This page about a low purine food/restricted carbohydrate 5 course meal, was last reviewed or updated on 13 August 2014
Written by: The Publisher and Editor of www.best-gout-remedies.com
I have hyperuricemia (high uric acid), the pre-gout condition that is so common, so I'm just as interested as any gout sufferer in lowering my uric acid. And in ensuring it doesn't rise further. I'm still on my low carbohydrate Atkins diet which has been going really well (51 lbs lost in the past 10 months*)
When I've finished the diet, I'll still monitor my daily carb (carbohydrate) intake. I assume this diet might help reduce my hyperuricemia through the insulin resistance route and because my weight is falling. But I don’t really know, in my case, and there aren't, unfortunately, any studies on a low carb diet for gout.
I don't wish to be bored by my food, and nor do you I'm sure. So I am going to describe a slap-up five course meal that would fit into any low purine diet and into a low carb diet for gout. And I will keep an eye out for fructose.
I shall explain the main ingredients, and their amount, for each of the dishes I'll be eating. Note their purines and carbs. But I won't explain preparation, nor the cooking methods, except for the gravy because I'll explain an old way of doing it which is low or medium purine.
And low carb – it doesn't require any kind of flour. If you want the methods you can easily find them on the internet, or in a cookery book, or view the videos I link to. (Don’t forget to add the carbs of any extra ingredients you use, and try to find out their purines’ amount). I'll be eating well known dishes. In all there are seven low purine recipes here.
This meal is an ideal Sunday splurge since it takes time to prepare, and most people would have that time on Sundays. I am aiming for a meal of low purine food and low carbohydrate food which will also be below my CCL (Critical Carbohydrate Level **) of 80 NET carbs daily.(** See below for the definition of net carbs). This is the level at which I’m likely to start putting on weight if I have 3 consecutive days above 80, and I learnt this number by trial and error.
STARTER – Cream of Watercress soup
I'll start with a cream of a (mainly) vegetable soup. This could be pea and ham, broccoli, minestrone or any vegetable. Celery soup is a good idea of course. A study found that purines in vegetables don't raise uric acid. In fact most vegetables are low purine food (except beans, including soy beans (soya beans)). Celery which has been frozen can be used in cooked dishes, but if it has been frozen it isn’t so good to eat standalone.
In my meal I'll be having cream of watercress soup. Not familiar with watercress? Here are three watercress sites:
United States Watercress site
This watercress soup recipe has no potato which keeps the carbs down. Some recipes include potato which costs a lot of carbs.
Watercress's ability to lower uric acid has not been proved, but it's exceedingly healthy, and contains a useful amount of quercetin. On one purines table it is low purine. Green leafy vegetables like this are not high or medium purine. Cream is a low purine food. Both watercress and cream are low carb.
Alternate starter – Cream of Celery soup If you are not familiar with watercress, celery soup is more anti-gout because celery has anti-gout properties that watercress does not.
FISH COURSE – Oysters or Caviar
I think any gout sufferer, or anyone else for that matter, should eat high omega-3 fish for their EPA and DHA twice a week so I won’t pass up a chance to eat some. The rub is that high omega-3 fish such as mackerel, sardines, tuna, trout, and pilchards are also purine rich foods.
Uric acid not low enough If my uric acid was 5.0 mg/dL or below (i.e. two points below from where trouble might begin at 7.0) I'd be very tempted to have some smoked high purine, high omega -3 fish. But it isn't. Unfortunately it is much higher, so my choice of fish for the fish course should be low purine or medium purine (and low carb).
So it will either be a dozen oysters (low purine, low carb, and quite high omega-3) - very cheap in the country I live in (Philippines), they can be bought for pennies each.
Or, and it's a Sunday splurge after all, some caviar on low carb bread toast. Caviar is medium purine and low carb. And it is very high in omega-3, about 6.5 grams of EPA + DHA per 100 grams.
MAIN COURSE - Stuffed Roast turkey with roast (roasted) potatoes, peas, broccoli and a low carb sausage stuffing.
Today I'll choose a roast turkey. Turkey is medium purine meat. On other days I would eat "red" meat, which is also medium purine on these purine tables.
A serving of this stuffing costs 5 carbs. The ingredients here are low and medium purine, if you leave out the poultry seasoning which might be high purine.
Hint When making any stuffing using breadcrumbs, try to use low/lower carb bread. If you have difficulty finding low carb bread in your country, look for low sugar bread which will be lower carbohydrate than other breads.
I definitely won't be having game/ game meat, (duck, goose, venison, pheasant etc.), nor offal (organ meat) because these are purine rich foods. I want low or medium purine meat.
What low purine food vegetables to eat with the turkey? If this was just a low purine meal, most vegetables would not be a problem. But high carbohydrate vegetables to be avoided, or carefully monitored, include potatoes and parsnips. Both are also high GI (the higher the GI the faster the glucose gets into the bloodstream and therefore the faster calling forth of insulin – not desirable).
But I have an allowance of up to 80 net carbs today, and that will allow me 3½ ozs (100 grams) of roast (roasted) potatoes, which will be 14.2 net carbs. The roast (roasted) potatoes are a bit of a luxury, but are my absolutely favourite (favorite) way of eating potatoes. The other veg will be 3½ ozs (100 grams) of peas and 3½ ozs (100 grams) of super healthy broccoli. Both are low purine, but I have to note the carbs in them – 3½ ozs peas: 8 net carbs; 3½ ozs broccoli: 4 net carbs.
Low purine gravy The gravy needs to be finessed to ensure it's low purine food. The low purine trick when preparing gravy is NOT to use stock cubes gravy powder or pre-prepared gravies that just require the addition of water and heat. These are purine rich foods and we want a gravy that is low purine food. So we'll use an original method of making gravies, before stock cubes and the pre-prepared ones arrived, and it is a low purine, low carb method.
I'd be inclined to prepare a vegetable stock base, or turkey stock, and pour it into the roasting pan after the cooked turkey, remaining fat, and anything else in the roasting pan has been removed, so that the stock collects up the turkey drippings. It's also called de-glazing. (This is a way to do it with roast meat too). Thicken the gravy by boiling it down, and add a tablespoon or so of butter. (If you thicken with flour make sure you count the carbs – 1 tablespoon is 6 net carbs).
PUDDING (DESSERT) - Strawberries and cream.
I don't care whether it's high summer or not. I want to eat low purine food luxuriously today without putting on weight or giving my uric acid level a push up, or feeling bored with food. So it's 6 ozs (170 grams) of strawberries plus some double (heavy) cream. Strawberries: 6 net carb grams per 100 grams. Cream: 3 tablespoons (45 grams) 1.4 net carbs.
Like the celery soup, this is definitely an anti-gout dish. Both strawberries and cream are low purine, and low carb.
Strawberries have been known to be good for gout. They won't do your uric acid any harm. At best they may lower uric acid a little.
And cream might just lower uric acid a bit too, or more likely, not raise it. Whether the two proteins in milk that have lowered uric acid a little in a study work this way in cream is not known.
Fortunately where I'm living fresh strawberries can be bought in December, but if I couldn’t buy fresh I would not hesitate to use frozen ones. If the shops were out of frozen strawberries, or other frozen berries, my fallback position would be some berries out of a can, plus cream with the juice drained away because of the carbs, and given to a non-dieter.
FINAL COURSE - A variety of cheeses with cracker biscuits
Cheeses are low purine food (made from milk after all) and low carb, so there's no problem with them. The cracker biscuits (flour is high carb, be careful) are low purine and so is the butter you spread on them. Butter is low carb too. So I'll just have a couple which will cost me about 8 net carbs out of my allowance today of up to 80.
I could pass on the crackers and eat the cheese with with fresh, crispy celery A great taste combination from British cuisine. Look at your crackers' nutrition panel for the cracker carbs.
And how will all this be washed down?
A couple of glasses of wine (in my case I prefer red, but you can have white) are not likely to have an elevating effect on my uric acid. But I'll just have the two, medium wine glass size. That will cost me 2.7 net carbs per glass, so 5.4 (not rounded). And no more alcohol at all. What else will I be drinking?
Tea and coffee Tea and coffee are thought to be low purine, and low carb, but if I had sour cherry juice... it has 19 carbs per 8 ozs glass. That would have to be noted and deducted from 80. (Sweet would would even higher).
So cherry juice is high carb. Just ignore cherry juice unless you have gout, in which case drink it, and cut something else down/out to maintain the up to 80 limit.
I won't be drinking eight glasses of water daily just yet, but if I had gout I would.
So that's it. My low purine food banquet meal of up to 80 net carbs.
Breakfast I've also had a breakfast of two scrambled eggs (low purine, no/low carb) and 3 slices of bacon fried in olive oil (no/low carb but medium purine), with a slice of buttered toast from low carb bread (low purine). Total 12 net carbs.
Because I've been on a low carb diet for a few months, my appetite has fallen so that will probably be enough, plus snacks. I'll snack on nuts and if I do get hungry it's back to the refridgerator (refrigerator) for more strawberries and cream. Or an apple.
Do I have any negative feelings of self denial to-day? None at all. I've eaten to my heart's content. Perfect!
** The Critical Carbohydrate Level was explained by Robert Atkins MD, founder of the Atkins diet. It's the number of Net carbs (total carbs – fibre (fiber, see below)) you can eat daily without putting on weight or losing it. He also called it the ACE (Atkins Carbohydrate Equilibrium), and now in Atkins parlance it's referred to as Phase 4, lifetime maintenance.
In most people it varies between 60 -100 net carbs daily, but you will have to find out what is yours.
*** NET carbs is the number of carbs you eat that matter. i.e. those that raise blood sugar. On nutrition panels, take the number of fibre (fiber) grams away from the number of total carbohydrates. This is the NET carbs number. If a food has fibre (fiber) content, the NET carbs number will be lower than the total carbs number. More info: http://www.atkins.com
Note My carbohydrate numbers are shown as a guide only. Your exact amounts may vary somewhat.
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