It is estimated that 2.4% of the Spanish population suffers from gout, which means that there are about 880,000 people affected by this disease, according to the EPISER study carried out by the Spanish Society of Rheumatology. One way to prevent this disease, as painful as it is debilitating, is Reduce consumption of foods containing purines.the so-called ‘foods with uric acid’.
What are purines?
To understand why some people have high uric acid, we must start by talking about purines. These molecules are part of our DNA and are created within our body. In fact, they are distributed throughout the cells and enter the bloodstream as they are naturally degraded during the cell cycle.
It is also obtained from the foods we consume, especially offal, red meat, its derivatives, and shellfish and fish, especially blue fish.
Purines, uric acid and hyperuricemia.
The body naturally breaks down purines into a metabolic craving, uric acid. We usually eliminate this desire without any problem through our body’s normal waste elimination mechanisms. About 70% is eliminated by the kidneys through urine and the rest is expelled through the intestines through feces.
The problem arises when some people are not able to eliminate purines and their metabolic waste so easily, or when they produce them in too high a quantity. In these cases, the following occurs: hyperuricemia or high uric aciduric acid levels greater than 7 mg/dl or 6 mg/dl in men and women, respectively.
This condition may not cause symptoms in some people. In others, however, it produces what is known as gout, which usually occurs in its most acute periods, the dreaded ones. gout attacks.
When does a gout attack occur?
A gout attack occurs “when gout forms uric acid (monosodium urate) crystals in the joints and soft tissues of the body. “Eliminating these crystals is key to treating the disease,” explains dietician-nutritionist Rocío Práxedes, a member of the Spanish Academy of Nutrition and Dietetics.
This disease causes pain, stiffness and immobility. It is found mainly in the joints of the big toe, knees and ankles, but can also affect the kidneys and cause kidney stones or kidney failure.
Gout patients tend to be associated with obesity, unhealthy eating habits and alcohol abuse. The expert reminds us that, although this is the general profile, there are exceptions. Around 60% of gout patients also have metabolic syndrome, which is a set of symptoms and signs of people who live with central obesity, hypertension, insulin resistance and hyperlipidemia. “These people, even if they maintain a healthy diet and an adequate weight, can still suffer from gout due to genetic factors, underlying diseases or metabolic problems that affect the production and excretion of uric acid.” Gout crises are also often associated with heavy meals, fasting or very restrictive diets, for example for weight loss.
On the other hand, having high levels of uric acid (hyperuricemia) does not always mean developing gout. “Many people with hyperuricemia never experience a gout attack. In fact, only a minority of those with high levels of uric acid develop this condition,” says Práxedes.
Gout tends to affect older men more, with a ratio of 4 men to 1 woman, especially after age 45, although this ratio changes to 3 men to 1 woman after age 65.
Diet and lifestyle tips to prevent gout
The amount of uric acid in the body is regulated by a balance between its production and excretion, mainly via the kidneys. An unhealthy diet and lifestyle can upset this balance.
To prevent a gout attack in people with high levels of uric acid in the blood, a balanced diet is recommended:
- Limited consumption of meat in general, and red and processed meat in particular
- Avoid alcoholic beverages
- Avoid foods rich in purines
- Reduce fructose intake from sugary drinks, pastries, sweets and foods with added sugars
- Choose foods rich in complex carbohydrates, such as legumes and whole grains.
The latter will help manage metabolic syndrome, which is common in this type of patient.
There are also certain foods in the diet that can prevent the onset of gout if consumed regularly. “We are talking about low-fat dairy products, eggs, foods rich in vegetable proteins (legumes and derivatives, nuts, whole grains, etc.), fruits and vegetables, infusions such as coffee, and drinking water in general,” says the expert.
Vegetables and legumes do not increase the risk
Although some varieties of vegetables, such as asparagus, spinach or mushrooms, and certain legumes, such as lentils, have a moderate amount of purines, “surprisingly, their consumption does not seem to increase the risk of developing gout. On the other hand, excessive alcohol and fructose in the diet have been shown to increase the likelihood of this happening.”
Vegetables also help neutralize acid in urine, which can promote the solubility and excretion of uric acid. “And they provide dietary fiber, which improves intestinal motility and can promote the excretion of uric acid through the intestine, although this route is less significant than renal elimination.”
In any case, a diet rich in fiber helps maintain a healthy weight. This factor is important, since overweight and obesity are associated with high levels of uric acid.
Avoid seafood and red meat during a gout attack
The uric acid content in the human diet is generally low, but some foods contribute to its formation due to the purines they contain. An increased risk of gout has been linked to a high consumption of red meat and seafood“Avoiding seafood and meat, particularly red and processed meat, during a gout attack is a recommended measure because it helps reduce uric acid production.”
What to do during a gout attack
When a gout attack occurs, nutritional and lifestyle advice becomes stricter:
- stricter restriction of foods high in purines to help control symptoms
- avoid long periods without eating (very restrictive diets, intermittent fasting, etc.)
- high carbohydrate diet
It is essential that people at risk of gout and hyperuricemia seek specific and personalized guidance from their doctor, for the correct diagnosis and prescription of drugs, if necessary, and from the dietician-nutritionist to individualize the diet and improve its adherence.
Unhealthy or risky habits
- ObesityExcess weight is related to higher levels of uric acid.
- Sedentary lifestyleLack of physical activity can contribute to obesity and high uric acid levels.
- Very restrictive diets (keto diet, dissociated, etc.) or fasting periods for weight lossWeight loss is associated with increased production of uric acid.
- Medications: Some drugs, such as certain diuretics, immunosuppressants or aspirin, can raise uric acid levels.
- DehydrationDrinking insufficient water can increase the concentration of uric acid in the blood.
The ALDI Council
If you have been diagnosed with an eating disorder, consult a dietician-nutritionist to help you manage your diet and guide you on which foods are best for you and which ones are best to restrict.
Rocio Praxedes. Corresponding Member CODiNuCoVa. Diploma in Human Nutrition and Dietetics CAP, diploma in Nutrition in obesity surgery, diploma in nutrition in kidney disease, diploma in clinical nutrition. Intensive courses specialized in obesity and artificial nutritional therapy. Official master’s degree in project management. Specialized course in nutrition and cancer. Since 2008 she has worked in private practice and since 2010 at Hospital Quirón Valencia. She has been CODiNuCoVa secretary between 2009 and 2017. And secretary of the General Council of Official Colleges of DN 2013-2016. Between 2008 and 2010 she was secretary of ADDECOVA. INSTAGRAM: rociopraxedesgomez. FACEBOOK: @rociodiethas. WEB: https://diethas.es/
