Gout is a disease associated with deficient 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, the formation of tofuses (foci of compaction) in the legs and earlobes. Therapy in the active period is medication, with the use of anti-inflammatories.
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 objective of dietary nutrition in patients with gout is to reduce the concentration of uric acid complexes in the blood plasma. The products the patient consumes must be selected so that none contains more than 150 mg of purines per 100 g of weight. The patient is shown in table 6.
The therapeutic diet is more effective if the following principles are observed:
- Strict compliance with 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, it helps to prevent salt deposition.
- The dietary approach, taking into account the frequency of attacks, the level of uric acid, the severity of the process. Outside of exacerbation, the diet should contain a reduced amount of protein, fat, sodium salts. Alcohol must be completely eliminated. In the active period, strict restrictions are shown: the food is economical, mainly liquid.
- Weight correction. For obese people, the products are selected so that the total caloric 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.
- No more than 200 mg of purine bases per day. The figure shown is critical for the patient. A large amount of uric acid compounds do not allow you to keep your level in the body within acceptable limits.
In addition to the above, compliance with the drinking regime is mandatory. If there are no contraindications for the cardiovascular system, the patient should consume about 2–2, 5 liters of fluid per day. Hydrocarbon mineral waters are recommended. This promotes the alkalinization of the internal environment, reducing acidity.
Nutrition during exacerbation
In the stage of increased uric acid content in the blood and recurrence of pathology, dietary restrictions are more significant. The total daily amount of protein must be kept within 70 g, fats - 80 g, carbohydrates - 240 G. The caloric content of the diet is 1950-2000 kcal. Diet - four times a day, in between, you should drink fluids. Food temperature is normal, 55–60 ° C for hot dishes and 15 ° C for cold dishes. There is no need for targeted thermal protection. It is best if the consistency of the food is liquid or pasty.
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, the person should not eat foods that are acceptable in the remission stage. It is necessary to refuse solid dishes, sweets, meat and fish in any form, eggs, sweets, spices, oils. The need for animal proteins is met exclusively by dairy substances. Restrictions must be observed throughout the attack. On average, this takes 5 to 7 days. After the inflammatory process in the legs slows down, they gradually return to their normal diet. The crossing takes 2 to 3 days.
Nutrition in remission
Adherence to a gout diet is necessary, even in the absence of severe 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. Its concentration can reach 1000 mg per 100 g, which is many times higher than the permitted values. In addition, extracts of meat, mackerel, sardines, the interior of cattle (liver, kidneys, brains), alcoholic beverages are categorically contraindicated.
Table 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 3, 200 kcal. The volume of fluid is 1, 5–2 liters, if that does not contradict the treatment of other illnesses that a person has.
The list of what a patient can do includes:
- kefir;
- fresh cabbage soup;
- buckwheat porridge; omelet
- ;
- rye bread;
- fruit jelly;
- vegetable oil;
- lemon or orange; mashed potatoes;
- fish soufflé; cereals
- ;
- eggs; cheese
- ;
- dietary meat in an amount not exceeding 120 g per day.
The level of purine bases is lower in products such as cereals, vegetables, honey, nuts and tomatoes. They can be consumed virtually without restrictions. Pork fat, beans, spinach, sorrel, mushrooms contain 50 to 150 mg of the substance, which must be considered in the elaboration of the menu.
For weight loss
Weight loss is recommended for patients with hyper-stenic and normostenic physique. The caloric 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 a pound a month. This will ensure an acceptable level of ketone body formation. With a marked lack of nutritional value of the products, their synthesis exceeds the permitted limits. A low calorie diet excludes or significantly limits the consumption of baked goods.
Prohibited foods: bread, pies, pizza, cakes, cheesecakes, pasties, sugar, sweets, sweet jams, preserves and so on.
The table must be based on the components:
- low-fat cottage cheese;
- kefir;
- vegetables;
- fruits.
Weight control is not limited to low calorie meals. The patient must lead an active lifestyle, practice physical education according to a program developed individually. Otherwise, dietary restrictions will be very strict, which will reduce the person's adherence to therapy.
Sample menu for a week
Gout patients should know exactly what is not and what is acceptable to eat. It is best for the person to clearly describe their diet over a relatively long period of time. Usually meals are developed 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 a high level of uric acid, the weekly diet can look like this.
Monday
- Breakfast # 1: casserole, coffee with milk.
- Breakfast # 2: baked apple.
- Lunch: vegetable soup, bread, rosehip broth.
- Afternoon snack: fruit jam.
- Dinner: cabbage rolls, kefir.
Tuesday
- Breakfast # 1: cheese, tea, bread.
- Breakfast # 2: orange.
- Lunch: thin cabbage soup, bread, herbs.
- Afternoon snack: buckwheat porridge.
- Dinner: kefir, carrot puree.
Wednesday
- Breakfast # 1: egg, fruit juice.
- Breakfast # 2: jam, mineral water.
- Lunch: vegetable borsch, rye bread, tea.
- Afternoon snack: milk jam.
- Dinner: dried fruit, jam.
Thursday
- Breakfast # 1: cucumber salad, rose hips.
- Breakfast # 2: orange pomace.
- Lunch: potato soup, fruit juice.
- Afternoon snack: pear.
- Dinner: scrambled eggs, dried apricots, lemon tea.
Friday
- Breakfast # 1: boiled beets, blueberry juice.
- Breakfast # 2: kefir.
- Lunch: barley soup, tea.
- Afternoon snack: milk, bread.
- Dinner: carrot chops.
Saturday
- Breakfast # 1: rice porridge, coffee.
- Breakfast # 2: watermelon.
- Lunch: soup, milk gelatin.
- Afternoon snack: fresh cucumber.
- Dinner: kefir, bread.
Sunday
- Breakfast # 1: boiled egg with sour cream and tea.
- Breakfast # 2: grapes.
- Lunch: cabbage chops, barley soup, juice.
- Afternoon snack: casserole.
- Dinner: pancakes, yogurt.
The diet provided is not complete. Any component of the list of what the patient is allowed can be added to it.
Care should be taken to ensure that the total caloric content of meals and the content of purine bases in them do not exceed the established limits.
Cooking methods
Dishes can be steamed or baked. This approach allows you to guarantee the ideal taste of the product, while maintaining its useful properties. Foods processed in this way assume a mild regimen for patients with a concomitant diagnosis of a gastroenterological profile. Cooking is acceptable, but if meat or fish are cooked this way, the broth will drain. The fact is that, in the processing process, about 50% of the purines contained in the animal muscle fibers are transferred to it.
Proper nutrition is one of the main components of treating gout in the legs. A person who does not fulfill the necessary conditions for the elaboration of a diet is much more likely to suffer relapses of the disease, even with pharmacological therapy properly selected. The 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 about what is not and what should be eaten from his attending physician. Therefore, at the first signs of pathology, you should seek help from a specialist who will competently select the diet and prescribe treatment.