet for gout patients

If there is severe pain in the joints, it is advisable to spend a fasting day on cottage cheese, but fasting, even short-term, is strictly prohibited. During an attack of gout, it is advisable to consume up to 100 g of nuts per day, which are not only a source of valuable proteins for the body, but also help to alkalize the internal environment of the human body, which prevents the loss of uric acid crystals in the tissues and urinary tract. Patients with gout can switch to ovolacto-vegetarianism in their daily diet, which will significantly improve their well-being and have a positive effect on the course of the disease. In this case, the source of proteins for the body is plant foods, as well as eggs and dairy products. If patients with gout are obese, the energy value of food should be reduced by limiting simple carbohydrates.

Gout: treatment with diet and folk remedies. Herbs for gout.

For mild forms of gout, it is recommended to eat wild strawberries: one or two glasses in the morning on an empty stomach, one glass after lunch and one or two glasses before bed. In case of gout, fresh blueberry fruit. Leaf tea will help black currant: Pour two teaspoons of chopped currant leaves into a glass of boiling water. Leave for two hours. Drink this tea every day between meals.

Dill seeds will also help treat gout. Decoction of fragrant dill seeds: pour a tablespoon of dill into 200 ml of boiling water, boil over low heat for one or two minutes. Leave for ten minutes. Drink warm once a day.
Various vegetable oils are very useful for gout - mustard, sesame, flaxseed, milk thistle and especially - hemp. Oils contain a balanced amount of polyunsaturated fatty acids, a complex of fat-soluble vitamins and microelements necessary for health and well-being. Such oils should be regularly included in the diet for seasoning cereal side dishes, porridges, and salads made from raw or boiled vegetables.

Traditional treatment for gout.

Among the medicinal plants and folk remedies, the following can be used for gout.
St. John's wort herb - 1 part, chamomile flowers - 2 parts, linden flowers - 1 part, black elderberry flowers - 1 part. Pour 1 tbsp. spoon of collection 200 ml of boiling water, leave for 1-2 hours in a thermos. Take half a glass 4-5 times a day for 2-3 months.
Take 1 part of meadowsweet flowers, 1.5 parts of bearberry leaf, 1 part of Hernia glabra herb, 1.5 parts of corn silks, 1 part of bean pericarp, 1.5 parts of elderberry, 1.5 parts of birch buds, 2 parts of horsetail , 1 part knotweed grass, 2 parts blue cornflower flowers. 4 tbsp. spoons of the collection pour 1 liter of cold water, leave overnight, boil over low heat for 5-10 minutes in the morning, leave for half an hour, strain, squeeze, take 6-7 times a day for a month.
At gouty arthritis A decoction of black elderberry has long been used (flowers, bark, leaves, roots are used). Take 20 g of flowers, pour a glass of boiling water, leave for 1 hour, strain. Drink a third of a glass 3-4 times a day before meals with 1 teaspoon of honey. Take the last portion of hot broth at night.
For gout(during an exacerbation) acute pain can be relieved with a slice of pickled apple, pressing it to the gouty bump and securing it with a bandage overnight.
Take St. John's wort (herb), chamomile (flowers), cordate linden (flowers), black elderberry (flowers) in equal parts. 3 tbsp. spoons of dry crushed collection pour 0.5 liters of boiling water into a thermos, leave for 1.5 hours, strain and drink a glass 2 times a day 30-40 minutes before meals as a means of normalizing metabolism and promoting the release of uric acid. At the same time, take 0.5-1 teaspoon of flower pollen, pollen and pollen (pre-infuse a single dose in 50 ml of boiled water at room temperature for 10-15 minutes, stirring occasionally) 2-3 times a day for 20-30 minutes before meals. The course of treatment is 40 days.
Melt 100 g of fresh unsalted butter, skim off the foam after boiling, add 100 ml of vodka, in which the golden mustache (a shoot at least 20 cm long) was infused for 10 days, set fire to this mixture, allowing the alcohol to boil away. Use the remaining mass to rub into the sore spot once a day for a month. Before the procedure, slightly warm the ointment and massage the sore area until you feel warm.
The following decoction is also effective: pour 3 teaspoons of finely chopped gentian root into 3 glasses of water, boil over low heat for 7-10 minutes, strain. Drink a glass an hour before meals or an hour and a half after, 3 times a day.
Take 30 g of crushed rhizomes with sandy sedge roots, add 3.5 glasses of water and cook in a sealed container until about 2 glasses of liquid remain. Then leave the broth for 2 hours, strain and take a quarter glass 3 times a day before meals.
Pour 15 g of rhizomes with the roots of the femoral saxifrage into 0.5 liters of water, boil for 15 minutes over low heat, leave, wrapped, for 4 hours, strain, take a third of a glass 3-4 times a day before meals.
Traditional medicine for gout recommends the following remedy: prepare a tincture of autumn colchicum tubers with apple cider vinegar. To do this, pour 1 part of dry crushed tubers with 12 parts of vinegar, leave for 2 weeks, and use for grinding.
For gout and polyarthritis, take 1 tbsp. spoon powder of dry apple peel and apple leaves, pour a glass of boiling water, leave for half an hour. Drink half a glass of infusion 2-3 times a day. The course of treatment is 1 month.
This collection is effective: 2 tbsp. spoons of crushed burdock root, 1 tbsp. a spoonful of chopped wheatgrass rhizome, 2 tbsp. Mix spoons of tricolor violet herb and pour 1 liter of boiling water in a thermos, leave for 1-2 hours, strain and take half a glass for gout 5 times a day an hour after meals.
Take 50 g of mullein flowers, pour in 0.5 liters of vodka or 70-proof alcohol, leave for 3 weeks, strain and use for rubbing.
Finely chop the roots of the autumn crocus, pour in 50-60 degree alcohol in a ratio of 1: 5, leave in a dark place, shaking occasionally. Use for rubbing.
Take 30 g of colchicum bulb and ash leaves and pour 300 ml of Malaga wine. Leave for 8 days, strain, add tincture of aconite and foxglove, 1 teaspoon each. Take 1 teaspoon in the morning and evening with a cup of tea.
Take sherry wine - 500 ml, colchicum bulbs - 250 g, poppy seed - 60 g, rum - 30 ml. Pour wine over the onion, add poppy seeds and rum (for flavoring). Take 20 drops per 1 glass of water 2 times a day.

When treating gout, the doctor prescribes a hypopurine diet. Gout occurs due to an imbalance in metabolism, which causes uric acid salts to be deposited in the joints. After some time, they begin to bother the patient in the form of pain and other symptoms. Let's take a closer look at what the hypopurine diet consists of, what foods you can eat, and which ones you should avoid.

The role of rational nutrition in joint diseases

If inflammatory processes in the joints worsen, body temperature may rise, pain in the affected areas, redness and swelling of the skin may occur. The main goal of a diet for metabolic disorders in the human body is to relieve the symptoms of gout, as well as to prevent complications.

Purine-rich foods are materials that fill the structure of cells. When destroyed, they turn into urea, which in large quantities leads to the development of a disease such as gout.

A large amount of purines is found in meat and fish. A diet for gout on the hands and other parts of the body without drug treatment can reduce the occurrence of attacks of this disease. But in order to completely cure the disease, it is necessary to follow the rules of therapeutic nutrition, as well as undergo medication therapy.

If there is a violation of purine metabolism, the menu can only be drawn up by a nutritionist, taking into account the characteristics of the patient’s body. If you follow only a general therapeutic nutrition plan, the human body may weaken, and the immune system will cause the development of allergies.

The antipurine diet does not completely eliminate the consumption of foods with purines. Otherwise, the body will not receive enough other substances that are needed for the functioning of all human systems and organs.

Features of the antipurine diet

The anti-purine diet is based on the fact that foods containing purines, oils and animal fats are excluded from the diet for some time. It is important to remember which foods you should not eat during treatment, as well as those that are recommended for consumption.

Prohibited Products

If you are worried about gout, avoid eating foods such as: smoked sausage and lard; legumes; fatty meat and offal; broths based on fatty meat.

When treating the disease, it is also important to forget about mushrooms, highly salted dishes and seasonings, coffee, alcohol, cocoa, strong tea, hot or spicy varieties of cheese.

Small amounts of skim milk and butter are allowed several times a week. It is also possible to eat salmon and trout from fish.

Authorized Products

The therapeutic diet for gout is varied. Allowed to eat:

• soups with vegetables, cereals and seafood;
• yoghurts, cottage cheese and sour cream;
• wholemeal bread;
• rye pasta;
• one egg a day;
• berries;
• apples, tangerines and oranges;
• jam and marmalade in small quantities.

Instead of animal fats, vegetable fats should be used for cooking. Season the dishes with dill.

You can also prepare this healthy treat: mix honey with dried fruits (except raisins), seeds and nuts. Consume several spoons throughout the day.

You can quench your thirst with green tea with lemon, herbal infusions, juices and compotes, sugar-free fruit drinks, and mineral water.

Carrying out fasting days

Gouty arthritis requires fasting days. But you can’t go hungry. You can eat red apples and also drink green tea.

It is also allowed to eat a salad of two types of vegetables during fasting days. To cleanse the body, dairy products are used: sour cream and cottage cheese with a minimum percentage of fat content.

You can also boil rice (70 grams) with milk. Divide the resulting porridge throughout the day. As a snack, you are allowed to eat 250 grams of red apples per day. You can make compote without sugar from them.

Compliance with table No. 6 according to Pevzner

Table No. 6 according to Pevzner relieves purine metabolism and normalizes all intestinal functions. This menu is prescribed if the patient has gout, uric acid diathesis, or oxaluria.

The dietary table according to Pevzner is considered complete nutrition. During the day, the body receives the required amount of proteins, fats and carbohydrates. It is only important to limit animal proteins, as well as products with purine compounds. It is recommended to eat alkaline radicals: vegetables, fruits, berries and milk. If the patient is overweight, carbohydrate intake is limited.

It is important to drink as much liquid as possible: water and natural juices.

All dishes must be boiled or steamed. Salt may be added in small doses. You should eat five times during the day.

Approximate diet according to table No. 6 according to Pevzner:

In the morning, eat a portion of carrot, cabbage and cucumber salad along with bran bread and tea. Have an afternoon snack with rowanberry broth, eggs, carrot and pumpkin salad.

Have lunch with compote, potato-squash cutlets, and milk-noodle soup. Have a snack with cottage cheese soufflé. Dine on vegetable cabbage rolls and croutons with milk.

Have breakfast with pumpkin pancakes with raisins, berry jelly and kefir. Have an afternoon snack with blueberry-apricot jelly. Have lunch with lingonberry broth, zucchini soup, potato and fish pie. Snack on a blackberry and banana smoothie. Have corn porridge with yogurt and salad for dinner. Salad: mix eggs with carrots, croutons and sour cream.

Have breakfast with carrot casserole with fruit and apple juice. Have an afternoon snack with cereal and milk. Have lunch with carrot soup, potato and cabbage salad, and tomato juice. Snack on lingonberry jelly with blueberry yogurt pie. Dine on oatmeal with applesauce and lingonberry broth.

Have breakfast with carrot curd, compote and millet porridge with apples. Have an afternoon snack with cereal yogurt. Have lunch with stewed cabbage, beef cutlet, rice porridge, grapefruit juice. Snack on a fruit salad. Dine on jelly, beet salad, and pasta casserole.

Have breakfast with buckwheat, toast with butter, and pomegranate juice. Have an afternoon meal with melon. Have lunch with carrot balls, cabbage soup with rye crackers and milk. Snack on peach and sour milk. Dine on pancakes with strawberries, peppers, stuffed rice, and compote.

Have breakfast with lingonberry drink, millet kulesh with milk. Enjoy your afternoon with strawberries and cream. Have lunch with fermented baked milk, potato balls and stewed vegetables. Snack on carrot juice. Dine on sea buckthorn juice, pumpkin pudding, and cucumber and tomato salad.

Have breakfast with rice, prunes, toast and milk. Have an afternoon tea with lemon and honey, fruit marmalade. Lunch on potato and pearl barley soup, pancakes, chicken fillet and pear drink. Snack on grape juice and sweet apples. Dine on banana cheesecakes, bran broth and cottage cheese.

Now you know what the hypopurine diet is and what the menu might look like. It is important that the antipurine diet is prepared by a nutritionist, taking into account the characteristics of the patient’s body. Gout should be treated with a diet for diabetes only under the strict supervision of a doctor, since in this case it is necessary to observe not only restrictions on the consumption of purine-containing foods, but also dietary habits with high blood sugar.

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Low purine diet

What are purines?

Purines(Purine) - organic nitrogen-containing compounds that are part of nucleic acids and are found in animal and plant organisms as a metabolic product. Purines are found in all cells of the body and in almost all foods. The reason for their widespread distribution is simple: purines are part of the chemical structure of our genes and the genes of plants and animals.

Without going into detail about the complex chemical processes that occur in a cell, let's say that when a cell dies, purines break down and uric acid is formed.

Functions of uric acid

This is a normal process - the formation of uric acid in the body as a result of the breakdown of purines. Uric acid has antioxidant properties and is a powerful stimulant of the central nervous system, inhibiting phosphodiesterase, which mediates the action of the hormones adrenaline and norepinephrine. Uric acid prolongs the effect of these hormones on the central nervous system. About 1 g of uric acid is formed in the body per day. Uric acid is excreted from the body in urine. However, under some circumstances, the level of uric acid in the blood and other parts of the body may become too high and unsafe.

Why do uric acid levels increase?

Our kidneys are responsible for keeping uric acid levels in the blood balanced. Kidney problems (such as decreased urine output from the kidneys), diseases that cause extensive cell death, a purine-rich diet, and other factors can lead to excessive accumulation of uric acid in various parts of the body. Uric acid itself and, especially, its salts (urates) are poorly soluble in water. Even with a slight increase in concentration, they begin to precipitate and crystallize, forming stones. Crystals are perceived by the body as foreign objects. In the joints, they are phagocytosed by macrophages, the cells themselves are destroyed, and hydrolytic enzymes are released from them.

For information

Phagocytosis is a process in which cells (protozoa, or blood cells and body tissues specially designed for this purpose - phagocytes) capture and digest solid particles.

This leads to an inflammatory reaction, accompanied by severe pain in the joints. This disease is called gout. Another disease in which urate crystals are deposited in the renal pelvis or bladder is known as urolithiasis.

Since uric acid is formed from the breakdown of purines, low purine diets are often used to combat the problem.

Foods High in Purines

Foods with very high levels of purine compounds: anchovies, grains, gravy, kidneys, liver, sardines.

Foods with high and moderately high levels of purines - asparagus, bacon, beef, veal tongue, carp, cauliflower, chicken, chicken soup, cod, crab, lobster, oysters, and shrimp, duck, goose, halibut, ham, beans, lentils , mushrooms, lamb, beans, peas, beans, perch, pork, rabbit, salmon, sheep, shellfish, spinach, tripe, trout, tuna, veal, venison.

Low purine foods

The following foods are low in purines.

• Eggs, nuts and nut butter
• Low-fat cheeses and low-fat ice cream
• Skim or 1% milk
• Vegetarian soups
• Vegetables not included in the list above
• All fruits and fruit juices
• Bread, pasta, rice, corn
• Tea, coffee, and cocoa
• Sugar, candy, and gelatin
• Oil

To maximally free meat from purines, it should be boiled in plain water (drain the water), and only then begin to prepare a particular dish. The same should be done with poultry or fish.

There are no requirements regarding the temperature of the finished dish or the cooking method.

Avoid or limit alcohol. Alcohol increases the production of purines.

If you are overweight, lose weight gradually. Rapid weight loss can increase uric acid levels.

Drink 8 to 12 cups of fluid every day to help reduce urate stone formation.

The diet is often combined with medications to lower uric acid levels.

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Diet for gout is the same element of therapy as medications, physiotherapy and therapeutic exercises. Consumption of prohibited foods reduces the effectiveness of therapy, fills cells with purines, and provokes active production of uric acid. The result is increased discomfort, severe pain in the joints, increased swelling, and poor tests.

When developing a treatment regimen, the doctor reminds the patient how important diet is for gout. A table of foods that have a positive and negative effect on the metabolism of uric acid in the body will help you create a menu for gout for every day.

General information about the disease

Causes and symptoms of gout:

• joint pathology develops with improper metabolism, excessive production or poor excretion of uric acid from the body. Urates accumulate in joints, impair the mobility of the problem area, and cause discomfort;
• the joints of the hands, ankles, fingers, toes, elbows, and knees suffer. Gouty nodules or tophi are visible under the skin in the area of ​​tendons and small joints. The formations interfere with movement in the affected area and worsen aesthetics;
• the disease occurs with periods of remission and exacerbation. During a gout attack, the patient experiences excruciating pain, the tissues around the joints swell, become hot to the touch, and health deteriorates;
• the main category of patients is men over 40 years of age, overweight, often drinking beer and red wine, including large quantities of meat dishes on the menu every day, and fans of strong tea and coffee;
• gout develops less frequently in women, mainly after 45 years of age due to hormonal changes during menopause. The lack of female sex hormones (estrogens) inhibits the breakdown of uric acid, urates accumulate in the joints. In addition to hormonal disorders, there are two more reasons - poor diet plus excess weight;
• Often the tendency to develop gouty arthritis is inherited. If there is a mention of gout in your family, you need to monitor the health of your joints and eat right.

Constant attention to your health, diet, movement, and supportive drug therapy reduce the frequency of gout attacks. Lack of treatment increases the severity of gouty manifestations, attacks occur more often.

Why you need to follow a diet for gout

The answer is simple: by consuming approved products, the patient himself regulates the level of production and elimination of dangerous urates. The more useful items, the less uric acid the body produces, the sooner urates are excreted by the kidneys. “Harmful” foods, on the contrary, accelerate the accumulation of harmful uric acid salts, slow down the excretion of urates, and provoke acute inflammation of the joints (gout attack).

Regular consumption of approved products normalizes the condition of the joints and the whole body:

• pain decreases, gout attacks occur less frequently;
• excess salts are removed, swelling decreases, inflammation goes away;
• weight returns to normal, health improves.

Information for patients! Giving up a diet and relying only on drug treatment does not give a positive result. Many organs suffer from long-term use of medications; diet is a safe tool for controlling well-being during gout.

Table of permitted and prohibited products

On what basis is the list of healthy and “harmful” foods compiled? Why are carrots and potatoes in one column of the table, and cauliflower and spinach in another?

Reasons for separation:

• foods allowed for gout contain a minimal amount of purines; regular consumption has a positive effect on the course of the disease and the condition of the joints;
• prohibited foods contain a lot of purines, provoke inflammation, swelling, and joint pain due to the accumulation of urates.

Proper nutrition solves two problems:

• prevents the production of uric acid in quantities exceeding the norm;
• ensures the supply of nutrients, prevents deficiency of minerals, vitamins, proteins, carbohydrates, fats, microelements.

Table of foods for creating a diet for gout

	Authorized products	Prohibited Products
Vegetables	Carrots, potatoes, beets, lettuce, pumpkin in any form	Spinach, sorrel, legumes, cauliflower, pickles, pickled vegetables
Meat and poultry	Low-fat varieties, boiled or steamed, 1 or 2 times a week are useful	Kidneys, liver, meat of young animals, brains, semi-finished meat products and canned food
Flour products, bread	Yesterday's rye and wheat bread, crackers, baked goods with bran	Butter and puff pastry are allowed in minimal quantities. High calorie cream cakes
Fish	Low-fat varieties, steamed, baked or boiled fish, no more than once or twice a week	Herring, sardines, fatty varieties of sea and river fish, preserved and canned fish, smoked fish
Cereals	All types in moderation
Sweet dishes, fruits	Plums, pears, apricots, grapes, fresh, boiled, in the form of dried fruits. Marmalade, jelly, fruit cream, marshmallow. Walnuts and hazelnuts	Figs, raspberries, chocolate, meringues, sweets with dyes
Dairy	Yogurt, low-fat kefir, milk, sour cream, cottage cheese, mild, unsalted cheese
Eggs	1 piece per day, preferably, boil, prepare an omelet
Broths, soups, sauces, spices	Soups with vegetable broth; when using meat or poultry, the first broth (3-5 minutes after boiling) must be drained. Sauces: sour cream, milk, tomato. Cinnamon is allowed as a spice	Strong broths: chicken, meat, mushroom, fish
Beverages	Juices, healing rosehip decoction, weak, not very sweet coffee and tea with milk, mineral water	Strong black tea, coffee, cocoa, chocolate, sweet carbonated drinks with dyes, alcohol
Salads, cold appetizers	Fresh vegetable salads, eggplant, squash caviar, vinaigrette	Smoked meat and fish, any canned meat and fish, all types of pickles
Fats	Vegetable, unsalted butter	Pork, beef, cooking fat, lard

General nutrition rules

• The entire amount of food per day is divided into 5-6 times. Fractional nutrition is the basis of health in gout. The portions are small, the diet contains a sufficient amount of nutrients;
• overeating is harmful. You need to get up from the table before your stomach is full;
• meat is allowed 2-3 times a week. For one day, the serving is 170 g for lean, boiled fish and only 150 g for meat;
• Fasting is prohibited, fasting days (milk, kefir, cottage cheese or fresh, boiled fruit) are recommended: once or twice a week is enough;
• An important rule is limiting salt. It is impossible to completely abandon sodium chloride, but it is necessary to reduce consumption. Excess salt increases swelling and interferes with the elimination of urates;
• during an exacerbation, the list of permitted products is reduced: it is important to reduce the load on the kidneys and reduce the production of uric acid;
• A prerequisite for minimizing the risk of relapse and alleviating symptoms is drinking up to two liters of clean water per day. Rosehip decoction, unsweetened, weak green tea, juices, still mineral water are useful.

Eating with certain restrictions shows positive results:

• the production of uric acid decreases;
• purine metabolism is normalized;
• the accumulation of urates is reduced;
• intestinal motility is restored.

Basic principles of nutrition:

• increased content of fruits, vegetables, milk and fermented milk products in the diet;
• a minimum amount of foods high in purines, oxalic acid, and table salt;
• liquid volume – at least two liters;
• moderate consumption of protein and carbohydrate foods.

High and Low Purine Foods

The following foods contain the most purines:

• sprats, sardines, herring;
• fish caviar;
• offal (liver, tongue, brain, kidneys);
• young meat contains much more purines than old meat;
• plant products: raspberries, peanuts, spinach, figs, sorrel. There are a lot of purines in legumes, mushrooms, cauliflower;
• strong tea, coffee, chocolate, cocoa, yeast.

• most berries;
• dairy products;
• bread;
• many fruits and vegetables;
• eggs;
• cereals

Find out effective methods of treatment with folk remedies at home.

A page is written about the symptoms and treatment of arthrosis of the knee joint.

How to cook food properly

• permitted types of heat treatment: boiling, baking, steaming;
• prohibited types of heat treatment: frying, drying, smoking;
• preparing the broth in a special way: 5 minutes after boiling, the broth is poured out, the meat is washed, poured with cold water, and brought to a boil again for further cooking;
• vegetables and fruits can be eaten raw, boiled, baked;
• Vegetable oil with a low purine content is recommended as a salad dressing. Do not use mayonnaise, replace it with a combination of natural yogurt and dill.

Antipurine diet for exacerbation of gout

Special nutrition during exacerbation of pathology is also recommended for urate nephrolithiasis. The patient must comply with restrictions to minimize the intake of uric acid and purines.

Authorized products:

• porridge;
• carrot;
• potato;
• eggs;
• chicken;
• cottage cheese;
• lemon;
• cucumbers;
• beet;
• pumpkin;
• dill;
• White cabbage;
• vegetable oil;
• kefir;
• watermelon.

During a gout attack, the total volume of fluid consumed per day increases to 2.5–3 liters.

Prohibited products:

• fish and meat broths;
• chocolate;
• whole milk;
• pastries, cakes;
• smoked meats;
• radish;
• strong coffee and tea;
• cauliflower;
• fatty fish;
• pork and beef;
• offal;
• alcohol;
• legumes;
• grape;
• salo;

The patient is obliged to monitor the condition of the kidneys, take tests on time, and monitor body weight. With frequent attacks, extra pounds are an additional burden on the affected joints, an indicator of the accumulation of urates and fluid in the tissues.

Following a diet for gouty arthritis improves the patient’s condition and prevents exacerbations. It is important to eat right not only during painful attacks, but also during remission. Consider the recommendations for creating a menu, and if possible, seek help from a nutritionist. Dietary restrictions allow you to reduce the amount of medications to relieve pain and swelling; refusal to diet worsens the condition of the joints, provokes increased production of uric acid, and problems in various parts of the body.

Read more about therapeutic diet No. 6 for gout in the following video: