Scope
This standard specifies the dietary guidelines, recommended intake of energy and essential nutrients for patients with hyperuricemia and gout.
This standard applies to the dietary guidance for adult patients with hyperuricemia and gout who are not combined with other diseases such as renal insufficiency.
Dietary Guidelines for Patients with Hyperuric Acid and Gout
1. General principles
Based on the principle of individualization, we should establish a reasonable diet and good lifestyle, limit high purine animal foods (see the table below for the purine content of common foods), control the ratio of energy and nutrient supply, maintain a healthy body weight, cooperate with regular uric acid-lowering medication, and regularly monitor and follow up.
2.Foods recommended to be avoided
Avoid animal offal such as liver and kidney, shellfish, seafood with shells such as oysters and lobsters, and thick gravies and gravies.
For patients with acute gout attack, poor drug control or chronic gouty stone arthritis, alcoholic beverages should also be prohibited.
3.Foods recommended for restriction
(1) animal foods with high purine content, such as beef, lamb, pork, etc.
(2) Fish food.
(3) Foods containing more fructose and sucrose.
(4) Various alcoholic beverages, especially beer and distilled spirits (white wine). The overall alcohol consumption should not exceed 2 alcohol units/day for men and 1 alcohol unit/day for women (1 alcohol unit is about 14g of pure alcohol). 1 alcohol unit is equivalent to 145mL of red wine with 12% ABV, 497mL of beer with 3.5% ABV or 43mL of distilled spirits with 40% ABV.
4.Recommended food choices
(1) Nonfat or low-fat dairy and its products, 300 mL per day.
(2) Eggs, 1 egg per day.
(3) Adequate amount of fresh vegetables, 500g or more per day.
(4) Encourage the intake of low GI cereals.
(5) Adequate water intake (including tea and coffee, etc.), at least 2000 mL per day.
5.Weight management
Patients who are overweight or obese should slowly lose weight to reach and maintain normal weight.
6.Eating habits
Establish good eating habits. Eating should be regular and quantitative or less and more meals, do not overeat or eat a lot of meat in one meal. Use less stimulating seasonings. Seafood, meat and high purine plant foods can reduce the amount of purine by cooking and then discarding the soup.
Energy and nutrients recommended intake energy intake energy to achieve and maintain normal body weight. Energy requirements should be estimated based on the patient’s gender, age, height, weight and physical activity. In the case of light physical activity level (e.g. sitting work), normal weight people are given 25kcal/kg to 30kcal/kg of energy per day, underweight people are given 35kcal/kg of energy per day, overweight/obese people are given 20kcal/kg to 25kcal/kg of energy per day; in the case of medium physical activity level (e.g. electrician installation), normal weight people are given 30kcal/kg to 30kcal/kg of energy per day. In the case of medium physical activity level (such as electrician installation), normal weight people are given 30kcal/kg to 35kcal/kg of energy per day, underweight people are given 40kcal/kg of energy per day, overweight/obese people are given 30kcal/kg of energy per day; in the case of heavy physical activity level (such as porter), normal weight people are given 40kcal/kg of energy per day, underweight people are given 45kcal/kg to 50kcal/kg of energy per day for normal weight, 45kcal/kg to 50kcal/kg of energy per day for underweight and 35kcal/kg of energy per day for overweight/obese.
Body mass index (BMI) is used to determine weight status, and the criteria are: BMI <18.5kg/m2 for underweight, 18.5≤BMI <24.0kg/m2 for normal weight, 24.0≤BMI <28.0kg/m2 for overweight, and BMI ≥28.0kg/m2 for obese.
Carbohydrates Carbohydrates provide 50% to 60% of the total energy. Added sugar intake should be limited. Low GI foods are desirable. Encourage whole grain foods to account for more than 30% of the full-day staple diet. Dietary fiber intake of 25g to 30g for the whole day.
The dietary intake of protein protein is 1g/kg/d, providing 10% to 20% of the total energy. Food sources recommended are dairy products and eggs.
Fat Fat provides 20% to 30% of the total energy throughout the day. Combined with obesity or metabolic syndrome should strictly limit the total daily fat intake to no more than 25% of the total energy for the day, and saturated fatty acids to no more than 10% of the total energy for the day. If combined with elevated plasma LDL cholesterol (≥2.59mmol/L), saturated fatty acid intake should be less than 7% of the total energy. Trans fatty acids should be less than 1% of the total energy for the whole day. The daily intake of linoleic acid and alpha-linolenic acid should account for 5% to 8% and 1% to 2% of the total energy of the day, respectively. Daily intake of monounsaturated fatty acids should account for 10%-15% of total energy.