Low-Purine Foods: Eat These Foods When You Have Gout

Low-purine foods help to reduce or prevent symptoms of gout. A rough compass, which foods contain little and which contain a lot of purines, supports the daily choice of food. If you want to orientate yourself, you can find out the most important information in this article.

Low in purines: Foods that have little impact on uric acid levels

Anyone who is confronted with the clinical picture of gout is often recommended to eat a ‘low-purine diet’. However, this is not succinct at all. Because it means in concrete terms: The choice of food is restricted. There are big differences in the purine content of each food group. However, no one needs to despair. With the right knowledge, you can still conjure up really varied and healthy dishes on the table.

• Purines are substances that are found in almost every living being – whether human, animal or plant. They are components of the genetic material, i.e. contained in the so-called DNA and RNA, and also form the ‘backbone’ of numerous energy carriers in the cells.
• So there is absolutely nothing wrong with purines per se. They are all natural and important building blocks of our lives and metabolism, just like sugars, fats, proteins and more. Our body can even make them itself.
• What can cause problems, however, is that purines are broken down in the body into uric acid. About 80 percent of this is excreted through the kidneys, the rest through the intestines. However, the excretion of uric acid via the kidneys can be disturbed.
• Malnutrition or medical treatment can also result in an excessive uric acid load in the body. These large amounts then lead to deposits and inflammatory reactions as well as pain in the joints. This is how gout develops. This is often referred to as hyperuricemia.
• The current recommendation from experts, such as the German Gout League eV: no more than 400 mg uric acid equivalents per day for gout sufferers. Converted into purines, that means a maximum of 167 mg per day. In the case of active relapses, a maximum of only 300 mg uric acid or 125 mg purines. The conversion factor is 2.4.

Recommended for gout: Low-purine classics

The content of purines is not the same in every living being and not in every organ or tissue, and therefore not in every food. Meat, sausage, fish and, above all, animal innards are usually just bursting with it. Uric acid levels of 150-200 mg/100 g are not uncommon among them. On the other hand, milk and milk products, edible fats and oils, many types of vegetables and fruit make little or very little contribution to the daily exposure to uric acid. You can access the following foods with low-purine food:

• Vegetables: You can wallow in them. Almost every vegetable, many salads bring you a lot of important vitamins, minerals and vital substances (secondary plant substances) with a very low purine content (figures in mg uric acid/100 g food): Alfalfa sprouts 15, green beans 43, Chinese cabbage 26, iceberg lettuce 11, Fennel 16, spring onion 15, cucumber 8, potato 20, pumpkin 7, carrot 15, pak choi 25, pepper 15, radish 10, tomato 10, white cabbage 20, zucchini 24, onion 25.
• Fruit: Two servings of fruit per day are recommended even with a low-purine diet. They bring a lot of vitamins, minerals and secondary plant substances and thus support a healthy metabolism. In general, fruit contains very few purines or uric acid equivalents. A few examples (each mg of uric acid per 100 g of food): apple 19, banana 25, pear 17, blackberry 15, strawberry 26, blueberry 22, raspberry 18, persimmon 15, orange 19, peach 21, plum 20, watermelon 20, grape about 25-30.
• Cereals & Co: Grains such as wheat and rye contain a lot of purines, but you can still access them to a limited extent. It is better to choose whole grain varieties instead of flour extracts, because the accompanying substances make up for the extra purines in the whole grain. A few examples: whole wheat flour 82, pasta made from durum wheat 60, husked rice 87, brown rice 134, wholemeal rye bread 77, oatmeal with even 100 mg uric acid equivalents per 100 grams.
• But be careful : Wheat germ – definitely a superfood with a normal diet – should be avoided by people with gout: they have a value of 843 mg.
• Milk and milk products: If you tolerate milk, cream and acidified products made from it such as yoghurt, buttermilk, quark, then go for it. ‘Zero’ Purin is a clear statement here. A cheese platter sometimes makes a medium contribution. Many types of cheese have a low to medium uric acid content, e.g. Tilsiter 10, Camembert 30 mg/100 g.
• Eggs: If you are not suffering from high cholesterol, then you can treat yourself to eggs more often. 4 mg of uric acid formed per 100 g is not much.
• Fats and oils: Whether animal or vegetable, fats are naturally purine-free. So you can use fats without hesitation, but of course you should always keep an eye on the calorie balance. Choose preferably healthy fats according to the fatty acid profile, above all high-quality vegetable fats such as olive, rapeseed or walnut oil.
• Escapees: There are no rules without exceptions. Even with vegetables, especially with different types of cabbage and mushrooms, one or the other nutrition expert reduces the recommended portions: For example, spinach with 57, Brussels sprouts 56 or broccoli 50, as well as mushrooms 90 and porcini mushrooms 92 mg uric acid per 100 g. However: You should not completely eliminate these foods, because their generally positive nutrient profile outweighs the disadvantage of the high purine content.

Uric acid driver: A little less of that

In addition to meat, sausage, offal and fish, there are a number of other foods that should not end up on the plate in abundance if purines are causing you problems. Choose ovo-lakto-vegetabil and try to enjoy the following things in moderation:

• Legumes : Better to choose other alternatives if you need to watch out for purines. Because legumes contain quite a lot of it. Above all, green peas with 555 mg uric acid equivalent/100 g, chickpeas and soybeans around 350, lentils around 200. The values ​​for meat substitutes are similar: tempeh 110, soy meat (dry) 355 and tofu 68 mg/100g.
• Nuts & Seeds : They are undoubtedly healthy foods, but unfortunately some of them contain too many purines. You should eat these only rarely and in small amounts: peanuts 70, linseed 105, poppy seeds 170, sunflower seeds 157 mg/100 g. In contrast, the green light applies to walnuts 26, Brazil nuts 23, almonds 41 and hazelnut kernels 42 mg uric acid equivalent per 100 g.
• Yeast and yeast biscuits: Every cell with genetic information is full of purines. This explains why yeast and yeast extracts are so high in purines that people with gout should avoid them. Yeast joins in.
• Fructose: Found in fruit on the one hand, but also in many sweetened foods in the form of glucose-fructose syrup, agave syrup and more. Soft drinks often contain a lot of it too. The problem: Fructose increases the body’s exposure to uric acid via certain metabolic pathways. Therefore, according to the evaluation of studies, the following now applies : also keep a moderate dose of fructose.
• Alcohol: ‘less is more’ also means here. The kidneys are hindered in their work by alcohol and excrete less uric acid. That explains so many gout attacks after a drinking bout. Also: beer does not contain an excessive amount of purines with about 12 mg uric acid equivalent/100 g – because the ‘liquid food’ quickly reaches half a liter or a whole liter, the uric acid load is then calculated at least 60 or 120 mg.
• Drink a lot: herbal tea and water are the right companions throughout the day. Both are not reflected in the purine load. Drinking enough is especially important with gout disease so that the uric acid can be excreted again. Your goal should be 2-2.5 liters per day.
• Good news: Contrary to previous guidelines, gout patients are now given the go-ahead for caffeine- and tea-containing beverages such as coffee, black and green tea or cocoa. They were suspected of increasing uric acid levels because they themselves contain purine bases. It is now known that they take other metabolic pathways.

Gout: What you should also consider

Gout is considered a typical disease of affluence. In times of need, she hardly ever appears. Then there are other risk factors that could indirectly drive up the uric acid level: obesity and overeating.

• No quick diet: Strong and short-term weight loss helps to reduce excess weight. Nevertheless, you should approach your goal of normalizing your body weight with caution if you are at risk of gout. Because fasting cures also burden the breakdown of body cells with uric acid. The kidneys would then be temporarily overloaded, and sudden gout flare-ups would then be conceivable.
• By the way: With a consistent implementation of a low-purine food selection, the erumamic acid level in the blood can be reduced by about 10-15 percent. There is a need for action from a uric acid value of 6.5 mg/dl. In this case, ask your doctor for specific nutritional advice.
• Calculated easily: The Deutsche Gicht -Liga eV offers a ‘ purine calculator ‘ on its website, which can also be downloaded as an app to your mobile phone. This makes it easy to convert your planned ingredients and food rations into uric acid quantities.
• Medication in an emergency : it is not always possible to slow down gout sufficiently with nutritional measures alone. There is an urgent need for action, especially if the attacks occur more than twice a year, if the uric acid level is above 9 mg/dl or if the kidneys show signs of damage due to uric acid crystals and inflammation. In this case, your doctor will prescribe additional medication for you. At the same time, you should also follow dietary measures.