Additional dietary recommendations can be made which reduce gout indirectly, hypertension, cardiovascular disease, diabetes, and metabolic syndrome.
The following suggestions do not meet with universal approval among medical practitioners.
Low purine diet:
* To lower uric acid:
o cherries were reported to reduce uric acid in a small study.
o celery extracts (celery or celery seed either in capsule form or as a tisane/infusion) is believed by many to reduce uric acid levels (although these are also diuretics). Celery extracts have been reported to act synergistically with anti-inflammatory drugs.
o Cheese has been recommended as a low-purine food, and dairy products have been found to reduce the risk of gout.
* Food to avoid:
o foods high in purines
+ limit food high in protein such as meat, fish, poultry, or tofu to 8 ounces (226 grams) a day. Avoid entirely during a flare up. Tofu has been proposed as a safe source of protein for gout patients due to its small and transient effect on plasma urate levels.
+ sweetbreads, kidneys, liver, brains, or other offal meats.
+ sardines and anchovies
+ Asparagus. Cauliflower. Mushrooms. Spinach. Dry beans (lentils & peas).
+ alcohol. Some claim that this applies especially to beer (high in guanosine), on the basis that brewer's yeasts are very rich in purine. Since most modern commercial beer contains only trace amounts of yeast, this claim requires further substantiation. Formerly, port wine was sweetened with litharge, causing lead poisoning, of which gout is a complication. Ironically, red wines, particularly those produced by traditional methods, contain procyanidins released from grape seeds during wine making, which have been reported to lower serum uric acid levels by an indirect mechanism. However, withdrawal of urate-lowering therapy is associated with recurrence of acute gouty arthritis.
+ meat extracts, consommés, and gravies
* To avoid dehydration:
o Drink plenty of liquids, especially water, to dilute and assist excretion of urates;
o Avoid diuretic foods or medicines like aspirin(aspirin should be avoided by those suffering from gout, unless specified by a qualified physician), vitamin C, tea and alcohol. The role of diuretics in triggering gout has been disputed.
* Moderate intake of purine-rich vegetables is not associated with increased gout.
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