What should I eat if I have high uric acid and am afraid of pain and go crazy?

With the improvement of people's living standards and changes in lifestyle, the prevalence of hyperuricemia and gout has increased year by year. Hyperuricemia and gout generally show a high incidence, younger age, higher male than female, and higher coastal than inland areas. So what is a low-purine diet, what foods need to be restricted, which foods should be encouraged to be consumed more, and how to choose appropriate exercise?

In ancient times, gout was common among emperors, generals, and high-ranking officials, and was closely related to their diet and lifestyle habits. In my country, many emperors were unable to govern due to severe gout or died of gout while in office, so it was called the "Emperor's Disease." With the improvement of living standards, more and more people have increased waist circumference and weight, and their uric acid levels are also flashing red lights. Blood uric acid levels are affected by many factors, including internal factors: age, gender, genetics, purine metabolism, weight, etc. and external factors: diet, drinking, environment, temperature, etc. Long-term hyperuricemia will significantly increase the risk of gout attacks, which is an important cause of renal damage, and is also an important comorbidity of obesity, metabolic syndrome, and lipid metabolism disorders.

The American College of Rheumatology, the UK Health Quality Standards Agency, and the Chinese Medical Association Endocrinology Branch all recommend that patients with gout, hyperuricemia, those with metabolic diseases and cardiovascular risk factors, and the elderly adopt a low-purine diet. Purines mainly come from seafood, red meat and other animal foods. After oxidative metabolism in the liver, they eventually form the final product of uric acid, which is excreted by the kidneys through urine. A low-purine diet can be understood as a diet that controls seafood, red meat and other animal foods. It can reduce blood uric acid by 10%-18%, reduce the number of acute gout attacks, and benefit more significantly for those with renal insufficiency and those who consume a high-purine diet.

The American College of Rheumatology's gout treatment guidelines state that, in the case of non-drug uric acid-lowering treatment, adjusting lifestyle and diet is to reduce the risk and frequency of gout attacks and lower blood uric acid levels. It is recommended that gout patients' diets be divided into three categories: Avoid eating : animal offal, high-fructose beverages, high-calorie beverages, any patient should avoid excessive drinking, and patients with acute gout attacks or poorly controlled gout are prohibited from drinking; Limit eating : beef, lamb, pork, high-purine seafood: sardines, shellfish, sweet juices, desserts, sweet drinks, alcohol, especially beer; Encourage eating : low-fat or fat-free dairy products, vegetables.

Alcohol can significantly increase gout attacks and raise uric acid levels. Different types of alcohol have different relationships with the onset of the disease. Beer, high-alcohol liquor, whiskey, etc. have more significant harm. Although low-alcohol wine has a smaller effect on uric acid levels, it still needs to be strictly limited. The American College of Rheumatology recommends that patients should completely quit drinking in the case of acute gout attacks, poor drug control, and chronic tophaceous arthritis. For patients with stable conditions, the number of drinking days per week should not exceed 4 days, and the amount of alcohol consumed by men should not exceed 2 units of alcohol per day, and that of women should not exceed 1 unit of alcohol per day. 1 unit of alcohol is about 14 grams of pure alcohol, which is equivalent to 100 ml of low-alcohol wine. Foods, beverages, candies, and even sweet natural fruit juices containing added sugars can increase blood uric acid levels. Therefore, if you want to control uric acid levels, don't forget to put all kinds of sweets and overly sweet fruits on the restricted list. Dairy products such as milk, yogurt, and cheese are important sources of high-quality protein, and very little uric acid is produced by metabolism. Whey protein and casein contained in dairy products can promote the reduction of uric acid levels and are important nutritional substitutes for patients who restrict animal foods. Since patients with high uric acid and gout often have chronic metabolic diseases such as overweight, obesity, and metabolic syndrome, it is recommended to choose skim or low-fat dairy products.

Eggs also produce very little purine, and are also an important supplement to high-quality protein when animal food is limited. However, since egg yolks contain a considerable amount of fat, they should not be consumed in excess. You can supplement with egg white on top of one egg per day. Eating a lot of vegetables, 250-500 grams per day, is helpful in controlling uric acid levels. Studies have found that even so-called high-purine vegetables, such as spinach, mushrooms, broccoli, etc., do not increase the body's uric acid levels. This may be related to the fact that the degree of hydrolysis and absorption of purines from plant sources in the gastrointestinal tract is much less than that of purines from animal sources. Caffeine and chlorogenic acid in coffee are strong antioxidants that can lower uric acid levels. Therefore, drinking more coffee can promote a decrease in uric acid levels.

It is also recommended to choose some simple exercises, such as walking, walking at a steady speed, Tai Chi, aerobics, Qigong, cycling and swimming, among which walking, cycling and swimming are the most suitable. Physical exercise should be stopped when gout attacks. Even if it is a mild arthritis attack, it is advisable to temporarily stop exercising until recovery before considering restarting exercise. (Feng Yanfei and Yao Huan, Peking University Shenzhen Hospital)