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Foods to Avoid

 

  Fish, sea foods, sardines, herrings, anchovies

  Meats, poultry or other flesh, meat extracts, gravies, marmite

  Liver, kidney, heart, sweet bread and brains

  Yeast and beer products, beer and alcohol

Foods recommended

 

  Milk, milk foods, and cheese; eggs

  Lettuce, tomatoes and green vegetables (except all beans, lentils, peas, spinach, oatmeal, asparagus, cauliflower, mushrooms)

  Vegetables and cream soups made from vegetables

  Sugar and sweets; gelatin

  Butter, polyunsaturated margarine and fats of any kind

  Fruit, nuts, peanut butter

  Beverages - water, fruit juice, cordials, carbonated drinks, tea, coffe and cocoa 

BEWARE

Gout patients, avoid both feasting and fasting 

Gout

Gout is considered a hereditary disease resulting from defective uric acid metabolism. Serum uric acids are raised and urates are deposited in the cartilages and articular cartilage of the joint. There are recurrent attacks of the pain and swelling of the joints. 

Primary Gout Gout due to a hereditary abnormality of uric acid metabolism is known as primary gout

Secondary Gout When the raised serum uric acid level results from excessive breakdown of cell nuclei, as in blood diseases like leukaemia, pernicious anemia, polycythaemia, and hemolytic anemias, it is known as secondary gout

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            DIETETIC MANAGEMENT

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Principles 
A low - purene, low - protein, easily digestible diet with a liberal fluid intake is advised 

Calories
Obese persons may be more prone to gout. The body weight should be reduced to normal. A heavy meal supplying high calories should be avoided, as it tends to precipitate an attack. 

Proteins and purines
Meats having high protein content, such as fish (herrings, salmons and sardines), sweet bread, liver, kidney, milk extracts and meat soup are always excluded. Flesh in the form of meat, fish and fowl is excluded during an acute attack. About 60 grams of protein a day is adequate, preferably supplied as vegetable and milk proteins.

Fats
Fat consumption is restricted, partly because its ingestion tends to cause detention of urates by the kidney, and partly to prevent obesity.

Carbohydrates
During an attack of gout the main source of calories should be carbohydrates, because of its protein sparing effects which

Fluids
A liberal intake of fluid should be advised to ensure a daily excretion of about 2000 ml of urine. 

Beverages
Tea and coffee contain methyl purines which are not converted by the body into uric acid. About 2 to 3 cups a day are permitted. 

Alcohol
There appears to be individual susceptibility to an attack of gout after ingestion of alcohol. Stopping alcohol may prevent attack of gout. 
Gouty patients usually tolerate a couple of ounces of white wine or whisky, but not beer, stout, or red wines.

• Hereditary
• Primary and secondary gout
• Fasting, which increases the serum uric acid level
• Alcohol; larger intake of  alcohol increases serum uric acid by decreasing urinary urate excretion.
• Drugs; Thiazids decrease kidney excretion of urate and raises serum uric acid
• Non vegetarian diet It is generally seen that gout is less common amongst vegetarians than non-vegetarians 
  

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