Have you heard of low purine diet? Low purine diet is diet that is prescribed to individuals who have gout, or have symptoms of gout, or have high or borderline uric acid in their blood results. Low purine diet is not a first line mechanism in treating gout or hyperuricemia (a condition of high uric acid level). Usually in the condition of gout attack, or when individual have swollen joint (usually in the big toe area), doctor or pharmacist will prescribe medication to ease the inflammation and diuretic medication to help with the retention of uric acid crystal.
These two prescription usually will be accompanied with pain killer to ease the pain. Depending on severity, condition, and individuals’ level of uric acid, the acute attack will slowly resolve in few days or week. However, if individuals fail to be cautious on food that they consume, gout may attack again (1,5). So here in this article, we are going to explain on diet that is suitable for individual with gout. Some said that it can be used for people who have kidney stone as well, but it is best to seek medical advise on what kind of stone itself, such as sometimes it can be calcium stone, oxalate stone, and many more thus avoidance of food must be made according to what kind of stone in the individuals body. Again, in this article we focus on gout.
Purine is found on many types of food, the only different is the amount of purine in a particular food. Certain food has high amount of purine while the other have low amount of purine. Food that is high in purine is the kind of food that has to be avoided by individuals with gout since it will be broken down into uric acid which for individual with gout it will be a huge problem (1,5,3).
Most carbohydrate does not have high amount of purine; thus, it is okay for individual to consume carbohydrate within recommended intake. However, as for people who have gout and diabetic, it is very tricky since wholegrain product has high amount of purine but has low glycemic index and high fiber, which is meant for individuals with diabetes but not gout, thus for individual with both problems, they need to balance in the amount of carbohydrates taken from these two source, meaning to say, let’s take rice as an example, certain days individual has to consume white rice while other days it can be brown rice. The same thing works for bread and pasta etc (carbohydrate-based food) (2,3,6).
Most of gout individuals must be cautious when it comes to protein-based food. Fish such as anchovies, sardines, scallops, tuna, codfish, herring, and haddock has high level of purine thus need to be avoided. Meat such as from goose and duck and organ meat such as brain, heart, liver, and kidney also have high amount of purine thus must be avoided or limit it intake. Gravies that is made from meat, like red meat broth or soup or stocks also has high purine (2,4,6).
For individual with gout, protein rich food can be consumed from source such as chicken, lean meat, and prawn. However, the consumption of meat also must be limited to 2-3 ounces only per day. For individuals with gout it is best to consume protein from legumes and eggs since most of it does not has high purine, but for individuals with gout and high cholesterol level consumption of eggs need to be limit as well. If for normal and gout individual consumption of egg is up to two eggs per day while for gout and high cholesterol need to limit to one only or better do not consume egg yolk for it can elevate your cholesterol level. You sure don’t want your cholesterol level rising while managing your uric acid level, don’t you ?
Vegetables and fruits
Most of the vegetables and fruits has low amount of purine except for asparagus, cauliflower, spinach, and mushroom. Thus, individuals with gout may consume vegetable without concern that it may elevate level of uric acid in the blood. As for individuals who has diabetes and gout, consuming a lot of vegetables also will help in the management of blood glucose level as well, but you need to consume fruits that has low glycemic index such as apple, strawberry, kiwi, and peach (2,3,7).
Milk and dairy products
Milk and dairy products are mostly low in purine. However, in consuming milk and dairy products, individuals need to be aware on the amount of fat they are ingesting. It is also not suitable for individual who has high cholesterol. Thus, always choose milk and dairy product that is low trans-fat, low saturated fat, and low sugar (2,3,7).
Other than category of food mentioned above or in the picture above, alcohol consumption also must be taking in cautious, for gout individuals, wine is better than beer. And, if you are considering supplementation consumption, it is best to avoid supplement that contained yeast. Consumption of low purine diet also must be together with drinking plenty of water and exercise which can help you to maintain or lose weight, which is one of the risks for gout (2,3,6). You may follow the low purine diet table below to understand diet for gout individuals better!
- 7 Tips following a low-purine diet. https://www.healthline.com/health/tips-for-following-low-purine-diet (Accessed on December 1, 2020).
- com. Low Purine Diet. https://www.drugs.com/cg/low-purine-diet.html (Accessed on December 1, 2020).
- Mayo Clinic. Gout: What’s allowed what’s not. https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/gout-diet/art-20048524 (Accessed on December 1, 2020).
- sg. Gout Diet: Top Carbohydrate, Dairy, Fruits, and Vegetables to eat. https://www.healthxchange.sg/food-nutrition/food-tips/gout-diet-carbohydrate-dairy-fruit-vegetable (Accessed on December 1, 2020).
- My Health Portal. Ministry of Health Malaysia (MOH). Gout. http://www.myhealth.gov.my/en/gout-5/ (Accessed on December 1, 2020).
- My Health Portal. Ministry of Health Malaysia (MOH). Diet Management for Gout. http://www.myhealth.gov.my/en/diet-management-for-gout/ (Accessed on December 1, 2020).
- Clinical Practice Guideline (CPG). Ministry of Health Malaysia (MOH). Gout.