Gouty arthritis is very closely related to diet, and it is possible to prevent gout by reducing the intake of purine-rich foods. The purine content of food is related to the type of food and the cooking method. Reasonable choice of food and food processing methods can help reduce the production of food-borne uric acid. Strict dietary control can completely reduce gout and even cure it, and every patient can do it with determination and persistence.
The purpose of dietary modification: to control the intake of exogenous purines, reduce the source of uric acid and promote the excretion of uric acid. This will lower the concentration of uric acid in the blood, reduce the deposition of uric acid, gradually improve the purine metabolism in the body, and prevent the development of complications.
The principles of dietary control: “four low and one more” dietary principles, i.e. low purine, low protein, low calories, low fat and drinking more water.
Specific dietary control practices
1.Limit the intake of purine
Acute phase: During the acute attack of gout, food containing high purine should be strictly limited, and purine should be controlled below 150mg per day to avoid excessive intake of exogenous purine. The main source of calories should be white flour and rice; milk, cheese, eggs, fruits, refined cereals, vegetables (except lobster, spinach, mushrooms and fresh peas which contain high purines) without purines or with low purines can be used; foods with high purines, such as animal offal, sardines, anchovies, thick gravy soup, soybeans and mushrooms and algae, etc. should be prohibited.
In remission: Give normal balanced diet to maintain ideal body weight and normal blood uric acid level. Avoid foods with high purine content and choose medium purine foods in limited amounts, with micropurine foods as the mainstay. Ideal body weight should continue to be maintained, weight gain should be avoided, and the fat limit should be adhered to for a long time.
Dietary control of chronic gout and asymptomatic hyperuricemia: Appropriate relaxation of purine intake, but animal offal, thick gravy and soup containing more purines are still prohibited. Give a balanced diet, maintain ideal body weight, limit the intake of fat and protein, and prevent excessive starvation, the body fat decomposition to produce ketone bodies. Meat, poultry, fish boiled and de-broiled alternately with eggs and milk, more alkaline vegetables and fruits, usually drink more water, less fried food, animal fat, too sweet and salty food, etc.
2.Limit the intake of energy
Maintain the ideal weight, obese people reduce weight, blood uric acid levels drop, gout attacks can be reduced. But weight loss should not be too hasty, should be gradual, so as to avoid the transitional decomposition of body fat, causing acute attacks of gout.
3.Low fat diet
Because of the role of fat has hindered the normal excretion of uric acid by the kidneys, and because of the high heat production of fat, easy to cause obesity, is not good for gout patients, in the acute gout attack period should be strictly limited. Cooking methods are easy to use steam, boil, stew, boil and other methods that use less oil, avoid frying, deep-frying and other cooking methods.
4, protein intake should not be too high
As protein intake can accelerate the synthesis of uric acid in gout patients, the protein intake should be controlled at 0.6g/(kg・d) to 1.0g/(kg・d) according to the condition. Milk and eggs are the main products, and they can be used freely because they do not contain nuclear protein. However, yogurt contains more lactic acid, which is not good for gout patients because it competes with uric acid for excretion. At the same time, try to use less or no broth, poultry, fish and shrimp, etc.
5, mainly carbohydrates
For gout patients, whether it is the usual or the New Year holidays, should ensure that the intake of staple foods account for about 60% of the total calories, never just eat vegetables without eating, the main food to carbohydrates, can choose rice, flour, corn and its products. As the main source of energy, carbohydrates can reduce the decomposition of fat, increase the excretion of urate and avoid the production of ketosis. But should try not to use sucrose, because sucrose decomposition and metabolism, can increase the generation of uric acid, honey is also not suitable for consumption.
6.Encourage the selection of alkaline food
Increasing the intake of alkaline food can reduce the concentration of serum uric acid and even make the urine alkaline, thus increasing the solubility of uric acid in the urine and promoting the excretion of uric acid. Patients should be encouraged to choose alkaline foods such as vegetables and fruits, which can both promote the excretion of uric acid and supply rich vitamins and inorganic salts to facilitate the recovery of gout. Such as vegetables, potatoes, sweet potatoes, milk, citrus, etc.
7.Drink more water
As the urine pH 6.0 or below, it is necessary to take alkaline drugs to alkalize the urine and facilitate the ionization, dissolution and excretion of uric acid. Therefore, it is necessary to drink more water to dilute the urine, and the total daily liquid intake should reach 2000-3000ml, so that the daily urine output can reach more than 2000ml to prevent the formation of stones.
8.Vitamins and minerals
A large amount of vitamin B and vitamin C to promote the dissolution of uric acid in the tissue stasis, so you should eat more alkaline and rich in vitamin B and vitamin C vegetables, fruits, etc., can promote the alkalization of urine, increase the solubility of uric acid in the urine.
9, limit the consumption of alcohol, drink in moderation
The ethanol in wine accelerates the rate of purine synthesis in human body, which increases the production of uric acid, and the ethanol contained in wine can increase the concentration of blood lactic acid, which can inhibit the secretion of uric acid by kidney tubules and reduce the discharge of uric acid. Beer contains a large amount of purine, which is very likely to induce or aggravate gout. Drinking alcohol tends to make lactic acid accumulate in the body, and lactic acid has a competitive inhibitory effect on the excretion of uric acid.
Therefore, although a large amount of alcohol can make the serum uric acid level significantly higher, inducing gout attacks. Chronic alcohol consumption in small amounts can stimulate increased purine synthesis and raise serum and urine uric acid levels. Beer also contains alcohol, so it should be avoided. Alkaline beverages such as cola, Sprite, soda, and soda can alkalize urine and help uric acid excretion, and can be consumed in moderation.
Yogurt is not good for gout patients because it contains more lactic acid. You should try to eat less sucrose or beet sugar, because half of them become fructose after decomposition and metabolism, and fructose can increase uric acid production, honey also contains high fructose, should not be consumed.
10, limit salt
Reduce sodium intake, sodium will promote the deposition of uric acid, so the daily salt intake is controlled within 6g, combined with hypertension, heart disease, renal insufficiency patients should be strictly limited to 3g or less.
11.Pay attention to food cooking methods
Reasonable cooking methods can reduce the amount of purine contained in food, such as boiling meat first and discarding the soup before cooking. In addition, chili, curry, pepper, mustard, ginger and other food seasonings can excite the plant nerves and induce acute attacks of gout, so they should be avoided as much as possible.