Diet taboos for high uric acid and blood lipids

Don’t rush into foods that are high in purine, high in saturated fat, and high in added sugar, and avoid the invisible calorie/purine trap. There is no “absolute can’t eat” thing. The essence of all taboos is “a matter of quantity.”

I saw a 32-year-old programmer last week. The physical examination showed that uric acid was 580 μmol/L and low-density lipoprotein was 4.2mmol/L. I was so frightened that I stopped eating all meat dishes when I went home. I didn’t even dare to touch tofu. I just boiled vegetables and brown rice. After three weeks, I lost 7 pounds. However, the uric acid increased to 610 μmol/L during the follow-up test. My blood lipids did not drop much. I was so weak that I couldn’t even go to work. To put it bluntly, I have believed in the rumors on the Internet about “all abstaining from oral intake”, completely ignored the body’s metabolic needs, and also relied on many cognitive misunderstandings.

Popular science in the early years indeed said that people with high uric acid should completely avoid soy products and all seafood. Now the 2020 version of "China's Guidelines for the Diagnosis and Treatment of Hyperuricemia and Gout" has long revised this statement: the metabolic absorption rate of plant purines is much lower than that of animal purines, such as tofu and soy milk. This kind of soy products that have been soaked, ground, and boiled can lose more than 60% of purine. As long as it is not an acute attack of gout, drinking a cup of soy milk and eating two taels of tofu every day is completely fine. On the contrary, it can supplement high-quality protein, which is much better than eating vegetables every day and causing malnutrition.

Of course, animal high-purine foods are not a one-shot kill. If you are craving for seafood, just avoid anchovies, sardines, and shellfish that contain more than 300 mg of purine per 100 g. Steamed seabass and salmon have similar purine content to lean beef. Eat it 1-2 times a week, about 100 g each time. It can also supplement Omega3 to help lower blood lipids, which is cost-effective. What you really want to touch as little as possible are animal offal, such as pork liver, pig brain, kidneys, etc., which are high in purine and cholesterol. After one bite, the two indicators will rise together. In fact, if you are greedy, you can eat it once or twice a year to satisfy your craving. There is really no need to show off with home-cooked food. There is also the old hot soup that many southern families love to drink. After simmering it for three or four hours, all the purine and fat in the meat are dissolved in the soup. You think it is a supplement, but in fact, drinking it is a burden.

Many people have a bigger misunderstanding about blood lipids. They think that high blood lipids mean they cannot eat fatty meat. Is it okay to just eat skinless chicken breasts every day? Not really. I used to have a little girl born in 1995. After her blood lipids became high, she ate light salads every day and added three spoons of Thousand Island dressing every time. After a month of review, her blood lipids did not drop but rose. When I asked, I found out that a small spoonful of Thousand Island dressing has 2g of saturated fat. Three spoonfuls of it is more invisible fat than eating a piece of fried chicken leg. Also, the croissants you usually eat, the shortening in egg yolk pastries, the excessive cooking oil in takeout, and even the creamer in milk tea are all invisible saturated fat. You think you are eating a vegetarian diet, but in fact, the calories have already exceeded the standard. It is strange that blood lipids can be reduced.

The most overlooked pitfall is actually added sugar. Don’t think that sugar has nothing to do with uric acid. After fructose enters the human body, it will directly promote purine synthesis and inhibit the excretion of uric acid by the renal tubules. If you drink a 500ml bottle of ice cola in the summer, there will be 50g of added sugar. After drinking it, the uric acid will rise much faster than if you eat two ounces of lean pork. There are also many people who think that healthy freshly squeezed juice has filtered out all the dietary fiber, and the rest is pure fructose. Drinking a glass of it is no different from drinking sugar water. It should also be mentioned here that not all fruits are off limits. Don’t eat more than 100g of high-sugar durian, lychee, and mango at one time. Usually eating an apple or orange as big as a fist can supplement dietary fiber and help lower blood lipids.

Of the many patients with double height I have come into contact with, those who have been able to control their indicators for a long time are never the ones who give up completely. They are all able to "flexibly adjust". For example, if you are having a dinner during a New Year or a holiday, if you really want to eat hot pot or barbecue, just eat a few pieces that are thin, don't drink beer or sweet drinks, drink a few more sodas, and eat lighter the next day, and there will basically be no big fluctuations. On the contrary, those who have been holding back for two or three months without daring to eat anything and suddenly have a big meal are most likely to have gout attacks and blood lipids soar.

In fact, there are so many taboos about rote memorization. To put it bluntly, don’t be greedy for too much. Don’t believe those anxiety articles on the Internet about “don’t touch even one bite.” Pay more attention to your body’s reaction. For example, if you eat soy milk once and there is no gout attack, and the reexamination indicators are normal, then feel free to eat it.； If your joints hurt the next day after eating seafood hotpot once, try less of it next time. The rhythm that suits you is easier to use than the hard rules imposed by experts.