for Gout

Meal Plan

From Medifasts Director of Nutrition

Achieving optimal health and weight control is not always a one-size-fits-all equation. Lifestyle choices and medical conditions can affect your food preferences and requirements, which in turn have an impact on how you can best lose weight. Although the Medifast 5 & 1 Plan for weight loss is our most popular plan, it may not be optimal for all people. The Nutrition Support team at Medifast has created additional programs to meet individual needs and accommodate a range of medical conditions and lifestyles. Through continual research and careful testing, Medifast is creating new products and weightmanagement programs in addition to the 5 & 1 Plan so that you can successfully lose weight and stay healthy. Medifast began with physicians and other health care professionals developing a safe, effective weight-loss method with lasting results. Decades later, the program and products continue to evolve. We thank you for choosing Medifast and encourage you to review the following adapted 5 & 1 Plan with your doctor before you begin.

About gout
Gout is a form of arthritis marked by the sudden onset of painful, inflamed joints. The classic symptoms include abrupt, burning pain, with swelling, redness, warmth, and stiffness in the joint. Gout most commonly affects the joints of the big toe, but can occur elsewhere in the body, including the joints and surrounding areas of the foot, ankle, or knee. Gout is caused by an accumulation of uric acid crystals in the joints. Crystals can form when abnormally high levels of uric acid (hyperuricemia) are present in the body over an extended period of time. Mild hyperuricemia usually does no harm, and most people with hyperuricemia never develop gout. However, certain individuals may be more prone to develop gout when uric acid levels in the blood are too high. Some of the risk factors for gout include: Genetics or a strong family history A body mass index (BMI) over 30 (obese) Untreated health conditions such as high blood pressure, diabetes, high cholesterol and triglyceride levels, or kidney disease The use of certain medications

A gout flare-up can last a few days or as long as several weeks, after which symptoms can disappear completely, without recurring for months or even years.

Dietary Factors
Gout flare-ups can occur without a specific cause, and can be brought on by excessive weight gain, certain medications (especially aspirin and diuretics), and too much alcohol, which interferes with the removal of uric acid from the body. Flare-ups can also be brought on by eating a large amount of foods that are high in purines (a type of uric acid).

Small amounts of purines are found in all meats, fish, and poultry, but some foods are especially high in purines, including: Organ meats (liver, brain, kidney, sweetbreads, etc.) Anchovies Herring Mackerel Game meats

See page 7 for more examples of high-purine meats.

Using a modied 5 & 1 Plan when you have gout

If you suffer with gout, losing weight can help. Excess weight puts more stress on your joints and can increase your risk of hyperuricemia. Medifast products are completely safe to use even if you have a history of gout; however, Medifast does recommend certain modifications to the 5 & 1 Plan. Those with gout should lose weight gradually and steadily, using a meal plan that is slightly more liberal in calories and carbohydrates yet more restricted in protein than the 5 & 1 Plan, to lessen the risk of increased uric acid levels. Medifasts modified program for gout does not induce a fat-burning state, which can increase uric acid levels in the blood. Its higher calorie level promotes a more gradual weight loss than the regular 5 & 1 Plan, and it encourages food choices with only low or moderate amounts of purines.

The modications: Limit animal protein in your diet. Choose no more than 6 ounces of low- or mod- erate-purine choices of lean meat, poultry, or fish per day. Incorporate two servings of low-fat or fat-free dairy products daily; dairy products may help to prevent or decrease the risk of gout. Increase total calories and carbohydrates to allow for a more gradual weight loss and to decrease the potential of developing elevated uric acid levels. Choose foods that are low and/or moderate in purines, and avoid moderate purine choices during a gout flare-up. Avoid alcohol during the weight-loss phase and during flare-ups. Drink plenty of calorie-free fluids; plain water can help remove uric acid from the body. Limit higher-purine vegetables such as asparagus, cauliflower, mushrooms, peas, and spinach, and avoid them totally during a flare-up.

Remember, these are general recommendations every individual is different, so its important to discuss any weight-loss program with your health care provider to determine if its right for you.

The Meal Plan for those with gout

The following meal plan provides approximately 1,200 calories per day, and is the suggested meal plan for those with a history of gout. 1,200 calories per day
Number of servings/day Medifast Meals Grain servings Vegetable servings Fruit servings Lean meat and meat substitute servings Milk or dairy servings Fat serving 2 2 3 2 two 3-oz servings 2 2 4

Medifast Meals
Choose any two Medifast Meals to incorporate into your daily eating plan.

Grains
Choose two servings daily. One serving of grain equals: 1 cup unsweetened cereal 12 cup cooked whole-grain cereal 13 cup cooked brown rice 12 cup cooked whole wheat pasta 1 slice whole-grain bread Choose these foods Whole-grain bread Brown rice Whole-wheat pasta Whole-wheat flour Whole-grain breakfast cereal instead of these foods Refined white bread White rice Refined flour pasta Refined flour Sugary breakfast cereal

Look for: Foods with whole oats, whole rye, or whole wheat listed rst on the labels ingredients list. Breads with at least 3 grams of fiber in each slice. Foods with fewer added sugars, fats, or oils.

Avoid: Be wary of foods labeled multi-grain, stone-ground, 100% wheat, or bran; these are usually NOT whole-grain products.

Fruits
Choose two servings daily. One serving of fruit equals: 12 cup cubed fruit or berries 1 medium-sized piece of fruit (such as an apple, pear, etc.)

All fruits are low in purines so feel free to choose from your favorite fresh, frozen, or canned fruits without added fat, sugar, or sauces.

Vegetables
Choose three servings daily. One serving of vegetables equals: 12 cup raw or cooked vegetables 1 cup raw salad greens

Choose fresh, frozen, or canned vegetables without added fat, sugar, or sauce. Limit the following purine-rich vegetables to no more than 12 cup daily: Asparagus Cauliflower Spinach Mushrooms Peas

Protein
Choose two servings of lean meat/meat substitutes daily, for a total of 6 ounces per day. One serving equals 3 ounces of cooked meat (the size of a deck of cards, computer mouse, or the palm of your hand). Each of the following is equivalent to 1 ounce of lean meat: 1 whole egg, 2 egg whites, or 14 cup egg substitute (such as EggBeaters) 34 cup fat-free, 1%, or 2% cottage cheese 14 cup cooked beans, lentils, or other legume 1 ounce low-fat cheese (less than 3 grams of fat per ounce) 4 ounces tofu Choose these foods Boneless, skinless chicken breast Lean ground beef or turkey (85-95% lean) instead of these foods Chicken thighs with skin Regular ground beef or turkey (70-80% lean) Deep-fried or processed meat or fish

Grilled, baked, or broiled meats or fish Look for:

Lean cuts of beef and pork, such as loin and round cuts. Skinless poultry, such as chicken breasts and turkey cutlets. Meat that is baked, broiled, poached, or grilled, rather than fried. At least two servings per week of fish rich in omega-3 fatty acids, such as salmon, albacore tuna, or trout. Fresh cuts of meats instead of processed.

Limit animal protein (fish, poultry, beef) to no more than 6 ounces daily. Meat substitutes made from soybeans, textured vegetable-protein tofu, legume-type beans, eggs, egg substitutes, and low-fat cheese can also be used as sources of lean protein.

Avoid high purine meats such as: Liver and other organ meats (heart, kidneys, etc.) Game meats Goose and partridge Anchovies, sardines, mackerel, herring Scallops and mussels

Dairy
Choose two servings daily. One serving of dairy equals: 1 cup skim or 1% low-fat milk 1 cup low-fat or fat-free soy milk 1 cup low-fat or fat-free buttermilk 12 cup fat-free evaporated milk 1 cup fat-free non-nutritive- or fructose-sweetened yogurt 12 cup fat-free or low-fat plain yogurt Choose these foods Skim or 1% milk Fat-free/low-fat yogurt Look for: Fat-free or low-fat milk, cheese, and yogurt. Sugar-free yogurt. instead of these foods 2% milk/whole milk Whole-milk yogurt

Avoid: Sweetened milk products containing added sugars, which increase calories.

Fats and other foods

Choose two servings of fat daily. Monounsaturated 1 tsp olive or canola oil 8 large black olives 10 large pimento-stuffed green olives 12 Tbsp peanut butter 6 almonds or mixed nuts 10 peanuts 18 avocado Polyunsaturated 2 Tbsp low-fat salad dressing 12 Tbsp mayonnaise 1 Tbsp light or reduced-fat mayonnaise 2 whole walnuts or 3-4 halves 2 tsp Miracle Whip salad dressing 1 Tbsp pumpkin or sunflower seed kernels 1 Tbsp light or reduced-fat Miracle Whip 1 tsp trans fat-free margarine 1 Tbsp whole sesame seeds 1 Tbsp light spread (such as Smart Balance or Benecol Light) instead of these foods Butter Palm, palm kernel, or coconut oil; solid shortening Chocolate; high-calorie, high-fat desserts

Saturated 1 tsp butter 2 Tbsp cream (or half and half) 2 Tbsp sour cream 1 Tbsp regular cream cheese 1 slice bacon 2 Tbsp reduced-fat cream cheese Choose these foods Trans fat-free margarine

Oils high in omega-3, such as canola, soybean, peanut, or olive oils Small amounts of nuts and seeds

Look for: More monounsaturated fats, moderate amounts of polyunsaturated fat, and less saturated fat for improved heart health.

Sample Meal Plans

Sample Menu #1
Breakfast cup cooked, plain (unflavored), regular (non-Medifast) oatmeal mixed with 4 oz 1% milk and topped with 1 medium, sliced banana Mid-Morning Snack Medifast Smore Crunch Bar Lunch Salad: 1 cup raw spinach leaves and 3 oz ground turkey breast with 2 Tbsp low-fat salad dressing Mid-Afternoon Snack 6 mixed nuts; 4 oz 1% milk to drink; 1 medium orange Dinner 3 oz boneless, skinless, chicken breast; cup diced mushrooms over cup whole-wheat pasta; cup cooked green beans Evening Snack Medifast Dutch Chocolate 70 Shake mixed with 8 oz 1% milk

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Sample Meal Plans (cont.)

Sample Menu #2
Breakfast 1 cup whole-grain flake cereal with 8 oz 1% milk; 1 medium orange Mid-Morning Snack Medifast Vanilla Pudding mixed with 8 oz 1% milk Lunch 1 3-oz chicken breast sandwich on 1 slice toasted whole-wheat bread dressed with Tbsp mayonnaise; cup raw, whole-leaf spinach; cup steamed edamame (soybeans) Mid-Afternoon Snack Medifast Peanut Butter Crunch Bar Dinner 3 oz broiled salmon; 18 of a sliced avocado; cup cooked broccoli Evening Snack grapefruit

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Sample Meal Plans (cont.)

Sample Menu #3
Breakfast Medifast Scrambled Eggs Mid-Morning Snack 1 cup Multi-Bran Chex with 1 tsp melted, natural peanut butter drizzled over top; 1 medium sliced banana; 8 oz 1% milk to drink Lunch cup brown rice; 3 oz broiled tilapia; cup raw broccoli Mid-Afternoon Snack Medifast Maryland Crab Soup Dinner 7.5 oz tofu meatballs; cup cooked asparagus seasoned with 1 Tbsp olive and vinegar sauce; 8 oz 1% milk to drink Evening Snack cup fresh green grapes; cup raw celery

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Support when you need it

Living with gout can sometimes be a painful experience, but weight loss and proper nutrition can go a long way in helping you reduce flare-ups and control your symptoms. Youll find more information about gout by visiting the National Institute of Arthritis and Musculoskeletal and Skin Diseases (www.niams.nih.gov). Please carefully review the information provided in this meal plan, and discuss it with your physician to determine the best approach to meet your individual medical needs and overall plan of care. The Nutrition Support team at Medifast is always ready to answer your questions about losing weight safely using Medifast products. Please feel free to contact us with any questions about this modified 5 & 1 Plan or any other aspect of losing weight with Medifast.

Nutrition Support
(800) 509-1281

Registered, Licensed Dietitians Certified Personal Trainers Program support, nutrition information, and exercise guidelines Answers to your product-related questions

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For more information about this specialized program, call (800) 509-1281.

Medifast for Gout Meal Plan 2010: Medifast, Inc. Owings Mills, Maryland
MD-GUI0410_Gout