Gout is a disease characterized by impaired metabolism. With it, uric acid salts are deposited in the joints. Gout is a fairly rare disease - there are three cases per thousand people. The disease affects men over forty years of age, in women it manifests itself in menopause. Gout affects all joints, from the joints of the hands to the joints of the legs.
The main symptom of gout is inflammation of a joint. An attack of the disease occurs early in the morning or in the evening, expressed as severe pain in the affected area. The temperature in the joint area rises, the skin begins to redden and shine.
In the treatment of gout, the most important role is played by therapeutic nutrition, the purpose of which is to reduce the level of uric acid compounds in the body. With gouty arthritis, purine metabolism is disturbed, which leads to inflammation of the joints and the development of various types of urolithiasis (for example, uraturia). To normalize this exchange, diet number 6, developed by the professor, is used.
Features of nutrition for a man
If purines enter the body in large quantities, the production of uric acid increases, its excretion through the kidneys slows down. As a result, the level of uric acid in the blood increases, and its crystals - urates - begin to deposit in the joint tissues. The richest in purines are meat and fish products, smoked meats, strong tea, coffee and cocoa.
Men get gout almost 10 times more often than women. In addition, the representatives of the stronger sex are faced with manifestations of this disease much earlier. If in women it manifests itself, as a rule, after 50 years, men experience the first attack of gout in the age range of 30-40 years.
This gender difference is mainly related to nutrition. Men consume a larger amount of food, in addition, they eat a lot of meat products and hot spices, and often accompany them with alcoholic beverages. All this leads to a significant increase in the level of uric acid in the blood, which is constantly maintained. An attack of gout usually occurs suddenly, and a large meal, hypothermia or a common cold can provoke it.
Gout can affect any joint, but in most cases the big toe is affected. The injury is usually unilateral and the first metatarsophalangeal joint of one of the legs is inflamed. The course of the disease, especially in the early stages, is usually paroxysmal. The duration of the attack varies from several hours to a week. When gout becomes chronic, the pain can be constant.
Table 6 is recommended during remission, in the absence of severe symptoms. On attack days, the 6E diet is indicated, which will also be useful for obese patients. It should be continued for several days as long as the pain persists. At the end of the attack, go back to diet number 6 again.
The hypopurine diet for gout is based on alkalinization, that is, alkaline foods are introduced into the diet: vegetables and dairy. If there are no contraindications, it is recommended to drink more water; daily fluid intake should be an average of 2. 5 liters.
Prohibited foods include products that contain oxalic acid, especially much of it in spinach and rhubarb. The amount of salt is limited to 10 g / day, the consumption of protein and fat is reduced. If you are overweight, it is advisable to reduce the amount of carbohydrate foods.
Meat and fish must first be boiled and then cooked in stews, roasts or rolls. During cooking, harmful substances pass into the broth, so you should not use it for cooking first courses. Soups and borscht are cooked only in vegetable broth with the addition of cereals, pasta or milk.
The classic system of therapeutic nutrition involves fractional nutrition, you need to eat at least four times a day. So the load on the digestive tract and excretory organs will be optimal. At the same time, the calorie content of diet No. 6 is 2500-2700 kcal, diet No. 6e - 1900-1950 kcal.
With the right menu, the diet will be balanced and complete, and reducing the consumption of foods that contain purines will not have negative consequences.
It is preferable to cook food for a couple or boil, bake in the oven. It is better to completely exclude fried foods, especially in the acute period. The temperature of the finished products does not matter - you can eat hot and cold, but hot dishes are better absorbed.
Diet number 6 is recommended, as a rule, until a long-term remission occurs. This period for each patient may be different: one or two months will be enough to restore health, while others will take several years.
Permitted and prohibited products
The list of products is compiled so that a person receives fats, proteins, carbohydrates, as well as vitamins and minerals in sufficient quantities. The daily protein norm according to diet No. 6 is 80-90 g, fat - 80-90 g, carbohydrates - 350-400 g.
The need for protein is covered mainly by dairy products, about 25% of fats are found in vegetable oils and most carbohydrates can be obtained from fruits and sugar. When diet number 6 is observed, the body receives about 150 mg of vitamin C, 1. 5 mg of thiamin, 3. 5 g of potassium, 0. 75 g of calcium and 0. 5 mg of retinol per day.
Table of foods allowed for gout:
|flour products, bread||Rye, wheat and bran bread|
|First courses, cereals, sauces||Soups with the addition of cereals, vegetables, noodles, milk; cereal porridge with milk; sauces based on milk, sour cream, tomato juice, or vegetables; stewed vegetable mixes and purees, fresh vegetable salads, vinaigrette|
|Bird meat||Lean pork and beef, rabbit, chicken, turkey|
|Fish||Pike, pike-perch, asp, cod, pollock, bream, as well as all shellfish: shrimp, squid, mussels, octopus|
|Dairy products||When buying, you should pay attention to the fat content of the product: kefir - 1-2%, cottage cheese - 3%, sour cream - 10-15%|
|Cheese||Brynza, mozzarella, suluguni, ricotta, as well as soft cottage cheese without salt|
|Eggs||Chicken (1 piece per day) or quail eggs (no more than 4 pieces per day) can be boiled, baked, stewed|
|cereals||Everything except oatmeal and whole grains.|
|Vegetables||Potatoes, corn, beetroot, onion, garlic, cabbage, eggplant, tomato, pumpkin and zucchini|
|Greenery||dill and parsley|
|Butter||All kinds of vegetables and creamy|
|fruit||Citrus, strawberries, pears, green apples, persimmons, apricots, dates, cherries, blueberries - fresh, baked and dried|
|walnuts||All types except peanuts, but not more than 30 g/day|
|condiments||Cinnamon, vanilla, bay leaf, citric acid, vinegar|
|To drink||Kisels, compotes, fruit and berry decoctions, fruit drinks, low-brew green and black tea, fruit and milk shakes and smoothies, fruit and vegetable juices (diluted with water), chicory drinks, alkaline mineral water, kvass|
|Candy||Jam, caramel, honey, marmalade, marshmallow, marmalade, jams and marmalades, protein meringues, marshmallows|
It should be noted that meat and fish should not be eaten often: 2-3 times a week is enough. Also, in one portion there should be no more than 150 grams of meat and 160 grams of fish. It should also be remembered that the broth in which these products are boiled should not be eaten. The same goes for the seafood chowder.
If using whole milk, it is best to dilute it with water beforehand. It is preferable to add butter to ready-made dishes, and not to use it in its pure form. Especially useful among vegetables are potatoes and cucumbers, because they contain potassium. This element helps eliminate uric acid from the body naturally.
It is recommended to replace animal fats with vegetable fats as much as possible so as not to overload the digestive tract and kidneys. Many of the approved foods have the ability to remove excess urate and reduce inflammation.
Some vegetables and fruits can be consumed, but in limited amounts. These include radishes, turnips, cauliflower, green onions, bell peppers, asparagus, radishes, celery, and plums. It is also impossible to abuse legumes, mushrooms, pickles, marinades and sausages.
Previously, doctors forbade eating tomatoes because of their oxalic acid content. Today, this vegetable is rightfully considered one of the most useful for gout in the legs. The percentage of acid in tomatoes is negligible, but they contain vitamins, minerals and organic acids.
Ripe tomatoes are a source of vitamin C (they contain almost as much as citrus), Boneand Btwo, PP, K and carotene, as well as potassium, phosphorus and iron. Thanks to this composition, the immune system is strengthened, metabolic processes are normalized, and the intensity of inflammation during attacks is reduced.
Reference: Tomatoes provide maximum benefit after heat treatment and in combination with vegetable fats.
If you remove unhealthy foods, i. e. high in purines, from your diet, it will almost immediately affect your well-being. The frequency and intensity of gout attacks will decrease, the work of the urinary and cardiovascular systems will normalize.
Thus, from the daily menu are excluded:
|flour products||Butter buns, cakes, pies, eclairs|
|First courses and sauces||Meat, fish, mushroom broths; sorrel soup, peas, lentils and beans, mayonnaise and sauces based on it|
|Bird meat||All kinds of sausages, meat from young lambs, calves and sheep, fatty pork, offal, stews|
|Fish||Oily fish: sardines, herring, anchovies, tuna, mackerel, trout, salmon and fish roe.|
|Cheese||Spicy and salty cheeses|
|fruit||Grapes, raspberries, figs, viburnum|
|spices||Mustard, horseradish, hot pepper|
|To drink||Strong tea, coffee, cocoa, alcohol of any concentration|
It should be noted that the purines in alcoholic beverages do not break down into uric acid when ingested. However, they are capable of suppressing the synthesis of the hormone vasopressin, which maintains normal fluid levels. With its active production, kidney function is stimulated, due to which excess uric acid is quickly excreted.
After drinking a beverage containing alcohol, the production of vasopressin decreases and the person becomes dehydrated. The volume decreases and the viscosity of the circulating blood increases, which leads to an increase in the level of uric acid.
In addition, the amount of moisture in the cartilage tissue decreases to a critical level, due to which it loses firmness and elasticity. The cartilage dries up and cracks, it cannot withstand the usual loads. As a result, the joint becomes inflamed and hurts even more.
Reference: Vodka is considered relatively safe by rheumatologists as it contains no purines. However, you can drink it in very small amounts - no more than 50 grams.
Diet number 6 provides 1 unloading day per week. On this day, a mono-diet is observed, consisting only of vegetables and fruits, or sour-milk products. You need to eat in a fractional way, avoiding a strong feeling of hunger, and drink water and drinks in the same volume.
The size of a single serving is approximately 150 gr. For example, on one of these days you can eat about 400 grams of cottage cheese and drink ½ liter of kefir. Another option is 1 - 1. 5 kg of apples or oranges. If you plan to eat vegetables, then you should choose only one variety (except radish and sorrel). Vegetables are used boiled, stewed, baked or raw, as well as in the form of juice.
Mineral water today can be bought at any supermarket, drinking it is useful for people with pathologies of the endocrine system and metabolic disorders.
Some people are not very fond of vegetables and dairy products. In this case, you can eat rice and apples all day. Rice (75 gr) should be boiled in milk diluted with water and eaten in small portions throughout the day. Apples can be eaten fresh or cooked in compote, but without the addition of sugar. A day is allowed to eat no more than 3 apples.
Reference: fasting is strictly prohibited, as it leads to a sharp increase in the concentration of uric acid in the blood.
How to eat with a gout attack
If an attack has begun, a strict diet is necessary, but not more than 3 days. For this period, it is necessary, first of all, to exclude meat and fish. With a long course of an attack of gout, fasting days should be carried out 2-3 times a week.
The full menu for one day might look like this:
- 1 breakfast: half a glass of rosehip infusion, chicory decoction or alkaline mineral water;
- 2 breakfasts - ½ portion of rice porridge or semolina, a glass of milk;
- afternoon snack (1-2 hours after the second breakfast): a glass of strawberry jelly or some fresh strawberries;
- lunch - ½ portion of vegetable puree, a glass of applesauce;
- afternoon snack - a glass of carrot juice or tomato juice;
- dinner - a glass of bifilin, fermented baked milk or kefir;
- before bedtime - lightly brewed black or green tea with the addition of milk and honey.
When the attack passes, you need to gradually expand the diet and introduce boiled meat into the diet. For better assimilation, it is advisable to pass it through a meat grinder or steam cutlets, meatballs and meatballs.
Seven-day menu for diet number 6
Proper nutrition, which is recommended for patients with gout, is diverse. In addition, all the recipes are very simple and the diet meals are delicious and satisfying. Each one can choose among the allowed products the ones they like the most.
- For breakfast: cheesecakes with honey, chamomile tea.
- For lunch: rice soup with potatoes, buckwheat with boiled chicken, a slice of black bread.
- For snack: apple and carrot fruit casserole, a glass of rose hips.
- For dinner: baked eggplant, boiled veal, compote.
- Before bedtime - a glass of fermented baked milk.
- For breakfast: scrambled eggs from 3-4 quail eggs, milk sausage, fresh cucumber salad, chicory drink.
- For lunch: milk soup with pasta, potato pancakes with sour cream, green tea.
- For snack: wheat bread toast, jam, a glass of alkaline mineral water.
- For dinner: steamed cod, vegetable stew with carrot and zucchini, bran bread.
- Before bedtime: curdled milk.
Milk noodle soup is low in calories, but an excellent source of protein and complex carbohydrates. Also, this dish contains potassium, iodine, manganese, iron, copper, calcium, vitamins B, C and D.
- For breakfast: hard-boiled egg, rice porridge with milk, sandwich with white bread and cheese.
- For lunch: mashed potatoes with boiled turkey, cherry jelly.
- For afternoon snack: cottage cheese with nuts and grated prunes, a glass of milk.
- For dinner: stuffed peppers with sour cream sauce.
- Before bedtime - a glass of kefir.
- For breakfast: a salad of grated apples and carrots, white bread toast with jam, weak tea.
- For lunch - lean borscht with sour cream, veal cutlet with millet porridge, black bread.
- For a snack - cottage cheese paste made from mashed cottage cheese with the addition of vanillin, butter and sugar. To prepare it, you need 200 grams of cottage cheese, 15-20 grams of butter, 2. 5 tablespoons of sugar and a pinch of vanillin. You can add sour cream or fruit to the finished paste.
- For dinner: baked potatoes with cheese. Such a casserole is made simply: potatoes are cut into thin plates and laid out with salts in a small form. Salt, pour over vegetable oil and put grated cheese on top. Cover the form with foil and place it in the oven for half an hour. Remove foil 5-10 minutes before ready.
- Before bed: chamomile tea.
- For breakfast: sandwiches with sausage, pear jelly.
- For lunch: beetroot soup, sour cream if you like, noodles with chicken meatballs.
- For a snack: carrot cutlets, tea.
- For dinner: soft-boiled chicken egg, baked zucchini, orange juice.
- Before bed: an apple.
- For breakfast: buckwheat with diluted milk, cottage cheese with noodles, rosehip broth.
- For lunch: beef goulash with boiled potatoes, tea with lemon.
- For snack: a glass of carrot juice.
- For dinner: barley and vegetable soup, cheese sandwiches, compote.
- Before bedtime - a decoction of wheat bran.
- For breakfast: potato pancakes with sour cream, a glass of milk.
- For lunch: baked lean pork with stewed cabbage, fruit jelly.
- For snack: cottage cheese pudding.
- For dinner: baked pumpkin with honey.
- Before bed: cranberry juice.
Cottage cheese pudding is a food rich in animal protein, tasty and easily digestible.
Reminder: do not forget that one of the days must be a download day.
This is a 7-day sample diet recommended for people with gout. However, such nutrition will also be useful for a healthy person: a fractional meal, a minimum of animal fats and a significant amount of vegetables and fruits have a beneficial effect on the gastrointestinal tract, and also contribute to the normalization of body weight.
Thanks to diet number 6, uric acid is excreted from the body in time, thereby preventing inflammation in the joints. The use of low-purine or purine-free foods significantly increases the effectiveness of drug therapy.
Since the reaction of urine changes to the alkaline side, the decomposition of kidney stones (stones) is accelerated and facilitated, and they leave the body painlessly. Proper nutrition significantly reduces or eliminates pain and allows you to achieve a stable remission. Be healthy!