Gout is a disease associated with impaired purine metabolism. Causes 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 (compression foci) in the legs. In the active period, therapy is the use of anti-inflammatory drugs.
To accelerate the onset and prolong the remission, the patient is advised to follow certain principles of nutritional treatment. Properly selected diet for gout can significantly improve the patient's quality of life, reduce the number of disease attacks and reduce the risk of irreversible damage to the kidneys, central nervous system and musculoskeletal system.
Objectives and principles of dietary adjustment
The main purpose of diet in patients with gout is to reduce the concentration of uric acid complexes in the blood plasma. The products consumed by the patient should be selected so that none of them contains more than 150 mg of purine per 100 g of body weight. The patient is shown in Table 6.
Therapeutic diet is most effective if the following principles are followed:
- Strictly follow the rules until irreversible changes occur. It is not possible to remove conglomerates already formed in the joints and kidneys using gastronomic restrictions. The selected menu has a protective purpose, prevents salt deposition.
- Dietary approach, taking into account the frequency of crises, uric acid levels, the severity of the process. In addition to aggravation, the diet should contain small amounts of protein, fat and sodium. Alcohol should be completely eliminated. During the active period, there are serious restrictions: food is small, mostly liquid.
- Weight correction. Products for obese people are selected so that the total caloric intake is below 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.
- No more than 200 mg of purine base per day. This figure is critical for the patient. Large amounts of uric acid do not allow the body to maintain its levels 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 helps to alkalize the internal environment by reducing acidity.
Nutrition during exacerbation
Dietary restrictions are most important in the increase of uric acid in the blood and the recurrence of the pathology. The total daily amount of protein should be kept between 70 g, fats - 80 g, carbohydrates - 240 g. The caloric content of the diet is 1950-2000 kcal. Diet - four times a day, occasionally drinking fluids. The cooking temperature is normal, 55-60 ° C for hot dishes, 15 ° C for cold ones. There is no need for targeted heat savings. The consistency of the food is better if it is liquid or knotty.
The following foods are recommended:
- milk;
- lactic acid drinks;
- vegetable juices;
- citrus-based juices;
- liquid cereals;
- grated fruits;
- fish caviar;
- tomato sauce.
When there are clinical manifestations of the disease, a person should not eat foods that are acceptable in remission. It is necessary to give up solid foods, pastries, meat and fish in any form, eggs, sweets, spices, fat. The demand for animal protein is met only by dairy products. Restrictions must be observed during the attack. On average, it takes 5-7 days. After reducing the inflammatory process in the legs, they gradually return to a normal diet. The transition takes 2-3 days.
Nutrition in remission
Adherence to the gout diet is necessary even in the absence of vivid symptoms. In this case, the restrictions are not as severe as during the flare-up. But they must be strictly observed. The main requirement is the complete elimination of meat from young animals with the maximum amount of purine. Their concentration can reach 1000 mg per 100 g, which is many times higher than the allowable values. In addition, meat extract, mackerel, sardines, beef (liver, kidneys, brains), alcoholic beverages are completely contraindicated.
Table 6 provides for the consumption of 100 g of protein and fat and 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 it does not contradict the treatment of other diseases of a person.
The list of things a patient can do includes:
- kefir;
- fresh cabbage soup;
- buckwheat;
- omelet;
- rye bread;
- fruit jam;
- vegetable oil;
- lemon or orange;
- mashed potatoes;
- fish souffle;
- cereals;
- egg;
- cheese;
- Dietary meat not more than 120 grams per day.
Purine base levels are lowest in grains, vegetables, honey, nuts and tomatoes. They can be eaten with virtually no restrictions. Lard, beans, spinach, sorrel, mushrooms, contain between 50 and 150 mg of the substance to be considered when designing the menu.
To lose weight
Weight loss is recommended for patients with hypertensive and normostenic physique. The caloric content of the diet should be reduced to 30 calories per kilogram. It is important to lose weight gradually, not more than one kilogram per month. This will ensure an acceptable level of ketone body formation. Due to the lack of a clear nutritional value of the products, their synthesis exceeds the permissible limits. A low-calorie diet excludes or significantly limits the consumption of baked goods.
Prohibited foods: bread, pastries, pizza, cakes, cheesecakes, pastries, sugar, candy, sweet jam, canned food, etc.
The table should be based on components:
- low-fat cottage cheese;
- kefir;
- vegetables;
- fruits.
Weight is not limited to low-calorie foods. The patient should lead an active lifestyle and exercise according to an individually developed program. Otherwise, dietary restrictions will be very strict, which will reduce a person's commitment to therapy.
Sample menu for a week
Gout patients need to know exactly what is not and what is acceptable to eat. It is better for a person to clearly describe his diet for a relatively long time. Generally, meals are prepared within 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 uric acid, the weekly diet may look like this.
Monday
- Breakfast # 1: casserole, coffee with milk.
- Breakfast # 2: baked apples.
- Dinner: vegetable soup, bread, hip juice.
- Afternoon snack: fruit jelly.
- Meals: cabbage rolls, kefir.
Tuesday
- Breakfast # 1: cheese, tea, bread.
- Breakfast # 2: orange.
- Lunch: lean cabbage soup, bread, greens.
- Afternoon snack: buckwheat.
- Meals: kefir, carrot puree.
Wednesday
- Breakfast # 1: eggs, juice.
- Breakfast # 2: marmalade, mineral water.
- Dinner: vegetable borscht, rye bread, tea.
- Afternoon snack: milk jelly.
- Lunch: dried fruits, jam.
Thursday
- Breakfast # 1: cucumber salad, rose hips.
- Breakfast # 2: orange pomace.
- Dinner: potato soup, fruit drink.
- Afternoon snack: pear.
- Meals: scrambled eggs, prunes, lemon tea.
Friday
- Breakfast # 1: boiled beets, blueberry juice.
- Breakfast number 2: kefir.
- Lunch: pearl barley soup, tea.
- Afternoon snack: milk, bread.
- Lunch: carrot cutlets.
Saturday
- Breakfast # 1: rice porridge, coffee.
- Breakfast number 2: watermelon.
- Lunch: soup, milk jelly.
- Afternoon snack: fresh cucumber.
- Food: kefir, bread.
Market
- Breakfast # 1: soft-boiled egg with sour cream and tea.
- Breakfast number 2: grapes.
- Dinner: cabbage cutlets, barley soup, juice.
- Afternoon snack: casserole.
- Dinner: pancakes, yogurt.
The diet is not complete. Any component from the list of those allowed to the patient can be added.
Care should be taken to ensure that the total caloric content of foods and the content of purine bases in them do not exceed the specified limits.
Cooking methods
Meals can be steamed or cooked. This approach allows you to ensure the optimal taste of the product while maintaining its useful properties. Food processed in this way requires a gentle regimen for patients with a parallel diagnosis of gastroenterological profile. Cooking is allowed, but if meat or fish is cooked in this way, the water is drained. The fact is that during processing, about 50% of the purines in animal muscle fibers are transferred to it.
Proper nutrition is one of the main components of gout treatment in the legs. A person who does not follow the necessary conditions to formulate a diet, even with adequate pharmacological treatment, is more likely to suffer from relapses of the disease. Refusing to eat properly during an exacerbation can help increase symptoms and increase recovery time. The patient receives detailed information from the attending physician about what not to eat and what to eat. Therefore, at the first signs of pathology, you should seek the help of a specialist who will choose a competent diet and prescribe treatment.