The Spring Festival is here, the celebration of large fish and meat, seafood feast, the old fire soup, the goblets and chips between the wine and talk happy. Such delicious food is the “standard diet” for “hyperuricemia” and “gout” – the legendary high purine diet. If you are on a purine diet, you are unfortunately one step closer to gout. So, what should be done to prevent and treat gout?
Gout yesterday, today and tomorrow
A. Yesterday of gout – high uric acid
Without hyperuricemia, there is no gout!
Every patient with gouty arthritis must have an unnoticed or unnoticed but unappreciated period of hyperuricemia before the attack. Why hyperuricemia exists – it is the result of eating excessive seafood, animal offal, meat food, old fire soup, drinking alcohol and other high purine diet when not paying attention, high purine diet and very little exercise, the body’s metabolism is affected, uric acid production increased, reduced excretion, blood uric acid level naturally went up.
Second, gout today – acute attacks of joint pain
How does hyperuricemia cause gout?
The saturation level of uric acid in normal human blood is about 400umol/L. When the blood uric acid concentration exceeds the saturation level, urate crystals will precipitate and deposit into the joints and bones. Every time there is a cause, such as a high purine diet that causes the blood uric acid level to rise again, new crystals will be deposited; or if there is a cause, such as explosive strenuous exercise, or incorrect use of uric acid-lowering drugs such as allopurinol or febuxostat, that causes a sudden drop in uric acid levels, the crystals that have been deposited will dissolve – whether it is the new deposition, or dissolution, will cause instability of the already deposited urate crystals, which will tend to release inflammatory factors, triggering sterile inflammation, and thus a gout attack.
Third, the tomorrow of gout – shocking to the eyes
The danger of gout – be careful of your heart, liver, pancreas and kidneys
Gout is prone to recurrence, and repeated attacks can involve multiple joints and lead to joint deformities. In addition to gout, hyperuricemia is also closely related to obesity, hypertension, coronary heart disease, hyperlipidemia, fatty liver and diabetes. In a small number of patients, the disease starts with kidney stones, which may cause back pain, hematuria, and in severe cases, renal failure, focal glomerular segmental sclerosis, and interstitial fibrosis. There is increasing evidence that hyperuricemia accelerates the rate of kidney failure. In short, if gout is left alone for a long time, then tomorrow the damage will be to the vital organs of the body – heart disease, diabetes, fatty liver, kidney failure will not be absent!
Scientific prevention and treatment, gout is nowhere to be seen!
As mentioned above, if uric acid is not controlled well, there are many bad consequences. However, we are not helpless in the face of gout. Let’s practice the following tips to make gout disappear – “keep your mouth shut, keep your legs open, drop your weight, drink more water, live a regular life, and take the right amount of medication”.
I. Keep your mouth shut
Limit alcohol and abstain from eating are equally important
The control of blood uric acid is as important as limiting alcohol and avoiding food. Alcohol will stimulate the liver to produce uric acid and interfere with the kidneys to remove uric acid, especially beer, which consumes a lot of water and produces a lot of purine during the fermentation process, which has a great impact on blood uric acid metabolism. Therefore, people with hyperuricemia or gout should try to limit alcohol consumption, especially beer and spirits. Studies have shown that those who drink 373g of beer per day (about one can) have a 49% higher risk of developing gout than those who do not drink alcohol. The consumption of spirits also increases the risk of gout by 15%. Research on the effect of red wine on gout attacks is controversial. Past studies have concluded that moderate amounts of red wine do not increase blood uric acid levels, but in recent years, studies have also indicated that any type of alcohol (including red wine) is associated with an increased risk of acute gout attacks. Therefore, our advice regarding alcohol consumption is: beer and spirits, forbidden; red wine, limited; if you really want to drink a little, then try it lightly!
Reasonable and balanced diet
Reduce the intake of high purine foods
Of course, in order to manage uric acid scientifically, diet should also be “taboo”. However, if you are careful, you will notice that our wording has changed. Instead of emphasizing “avoiding” high purine foods, we are now putting more emphasis on “reducing” high purine foods. We should eat a balanced diet with small amounts of meat, but not large amounts of fish.
Modern medicine is placing more and more emphasis on empathy. What is empathy? Empathy is, gout patients, you do not steal, do not rob, do not sell guns and ammunition, as long as the disease control allows, occasionally is rich + capricious, just want to eat a couple of Qingdao prawns, so what? Then eat, we are not ascetics, the occasional shallow taste without much moral condemnation, and really agreed, but remember that seafood should not be eaten in large quantities. Animal offal and shellfish can greatly increase the risk of gout and should be avoided as much as possible.
Encourage the consumption of dairy products, vegetable protein
Studies have shown that people who consume large amounts of dairy products and vegetable proteins have a reduced risk of developing gout. This puts beans and soy products at risk. Previously, beans were thought to be a high purine food, but new research shows that beans, especially soy products, not only do not cause elevated blood uric acid levels, but can lower them, and they are a protective factor against 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 will be part of the loss of purine, so the intake of soy products should be encouraged rather than restricted.
Reduce the intake of fructose-rich beverages
Recent studies have shown that fructose-rich or sweetened soft drinks, fruit juices, and fructose-rich fruits are also newly identified risk factors. And some western studies have shown that cherries/cheerios have been shown to lower blood uric acid and reduce gout attacks.
Reduce lipid intake
Saturated fatty acids reduce the body’s ability to remove uric acid, and animal products are usually high in saturated fatty acids, so choosing plant-based proteins and low-fat and nonfat dairy products will help you reduce your dietary intake of saturated fatty acids. High-fat meals are also a cause of obesity, which can lead to gout.
Increase your intake of fresh vegetables
Regular consumption of fresh vegetables is a protective factor against the development of gout and is therefore encouraged.
Second, open your legs, lower your weight and drink more water
Regular exercise is not only beneficial to the metabolism of uric acid, but also beneficial to weight loss and blood lipid and blood sugar control in many aspects. It is recommended that 3-4 times a week each 30-50 minutes of exercise, can be running, cycling, swimming, the amount of exercise should be gradually increased, in order not to feel overworked as the most appropriate. However, care should be taken to prevent overly strenuous exercise or sudden exposure to cold. Controlling diet and increasing exercise is good for weight control, and reducing weight can reduce the risk of gout attacks, forming a positive cycle, great. In addition, you should also drink a lot of water, 2000-2500ml of water intake per day, uric acid excretion is proper.
Three, regular life
Regular rest and diet, regular life, avoid fatigue, no smoking, can reduce the risk of gout / hyperuricemia.
Fourth, the appropriate amount of medication
People think that gout is a disease that comes from eating, however, lifestyle interventions do not solve all the problems. The cause of gout is hyperuricemia, and most of this uric acid is produced by the body’s metabolism, with only about 20 percent coming from food intake. Even strict lifestyle interventions can only reduce blood uric acid by about 60umol/L or so, which does not achieve the target value of 360 or 300umol/L for most patients. Gout control requires that blood uric acid be reduced to the target value and maintained below the target value for a long time in order to prevent recurrent gout attacks and adverse outcomes of gout-related organ damage such as kidney damage.