Managing Protein intake during a Gout Attack ( High Uric Acid Levels)

I am a tennis player. Last summer and again now I developed shooting pain in my wrist and ankle. A blood test revealed high uric acid levels. Could you explain this condition and any dietary changes which could reduce these levels?

This condition is commonly called Gout.

When protein rich foods specially non- veg like fish, seafood, mutton, chicken, beef, glandular meat like liver, kidney, etc. are digested in the body, uric acid is formed as a break down product. This must be flushed out of the body with plenty of water. If not urate crystals will form and lodge themselves in the cartilages of the joints like wrist, elbow, shoulder, ankle, toes, etc. This will result in shooting pain or a pricking pain.

This is seen to occur more frequently and obviously in summer as the normal water intake may be insufficient for the hot days. So the first step is to drink much more water than you drink now.

Second step is to make it a rule to eat less non-veg in the summer days. Try to eat it only once a day and preferably only at lunch so that there is time to digest it. Soups and gravies of meat or fish produce high levels of uric acid, so please avoid. Try to take out the pieces of non-veg from the curry or gravy when you eat non-veg. Use dhal/sambar as the liquid or gravy item along with roti or rice.

Athletes and sportsmen like tennis, badminton, cricket, etc. players seem quite susceptible to this. This could be due to increased perspiration during training and insufficient water consumption. Also players seem to be in and out of special training camps where lots of non- veg food is available. They eat large amounts of it thinking it will build their body. You need the protein but try to consume milk, egg and dhals along with the meat so that you eat lesser quantities of meat/poultry/fish. Milk and egg white are protein foods that do not raise uric acid levels.

Custard apple, chickoo, beans, peas, pulses-channa, rajma, moong sprouts and spinach too must be avoided when there is pain. These foods contain a high amount of purine, which gets converted to uric acid in the body. After the uric acid levels come down these may be eaten occasionally. We have also observed sudden gout attacks of pain after the consumption of too much alcohol, so please avoid.

Any kind of fasting and feasting can bring on an attack of pain. When fasting tissues, muscles in your own body are broken down and as this is similar to the breakdown of non-veg, uric acid is formed. When you over eat or binge eat, lots of breakdown of food occurs and uric acid concentrations rise and attacks of pain occur. Men are more prone to this condition than women. The level in the blood should not be more than 6mg/dl for men and 5mg/dl for women. Some women develop this after menopause.

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