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Eating Guidelines for Gout Eating and Gout High levels of uric acid can cause gout and kidney stones. Your body makes most of the uric acid (85%). You may need to take medicine to lower the amount of uric acid your body makes or to help your body to get rid of extra uric acid. Purines in your diet can also make uric acid levels go up. This resource will help you to lower the purines in your diet to help lower the portion (15%) of uric acid that comes from foods and drinks.

Steps You Can Take When Having an Acute Attack of Gout •

Drink two or three litres (8 to 12 cups) of fluid daily; at least half of this fluid should be water.

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Limit your intake of alcohol or do not drink alcohol. Alcohol can make your uric acid levels go up. If you choose to drink alcohol, do not drink more than one drink three times per week. If you are not sure if you should use alcohol, talk about this with your doctor.

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Look at the Purine Content of Foods chart included in this handout. Foods on the High Purine list should be avoided. Use foods on the Moderate Purine list in moderation. Eat foods on the Low Purine list daily.

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Eat a moderate amount of protein every day. Good protein sources are tofu and low fat milk products, with small amounts of peanut butter and eggs. Eat less meat, fish, chicken and turkey (have no more than 4-6 ounces per day).

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Emphasize high carbohydrate foods (breads, cereals, rice, pasta, vegetables and fruits).

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Choose lean meats, fish, chicken and turkey without the skin, and low fat milk products. Broil, bake or grill foods rather than deep-frying them. Use lower fat desserts. Limit added fats like butter, margarine, oils, and salad dressings to 3-6 teaspoons per day.

This information is not meant to replace the medical counsel of your Doctor or individual consultation with a Registered Dietitian. Copyright 2005 Dial-A-Dietitian. All rights reserved. May be reproduced for in its entirety provided source is acknowledged. Up for Review 2006 www.dialadietitian.org

Steps You Can Take Between Flare Ups or if You Have Chronic Gout In between flare ups (when you do not have symptoms of gout), or if you have chronic gout: •

Continue to drink at least 8 cups of fluid daily, at least half as water.

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Continue to limit alcohol intake. Discuss alcohol use with your doctor.

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Follow a balanced, nutritious diet, using Canada’s Food Guide to plan meals. Continue to be careful with the foods on the High Purine list. Eat a moderate amount of protein each day.

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Keep your body weight in a healthy range. Being overweight can cause uric acid to build up in your body. If you need to lose weight, lose it slowly: ½ to 1 kg (1-2 pounds) a week. Losing weight quickly may cause a gout attack. Follow a balanced, healthy diet to lose weight. Fasting or following a high protein diet to lose weight can make gout worse. More Information For You

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BC HealthGuide. www.bchealthguide.org. Medically approved health information.

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Canada’s Food Guide to Healthy Eating. http://www.hc-sc.gc.ca/fn-an/food-guidealiment/index_e.html.

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The Arthritis Society. www.arthritis.ca. Call 1-800-321-1433.

References Used For Determining the Purine Content of Foods: Pennington J A. Bowes & Church's food values of portions commonly used (17th ed). Lippincott-Raven Publishers, 1998. Mahan LK & Escott-Stump S(Eds). Krause's food, nutrition and diet therapy (10thed). WB Saunders Company, 2000.

This handout distributed by: Toll-free 1-800-667-3438

Dial-A-Dietitian Greater Vancouver 604-732-9191

www.dialadietitian.org

A free nutrition information line for British Columbians that offers easy-to-use nutrition information for self-care, based on current scientific sources. Our registered dietitians can provide brief nutrition consultation by phone. For in-depth nutrition counselling, they will guide you to hospital dietitians or community nutritionists in your area. Nutrition information is just a call or click away!

This information is not meant to replace the medical counsel of your Doctor or individual consultation with a Registered Dietitian. Copyright 2005 Dial-A-Dietitian. All rights reserved. May be reproduced for in its entirety provided source is acknowledged. Up for Review 2006 www.dialadietitian.org

Purine Content of Foods Low Purine (0-50 mg/100 g)

Medium Purine (50-50 mg/100 g)

High Purine (150-825 mg/100 g)

Food Group Breads and Cereals

Use As Desired breads and cereals, noodles, rice, cornbread

Fruit Vegetables

all, including juices most vegetables

Protein Foods

eggs, nuts, peanut butter

Choose lean meats, Poultry without the skin, and fish. Cook without added fat. Milk & Milk Products Choose low fat products. Fats & Oils Limit use of fats & oils. Soup

Other

Use In Moderation Limit to 2/3 cup raw daily: • oatmeal Limit to ¼ cup raw daily: • wheat bran, wheat germ Limit to ½ cup serving daily: • asparagus, cauliflower, spinach, mushrooms, green peas Limit of 1-2 servings daily: • meat, poultry (2-3 ounces) • fish, shellfish (2-3 ounces) • dried peas/beans/ lentils (1 cup cooked)

Avoid

liver, kidney, heart, brains, sweetbreads, game meats, goose, partridge, anchovies, sardines, mackerel, herring, scallops, mussels

all

all (in moderation)

vegetable soups made with vegetable stocks

sugar, syrup, sweets, gelatin, soft drinks, tea, coffee

gravy

meat soups and broths

meat extracts (Oxo®, Bovril®) yeast taken as a supplement mincemeat

cereal beverages (Postum®) chocolate, custard, pudding white sauce condiments, salt, herbs olives, pickles, relishes vinegar, popcorn

This information is not meant to replace the medical counsel of your Doctor or individual consultation with a Registered Dietitian. Copyright 2005 Dial-A-Dietitian. All rights reserved. May be reproduced for in its entirety provided source is acknowledged. Up for Review 2006 www.dialadietitian.org