Diet has an impact on both gout attacks, clinical diagnosis, and drug selection. First of all, gout and diet are closely related, and a gout attack is likely to be caused by alcohol consumption or overeating prior to the attack. The adverse effects of diet on gout include increased blood uric acid levels and reduced uric acid excretion by affecting insulin resistance. Because of the adverse effects of diet on gout, national and international gout guidelines emphasize that the first choice of gout treatment is non-pharmacological, with diet control at its core, especially for patients with chronic renal insufficiency and high purine diets.
Hyperuricemia and gout are nutrition-related diseases, so a healthy diet is important throughout the treatment process. “Three less and one more”, i.e.: low purine, low calorie, low fat and salt, and more water, as well as limiting smoking and alcohol.
Diets that need to be restricted for gout patients include red meat and seafood containing high purines
1. Encourage a low purine diet: It is important to control the intake of purine in food in gout treatment, especially for gout patients with a family history, who should change their bad eating habits early. The first is animal offal containing high purines, while soft drinks rich in fructose or sweetened, fruit juices, and sugar-rich fruits are also newly identified risk factors. Many studies in the West have shown that cherries have the effect of lowering blood uric acid and reducing gout attacks. Among alcohol, beer has the strongest correlation with gout attacks, and strong alcohol can also increase the risk of gout attacks, so it should also be avoided. Diets that need to be restricted include red meat (also poultry skin) and seafood that is high in purines. Diets that are encouraged are low-fat or nonfat dairy products and vegetables.
Foods high in purines (>150mg of purines per 100g of food) include:
(1) All animal livers, pork intestines, and thick gravies.
(2) Fish and shellfish: silver carp, scallops, sea eel, sardines, all shellfish, dried shellfish, dried small fish, etc.
(3) Vegetables: bean sprouts, asparagus, nori, shiitake mushrooms, wild mushrooms, etc.
Foods with medium purine content.
(1) Meat: chicken, lean pork, beef, lamb, duck intestine, pork kidney, rabbit, etc.
(2) Fish and shrimp: grass carp, carp, shrimp, abalone, crab, etc.
(3) Vegetables: soybeans, dried beans, spinach, string beans, peanuts, silver ears, cashew nuts, chestnuts.
Foods containing less purine (less than 25mg of purine per 100g of food).
(1) Dairy: dairy products, eggs.
(2) Cereals: rice, noodles, rice flour, pasta, corn, etc.
(3) Vegetables: cabbage, mustard, leek, bitter melon, winter melon, cucumber, eggplant, carrot, onion, tomato, wood ear, taro, potato.
(4) Animal oil, vegetable oil.
(5) Sea cucumber, jellyfish skin, pig’s blood.
(6) Almost all fruits contain less purines.
The first choice for gout treatment is non-pharmaceutical treatment, the core of which is to control the diet
2, encourage into alkaline food: because the body’s alkaline environment is conducive to the dissolution and discharge of uric acid salt crystals. The so-called
“alkaline food” is the food that produces more sodium, potassium, calcium and magnesium ions after metabolism and more alkali in the body, mainly vegetables and fruits, especially alkaline vegetables with high potassium and low sodium. Strongly alkaline foods include grapes, tea, wine, kelp, etc. Medium alkaline foods include dried turnips, carrots, soybeans, tomatoes, bananas, oranges, strawberries, lemons, and spinach. Weakly alkaline foods include red beans, apples, onions and tofu, etc. The EULAR recommended guidelines emphasize that gout patients can eat more alkaline foods – cherries. Studies have shown that cherries can significantly lower uric acid by increasing glomerular filtration rate or decreasing uric acid reabsorption. In addition, adequate amounts of vitamin C can reduce the number of gout attacks.
3, control the total intake of alcohol: forbidden to drink beer and white wine, can drink red wine in moderation. Research suggests that the risk of gout is 2.5 times greater than that of non-beer drinkers who drink more than two glasses of white wine with an alcohol content of 15g per day, and the risk of gout is 1.6 times greater than that of non-drinkers who drink whiskey containing lead, which can increase the risk of gout 3 times.
4, beans are high purine food: but new research shows that beans, especially soy products not only does not cause an increase in blood uric acid levels, but can reduce blood uric acid, they are protective factors for gout. The mechanism is mainly due to the fact that beans have the effect of both increasing blood uric acid and promoting uric acid excretion, and the latter effect is more significant, and in the processing of beans into soy products purine will be part of the loss, so the intake of soy products should be encouraged rather than restricted. In addition, coffee also has the effect of lowering uric acid, but the effect is weak, while drinking tea may have a certain promotion effect on the excretion of uric acid due to the increased water intake.
Doctors and patients have a better understanding of the traditional dietary factors that have an effect on gout, such as offal, red meat and alcohol, but neither has a good understanding of the new developments in gout diet, so the future of dietary management of gout should be better learned by both doctors and patients. Doctors have a misconception in alkalinizing urine: taking baking soda – sodium bicarbonate, gout patients have an imbalance in their own potassium and sodium ion concentration, the correct one should be taking sodium potassium bicarbonate or potassium citrate.