• Low-Purine Diet

    What Is Purine?

    Purine is a compound found primarily in foods of animal origin. It is especially high in organ meats, anchovies, mackerel, and sardines.

    Why Should I Follow a Low-Purine Diet?

    A low-purine diet is usually recommended if you have gout . It may also be recommended if you have kidney stones or have had an organ transplant.
    The body metabolizes purine into uric acid. A buildup of uric acid can worsen symptoms of gout. If you have gout, eating a low-purine diet can help minimize uric acid production and thereby improve symptoms.

    Eating Guide for a Low-Purine Diet

    Food Category Foods Recommended Foods to Limit or Avoid
    Grains
    • Enriched breads, cereals, rice, noodles, pasta, and potatoes
    • Oatmeal (no more than 2/3 cup uncooked, daily)
    • Wheat bran, wheat germ (no more than ¼ cup dry, daily)
    Vegetables
    • All except those on the “foods to limit or avoid” list
    • Mushrooms, green peas, dried peas and beans, spinach, asparagus, cauliflower (no more than ½ cup per day)
    Fruits
    • All fruit and juices
    Dairy
    • Nonfat or low-fat milk, yogurt, and cheese
    • Eggs
    Meat and Beans
    • Eggs, peanut butter, and nuts
    • Red meat (eg, beef, lamb, pork, and veal), poultry, fish, and shellfish (no more than 4-6 ounces per day)
    • Dried peas, beans, and lentils (no more than 1 cup cooked daily)
    • Avoid: sweetbreads, sardines, anchovies, liver, kidneys, brains, meat extracts, herring, mackerel, scallops, gravies, goose, heart, mincemeat, and mussels
    Oils
    • Gravies and sauces made with meat
    Beverages
    • Carbonated beverages, coffee, tea, cocoa
    • Beer and other alcoholic beverages
    Other
    • Low-fat milk-based or vegetable stock-based soups
    • Sugars, sweets, gelatins
    • Salt, herbs, spices, and condiments
    • Baker’s and brewer’s yeast
    • Stock-based soups (eg, bouillon- and broth-based)

    Suggestions

    In addition to following a low-purine diet, here are some other suggestions for decreasing uric acid production:
    • Avoid or limit your intake of alcohol, especially beer. While alcohol does not contain purines, it increases your production of purine.
    • Drink 8-12 cups of fluid every day. This will help dilute your urinary uric acid, which can help prevent kidney stones from forming.
    • Consume low-fat or nonfat dairy products, such as milk and yogurt, on a regular basis. Research shows that these foods may help prevent gout from occurring.
    • Limit your intake of fat to 30% of your calories.
    • Don’t follow low-carbohydrate diets.
    • Avoid rapid weight loss, as this can increase your uric acid levels. If you need to lose weight, do so gradually.

    RESOURCES

    The Arthritis Foundation http://www.arthritis.org/

    The Purine Research Society http://www.purineresearchsociety.org/

    CANADIAN RESOURCES

    The Arthritis Society http://www.arthritis.ca/

    Dietitians of Canada http://www.dietitians.ca/

    References

    Choi HK, Liu S, Curhan G. Intake of purine-rich foods, protein, and dairy products and relationship to serum levels of uric acid: the Third National Health and Nutrition Examination Survey. Arthritis Rheum. 2005;52:283-289.

    Fam AG. Gout: excess calories, purines, and alcohol intake and beyond. Response to a urate-lowering diet. J Rheumatol. 2005;32:903-905.

    Gout: is a purine-restricted diet still recommended? American Dietetic Association website. Available at: http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/nutrition%5F5314%5FENU%5FHTML.htm . Accessed June 22, 2007.

    Hyon CK, Mount DB, Reginato AM. Pathogenesis of gout. Ann Intern Med. 2005;143:499-516.

    Low-purine diet. University of Pittsburgh Medical Center website. Available at: http://patienteducation.upmc.com/Pdf/LowPurineDiet.PDF . Accessed June 21, 2007.

    Nutrition care manual. American Dietetic Association website. Available at: http://nutritioncaremanual.org/auth.cfm?p=%2Findex.cfm%3F . Accessed January 3, 2009.

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