Low purine diet
|Low purine food and drink|
|Breads and cereals: low fiber, white flour, or refined grain types|
|Coffee and tea|
|Cream-style soups made with low-fat milk|
|Eggs (limit to 3 to 4 per week)|
|Fruits and juices|
|Fats and oils in small amounts|
|Low-fat and fat-free cheeses|
|Milk: skim or 1% (limit to 24 ounces per day)|
|Nuts and peanut butter: limit if trying to lose weight|
|Pasta and macaroni|
|Soups made without meat extract or broth|
|Sugar, syrup, and other sweets in small amounts|
|Vegetables not on the following lists|
|Medium purine food and drink|
|Beef, lamb, pork, and other red meats not on the high purine list|
|Dried beans, peas, lentils|
|Fish and shellfish not on the high purine list|
|Fresh beans and peas|
|Meat soups, broths, gravies|
|Oats and oatmeal|
|Poultry foods not on the high purine list|
|Wheat germ and bran|
|Whole grain foods|
|Yeast: all types|
|High purine food and drink|
|Broths, bouillons, and consommés|
|Caviar or roe|
|Game meats, like goose, duck, and partridge|
|Some fishes, like herring and mackerel|
|Organ meats: brains, heart, kidney, liver, sweetbreads|
|Scallops and mussels|
According to the American Dietician Association (ADA), foods that contain 150mg or more purines per 100g serving should be avoided. In addition to limiting purine-containing foods, the diet also includes modification of these dietary factors:
Protein intake limited to 10-15% of total calories or 0.8g per kg body weight for well-nourished individuals. Persons who are poorly nourished or in the inflammatory phase of the disease should consume 1.5-2.0g per kg body weight per day.
Carbohydrate intake should be 50-55% of total calories.
Limit fat intake to 30% of total calories.
Cholesterol intake should be less than 300mg per day.
Maintain or achieve a healthy body weight. If weight loss is indicated, it should be gradual. Rapid weight loss through fasting or use of low-carbohydrate diets can cause the body to produce ketones, which may increase hyperuricemia.
Alcohol, especially beer, should be avoided because it increases purine production, leading to higher uric acid levels in the blood and urine.
Adequate fluid intake helps dilute urinary uric acid, which helps prevent formation of renal calculi. It is advised to drink 2 to 3L or 8 to 12 cups of fluid daily.
Other aspects of nutrition therapy, such as controlling diabetes mellitus, hypertension, and atherosclerosis, are also recommended.
Lifestyle changes along with medication are often needed to control hyperuricemia. Diet is generally considered an adjunct therapy to medication, but may be used as an alternative treatment if medications are not tolerated.
Do not follow a high-protein diet as it can worsen gout conditions.