Dietetics for NursesProudfit, Fairfax T. (Fairfax Throckmorton)
Science
Dietetics for Nurses
Proudfit, Fairfax T. (Fairfax Throckmorton)
Diet in disease
~Acid-forming and Base-forming Foods.~--Mendel[61] states: "There are
foods which act as potential acids and others which function as bases
in the organism. When burned up either in the laboratory or in the
body cells, they have a preponderance of acid or base, as the case may
be, in their ash." In this respect potatoes, apples, raisins, and
cantaloupes, for example, are base-forming foods which depress the
output of ammonia and increase the solubility of uric acid in the
urine, whereas meal, cereals, and prunes (the latter with their
content of benzoic acid) furnish acids in predominance.
~Purin Bases.~--These compounds are formed in the body as cleavage
products of nucleoproteins or taken into the body in food. The chief
of these products are ~adenin~, ~guanin~, ~hypoxanthin~, ~xanthin~,
and ~uric acid~. The latter is the most highly oxidized of all the
purin bases and is the form in which they are chiefly eliminated in
the urine.
~Formation of Uric Acid.~--The formation of uric acid can in a measure
be controlled by attention to the diet, eliminating those foods known
to be purin-bearing. Normally from 1 to 3% of the nitrogen eliminated
will be in the form of uric acid. The normal human being oxidizes
about half of the purins eaten and excretes about half, mainly in the
form of uric acid. According to Mendel, the formation of uric acid
takes place throughout the body, and its partial destruction is
accomplished by the kidneys, muscles, and liver. The formation of
purins in the body and their elimination in the form of uric acid is
especially significant in certain pathological conditions, gout, for
example, in which the body has difficulty in eliminating these
compounds.
The purin bodies are both endogenous and exogenous--that is, they may
be brought into the body in food as such, or they may be formed as a
result of the metabolism of the body tissues. For this reason the
damage wrought by these substances may to a certain extent be
controlled by eliminating the purin-bearing foods from the diet.
Flesh-foods are high in purins, especially the highly nucleated
glandular organs, liver, thymus (sweetbreads), etc., kidney, beef,
mutton, veal, pork, chicken, turkey, goose, sardines, anchovies, all
kinds of fish except cod. Among the vegetable foods asparagus, beans,
peas, and spinach are highest in purins. Boiling extracts much of the
purins from food. Meat especially should be prepared by this method,
if used in the diet of individuals suffering from gout. Eggs and milk
are purin free, and may be used freely. Certain substances increase
the difficulty of eliminating uric acid. Alcoholic beverages for
example are especially deleterious.
~Creatinin.~--This end-product of protein metabolism is, like uric
acid, endogenous and exogenous. It is one of the normal constituents
of the urine. The quantity is fairly constant for the individual,
averaging about 0.02 gram per kilogram of body weight per day.
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