Instructions for a low-purine caffeine-free diet

This diet sheet was prepared by the Purine Research Unit, St Thomas’ Hospital, London, and is included in PUMPA’s booklet Caring for Children with Lesch-Nyhan Disease.

Important: as so many things can affect any treatment or diet suggested, such as the patient’s age, physical condition and medication, if any, you should always contact your doctor or consultant before embarking on any diet or treatment.

The instructions below apply to the collection of samples for purine investigations, but it may be helpful to patients to know which foods are rich in purines and thus should be avoided when preparing meals. Because the diet is recommended by the Purine Research Unit specifically to aid them in their investigations, adult gout sufferers should use this dietary information as a rough guide only. For a more varied diet, they should seek the advice of their regular dietician.

For purine studies it is advisable to try to eat a diet identical with your normal diet in terms of butter, fats, bread, potatoes and other vegetables, etc., but avoid the meat, fish and other food and drink outlined below with a high purine content in Section 1 and substitute a low-purine equivalent from Sections 2 and 3.

Section 1: Food and drinks not allowed

  • Offal: sweetbreads, heart, liver, kidney and paté
  • Seafood: sardines, sprats, herring, bloaters, fish roe, trout, salmon, lobster, crab, prawns, oysters, cockles, mussels, etc.
  • Vegetables: asparagus, avocados, peas, spinach, mushrooms, broad beans, cauliflower
  • Soya products, pulses and legumes
  • Alcoholic beverages and yeast extracts; meat or vegetable extracts (Marmite, Vegemite, Bovril, etc.)
  • Tea, coffee (other than decaffeinated), cocoa products such as Ovaltine, chocolate, or chocolate biscuits, chocolate puddings and Coca Cola, Pepsi Cola, or Lucozade (note: this only refers to diet when samples are being collected for the laboratory: these foods and beverages all contain methylated xanthines, which make analysis difficult in the laboratory)

Section 2: Food and drinks allowed

  • Milk, cheese, eggs, butter, margarine, cream, ice cream
  • Bread, flour, cakes, scones, biscuits, cereals
  • Sugar, jam, marmalade, honey and sweets
  • Salads (e.g. lettuce and tomato)
  • Fresh, cooked or tinned fruits, nuts
  • Puddings, (milk, etc.), except those containing chocolate or cocoa
  • Decaffeinated coffee or tea
  • Fruit juices, soft drinks, except Coca Cola, etc.

Section 3: Food allowed in moderation (one meal per day)

  • Beef, lamb or mutton, pork, bacon, ham, poultry, sausages, tongue and meat soups
  • Small helpings of vegetables (except those in Section 1), e.g. carrots, potatoes, leeks, cabbage, Brussels sprouts, runner and French beans, marrow, courgettes
  • Fish, except those in Section 1

Purine, RNA and protein content of selected foods (mg/100g)

food adenine guanine anthine xanthine hypox-purines RNA total protein (%)
organ meats
beef liver627461019726820
beef kidney4247636121313418
beef heart1516381021714919
beef brain1212261121626111
pork liver5977718228925922
chicken liver7278712224340220
chicken heart32411213822318718
lamb liver324354181478822
lamb heart302320981715019
fresh seafood
anchovies8185621241134120
clams142412861368517
mackerel1126515219420323
salmon26801113325028923
sardines6118621523434323
squid1815247813510015
canned seafood
anchovies03914268321630
clams305720524420
herring1518061773788217
mackerel23109169824612226
oysters392230161072399
salmon23391313882626
sardines19953025539959024
shrimp1612151912341022
tuna27131191142529
dried legumes
garbanza beans (chickpeas)17141875635621
cranberry beans211923127524817
split peas8874112219517321
red beans5451154216214020
lentils10482201622248428
black-eye-peas7780324123030622
large lima beans4241145214929321
baby lima beans4639253414419019
pinto beans5754164417148520
small white beans5974254420230518
great northern beans5668256421328418

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