Diet and self-care for gout patients

  I often encounter patients with gout or hyperuricemia on physical examination asking about diet and precautions in daily life during outpatient visits.  Gout is a group of chronic diseases caused by disorders of purine metabolism and/or impaired uric acid excretion. As people’s living standard improves and work pressure increases, nutritious diet structure and irregular living habits become important factors for high incidence and recurrence of gout. Therefore, for gout patients, in addition to actively cooperating with doctors, taking medication on time and having regular follow-ups, self-conditioning is also an essential part of the treatment plan.  The two principles of self-conditioning: keep your mouth shut and move your legs more.  1, quit smoking and alcohol: smoking is harmful to health, and is detrimental to the healing and recovery of various systemic diseases. Alcohol is an important trigger for the recurrence of gout, alcohol can speed up the synthesis of purine in the human body and promote purine production; in addition, the ethanol in wine will stimulate the synthesis of lactic acid and the accumulation of ketone bodies in the body, both of which are detrimental to the excretion of uric acid by the kidneys. In all kinds of alcohol, beer not only has the above-mentioned hazards, even in the fermentation process itself will produce a lot of purines, so beer is an absolute contraindication for gout patients.  2, limit purine: purine metabolism disorder is the main cause of gout, high purine diet will aggravate the disease. Purine-rich foods include: animal offal (liver, intestine, kidney, brain), seafood (sea fish, shrimp, crab, shellfish, sea vegetables), meat and poultry (cattle, sheep, chicken, goose), soup (especially hot pot soup, gravy), beans (peas, soybeans), peanut rice, spinach, etc. For gout patients, low purine fruits and vegetables, low-fat milk is a good choice.  3, low fat: First, many high-fat food is also high purine food, and second, hyperlipidemia can affect the discharge of uric acid out of the body, but also lead to obesity, aggravating metabolic disorders.  4, drink more water: water can promote the excretion of uric acid in the body, gout patients should maintain a daily water intake of 2000-3000 ml. Always have a glass of water with you, so that you can drink water diligently, drink more water, and not wait for a sense of thirst before drinking water. Because the feeling of thirst is the body’s signal of water shortage, the water drunk into the body when thirsty is mainly used to replenish cellular water shortage, but not enough to promote uric acid excretion. Many patients are not accustomed to drinking plain water, think that drinking tea is both nourishing and hydrating. But tea in a tannic acid substances will affect uric acid excretion, so it is not recommended that gout patients drink strong tea, clear tea can drink a small amount.  Move your legs more: Some studies have confirmed that blood uric acid levels are positively correlated with body mass index and that obese people are more likely to suffer from gout. Therefore, it is recommended that gout patients do more aerobic exercises such as swimming, walking, jogging and Tai Chi while adjusting their diet. Moderate exercise can not only control weight, but also enhance physical fitness and promote metabolism, which is beneficial to control the disease.  Second, the misconception of self-conditioning: We advocate gout patients to “control the diet” “moderate exercise” way of self-conditioning, but does not recommend or even oppose patients through “random medication However, we do not recommend or even oppose patients to self-medicate by taking “random medication”. Many patients mention that they have heard that a gout patient is taking a certain medicine well, so they buy it to try; or they take the medicine prescribed by their doctors …… orally every time they have a pain attack. These are incorrect medication habits.  Gout is divided into an acute attack period and a remission period, and there are different treatment plans and drug choices for different periods. As each drug has its unique side effects and contraindications, doctors will consider the patient’s symptoms and signs and various test results before determining the treatment drug, and analyze and select carefully. Therefore, whether it is the first diagnosis of gout or a recurrence, patients should seek medical attention in a timely manner and standardize treatment under the guidance of a doctor.