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It is well-established that a diet low in purines reduces the serum level of uric acid, the primary risk factor for gout. The solubility threshold for uric acid is approximately 6.7 mg/dl. Healthy subjects in the Normative Aging Study who had serum levels of uric acid over 9.0 mg/dl suffered a 22% incidence of gout over six years, compared to less than one percent for those with 7.0-8.9 mg/dl. The average uric acid level in men is 5.0 mg/dl, and substitution of a purine-free formula diet reduces this to 3.0 mg/dl. A purine-restricted diet lowers the level nearly as much (1-2 mg/dl). Ingestion of 500 mg of vitamin C per day has been shown to bring about a 0.5 mg/dl decrease in serum uric acid through increased excretion.
In a large prospective study, high consumption of meat and seafood were found associated with an elevated risk of gout onset (41% and 50%, respectively). High consumption of dairy products was associated with a 44% decrease in the incidence of gout. Consumption of purine-rich vegetables or a high protein diet had no significant correlation. Consumption of beer, which is rich in guanosine, is associated with a 49% increase in relative risk per daily 12-oz serving. By contrast, consumption of spirits was associated with only a 15% increase in relative risk, and no association at all was found with wine consumption.
Additional dietary recommendations can be made which target gout indirectly by opposing gout risk factors such as obesity, hypertension, cardiovascular disease, diabetes, and metabolic syndrome.
The following suggestions do not meet with universal approval among medical practitioners.
Low purine diet:
* To lower uric acid:
o cherries were reported to reduce uric acid in a small study (PMID 12771324, PMID 14776685)
o strawberries or blueberries (and other dark red/blue berries) are also reputed to be beneficial.
o celery extracts (celery or celery seed either in capsule form or as a tea) is believed by many to reduce uric acid levels (although these are also diuretics).[citation needed] Celery extracts have been reported to act synergistically with anti-inflammatory drugs (PMID 15035799)
o any kinds of cheese. Cheese has been recommended as a low-purine food , and dairy products have been found to reduce the risk of gout.
* Food to avoid:
o foods high in purines
+ limit food high in protein such as meat, fish, poultry, or tofu to 8 ounces (226 grams) a day. Avoid entirely during a flare up. Tofu has been proposed as a safe source of protein for gout patients due to its small and transient effect on plasma urate levels. (PMID 9598181)
+ Tamarind
+ sweetbreads, kidneys, liver, brains, or other offal meats[2] (PMID 7904493)
+ sardines and anchovies [3]
+ Seafood (PMID 15014182)
+ alcohol. (PMID 15094272) Some claim that this applies especially to beer, on the basis that brewer's yeasts are very rich in purine. In view of the fact that most modern commercial beer contains trace amounts of yeast, this claim requires substantiation. Others claim that red wine is particularly bad for gout, though again it is difficult to find an explanation. Formerly, port wine was sweetened with litharge, causing lead poisoning, of which gout is a complication. Ironically, red wines, particularly those produced by traditional methods [4] contain procyanidins released from grape seeds during wine making, which have been reported to lower serum uric acid levels by an indirect mechanism. However, withdrawal of urate-lowering therapy is associated with recurrence of acute gouty arthritis. Alcohol may also reduce the rate of uric acid excretion.
+ meat extracts, consomme's, and gravies
* To avoid dehydration:
o Drink plenty of liquids, especially water, to dilute and assist excretion of urates;
o Avoid diet sodas (these act as diuretics in many people, causing uric acid to concentrate in the blood which can then easily precipitate)[citation needed]
o Use sparingly diuretic foods or medicines like aspirin, vitamin C, tea and alcohol. The role of diuretics in triggering gout has been disputed (PMID 16291814)
* Folklore has it that Joe-Pye weed flushes uric acid quickly, but continued use can damage the liver or kidneys
* Another folk remedy is the use of oenomel, a drink with honey and unfermented grape juice.
* Moderate intake of purine-rich vegetables is not associated with increased gout.
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Important notice:
The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other
qualified health provider with any questions you may have regarding a medical condition.
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