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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.
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.
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:
These foods have high purine levels
These foods have moderately high purine levels
National Institute of Arthritis and Musculoskeletal and Skin
Diseases
www.nih.gov/niams/
Arthritis Foundation
www.arthritis.org
The Purine Metabolic Patients Association
www.pumpa.org
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.
www.marinurology.com/articles/calculi/foods/purines.htm
Wolfram G. [Diet therapy in gout]. Ther Umsch 1995;52:524–7.
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The information presented in the Food Guide is for informational purposes only and was created by a team of US–registered dietitians and food experts. Consult your doctor, practitioner, and/or chemist for any health problem and before using any supplements, making dietary changes, or before making any changes in prescribed medications. Information expires August 2007.