Gout is a disease that is associated with an 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 and earlobes. Therapy in the active phase is drug treatment with anti-inflammatory drugs.
In order to accelerate the onset of remission and extend its duration, the patient is recommended to adhere to certain principles of nutritional therapy. 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 contain more than 150 mg of purines per 100 g of weight. Table 6 is shown to the patient.
The diet is most effective when the following principles are followed:
- Strict adherence to rules until irreversible changes occur. It is impossible to remove already formed conglomerates in the joints and kidneys with the use of gastronomic restrictions. The selected menu has a preventive purpose and helps prevent salt build-up.
- The nutritional approach, taking into account the frequency of crises, uric acid levels and the severity of the process. Outside of the exacerbation, the diet should contain a reduced amount of proteins, fats and sodium salts. Alcohol should be completely eliminated. During the active period, strict restrictions are shown: the food is economical, mostly liquid.
- Weight correction. For overweight people, products are selected so that the total calorie content is 300-500 kcal per day below the energy consumption. The patient's lifestyle and daily physical activity should be taken into account.
- Not more than 200 mg purine bases per day. The number given is critical for the patient. A large amount of uric acid compounds does not allow their level in the body to be kept within acceptable limits.
In addition, compliance with the drinking regime is required. If the cardiovascular system has no contraindications, the patient should drink about 2 to 2. 5 liters of fluid daily. Hydrocarbonate mineral water is recommended. This promotes the alkalization of the internal environment and reduces the acidity.
Diet during the exacerbation
At the stage of increased uric acid content in the blood and a recurrence of the 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, you should drink fluids in between. The food temperature is normal, 55–60 ° C for hot dishes and 15 ° C for cold ones. Targeted thermal protection is not required. It is better if the consistency of the food is runny or mushy.
The following foods are recommended:
- milk;
- lactic acid drinks;
- vegetable juices;
- citrus-based juices;
- liquid grain;
- 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 of any kind, eggs, sweets, spices, oils. The need for animal proteins is covered 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.
Diet in remission
Adherence to a gout diet is necessary even without serious symptoms. The restrictions in this case are not as severe as in exacerbations. However, they must be strictly observed. The basic requirement is the complete elimination of meat from young animals that contains the maximum amount of purines. Their concentration can reach 1000 mg per 100 g, which is many times higher than the permissible values. Meat extracts, mackerel, sardines, the insides of cattle (liver, kidneys, brain) and alcoholic beverages are also categorically contraindicated.
Table 6 implies the consumption of 100 g proteins and fats, 450 g 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 from which a person suffers.
A patient's list of options includes:
- kefir;
- fresh cabbage soup;
- buckwheat porridge;
- omelette;
- rye bread;
- fruit jam;
- vegetable oil;
- lemon or orange;
- mashed potatoes;
- fish soufflé;
- grain;
- eggs;
- cheese;
- Food meat in an amount not exceeding 120 g per day.
The content of purine bases is lowest in products such as grain, vegetables, honey, nuts and tomatoes. They can be eaten with practically no restrictions. Pork fat, beans, spinach, sorrel and mushrooms contain 50-150 mg of the substance, which should be taken into account when creating the menu.
For weight reduction
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 the weight loss is gradual, no more than a kilogram per month. This ensures an acceptable level of ketone body formation. With a pronounced lack of 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, cakes, pizza, cakes, cheesecakes, pastries, sugar, sweets, sweet jams, jams, etc.
The table should be based on the following components:
- low-fat cottage cheese;
- kefir;
- vegetables;
- fruits.
Weight management is not limited to low-calorie meals. The patient should lead an active lifestyle and exercise according to an individually developed program. Otherwise, the dietary restrictions will be too strict, reducing the person's compliance with therapy.
Sample menu for a week
Patients with gout should know exactly what is not and what is acceptable to eat. It is better for a person to clearly describe their diet over a relatively long period of time. Usually the meals are developed for a week. The existing scheme can be used for several months. After that, the crockery set is completely changed or stirred every day. With an elevated uric acid level, the weekly diet can look like this.
Monday
- Breakfast No. 1: casserole, coffee with milk.
- Breakfast No. 2: Baked apple.
- Lunch: vegetable soup, bread, rosehip broth.
- Afternoon snack: fruit jelly.
- Dinner: cabbage rolls, kefir.
Tuesday
- Breakfast No. 1: cheese, tea, bread.
- Breakfast No. 2: orange.
- Lunch: lean cabbage soup, bread, herbs.
- Afternoon snack: buckwheat porridge.
- Dinner: kefir, carrot puree.
Wednesday
- Breakfast No. 1: egg, fruit juice.
- Breakfast No. 2: jam, mineral water.
- Lunch: vegetable borscht, rye bread, tea.
- Afternoon snack: milk jelly.
- Dinner: dried fruits, jam.
Thursday
- Breakfast No. 1: cucumber salad, rose hips.
- Breakfast No. 2: orange pomace.
- Lunch: potato soup, fruit drink.
- Afternoon snack: pear.
- Dinner: scrambled eggs, dried apricots, tea with lemon.
Friday
- Breakfast No. 1: boiled beets, blueberry juice.
- Breakfast No. 2: Kefir.
- Lunch: pearl barley soup, tea.
- Afternoon snack: milk, bread.
- Dinner: carrot cutlets.
Saturday
- Breakfast No. 1: rice porridge, coffee.
- Breakfast No. 2: watermelon.
- Lunch: soup, milk jelly.
- Afternoon snack: fresh cucumber.
- Dinner: kefir, bread.
Sunday
- Breakfast No. 1: soft-boiled egg with sour cream and tea.
- Breakfast No. 2: grapes.
- Lunch: cabbage cutlets, barley soup, juice.
- Afternoon snack: casserole.
- Dinner: pancakes, yogurt.
The specified diet is not complete. All components from the list of items allowed for the patient can be added.
Care should be taken to ensure that the total calorie content of meals and the content of purine bases in them do not exceed the established limit values.
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 processed this way require a gentle regimen for patients who are concurrently diagnosed with a gastroenterological profile. Cooking is acceptable, but if meat or fish is cooked this way, the broth will drain. 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 treating gout on the legs. A person who does not meet the necessary conditions for creating a diet is much more likely to suffer from relapses of the disease, even with a sufficiently selected pharmacological therapy. Refusal to eat 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 from the attending physician about what not and what should be eaten. Therefore, at the first signs of pathology, you should seek help from a specialized specialist who will competently choose a diet and prescribe treatment.