Gout: what diet to use in a gout attack

Gout, also known as gout, is caused by the build-up of uric acid crystals in the joints and periarticular tissues. Joint swelling and pain should prompt you to change your diet, which is the mainstay of gout treatment. What diet is recommended for gout?

Whydietsupports the fight against a serious disease such as gout?

Gout is a metabolic disease in which there is an abnormal breakdown of purines (nitrogenous bases) present in proteins. It then leads to hyperuricemia, i.e. an increase in the concentration of uric acid in the blood.

The next stage is the crystallization of sodium urate in the periarticular fluid and the formation of urate s alt deposits in the tissues, which results in painful arthritis. The course of gout usually begins with an attack of the big toe joint. Gout is known as a disease of welfare.

The increase in the number of diseases is strongly related to the change in lifestyle - less exercise, unhe althy diet, use of stimulants, taking medications, e.g. antibiotics. The increase in the incidence of gout positively correlates with obesity, diabetes, hypertension and cardiovascular diseases.

Diet for gout - rules

People suffering from gout should avoid drinking alcohol (apart from small amounts of wine), as it increases inflammation in the joints and aggravates joint pain. Studies have shown that men who drank 2 bottles of beer every day are 2.5 times more likely to develop gout, while men who drank 2 glasses of wine daily were not at increased risk of developing gout.

In gout, you should drink 3-4 liters of water every day, which accelerates the excretion of uric acid and prevents its crystallization in the tissues. It is recommended that you drink water just before bedtime to help prevent the formation of acid crystals in the kidney tubules. If the patient maintains a he althy body weight, meals should be normocaloric.

Overweight and obese people should limit the caloric content of meals and strive for he althy weight reduction, as obesity is closely related to the rise of uric acid in the blood. Fasting and diets with a high caloric deficit are forbidden. They lead to an increase in uric acid concentration inblood.

Scientific research has shown that a diet with a predominance of carbohydrates promotes the excretion of uric acid, and that a diet high in fat enhances urate reabsorption. It is recommended that in the treatment of gout, the supply of energy from nutrients should be at the level of:

Although gout is closely related to nutrition, and the evidence for the positive effects of dietary management on gout management is clear, research shows that patients do not make changes to their diet.

• 15-20% protein
• 30% fat
• 50-55% carbohydrate

Eat 4-5 meals a day. The last one about 3-4 hours before bedtime. This is very important as uric acid retention gets worse at night. The dishes should be varied so as not to lead to a deficiency of vitamins, minerals, amino acids or essential fatty acids.

It is recommended to eliminate deep-fried and baked foods with added fat. Culinary techniques indicated include cooking, stewing without browning and baking without fat. It is very important to cook the meat in plenty of water as this allows some of the purines it contains to be released. Then the cooking water should be poured away. Meat should be eaten in limited amounts, but not completely eliminated.

It is recommended to eliminate seafood, bone and meat extracts, broths, meat and bone stocks from the menu. Recommended sources of protein are eggs and dairy. You need to limit the simple sugars contained in the diet, including in sweets, drinks and juices. Their source is also fruit, hence the recommendation to limit fruit in gout.

Glucose and fructose can be partially metabolized to lactic acid, which inhibits the excretion of uric acid in the urine. Sodium works in a similar way, so you need to limit the amount of s alting in your food. In patients with gout, decreased levels of vitamin D3 are often observed. Its supplementation seems justified, because meeting the demand for this vitamin with a diet is difficult.

Moderate exercise is recommended, with the advantage of strength over aerobic exercise, which enables the use of fatty acids as a substrate for energy production and does not contribute to the formation of lactic acid. Due to the fact that urate precipitates when the body temperature is lowered, hypothermia should be avoided. Mental stress is also a factor that exacerbates hyperuricemia.

Diet for gout - recommended and contraindicated products

Diet for gout is an essential part of treatment. Its purpose is to reduce uric acid levels inblood, thus reducing or even completely eliminating attacks of arthritis caused by its crystallization and avoiding irreversible joint and kidney complications.

The general principles of gout nutrition include:

• contraindicated - beer and other alcoholic beverages except wine, meat, offal, meat preparations, broths, jelly, seafood, sardines, herring, cod, salmon, mackerel, trout, geese, turkeys, sweetened drinks, juices fruity, large amounts of fruit, honey, fructose
• indifferent - cereal products, high-fat dairy products, eggs, vegetables, tea, wine
• Recommended - skim milk, low-fat dairy products, coffee, also decaffeinated

The key component of foods are purines, which are present in proteins from which the body produces uric acid. The diet for gout is a low purine diet. Daily, you can eat food that releases a maximum of 300-500 mg of uric acid, and during attacks of the disease - 120 mg.

However, this is not the only food ingredient that should be taken into account when planning a menu, and the high purine content does not always exclude the product from consumption.

The most significant increase in the concentration of uric acid in the blood is caused by:

• offal
• seafood
• red meat
• oily fish
• essential meat stocks

It seems reasonable to calculate the amount of uric acid in the diet only from these products. Scientific studies have shown that the purines in legumes, spinach and other vegetables do not increase blood uric acid levels and are safe to consume. Purines in vegetables and legumes are contained in dietary fiber fractions and excreted from the body.

Lean dairy products are especially recommended: milk, yogurt, kefir, buttermilk, cottage cheese. These foods, thanks to the presence of proteins (casein and lactalbumin), accelerate the excretion of uric acid from the body and prevent its crystallization in the joints.

Relief of gout symptoms is influenced by the consumption of:

• fiber (groats, cereals, wholemeal bread and pasta, vegetables, fruits)
• vitamin C (pepper, parsley, kale, broccoli, Brussels sprouts, orange, strawberry, black currant, kiwi)
• folates (lentils, chickpeas, asparagus, spinach, romaine lettuce, broccoli, beans, kale, beetroot, Brussels sprouts, avocado)

Scientific research has also confirmed that the consumption of cherries reduces the concentration of uric acid in the blood and reduces joint inflammation.

Products you needeliminate alcohol, sweets, sweetened drinks, juices, foods containing glucose-fructose syrup, meat stocks, offal, seafood from your diet.

Important

Diet in a nutshell

• base your menu on vegetables
• eat 1-2 servings of fruit daily. Cherries are the most recommended
• eat dark bread, cereals, groats, rice, legumes
• eat dairy products and eggs
• limit meat and fish. Avoid eating portions of more than 100-150 g
• eliminate highly processed foods, sweet drinks and juices
• drink at least 3 liters of water a day
• do not drink alcohol except wine

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Author: Time S.A

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Diet for gout - what products are uric acid made from?

Food can be divided into:

• products that produce less than 50 mg of uric acid / 100g
• products that produce 50-100 mg of uric acid / 100g
• products that produce more than 100 mg of uric acid / 100g

Dietary recommendations for gout before 2010 were strictly based on this division, recommending products from the first group in the diet and eliminating those from the third group. However, new research has shown that only meat and fish products have an influence on the increase in the level of uric acid in the blood, and that legumes, spinach and broccoli are safe for people suffering from gout.

Foods providing less than 50 mg uric acid / 100 g

Products	Home measure=portion [g]	Amount of uric acid from 1 serving [mg]
Milk	200	16
Curdled milk	200	16
Blue cheese	30	2
Cheese	30	2
Cottage cheese	50	5
Fats and oils	10	0
Tag	30	22
Mortadela	30	29
Salami	30	31
Cooked ham	30	31
Kajzerki	50	11
White bread	70	7
crispbread	30	18
Pasta	60	24
Red beets	200	38
Zucchini	200	26
Onion	200	48
White cabbage	200	44
Sauerkraut	200	32
Chinese cabbage	50	11
Carrot	200	34
Cucumbers	200	14
Tomatoes	200	22
Radishes	100	15
Lettuce	50	7
Potatoes	250	40
Sunflower seeds	30	43
Sesame seeds	30	19
Hazelnuts	30	11
Walnuts	30	8
Peanuts	30	24
Mushrooms	200	34
Gooseberry	150	24
Ananas	150	29
Peaches	150	32
Cherries	150	29
Pears	150	18
Apples	150	21
Kiwi	150	29
Raspberries	150	27
olives	25	7
Oranges	150	29
Currants	150	26
Strawberries	150	32
Grape	150	41
Cherries	150	29

Foods providing 50 - 100 mg of uric acid / 100 g

Products	Home measure=portion [g]	Amount of uric acid from 1 serving [mg]
Flądra	100	93
Lin	100	80
Beef, brisket	100	90
"frankfurters" sausages	100	89
Sausages	100	78
Pumpkin	200	88
Beansasparagus	200	74
Kale	200	96
Red cabbage	200	64
Savoy cabbage	200	74
White beans	75	96
Pea	75	71
Lentils	75	95
Banana	150	86
Melon	150	50

Foods providing more than 100 mg of uric acid / 100 g

Products	Home measure=portion [g]	Amount of uric acid from 1 serving [mg]
Cod	100	109
Karp	100	160
Salmon	100	170
Mackerel	100	145
Trout	100	297
Zander	100	110
Sardine	100	345
Sola	100	131
Pike	100	140
Smoked sprat	100	804
Follow	100	210
Shrimp	100	147
Veal	100	150
Lamb	100	140
Beef Pork	100	120
Beef roast beef	100	110
Pork neck	100	145
Pork ham	100	160
Roast chicken	100	115
Chicken breast	100	175
Chicken thigh	100	110
Thymus	100	1260
Veal liver	100	218
Beef liver	100	515
Beef liver	100	554
Goose	100	165
Hare	100	105
Broccoli	200	162
Brussels sprouts	200	138
Green peas	200	168
Cauliflower	200	102
Corn	200	104
Pepper	200	110
Por	200	148
Spinach	200	114
Oyster mushrooms	200	100
Boletus	200	184
Mushrooms	200	116

Worth knowing

Dietary recommendation for acute gout

Recommendations should only be used until symptoms of acute gout have disappeared

• meatless diet based on gruel
• a large amount of water, at least 3 liters a day
• eating dark fruits, especially cherries, whose phenolic compounds accelerate the excretion of uric acid

Aleksandra Żyłowska-Mharrab, dietician Food technologist, dietitian, educator. A graduate of Biotechnology at the Gdańsk University of Technology and Nutritional Services at the Maritime University. A supporter of simple, he althy cuisine and conscious choices in everyday nutrition. My main interests include building permanent changes in eating habits and individually composing a diet according to the body's needs. Because the same thing is not he althy for everyone! I believe that nutritional education is very important, both for children and adults. I focus my activities on spreading knowledge about nutrition, analyze new research results, and make my own conclusions. I adhere to the principle that a diet is a lifestyle, not strict adherence to meals on a sheet of paper. There is always room for delicious pleasures in he althy and conscious eating.