Gout is a disease associated with an altered exchange of purine bases. It leads to the deposition of uric acid salts in the joints and internal organs.
The main symptom is recurrent attacks of acute arthritis, formation of tofus (compaction foci) on the legs, earlobes. Therapy in the active period is drug therapy, with the use of anti-inflammatory drugs.
In order to accelerate the onset of remission and increase its duration, the patient is recommended to adhere to certain principles of nutritional therapy. A properly selected diet for gout can significantly improve the patient's quality of life, reduce the number of attacks of the disease, and reduce the risk of irreversible damage to the kidneys, central nervous system and musculoskeletal system.
Goals and principles of diet correction
The main goal of dietary nutrition in patients with gout is to reduce the concentration of uric acid complexes in the blood plasma. The products that the patient consumes must be selected so that none of them contain more than 150 mg of purines per 100 g of weight. The patient is shown in table 6.
The diet is most effective if the following principles are followed:
- Strict adherence to the rules until irreversible changes occur. It is impossible to remove already formed conglomerates in the joints and kidneys using gastronomic restrictions. The selected menu has a preventive purpose, it helps to prevent the deposition of salt.
- The dietary approach, taking into account the frequency of seizures, the level of uric acid, the severity of the process. Outside of the exacerbation, the diet should contain a reduced amount of protein, fat and sodium salts. Alcohol should be completely eliminated. In the active period, severe restrictions are shown: food is sparing, mostly liquid.
- Weight correction. For obese people, products are selected so that the total calorie content is below the energy consumption level of 300-500 kcal per day. The patient's lifestyle and daily physical activity level must be considered.
- Not more than 200 mg of purine bases per day. The figure shown is essential for the patient. A large amount of uric acid compounds does not allow to keep their level in the body within acceptable limits.
In addition to the above, compliance with the alcohol consumption regime is required. If there are no contraindications from the cardiovascular system, the patient should consume approximately 2–2, 5 liters of fluid per day. Hydrocarbonated mineral waters are recommended. This favors the alkalinization of the internal environment, reducing acidity.
Nutrition during exacerbation
In the phase of increased blood uric acid content and relapse of the disease, dietary restrictions are more significant. The total daily amount of protein must be kept within 70 g, fat - 80 g, carbohydrate - 240 g. The calorie content of the diet is 1950-2000 kcal. Diet: Four times a day, in the middle, you should drink liquids. The food temperature is normal, 55–60 ° C for hot dishes and 15 ° C for cold ones. There is no need for targeted heat savings. It is best if the consistency of the food is liquid or pasty.
We recommend the following foods:
- milk;
- lactic acid drinks;
- vegetable juices;
- citrus-based juices;
- liquid cereals;
- grated fruit;
- fish caviar;
- tomato sauce.
In the presence of clinical manifestations of the disease, a person should not eat acceptable foods in the phase of remission. It is necessary to refuse solid dishes, pastries, meat and fish in any form, eggs, sweets, spices, oils. The need for animal proteins is met exclusively by the milk substances. Restrictions must be observed throughout the attack. On average, this takes 5-7 days. After the inflammatory process on the legs subsides, they gradually return to the usual diet. The crossing lasts 2-3 days.
Nutrition in remission
Compliance with a gout diet is necessary even in the absence of vivid symptoms. The restrictions in this case are not as severe as during exacerbations. However, they must be strictly observed. The fundamental requirement is the complete elimination of the meat of young animals, which contains the maximum amount of purines. Their concentration can reach 1000 mg per 100 g, which is several times higher than the permissible values. In addition, meat extracts, mackerel, sardines, bovine offal (liver, kidney, brain), alcoholic beverages are categorically contraindicated.
Table number 6 implies the consumption of 100g of protein and fat, 450g of carbohydrates per day. The total nutritional value of the daily menu is 3200 kcal. The volume of the fluid is 1. 5-2 liters, if this does not contradict the treatment of other diseases that a person has.
The list of what a patient can do includes:
- kefir;
- fresh cabbage soup;
- buckwheat porridge;
- omelette;
- rye bread;
- fruit jam;
- vegetable oil;
- lemon or orange;
- mashed potatoes;
- fish soufflé;
- cereals;
- eggs;
- cheese;
- diet meat in an amount not exceeding 120 g per day.
The level of purine bases is lowest in foods such as cereals, vegetables, honey, nuts and tomatoes. They can be eaten practically without restrictions. Pork fat, beans, spinach, sorrel, mushrooms contain from 50 to 150 mg of the substance, which should be taken into account when compiling the menu.
For weight loss
Weight loss is recommended for patients with hypersthenic and normostenic physique. The calorie content of the diet should be reduced to 30 calories per kilogram of weight. It is important that weight loss occurs gradually, no more than one kilogram per month. This will ensure an acceptable level of ketone body training. With a pronounced lack of nutritional value of products, their synthesis exceeds the permissible limits. A low-calorie diet excludes or significantly limits the consumption of baked goods.
Forbidden foods: bread, cakes, pizza, pies, cheesecakes, pastries, sugar, sweets, sweet jams, preserves and so on.
The table should be based on the components:
- low-fat cottage cheese;
- kefir;
- vegetables;
- fruits.
Weight management is not limited to low calorie meals. The patient must lead an active lifestyle, engage in physical education according to an individually developed program. Otherwise, the dietary restrictions will be too strict, which will reduce the person's adherence to therapy.
Sample menu for one week
Patients with gout should know exactly what is not and what is acceptable to eat. It is best if a person clearly describes his diet over a relatively long period of time. Meals are usually developed for a week. The existing scheme can be used for several months, after which the set of dishes is completely changed or mixed every day. With an increase in the level of uric acid, the weekly diet can be similar to this /.
Monday
- Breakfast n. 1: saucepan, coffee with milk.
- Breakfast n. 2: baked apple.
- Lunch: vegetable soup, bread, rosehip broth.
- Afternoon snack: fruit jelly.
- Dinner: cabbage rolls, kefir.
Tuesday
- Breakfast n. 1: cheese, tea, bread.
- Breakfast n. 2: orange.
- Lunch: lean cabbage soup, bread, herbs.
- Afternoon snack: Buckwheat porridge.
- Dinner: kefir, carrot puree.
Wednesday
- Breakfast n. 1: eggs, fruit juice.
- Breakfast n. 2: jam, mineral water.
- Lunch: vegetable borsch, rye bread, tea.
- Afternoon snack: milk jelly.
- Dinner: dried fruit, jam.
Thursday
- Breakfast n. 1: cucumber salad, rose hips.
- Breakfast n. 2: orange pomace.
- Lunch: potato soup, fruit drink.
- Afternoon snack: pear.
- Dinner: scrambled eggs, dried apricots, lemon tea.
Friday
- Breakfast n. 1: boiled beets, cranberry juice.
- Breakfast n. 2: kefir.
- Lunch: pearl barley soup, tea.
- Afternoon snack: milk, bread.
- Dinner: carrot cutlets.
Saturday
- Breakfast n. 1: rice porridge, coffee.
- Breakfast n. 2: watermelon.
- Lunch: soup, milk jelly.
- Afternoon snack: fresh cucumber.
- Dinner: kefir, bread.
Sunday
- Breakfast n. 1: soft-boiled egg with sour cream and tea.
- Breakfast n. 2: grapes.
- Lunch: cabbage cutlets, barley soup, fruit juice.
- Afternoon snack: casserole.
- Dinner: pancakes, yogurt.
The diet given is not complete. You can add any component from the list of what is allowed to the patient.
Care must be taken to ensure that the total calorie content of meals and the content of purine bases in them does not go beyond the established limits.
Cooking methods
The dishes can be steamed or baked. This approach allows you to ensure the optimal taste of the product, while maintaining its useful properties. The processed food requires a delicate regimen for patients with concomitant gastroenterological diagnoses. Cooking is acceptable, but if the meat or fish is cooked this way, the broth is drained. The fact is that about 50% of the purines contained in animal muscle fibers are transferred in the processing process.
Proper nutrition is one of the main components of the treatment of gout of the legs. A person who does not meet the conditions necessary to work out a diet is much more likely to suffer from relapses of the disease, even with properly selected drug therapy. Refusal of proper nutrition during an exacerbation contributes to an increase in symptoms and an increase in the time required for recovery. The patient receives detailed information on what not to and what should be eaten from his doctor. Therefore, at the first signs of pathology, you should seek the help of a specialized specialist who will competently select a diet and prescribe treatment.