Diet taboos for high uric acid

All alcoholic beverages, animal offal/shelled seafood/thick broth cooked for more than 2 hours and other ultra-high purine foods, and sweet drinks and desserts with added fructose syrup and white sugar will be blacklisted directly.； Control the amount of purine-containing foods such as poultry, freshwater fish, and soy products as needed, but do not eliminate them entirely. ； There is no need to deliberately avoid high-purine vegetables and whole grains such as spinach, asparagus, and mushrooms, just eat them normally.

You may not believe it, but when my dad’s physical examination last year revealed that his uric acid level was 560, his first reaction was to throw away all the spinach and dried mushrooms at home and eat boiled cabbage for two weeks. However, the uric acid level rose to 610 during the retest. I went to the nutrition department for consultation and found out that I had fallen foul of several misunderstandings that had been circulating for almost ten years.

As for whether high-purine vegetables should be tabooed, the industry has always had different opinions. In the early years, the old guidelines recommended limiting the intake of asparagus, spinach, and mushrooms because the purine content per 100 grams exceeded 150 mg, which was a high-purine food. However, in the past five years, both the domestic "Hyperuricemia and Gout Diagnosis and Treatment Guidelines" and the updated recommendations of the American College of Rheumatology have clearly mentioned plant-based purine. The body absorption rate is less than 1/3 of animal purine, and the potassium, dietary fiber, and vitamin C contained in this kind of food can also promote the excretion of uric acid. Unless you fry more than a pound of spinach every time, it will not have a significant impact on uric acid. My dad later ate mushrooms and stir-fried vegetables normally, and there was no fluctuation in uric acid.

Many people think that high uric acid only requires controlling purine. In fact, fructose is the "hidden killer" of many asymptomatic patients with high uric acid. I once met a 1998-year-old young man in a gout patient group. He never drank alcohol or ate seafood. He only ate light dishes from the cafeteria. His uric acid spiked to 580. After tracing the source for a long time, I discovered that he drank two bottles of iced black tea every afternoon to relieve the heat. A bottle of iced black tea contains more than 30g of added sugar. After entering the human body, a large amount of uric acid will be metabolized and the uric acid excretion function of the kidneys will be inhibited. It is equivalent to "producing uric acid" while "blocking the outlet." A different point of view should be mentioned here: some nutritionists believe that high-sugar tropical fruits such as lychees, mangoes, and longans should also be restricted. However, the current mainstream recommendation is to eat 200-350g of fresh fruits every day (roughly one apple plus one oranges) is absolutely fine, as long as you don’t show off a few kilograms of lychees, or drink freshly squeezed juice as water - most freshly squeezed juices sold outside will add syrup, even if they are squeezed at home, one cup will use three or four oranges, and the fructose intake has already exceeded the standard.

Let’s talk about the most commonly asked question: “Can I drink less red wine?” A few years ago, there were indeed small-sample studies saying that a small amount of red wine would not significantly increase uric acid, and even had a circulatory effect. However, in recent years, large-sample follow-up data have come out, and it has become clear that alcoholic beverages will inhibit the uric acid excretion function of the renal tubules. Even if you only drink a sip of white wine, uric acid will increase by 10%-20% in the next 12 hours. If you drink beer, which itself contains a lot of purines, the increase will be even higher. If you really want to socialize, drink more sugar-free sparkling water or light tea to stop it. Don't use the old saying that "red wine reduces uric acid" as a shield.

Many people go completely vegetarian as soon as they are diagnosed with high uric acid. This is really unnecessary. There is a girl next to me who went on a vegetarian diet for a month in order to reduce uric acid. She did not even dare to eat more eggs and milk. As a result, the uric acid level rose from 490 to 520. This is because the daily caloric intake is not enough, and the ketone bodies produced by the body's metabolism of fat compete with the uric acid for excretion channels, and instead hold the uric acid high. It is perfectly fine to eat a palm-sized amount (about 100g) of medium-purine ingredients such as chicken breast, grass carp, and northern tofu every day. Supplementing enough high-quality protein can make metabolism more stable, which is much more reliable than eating boiled vegetables every day.

I have helped my dad adjust his uric acid for almost two years. Now he is stable at around 380 and has never had gout. To be honest, he has not been told not to eat this or that. I have replaced all his favorite white wine and orange soda with light tea and sugar-free sparkling water. He basically avoids thick broth and animal offal. He occasionally eats drunken shrimp if he is craving for it. In the next two days, he will eat more vegetables and drink more water, and his uric acid will not spike. After all, 70% of uric acid in the human body is produced by endogenous metabolism, and diet only accounts for 30%. Don't put too much psychological burden on yourself. On the contrary, anxiety will affect metabolism, which is much greater than eating two more bites of mushrooms.