High levels of uric acid – what to do?

High levels of uric acid – what to do?

Have you ever been to the doctor and been told that your levels of uric acid were excessively high? There are certain alterations to the diet which, together with medication if prescribed, will help reduce uric acid levels and thereby avoid serious complications such as gout.
A high uric acid level in the blood is called hyperuricemia. When purine is broken down, uric acid is produced. Purine is a substance found in many foods. Once produced, uric acid is carried in the bloodstream, passes through the kidneys and is expelled when urinating.
When the body produces an excessive amount of uric acid or the kidneys don’t eliminate this excess rapidly enough, hyperuricemia may occur. In severe cases it may lead to gout. Crystals accumulate in the joints, causing inflammation and acute pain.
There are some risk factors which include: excessive intake of alcohol, obesity, hypertension, kidney diseases, cardiovascular diseases, diabetes or a purine rich diet.
Foods which are rich in purine include: liver, brains, heart, tongue and kidneys, some shellfish (mussels, shrimps and seafood), fish (sardines, anchovy, mackerel and yeasts) and beer. When uric acid levels are high, these should be avoided.
Other foods with moderately high concentrations of purine are: meat, especially from young animals (chicken, veal, goat, lamb, suckling-pig, goose, meat extracts), oats, pulses (lentils, peas, beans) and some vegetables (asparagus, mushrooms, spinach, green beans).

Strategies for people with risk factors

Drinking plenty of fluids: especially water (at least 2 litres/day) will help with the expulsion of uric acid from your body.
▪ Increase the amount of water intake on hot days and during exercise in order to avoid dehydration;
▪ Add mint leaves, cucumber slices or lemon juice to your water bottle for flavour;
▪ Start your day with a large glass of water;
▪ Between meals drink herbal infusions – tea;
▪ Drink vegetable and fresh fruit juices;
▪ Add vegetable soup to each meal – lunch and dinner;
▪ If you are overweight or obese, losing weight will reduce risk factors
▪ Start practicing some type of physical activity (1 hour/day walking, swimming, cycling, dancing)
▪ Eat often and in small amounts, avoid more than three-hour intervals between meals;
▪ Avoid fatty and fried food (fast-foods, cream sauces, béchamel, pastry, cakes, ice cream and butter). Saturated fats lower the body’s ability to eliminate uric acid.
▪ Always include carbohydrates to your weight loss diet (potatoes, pasta, rice, whole meal bread) and avoid high-protein diets as they can contribute to an increased production of uric acid;
▪ Choose low-fat dairy products (yoghurts, cottage cheese)
Reduce the ingestion of meat and fish
▪ Eat no more than one small piece of fish or meat per day (+- 90g) and avoid the ones with high purine content;
▪ Make one vegetarian dish per day: e.g. omelet with vegetables, rice and salad with a skimmed yoghurt sauce;
▪ Add tofu, soya or egg dishes to your diet;
▪ Increase the amount of vegetables and whole grain cereals in your diet.
Avoid drinking alcohol, especially beer, as it interferes with the elimination of uric acid from the body
▪ Prefer water, fresh fruit juices or herbal tea as drinks;
▪ On special occasions, choose red wine instead of beer (during a bout of gout avoid all alcoholic drinks)
To assist you in increasing your water intake try…adding pineapple or orange with ginger to water.
Ingredients:
– ½ cup diced pineapple;
– ½ cup sliced orange;
– 1 tablespoon grated ginger
Liquidise the fruit with the ginger in a jar filled with water. If you prefer you may add sweetener.
Other ingredients you may wish to add instead of ginger are: cinnamon, berries, cucumber, aniseed or mint leaves.
You can fill your 1.5 litre bottle of water with your homemade tasty water to take to work and drink it during the day.
At home in the evening, don’t forget to make yourself one or two or more cups of delicious herbal infusion teas such as fennel, nettle and horsetail.
By Marina Augusto Estevão
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Marina Augusto Estevão is a dietician at the Hospital Particular do Algarve Group