Julie Bove > wrote:

>I have to cook for a person with gout. And his favorite foods are the worst
>ones for it. Asparagus, red meat and seafood. And I was unwittingly
>serving the wrong things. Chicken with mushroom sauce. The chicken may
>have been okay but apparently mushrooms are not. And I've been making a lot
>of dried beans because they're cheap. Oops!
>
>I know that most fruit and vegetables are good. Spinach is not. I know
>that whole grains are good and that tofu might be okay. Eggs might be okay.
>But some people react to them.
>
>I am just kind of stumped when it comes to protein. I've been serving
>chicken and turkey but I'm sure that will get old. I have seen mixed things
>about cheese. Does cheese bother you?
>
>What can I fix? Luckily this person isn't a picky eater.

The good news is designing a gout diet is pretty straightforward.
The bad news is that there is a lot of misinformation out there.

Here is a summary of what you need to know:

Firstly, all persons with gout should normally be on lifetime
uric-acid control medication, with periodic blood monitoring.
The purpose of the diet is to lower the serum uric acid even
further, but not many people with gout can rely on diet alone.

(Some can, but usually after decades of medication treatment, which
has finally reduced the stored uric acid in their tissues.)

On the other hand, some people with gout rely on medication
alone and simply ignore diet. If their blood work continues
to be okay, there is no real problem with this, other than
one might be using higher dosages of the drugs than would
otherwise be necessary.

Assuming one wants to address diet, the three components that need
to be restricted for a gout diet a purines, alcohol, and fructose.

Purines are found in almost all protein sources and some vegetable sources.

Among protein sources, the only ones that is completely purine-free is
dairy. Egg whites also contain no purine. Everything else
that has protein also has purines, but in somewhat different
ratios.

Among vegetables, there are some with more purines than others --
you've already identified a couple such as asparagus and mushrooms.

Given with this information, you can go in several directions planning
a diet but the likely outcome is as follows:

1) The diet must contain the daily value of protein, but not much more.
The DV of protein is 50 to 60 grams.

2) A significant fraction of the protein should come from dairy.
(In my case, I try to get half my protein from dairy.)

3) Frutose (including all sweets) and alcohol should be cut back.

4) Vegetables are okay but avoid mass quantities of those vegetables
known to be high purine. Starches are okay (unlike sugar which is
one-half fructose, starches do not contain much fructose). Fats
are okay.

Some meat products, such as organ meats, are particularly high
in purines. On the other hand, some such as sausages or salami
are relatively low, because they are high fat without much protein.
The purines are associated with the protein part of the meat.

Previously, I posted a list of purine content vs. protein content
for various foods and I will see if I can locate that and re-post.


Steve