Gout, a metabolic disorder characterized by elevated uric acid levels in the blood, can be considered a “threshold” disease. The primary goal of dietary management for individuals with gout is to prevent sudden spikes or large accumulations of uric acid in the body. This approach aims to reduce the burden of urate crystals, thereby preventing recurrent gout flare-ups and altering the disease’s progression. Additionally, addressing the nutritional concerns that arise from patients’ tendency to overcorrect their diets due to fear of exacerbating their condition is another critical aspect of dietary management.
Dairy and Eggs: Essential Daily Intake
Dairy products and eggs are particularly friendly for those with gout, as evidenced by their minimal purine content. Considering that many individuals with gout also struggle with being overweight or obese, it is recommended to consume 250-300ml of low-fat milk daily (there’s no need for full fat removal). As for eggs, limiting egg yolks to one per day and consuming 1-2 egg whites is advisable.
Meat Consumption: Strategic Selection
When it comes to meat, both the type and amount are crucial. Which meats are preferable? It is advised to limit consumption of beef, lamb, and pork, while leaning towards poultry and freshwater fish. Generally, meat intake should be capped at 100g per day. With additional daily intake of 300ml of low-fat milk, 1-2 eggs, and some soy products, there should be no concerns about insufficient nutrition.
It is important to note that processed meats such as bacon, cured meats, and salted ham contain relatively concentrated amounts of purines and salt due to dehydration and salting during preparation, making them best avoided.
Vegetables: Abundant and Beneficial
The majority of leafy greens, melons, tubers, and roots are low in purines, and consuming ample amounts of fresh vegetables is beneficial for controlling blood uric acid levels and improving metabolic syndrome. Dried mushrooms, seaweed (such as kelp and wakame), and plant embryos generally have higher purine content; however, these are lower when fresh or rehydrated. Moderate inclusion as part of a dish, like adding mushrooms to stir-fried greens or kelp to winter melon soup, or mixing a small amount of wheat germ into rice, are safe and healthy practices.
Soy Products: Enjoy in Moderation
Gout patients need not shy away from soy! While it is true that dried soybeans like black beans have high purine content, the process of making tofu, soy milk, and other soy products removes some purines through the liquid, reducing the risk of purine intake. For instance, 100g of plump tofu, enough to fill a palm, contains only 68mg of purines, equivalent to the purine content of just 25g of dried beans.
The type of purines found in soy differs from that in meat; the metabolism of adenine in soy to uric acid is more complex compared to the quicker conversion of inosine in meat. Studies on Asian populations have found that consuming soy and other legumes may reduce the risk of developing gout. Soy lovers with gout can relax: moderate soy consumption is beneficial and harmless, and substituting meat with soy products can enhance health.
Fruits: Alluring but Best in Moderation
While it may seem tempting to indulge in fruits that are rich in water, fiber, and flavor, especially when meat consumption is limited, this is not without caution. Excessive intake of fructose and sucrose has been linked to gout flare-ups. Careful selection is advised for fruits high in fructose, such as apples, oranges, longans, lychees, pomelos, persimmons, and pomegranates.
Why might sweet fruits lead to painful consequences? Fructose accelerates the conversion of purines, increasing uric acid production and reducing kidney excretion of uric acid. Additionally, a genetic variant affecting the function of a transport protein (SLC2A9) has been identified in individuals with gout, which promotes hyperuricemia after sucrose intake. For gout patients, a daily fruit consumption of around 200g is appropriate – remember not to overindulge!
Hydration: Prioritize Plain Water
Many individuals with gout understand the importance of staying hydrated, aiming for a substantial intake of water. It is recommended to use a marked cup to measure water intake, striving for a daily total of 2500ml.
Juices: Minimize Consumption
Just as it’s important to limit meat broths for those with gout, many are unaware that juice consumption should also be minimized. Given the aforementioned effects of fructose on uric acid production, sugary juices and fructose-containing beverages should be avoided, including freshly squeezed orange, apple, grape, and pear juices, as these are easily consumed in excess.
Tea and Coffee: Enjoy Without Worry
Individuals with gout often harbor natural concerns about tea and coffee, as if the dark color of these beverages directly correlates with increased uric acid levels. However, the reality is quite different. The metabolic byproducts of caffeine, theobromine, and theophylline are methyl urate salts, distinct from the urate salts associated with gout. Therefore, these natural beverages can be enjoyed without worry. Considering that many people with gout also have cardiovascular diseases, it is important to avoid consuming excessive amounts of strong tea or coffee.
Alcohol: Best to Limit
Alcohol is one of the risk factors associated with gout flare-ups, with both acute binge drinking and regular consumption of beer, spirits, and wine contributing to the onset and progression of gout. Alcoholic beverages are inherently unfavorable for managing chronic diseases and metabolic syndrome. Therefore, individuals with gout are advised to steer clear of alcoholic drinks.
Numerous studies have highlighted the protective role of certain foods or nutrients against gout, such as cherries, coffee, and vitamin C. However, relying on these foods to prevent gout is insignificant compared to the therapeutic effects of medication in lowering uric acid levels. Instead, focus on adopting dietary habits that control uric acid and reduce body weight, such as consuming fresh vegetables, actively including low-fat dairy products, selecting fruits in moderation, reducing red meat intake, and avoiding sugary drinks.