При распаде пуринов образуется мочевая кислота, которая в норме выводится почками и кишечником наружу. Если же происходит сбой в выведении этого вещества (при заболеваниях почек, например) или увеличивается количество поступающих в организм пуринов, то уровень мочевой кислоты зашкаливает, и она откладывается в суставах. Решением проблемы будет налаживание работы почек и уменьшение количества потребляемых пуринов. С этой целью разработана специальная диета (стол №6 по Певзнеру) для людей с повышенным уровнем мочевой кислоты в организме. Она основана на исключении продуктов, которые содержат пурины.
Какие продукты нужно полностью исключить при подагре?
Пуриновые основания – это одна из составляющих ДНК клеток. Практически все продукты питания содержат пурины, хоть в небольшом количестве. Диета исключает только те продукты, которые больше других содержат в себе пурины. Это продукты животного происхождения, особенно мясо и субпродукты. Из растительной пищи – это бобовые. А молоко и молочные продукты, несмотря на то, что содержат большое количество белка, не насыщены пуринами.
Алкоголь, который также запрещен при подагре, не содержит в себе пуринов. Но он значительно затрудняет выведение мочевой кислоты почками. И если прием алкоголя совместить с продуктами, богатыми пуринами, то количество мочевой кислоты в крови и моче резко увеличится.
Список нежелательных продуктов при подагре
- Хлеб и изделия из муки. Продукты из сдобного теста – вредные при подагре. Их можно заменить любыми изделиями из ржаной муки или грубого помола.
- Мясные продукты содержат огромное количество пуринов, особенно бульоны. Поэтому полностью исключаются первые блюда на мясных бульонах. Мясо ограничивается в употреблении. Его разрешается употреблять только в период, когда нет обострения, только нежирных сортов и только после термической обработки. После варки разрушается половина пуринов, содержащихся в мясе. Категорически запрещены любые субпродукты – печень, почки, сердце и прочее. Также запрещенные продукты – это мясо молодых животных (телят, цыплят, поросят, ягнят и других).
- Рыбные продукты. Жирная рыба и особенно консервы из нее содержат большое количество пуринов. Поэтому нельзя употреблять рыбные бульоны и жирные сорта рыбы. Это в основном морская рыба – форель, семга, сельдь, треска. Копченая, маринованная и соленая рыба также противопоказана. Тоже касается и морепродуктов – креветок, кальмаров, икры и прочего. Рыбу можно употреблять только нежирных сортов, только в отварном виде и не чаще 2 – 3 раз в неделю.
- Грибы – это продукты, противопоказанные при подагре. Запрещены грибные бульоны и блюда с грибами в любом виде. Они содержат большое количество пуриновых оснований. Единственный гриб, который можно употреблять при подагре – это чайный. Его используют и для устранения болевых приступов при обострении подагры.
- Молочные продукты. Молоко – это единственный продукт животного происхождения, который разрешен при подагре. Исключением являются сыры копченых и соленых сортов – брынза, сулугуни, фета, адыгейский, «колбасный» и другие. Также запрещены сыры с добавлением специй.
- Овощи. Запрещены при подагре все бобовые. Это фасоль, спаржа, горох, чечевица, соя и другие. Также большое количество пуринов содержит щавель, шпинат, ревень, листовой салат и цветная капуста. Все остальные овощи разрешены, но не в маринованном виде.
- Фрукты и ягоды. Запрещаются очень сладкие плоды инжира, клюквы и малины. Шоколад, конфеты и торт со сливочным кремом также противопоказаны. Сухофрукты не запрещены, но употреблять их можно в небольшом количестве и в промежутках между приступами подагры.
- Напитки. Кофе, чай и какао строго запрещены в период обострения заболевания. В промежутках между приступами можно выпить некрепкий кофе с молоком. Также не разрешены напитки, содержащие дрожжи – квас и пиво. Кроме этого, при подагре вредно красное вино и любой другой алкоголь. Консервированные компоты, газированные напитки и компоты из сухофруктов нежелательны при подагре. В большом количестве разрешается пить воду без сахара и газа, а также свежевыжатые соки, особенно из цитрусовых, отвар шиповника, молоко.
- Соусы и пряности. Все острые соусы (горчица, хрен), смесь перцев, кетчуп и майонез запрещены. Также не разрешаются маринованные закуски и соусы на бульонах.
Следует отметить, что диета – это основа в лечении подагры. Без соблюдения рекомендаций по питанию прием лекарственных средств может быть неэффективным. Несмотря на широкий перечень продуктов, запрещенных при подагре, рацион пациента должен содержать не менее 70 грамм белков, 80 грамм жиров и 400 грамм углеводов. Питание должно быть дробным, небольшими порциями через каждые 2,5 – 3 часа. Важно употребление большого количества жидкости, что обеспечит лучшее выведение мочевой кислоты.
Нужно правильно подобрать полезные продукты при подагре, чтобы хорошо питаться, не вызывая осложнений. При болезни нарушен обмен веществ, который ведет к отложению солей. Это значит, что из рациона нужно исключить продукты, содержащие пурины. Такая диета поможет облегчить симптомы болезни, а в дальнейшем способствует, при правильном лечении быстрому выздоровлению.
Зачем нужна диета?
Правильное питание при подагре предотвращает подагрические приступы, обострения и улучшает самочувствие пациента. Рацион эффективно дополняет основную терапию. Часто специалисты назначают при мочекаменной болезни и подагре, когда нарушен метаболизм, происходит отложение солей или образование уратов, диету N 6. Она способствует нормализации обменных процессов, выводу мочевой кислоты из организма, а также солевых отложений. Сюда входят рекомендованные продукты, без содержания пуринов, которые полезно употреблять для здоровья и организма в целом.
Нужно регулярно питаться, 4—5 раз в день, небольшими порциями. Нельзя голодать и злоупотреблять пищей, так как это способствует болевым приступам. Важно употреблять воду до 2 л в сутки, при обострении — 3 л. Диета при подагре на ногах разрешает пить фруктовые и овощные соки, травяные отвары или морсы. Врачи рекомендуют компот из фруктов и чернослива, кисель, воду. Также нужно минимизировать употребление соли, не более 5 мг в сутки. С помощью диеты можно похудеть, что актуально для людей с лишним весом.
Разрешенные продукты для больных подагрой
Таблица представляет список продуктов, которые можно употреблять:
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