NUTRITIONAL TREATMENT OF GOUT

Urični arthritis (giht, ulozi) je sistemska bolest, a najčešće se ispoljava na zglobovima. Nastaje kao posljedica povećane koncentracije urične kiseline u krvi koja kristalizira u formi mononatrijevog urata, akumulirajući se u zglobovima, tetivama, te u okolnim tkivima. Nastali kristali pokreću lokalne imunološki posredovane upalne procese u tkivima. Urična kiselina nastaje složenom endogenom enzimski posredovanom razgradnjom purina ali i drugih jednostavnih metabolita. Purini su komponente nukleoproteina, a nalaze se u različitim količinama u većini vrsta hrane. Ograničenje egzogenog unosa purina sa hranom smanjuje mogućnosti stvaranja urične kiseline, reducira metabolički stres i nastanak upalnih procesa. Prema nivou sadržaja purina hrana se može podijeliti na hranu sa visokim sadržajem (100 do 1000 mg purina/100 g), hranu sa srednjim (10 do 100 mg purina /100 g) i hranu sa niskim sadržajem purina. Način ishrane samo dijelom može uticati na tretman bolesti. Tradicionalno, dijeta sa vrlo niskim egzogenim unosom purina preporučuje se u akutnim stanjima uz medicinski tretman. Nutritivni tretman bolesti treba biti bazirana na smanjenju tjelesne mase, primjerenom unosu ugljičnih hidrata, smanjenom unosu zasićenih masnoća i holesterola, primjerenom u unosu proteina, povećanim unosom tekućine i eliminacijom konzumiranja alkohola. Nutritivni tretman može dati značajanu podršku medicinskom tretmanu bolesti.Uric arthritis (gout) is a systemic disease, and usually manifests in the joints. Occurs as a result of increased concentrations of uric acid in the blood, which crystallizes in the form of mono sodium urate, accumulates in the joints, tendons, and in the surrounding tissues. The resulting crystals promote local immune-mediated inflammatory processes in tissues. Uric acid is formed by complex endogenous enzyme mediated degradation of purines and other simple metabolites. Purines are components of the nucleoprotein, and are found in varying amounts in most foods. Restriction of dietary purine intake of food decreases the ability to create uric acid, reducing metabolic stress and the occurrence of inflammatory processes. According to the level of purine content foods can be divided into foods with a high content 100 to 1000 mg purine/100 g), food with medium (10 to 100 mg purine/100 g) and foods that are low in purine. Only part of the diet may affect the treatment of disease. Traditionally, diets with very low intake of exogenous purine is recommended in acute situations with medical treatment. Nutritional treatment of disease should be based on weight reduction, adequate intake of carbohydrates, reduced intake of saturated fat and cholesterol, the appropriate protein, increased intake of fluids and elimination of alcohol consumption. Nutritional treatment can provide significant support to the medical treatment of disease