Diet taboos for gout patients

The core dietary taboo for gout patients is never that they cannot touch certain foods; Avoid long-term and large intake of foods high in animal purines, high fructose, and high alcohol Most of the "you can't eat all seafood" and "you can't touch a bite of soy products" spread on the Internet are outdated misunderstandings.

Last week, I met an old man named Chen who has suffered from gout for 8 years in the clinic. He had heard someone say that all high-purine foods should be banned, including spinach and bean sprouts. He usually eats seafood so much that he swallows his saliva. However, his daughter bought him two kilograms of mangosteen a few days ago. He was afraid that I ate almost a pound in two consecutive days, and my big toe swelled like a steamed radish in the middle of the night. When I checked, my uric acid jumped from 420 μmol/L to 610 μmol/L. I grinned in pain. I said if I had known it would not be so miserable after eating two pounds of shrimp.

Speaking of which, we have to mention the two current mainstream clinical views on gout diet. The old-school doctors will also insist on strict purine intake limits, requiring daily purine intake to be controlled within 150mg, and all foods with purine exceeding 250mg/100g will be blacklisted, regardless of whether they are of animal or plant origin.； However, after 2020, both the American College of Rheumatology and domestic gout diagnosis and treatment guidelines prefer a "classified treatment" approach - also high-purine foods, animal-derived red meat, animal offal, and shelled seafood will significantly increase blood uric acid and increase the risk of gout attacks. High-purine plant foods such as asparagus, spinach, and mushrooms will hardly affect uric acid levels after ingestion, and there is no need to ban them.

The invisible killer that many people tend to overlook is actually fructose. Don’t think that sweet things have nothing to do with gout. After fructose enters the human body, it will directly promote the production of uric acid and inhibit the excretion of uric acid by the renal tubules, which is equivalent to blocking the sewer pipes while water is flowing in. It is strange that the uric acid is not high. I've seen many young people in their twenties who don't drink alcohol or eat offal, but love to order full-sugar milk tea and freshly squeezed juice every day. The physical examination showed that the uric acid level was over 500, and they still looked confused and didn't know what was going on. Some people think that fruits are healthy and they eat them. High-fructose fruits such as mango, lychee, longan, and cherries. Eating half a catty at a time is no different from drinking half a cup of milk tea. It can really induce gout.

As for alcohol, needless to say, whether it is white wine, beer or red wine, as long as it contains alcohol, it will affect the excretion of uric acid. Don’t believe that red wine can soften blood vessels and drink less. Current research has made it clear that drinking alcohol will increase the risk of gout attacks. If you really can’t avoid it during the holidays, drink at most 1 small glass of low-alcohol red wine to satisfy your cravings. Don’t be greedy.

I have come into contact with so many gout patients. To be honest, you really don’t need to behave like an ascetic. As long as you are in a stable period, your uric acid is controlled below 360 μmol/L for a long time, and you occasionally eat skewers or two hairy crabs. As long as you don’t eat them consecutively, you will basically not get sick. On the contrary, there are patients who dare not eat or touch anything every day. Their long-term protein intake is insufficient, their immunity is reduced, and gout attacks become more frequent. There is also the most frequently asked question about soy products. There is really no need to ban them. Current research has long confirmed that soy products can promote the excretion of uric acid. Unless you really feel pain every time after eating it, drinking a cup of soy milk and eating a piece of mapo tofu is absolutely fine.

Of course, don’t think that everything will be fine with diet control. You must know that diet can only help you reduce uric acid by 10%-18% at most. If your uric acid has soared to more than 580 μmol/L, it will be difficult to reduce it to the normal range even if you eat boiled vegetables every day. If you need to see a doctor for prescription medication, don’t force it. To put it bluntly, the dietary taboos for gout are never to give you a long list of fastings, but to help you develop healthier eating habits. Don’t eat hazelnuts every day just to satisfy your cravings, and don’t make life less interesting because of taboos. Just find a balance.