Generality
The diet for hyperuricemia (or high uric acid) is a specific diet to combat excess uric acid in the blood which, if neglected, can give rise to gout.
What is uric acid?
Uric acid is a derivative of the metabolism of purines, nitrogen compounds that enter the structure of DNA.
Normally, uric acid is eliminated by renal filtration and, minimally, through digestive secretions.
The body of people with hyperuricemia and gout tends to accumulate far more purines and uric acid than normal.
What is hyperuricemia?
Hyperuricemia is an excess of uric acid in the blood, which is based on an inherited genetic predisposition.
This tendency favors metabolic decompensation, which can be aggravated in the presence of various behavioral factors (including diet).
When do we talk about hyperuricemia?
Hyperuricemic is considered to be the person who, after 5 days of hypopuric diet and without taking drugs that affect uricemia (vitamin C, vitamin PP, salicylic, diuretic), has uric acid values in the blood higher than:
- 7.0 mg / dl if man
- 6.5 mg / dl if female.
After 9 mg / dl the risk of gout becomes high and specific medications are administered (see drugs for the treatment of gout).
What is gout?
Definition of gout
Gout is a metabolic pathology, chronic and hereditary, caused by severe hyperuricemia, which tends to form deposits of crystals in the joints and kidneys.
These accumulations of uric acid in the joints cause acute inflammation, triggering painful symptoms that are sometimes very intense.
The same applies to kidney deposits that cause stones.
Symptoms of gout
The disease manifests itself with acute inflammatory arthritis arthritis.
It causes pain, redness and swelling of the joints.
On the other hand, uric acid lithiasis triggers symptoms similar to other types of stones (see symptoms of kidney stones).
Causes and predisposing factors
As we have said, hyperuricemia and gout are disorders caused by one or more inherited genetic defects, which can be aggravated by predisposing factors.
Causes
Hereditary genetic factors of severe hyperuricemia and gout can intervene on two distinct fronts:
- Excessive synthesis of purines
- Reduced urinary excretion of uric acid; in this case we speak of normal-producing and hypo-secretory patients.
Ultimately, hyperuricemia may be the consequence of increased uric acid synthesis and / or reduced urinary elimination.
predisposing factors
Predisposing factors hyperuricemia and gout are:
- Bad diet
- Overweight
- Low level of physical activity.
Diet
The current availability of effective drugs to combat hyperuricemia and gout has helped to reduce the importance of the traditional, and severe, diet.
In light of this consideration, and bearing in mind the hereditary nature of the disease, the contribution of the diet is now considered negligible.
Basic principles of the diet
The fundamental principles of the diet for hyperuricemia and gout are:
- Combat overweight.
- Reduce the global supply of nitrogen compounds and nutrients that worsen uric acid metabolism.
- Increase the amount of water and nutrients that improve uric acid metabolism (see below).
- Avoid a globally excessive diet (see below).
Drugs associated with diet
The drugs most used for hyperuricemia and gout are aimed at preventing excess uric acid, its accumulation and the appearance of joint as well as kidney symptoms.
- The drugs used as antigotta agents, instead, are mainly those that promote the excretion of uric acid (such as colchicine) or that inhibit its synthesis (such as allopurinol).
- The reduction of symptoms that affect only one joint instead, is carried out by administering non-steroidal anti-inflammatory drugs (NSAIDs, such as diclofenac, ketoprofen, etc.).
NB . Acetylsalicylic acid is not recommended.
Food Advice
Lose weight
If necessary, lose weight.
This aspect plays a fundamental role if the body mass index exceeds the obesity threshold (BMI> 30).
Nutrition should be characterized by caloric moderation, in order to avoid, as far as possible, bingeing and excesses.
The gradual reduction of superfluous weight seems in fact to have brought more benefits than a dietary regimen that is attentive only to the elimination of foods rich in purines. Not surprisingly, heavier people usually have higher levels of uric acid.
Be careful though! Better to stay away from prolonged fasting and drastic or too restrictive diets, which have the reputation of triggering gouty attacks.
Reduce purine and protein intake
purines
It is important to reduce purines above all and, to a lesser extent, proteins.
To do this it becomes necessary that the diet is:
- Free of purine rich foods.
- With few foods with an average purine content.
- At the same time favoring the intake of low purine foods.
The table below shows the detail of the purine content in the most consumed foods.
| Foods with high purine content (150 to 800 mg / 100 g) | Anchovies or anchovies, sardines, herring, mackerel, mussels, sweetbreads, liver, kidney, brain, meat extract, game |
Foods with average purine content (50 to 150 mg / 100 g) | Meat, poultry, fish (except those with a high purine content), oysters, prawns, crabs, crustaceans, cured meats and sausages in general; peas, beans, lentils, asparagus, spinach, cauliflower, mushrooms, peanuts, wholegrain products |
Low purine foods (0 to 50 mg / 100 g) | Milk, eggs, cheeses, vegetables, vegetables (except those listed above), fruit, pasta and other cereals (except for wheat germ and whole grain products) |
Protein
The reduction in global protein intake is a fairly simple dietary correction.
In general, it is sufficient to reduce the overall quantity of: meat, pasca products, eggs, cheeses and purified vegetable derivatives (wheat muscle, seitan, etc.).
Decrease alcohol
Alcohol is harmful to the metabolism of purines.
All alcoholic beverages should be avoided, especially in excessive quantities.
In case of pre-existing and indispensable habit, it is advisable to limit its intake to very little wine drunk with meals.
For high gradation, spirits are to be banned.
Furthermore, beer is particularly inadvisable because it has a high purine content compared to wine and other spirits.
Moderate the introduction of fructose
Fructose is a sugar that worsens the metabolism of uric acid and favors its accumulation.
It is mainly contained in certain sweeteners, in desserts, in sweetened drinks and in sugary fruits (persimmons, figs, grapes, mandarins and bananas) or preserved (marmalade, candied fruit, syrup, etc.).
Prevent excess fat
A diet high in fat seems to be related to the worsening of uric acid metabolism.
Should be avoided:
- Too many seasonings
- Meat, fish and fatty cheeses
- More than two or three egg yolks a week
- Fatty fruits like avocado, coconut, etc.
- Cooking methods that require the use of a lot of fat, especially frying.
Ensure a sufficient amount of complex carbohydrates
The complex carbohydrates, of which the main ancestor is starch, favor the urinary excretion of uric acid.
It is not necessary to exaggerate, the recommended ration typical of the Mediterranean diet is considered sufficiently adequate (ie at least half the daily calories).
Ensure proper hydration
It is very important to ensure the right amount of water for the body.
Drinking in abundance can prevent kidney stones to which the gouty ones are particularly exposed.
Even herbal infusions can be a good solution to increase your dietary fluid intake; in addition, some diuretic teas can promote the excretion of excess uric acid and reduce blood pressure.
It is advisable to take at least one milliliter of water per calorie in the diet.
A normal person who follows a 2000 kcal diet should introduce at least 2 L of water per day contained in food and beverages; for a hyperuricemic or a gouty, it is advisable to drink at least 2 L of water (which added to the food can contribute to more than 3 L daily).
Increase omega 3 consumption
In the diet for hyperuricemia and gout, at least two or three portions of fish rich in omega three per week (especially blue and cold seas) cannot be missing.
In fact, omega 3 helps modulate the body's inflammatory state by reducing the incidence of inflammatory diseases including gouty arthritis.
Other sources of omega 3 are: salmon oil, cod liver oil, krill oil, seaweed oil, squid oil and certain vegetable seed oils (eg chia, kiwi, etc.).
Fish intake should be done avoiding species with high purine content such as sardines.
What to eat
View the example of a gout diet
