Gout was called a “court disease” in the past, because it was only caught by the royal family and nobles. But now the prevalence of gout has increased significantly. According to the 2017 White Paper on China’s Gout Status Report, the number of patients with hyperuricemia in my country has reached 170 million, and there are more than 80 million patients with gout. Gout has become the second largest metabolic disease after diabetes.
In addition to joint pain during a gout attack, long-term hyperuricemia can also affect the patient’s kidney function and increase the risk of hypertension, diabetes, myocardial infarction and cerebral infarction. Therefore, it is very important to control the level of uric acid in patients with gout.
Uric acid is the end product of purine metabolism. 80% of the uric acid in the human body comes from nucleic acids and other purine chemicals that are decomposed by cell metabolism, and 20% comes from food. The goal of diet control for gout patients is to control the 20% of exogenous uric acid intake and promote the excretion of uric acid. So what should I eat if I have gout? What can and cannot be eaten?
First, we need to understand the purine content of food. According to the purine content of food, we divide it into ultra-high purine food, which is the food that patients with gout and high uric acid should avoid completely; medium-high purine food, it is recommended to strictly limit it, not to eat during the acute attack of gout; medium-low purine food, Be careful when eating; low-purine food, almost no need to care about its purine content.
List of Purine Contents in Different Foods
According to the table on the right, most fruits and vegetables are low-purine foods, which are generally edible. Especially alkaline foods, such as cucumbers, pumpkins, potatoes, cabbage, rape, carrots, etc., eat more as appropriate to prevent the formation of stones. However, please choose vegetable foods with high purine content such as shiitake mushrooms, straw mushrooms, asparagus, seaweed, kelp and grain germ.
Patients with gout should try to avoid eating too much sugary drinks and fruits with high sugar content (especially fructose), such as apples, oranges, longans, lychees, grapefruits, persimmons, and pomegranates. Because the fructose content in the blood of the patient rises, it will cause the blood uric acid and the uric acid content in the urine to increase rapidly. Eat fruits with low fructose content in moderation, such as green plums, cucumbers, watermelons, coconut water, strawberries, pineapples, peaches, plums, etc. Relatively speaking, lemons, cherries and olives are beneficial to patients with gout.
In terms of animal food, it is recommended that patients choose white meat as much as possible, mainly lean meat, and pay attention to processing methods. In terms of species, meat that is generally darker before cooking is called red meat, such as mammals, including cattle, sheep, pigs, etc., with higher purine content than white meat (such as non-mammalian animals, including chickens, ducks, Geese and freshwater fish etc.). The purine content of animal organs is generally higher than that of ordinary meat. Fat meat also contains a lot of fat and cholesterol, which can easily cause obesity and aggravate uric acid metabolism disorders. Therefore, lean meat should be the main diet for eating meat. The content of purines such as egg white, milk and sea cucumbers is low. Yogurt is recommended to eat as little as possible due to its high lactic acid content.
The amount of meat consumed varies from person to person, and there is no uniform standard. However, it is generally believed that when there is no acute attack of gout, the patient’s daily meat intake should not exceed 100 grams. If it is an acute attack of gout, the meat intake should be temporarily reduced, controlled within 50 grams per day, or even not eaten. In addition, attention should be paid to the processing methods of meat products. Cured, smoked, and cured meats have high purine and salt content, which can interfere with the metabolism of uric acid and should not be consumed by patients. When using condiments, please also avoid using too much salt, sugar, spices and seafood condiments.
For patients with no kidney or heart contraindications, it is recommended to drink 2 to 3 liters of water per day to ensure that the urine volume is about 2 liters to promote the excretion of uric acid from the urine. The pH value of urine is between 6.3 and 6.8, which is conducive to the excretion of uric acid and reduces the formation of urate crystals. Therefore, in addition to boiled water, you can drink weakly alkaline small-molecule water, such as soda water, lemonade and so on. Coffee and tea can be drunk appropriately, but firstly, avoid adding sugar, secondly, do not drink strong tea or strong coffee, otherwise, it may affect the metabolism of uric acid.
Beer contains purines, and many patients know that they cannot drink it. Although the purine content in wine and liquor is very low, alcohol promotes the absorption of purines, and it is easy for patients to eat a lot of high-purine foods during drinking, so drinking alcohol will increase the risk of gout.
In addition to diet, we also recommend that gout patients exercise regularly without joint swelling and pain after the acute attack of gout. Take aerobic exercise as much as possible, 4 to 5 times a week, 0.5 hour to 1 hour each time, drink appropriate water during and after exercise to promote uric acid excretion, and try to maintain an ideal body weight.
It should be particularly emphasized that although gout is closely related to diet, not all of them are eaten. For the occurrence of hyperuricemia, endogenous metabolic disorders are more important than exogenous factors. And diet is often the trigger for the acute onset of gouty arthritis. It can be seen that although gout is closely related to diet, it is mainly formed by metabolic disorders. In daily life, it is impossible and unnecessary for gout patients to pursue a zero-purine diet one-sidedly.