Low-purine diet: who needs it, list of products, menu

General rules

purines in the body consists of two sources of their supply - endogenous (internal) synthesis and intake from food.
Purine metabolism is a chain of complex biochemical reactions involving various enzyme systems. During the process of metabolism of purine nucleotides, the end product is uric acid , which is excreted from the body by the kidneys. However, when purine metabolism is disrupted, uric acid is not excreted to physiologically normal levels and a state of hyperuricemia (increased levels of uric acid in the blood) occurs.

When a certain concentration of uric acid is reached, crystals begin to form, which are subsequently deposited in the synovium of the joints, kidneys and under the skin, causing diseases such as gout , urolithiasis , cystinuria , uric acid diathesis , oxaluria . Violation of purine metabolism in most cases is also accompanied by a violation of lipid metabolism.

In order to reduce the intake of purines from food, a low-purine diet . This diet includes Table No. 6 , the purpose of which is to normalize the processes of purine metabolism, reduce the level of uric acid and its salts and correct the urine reaction in the alkaline direction. Alkalinization of urine increases the solubility of urates , which accelerates the removal of uric acid from the body and disrupts the process of their formation.

The hypopurine diet involves limiting the diet of foods that contain large amounts of purines, as well as oxalic acid, while limiting the intake to 10 g/day of sodium chloride. At the same time, the diet is expanded to include foods that have an alkalizing effect (milk, vegetables/fruits). The content of purines in food varies widely and a special table gives an idea of ​​their amount.

The table of purines in food allows the patient to navigate the choice of foods for his diet. However, not all purine bases are broken down into uric acid, and risk factors include only those purines that, as a result of cleavage, are converted into uric acid in the body. These include purine compounds such as guanine , adenine , hypoxanthine , xanthine .

Other purine compounds - caffeine , theophylline and theobromine , found in cocoa, coffee, tea and chocolate, are not dangerous. The maximum amount of purine bases is found in meat and animal by-products that are actively involved in metabolism: liver, calf thymus, kidneys and products with rapidly dividing cells (yeast, cereal sprouts, asparagus, young greens).

The energy value of the dietary table is 2700-3000 kcal with a restriction in the diet of proteins to 70-80 g and up to 80-90 g of fats (mainly due to refractory ones). Carbohydrate consumption is at a level of 400 g (in the absence of obesity ). The volume of free liquid is 2 liters or more. Small meals up to 5-6 times a day with plenty of drink on an empty stomach and in between meals.

There are no special requirements for the culinary processing of products, with the exception of meat, which, before further processing, is cooked with preliminary short-term (5-10 minutes) boiling and draining of the first broth. In the menu outside the period of exacerbation, meat/fish dishes can be present no more than 2-3 times a week, and their weight should not exceed 150-170 g per day

The antipurine diet provides fasting days with a frequency of once a week (curd-kefir in the form of 1 liter of kefir and 400 g of low-fat cottage cheese or fruit - with the consumption of up to 1.5 kg of vegetables/fruits) with an increase in the volume of free liquid on such days to 2, 5-3 liters.

Fasting days are especially important during an exacerbation period and during this period they are carried out every other day. Thus, a purine diet for gout during an exacerbation involves excluding any type of meat and fish from the diet by increasing the consumption of fermented milk products, soups based on vegetables and milk, herbal teas and fruit infusions.

Purines are not scary at all

Today, very often, from various channels, we are bombarded with tons of information that purines are terribly harmful substances. Well, we will reassure you: purines are not as scary as they are portrayed to be.

We can say that they are not scary at all - after all, for example, without these substances there would be neither DNA nor RNA, and this alone sounds frightening.

And caffeine is also purine, which for coffee lovers is perhaps the main argument in their favor.

Purines are found almost everywhere: in the cells of our body, in the cells of animals and plants - their quantity is replenished along with the diet every day.

And when cells are destroyed, purines, which cannot, according to all the laws of chemistry, disappear into nowhere, turn into uric acid.

Varieties

In the presence of obesity, patients are prescribed a purine-free diet - dietary Table 6E . It is characterized by a lower energy value of the diet (1950-2000 Kcal), protein content is reduced to 70 g, fat - to 80 g, and carbohydrate intake - to 250 g, mainly due to simple carbohydrates (fresh wheat bread, sugar, honey, confectionery /flour products, sweets).

The consumption of meat in the diet is limited to 1-2 times a week, drinking plenty of water, alkaline mineral water is especially recommended. The diet is not complete and can be prescribed to patients for a short period of time (up to two weeks).

Diet and important details

Be prepared to redistribute the number of meals: instead of the usual breakfasts “on the fly” and dinners “to the fullest”, you will have 4 meals a day, complete and balanced.

You will have to give up foods that contain a large amount of purines and oxalic acid - but we will return to this later, do not rush to be sad about a meager diet.

As for the cooking process, remember: the “first” broth for poultry and fish is not the best assistant in the fight for health.

You need to boil the meat in a large amount of water, discarding the first broth without regret.

Authorized Products

The diet should contain many different vegetables: eggplants, white cabbage, carrots, tomatoes, zucchini, cucumbers, potatoes. White and black bread are allowed. It is important to include fruits and various berries in your diet - pears, plums, apples, apricots, oranges. Turkey, rabbit, and chicken are allowed. You can eat chicken eggs and boiled fish. Fermented milk products, low-fat cottage cheese and dishes made from it, low-fat cheeses, and milk are required in the diet.

Pasta and various cereals cooked with diluted milk are recommended. It is important to include vegetable oils (linseed and olive) in your diet. Among sweets, marshmallows are allowed, not chocolate candies, jam, marmalade, marshmallows.

Drink - green tea, vegetable juices, compotes and fruit drinks, decoctions of chicory, rose hips, wheat bran, fruits, berries, kvass. The diet should include slightly mineralized non-carbonated alkaline mineral waters, cucumber juice, and lingonberry juice.

Table of permitted products

Basic rules of the hypopurine diet

All important information has been stated above. Also, patients who create a low-purine diet on their own should know that the amount of protein consumed in the daily diet should be reduced to approximately 100 g. Less is possible, but not more. Meanwhile, protein is an important element for the construction of new cells. Therefore, it is also impossible to limit it too much.

Only low-fat foods should be included in the diet. If there is obesity, the menu is designed in such a way that the amount of carbohydrates received is as low as possible. The diet is based on low-calorie foods, which will help you gradually lose excess weight. You may need the help of a nutritionist.

You need to drink more regular water - at least 1500 ml per day. If you have diseases of the cardiovascular system, you need to discuss the norm with your doctor. Limit salt intake to approximately 10 g per day.

Fully or partially limited products

The low-purine diet excludes the consumption of red meat and all types of offal (kidneys, liver, heart), salted, fatty and fried fish, seafood (shrimp, shellfish), caviar, canned fish, and all smoked meats. Pork, beef and cooking fats are limited. Foods rich in plant proteins (beans, beans, lentils, peas, soybeans), and various spices (pepper, horseradish, mustard) are excluded from the diet. It is prohibited to consume chocolate, sharp cheeses, cream cakes, pastries, as well as some berries - cranberries, grapes, figs, raspberries.

The consumption of carbohydrates in the form of bread, porridge with meat broth is limited. It is undesirable to introduce cauliflower, peppers, mushrooms, spinach, sorrel, rhubarb, asparagus, radishes, and celery into the diet. Despite the fact that purines contained in black tea, coffee, and cocoa are not broken down, their limitation is justified because, having a diuretic effect, they dehydrate the cell, thereby increasing the concentration of uric acid. Limit salt consumption. Drinking alcohol-containing drinks, especially red wines, beer and cognac, is absolutely unacceptable.

Table of prohibited products

How to plan a diet correctly?

The diet is based on the list of products presented above. A low-purine diet must be balanced so that the body receives all the substances necessary for its proper functioning. If it’s difficult to create a menu on your own, you can seek help from a doctor or find ready-made options. But in general, there is nothing complicated in this issue if you know which products are prohibited and which are allowed.

You can include dishes prepared according to the following recipes in your diet:

• Carrot salad. Grate the vegetable, boil the egg and chop. Mix the ingredients, add croutons and season the salad with low-fat sour cream.
• Milk vermicelli soup. Boil 1 liter of milk in a saucepan. Break vermicelli into small pieces. Place in milk and cook for 15 minutes until tender.
• Fruit and berry salad. You should definitely include it in your low-purine diet menu. Peel the apple and pear, then cut into pieces. Turn kiwi into puree. Mix all products together, season with yogurt or sour cream. You can add a few slices of strawberries.

The hypopurine diet gives the first positive results after a short period of time, if you follow all the recommendations and follow the agreed rules. After about a week, the patient's condition improves significantly, and the symptoms soften. This has a positive effect not only on a person’s physical condition and general well-being, but also has a beneficial effect on the emotional sphere.

Below are several diet options for gout and high uric acid. They are examples of how to create your own diet. You can also use these options for your daily meals.

Low purine diet menu

The low-purine diet menu for a week includes the maximum number of permitted foods, taking into account the permitted methods of culinary processing, which allows you to diversify the patient’s diet.

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

The role of fasting days in the hypopurine diet

They must be carried out, as this has a positive effect on the patient’s well-being. We can say that in the diet for gout and high uric acid, this is a separate point that should be observed. You cannot completely give up food even for one day. It is recommended to eat red apples and drink herbal or green tea. A salad of two types of vegetables, low-fat sour cream and cottage cheese are suitable. On fasting days, boiled rice with milk is used. You need to prepare 70 g of cereal and spread it out throughout the day. Such fasting days will have a positive impact on both health and well-being. It is recommended to carry them out once a week.

Reviews and results

Most patient reviews indicate that a low-purine diet is quite effective for disorders of purine metabolism and allows it to be normalized relatively quickly.

• “... Having had gout for a long time, at the first sign of an exacerbation I immediately go on a vegetarian diet with 2-3 fasting days on vegetables or kefir, and then I switch to Diet 6, at the same time, I increase my physical activity - I work out in the gym”;
• “... I have been following a strict anti-purine diet for almost 7 years. In combination with taking anti-gout medications, I achieved good results. I have had no seizures for 4 years now, and it has become much easier for me to move around”;
• “... I am almost 60 years old and have had gout with frequent attacks for almost 10 years. The pain is very strong, I can’t leave the house, I move around the house on crutches. I relieve the pain with pills and go on a diet with vegetables. Usually after 2 weeks the pain goes away and I can lead my normal life.”

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But even at this stage there is no need to panic: this is a very useful process, as long as there are not too many purines in the body!

At this moment, purines “forget their place” - they begin to accumulate in excess, threatening gout and other problems, instead of protecting the safety of our

vessels.

This is why it is so important to bring the process of purine metabolism back to normal with the help of a therapeutic diet - it is simply impossible to curb these “mechanisms” in any other way!

What is possible

The diet should be healthy and balanced: a type of diet similar to vegetarian is perfect. Vegetable or milk soups, fruits, and fermented milk products will be useful. Those with a sweet tooth can afford dried fruits, milk jelly, non-chocolate candies, and jam. Also, a diet for heel spurs can include almost any vegetables. The diet should also consist of the following products:

• Nuts and seeds
• Porridge with milk diluted with water
• Cheese, if it is a low-fat variety
• Herbal drinks

Hypopurine diet option No. 3

This is the treatment table No. 6 proposed by Pevzner. The diet is bland, the menu is quite varied. Another option:

• Breakfast: vinaigrette with sour cream, a slice of bread with butter, cottage cheese, tea.
• Snack: scrambled eggs, buckwheat, juice.
• Lunch: soup with vegetables with sour cream, meat fried in croutons, fried potatoes with sauerkraut.
• Snack: compote.
• Dinner: vegetable cutlets, pasta casserole, jelly.
• Snack: a bun with a glass of milk.

Creating a menu will not be difficult even for a person far from medicine and nutrition. The main thing is to remember the list of foods that you can eat and purine-containing foods that are prohibited.

Hypopurine diet option No. 2

It is proposed to create a weekly diet yourself from the dishes listed below.

For breakfast:

• pumpkin raisin pancakes;
• carrot casserole with fruit;
• carrot curd;
• buckwheat porridge;
• weak teas and coffee;
• millet porridge with apples;
• toast with butter or cheese.

For lunch:

• potato and carrot bits;
• vegetable stew;
• cabbage soup with rye crackers;
• braised cabbage;
• beef cutlets;
• rice porrige;
• carrot or zucchini soup;
• potato and cabbage salad;
• tomato and grant juice;
• potato and fish pie;
• milk noodle soup.

For dinner:

• vegetable cabbage rolls;
• corn porridge with yogurt;
• salad with egg, carrots and croutons;
• oatmeal with applesauce;
• lingonberry broth, yogurt, milk or jelly;
• beet salad;
• pasta casserole;
• pancakes with strawberries;
• peppers stuffed with rice;
• pumpkin pudding;
• a fresh vegetable salad.

For a snack:

• curd soufflé;
• blueberry-apricot jelly;
• blackberry and banana smoothie;
• cereal with milk;
• blueberry yogurt pie;
• fruit salad;
• cereal yogurt;
• melon;
• peach with curdled milk;
• strawberries and cream;
• carrot juice.

It is important not to forget that portions should be small.

Where are purines found?

A feature of the pathology is a wave-like course, with exacerbations developing after consuming certain foods. Therefore, the main rule of the hypopurine diet for gout is to limit the intake of purines into the body.

Based on the purine content per 100 g, products are divided into three groups:

• with high content – ​​from 150 mg;
• with an average content of 50 to 150 mg;
• with low purine levels – up to 50 mg.

Every patient needs to know which foods contain purines. They are completely excluded from the diet. Foods from the second group are eaten little by little and only in the absence of exacerbation. If purine metabolism is impaired, it is recommended to choose only products that contain less than 15 mg of purines per 100 g of product. That's why this diet is called low-purine diet. When choosing a diet, each patient must use a table that shows the content of these substances per 100 g of product.

But the patient should remember that purines from animal products and those containing oxalic acid are more dangerous. Therefore, spinach or sprats are more likely to cause aggravation than tea or chocolate.

All focus on nutrition

Hippocrates saw the undeniable connection between food and gout. He associated it with excess food consumption. During the Middle Ages, eating enough meat and drinking wine every day was considered a sign of wealth. At that time, the disease was common among royalty and was even the subject of glorification in literature.

But now, when supermarkets offer food abundance, it is better to moderate your ardor. Drug treatment will not give the desired effect without full adherence to the diet. There is no need to abuse meat, confectionery and alcohol products. It is best to remember the traditional basics of a low-calorie healthy diet with plenty of vegetables, minimize sugar and drink plenty of water.