This presentation tackles the topic of dietary necessities for patients suffering from Gout. Presentation provides critical information but should be combined with knowledge of the presenter since it's meant for proper presentation and not read-only. Use freely to study or present.

1. Diet in gout
Jan Stanislav Dorosz
M1770

2. Gout
Gout appears when there is too big accumulation of uric acid (hyperuricemia) in the
blood. When concentration of uric acid passes the threshold it can no longer stay
dissolved.
Excess uric acid forms needle-like crystals inside the joints.
Formation of uric crystals leads to inflammatory response resulting in WBC attacking the
uric acid deposits. This ends in joint pain and inflammation and is called “acute gout
attack”.
If left untreated deposits may become big enough to interfere with physiological structure
and function of the joint. (i.e. tophus).

3. Gout
Increased uric acid levels in the blood may be a result of either increased uric acid
production in liver or diminished uric acid elimination through kidneys.
Liver: Uric acid is a waste product of purine metabolism.
Kidney: Diminished uric acid elimination may be caused either by dehydration or
diminished kidney function.

4. Risk factors
There are several risk factors which can promote development of gout.
- Males (more uric acid production) and females after menopause
- Obesity
- Family history of gout
- Certain medical conditions (Hypertension, Heart and Kidney diseases etc.)
- Certain medications (Thiazide diuretics,

5. Goal of diet in gout
The main goal in diet used in gout patients is to keep healthy weight, healthy dietary
habits and reduce intake of contraindicated foods.
It is important for patients to give them professional advice and reach compromise.
Some patients when left without alternatives refuse to follow the diet and severely
increase risks of complications. (For example alternatives to red meat, seafood, etc.)

6. Contraindicated foods
Unfortunately for patient the list of contraindicated foods is long and consists of:
- Animal origin purine-rich proteins (red meat, seafood)
- Alcohol (especially beer, vodka, whiskey) - ethanol metabolism increases ATP
degradation leading to purine release and increase in uric acid levels.
- Sugar-sweetened beverages (fructose is the only carbohydrate known to increase
uric acid levels)
- Caffeinated beverages

7. Recommended foods
- Plant origin proteins (evidence suggests that protein intake per se is not responsible
for elevating uric acid levels, red meat and seafood intake however does)
- Vegetables (not only are they rich in vitamins and unprocessed nutrients, they also
proved to be safe in gout* - purine rich)
- Low-fat dietary products (showed to have uricosuric and anti-inflammatory action)
- High Vitamin C intake (heavily aids excretion of uric acid by kidneys - dose of
500mg/day)
- High water intake (to stay hydrated especially if one is using products that increase
water elimination) (ADDITIONALLY! Gout severely increases risk of kidney
stones formation, therefore high water intake - over 2-2,5 l/day is recommended)

8. References
1. Nutrition Guide for Clinicians, 30.11.2020,
<https://nutritionguide.pcrm.org/nutritionguide/view/Nutrition_Guide_for_Clinicia
ns/1342063/all/Gout>
2. Centers for Disease Control and Prevention, 30.11.2020,
<https://www.cdc.gov/arthritis/basics/gout.html>
3. National Library of Medicine, 30.11.2020,
<https://pubmed.ncbi.nlm.nih.gov/19353717/>

9. Thank you