Abstract: Gout is a kind of metabolic syndrome, just like the well-known "diseases of wealth" such as diabetes, hyperlipidemia and obesity. With the improvement of people's living standards and the change of lifestyle, the incidence of gout is increasing year by year, and our understanding of it is far from other diseases.
Gout is also a kind of metabolic syndrome, just like the well-known "diseases of wealth" such as diabetes, hyperlipidemia and obesity. With the improvement of people's living standards and the change of lifestyle, the incidence of gout is increasing year by year, and our understanding of it is far from other diseases.
Gout is actually a disorder of protein metabolism in the body. The synthesis or excretion of uric acid (the oxidative metabolite of purine) increases or decreases, resulting in hyperuricemia. When the blood uric acid concentration is too high, uric acid is deposited in joints, soft tissues, cartilage and kidneys in the form of sodium salt, causing foreign body inflammatory reactions in tissues. Because gout is very painful when it attacks, and even difficult to walk when it is serious, but in the early stage of the disease, it will naturally recover in a few days even if not treated, so it is called "gout".
There are some special requirements for the diet of gout patients. The purpose is to reduce the intake of uric acid and increase the excretion of uric acid as much as possible. The following principles should be noted:
① Low calorie diet: Since body mass index is positively related to hyperuricemia, obese people should limit their energy intake, and overweight patients can reduce their daily total energy intake 10%~15% ； Weight loss per month 0.5~1 Kg, so as to gradually reduce the weight to the ideal weight range; Avoid losing weight too fast, which may cause acute attack of gout.
② Low purine diet: if the intake of purine in the diet is too high, the production of uric acid in the body will increase; The daily purine intake of normal people is 600~1000 Mg, patients with gout should limit the intake of purine in the diet for a long time, and patients with acute gout should choose a low purine diet, and the amount of purine should be strictly controlled every day one hundred and fifty If it is less than mg, it can be relaxed properly during remission period, but high purine foods (animal viscera, seafood, beans, etc.) should still be taboo.
③ Low protein diet: In addition to controlling foods with high purine content, gout patients should also appropriately reduce protein intake in the diet to 0.8~1.0 G is appropriate; The protein supply should be mainly vegetable protein, and animal protein can be milk and eggs, because they are high quality proteins rich in essential amino acids and contain less purine; Gout patients should not choose meat, poultry and fish viscera; In addition, because purine is easily soluble in soup, the purine content of various broth is very high, so lean meat and poultry need to be boiled before eating.
④ Low salt and low-fat diet: due to the oxidation of fat, the energy produced is about carbohydrate and protein two In order to reduce weight, gout patients should limit the intake of fat. Some studies have shown that fat has the effect of blocking the excretion of uric acid in the kidney, and it should be restricted in the acute attack of gout; The general fat intake is recommended to be controlled at daily 40~50 G, fish, rabbit, chicken breast, duck breast, etc. with less fat should be used, vegetable oil should be used instead of animal oil, and cooking methods with less oil should be used; Since gout patients are prone to hypertension, hyperlipidemia and kidney disease, sodium salt intake should be limited 2~5 gram / The weather is just right.
⑤ Increase the intake of vegetables and fruits: vegetables and fruits are alkaline foods. After metabolism in the body, they produce slightly alkaline substances, which can reduce the acidity of blood and urine, alkalize urine, and increase the solubility of uric acid in urine; Vegetables and fruits are rich in vitamins, especially vitamins C , can promote the dissolution of urate in tissues; Gout patients should eat more vegetables and fruits. Watermelon and wax gourd are not only alkaline food, but also have obvious diuretic effect, which is more beneficial to gout patients.
⑥ Drinking more water: drinking more water is conducive to the excretion of uric acid, preventing uric acid kidney stones, and delaying progressive kidney damage. Therefore, general patients advocate drinking water every day two thousand More than ml (approx 8~10 Cup), in order to prevent urine concentration at night, you can also drink a moderate amount of water before going to bed; However, those with renal insufficiency and abnormal cardiopulmonary function should limit their water intake according to their condition; Drinking water should be boiled water, light tea, mineral water and fruit juice. Strong tea, coffee, cocoa and other drinks can stimulate the autonomic nervous system and should be avoided.
⑦ Avoid drinking: alcohol metabolism increases blood lactic acid, which can competitively inhibit the excretion of uric acid; In particular, beer itself contains a large amount of purine, which can increase the concentration of blood uric acid. Therefore, in clinical practice, it is often seen that a typical case of one-time excessive drinking with high purine and high-fat diet induces gout attack.
⑧ Choose reasonable cooking methods: reasonable cooking methods can reduce the purine content in food, such as cooking meat and discarding soup before cooking; The use of steaming, boiling, stewing, stewing, boiling and other methods can significantly reduce the amount of cooking oil; Spices such as pepper, pepper, Chinese prickly ash, mustard, ginger, etc. can excite the autonomic nervous system and induce acute gout attack. Avoid eating them as much as possible.
(Liu Peng)
( Encyclopedia of Famous Doctors Expert of the Ministry of Health Clinician Science Popularization http://www.baikemy.com )
