What foods can't gout patients eat? The relationship between hyperuricemia and gout

Gout is a metabolic disease with a long history. In ancient times, most of the patients were emperors and nobles. The disease is closely related to the dietary structure. The incidence rate is higher in Europe and the United States, where animal food is the main food. After World War II, Japan's dietary structure tended to be similar to that of Europe and the United States, and the incidence rate of gout increased significantly. The incidence rate of hyperuricemia in my country is lower than that in Western countries, but in recent years, the consumption of animal food has increased significantly and exercise is insufficient, resulting in a continuous increase in the incidence of gout. It is predicted that gout will become the second largest metabolic disease in my country after diabetes.

What is ventilation disease?

What exactly is gout? Gout is a group of diseases caused by purine metabolism disorders and/or uric acid excretion disorders.

Its clinical features are: hyperuricemia, recurrent attacks of acute gouty arthritis, deposition of tophi, characteristic chronic arthritis and joint deformities, chronic nephritis and renal uric acid stones, renal parenchymal damage, and even uremia.

What is the relationship between the "hyperuricemia" mentioned above and gout? Hyperuricemia is a biochemical marker of gout, and serum uric acid saturation concentration > 420μmol/L is hyperuricemia. Routine physical examinations now include blood uric acid level measurements. In recent years, the number of people in my country whose blood uric acid levels exceed normal values ​​has increased sharply. Among these people with hyperuricemia, about 10-15% will develop gout. The higher the blood uric acid concentration, the greater the risk of gout. When high blood uric acid is found, timely adjustment of the diet structure and correction of unscientific lifestyles will prevent most people from developing gout throughout their lives.

The sources of uric acid in the human body are endogenous and exogenous. Endogenous sources account for 80%, which come from purine synthesized in the liver after the decomposition of amino acids, ribose phosphate and nucleic acids in the body; exogenous sources account for 20%, which come from foods rich in purine and nucleoprotein. Purine, whether endogenous or exogenous, will eventually generate uric acid in the human body.

Under normal circumstances, 2/3 of the uric acid produced by the human body is excreted through urine and 1/3 is excreted through the intestines. Excessive production and/or poor excretion of uric acid will cause it to accumulate in the blood, leading to "hyperuricemia".

Causes of gout attacks

The causes of gout attacks are also related to uric acid metabolism :

1. High-purine diet : Seafood, animal offal, broth, and beer are foods with the highest purine content, which will cause a large amount of uric acid to accumulate in the body.

2. High-energy diet . Protein decomposition produces uric acid; fat decomposition produces acetoacetic acid, and the final metabolite is keto acid; sugar decomposition produces pyruvic acid and lactic acid. These acidic substances hinder uric acid metabolism.

3. Drinking a lot of alcohol . The acetic acid in ethanol metabolism makes the body fluids acidic. Drinking a lot of alcohol leads to an increase in lactic acid, which can inhibit the secretion of uric acid by the renal tubules and reduce uric acid excretion.

4. Intense exercise . Intense exercise, extreme dieting, and excessive fatigue will produce a large amount of acidic substances such as ketoacid and lactic acid, which hinder the excretion of uric acid. Rapid weight loss can easily induce gout attacks. The incidence of hyperuricemia and gout in people who have been engaged in professional sports training for a long time is significantly higher than that of ordinary people.

5. High mental stress . Long-term mental tension and psychological pressure affect the normal metabolism of the human body, causing uric acid metabolism disorders, while mental stimulation and stress reactions can trigger gout attacks.

6. Insufficient drinking water . Excessive sweating and insufficient drinking water can reduce urine production, which is not conducive to uric acid excretion.