Monday, March 10, 2003
Gout-free diet
THERE's no such thing! This is our answer to one of the questions sent by our readers reacting to the article on gout last week. It is not just a matter of semantics but what doctors and dietitians can offer to gout-sufferers is a list of foods known to be "low in purines," the metabolic substrate from which uric acid is formed.
Truth to tell, Ilocanos, Pangasinenses and Cordillerans are at high risk of developing gout. The Ilocano food fare, which is very similar to favorite dishes of neighboring Pangasinan, is basically innards or internal organs cooked in myriad delicious ways.
Our parties, big or small, have tables laden with the likes of igado, dinakdakan, kilawen, bopis, dinuguan. The ingredients of these mouth-watering dishes are livers, kidneys, lungs, intestines, heart and sweetbreads, all top-heavy with purines. Our Cordillera brothers also eat with gusto all sorts of beans, which are regarded as very rich sources of adenine and guanine, purines which are converted to uric acid inside the body.
Another bothersome observation is the direct relationship of alcohol consumption with hyperuricemia and its eventual complication, gout accompanied by deposition of uric acid crystals called Tophi in soft tissues like ear lobes, wings of the nose and in joints especially the big toe. There is that ongoing rumor, quite unverified, that Baguio folks consume more alcohol than other Filipinos if just to ward off the chilly weather. Whether that is true or not, the metabolite of alcohol or ethyl alcohol behaves as weak acid and once it is in the kidneys, thus competing with uric acid for its excretion or removal.
In general, fishes, whether fresh water or salt water variety, are a welcome treat, especially among patients with hypertension and heart disease. But to a patient with high uric acid or already a victim of excruciating gout pains, the following fishes should be avoided or taken in small amounts: anchovies, sardines, mackerel and herring. Even mussels, shrimps and scallops have marked purine content. The following vegetables have also significant amounts or purines hence uric acid: asparagus, cauliflower, spinach, dried peas and mushroom.
Lest our readers start thinking that they won't be able to eat anymore, just to avoid gout, here's good news. Baguio has an abundance of celeries, cabbage, onions, leeks and parsley with can be consumed in moderate amounts. Milk, cheese and eggs are good protein sources especially during acute bouts of gout when meats are absolutely forbidden.
Much interest has been heaped lately on cherries. It is suggested although no yet confirmed by wide spread research projects, that cherries contain an enzyme that helps break down uric acid and to enhance urinary excretion. Although seeded, strawberries and blueberries are also allowed. Ironically, cranberries that are helpful to patients with kidney disease are not recommended to gout-sufferers because cranberries are acid formers that favor crystallization of uric sediments in the urinary tract.
All these dietary recommendations are brought to naught if the person forgets the most basic advice; which is 8-10 glasses of water. Water dilutes and therefore, lowers the acidity of urine pH and it increases the frequency of urination, athus removing uric acid from the body.
At this point in time, it is reassuring to know that for hyperuricemia, we have Allupurinol as inhibitor of xanthine oxidase, whhich form uric acid. Allurase 300 mg taken daily lowers blood uric acid. Although a strong gastric irritant, Colchicine can be used during acute gouty attacks, or patients may try the antiflamatory and pain relieving effects of a drug very new in the market, Etoricoxib 90 mg Arcoxia taken once daily relieves pain of joints. These, on top of smart choices and smaller portions of a variety of foods should alleviate the signs and symptoms of gout.
(March 9, 2003 issue)
Want Sun.Star news on your mobile phone? Click here.
Write letter to the editor. Click here.
Join the Sun.Star message board. Click here. |
