Once many people are found to have high uric acid or gout, they will be "kidnapped" by many dietary taboos - seafood cannot be eaten, broth, fish soup, hot pot soup cannot be drunk, and even tofu and fruits dare not touch. So how should people with gout and hyperuricemia eat? Recently, the National Health Commission issued the "Dietary Guidelines for Hyperuricemia and Gout (2024 Edition)", which provides examples of recipes and nutritional health suggestions for different seasons, different regions, and different groups of people.
From 2018 to 2019, the surveillance data of chronic diseases and risk factors in China showed that the prevalence of hyperuricemia and gout among the first residents in China was 14%, and the prevalence of gout was 086%～2.20 per cent, higher for men than for women, higher in urban than rural, and higher in coastal than inland. The prevalence of gout is increasing year by year, and the age of onset tends to be younger.
The occurrence of hyperuricemia and gout is closely related to diet and lifestyle, especially long-term intake of high-energy foods, high amounts of alcohol and/or high-fructose beverages. Obesity is an independent risk factor for hyperuricemia and gout. According to the theory of nutritional science, the theory of diet and nutrition of traditional Chinese medicine and the literature evidence of related chronic disease scientific research, on the basis of the joint discussion and consensus building of the expert group, 7 principles and suggestions were put forward for the daily diet of people with hyperuricemia and gout. Includes:1The food is varied and the purines are limited. 2.Plenty of vegetable milk and limit fructose. 3.Drink plenty of water and limit alcohol consumption. 4.Scientific cooking, less raw and cold. 5.Eat a balanced diet and maintain a healthy weight. 6.Differentiation of syndromes and bodies, according to the person's diet. 7.Choose the right meal according to the place and time.
a) Foods are diverse, and purines are restricted.
Ensure the intake of cereals and potatoes, vegetables and fruits, livestock, poultry, fish, eggs and milk, soybeans and nuts every day, and the variety of food should be no less than 12 kinds per day and not less than 25 kinds per week. Adjust the ratio of energy provided by carbohydrates, proteins, and fats in your diet.
Animal offal, such as liver, kidney, heart, etc., the purine content is generally higher than that of ordinary meat, and the choice should be avoided as much as possible. Eggs are low in purines such as egg white and milk, so they can be eaten safely. Although the purine content of soybeans is slightly higher than that of lean meat and fish, the utilization rate of purines in plant foods is low, and the purine content of soy products such as tofu and dried tofu is reduced after processing, so they can be eaten in moderation.
It is advisable to choose carbohydrate foods with a low glycemic index, with whole grains not less than 30% of the staple food amount per day, and dietary fiber intake reaching 25 30g.
2) Sufficient vegetables and milk, and limit fructose.
Vitamins, phytochemicals and other nutrients can promote the excretion of uric acid in the kidneys and play a role in reducing uric acid. Fresh vegetables (such as chicory, fresh lilies), fruits (such as cherries, strawberries rich in vitamin C), plant-based drinks (such as sugar-free coffee, tea) and herbs (such as coix seeds, nootropic seeds) are usually rich in phytochemicals, such as alkaloids, phenolic acids, flavonoids, stilbens and glycosides, etc., which have a certain effect in reducing blood uric acid levels, helping to improve hyperuricemia and reduce the risk of gout attacks.
It is recommended to eat more fresh vegetables every day, and it is recommended to consume no less than 500g per day, and dark vegetables (such as purple cabbage and carrots) should account for more than half. Milk protein is an important high-quality protein**, which can promote uric acid excretion and encourage the daily intake of more than 300ml or equivalent of milk and dairy products.
Fructose can induce metabolic abnormalities and cause insulin resistance, which has the potential to induce an increase in uric acid levels, and foods with high fructose content, such as sugar-sweetened beverages, freshly squeezed fruit juices, fructose syrup, and preserved fruit fruits, should be restricted. Although fruits contain fructose, nutrients such as vitamin C, flavonoids, polyphenols, potassium, and dietary fiber in fruits can change the effect of fructose on uric acid, so there is no significant correlation between fruit intake and gout. The recommended daily intake of fruits is 200 350g.
3) Drink plenty of water and limit alcohol consumption.
Drinking water regularly and regularly can promote uric acid excretion. People with hyperuricemia and gout should drink enough water under normal heart and kidney function, and it is recommended to drink 2000 to 3000ml per day. Try to maintain a urine output of more than 2000ml per day. Priority should be given to plain water, lemon water, weak tea, sugar-free coffee and soda, but excessive consumption of strong tea, strong coffee, etc., should be avoided, and raw and cold drinks should be avoided.
Drinking alcohol increases the risk of hyperuricemia and gout. Alcohol metabolism affects the release of purines and promotes increased uric acid production, and alcohol also leads to an increase in serum lactate, which reduces uric acid excretion. Some alcoholic beverages also contain purines, usually rice wine has a higher purine content, followed by beer. Although the purine content of liquor is low, the alcohol content of liquor is high, which is easy to accumulate lactic acid in the body and inhibit the excretion of uric acid. Therefore, alcohol consumption should be limited, and patients with acute gout attacks, poorly controlled medications, or chronic gouty arthritis should refrain from alcohol.
4) Scientific cooking, less raw and cold.
Proper food cooking and processing methods are of great significance for the prevention and control of hyperuricemia and gout. Less salt and less oil, less condiments, and a bland diet can help control or lower blood uric acid levels. It is recommended that the daily salt intake should not exceed 5g, and the daily cooking oil should not exceed 25 30g. Reduce cooking methods such as frying, frying, and marinating, and advocate eating meat after boiling, and try not to drink soup. Cured, cured or smoked meat has high purine and salt content, and people with hyperuricemia and gout should not eat it.
For people with hyperuricemia and gout, regular consumption of raw and cold foods such as ice cream and raw and cold seafood can easily damage the function of the spleen and stomach, and at the same time, it can lead to an increase in the precipitation of urate crystals and induce gout attacks. Therefore, patients with gout should eat less raw and cold foods.
5) Eat a balanced diet and have a healthy weight.
Overweight and obesity increase the risk of gout in people with hyperuricemia,** and weight loss can significantly reduce blood uric acid levels. Overweight and obese hyperuricemia and gout should meet the daily essential nutritional needs by improving the dietary structure and increasing regular exercise to achieve energy intake less than energy expenditure. At the same time, avoid excessive dieting and weight loss too fast to reduce 0. per week5～1.0kg is appropriate, and finally control the weight within a healthy range. For overweight and obese people, energy intake can be reduced by 250 500 kcal per day and 250 500 kcal of energy can be consumed through exercise. The appropriate body mass index (BMI) for a healthy weight for adults aged 18 to 64 is 185～23.9kg m2, 65 for seniors aged 20 and over0～26.9kg/m2。
Developing the habit of regular and moderate exercise is one of the effective prevention and treatment measures for hyperuricemia and gout. Under the principle of ensuring safety, people with hyperuricemia and gout should choose suitable sports for themselves and exercise step by step.
6) Differentiation of syndromes and bodies, and feeding according to the person.
The key to gout nutrition is to regulate the spleen and stomach, and it is recommended to eat white lentils, corn whiskers, malt, yams, seeds, jujubes, orange peel, hawthorn, five-fingered peach, poria cocos, etc. The main muscles of the spleen, choose gentle, small amounts, and continuous exercises, which can stretch the muscles and bones, and make the spleen and stomach healthy. Combined with the physical characteristics and clinical symptoms of the patient, according to the common TCM syndrome types, the diet is reasonable.
Dampness syndrome, common in the asymptomatic hyperuricemia phase and the intermittent period of gout, this type of population is more common in phlegm and dampness, should avoid cold-induced acute attacks of gout, strictly control the fat and sweet taste, that is, limit the total intake of purines and proteins, low-salt diet, especially avoid sweet, greasy, sour, astringent food; It can be eaten coix seed, orange peel, and poria cocos instead of tea.
In addition to strictly restricting the intake of purines and proteins, especially salt, tobacco and alcohol, to avoid the acute attack of gout induced by external wind chill and wind heat, it is recommended to eat mangosteen, watermelon, water chestnut, etc., which can be used to cook soup and drink with red adzuki beans, papaya, coix seeds, etc.
Phlegm stasis pattern is common in the intermittent phase of gout and chronic gouty arthritis, and blood stasis and phlegm-dampness constitution are more common in this group of people. Patients should drink plenty of water, strictly limit high-fat, high-cholesterol foods and high-salt diets, and eat fungus, hawthorn, peach kernels, etc.
Spleen and kidney deficiency syndrome, common in the stage of chronic gouty arthritis, this kind of people with yang qi deficiency constitution is more common, should eat warm food, can eat ginger, astragalus, poria, walnut, lychee, etc.
7) Choose the right meal according to the place and time.
Coastal areas are rich in ingredients, and there are long-term habits of eating seafood, and some areas have the habit of making soup based on high-purine ingredients; In inland areas, livestock and poultry meat, freshwater fish and shrimp are often eaten, and the intake of vegetables and fruits is relatively low. In plateau areas, barley, ghee, beef and mutton are often eaten, and vegetables and fruits and water consumption are less.
Adjust to the time and season. In spring, you should lie down at night and get up early, eat a light and refreshing diet, consume carbohydrates based on the daily energy requirements, and eat more vegetables and fruits rich in vitamins and dietary fiber. In summer, the food is light, nutritious, and easy to digest, so it is recommended to eat loofah, winter melon, etc., and eat less seafood, animal offal, animal meat, and less raw and cold. In autumn, the summer heat gradually disappears, the dryness is the way, the living should be early to lie down and get up early, the mood should be stable and peaceful, eat less fish, shrimp, crabs, it is recommended to eat lotus seeds, lotus roots, water chestnuts, lilies and other sweet, healthy, moisturizing and dry products. In winter, the temperature should be supplemented, the living should be bed early and get up late, the residence should be kept warm, pay attention to the cold, and control the intake of hot pot, skewers, broth, etc. in the diet.
In addition, gouty arthritis is easy to be induced by cold, so it is necessary to pay attention to keeping warm in autumn, winter, summer and autumn when the climate alternates between cold and hot, and pay attention to the temperature of air conditioning not to be too low in summer.
Link: "*Dietary Guidelines for Hyperuricemia and Gout (2024 Edition)" publishes the purine content of common foods.
Foods are generally classified into four categories according to their purine content for reference when choosing food.
The first category: high in purines, containing 150 1000mg per 100g.
Food examples: liver, kidney; seaweed, seaweed (dried); Mackerel, mussels, oysters, nudibranchs, squid, etc.
The second category: high purine content, containing 75 150mg per 100g.
beef, pork, lamb; rabbits, ducks, geese; Carp, flounder, grass carp, etc.
Category III: low purine content, 30 75mg per 100g.
rice, oats, buckwheat; beans, cauliflower; Shiitake mushroom (fresh), enoki mushroom (fresh), mouth mushroom (fresh), etc.
Category IV: Low in purines, 30mg per 100g.
potatoes, sweet potatoes; carrots, rape, lettuce, bamboo shoots; fruits; milk and milk products, etc.
*List of recommended foods for people with hyperuricemia and gout.
Cereals and potatoes: brown rice, whole wheat flour, corn, barley, buckwheat, yellow rice, oats, millet, sorghum, quinoa, sweet potato, purple potato, etc.;
Meat: lean meat, skinless poultry, etc.;
Eggs: eggs, duck eggs, etc.;
Milk: skim milk, low-fat milk, fresh milk, pure milk, low-sugar yogurt, etc.;
Soybeans and products: tofu, dried tofu, etc.;
Vegetables: fresh vegetables;
Fruits: cherries, strawberries, pineapples, peaches and other fresh fruits;
Edible oil: perilla oil, flaxseed oil, walnut oil, olive oil, tea seed oil, rapeseed oil, sunflower oil, corn oil, sesame oil, soybean oil, peanut oil, germ oil, etc.;
Condiments: low sodium salt (no more than 5g per day).
Yangtze Evening News Purple Cow News reporter Yu Dandan.
Visual China.