Diet for Gout Patients

  Principles of dietary treatment: For acute attacks of primary gout, it is important to terminate the symptoms of the attack as soon as possible, to treat it actively, to control the symptoms of acute gouty arthritis and to reduce the patient’s pain. Reduce the intake of purine-rich foods in the diet to reduce the source of uric acid, and promote the excretion of uric acid from the body with all therapeutic means. For secondary gout, it is necessary to find out the cause of the disease and actively treat the symptoms and causes. Through dietary control and drug treatment, it is completely possible to control the acute attack of gout, stop the aggravation and development of the disease, gradually improve the purine metabolism in the body, reduce the concentration of uric acid in the blood, reduce its deposition and prevent complications. The principles are three low and one high, namely low purine or purine-free diet, which can reduce blood uric acid production; low energy intake to eliminate overweight or obesity; low salt and low fat diet to prevent gout complications; and large amount of water to facilitate the dissolution and excretion of uric acid.  1. Restrict purine intake: Patients should control the intake of foods with high purine content for a long time. In the acute stage, a low purine diet should be used, with purine intake strictly limited to 150mg per day; high purine foods such as animal offal, bone marrow, thick broth, meat pies, sardines, anchovies, shrimps and mushrooms are prohibited. Restrict the intake of purine food to reduce exogenous nuclear protein and lower serum uric acid level, which is important to prevent or reduce the acute attack of gout, reduce the deposition of uric acid salt in the body and prevent the formation of uric acid stones.  2.Control energy intake and maintain ideal body mass: Most gout patients should control the total dietary caloric intake appropriately, with 6726-7531kJ as the appropriate total dietary calories. Body mass should preferably be lower than 10%-15% of the ideal body mass. For obese patients to have weight loss measures, should be gradual, to reduce 1Kg per month is appropriate, because the sudden reduction of calorie intake will lead to ketonemia; weight loss too fast, promote fat decomposition, easy to trigger the acute attack of gout, therefore, we should consider the energy intake against their body mass, eight minutes full per meal, and at the same time to adhere to exercise.  3, moderate protein intake: high protein diet can lead to increased endogenous purine synthesis, may increase the precursors of uric acid, protein intake of 50 to 70 grams throughout the day is appropriate, mainly plant protein, animal protein can be used milk, eggs. Because milk and eggs have no cell structure and do not contain nucleoproteins, they can be used as the main source of protein for gout patients.  4. Low-fat, low-salt, low-cholesterol diet: In order to prevent and treat possible gout complications, a low-fat, low-salt, low-cholesterol diet should be adopted at the same time, with fat controlled within 50g, sodium 2~5g and cholesterol around 300mg. Soy sterols and phytochemicals in beans and their products can lower cholesterol. Therefore, in acute gout patients, when choosing eggs as the main source of protein, the intake of soy products can be increased appropriately to promote the metabolism of cholesterol.  5, eat more alkaline food: most gout patients with low pH value of urine, uric acid supersaturation prone to kidney stones. Uric acid is easy to dissolve in alkaline environment, vegetables and fruits are alkaline food, so gout patients should eat a variety of vegetables and fruits, such as cabbage, celery, eggplant, radish, cucumber, winter melon, watermelon, apple, pear, etc. You can also intake some nut foods, such as peanuts, almonds, walnuts, etc. Watermelon, winter melon is not only alkaline food, but also diuretic effect, which helps the treatment of gout.  Sufficient amount of vitamins and minerals: supply rich vitamin C and vitamin B, which can dissolve the uric acid salt accumulated in the body, promote the excretion of uric acid, reduce the blood uric acid concentration, and facilitate the excretion of uric acid. The anthocyanins in vegetables and fruits can significantly reduce blood uric acid, so it is emphasized that we must eat more vegetables and fruits of different kinds and colors, especially for gout patients, which can promote their uric acid excretion and slow down the pain of joints.  Provide sufficient water: Adequate water intake can promote the dissolution of uric acid in the body, facilitate uric acid excretion, prevent uric acid kidney stones and slow down the development of the disease. Patients should drink 2000~3000ml of water every day, but patients with renal insufficiency and heart failure should drink according to the previous day’s urine volume. In order to prevent nocturnal urine concentration, patients should also be hydrated at night and can drink an appropriate amount of soda water to alkalize urine, and it is recommended that patients take a hot bath once a day to help promote uric acid excretion in the body.  Prohibit alcohol and use less stimulating drinks or condiments: ethanol in alcohol can cause lactic acid to accumulate in the body, and lactic acid has a competitive inhibitory effect on uric acid excretion, which increases blood uric acid and triggers gout attacks. Alcoholism and hunger are often triggers for acute gout attacks, so alcohol consumption should be strictly limited and beverages such as strong coffee and tea should be avoided, and even condiments and spices should not be consumed.  The following provides a recipe suggested by experts for patients with gout and hyperuricemia.  1. Do not consume the following foods: liver, kidney, sardines, pancreas, brain, gravy, chicken juice.  2.Do not use more than 1 time per week: beef, lean pork, duck, goose, wild duck, sausage, bacon, veal tongue, lentils.  3.No more than 4 times a week: chicken, crab, mackerel, white fish, lamb, broth, chicken soup, cereal, cauliflower, spinach, peas, broad beans, soybeans and their products, fresh mushrooms, stomach, coarse grains.  4.You can choose freely without or with very little purine: fruit juice, light tea, white rice, bread, cookies, eggs, fruits, milk and its products, radish, string beans, cucumber, potatoes, tomatoes, cabbage, beets, oyster shoot, green vegetables, sweet potatoes, white flour, etc.  5, In addition, please keep drinking 2500~3000ml of water every day, and at the same time, take baking soda tablets (SB ) 0. 5g/tablet every morning, lunch and dinner, 1 or 2 tablets to maintain the blood pH (acidity/alkalinity) as weak alkaline, which is extremely beneficial to the prevention and treatment of gout.