A low-purine diet is often prescribed for individuals with
gout and Lesch-Nyhan Syndrome (a rare genetic disorder that occurs in 1/100,000 people).
People with diabetic nephropathy need to restrict proteins, a regimen that includes, but is
not limited to, the restrictions imposed by a low-purine diet.
Why do people follow this diet?
In people who have gout, uric acid production in the body is
increased while its elimination is reduced. The excess uric acid builds up in the bloodstream,
is deposited in the small joints or soft tissues, and causes symptoms that resemble arthritis.
Purine is a compound that is mainly found in animal protein and is metabolized to uric acid in
the body. A high-purine diet, obesity, regular
alcohol consumption, and diuretic therapy can all
contribute to elevated uric acid levels in individuals with gout. Preliminary research
suggests that insulin resistance may also play a role in the development of gout. A low-purine
diet and medications—such as non-steroidal
anti-inflammatory drugs, corticosteroids, and allopurinol—are commonly used to treat gout. An
effective diet is important to avoid or reduce complications and lessen the expense of drug
treatment. Restricting calorie intake and alcohol consumption, and losing weight (if
overweight), can also reduce uric acid levels. It is also important to drink plenty of fluids
to increase uric acid excretion from the body. Alternative sources of protein should be
included in a low-purine diet.
What do I need to avoid?
To avoid purine ask about ingredients at restaurants and
others’ homes, and read food labels. The following list is not complete. Consult with a
healthcare professional before making any significant changes to your diet.
The following foods have very high purine levels, and should
be avoided completely:
- Anchovies
- Bouillon
- Brains
- Broth
- Consommé
- Dried legumes
- Goose
- Gravy
- Heart
- Herring
- Kidneys
- Liver
- Mackerel
- Meat extracts
- Mincement
- Mussels
- Partridge
- Roe
- Sardines
- Scallops
- Shrimp
- Sweetbreads
- Yeast (baker’s and brewer’s)
- Yeast extracts (e.g., Marmite, Vegemite)
These foods have high purine levels
- Fish (including shellfish)
- Poultry
- Meat (except those with very high purine
content, noted above, or those with moderately high purine levels, noted below)
These foods have moderately high purine levels
Are there any groups or books?
National Institute of Arthritis and Musculoskeletal and Skin
Diseases
http://www.nih.gov/niams/
Arthritis Foundation
http://www.arthritis.org
The Purine Metabolic Patient’s Association
http://www.pumpa.co.uk
Bibliography
Dessein PH, Shipton EA, Stanwix AE, et al. Beneficial effects of
weight loss associated with moderate calorie/carbohydrate restriction, and increased
proportional intake of protein and unsaturated fat on serum urate and lipoprotein levels in
gout: a pilot study. Ann Rheum Dis. 2000;59:539–43.
Emmerson BT. The management of gout. N Engl J Med
1996;334:445–51.
Mahan LK, Escott-Stump S, eds. Krause’s Food, Nutrition and
Diet Therapy. 10th ed. Philadelphia, PA: W.B. Saunders Company; 2000.
http://www.marinurology.com/articles/calculi/foods/purines.htm
Wolfram G. [Diet therapy in gout]. Ther Umsch
1995;52:524–7.
Copyright © 2002 Healthnotes, Inc. All rights
reserved. www.healthnotes.com
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Foodnotes.
The information presented in Foodnotes is for informational
purposes only and was created by a team of U.S. registered dietitians and food experts.
Consult your doctor, practitioner, and/or pharmacist for any health problem and before using
any supplements, making dietary changes, or before making any changes in prescribed
medications. Information expires December 2003.
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