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 tofus (foci of compaction) on the legs, earlobes. Therapy during 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. Correctly selected diet for gout can significantly improve the quality of life of the patient, reduce the number of attacks of the disease, reduce the risk of irreversible damage to the kidneys, central nervous system and musculoskeletal system.

Objectives and principles of nutritional correction

The main objective of dietetic 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 chosen so that none of them contains more than 150 mg of purines per 100 g of weight. The patient is shown in Table 6.

The therapeutic regimen is most effective if the following principles are observed:

1. Strict adherence to the rules until irreversible changes occur. It is impossible to remove conglomerates already formed in the joints and kidneys using gastronomic restrictions. The selected menu has a preventive purpose, helps to prevent salt deposit.
2. The dietary approach, taking into account the frequency of attacks, the level of uric acid, the severity of the process. Apart from the exacerbation, the diet should contain a reduced amount of protein, fat and sodium salts. Alcohol must be completely eliminated. In the active period, strict restrictions are displayed: the food is thrifty, mainly liquid.
3. Correction of the weight. For obese people, products are selected so that the total calorie content is less than the level of energy consumption of 300-500 kcal per day. The patient's lifestyle and level of daily physical activity should be taken into account.
4. No more than 200 mg of purine bases per day. The number indicated is critical for the patient. A large amount of uric acid compounds does not keep 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 to 2, 5 liters of fluid per day. Hydrocarbon mineral waters are recommended. This promotes alkalization of the internal environment, reducing acidity.

Nutrition during exacerbation

At the stage of increasing the content of uric acid in the blood and recurrence of the pathology, dietary restrictions are most important. The total daily amount of protein should 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 between, you need to drink liquid. The temperature of the food is normal, 55–60 ° C for hot dishes and 15 ° C for cold dishes. There is no need for targeted thermal savings. It is better if the consistency of the food is liquid or pasty.

The following foods are recommended:

• milk;
• lactic acid drinks;
• vegetable juice;
• citrus juice;
• 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 stage of remission. It is necessary to refuse solid dishes, pastries, meat and fish in any form, eggs, sweets, spices, oils. The animal protein requirements are satisfied exclusively by milk ingredients. Restrictions must be observed throughout the duration of the attack. On average, it takes 5-7 days. After the inflammatory process on the legs subsides, they gradually return to the usual diet. The crossing lasts 2 to 3 days.

Nutrition in remission

Adherence to a gout diet is necessary even in the absence of acute symptoms. Restrictions in this case are not as severe as in exacerbations. However, they must be strictly observed. A 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, extracts of meat, mackerel, sardines, the interior of cattle (liver, kidneys, 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 liquid is 1. 5-2 liters, if this does not contradict the treatment of other diseases of a person.

The list of what a patient can do includes:

• kefir;
• fresh 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 not exceeding 120 g per day.

The basic level of purine is lowest in products such as grains, vegetables, honey, nuts and tomatoes. They can be consumed without any restriction. Pork fat, beans, spinach, sorrel and mushrooms contain 50-150 mg of the substance, which should be taken into account when developing the menu.

To lose weight

Weight loss is recommended for patients with hypersthenic and normosthenic physique. The calorie content of the diet should be reduced to 30 calories per kilogram of weight. It is important that the weight loss be done gradually, not 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.

Forbidden foods: bread, pies, pizza, cakes, cheesecakes, pastries, sugar, candies, sweet jams, preserves, etc.

Table must be component based:

• low fat cottage cheese;
• kefir;
• vegetables;
• fruit.

Weight management isn't limited to low-calorie meals. The patient should lead an active life, engage in physical education according to an individually developed program. Otherwise, the dietary restrictions will be too strict, which will reduce a person's adherence to therapy.

Sample menu for a week

Patients with gout need to know exactly what is not and what is okay to eat. It is better if a person clearly describes their diet for a relatively long period of time. Usually meals are worked out for a 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 increase in uric acid levels, the weekly regimen may look like this /.

Monday

• Breakfast n ° 1: casserole dish, café au lait.
• 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, mashed carrots.

Wednesday

• Breakfast n ° 1: egg, fruit juice.
• Breakfast n ° 2: marmalade, mineral water.
• Lunch: vegetable borscht, rye bread, tea.
• Afternoon snack: milk jelly.
• Dinner: dried fruits, 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, blueberry 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 # 1: boiled egg with sour cream and tea.
• Breakfast n ° 2: grapes.
• Lunch: cabbage cutlets, barley soup, juice.
• Afternoon snack: casserole.
• Dinner: pancakes, yogurts.

The given scheme is not complete. All the components of the list of what is allowed to the patient can be added to it.

Care must be taken to ensure that the total calorie content of meals and the base content of purines do not exceed 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. Foods treated in this way assume a gentle diet for patients with concomitant diagnoses of a gastroenterologic profile. Cooking is acceptable, but if the meat or fish is cooked this way, the broth will drain. The fact is that during processing about 50% of the purines in animal muscle fibers are transferred to it.

Good nutrition is one of the main components in treating gout on the legs. A person who does not meet the conditions for developing a diet is much more likely to suffer from relapses of the disease, even with properly selected pharmacological therapy. Refusal of adequate 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 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.