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Gout - The Disease And Diet (Part II)

By Mumtaz Khalid Ismail

More Links Management of gout Dietary management Allowed-Low purine content foods Restricted - Fair purine content foods Avoided - High purine content foods Sample Menu for gout patients

A person suffering from gout can lead a normal life provided he is prompt in taking medical aid and a slight change in life style including diet.

All gouty patients must be assessed about eating and drinking habits that are linked with high uric acid. The treatment of gout may be possible by diminishing the synthesis of uric acid in the body or by increasing the excretion. A number of drugs are effective in the treatment of gout and diet is considered to be an adjunct to drug therapy. Controlling body weight through a well-planned programme of exercise and diet can also help to relieve gout. Fasting can also precipitate an attack of gout. In traditional medicine cherries, leeks and celery are used to lower blood levels of uric acid.

Low purine content and moderate fat is recommended for gouts. Food rich in nucleic acids and nucleoprotein e.g. meat, fish, organ meats should be avoided. Liberal amounts of fluid intake are advisable.

Calories and carbohydrate

Calories have to be restricted for obese persons to maintain an ideal body weight. The body weight should be maintained to normal to prevent further damage of the weight bearing joints due to over weight. Rapid weight loss either by starvation, by extremely low calorie diets or by excessive exercise can precipitate an attack of gout. A gradual weight loss with moderate exercise will be preferable for the patients who are suffering from gout. During an attack of gout the main source of calories should be from carbohydrates for its protein sparing effect which reduces the endogenous protein break down.

Proteins

The protein intake should be between 50-60gms per day for an adult and this can be supplied from cereals, milk, egg and vegetables. High purine containing food such as fish, meat, liver, kidney should be avoided. It is no great hard ship to avoid these foods for a non vegetarian compare to the hardship they have to undergo during illness.

Fat Consumption

Moderate amount of fat intake is permitted. High fat consumption should be restricted since fat tends to decrease uric acid excretion in urine.

Fluids and beverages

Liberal intake of fluid at least 2 to 3 litres per day is advised as it helps to increase the volume of urine excreted. Even though tea, coffee and cocoa contain methyl purine the body do not convert this type of purine into uric acid. About 2-3 cups of tea or coffee or cocoa are permitted in a day. All alcoholic drinks are best to be forbidden.

              (below 50mg purine per 100 gms of edible portion)

1. Milk and milk products
2. Eggs
3. Cereals
4. Vegetables except those listed below
5. Fruits
6. Sugar and sweets ( must be restricted if the person is obese)
7. Fats and oils ( 1-2 tbsp. per day)
8. Nuts

              (50 - 500 mg purine per 100 gms of edible portion )

1. Pulses 1 cup per day but exclude during an acute attack
2. Vegetables like peas, beans, spinach, apple, mushrooms and cauliflower

              ( 500 - 1000 mg purine per 100 gms of edible portion)

1. Meat
2. Fish especially white bait, sardines, and herring.
3. Liver
4. Kidney
5. Heart
6. Pancreas
7. Sweet bread
8. Crab
9. Brain

	Diet plan A (Vegetarian)	Diet plan B (Non vegetarian)
	Tea / Coffee - 1 cup	Tea / Coffee - 1 cup
	Cornflakes - 1/2 cup Skim milk - 1 cup	Broken wheat ( dhalia) - 1/2 cup Skim milk - 1 cup
	Fresh fruits or fresh fruit juice	Fresh fruits or fresh fruit juice
	Rice -1/2 cup Chapathi - 2 nos Thin Dhal - 1/2 cup Turiya sabji - 1 cup curd- 1 cup ,salad	Chapathi - 3 nos Egg curry - 1 no cabbage sabji - 1 cup curd- 1/2 cup salad
	Tea / coffee - 1 cup	Tea / coffee - 1 cup
	Tomato soup - 1 bowl roti - 2 Thin Dhal - 1/2 cup Ladies finger sabji - 1 cup milk pudding	Carrot soup - 1 bowl Veg pulao with boiled one egg Curd raita 1/2 cup Fruit salad

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