The old man next door has gout and dares not eat tofu! Can he eat tofu?

Gout is known as the immortal cancer. It is very painful to suffer from it, but it will not kill you. During the gout attack, even a breeze can make you grimace in pain, as if you were being cut by a knife.

Although people now have a wide variety of food choices, most people's diets are not balanced, especially unhealthy lifestyles such as excessive consumption of meat and fish, drinking and smoking. In order to attract attention, some people perform "eating broadcasts" and "drinking broadcasts" on various platforms. Some netizens even posted videos challenging themselves to drink 10 bottles of liquor at a time, and some even vomited during the drinking broadcast.

The problems that follow are not only obesity, high blood lipids, diabetes, and stomach problems, but also an increased risk of gout. Spring is the peak season for gout, and many people dare not even eat soy products to avoid gout attacks.

If you have gout, do you really not want to eat soy products?

01 How do you get gout? The root cause: overeating and overdrinking

Gout is a disease caused by purine metabolism disorder. It used to be very common in developed Western countries. In recent years, there are also many people suffering from it in my country. Uric acid is a metabolite of purine, 80% of which comes from normal decomposition in the body and 20% from diet.

Under normal circumstances, uric acid can be excreted from the body through the kidneys, intestines, and sebaceous glands; however, once excessive consumption occurs, problems occur in the body's mechanisms, and the production and excretion of uric acid become unbalanced. This causes uric acid to accumulate in the body, causing uric acid crystals to accumulate in cartilage, soft tissues, kidneys, and joints, resulting in redness, swelling, and tingling, which is what we call gout. [1, 2]

According to the latest diagnostic criteria for hyperuricemia in my country, if the fasting blood uric acid (SUA) concentration is >420 μmol/L on two different days under a normal purine diet, regardless of gender, hyperuricemia can be diagnosed. At the same time, if the cumulative score is ≥8 points according to the table below, it is gout. [3]

▲Figure: Screenshot of the literature[3]

02 What is the current situation in my country? Incidence rate: not low!

A meta-analysis of 44 studies showed that from 2000 to 2014, the prevalence of hyperuricemia in my country was 13.3%, and the prevalence of gout was 1.1%, and both showed an upward trend. [2] It seems that we really need to pay enough attention to this "immortal cancer"!

Since diet has such an important influence on the occurrence and severity of gout, it is really important to know what foods you can eat and what foods you can’t eat. For example, can gout patients still eat tofu, as mentioned at the beginning of the article?

03 Can I eat tofu if I have gout? Yes!

Most plant foods have lower purine content than animal foods, but some plant foods have higher purine content, such as beans, fungi, spinach, etc. Among them, the purine content of bean foods such as soybeans, mung beans, black beans, and red beans is 218mg/100g, 196mg/100g, 170mg/100g, and 156mg/100g respectively. The purine content of vegetables we often eat, such as cabbage, cucumber, and tomato, is 14mg/100g, 11mg/100g, and 17mg/100g respectively. [4]

In comparison, beans are high in purine. However, even so, there is no need to worry too much.

Some studies have shown that eating beans may not increase the risk of gout, but may reduce the risk of gout. [2] Another study of 752 male elderly people over 65 years old found that reducing soy intake may increase the incidence of hyperuricemia and chronic kidney disease. [2]

If you are really worried, you can choose to eat soy products instead of whole beans, such as tofu, soy milk, yuba, or even vegetables after bean sprouts, such as mung bean sprouts and soybean sprouts. They are all foods obtained after further processing of beans. During the processing, they go through multiple processes such as soaking, and some purines will be lost, so the content will be greatly reduced.

Purine in soybeans: 218mg/100g

Northern tofu purine: 68mg/100g

Purine in soy milk (20%, sugar-free): 63 mg/100 g

Purine in sweet soy milk: 29mg/100g

The purine content of yuba is slightly higher, at 160mg/100g.

Mung bean bud purine: 11mg/100g

Soybean sprout purine: 29mg/100g

Among them, the purine content of soy milk is related to the degree of dilution. The soy milk we usually buy in breakfast shops has a high water content. In fact, the concentration of pure soy milk is very low, and the purine content is even less.

Therefore, if gout patients do not have other special diseases or severe kidney disease, they can eat soy products. How much should they eat? According to the recommendation of the "Dietary Guidelines for Chinese Residents", 25g of soy per day is enough. [5]

This is equivalent to 50g of tofu shreds (one fist of a woman), 50g of dried tofu (one fist of a woman), 100g of northern tofu (the size of 5 mahjong blocks), 150g of southern tofu, 200g of rennet tofu, and 400g of soy milk (10% concentration) in soy products.

04

If you have gout, you should pay attention to these 7 points

Diet:

① Do not eat animal liver or shellfish.

② Do not drink broth or hot pot soup.

③ Do not drink alcohol or sweet drinks.

④ Limit the consumption of red meat, such as pork, beef and mutton.

⑤ Drink plenty of water, more than 2000mL per day.

In sports:

① Regular exercise can lower blood uric acid levels. It is recommended that gout patients maintain aerobic exercise more than 5 times a week, with each exercise lasting more than 30 minutes.

② Do what you can and avoid strenuous exercise.

To sum up: bad eating habits are an important factor in causing gout. Healthy people must pay attention to their diet to avoid being tortured by gout.

People who already have gout should pay more attention to their dietary choices to avoid more serious diseases caused by poor control of the disease, such as kidney stones, chronic kidney disease, etc.

References:

[1] Gu Jingfan, Du Shouyin, Guo Changjiang. Modern Clinical Nutrition, 2nd Edition[M]. Science and Technology Press, 2009

[2] Yang Yuexin, Ge Keyou. Chinese Nutrition Science Encyclopedia 2nd Edition (Volume 2)[M]. People's Medical Publishing House, 2019

[3] Guidelines for diagnosis and treatment of hyperuricemia and gout. World Journal of Traditional Chinese Medicine. 2021.16(2):183-189.

[4] Yang Yuexin. Chinese Food Composition Table 6th Edition Volume 2[M]. Peking University Medical Press, 2018

[5] Chinese Nutrition Society. Dietary Guidelines for Chinese Residents[M]. People's Medical Publishing House, 2016

Author | Xue Qingxin, member of Chinese Nutrition Society, registered dietitian, registered nutrition technician, health manager, public nutritionist

Review | Song Shuang, Associate Researcher, Institute of Nutrition and Health, Chinese Center for Disease Control and Prevention

This article was first published on the "Science Rumor Refutation Platform"