What are the dietary taboos for gout?

The core principle is to avoid foods that can quickly increase uric acid and induce acute attacks. The first thing to do is not to consume large quantities of high-purine, high-fructose, and alcohol-containing foods for a long time. Don’t believe the extreme statements on the Internet that “all soy products cannot be touched” and “you can’t eat even a bite of meat.” Most patients only need to control their daily purine intake within 200 mg, and avoid specific foods that are clearly known to cause attacks. There is no need to over-diet and make eating feel like torture.

A while ago, I met an older brother who has been suffering from gout for 3 years, and he stepped on an invisible trap that many people didn't notice. He had heard people say that gout only requires avoiding seafood and beer, so he simply put off all social activities. He usually squeezes freshly squeezed orange juice at home and drinks it every day. He feels healthy and takes vitamins. As a result, his feet hurt so much in the middle of the night last week that he couldn't even put on slippers. He was helped by his family to go to the emergency room. When he found out, his uric acid level soared to 680 μmol/L, which was higher than when he was drinking beer to socialize. After asking, he found out that it was caused by the two large glasses of concentrated juice he drank every day.

Many people think that only seafood beer can increase uric acid. In fact, fructose is the most hidden substance. When it is metabolized in the body, it will not only accelerate the synthesis of purine, but also inhibit the excretion of uric acid by the renal tubules, which is equivalent to blocking both ends and pushing up the uric acid level, especially if it is removed. Freshly squeezed juices with dietary fiber, fructose syrup added to milk tea, and even particularly sweet lychees and longans can easily trigger attacks if eaten too much at one time. Many patients told me that after quitting sweet drinks, their uric acid dropped by 70 to 80% without taking medicine, and the effect was particularly obvious.

As for alcohol, it goes without saying, but there is a lot of controversy now. Some people say that drinking a small amount of red wine is okay. Current research does show that a small amount of red wine will not significantly increase blood uric acid. However, in clinical practice, we have seen that many patients can induce acute pain even if they only drink half a glass of red wine. Therefore, there is no unified standard on this matter. You can just take a sip occasionally if you don’t react after drinking it. If you drink it and it hurts, it’s a no-no. You can’t commit the crime of suffering for a sip of wine.

For example, there was a lot of talk before about not eating soy products, but now there is no conclusion. Soybeans themselves are indeed not low in purines, but most of the purines are lost with water in the process of making tofu and soy milk. There are currently studies that say that eating soy products in an appropriate amount can help lower uric acid. However, some patients do suffer from attacks after eating them, so you can just avoid them. You don’t have to follow the trend and don’t dare to touch them with chopsticks. There are also vegetables containing oxalic acid such as spinach. As long as you blanch them in water for 1 minute in advance, the oxalic acid can basically be removed. There is no need to include them on the taboo list.

To be honest, you really don’t need to calculate the purine table every time you eat. When you go out to dinner, don’t touch the old hot soup or hot pot dishes. When you drink, choose boiled water or light tea. It is safer than anything else. Eating is a happy thing. As long as you avoid those core minefields, you don’t have to irritate your mouth too much.