October 6, 2003

Diet for Gout

Gout and kidney stones can be caused by high levels of uric acid. Most of the uric acid (85%) is made by the body. You may need to take medication to reduce the amount of uric acid the body makes, or to help the body to get rid of extra uric acid. Purines in the diet can also increase uric acid levels. By following these dietary guidelines you will lower the purines in your diet, which may lower the small portion (15%) of the uric acid in your blood that comes from foods or beverages.

GUIDELINES (contd)
Between flare ups or chronic gout: In between flare ups (when you do not have symptoms of gout), or if you have chronic gout: 1. Continue to drink at least 8 cups of fluid daily, at least half as water. 2. Continue to limit alcohol intake. Discuss alcohol use with your doctor. 3. Follow a normal, nutritious diet, using Canadas Food Guide to plan meals. Continue to use caution with the foods on the High Purine list. Eat only a moderate amount of protein. 4. Maintain a desirable body weight. Being overweight can result in a build up of uric acid in the body. If you need to lose weight, reduce it gradually: 0.5-1.0 kg (1-2 pounds) per week. Rapid weight loss may cause an attack of gout. Follow a sensible, balanced diet to lose weight. Do not fast or follow a high protein diet to lose weight because these can make gout worse.
1 Yamakita J., et al. (1998). Effect of tofu (bean curd) ingestion and on uric acid metabolism in healthy and gouty subjects. Adv Exp Med Biol, 431, 839-42.

GUIDELINES
When you are having an acute attack of gout: 1. Drink two or three litres (8 to 12 cups) of fluid daily, at least half as water. 2. Limit your intake of alcohol or do not drink alcohol. Alcohol can result in a build up of uric acid in the body. If you choose to drink, do not drink more than one drink three times per week. If you are unsure about the use of alcohol, discuss it with your doctor. 3. Look at the Purine Content of Foods chart on the back of this page. Avoid foods on the High Purine List. Use in moderation the foods on the Moderate Purine list. Eat foods daily on the Low Purine list. 4. Eat only a moderate amount of protein. Good 1 protein sources are tofu and low fat milk products, with small amounts of peanut butter and eggs. Eat less meat, fish, and poultry (to a maximum of 4-6 ounces per day). 5. Emphasize high carbohydrate foods (breads, cereals, rice, pasta, vegetables and fruits). 6. Limit the fats in your diet by choosing lean meats, fish, skinless poultry, and low fat milk products. Dont eat deep fried foods and high fat desserts, and limit added fats like butter, margarine, oils, and salad dressings to 3-6 teaspoons per day.

For more information, contact: The Arthritis Society Toll-free: 1-800-321-1433 Website: http://www.arthritis.ca

This information is not meant to replace the medical counsel of your doctor or individual consultation with a registered dietitian. This information may only be used in its entirety.

DIAL-A-DIETITIAN NUTRITION INFORMATION SOCIETY OF B.C.

Greater Vancouver: (604) 732-9191 Toll-Free in B.C.: 1-800-667-3438 Web site: http://www.dialadietitian.org

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Diet for gout (contd)

October 6, 2003

PURINE CONTENT OF FOODS FOOD GROUP

(0-50 mg purines/100 g)2

LOW PURINE

(50-150 mg purines/100 g)2

MODERATE PURINE
USE IN MODERATION

(150-825 mg purines/100 g)2

HIGH PURINE
AVOID

USE AS DESIRED Breads and Cereals

breads & cereals 3 noodles rice
2 3 3 2,3 2

Limit to 2/3 cup raw daily: 2 oatmeal Limit to 1/4 cup raw daily: 2 2 wheat bran , wheat germ

cornbread

Fruit Vegetables

All , including juices Most vegetables

2,3

Limit to 1/2 cup serving 2 daily : asparagus, cauliflower, spinach, mushrooms, green peas Limit of 1-2 servings daily : 2 meat, poultry (2-3 oz) 2 fish, shellfish (2-3 oz) 2 dried peas/beans/lentils (1 cup cooked)
2

Protein Foods
Choose lean meats, poultry without the skin, and fish. Cook without added fat.

eggs , nuts peanut butter

2,3

2,3

liver , kidney , heart , 2,3 2,3 brains , sweetbreads , 3 3 game meats , goose , 3 2,3 partridge , anchovies , 2,3 2,3 sardines , mackerel , 2,3 2,3 herring , scallops , 3 mussels

2,3

2,3

Milk & Milk Products

Choose low fat products

All

2,3

Fats & Oils

Limit use of fats & oils

All (in moderation)

2,3

Gravy

2,3

Soup

vegetable soups made 2 vegetable stocks

meat soups and broths

meat extracts (e.g. Oxo, Bovril) yeast taken as a 3 supplement

2,3

Other

sugar syrup, sweets 2,3 geletin 3 soft drinks, tea coffee cereal beverages 3 (Postum) chocolate, 3 custard, pudding white sauce
3 3

2,3

Mincement

condiments, salt, herbs 3 olives, pickles, relishes 3 vinegar, popcorn

2 3

Pennington, J. A. (1998). Bowes & Church's food values of portions commonly used (17th ed.). Philadelphia: Lippincott-Raven Publishers. Mahan, L. K., & Escott-Stump, S. (Eds.). (2000). Krause's food, nutrition and diet therapy (10th ed.). Philadelphia: W.B. Saunders Company.

This information is not meant to replace the medical counsel of your doctor or individual consultation with a registered dietitian. This information may only be used in its entirety.

DIAL-A-DIETITIAN NUTRITION INFORMATION SOCIETY OF B.C.

Greater Vancouver: (604) 732-9191 Toll-Free in B.C.: 1-800-667-3438 Web site: http://www.dialadietitian.org

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