Can't eat oyster sauce if you have gout? The three types you really shouldn't eat are

Rumor: "People with high uric acid and gout cannot eat oyster sauce"

There are many "popular science" on the Internet saying that oyster sauce has high purine content and that patients with high uric acid and gout should not eat it. However, some "popular science" also say that oyster sauce does not have high purine content and that oysters have been diluted before being made into oyster sauce, so it is fine to eat it normally.

Rumor analysis: Both of these statements are somewhat one-sided.

Oyster sauce is indeed a high-purine food, but as a condiment, the dosage should be controlled. Patients with high uric acid and gout in remission can use it less.

There are some colleagues around me who cannot control their diet but have high uric acid. They get sick at least once a year and are in great pain. Therefore, for friends with gout and high uric acid, it is also very important to reduce purine in the diet, especially during gout attacks. There are many different opinions on whether gout patients can eat oyster sauce. In fact, whether oyster sauce can be eaten is not absolute. You need to pay attention to the timing when you want to eat it.

The purine content of oyster sauce varies greatly, but it is not completely inedible

1. The purine content of oyster sauce varies greatly

Oyster sauce is a condiment made from oysters and is widely used in cooking to enhance the flavor of dishes. There are two mainstream opinions on whether oyster sauce is a high-purine food: one is that oyster sauce is made from oysters, and seafood is high in purine, so oyster sauce must also be high in purine; the other is that oyster sauce is the juice of boiled oysters, which is equivalent to the bath water of oysters and does not contain much purine. Most of these two opinions are personal understandings, not objective facts. In fact, there is currently no official data on the purine content of oyster sauce. From the purine determination experiment of Chen Shasha and others, it can be seen that the total purine content of oyster sauce is 207.35mg/100g. According to the classification of food purine content, foods with purine content exceeding 150mg/100g are considered high-purine foods [1].

Of course, the purine content of different oyster sauces will vary, because different brands use different concentrations of oyster juice, and whether or not they use flavor-enhancing nucleotides (which can be metabolized into purines in the body) is also different, which leads to different purine levels in different oyster sauces. For example, there are oyster sauces with a concentration of 100%, and some are marked as 30%, 12%, and many do not mark the ratio, which may be less than 10%. The lower the ratio, the lower the purine content will generally be.

2. Gout patients should not eat during the attack period and should eat less during the remission period.

For friends with gout, you need to pay attention to the stage of your gout. During the acute attack of gout, the joints are swollen and painful, and you should strictly avoid high-purine foods at this time. The intake of oyster sauce may increase the purine content in the body, leading to increased uric acid levels, aggravating joint inflammation and pain. When gout enters the remission period, joint swelling and pain gradually subside, and patients can adjust their diet appropriately. At this time, gout patients can consume a small amount of oyster sauce, but they need to be careful to control the intake. Since oyster sauce is mainly used as a condiment, the intake per meal is relatively small, so the effect on gout is also small. In order to avoid another attack of gout, it is recommended that patients still consume oyster sauce with caution during the remission period and not in excess.

Oyster sauce has a high salt content, so don’t put too much

The "Chinese Multidisciplinary Expert Consensus on the Diagnosis and Treatment of Hyperuricemia-Related Diseases (2023 Edition)" recommends that patients with high uric acid intake oyster sauce "limited consumption", that is, people with high uric acid should control their intake, but they are not completely forbidden to eat it. It is worth noting that the original text of this dietary advice is:

Limit food intake: beef, lamb, pork, seafood rich in purine, seasoning sugar, desserts, seasoning salt (soy sauce and sauces), wine, fruit wine

Oyster sauce belongs to the category of "seasoning salt (soy sauce and dressing), which means that the reason why oyster sauce is recommended to be "limited" is mainly because of its high salt content. Not only oyster sauce, but all seasonings with high salt content, including MSG and chili sauce, should be carefully controlled.

Consuming too much oyster sauce will not only increase the saltiness of the dishes and affect blood pressure, but excessive sodium intake will also increase the burden on the kidneys, hinder the kidneys' excretion of uric acid, and worsen gout symptoms.

1. Using oyster sauce in cooking can easily lead to excessive sodium intake

The Hong Kong Consumer Council once sampled 15 oyster sauces on the market and found that the sodium content in these oyster sauces is generally high! For example, one of the oyster sauces contains 5,100 mg of sodium per 100 grams! What does this mean? It is equivalent to using only 2 spoons (about 18 grams per spoon) of this oyster sauce for a meal, and the sodium intake is almost reaching the recommended upper limit for each meal. Let's take a look at the situation in daily cooking. According to the recipes on the food APP, it is often necessary to add 3 spoons of oyster sauce and half a spoon of salt to make a dish for 4 people. If we calculate based on the average sodium content of these 15 oyster sauce samples (3,658 mg per 100 grams), the total sodium content of this meal is as high as 2,975 mg! If four people share it equally, then each person will consume 744 mg of sodium in the seasoning alone. This is far more than the upper limit of sodium intake per meal. (According to the recommendations of the Chinese Nutrition Society, our daily sodium intake should not exceed 2,000 mg, which is no more than 667 mg per meal.) Therefore, when purchasing oyster sauce, you must pay attention to the sodium content and control the amount to avoid excessive sodium intake. Controlling the amount of oyster sauce can not only reduce sodium intake, but also help control purine intake.

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2. Do this to reduce the amount of oyster sauce

When using oyster sauce, the usual method is to shake it out. However, the shaking method is very random, and sometimes a lot of it is shaken out, and the amount cannot be controlled. It is recommended to choose a squeeze bottle when purchasing, so that the amount can be controlled by squeezing. In addition, you can also replace the bottle mouth of the oyster sauce with a squeeze pump and decide the amount to be pumped out according to your needs.

Gout patients are more recommended to eat like this

Oyster sauce is popular for its unique flavor, but it is not the only one that can enhance the flavor of gout patients' diet. Other seasonings and cooking methods can also be used to make delicious dishes without adding burden to gout patients. For example, spices such as onions, ginger, and garlic can be used for seasoning to increase the aroma and taste of dishes. Ingredients can also be marinated in advance to make them tasty and reduce the use of seasonings.

In terms of ingredient matching, you can choose some ingredients that have umami flavor, such as low-purine fresh mushrooms. These ingredients themselves are rich in umami substances. Through reasonable matching and cooking, delicious dishes can be made without increasing the burden on gout patients.

Aim for no more than 5 grams (about one teaspoon) of salt per day. This includes salt from all sources, such as salt in food itself, salt added during cooking, and salt in processed foods.

What should you not eat if you have gout?

Gout patients need to strictly control their purine intake in their diet. Knowing the foods that gout patients really cannot eat can help patients better adjust their diet and control uric acid levels.

1. High-purine foods

Gout patients should avoid consuming high-purine foods. The purine in these foods will be metabolized into uric acid in the body, leading to increased uric acid levels and worsening the condition. Common high-purine foods include animal offal (such as liver, kidney, brain, etc.) and seafood (such as shrimp, crab, shellfish, etc.). In addition, some meats (such as beef, lamb, etc.) and soups (such as thick soup, hot pot soup, etc.) also contain high purine. Taking the more popular duck products as an example, the purine content of offal exceeds 300mg/100g, which is far higher than the lower limit of high purine.

If you just check the seafood category, you will find that many of them are high in purine.

2. High fructose foods

Although high-fructose foods have a low purine content, fructose will produce uric acid during metabolism in the body, leading to increased uric acid levels. Studies have shown that high-sugar beverages can increase the risk of gout attacks. Therefore, gout patients should also avoid consuming too much high-fructose foods, such as fruit juice, beverages containing fructose syrup, etc.

3. Alcohol

Alcohol affects uric acid in many ways. First, the metabolic process of alcohol triggers the release of purine substances in the body, which in turn promotes a significant increase in the production of uric acid, directly exacerbating the increase in uric acid concentration in the blood. Secondly, alcohol intake will also reduce the excretion of uric acid. Because alcohol can cause an increase in serum lactic acid levels, it will effectively reduce the kidney's ability to excrete uric acid. This means that even if the amount of uric acid produced in the body remains unchanged, uric acid levels will still rise due to reduced excretion. In addition, some alcoholic beverages themselves contain a certain amount of purine, which is undoubtedly adding insult to injury. Therefore, the Chinese Nutrition Society recommends that adults should not consume more than 15g of alcohol per day.

Summarize

It is not absolutely true that gout patients cannot eat oyster sauce. It is fine to use a small amount of oyster sauce as a condiment during the remission period. The key is to control the total amount of purine in the diet. Animal offal, seafood, high-fructose foods and alcohol should be consumed with more caution. In addition, gout patients should also pay attention to salt intake.

Looking in the mirror of rumors

For chronic diseases such as gout, my country's Centers for Disease Control and Prevention, Nutrition Society and other relevant authoritative organizations have issued dietary guidance recommendations. You can follow the professional advice to develop your own diet plan instead of blindly believing in unconfirmed rumors.

In addition, the dietary guidance for gout patients should mainly follow the following principles: limit high-purine foods, moderate protein, limit salt intake, limit alcohol, increase vegetables and fruits, etc.

References

[1] Chen Shasha, Liu Xin, Li Xiaolan, Du Lili. Study on the distribution of purine substances in common condiments based on liquid chromatography-tandem mass spectrometry[J].[2024-10-11].

[2] Department of Food Safety Standards, Monitoring and Evaluation, National Health Commission, et al. Dietary Guidelines for Adults with Hyperuricemia and Gout (2024 Edition)[J]. Health Research, 2024, 53(3):352-356.

[3] Chinese Society of Critical Metabolic Diseases, Multidisciplinary Consensus Expert Group on Diagnosis and Treatment of Hyperuricemia-Related Diseases, Zou Hejian, et al. Multidisciplinary Expert Consensus on Diagnosis and Treatment of Hyperuricemia-Related Diseases in China (2023 Edition)[J]. Chinese Journal of Practical Internal Medicine, 2023, 43(6):461-480.

[4] Hong Kong Consumer Council. Sugar content in sauces cannot be ignored. Oyster sauce is high in sodium and sugar and should be used with caution. https://www.consumer.org.hk/tc/press-release/471-condiments-sauces

[5]Forman JP, Scheven L, de Jong PE, Bakker SJ, Curhan GC, Gansevoort RT. Association between sodium intake and change in uric acid, urine albumin excretion, and the risk of developing hypertension. Circulation. 2012 Jun 26;125(25):3108-16. doi: 10.1161/CIRCULATIONAHA.112.096115. Epub 2012 Jun 18. PMID: 22711274; PMCID: PMC3804910.

[6] Chinese Nutrition Society. Dietary Guidelines for Chinese Residents[M]. People's Medical Publishing House, 2022

[7] Yang Yuexin. Chinese Food Composition Table 6th Edition Volume 2[M]. Peking University Medical Press, 2019

Author: Li Chun, registered nutritionist

Review｜Ruan Guangfeng, Deputy Director of Kexin Food and Health Information Exchange Center