Gout symptoms and dietary taboos

In the acute phase, the intake of foods high in purine, high in added fructose, and high in alcohol must be strictly avoided. In the remission phase, restrictions can be relaxed appropriately according to one's own blood uric acid level. There is no 100% untouchable food. All taboos must be dynamically adjusted based on individual responses and attack frequency, and there is no need to blindly apply one-size-fits-all.

Not long ago, I met my elder brother who has been suffering from gout for 5 years. Since the first attack, he has given up all soy products and mushrooms. He even dared not eat more spinach. As a result, last week he drank two glasses of ice lemonade with triple sugar. His feet hurt as if they were pinched by the door in the middle of the night. When he came to the hospital, his uric acid level soared to 680 μmol/L. He himself was wondering, I obviously didn’t touch seafood beer?

Many people's impression of gout diet is still based on the old rule of "avoid seafood and beer", but in fact, high fructose intake has long been the number one trigger for young gout patients. Like milk tea, fruit-flavored sodas, freshly squeezed juices, and even many breads and puffed snacks with fructose syrup added, the added fructose in them will accelerate the production of uric acid during the metabolic process and inhibit the excretion of uric acid by the renal tubules. It is equivalent to pouring water into the pool while blocking the drain tightly. It would be strange if the uric acid does not rise. I met a 19-year-old young man in the clinic before. He never smoked or drank and did not like to eat seafood. He only liked two cups of iced milk tea every day. His first gout attack made him sit in the clinic crying in pain, and his feet were swollen like steamed buns.

As for the purine that everyone is most concerned about, you don’t actually need to follow the food purine table and eat one by one, and live a duller life than a monk. In the acute stage, when you are in so much pain that you can’t get out of bed, don’t touch any food with particularly high purine content, such as animal offal, sardines, oysters, thick broth, or braised food. If you are really greedy, after the acute stage, your uric acid has stabilized below 360 μmol/L for more than 3 months. Occasionally eating one or two mouthfuls to satisfy your craving is not a big problem, as long as you don’t show off half a kilogram of braised shrimp at one time or drink three bowls of Laohuo soup.

Speaking of which, the most controversial issue now is whether soy products can be eaten. In the past, the older generation said that soybeans are high in purine and should be avoided altogether. Now the latest gout guidelines in China clearly recommend that gout patients can eat soy products. After all, most of the purine in soybeans is lost with water during processing into tofu and soy milk, and the human body absorption rate of plant purine is about 30% lower than that of animal purine. As long as you don’t eat two or three kilograms of brine tofu in one meal, there will basically be no problem. However, many clinicians will recommend temporarily stopping eating during an attack. After all, everyone’s metabolic ability is not bad at all. If someone drinks a bowl of soy milk and it can cause pain for two days, then naturally don’t touch it. Your own physical experience is more accurate than any guide. There are also foods such as mushrooms and spinach that were previously included in the "taboo list". It has long been proven that as long as you don't cook a large plate at once and eat it as a meal, it will not induce gout at all, so there is no need to scare yourself.

Some people always ask if they can drink less red wine? This controversy is not small. European guidelines say that drinking less than 100ml of red wine a day will not significantly increase uric acid. However, most doctors in China still recommend not drinking it if you can. After all, no matter what kind of wine, metabolism will produce lactic acid, which robs the excretion channel of uric acid. If you don’t control your uric acid, you may be affected by even a sip of cold beer. If you really want to take a few sips to join in the excitement of the dinner, you have to wait for more than half a year after the uric acid has stabilized. Don’t joke with your feet.

Oh, by the way, many people ask whether soda water can cure gout? Don't listen to the nonsense of the merchants. Ordinary soda water without additives can only help alkalize urine and help uric acid be excreted more smoothly. If you buy the fruity sparkling water with a bunch of fructose syrup added, it will increase uric acid. It is better to drink two more sips of plain water. Drink 2000ml every day, which is more effective than any IQ tax.

Many patients I have come into contact with either overcorrected and did not dare to eat anything. In the end, they were skinny and skinny, and their poor immunity led to more frequent attacks. Or they thought that they could eat and drink as much as they wanted after taking uric acid-lowering drugs. As a result, their uric acid went up and down, and their tophi grew faster than anyone else. It’s really not necessary. Dietary control is only a part of gout management, accounting for only about 30%. Don’t expect to get rid of the root cause by just relying on food taboos, and don’t expect to die if you don’t eat taboos at all. If you eat a certain food that you have never touched before, and then have a gout attack within 24 hours, try to eat it as little as possible next time. Everyone's metabolism is different, and a diet that works for others may not be suitable for you. It is better to suffer less than anything else.