Nutrición e hiperuricemia
Resumen
El aumento de la incidencia y prevalencia de hiperuricemia asintomática, la que está fuertemente asociada a los factores de riesgo cardiovasculares clásicos y la dificultad para definir su tratamiento con drogas ha jerarquizado al tratamiento dietético, a los efectos de identificar los alimentos que pueden tener efectos protectores sobre el nivel de ácido úrico plasmático (AU). Los niveles del AU dependen de la producción endógena (10%), disminución de la excreción (90%) o de ambas. La producción del AU depende de la ingesta de purina, sin embargo, una dieta rica en purina sería responsable solo de un aumento en 1 a 2 mg / dl del AU sérico. La pérdida < 5 kg disminuye hasta un 45% el riesgo de aumentar el AU, mientras que pérdidas superiores reducirían al menos el 60% del riesgo. De igual manera, el descenso del peso máximo y la estabilidad del peso disminuyen el riesgo de hiperuricemia. Se sugiere que este descenso no sea brusco para evitar el catabolismo muscular que puede conducir a sarcopenia con pérdida de la fuerza y debilidad muscular y aumento concomitante del AU. Reducen los niveles séricos de AU: leche, yogur y quesos blancos, las frutas ricas en vitamina C, huevos, frutas secas sin sal, legumbres (incluidas la soja) y pollo, salmón, bacalao y langosta. Debe limitarse las carnes rojas (cerdo, ternera, cabrito), y evitarse mariscos, pescados (trucha, atún, palometa, vieiras, anchoa, arenque, sardinas y atún en aceite), tocino, vísceras, pavo, cordero.
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