NUTRITIONAL MANAGEMENT IN GOUT (Modern Approach)
Diet plays a vital role in the management of gout. Clinical studies suggest that proper nutritional therapy is useful in gout. Since different nutrients affect this condition in different ways, following dietary guidelines will help you in deciding the right foods for this specific metabolic disorder.
Principles of dietary management
Obese person may be more prone to gout as this will insert more pressure on the weight-bearing joints. To avoid this, one should consume only so many calories as is required by the body. Try to change your heavy meal into a healthy one by incorporating plenty of fresh fruits and vegetables in your regular meals. If you are obese, try to reduce the weight gradually. Do not try fasting or crash dieting as these practices can precipitate attacks of gout.
Proteins and purines
Gout is a purine metabolism disorder. Purines are nitrogenous bases that are an integral part of the genetic material (D.N.A. and R.N.A.- found in the nucleus of cells). When these purine compounds disintegrate they raise the level of uric acid. Since the level of uric acid increases with increased dietary purines, purine intake of gouty arthritis patients should be restricted. Moderate amount of protein i.e. about .7-1 gm /kg body weight is recommended.
The following table shows the purine content of various food products. You may take the help of this list to choose the food products you like:
Restricted fat intake is advised in this situation. Ingestion of fats /oils causes retention of urate crystals in the body and can lead to further obesity. As mentioned above obesity worsens the situation by exerting more pressure on the weight bearing joints.
Gout patients should take large amounts of carbohydrates. Carbohydrates have an unique protein-sparing effect which reduces the endogenous (internal) protein breakdown.
Liberal fluid intake is beneficial, as it helps in the excretion of uric acid. This reduces the chances of formation of renal calculi. A recommended quantity of at least 3 L/day of fluids should be taken. Tea and coffee can be taken in restricted amounts as they contain methyl purines, which in turn can not be converted into purines.
Alcohol and alcoholic beverages should be completely avoided. They not only enhance uric acid production but also hamper the secretion of uric acid.