April 20 is World Gout Day, let's take a look at the knowledge of gout.
Gout is inextricably linked to uric acid levels
Uric acid deposition: the normal value of uric acid is 420 μmol/L, when the blood uric acid is measured twice on the same day above 420 μmol/L, it is considered to be hyperuricemia.
If the uric acid in the human body is too high for a long time, it is easy to precipitate crystals from the blood, and it is deposited in the joints and surrounding tissues, which may cause local inflammatory reactions and form gout.
Violent fluctuations in uric acid: violent fluctuations in uric acid are often an important cause of gout attacks, and those with normal uric acid levels can also induce the body's stress resistance and form gout due to violent fluctuations in uric acid.
Gout is divided into acute and chronic phases
Acute phase: manifested as redness, swelling, heat and pain in the joints (redness, swelling, increased skin temperature, severe pain), which some people describe as a pain when a gust of wind blows. It can last about 2-3 weeks, and pain often takes 48-72 hours to resolve;
Chronic phase: redness, swelling, heat and pain symptoms disappear, but pay attention, this does not mean that gout is better. If the uric acid level does not drop to the standard value, it will still recur when uric acid fluctuates violently. Uric acid levels cannot be controlled to the standard value for a long time, and may also develop into chronic metamorphosis, that is, although in the chronic phase, there are still symptoms of joint swelling and pain, and even daily pain.
Prone areas: bones, joints and surrounding tissues, most commonly the big toe. Because of the slow blood flow rate and low temperature here, uric acid crystals are easier to precipitate and deposit. Good time: Night. Because people lie flat at night and rest, the blood flow rate is slower and uric acid deposition is more likely to occur.
People with high incidence: obese people; special medication groups, such as patients with high blood pressure who take diuretics for a long time; people with a family history of gout. From the perspective of age and gender, people of all ages have gout, but the difference between men and women is large, and it is more common in men, while young women basically do not get gout.
Is it feasible to lower uric acid by controlling the diet alone?
As we mentioned above, gout is caused by high uric acid levels and violent fluctuations in uric acid, so the most fundamental way to treat gout is to control uric acid. However, whether it can achieve the purpose of lowering uric acid by controlling the diet only needs to clarify two points:
Uric acid value
Scientific studies have shown that our simple dietary control can probably reduce uric acid by 80-100 μmol/L.
Therefore, if the patient's uric acid level is just a little more than 420 μmol/L, through dietary control, it is possible to achieve uric acid standards; but if the patient's uric acid reaches 800 μmol/L, 900 μmol/L, diet alone can not be controlled.
Source of uric acid
The sources of uric acid are divided into exogenous and endogenous. Exogenous uric acid is related to our diet; endogenous uric acid is produced after cell metabolism.
So if endogenous elevated uric acid causes gout, controlling diet is of no use. If the following 2 requirements are met, the increase in uric acid is small, and the high uric acid is caused by exogenous dietary intake, you can first reduce uric acid by controlling the diet, and then increase other treatments if the effect is not good.
Must gout patients eat high purine foods?
I believe that many gout patients have heard that we should pay attention to a low-purine diet, but can't eat foods with high purines? Not really. Uric acid is the product of purine metabolism in the body, and from this point of view, gout patients do need to pay attention to the low-purine diet.
But in fact, purines are present in both animals and plants, and the onset of gout is mainly related to abnormal purine intake in animals, and the effect of plant purines is small.
Therefore, gout patients should strictly prohibit seafood, animal offal, broth and other animal foods with high purine content, after the uric acid reaches the standard, you can restrict the eating of a little red meat (beef, lamb), as for white meat (chicken, duck, goose) can be more relaxed, but pay attention to peeling.
For soy products such as soy milk and tofu, or common high-purine plants such as mushrooms, gout patients can not strictly limit their intake. As long as there are no problems such as allergies, you can eat it.
In addition, you should also eat more green leafy vegetables, stem plants, etc., and also pay attention to controlling the total calorie intake.
Then let's talk about drinks
Water: Drinking water is important for gout patients, because uric acid is mainly excreted through urine, and in order to make uric acid come down, a certain amount of water must be guaranteed.
It is generally recommended that patients with gout drink 2000-2500ml of water per day, up to a maximum of 4000ml, so as not to aggravate the burden on the kidneys.
Soda: The effect of lowering uric acid is relatively weak, but it can also be properly drunk, pay attention to the ingredient list when choosing, and try to choose sugar-free products to avoid excessive calorie intake.
Alcohol: It is generally recommended that all alcohols should not be drunk.
Because rice wine and beer contain a large number of purines; liquor contains high calories, and often accompanies a lot of appetizers, it is easy to cause calories to exceed the standard; wine is more controversial, some early literature shows that you can drink a little, but in recent years, the disease guidelines still recommend not to drink.
Sugary drinks: Drinks on the market often contain fructose syrup, and the effect of fructose syrup on gout is the same as that of wine, and may even be greater than the impact of wine, so it is not recommended to drink.
Milk: Studies have shown that milk can make uric acid have a certain decline, so milk can be drunk, but if there is lactose intolerance, it is easy to diarrhea after drinking, and lactose-free milk or yogurt can be selected.
References: Medical Microvision official website - Wang Hailong Chief Physician "Traditional Chinese Medicine for the Treatment of Gout"