Tuesday, November 29, 2022

Should you avoid all high-purine foods in gout?

Not all purines are bad for high uric acid and gout. Some high-purine foods have purines that do no raise the blood levels of uric acid and are no more prohibited in gout.

Many food items have certain compounds called purines. They are metabolised or digested to form uric acid, which is excreted. If uric acid is produced in excess or is not excreted adequately, blood levels of uric acid rise. This can lead to a painful disorder of the joints called gout. Lowering high blood uric acid reduces the chances of gout attacks.

The body makes nearly 75% of our daily purine needs. The rest are ingested through foods. So individuals with high blood uric acid are advised to avoid foods high in purines. They are told not to eat meats, seafood, poultry, pulses, and vegetables such as spinach and asparagus. That is a textbook view, which is outdated and wrong.

It turns out that not all purines are bad. There are 4 types of purines: adenine, guanine, hypoxanthine, and xanthine. Out of these, only adenine and hypoxanthine raise the level of blood uric acids. The other two have minimal effect.

Various foods contain different combinations and amounts of purines. Many high-purine vegetables are rich in guanine. Plus, they are excellent sources of phytonutrients. So they should be allowed in diets advised in high uric acid and gout.

Similarly, fatty fish such as tuna, salmon, and mackerel are high in purines. However, they are excellent sources of omega-3 oils. So they should not be avoided in the diet for gout. Incidentally, fish oil is perfectly fine in gout as it is filtered and purines are removed from it.

The new trend is to differentiate between different high-purine foods. Here are the recommendations:

  • Avoid: Organ meats, shellfish (shrimps), high-fructose corn syrup-based drinks, alcohol overuse;
  • Limit: Meat proteins (chicken, pork, lamb, and beef), sugary foods (naturally-sweet fruit juices, sugar-sweetened beverages), alcohol, high sodium products (table salt, sauces, gravies), high-purine vegetables (cereals, beans, mushrooms, and soybean products);
  • Encourage: Low fat dairy, coffee, tea, eggs, whole grains, fatty fish.

Read:
Preventive strategies for high uric acid & gout;
Supplements for high uric acid & gout.

First published on: 12th August 2022
Image credit: Rheumatoid arthritis photo created by karlyukav – www.freepik.com

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