Gout, a metabolic disorder characterized by the deposition of urate crystals in various tissues, is often associated with a diet high in purines. The dietary management of gout involves avoiding certain foods and drinks that can exacerbate the condition. Here are some key considerations and restrictions that individuals with gout should be aware of:
Moderation in Alcohol Consumption: Excessive alcohol intake, particularly beer, has been linked to gout flare-ups. Ethanol affects blood uric acid levels through several mechanisms, including the consumption of purine-rich foods during drinking, increased lactic acid concentration due to ethanol metabolism, which inhibits renal excretion of uric acid, ketosis from excessive drinking, and the conversion of adenine nucleotides to uric acid. Lead-containing alcoholic beverages like whiskey have also been suggested to triple the risk of gout attacks.
Avoiding Hunger: Fasting or reduced food intake can trigger gout flares as well. When hungry, plasma levels of acetoacetate and β-hydroxybutyrate increase, affecting the kidney’s ability to excrete uric acid.
Misconceptions about Soy Products: There is a misconception that soy products should be avoided by gout patients. However, research from China and Japan indicates that most beans do not contain high levels of purines. Therefore, soy products can be consumed in moderation, contrary to traditional beliefs. This is supported by the low incidence of gout among Buddhist monks who regularly consume soy products.
Adequate Protein Intake: While an excess of protein can lead to increased purine synthesis, it is important to maintain a balanced intake. Low-purine sources such as milk and eggs can be prioritized. It is advisable to improve the structure of animal food consumption, reducing fatty pork and increasing lean poultry and fish.
Limiting Fat and Cholesterol: A diet high in fat and cholesterol can contribute to arteriosclerosis and hinder the excretion of uric acid by the liver and kidneys. Using vegetable oils rich in vitamin E and linoleic acid, such as soybean, peanut, olive, tea seed, sesame, corn, and safflower oils, can help prevent vessel damage.
Reducing High-Cholesterol Foods: Foods high in cholesterol, such as animal offal (heart, liver, intestines, kidneys, brain), egg yolks, shrimp, fatty meats, squid, cuttlefish, butter, and cream, should be consumed sparingly.
Sodium Restriction: Excessive salt intake can cause arteriolar constriction and hypertension, accelerating the hardening of renal arteries. Reducing sodium intake can lower blood pressure and decrease fluid retention. Daily salt consumption should be controlled at 2-3 grams, with consideration given to the sodium content in soy sauce and other processed foods.
Increasing Potassium-Rich Foods: Potassium-rich foods can counteract the pressor effects of sodium and promote the dissolution of uric acid in urine, reducing precipitation and increasing excretion. Good sources of potassium include lean meats, fish, poultry, fruits like bananas and citrus, and vegetables such as potatoes, broccoli, and spinach.
Adequate Hydration: Drinking plenty of water is crucial for the excretion of uric acid through the kidneys. Maintaining proper hydration helps to prevent the accumulation of uric acid.
In summary, individuals with gout should be mindful of their diet, avoiding high-fat, spicy, and purine-rich foods while incorporating foods that promote healthy digestion and reduce the burden on the spleen and stomach. By doing so, they can better manage their condition and prevent gout flare-ups.