Low purine diet
Low-Purine Diet
IntroductionWhy this diet?Foods to avoidBest betsResourcesBibliographyA low-purine diet is often prescribed for individuals with gout andLesch-Nyhan Syndrome (a rare genetic disorder that occurs in 1/100,000people). People with diabetic nephropathy need to restrict proteins, aregimen that includes, but is not limited to, the restrictions imposed by alow-purine diet.
Why do people follow this diet?In people who have gout, uric acid production in the body is increased whileits elimination is reduced. The excess uric acid builds up in thebloodstream, is deposited in the small joints or soft tissues, and causessymptoms that resemble arthritis. Purine is a compound that is mainly foundin animal protein and is metabolized to uric acid in the body. A high-purinediet, obesity, regular alcohol consumption, and diuretic therapy can allcontribute to elevated uric acid levels in individuals with gout.Preliminary research suggests that insulin resistance may also play a rolein the development of gout. A low-purine diet and medications-such asnon-steroidal anti-inflammatory drugs, corticosteroids, and allopurinol-arecommonly used to treat gout. An effective diet is important to avoid orreduce complications and lessen the expense of drug treatment. Restrictingcalorie intake and alcohol consumption, and losing weight (if overweight),can also reduce uric acid levels. It is also important to drink plenty offluids to increase uric acid excretion from the body. Alternative sources ofprotein should be included in a low-purine diet.
What do I need to avoid?To avoid purine ask about ingredients at restaurants and others’ homes, andread food labels. The following list is not complete. Consult with ahealthcare professional before making any significant changes to your diet.
The following foods have very high purine levels, and should be avoidedcompletely:
AnchoviesBouillonBrainsBrothConsommDried legumesGooseGravyHeartHerringKidneysLiverMackerelMeat extractsMincementMusselsPartridgeRoeSardinesScallopsShrimpSweetbreadsYeast (baker’s and brewer’s)Yeast extracts (e.g., Marmite, Vegemite)These foods have high purine levels
Fish (including shellfish)PoultryMeat (except those with very high purine content, noted above, or those withmoderately high purine levels, noted below)These foods have moderately high purine levels
AsparagusCauliflowerLegumesLentilsMushroomsOatmealPeas (dried)SoySpinachTripe
Best betsBeverages (carbonated)ButterCereals and cereal productsCheese (all kinds)Cocoa (however, caffeine is prohibited in Lesch-Nyhan Syndrome)CornCornbreadEggsFruit juicesFruitsGelatinIce creamMilkNoodlesNutsRefined wheat flourTapiocaVegetables (except those noted above)White bread and crackers (but not whole wheat, which is moderately high inpurines)White rice
Are there any groups or books?National Institute of Arthritis and Musculoskeletal and Skin Diseaseshttp://www.nih.gov/niams/
Arthritis Foundationhttp://www.arthritis.org
The Purine Metabolic Patient’s Associationhttp://www.pumpa.co.uk
BibliographyDessein PH, Shipton EA, Stanwix AE, et al. Beneficial effects of weight lossassociated with moderate calorie/carbohydrate restriction, and increasedproportional intake of protein and unsaturated fat on serum urate andlipoprotein levels in gout: a pilot study. Ann Rheum Dis. 2000;59:539-43.
Emmerson BT. The management of gout. N Engl J Med 1996;334:445-51.
Mahan LK, Escott-Stump S, eds. Krause’s Food, Nutrition and Diet Therapy.10th ed. Philadelphia, PA: W.B. Saunders Company; 2000.
http://www.marinurology.com/articles/calculi/foods/purines.htm
Wolfram G. [Diet therapy in gout]. Ther Umsch 1995;52:524-7.
Candelaria Halladay on September 27th, 2007
Such a diet can reduce urate level by up to 20%. It is unlikely torelieve gout or to significantly reduce the need for medication.
Following such a diet is not trivial and excludes “healthy” foods suchas oily fish and whole wheat.
Tim Modglin on September 28th, 2007
I don’t know if this is the right thread, but I’ve hadgout for about 7 years and I am 38. There have beentimes when I had a very difficult times just gettingout of bed because of swollen ankles and knees. Idon’t get gout very much anymore in these areas but Ihave recently had it in both wrist. Now what I doother than seeing the doctor for indomethcin, I drinkup to 2 liters of water a day and drink pure blackcherry juice. It works for me and I found that infohere on this thread.