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Low-protein diet plan for people suffering from gout

Monitoring your protein intake will go a long way in helping you find relief from gout.

Gout is a clinical condition in which uric acid crystals get deposited in the joints, thus leading to pain, inflammation, joint stiffness, swelling and redness. Dietary management of gout includes reduction of high uric acid levels in the blood and increased excretion of uric acid via urine.

The relation between dietary protein and gout

The precursor of gout is high uric acid level. People with gout have to be very careful about their food intake because food has a direct relationship with blood uric acid levels. Furthermore, such individuals are also advised to avoid the intake of purine-rich foods [1]. This is because in the human body, purine is broken down to uric acid. A diet high in purine will, in turn, increase the level of uric acid in the blood. Therefore, restriction of purine rich foods is the basic and the most important step in the management of gout.

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Non-vegetarian foods

Animal protein (non-vegetarian foods) are rich in purine. Therefore, people with gout should strictly restrict their intake of non-vegetarian foods Rich sources of animal protein include:

  • Poultry
  • Meat
  • Seafood

Various clinical studies [2] have revealed that intake of seafood and meat increases blood uric acid levels. On the other hand, protein coming from dairy products such as milk and curd help in reducing high blood uric acid levels. Among all the non-vegetarian foods; fish, shellfish, red meat and organ meat are major sources of uric acid whereas, chicken is a moderate source of uric acid. Therefore, except chicken all other animal proteins should be out of the food list for those with gout whereas, 1-2 medium pieces of lean meat such as chicken can be consumed once in ten days.

Vegetarian foods

As compared to non-vegetarian foods, vegetarian foods are not a great source of protein. Intake of dairy products such as milk, curd, buttermilk and lassi (without sugar) reduces the level of blood uric acid. Casein and lactalbumin are the two proteins present in milk that lowers the level of blood uric acid by increasing its excretion. Though milk contains protein, it is a poor source of purine. Thus, complete elimination of dairy products is not needed. Other vegetarian sources of protein such as soy and dals can also be consumed safely. In addition to non-vegetarian foods, some whole pulses are also a rich source of purine [3]. Such pulses include:

  • Whole moong
  • Chana
  • Tur
  • Matki
  • Kulthi

Other foods to limit

  • Soft drinks/ Cold drinks
  • Sugar-sweetened beverages- juices, sherbet, fruit squash.
  • Bread, biscuits, rusk, toasts (products made out maida)
  • Beer
  • Wine
  • Soda
  • Unhealthy fat coming from red meat and high-fat dairy products.
  • Purine-rich vegetables such as green peas, mushrooms, cauliflower and spinach

Healthy Foods Recommended

  • Vitamin C rich foods such as- kiwi, grapefruit, berries, tomatoes and citrus fruits. Vitamin C increases the excretion of uric acid via urine and thus, reduces the level of uric acid in the blood.
  • Cherries- Cherries are rich in anthocyanins; a healthy compound that is rich in anti-oxidants. These antioxidants reduce inflammation and severity of pain.
  • Whole grains: Wheat, broken wheat, wheat flour, barley and brown rice.
  • Low-fat dairy products.
  • Green tea
  • Low purine vegetables such as: aubergine, beetroot, cabbage, carrot, cucumber, kale and lettuce.
  • To manage your condition better, learn about the foods you can eat and should avoid.

Diet Plan for Individuals with Gout

  • Breakfast: 1 bowl broken wheat or barley with low fat dairy milk/ 1 roti with 1 bowl thin dal.

Reason: Select high fibre products and replace buffalo milk (high-fat milk) with cow's milk (low fat milk)

  • Mid-morning: 1 low purine fruit and vitamin C rich fruit.

Reason: Low purine fruit produces less uric acid.

  • Lunch: 1 bowl salad (use low purine vegetables) + 1 roti/ 1 katori brown rice + 1 bowl split dal (thin consistency)/ 1 katori low fat paneer/ 1 katori chicken curry with 1 medium sized piece of chicken + 1 glass thin buttermilk

Reason: Weight loss is the main step in the management of gout. This is because people who are obese or overweight are at a higher risk. So start your meal with a lot of healthy salad and restrict the amount of carbohydrate intake.

  • Mid-evening: 1 cup green tea + 1 portion fibre-rich cereal grain

Reason: Do not select maida rich (low fibre) products.

  • Evening: 2 whole walnuts/ 4 almonds/ low purine vegetable soup

Reason: Almonds and walnuts are low in purines. Select home-made vegetable juice or soup over fruit juices and soft drinks.

  • Early dinner: 1 bowl salad (use low purine vegetables) + 1 roti/ 1 katori brown rice + 1 bowl split dal (thin consistency)/ 1 katori low fat paneer/ 1 katori chicken curry with 1 medium sized piece of chicken + 1 glass thin buttermilk.

References

1. Choi, H. K., Liu, S. and Curhan, G. (2005), Intake of purine-rich foods, protein, and dairy products and relationship to serum levels of uric acid: The Third National Health and Nutrition Examination Survey. Arthritis & Rheumatism, 52: 283 289. doi: 10.1002/art.20761

2. Hyon K. Choi, M.D., Dr.P.H., Karen Atkinson, M.D., M.P.H., Elizabeth W. Karlson, M.D., Walter Willett, M.D., Dr.P.H., and Gary Curhan, M.D., Sc.D. N Engl J Med 2004; 350:1093-1103

3. Teng GG, Pan A, Yuan JM, Koh WP. Arthritis Rheumatol. 2015 Jul;67(7):1933-42. doi: 10.1002/art.39115.

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