Diet for gout: what to eat to avoid exacerbations

Gout is a disease associated with impaired exchange of purine bases. Leads to the deposition of uric acid salts in the joints and internal organs.

The main symptom is recurrent attacks of acute arthritis, the formation of tofuses (foci of compaction) on the legs and earlobes. Therapy in the active period is medication, 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 should be selected so that none of them contains more than 150 mg of purines per 100 g of weight. The patient is shown table 6.

The diet is most effective if the following principles are followed:

1. Strict adherence to 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, helps to prevent salt deposition.
2. The dietary approach, taking into account the frequency of crises, the level of uric acid, the severity of the process. Outside of exacerbation, the diet should contain a reduced amount of proteins, fats, sodium salts. Alcohol should be completely eliminated. In the active period, strict restrictions are shown: the food is sparing, mostly liquid.
3. Weight correction. For obese people, products are selected so that the total calorie content is below the level of energy consumption by 300-500 kcal per day. The patient's lifestyle and level of daily physical activity should be considered.
4. Not more than 200 mg of purine bases per day. The indicated figure is critical for the patient. A large amount of uric acid compounds does not allow maintaining their level in the body within acceptable limits.

In addition to the above, compliance with the drinking regime is required. If there are no contraindications from the cardiovascular system, the patient should consume about 2–2. 5 liters of fluid per day. Hydrocarbonate mineral waters are recommended. This promotes alkalization of the internal environment, reducing acidity.

Nutrition during exacerbation

At the stage of increased uric acid content in the blood and recurrence of pathology, dietary restrictions are most significant. The total daily amount of proteins should be kept within 70 g, fats - 80 g, carbohydrates - 240 g. The calorie content of the diet is 1950–2000 kcal. Diet - four times a day, in between, you should drink liquid. The food temperature is normal, 55–60 ° C for hot dishes and 15 ° C for cold ones. There is no need for targeted thermal sparing. It is better if the consistency of the food is liquid or mushy.

The following foods are recommended:

• milk;
• lactic acid drinks;
• vegetable juices;
• citrus-based juices;
• liquid cereals;
• grated fruits;
• fish caviar;
• tomato sauce.

In the presence of clinical manifestations of the disease, a person should not eat foods that are acceptable at the stage of remission. It is necessary to refuse solid dishes, pastries, meat and fish in any form, eggs, sweets, spices, oils. The requirement for animal proteins is met exclusively by milk substances. Restrictions must be observed throughout the duration of 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 takes 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 meat from young animals, which contains the maximum amount of purines. Their concentration can reach 1000 mg per 100 g, which is many times higher than the permissible values. Also, meat extracts, mackerel, sardines, the insides of cattle (liver, kidneys, brains), alcoholic beverages are categorically contraindicated.

Table number 6 implies the consumption of 100 g of proteins and fats, 450 g of carbohydrates per day. The total nutritional value of the daily menu is 3200 kcal. The volume of 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 cabbage soup;
• buckwheat porridge;
• omelet;
• rye bread;
• fruit jam;
• vegetable oil;
• lemon or orange;
• mashed potatoes;
• fish soufflé;
• cereals;
• eggs;
• cheese;
• dietary meat in an amount of not more than 120 g per day.

The level of purine bases is lowest in products such as cereals, vegetables, honey, nuts, and tomatoes. They can be eaten with virtually no restrictions. Pork fat, beans, spinach, sorrel, mushrooms contain from 50 to 150 mg of the substance, which should be taken into account when drawing up the menu.

For weight loss

Weight loss is recommended for patients with hypersthenic and normosthenic physique. The calorie content of the diet must 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 formation. 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.

Prohibited foods: bread, pies, pizza, cakes, cheesecakes, pastries, sugar, candy, sweet jam, 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, exercise according to an individually developed program. Otherwise, dietary restrictions will be too strict, which will reduce the person's adherence to the therapy.

Sample menu for a week

Patients with gout should know exactly what is not and what is acceptable to eat. It is better if a person clearly describes his diet for a relatively long period of time. Usually meals are developed for one week. The existing scheme can be used for several months, after which the set of dishes is completely changed or stirred every day. With an elevated level of uric acid, the weekly diet may look like this /.

Monday

• Breakfast # 1: casserole, coffee with milk.
• Breakfast # 2: baked apple.
• Lunch: vegetable soup, bread, rosehip broth.
• Afternoon snack: fruit jelly.
• Dinner: cabbage rolls, kefir.

Tuesday

• Breakfast # 1: cheese, tea, bread.
• Breakfast # 2: orange.
• Lunch: lean cabbage soup, bread, herbs.
• Afternoon snack: buckwheat porridge.
• Dinner: kefir, carrot puree.

Wednesday

• Breakfast # 1: egg, fruit juice.
• Breakfast # 2: marmalade, mineral water.
• Lunch: vegetable borscht, rye bread, tea.
• Afternoon snack: milk jelly.
• Dinner: dried fruits, jam.

Thursday

• Breakfast # 1: cucumber salad, rose hips.
• Breakfast # 2: orange pomace.
• Lunch: potato soup, fruit drink.
• Afternoon snack: pear.
• Dinner: scrambled eggs, dried apricots, lemon tea.

Friday

• Breakfast # 1: boiled beets, blueberry juice.
• Breakfast # 2: kefir.
• Lunch: pearl barley soup, tea.
• Afternoon snack: milk, bread.
• Dinner: carrot cutlets.

Saturday

• Breakfast # 1: rice porridge, coffee.
• Breakfast # 2: watermelon.
• Lunch: soup, milk jelly.
• Afternoon snack: fresh cucumber.
• Dinner: kefir, bread.

Sunday

• Breakfast # 1: soft-boiled egg with sour cream and tea.
• Breakfast # 2: grapes.
• Lunch: cabbage cutlets, barley soup, juice.
• Afternoon snack: casserole.
• Dinner: pancakes, yogurt.

The given diet is not complete. Any components from the list of what is allowed to the patient can be added to it.

Care should 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

Dishes can be steamed or baked. This approach allows you to ensure the optimal taste of the product, while maintaining its useful properties. Food processed in this way assumes a gentle regimen for patients with concomitant diagnoses of a gastroenterological profile. Cooking is acceptable, but if meat or fish is cooked in this way, the broth is drained. The fact is that during processing, about 50% of the purines contained in animal muscle fibers are transferred to it.

Proper nutrition is one of the main components of treatment for gout on the legs. A person who does not comply with the necessary conditions for drawing up a diet is much more likely to suffer from relapses of the disease, even with adequately selected pharmacological 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 and what should be eaten from his attending physician. Therefore, at the first signs of pathology, you should seek help from a specialized specialist who will competently select a diet and prescribe treatment.