Table of dietary taboos for high uric acid

Alcohol, fructose-added foods, ultra-high purine animal foods, and other foods do not need to be completely fasted. Just control the intake based on your own uric acid level.

You must have seen many people using the old version of the taboo list. They didn't even dare to touch spinach or tofu, and they didn't even touch a bite of seafood. As a result, they drank freshly squeezed juice every day, and their uric acid kept rising. I recently met a 40-year-old gout patient who had given up seafood and beer for 3 years. He only drank freshly squeezed corn juice at every dinner party. Last month, he was still in pain and couldn't get out of bed. When he checked, his uric acid level soared to over 700. The honey and extra fructose syrup added to the corn juice were causing trouble for a long time.

Let’s talk about the issue of alcohol first. There is actually a bit of controversy here: In the early years, some European and American guidelines believed that red wine within 100ml per day would not induce gout and could even slightly improve metabolism. However, in recent years, domestic large-sample follow-up data has confirmed that as long as alcohol is consumed, it will competitively inhibit the excretion of uric acid during the metabolic process, regardless of whether it is white wine. Beer or red wine, you must not touch it during a gout attack. It is best to quit completely during the stable period. If you really want to take a sip, you must at least make sure that your blood uric acid has been controlled within the standard range for three consecutive months (men <420 μmol/L, women <360 μmol/L), and the intake is controlled within 50ml.

Let’s talk about the most familiar ultra-high purine foods, which are animal foods with a purine content of more than 150mg per 100g: animal offal (pork liver, kidneys, brains, chicken hearts, etc.), shelled seafood (oysters, scallops, shrimps, crayfish yellow), thick broth that has been simmered for more than 2 hours, old-fire soup, and hot pot soup. Don’t just drink the soup base when making hot pot at friends gatherings in winter. The purine content in the hot pot soup is enough for you to eat normal home-cooked meals for three days. If you then drink ice cola and make the soup, it is basically like sending yourself an invitation to a gout attack. You must not touch these foods during the attack period. If you really want to eat them during the stable period, for example, if you want to eat grilled oysters in summer, it is okay to eat 1-2 oysters occasionally to satisfy your cravings. Just do it every once in a while.

Here we need to clarify a misunderstanding that has been circulating for many years: many people say that high-purine plants such as spinach, asparagus, beans, and mushrooms cannot be eaten. In fact, this is an outdated conclusion. The 2020 version of China's Guidelines for the Diagnosis and Treatment of Hyperuricemia has clearly mentioned that the bioavailability of plant purines is much lower than that of animal purines, and the dietary fiber and vitamins in this type of food can also promote the excretion of uric acid. Even soybeans with high purine content have lost most of their purines in the process of making tofu and soy milk, so they can be eaten normally. Unless you've tried it yourself, every time you eat asparagus or tofu it will trigger gout, so just avoid it and don't just follow other people's lists.

Don’t think that just controlling purines is enough. 90% of young people with high uric acid are caused by invisible fructose. If you look at milk tea, carbonated drinks, bottled juices, honey, and even many so-called "healthy sugar-free drinks" sold on the market, fructose syrup is added. After fructose enters the body, it will not only promote the synthesis of uric acid, but also inhibit the excretion of uric acid by the renal tubules. The dual effect of raising uric acid is more efficient than eating a meal of seafood. I met a 20-year-old young man not long ago. He doesn't drink alcohol or eat seafood. He drinks two cups of iced milk tea every day. His physical examination showed that uric acid was 620 μmol/L. I was still confused and didn't know what was going on. Even if it is freshly squeezed pure juice, don’t drink too much. Just eat the fruit directly. After the juice is squeezed, the dietary fiber is removed, and the fructose concentration is doubled. It is not as healthy as eating an apple directly.

In fact, to put it bluntly, there are not so many things that must not be eaten when uric acid is high. I have seen many people make a page full of fasting lists at the beginning, not daring to touch this and not dare to taste that. After half a month, a friend breaks the habit after a dinner date, and the uric acid will explode after eating a random meal. Instead, it is better to relax from the beginning. Except for the three types of must-haves mentioned above, it is okay to eat other foods in moderation. Everyone’s metabolic capacity is different. If someone else eats seafood that is fine, you may have an attack after eating it. Instead of copying other people’s taboo lists, it is better to keep two food diaries yourself, test uric acid after eating, and slowly figure out your own body’s tolerance. It is more effective than anything else.