Diet for gout is an integral part of complex therapy. If pharmacological medications help relieve pain, then it is possible to avoid another attack only by eating properly and balanced. Nutritionists recommend eliminating foods with purines from your diet. These are fatty meats, rich broths, and some types of vegetables. Correcting the weekly menu will allow you to achieve stable remission and lead an active lifestyle.
Content
- General description of the disease 1.1. Principles of treatment
- Can you drink alcohol if you have gout?
- The effect of alcohol on gout: risk factors 3.1. What to do if you have uncontrollable cravings for alcohol
Gout is one of the most common causes of acute arthritis. Over the past few decades, experts have noted a steady increase in morbidity, which is associated with the influence of various factors, including the widespread prevalence of cardiovascular pathologies, obesity, a decrease in the quality of food consumed, and an unfavorable environmental situation. Alcohol addiction also plays a significant role. According to experts, alcohol in gout is one of the serious risk factors for the development of both the disease itself and exacerbation during remission.
How to eat the product correctly
Tomato fruits are recommended to be consumed after heat treatment, for example, in the form of tomato paste or as part of a vegetable stew. Before cooking, it is recommended to carefully evaluate the degree of compatibility of products.
For people suffering from gout, you can prepare vegetable stew using this recipe:
- Peel two medium tomatoes, an onion and an eggplant and cut into circles.
- Place in layers in a frying pan, adding 3 tablespoons of odorless vegetable oil.
- Bake in the oven until done.
For this disease, you can eat tomatoes stewed, add them to cooked dishes, or steam them.
It is not recommended to consume salted and pickled tomatoes if you have arthritis - this can provoke an attack.
General description of the disease
The pathology is based on hyperuricemia - an increase in the synthesis of uric acid or the accelerated breakdown of nucleotide compounds with the formation of urates and a simultaneous decrease in their excretion by the kidneys. In addition to hereditary metabolic characteristics, the main causes of urea accumulation include:
- congenital or acquired pathologies of the hematopoietic system (leukemia, polycythemia, etc.), anemia, coagulation disorders;
- malignant tumors regardless of their location;
- some previous infections (mononucleosis, etc.);
- chronic kidney pathologies;
- uncontrolled use of diuretics, corticosteroids and some other drugs;
- heavy metal intoxication;
- thyroid diseases;
- regular, too intense physical activity, etc.
The disease occurs in several stages:
- Despite the beginning of metabolic disorders, there are no external manifestations of the disease.
- Attacks of acute gouty arthritis are typical, with the first metatarsophalangeal joint (big toe) being primarily affected. Inflammation develops due to the formation of urea crystals, which provoke a massive release of pro-inflammatory factors (cytokines, lytic enzymes, etc.). The onset of the attack is acute (symptoms develop literally within a few hours), usually after injury, infection, stress, eating purine-rich foods and drinking.
- Chronic gouty arthropathy develops. There is a generalization of the inflammatory process with the involvement of new joints and their deformation. The interictal period is shortened. Tophi (local accumulations of urates) gradually form on the skin, in the area of the fingers, knee joints, and feet. The eyelids and wings of the nose may also be affected.
Principles of treatment
The basis of therapy is a properly selected diet. You should completely avoid (or at least limit) the use of:
- meat by-products;
- fatty fish;
- fish and meat broths (and, accordingly, soups based on them);
- sausages;
- legumes, greens;
- sweets;
- carbonated drinks, strong tea and coffee.
The basis of the diet should be dairy and fermented milk products, vegetables (except for radishes, cabbage), fruit, boiled or steamed lean meat or fish, seafood, eggs. In case of exacerbation, drugs are used to normalize purine metabolism and reduce the level of uric acid, NSAIDs.
Can you drink alcohol if you have gout?
For a long time, it was alcohol in combination with excess eating that was considered the only cause of the disease. And although today the polyetiological nature of the disease is no longer in doubt, experts are convinced that drinking has an even worse effect on its course than errors in diet. It is believed that about half of exacerbations occur due to alcohol consumption.
The negative effect of alcohol on gout is due to changes in kidney function, increased reabsorption of urates and, accordingly, hyperuricemia. In addition, with regular violation of the doctor's ban on drinking, the metabolism of some biologically active compounds (in particular, adenosine triphosphate - ATP) changes, which is accompanied by serious pathological changes in purine metabolism.
Ethanol also affects the pharmacokinetic parameters of medications used to treat the disease. For example, in patients who regularly drink, the concentration of Allopurinol in the blood is lower (even when taken in the dose prescribed by the doctor) than is necessary to achieve the required therapeutic effect.
Data from clinical studies allow us to answer the question about the effect of individual alcoholic beverages on the course of the disease. Thus, it has been proven that the maximum increase in urea concentration occurs after drinking beer, and in women this toxic effect is more pronounced than in men. It has been established that drunkenness greatly increases the risk of concomitant cardiovascular disorders.
The fact is that standard beers, in addition to alcohol themselves, contain purines (about 8–10 mg per 100 ml). Most likely, the metabolism of purine bases causes hyperproduction of urate.
The opinion of doctors regarding what kind of alcohol is suitable for gout is ambiguous. On the one hand, wine does not cause such a pronounced increase in uric acid levels (naturally, we are talking about high-quality, natural varieties). But on the other hand, a 10-year observation of patients suffering from hyperuricemia demonstrated that even occasional drinking in moderate quantities provokes an exacerbation.
Doctors' opinion
Most often, doctors calmly allow the consumption of tomatoes if you have gout. This product affects your health and, in case of joint diseases, can prevent the development of complications.
By adding tomato to the diet, it is possible to maintain normal acid levels in the body.
Tomatoes contain acids such as oxalic, tartaric, acetic, glycolic and others. Not all doctors are confident in the beneficial effects of tomatoes on the body of a person suffering from gout, but most of them do not prohibit consumption.
The effect of alcohol on gout: risk factors
In addition to the negative impact of alcohol on the pathogenetic mechanisms of disease progression, systematic drinking also leads to:
- non-compliance with the diet or medication regimen prescribed by the doctor;
- obesity;
- regular episodes of dehydration (typical of binge drinking)
- increased risk of damage to the heart muscle and kidneys (doctors emphasize that renal failure due to gouty arthritis is fatal in 20% of cases);
- arterial hypertension;
- pathologies of the gastrointestinal tract, which makes it difficult to use non-steroidal anti-inflammatory drugs - one of the main drugs for alleviating arthralgia.
What to do if you have uncontrollable cravings for alcohol
Even in the absence of other diseases, a pathological craving for strong drinks is a good reason to consult a narcologist. In case of gouty arthritis and concomitant diseases, drugs for anti-alcohol coding are used with caution. But even if there are contraindications to this method of treating alcoholism, doctors will select a completely safe way to get rid of addiction (for example, psychotherapy, hypnotic blocking). Effective rehabilitation programs will also help you cope with drunkenness.
Each person is individual, so it is simply impossible to establish a “safe minimum” amount of drinking. And in all international recommendations and treatment protocols there is a clear answer to the question of whether it is possible to drink alcohol for gout - any alcohol-containing drinks are strictly contraindicated. In addition, doctors emphasize that the success of therapy largely depends not on the medications taken, but on diet.
Literature:
- Zhelyabina O.V., Eliseev M.S. Diet for gout and hyperuricemia. — Scientific and practical rheumatology, 2021. — 55(4).
- Gromova M.A., Tsurko V.V., Melekhina A.S. A rationally based approach to nutrition in patients with gout. — Clinician, 2021. — 3–4, volume 13.
- Khitrov. ON THE. Gout is the queen of diseases and the disease of kings (10 commandments of gout). - Medical Council, 2012. - No. 3.
- Barskova V.G., Eliseev M.S., Nasonova V.A., Nasonov E.L. Alcohol and the clinical picture of patients with gout. - Modern rheumatology, 2007. - No. 1.
The text was checked by expert doctors: Head of the socio-psychological service of the Alkoklinik MC, psychologist Yu.P. Baranova, L.A. Serova, a psychiatrist-narcologist.
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How to cook delicious and healthy dishes with tomatoes
To diversify your diet, it is recommended to include several dishes prepared with the addition of tomatoes. It is recommended to use them 3-4 times a week.
Here is a list of several healthy and affordable dishes:
- Gazpacho. To prepare it, puree 2 large tomatoes, 3 cucumbers, a medium-sized bell pepper, and a quarter of an onion in a blender. Pour the mixture into a clean salad bowl and place in the refrigerator for an hour. Before serving, garnish the dish with vegetables or finely chopped herbs.
- Tomato soup. Boil 4-5 tomatoes without peeling them, then remove them. Cook the tomatoes until pureed, stirring constantly. Add sautéed carrots and onions to it, stir and bring to a boil. Boil the potatoes, cut into cubes, combine everything and bring to a boil. You can serve it with greens.
- Pasta with tomatoes and shrimp. Chop the tomatoes and simmer in a saucepan with a lid for about 5 minutes. Grind a bunch of basil and a couple of cloves of garlic in a blender. Boil the pasta and scald the shrimp with boiling water. Mix everything with the tomato mixture.
- Tomato salad with cheese and garlic. Cut the tomatoes into slices, place in a frying pan with a small amount of vegetable oil and heat without stirring. Then place in a clean salad bowl, mix with chopped garlic and mozzarella cheese, cut into pieces.
Tomato salad with cheese and garlic
