The factors that cause the development of gout are mainly the excessive intake of purine from food, the disorder of purine metabolism in the body and the decrease of kidney excretion function, resulting in the increase of uric acid in the patient’s blood. The final breakdown products of purine from food are very different from those from the metabolic process of the body. The latter are mainly broken down into nucleic acid and used by tissue cells through a complex metabolic process under the action of various enzymes, while a small portion is broken down into uric acid. The vast majority of purines from food sources are produced as uric acid, which is rarely used by the body. Therefore, the amount of purine intake from food has a great impact on the concentration of uric acid, so it is necessary for gout patients to moderate the amount of purine intake in their diet. The diet of gout patients should be individualized and combined with restriction and deployment.
Total diet control The total diet control includes two parts.
(1) Controlling the total daily intake of purines. Even if you do not eat purine-rich foods, if you eat a large amount of the second type of food, the total daily intake of purines will exceed the limit, causing an increase in uric acid synthesis, so the total amount should be appropriately limited when supplementing the second type of food.
(2) Control the total amount of calories consumed daily. Control the total number of calories in the daily diet and reduce body weight. Obesity is one of the risk factors of gout, and blood uric acid is positively correlated with body mass index. The diet of gout patients should be controlled at about 80% of the normal diet, and overeating is strictly prohibited. Gout patients often have a sudden rise in blood uric acid levels after overeating, resulting in an attack of gouty arthritis.
Adjusting the diet based on the blood uric acid value to control the blood uric acid at a normal level is an important measure to prevent gout attacks. We recommend that gout patients should have their blood uric acid tested frequently. When blood uric acid rises above 480 μmol/L, there is a risk of a gout attack at any time. According to the purine content, foods are classified into three categories: low purine foods (purine <25mg per 100g of food), medium purine foods (purine 25-150mg per 100g of food) and high purine foods (purine 150-1000mg per 100g of food). However, this is only a principle estimate, in clinical practice, the necessary adjustments should be made according to the actual situation.
The first category, foods with high purine content, whether in the acute or remission period of gout patients are prohibited foods. Purine-rich foods (>100mg/100g).
(1) Legumes and vegetables: soybeans, soybean sprouts, mung bean sprouts, bean seedlings, lentils, purple cabbage, cauliflower, shiitake mushrooms.
(2) Abstain from foods high in cholesterol: meat (beef, lamb, duck, goose, pigeon), animal offal (liver, intestines, kidney, brain, heart, belly, stomach, lung, pancreas and other offal), fatty meat, squid, fish, cuttlefish, dried meat, meat pies, thick gravy and thick chicken soup, duck soup, broth, etc.
(3) Aquatic products: seafood (sea eel, cod, squid, scallop, abalone, crab, lobster, salmon, sardine, tuna, sardine, anchovy, carp, sea bass, trout, cod, anchovy, rainbow skin, eggs, dried fish and other sea fish), shellfish, shrimp, sea cucumber.
(4) Other: yeast powder, all kinds of wine, especially beer, Shaoxing wine beer. Soybean food, lentils, spinach, cauliflower, asparagus, mushrooms, gumbo, wheat bark.
(5) abstain from eating acidic food, such as coffee, fried food, high-fat food, less coffee, tea, cocoa. Acid-base imbalance will affect the body functions and increase the burden on the liver and kidneys.
The second category, containing a medium amount of purine food, so all patients who are in remission can choose one animal food and one vegetable from it, but the consumption should not be too much. Purine content (25~50mg/100g).
(1) Beans and products: bean products (tofu, dried beans, dairy bean curd, soy milk, soy milk), dried beans (mung beans, red beans, black beans, fava beans), bean seedlings, bean sprouts.
(2) Meat: ham, mutton, beef soup, chicken, bacon, beef, chicken and other poultry and livestock meat.
(3) Aquatic products: grass carp, carp, cod, herring, salmon, flounder, sea bass, crab, eel, eel, snails, abalone, fish balls, shark fins, shrimp, and shellfish such as clams.
(4) Vegetables: spinach, bamboo shoots (asparagus, asparagus, dried bamboo shoots), beans (string beans, green beans, beans, peas), kelp, golden needles, silver fungus, mushrooms, cauliflower.
(5) Fats and oils and others: peanuts, cashew nuts, sesame seeds, chestnuts, lotus seeds, almonds.
The third category, containing a small amount of purine food, patients can choose to eat at will, without strict control. Purine content (<25mg/100g).
(1) Staple foods: rice (rice, millet, corn, glutinous rice), wheat (barley, wheat, oats, buckwheat, cereals), flour products (refined white flour, rich flour, noodles, cornmeal, steamed buns, bread, cookies, cakes), starch, soda crackers, butter snacks, sorghum, macaroni, potatoes, sweet potatoes, yams, water chestnuts, etc.
(2) Dairy: fresh milk, condensed milk, cheese, yogurt, cream of wheat, butter, milk, ice cream, etc.
(3) Meat: eggs, duck eggs, skin eggs, pig blood, chicken blood, duck blood, goose blood, etc.
(4) Vegetables: cabbage, cabbage, lettuce (lettuce), amaranth, snowy red, chrysanthemum, celery, mustard, water spinach, leek, leek, eggplant, melon (cucumber, winter melon, loofah, melon, carrot, bitter melon, etc.), radish (carrot, dried radish, etc.), olive, olive greens, gourd, green pepper, onion, onion, garlic, garlic, ginger, wood ear, squash, chili, kimchi, amaranth, tomato, etc. Most of the vegetables are low purine food.
(5) Fruits: apples, bananas, red dates, black dates, pears, mangoes, oranges, oranges, lemons, lotus, grapes, pomegranates, peaches, pipers, pineapples, plums, kumquats, watermelons, poinsettias, papayas, frankincense melons, raisins, dried longans and other fruits are basically low purine foods and can be eaten without worry.
(6) Fats and oils: vegetable oil, melon seeds, butter, cream, almonds, walnuts, hazelnuts, dried fruits, sugar, honey, animal agar.
(7) beverages: mineral water, soda, cola, soda, cream of wheat, tea, juice, coffee, chocolate, cocoa, jelly, etc.
(8) Other: tomato sauce, peanut butter, jam and other sauces, soy sauce, winter melon candy, coix seeds, dried fruits, jellyfish, seaweed, snacks and condiments made of animal glue or agar.
Gout patients should abstain from eating first-class foods, strictly limit the intake of second-class foods, and eat less third-class foods; when the blood uric acid drops below 380μmol/L, the intake of second-class foods can be relaxed appropriately.