What you can and cannot eat if you have gout: menu and diet No. 6

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Home Health from A to Z Useful information Diet No. 6

Publication date: 05/19/2021

until December 31

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Diet rules No. 6

Before drawing up the diet itself, the Soviet scientist Manuil Pevzner investigated the causes of gout and uric acid stones in the liver and kidneys. The main factor in the development of these diseases are nitrogenous substances – purines. These components are found in every organism and plants. They themselves are safe: in a healthy body they break down, forming uric acid, and are excreted naturally. Disturbances in this process can be hereditary. But most often such a failure occurs due to improper nutrition.

If the body does not metabolize purines properly, uric acid crystallizes and forms stones and deposits.

Content:

• Diet rules No. 6
• List of products for table No. 6
• Menu for table No. 6
• Additional recommendations

Diet No. 6 for gout reduces the intensity of manifestations by eating alkalizing foods. The basis of the diet is vegetable and dairy dishes. The patient will also have to follow a drinking regime; there should be a lot of free fluid - approximately 2.5 liters per day if the patient does not have severe edema, chronic heart or kidney failure.

Products that contain oxalic acid are excluded from the menu and the amount of salt is limited (10 g per day). There should be little protein and fat; if illnesses are accompanied by weight gain, carbohydrates are also reduced.

All types of meat and fish are pre-boiled, because during cooking half of the nitrogenous substances remain in the water. For this reason, broths are not used as food, and during the first attack of gout or during its exacerbation, meat is excluded from the diet. For the same reason, soups can only be prepared with vegetable broths. After boiling, fish and meat can be used 2-3 times a week for other dishes: minced meat, casseroles, rolls, roasts, etc. Only dietary first courses are allowed: cabbage soup, beetroot soup, okroshka, borscht. You can add cereal, milk or a little noodles to them.

In general, nutrition according to diet No. 6 is the basis of a healthy diet. Meals on the diet are fractional, you need to eat at least 4 times a day. During exacerbations of the disease, the patient needs up to 1900 kcal per day. After an exacerbation and during the period of remission - 2800 kcal. The diet is balanced and complete, as it contains all the necessary components. Reducing purine intake (even over a long period of time) does not cause side effects or complications.

Dishes can be prepared using any heat treatment; you need to reduce the amount of fried food (2-3 times a week). The temperature of the food served is not strictly specified: it can be hot or cold.

Therapeutic diet number 6 is prescribed to the patient until significant improvement occurs. As a rule, this is a long-term nutrition program and, depending on the course of the disease, can last a couple of months or can drag on for years. Below we will consider in detail the diet number 6.

Mechanism of therapeutic action

Purine bases (nucleotides) represent a class of organic compounds that are the basis of the genetic material of cells (DNA, RNA). In the human body, they are involved in a complex metabolism, which results in the formation of uric acid, which is excreted in the urine. Gout is a metabolic disease in which the number of enzymes directly involved in nucleotide metabolism decreases. The result is an increase in the concentration of uric acid, the excess of which is deposited in the tissues in the form of crystals of uric acid salts. Some of them often accumulate in the tissues of joint structures, leading to the development of a specific inflammatory process and attacks of pain (attacks of “gouty” joint pain). Diet 6 for gout involves reducing the intake of purine bases into the human body, thereby reducing the concentration of uric acid in the blood and its salts in tissues.

Due to the reduced content of oxalic acid in the diet, it is possible to reduce the intensity of the formation of insoluble stones, therefore diet 6 helps prevent the development of urolithiasis. The table mainly includes food products that affect the reaction of urine, causing it to become alkaline. This leads to partial dissolution of already formed acid salts and insoluble stones from them.

Eating at least 4 times a day, reducing the level of refractory fats and extractive compounds have a beneficial effect on the state of the digestive system and the general well-being of a person.

List of products for table No. 6

To stop the formation of crystals from uric acid, you need to include alkaline food in table number 6:

• vegetables and fruits (fresh, cooked and pickled in large quantities);
• roots;
• bread from any flour (only 2nd grade);
• boiled and baked meat (150 g per day);
• lean fish (170 g per day);
• quail or chicken eggs (1-2 pieces per day);
• any cereals (except for dried unrefined cereals);
• prunes;
• fermented milk products, milk, cottage cheese;
• citruses;
• nuts;
• marmalade, pastille, honey, jam, jam;
• alkaline waters, chicory, green tea;
• herbal decoctions.

It is necessary to exclude from the menu foods containing purines:

• mushroom broths, meat soups, fish soup;
• fish caviar;
• fatty meat and poultry, offal;
• spinach and sorrel;
• mushrooms in any form;
• peas, soybeans, beans (except green beans), legumes;
• rich and sweet pastries;
• salted cheese;
• margarine (pure or in dishes);
• any smoked meats;
• raspberries, cranberries, viburnum, rhubarb, figs;
• spicy and highly salty: sauces, spices, herbs;
• alcoholic drinks.

It’s better to print out the grocery list or write it on a piece of paper to make it easier to follow all the diet rules at first. Making a daily diet from the proposed permitted foods is not as difficult as it might seem: you can have a first meal, meat with a side dish, cutlets, casseroles, homemade dumplings and dumplings, and much more. For a visual example, consider the menu for the week and some dietary recipes.

Harmful foods: the main enemies of gout

There will be no problems with creating a nutrition menu for gout. Doctors have clearly prescribed prohibited, unwanted and permitted products. The diet is compiled based on these lists. What foods should you not eat if you have gout?

1. Pork, beef, other red meat. Particularly harmful are the legs, heads, and tails—the parts of the animal that produce the sticky broth. Strong broths, jellies, lard, and smoked meats are prohibited.
2. Fish is partially limited. Salted, smoked, fried, fatty fish and canned food are prohibited.
3. Animal fats (except butter), products and dishes containing them.
4. Legumes: peas, beans, soybeans, chickpeas, peas.
5. Alcohol.
6. Spices, except salt, bay leaf and vinegar.
7. Coffee, cocoa and strong brewed tea.
8. Some berries are raspberries, grapes, figs.

What should you not eat in large quantities if you have gout? What foods should you limit? You should not include a lot of mushrooms, pickles, butter, and herbs in your diet. You can eat boiled meat and fish, but in limited quantities. Food for gout should be salted in moderation; it is better if the dishes are slightly under-salted. For vegetables, reduce the amount of tomatoes, radishes, celery, cauliflower, and sorrel.

Menu for table No. 6

Sample menu for a week for patients with gout and urolithiasis.

First day

Breakfast: cottage cheese pancakes, honey, chamomile decoction.

Lunch: a handful of prunes, homemade compote.

Lunch: soup with rice and bell pepper, mashed potatoes with stewed meat (70 g), bread.

Dinner: grilled or oven-baked vegetables, boiled beef (80 g).

Before bed: decoction of rose hips.

Second day

Breakfast: oatmeal with pieces of ripe apple and banana, chicory with milk.

Lunch: bran bread toast, jam, alkaline mineral water.

Lunch: milk soup with noodles, fresh vegetable salad.

Dinner: a piece of fish, stewed carrots and zucchini, bread.

Before bed: natural drinking yogurt.

The third day

Breakfast: soft-boiled egg, boiled milk sausage, fresh cucumbers, chicory drink.

Lunch: cottage cheese pasta with fresh fruit.

Curd paste: rub 200 g of low-fat cottage cheese through cheesecloth or a fine sieve. In a separate bowl, grind 50 g of sugar, 10 g of vanillin and 15 g of unsalted butter. Combine the two masses and add two tablespoons of sour cream, stir everything well. The finished paste can be used as a separate dessert or mixed with fruits and prunes.

Lunch: vegetarian beetroot soup, a little sour cream, pasta with chicken quenelles.

Dinner: potato casserole with hard cheese.

Casserole with cheese: cut raw potatoes into slices and place in a greased pan, alternating with grated cheese. The last layer should be cheese, put a few pieces of unsalted butter on it and pour over 100 ml of milk. Bake under foil or lid.

Before bed: chamomile decoction.

Fourth day

Breakfast: potato pancakes, sour cream, green tea.

Lunch: cottage cheese with mashed prunes and nuts, milk.

Lunch: soup with rice, potatoes and vegetables, vinaigrette, separately steamed meatballs, bread.

Dinner: fish jackdaws, steamed carrots, green beans.

Fish jackdaws: mince 200 g of pike perch fillet (with skin included). Pour 50 ml of milk into the minced meat and add 10-15 g of starch. Form oblong jackdaws and place them in boiling salted water for 10 minutes.

Before bed: bran decoction.

Day five

Breakfast: omelette of one egg, milk and wheat flour, vegetable salad, tea.

Lunch: fresh fruit (salad or smoothie), some walnuts.

Lunch: borscht without meat, sour cream, buckwheat porridge.

Dinner: pilaf with prunes, freshly squeezed juice.

Before bed: milk.

Day six

Breakfast: apple and carrot salad, toast with jam, chicory.

Lunch: berry jelly or jelly.

Lunch: tomato soup, oatmeal, rabbit or beef cutlet, bread.

Dinner: stuffed peppers with sour cream.

Before bed: fresh carrots.

Day seven

Breakfast: sandwiches with cheese, plain yogurt, tea.

Lunch: cottage cheese, berry juice.

Lunch: soup with barley and vegetables, potato cutlets in sour cream.

Dinner: a piece of boiled lean pork, fresh vegetable salad, buckwheat porridge.

Before bed: kefir.

Patients with gout are prescribed fasting days, 1-2 times a week. To unload, you can choose one product and eat only it throughout the day. Low-fat or calcined cottage cheese is well suited for such purposes. On a fasting day, you need to consume 150 g of it every time you feel hungry. It is forbidden to completely starve, this leads to even greater accumulation of uric acid in the blood.

So, for uric acid diathesis and gout, table number 6 is used. The diet excludes foods that contain a lot of purines. The therapeutic menu consists of alkaline foods that help remove breakdown products of nitrogenous substances from the body. As a result of such a diet, the patient gradually normalizes the correct process of excretion of uric acid, urine stones are broken down and new ones do not form.

Indications

There are several main medical indications, in the presence of which diet 6 is prescribed, these include:

• Gout.
• Uric acid diathesis with an increased likelihood of the formation of insoluble stones in the hollow structures of the urinary tract.
• Uraturia is an increased excretion of insoluble urate salts in the urine.
• Urolithiasis - diet 6 is a prerequisite for successful treatment of the formation of insoluble stones in the hollow structures of the urogenital tract, as well as for the prevention of the pathological condition.
• Oxaluria is an increase in the concentration of insoluble acid salts of oxalates in the urine, which is the initial stage of the development of urolithiasis.
• Cystinuria is an increase in the level of certain insoluble salts in the urine that have an acidic reaction. The pathological process in most cases is of hereditary origin.

Approximate diet

Diet No. 6 brings noticeable relief both during an exacerbation of gout or urolithiasis, and during the period of recovery from these ailments

A person prepares the “Table 6” diet for gout every day independently. The official diet provides only examples of dishes that can be adopted. Your doctor will give you precise recommendations on strict adherence to the menu.

The daily ration of the “Table 6” diet for gout necessarily includes about 2-3 liters of liquid. Salt can be consumed no more than 5 g.

Monday

• Breakfast: oatmeal with berries, tea, yesterday's bran bun
• Second breakfast: fruit salad
• Lunch: tomato soup, steamed chicken cutlets
• Second lunch: bell pepper and white cabbage salad
• Dinner: cottage cheese casserole with bananas

2-3 hours before going to bed, you can eat an apple or drink a glass of kefir. This late-night snack can be done any day. During the day, you should drink mineral water with an alkaline composition, rosehip decoction, and chicory.

Tuesday

• Breakfast: boiled egg, cucumber and tomato salad, rye toast
• Second breakfast: 100 g low-fat cottage cheese with a spoon of honey
• Lunch: potato soup with chicken meatballs, rice with vegetables, rosehip broth
• Second lunch: salad with seaweed, apple
• Dinner: fruit salad, a glass of low-fat kefir

Wednesday

• Breakfast: buckwheat porridge with milk diluted with water
• Second breakfast: cheesecake with honey
• Lunch: vegetarian borscht, beet salad, steamed fish cutlets
• Second lunch: salad of white cabbage and carrots, jelly with berries
• Dinner: rice with vegetables

Thursday

Cabbage and tomato salad - tasty and healthy

• Breakfast: boiled beet salad with low-fat sour cream, rye bun
• Second breakfast: cabbage and tomato salad
• Lunch: onion soup with croutons, pearl barley porridge with cabbage cutlet
• Second lunch: a glass of fresh berries
• Dinner: chicken meatballs with rice

Friday

• Breakfast: cottage cheese with berries and honey
• Second breakfast: apple and orange
• Lunch: potato soup with barley, vinaigrette
• Second lunch: one steamed chicken cutlet
• Dinner: vegetable cabbage rolls with rice, but without meat

Saturday

• Breakfast: semolina porridge with milk
• Second breakfast: fruit salad
• Lunch: vegetable soup, 100 g boiled chicken with boiled zucchini
• Second lunch: beetroot and carrot juice
• Dinner: bell pepper stuffed with rice

Doctor's opinion

Diet 6 was developed by physician Pevzner to improve the metabolism of uric acid in gout. At the same time, first of all, it was possible to achieve a decrease in the flow of nucleotides into the human body, which accordingly affected the course of gout. Within a few days after starting food intake, the patient’s general condition improved, and the frequency, duration and severity of gout attacks decreased. By reducing the functional load on the digestive organs, their work improves, dyspeptic symptoms, including bloating (flatulence), stool disorders, and discomfort in the stomach, are reduced. In the presence of concomitant obesity, the use of a modified diet 6 made it possible to reduce the patient's body weight. Dietary recommendations can be carried out in a medical hospital or at home. Table 6 is recommended for people with a hereditary predisposition to the development of gout to prevent pathological disorders of nucleotide metabolism.

Contraindications

There are several contraindications for using diet 6, these include:

• Individual intolerance to most products that form the basis of table 6 or the development of an allergic reaction in response to their entry into the human body.
• Severe cardiovascular pathology.
• Acute inflammatory kidney diseases.

The presence of contraindications is usually the basis for correction of dietary recommendations. At the same time, the list of permitted products is expanded or narrowed, certain dishes are replaced, as well as the diet. After the correction, it is usually possible to achieve the necessary therapeutic effect from the diet without negative effects on the human body.

Comments from nutritionists. Pros and cons of the diet.

Treatment of gout at the Gorny sanatorium necessarily includes dietary nutrition. Patients receive recommendations on how to eat properly if they have gout at home, which helps avoid exacerbations and complications.

“The right choice of a sanatorium is a significant step towards maintaining and increasing health. “Gorny” is a resort complex that combines the experience and knowledge of Russian and Soviet balneology. The presence of modern medical equipment and innovative installations, the professionalism of the staff and love for their work will serve as the key to extending longevity,” - head doctor of the sanatorium Alexander Olegovich Karaulov.