Gout is actually a disorder of protein metabolism in the body, with increased synthesis or reduced excretion of uric acid, resulting in hyperuricemia. When the blood uric acid concentration is too high, uric acid is deposited in the form of sodium salts in joints, soft tissues, cartilage and kidneys, causing a foreign body inflammatory reaction in the tissues. Uric acid is metabolized by purines. Normal people take in only about 20% of the purines from the diet, and the rest is produced during the metabolism of the body. Myth 1: There is no need to control the total energy intake. Some patients believe that the dietary principle of gout is to eat as little purine-rich food as possible, and there is no special requirement for the total daily energy intake. Analysis: This perception is incorrect. Body mass index is positively correlated with hyperuricemia, so for obese or overweight gout patients, in addition to limiting foods with high purine content, the total daily energy intake should be controlled. This can be done by reducing the daily energy intake by 10% to 15% and reducing the body weight by 0.5 to 1 kg per month to gradually bring the weight down to the ideal range. During this period, do not lose weight too fast, otherwise it is easy to cause an acute attack of gout. Suggestion: For obese or overweight gout patients, the total daily dietary intake of energy can be calculated at 20-25 kcal per kg of standard body weight, and the ratio of protein to fat energy supply should be reduced appropriately. Misconception 2: Equating animal food with high purine food. Some patients think that animal food is high purine food, so they stay away from animal food such as fish, meat, eggs and milk in their own recipes. Analysis: This understanding is incorrect. Animal food refers to a large group of foods such as fish, meat, eggs and milk, which are rich in protein, fat, carbohydrates, vitamins, minerals and other nutrients. Many of these foods do contain a lot of purines, such as animal offal, broth, various kinds of meat and most fish, but milk and eggs are low purine foods and high quality protein rich in essential amino acids, which gout patients can eat. Suggestion: Gout patients should follow a low purine diet and try to limit the intake of animal foods such as animal offal, seafood, fish and meat. For milk and eggs, it is perfectly fine for gout patients. Patients with hypercholesterolemia need to pay attention to not overdoing the egg yolk. In addition, because purines are easily dissolved in soup, various kinds of meat soup purine content is very high, less severe gout patients also can not drink meat soup, but can be boiled lean meat after abandoning the soup limited consumption. Misconception 3: Equating vegetables with low purine food Some patients think that vegetables have low purine content and will not stimulate gout, so they do not need special restrictions. Analysis: This perception is incorrect. It is true that the purine content of vegetables is generally lower compared to animal foods such as animal liver, seafood and broth, but some vegetables are not low purine foods. Beans and their products, asparagus, shiitake mushrooms, purple cabbage and bean seedlings are high in purines. Therefore, it is one-sided for gout patients to equate vegetables with low purine foods and insist that “vegetarians should not eat meat”. Suggestions: In addition to limiting animal foods with high purine content during acute attacks, gout patients should also try to avoid vegetables with high purine content such as beans, asparagus, shiitake mushrooms and nori. Myth 4: Beer, tea and coffee are good for the discharge of uric acid. Some patients believe that purines are easily soluble in water, so drinking more water, beer, tea or coffee is good for uric acid patients. Analysis: This understanding is not entirely correct. Purine is easily soluble in water, so it is good for gout patients to drink more water, which is good for uric acid excretion, preventing uric acid kidney stones and delaying progressive kidney damage. But drinking more beer is not good, because alcohol metabolism can make the blood lactic acid concentration rise, lactic acid can inhibit renal tubular secretion of uric acid, so that the kidney excretion of uric acid lower; and beer itself also contains purine, so that the blood uric acid concentration increases, easy to induce gout. Strong tea, coffee and other beverages have an excitatory effect on the autonomic nerves, which may also induce acute attacks of gout, and gout patients should avoid drinking. Suggestions: Gout patients should drink more water, generally at least 2000 ml per day, with kidney stones can best reach 3000 ml, but kidney insufficiency or abnormal heart and lung function to limit water intake according to the condition. Drinking water should be used plain water, mineral water, juice or light tea, beer, coffee, strong tea water, etc. should be used sparingly. Myth 5: The dietary principles of the acute and remission periods are the same Analysis: This understanding is incorrect. The normal dietary intake of purine is 600 to 1000 mg per day, and the purine intake should be controlled within 150 mg per day during the acute attack period, which is beneficial to terminate the acute gouty arthritis attack as soon as possible and strengthen the efficacy of drugs. A low purine diet should also be followed during remission, but the restriction can be relaxed slightly. For ease of use, foods are generally divided into three categories according to purine content: Category I: less purine, less than 50 mg of purine per 100 g of food rice, glutinous rice, rice flour, millet, corn, rich flour, eggs, milk, pumpkin, winter squash, cucumber, eggplant, loofah, bitter gourd, mustard, cabbage, radish, carrot, tomato, lettuce, kale, celery, cabbage, yam, potato, onion The second category: high purine content, 50-150 mg of purine per 100 grams of food cereals, bran, black sesame, red beans, green beans, black beans, black beans, cauliflower, chrysanthemum, wolfberries, string beans, leeks, spinach, mushrooms, asparagus, kidney beans, peas, green beans, chicken, lamb, ham, pork, beef Lentils The third category: high purine content, 150-1000 mg of purine per 100 g of food animal offal, brain, soy, thick gravy, oysters, yeast powder, white scallop, carp, cod, sea bass, eel, shellfish, sardines, anchovies, beer, nori, shiitake mushrooms, bean seedlings. Suggestions: In the acute phase, gout patients are advised to choose foods containing less purines in the first category, mainly milk and its products, eggs, fine grains, vegetables and fruits. In the remission period, the second type of food containing medium amount of purines can be added, but in moderation, such as meat should not exceed 150 grams per day, especially do not eat too much in one meal, boiling meat and discarding soup will reduce the intake of purines. Avoid foods with high purine content in the third category, whether in the acute or remission phase.