What are the dietary taboos for gout?

The core taboo of the gout diet is actually to give priority to avoiding foods that can quickly increase uric acid and inhibit uric acid excretion, instead of fasting all high-purine foods according to the purine table. Many foods that you think are safe may actually be the culprits of inducing gout.

Lao Chen, who was in the same uric acid management group as me a while ago, has a history of gout for four years. He is so self-disciplined that he doesn't even dare to touch tofu. At the last family dinner, he deliberately avoided all seafood and fatty meats, so he ate two fried spring rolls and drank two glasses of ice orange juice. As a result, his big toe was rolling in pain in the middle of the night. When he went to the emergency room, his uric acid level soared to over 700. Many people don’t know that the large amount of fructose in sweet drinks such as iced orange juice is much more harmful than one or two boiled high-purine meats. Fructose will directly generate uric acid during metabolism, and will also inhibit the excretion of uric acid in the kidneys. It is a category that patients with gout must absolutely avoid whether in the acute or remission phase, including carbonated drinks with fructose syrup. Sour drinks, commercially available milk tea, and sweet and freshly squeezed juices all count. Don’t think that freshly squeezed ones are healthy. Not to mention everyone’s favorite summer barbecue with cold beer, which is the number one cause of gout. Beer itself inhibits the excretion of uric acid, and the purine content of grilled meat doubles. I can’t count how many people I have seen go to the emergency room in the middle of the night after eating barbecue.

Having said this, someone must ask, is the long-standing saying that soy products should not be touched and seafood should be avoided true? In fact, this is still a controversial point in the academic circles. Earlier dietary guidelines did place soy products in the restricted area of medium and high purine. However, in recent years, more and more studies have found that the metabolic pathways of plant purines are different from animal purines. Processed tofu and soy milk have lost most of their purines during the production process. As long as Unless you are in the acute stage of severe pain, drinking a cup of soy milk and eating half a piece of tofu every day will basically not induce gout. Many patients around me who have stable uric acid have been doing this for a year or two, and their uric acid has not fluctuated significantly. Of course, if you do feel uncomfortable after eating soy products, then there is no problem in avoiding it.

Seafood does not have to be blackened. The purine content of sea cucumbers and jellyfish is lower than that of many vegetables, so it can be eaten normally. For seafood with high purine content, such as salmon and shrimp, as long as your uric acid has been stable below 360 μmol/L for more than 3 months, you can eat one or two at a time. There is basically no problem if you throw away the soup after cooking and then eat it. What you really need to completely avoid are high-purine seafood in shells such as oysters and shrimps, as well as animal offal, thick broth that has been simmered for several hours, and hot pot soup. These are categories that may cause you to be shocked after just one bite.

Many people stare at the purine table when they have gout, but ignore the effects of high-salt and high-oil foods. There was a young man in his early twenties in the group. After his uric acid was found to be 620, he did not dare to touch a bite of meat. He ate white porridge with bibimbap sauce every day. As a result, the uric acid increased by 30 after a month. This is because the bibimbap sauce contains too much salt and invisible sugar. Eating too much will also inhibit the excretion of uric acid. You should also use less seasoning in cooking and try to be as light as possible.

In fact, you don’t have to be like an ascetic with gout and dare not eat anything. My own uric acid has been stable at around 340 for almost two years. Occasionally I will eat one or two bites of braised beef when I am craving for food. As long as I control the amount and avoid those absolute minefields, there is no need to reduce the quality of life because of this disease. Of course, if it is in the acute stage, I still eat light food with low purine. It is not too late to adjust slowly after the pain has passed.