The encounter that night, now when I think back to the back will still seep cold sweat.
You were promoted, called a group of buddies to eat hot pot to celebrate a lot: the seafood was raw and mushrooms were tender, the cups were intertwined with beer, it was really joyful and painful. After having fun, go home and fall asleep, then fall into dreamland.
But you never thought that in the middle of the night, you suddenly woke up with an unbearable pain that you can’t name. You feel like a million pins and needles in the joints of your big toe, making you want to hold your head and wail. One more look at the pain, but even more frightening: the big toe red and swollen, accompanied by a burning sensation like stepping on a red-hot coal. At this point you can hardly walk, even the quilt lightly touching that toe will be painful to the heart.
Two words on the hospital diagnosis: gout. The doctor tells you: you will have to live with uric acid medication for the next few days. And you have to watch your diet and keep your mouth shut!
Gout, not just pain
This has to start with the cause of gout. Gout is essentially a disease caused by an abnormal metabolism of purines, resulting in an increase in uric acid in the blood. As the blood uric acid concentration rises, the uric acid eventually forms urate crystals that accumulate in the joints and kidneys, triggering an inflammatory response – the severe pain described above.
So, if gout is a painful “tragedy,” then Hyperuricemia is an essential “prequel. Fortunately, most people who develop hyperuricemia do not develop gout and are treated as symptom-free patients. But it’s really a game of probability – the higher the blood uric acid level, the higher the chances of developing gout in the future.
In addition, the ratio of men to women with hyperuricemia is as high as 20 to 30 to 1. This is because women are protected by high levels of estrogen, which promotes the excretion of uric acid from the body. It also peaks in men around the age of 40-50, earlier than in women – women’s estrogen levels plummet after menopause, so the onset of the disease often occurs after menopause.
Once gout occurs, the consequences go far beyond pain. Long-term gout may lead to chronic gouty arthritis, leading to dysfunction, while uric acid nephropathy and kidney stones are a threat to kidney function, and can even develop into renal failure and uremia in severe cases.
At the same time, don’t think that asymptomatic hyperuricemia can rest on its laurels: even without gout, patients with hyperuricemia are about 20 times more likely to develop urinary stones than the general population, and about 20% to 40% of patients with hyperuricemia will also develop uric acid nephropathy.
In addition, hyperuricemia is also a risk factor for many other diseases such as hypertension, diabetes, hyperlipidemia, coronary heart disease, and cerebral infarction (gout, moreover).
Now you should not dare to take it lightly.
Gout, how to avoid high purine diet
Blood uric acid comes from purines, and exogenous purines are eaten off the stomach. Although they only account for about 20% of the total uric acid in the body, they are still very critical because they are a relatively easy part to control.
The middle-aged men who are at the peak of their careers, socializing and eating out, especially those with high blood uric acid, should be especially careful and insist on avoiding a high purine diet.
1, rely on the sense of taste to determine the high purine diet
Purine is a substance that exists in the nucleus of cells, so basically any food contains purine to a greater or lesser extent. Generally, the more cells there are in a food, the higher the purine content; conversely, foods that contain only one cell, like eggs, have very low purine levels, even if they are large.
Of course, you are not an immortal and cannot calculate the purine content by counting the number of cells in a food, so what should you do?
Your taste instincts may help you: one of the characteristics of foods high in purines is “freshness”, and the fresher the food, the higher the purine content is likely to be. In fact, purine itself is one of the indicators of ‘freshness’.
At this point, maybe you can already guess a thing or two. Yes, that’s right, animal offal, many kinds of seafood and thick soup and gravy are “classic” high purine foods.
2.According to science, the purine content of food is carefully divided
But feelings are not always reliable, we need scientific criteria to classify the purine level of food in detail.
Category 1: High purine foods (100 – 1000 mg of purine per 100 g)
Animal offal (especially liver), thick gravy (hot pot), fish eggs, sardines, brain, yeast, etc.
Category 2: Medium purine foods (75 C 100 mg of purine per 100 g)
Freshwater fish such as sea bass, sea fish such as cod, shellfish, eel and eel, prosciutto, pork, beef, rabbit, venison liver, poultry, etc.
The third category: low purine foods (purine < 75 mg per 100 g of food)
Mackerel, tuna, white fish, lobster, crab, oyster, ham, lamb, chicken, cereal, bread, coarse grains, asparagus, cauliflower, string beans, green beans, peas, kidney beans, spinach, dried beans, tofu, etc.
Fourth category: Very low purine foods
All kinds of fruits, dried fruits, sugar, eggs, dairy, soft drinks, tea, coffee, chocolate, all kinds of fats, peanut butter, jam, etc.
3.Food selection for gout patients
(1) Food selection and taboos
Gout and hyperuricemia patients should focus their daily meals on the third and fourth food groups, while the first food group should be avoided.
(2) Animal and plant food trade-offs
In addition, recent studies have found that animal purines are more harmful than plant purines for the same purine level of high purine foods. Another epidemiological study even concluded that phytogenic purines seem to be harmless and beneficial, but this has not been recognized by international authorities and needs to be observed with caution.
(3) Foods high in sugar are worthy of caution
A special note: the fourth category of very low purine foods appears to be very safe, but the high sugar foods contained therein require extra caution.
Although high sugar foods and beverages are hardly a concern from a purine perspective, recent studies have suggested that high sugar also has a surprising effect on blood uric acid levels – the higher the sugar intake, the higher the blood uric acid levels. The underlying mechanism for this phenomenon is still unclear, but it is enough of a cautionary tale to remind oneself to reduce the intake of high-sugar foods in daily life, especially carbonated beverages and other juice-based soft drinks that contain large amounts of high fructose syrup.
(4) Actual intake
Another thing to think about is that although purine levels in foods are calculated as the amount of purine per 100 g, the actual health advice should not only be based on numerical comparisons to examine the effect of a food on gout, but also on the actual intake of that food in the diet.
This is more prominent in another major food group: alcoholic beverages.
Can you drink alcoholic beverages if you have gout?
The purine content of alcoholic beverages is calculated as the number of milligrams of purine per 100 milliliters. According to the Japan Foundation for Public Welfare? Gout Foundation, the purine content of the most common alcoholic beverages in social dining is
Japanese shochu: almost zero milligrams per 100 milliliters
Whiskey: 0.1 mg / 100 ml
Brandy: 0.4 mg / 100 ml
Japanese style sake: 1.2 mg / 100 ml
Wine: 0.4 mg / 100 ml
Beer: 5 – 6 mg / 100 ml
Shaoxing wine (yellow wine): 11.6 mg / 100 ml
It can be seen from this that high alcoholic beverages generally have little problem with purines, and wine is fine, but beer and yellow wine are ‘off-limits’ to high-risk groups. Beer, in particular, is not as good as yellow wine in terms of unit value, but because beer is much smaller in alcohol content than yellow wine and contains carbonated vapor, it is particularly refreshing and very good for meals when mixed with offal, meat and seafood, etc. One can’t help but drink one glass after another, which often leads to a higher overall purine intake than yellow wine.
By the way, the incidence of gout in Qingdao is the highest in the country, of which the incidence of gout in adult men is as high as 2.2%, much higher than the national 0.96%. One of the reasons for this is that Qingdao is by the sea and produces a lot of seafood, and Qingdao men are particularly fond of beer and seafood feasts.
So the question is: Is the high incidence of gout caused by beer and seafood simply because beer and seafood are each high purine foods, and the total amount of purine is too high when added together?
No, not really.
It is true that the total purine is higher, but there is another point that many people may not think of: the metabolism of alcohol in the body raises the blood lactate concentration, which inhibits uric acid excretion in the kidneys. In some people, the excretion of uric acid is further inhibited by excessive Binge Drinking, which causes blood ketosis. Although the mechanism of alcohol’s effect on blood uric acid needs to be studied in depth, the contribution of alcohol to high purine foods is enough to warrant attention.
Gout, other lifestyle interventions
There are two more important points.
1, significantly increase the total daily water consumption.
It is better to drink a small amount each time, several times, do not wait until you feel thirsty to drink water.
The reason is simple: to promote uric acid excretion.
But also pay attention to the method.
(1) to drink pure water, not soft drinks or other beverages such as coffee.
(2) do not drink before going to bed, so as not to increase the burden on the kidneys during sleep.
2, adhere to moderate exercise (but do not be overly aggressive).
Exercise can also promote uric acid excretion, but also to prevent gout and hyperuricemia another risk factor: obesity.
Finally, once again, keep your mouth shut
Avoid foods high in purines: animal offal, seafood and fish eggs, thick soups and gravies.
Beware of alcoholic beverages: avoid beer and yellow wine, red wine is relatively good.
Drink less beverages: drink less carbonated drinks and fruit juice soft drinks containing high fructose syrup.
I can understand your feelings: these three types of things are really full of charm, want to not touch how tormented!
But you must do – for your health not to drift in purine!