Disease Specific Nutrition Tips

Rule Out Gout – With Gout Diet

Do you have raised uric acid levels? Uric acid is normally excreted in urine. However, excess of uric acid produced by the body from foods we eat and/or internal cellular or nitrogen utilization can increase uric acid levels in blood. Normal blood range of uric acid is 2 to 7 mg/100 ml. If your levels are above 7 mg/100 ml then you are at risk of developing the disorder called gout. Range of uric acid can rise up to 20 mg/100ml in severe gout.

Gout is a chronic disease due to an inherited abnormality of purine metabolism. Purine is a nitrogenous base found in neucleotide for synthesis of DNA and RNA. Cellular materials of plants, grams, legumes and animal glandular organ meats (liver, kidney, brain) contain neucleoproteins. These are digested and converted to purines, which are finally oxidized to uric acid. Uric acid is thus a breakdown product of purines that dissolves in blood and is passed through kidneys into urine for excretion.

A number of risk factors are related to development of increased uric acid levels and gout:

  • Genetics: Heredity plays an important role in determining individual’s risk. Almost 18% of people with gout have family history of the disease.
  • Gender and age: It is more common and in male than in females. And is more common in adults
  • Excess weight: Being overweight and obese increases risk of developing high uric acid levels and gout since there is more tissue available for turnover and breakdown that leads to excessive uric acid production.
  • Drinking too much alcohol: It interferes with removal of uric acid from body and increases uric acid levels.
  • Eating too many foods rich in purines: This can aggravate gout and symptoms.
  • Exposure to lead in environment: This can also lead to gout.

High uric acid can show various symptoms:

  • Hot, swollen and tender big toe that even a blanket may seem to be intolerable.
  • Acute gout attack which indicates sudden and severe attacks of reness, tenderness and pain in joints.
  • Mostly big toe is affected; but in chronic conditions elbow and outer fleshy ridge of ear may also show symptoms. Uric acid crystals called urate deposit in these areas showing swelling and tenderness of joint with severe pain.
  • Main Complication of gout is chronic kidney failure which can be prevented by proper management of gout.

Dietary management of gout includes consumption of low purine intake. About one third of body’s uric acid is attributed to diet. Thus changing your diet to foods with lower purines can help you to relieve symptoms. In case of severe gout, purine restriction should be 100 to 150 mg/day.

  • Organ meats like brain, kidney, liver; gravies, sardines, broths, meat extracts, minced meat, sweet breads contain highest amount of purines (150 – 825 mg/100 g) and should be strictly avoided.
  • Limit foods containing moderate amount of purines (50 – 150 mg/100 g) which include whole grain breads or cereals, cauliflower, spinach, legumes (beans, peas and lentils) meat soups and broths, mushrooms, asparagus, oatmeal, chicken, wheat germ and bran and fresh salt water fish.
  • Beverages (Coffee, tea and soda) , cereals, cheese, eggs, butter and fats of any kind, vegetables and fruits and other complex carbohydrates, fruit juices, milk, nuts, gelatin, soups, etc. are the foods which contain lowest purines (<50mg/100 g) and can be consumed.
  • Encourage intake of fluids (≥3 liters/day) to assist with excretion of uric acid and to minimize possibility of renal calculi formation.
  • Uric acid crystal/stone excretion tends to reduce by fat and thus diet should be low in fat.
  • Being overweight and obese increases risk of high uric acid levels, losing weight during quiescent phase of disease should be encouraged. Various researches suggest that losing weight and consuming lower calories than usual can reduce uric acid level and frequency of gout attacks even without taking a low purine diet.
  • Avoidance of alcohol (especially beer and wine) is recommended.

Diet is an auxiliary measure to medication. Drugs are already very effective in lowering serum uric acid concentration. Thus along with drug therapy a dietary management can help in maintaining weight, reducing gout attacks and improve overall health.

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