What should I eat if my uric acid level is high?

Author: Chen Zhou, Department of Nephrology, Shanghai Changhai Hospital

Reviewer: Mei Xiaobin, Chief Physician, Nephrology Department, Shanghai Changhai Hospital

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Did you know? Uric acid is a metabolic waste product. Normally, it is excreted from the body with urine. However, if your uric acid level is too high, it will lead to hyperuricemia and may even cause gout. Gout is not just a pain. It will make your joints swollen, red, hot, and painful, like being pricked by a needle. So, if your uric acid level is high, don't take it lightly and adjust your eating habits in time.

How should patients with hyperuricemia eat?

The healthy eating pattern of patients with hyperuricemia can refer to the dietary recommendations for gout patients. Many studies have found that a diet rich in meat and seafood, alcoholic beverages, carbonated drinks and fruit juices with high fructose or sucrose content are all dangerous types of diet for gout!

Compared with the Western diet (referring to the high intake of red meat and processed meat, French fries, refined grains, sweets and desserts), the DASH diet significantly reduces the incidence of gout. Therefore, for patients with hyperuricemia, like gout patients, it is recommended to focus on reducing meat and seafood intake and avoiding alcohol on the basis of the DASH diet.

Therefore, for patients with hyperuricemia, like gout patients, it is recommended to focus on reducing the intake of meat and seafood and avoiding alcohol on the basis of the DASH diet. For specific dietary principles, please remember the following points (3 more, 3 less, 3 no).

1. Eat more vegetables

For patients with hyperuricemia and gout, you can embrace vegetables as much as you want, no matter whether it is a high-purine food or not, because that is not important! Why? Because the purines in vegetables are mainly free purines, not nucleotides. The absorption rate of free purines in the human body is very low, only about 10%. The absorption rate of nucleotides in the human body is very high, reaching more than 85%. Therefore, the purines in vegetables have little effect on uric acid levels. On the contrary, the alkaline elements such as potassium, magnesium, and calcium that are rich in vegetables can neutralize acidic substances in the body and promote the excretion of uric acid. Moreover, vegetables can also provide rich vitamins, minerals, antioxidants and other substances that are beneficial to health.

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2. Eat more fruits

Fruits are also good friends of patients with hyperuricemia and gout. Fruits contain a lot of water and cellulose, which can increase urine and bowel movements and help excrete uric acid. Fruits also contain alkaline elements and antioxidants, which can regulate the pH value of body fluids and resist damage from free radicals. But be careful of particularly sweet fruits such as figs, apples, grapes, and oranges. It is recommended not to eat them! Because these fruits contain high fructose. Fructose is a monosaccharide that consumes a large amount of phosphate compounds when metabolized in the human body and promotes the synthesis of uric acid. Therefore, excessive intake of fructose can lead to elevated uric acid and gout attacks.

3. Drink more water

Drinking water is one of the simplest and most effective ways to lower uric acid levels. Drinking water can dilute the uric acid concentration in the blood, increase the kidney's filtration rate of uric acid, and promote the excretion of uric acid. It is generally recommended to drink at least 2000 ml (8 cups) of water every day. Of course, you can also drink some other sugar-free and caffeine-free liquids, such as tea, coffee, soy milk, etc. But avoid drinking sugary or alcoholic drinks because they will increase your uric acid levels.

4. Eat less salt

Excessive salt intake can lead to high blood pressure, edema, increased burden on the kidneys and other problems. These problems will affect the excretion of uric acid and increase the uric acid level. Therefore, patients with hyperuricemia and gout should control their daily salt intake to less than 6 grams. This means eating less pickles, preserved products, soy sauce, MSG and other condiments, less instant noodles, potato chips, ham and other processed foods, and less takeout, fast food and other high-salt foods. It is best to cook by yourself and use spices, herbs, lemon juice and other ingredients instead of salt to increase the flavor of the food.

5. Eat less shellfish

Seafood is a delicious delicacy that many people like, but for patients with hyperuricemia and gout, seafood is a dangerous food. Why? Because seafood contains a large amount of nucleotides and is a high-purine food. Especially shellfish, such as oysters, scallops, clams, mussels, etc., their purine content is very high, even higher than that of animal offal. Therefore, patients with hyperuricemia and gout should try to avoid eating shellfish to avoid causing elevated uric acid and gout attacks.

6. Eat less animal offal

Animal offal is a nutritious food, but it is also a high-purine food. Animal offal contains a large amount of nucleotides and purine bases, which will produce a large amount of uric acid after metabolism in the human body. Therefore, patients with hyperuricemia and gout should eat less animal offal, such as liver, kidney, heart, pancreas, brain, etc. If you must eat it, you should control it to no more than 50 grams per week, and cook it by boiling or steaming to reduce the loss of purine.

7. Don’t drink soup

Many people think that drinking soup is a healthy habit, but for patients with hyperuricemia and gout, drinking soup is a dangerous behavior. Why? Because the truth you don't know is: the nutrition is in the meat, and the purine is in the soup. When you use meat or seafood to make soup, the purine in them will dissolve into the soup, while the nutrition in the meat will be locked. So, when you drink such soup, you are equivalent to drinking a bowl of concentrated uric acid liquid. This is very bad for your body. Therefore, patients with hyperuricemia and gout should drink less bone soup and meat soup, and never think that all the nutrition is in the soup.

8. Don’t drink alcohol

Wine is a beverage containing alcohol, which produces lactic acid when metabolized in the human body. Lactic acid inhibits the excretion of uric acid by the kidneys, causing uric acid to accumulate in the blood. Therefore, drinking alcohol can lead to elevated uric acid levels and gout attacks. The wine here includes all alcoholic beverages such as beer, liquor, wine, cocktails, etc. None of them is safe. Therefore, patients with hyperuricemia and gout should completely quit drinking, or at least control their daily alcohol intake to less than 10 grams.

9. Avoid sugary drinks

Sugary drinks are liquids containing a lot of sugar, which consume a lot of phosphate compounds when metabolized in the human body and promote the synthesis of uric acid. Therefore, drinking sugary drinks can lead to increased uric acid levels and gout attacks. Sugary drinks here include carbonated drinks, fruit juices, milk tea, sports drinks and all other liquids with added sugar, none of which are healthy. Therefore, patients with hyperuricemia and gout should avoid drinking sugary drinks, or at least control their daily intake to less than 150 ml.