Q: It is said that food items that cause increased production of uric acid in the body (wines, fermented food, sprouts of all varieties) should be avoided in gout. What kind of fermented (vegetarian) food we should avoid in a typical Indian scenario? Does it mean that buttermilk also should be avoided as yoghurt is fermented food and for that matter idli, dosa, etc.?

A:Gout is caused by high levels of uric acid in the body. The uric acid forms crystals in the joints causing pain and inflammation. Purines consumed in the diet account for about 50 percent of the uric acid produced in the body. Therefore, avoiding foods high in purines or following a modified purine diet may help improve gout. The gout diet puts emphasis on dairy products, vegetable protein and water intake and avoiding food high in purines. Milk is a purine free food and can be safely consumed. On the other hand, fermented milk products such as yoghurt, buttermilk and aged cheeses have purines and hence should be avoided. The non-fermented milk products like cottage cheese and whey protein can be taken. General guidelines for gout are - - Restrict meat/fish/poultry intake - Avoid alcohol - Lose weight if overweight - Exercise regularly - Drink 8-10 glasses of water a day - Eat plenty of fruits & vegetables - Have more starchy foods like rice, bread, noodles etc. Restrict foods high in purines: - Organ meats such as liver, kidney - Selected fish and shellfish - Meat & yeast extracts brewers and bakers yeast - Meat soups & stock cubes - Pulses like channa, rajma, moong, sprouts, lentils and soyabean - Selected vegetables - spinach, beans, asparagus, cauliflower, mushrooms & peas