[Gout] is a very common disease among modern people. In terms of medical definition, the main diagnostic reference is: "The presence of uric acid crystals or tophi in symptomatic joints or bursa." (For details, please refer toChinese guide); but in practice, doctors usually make a comprehensive assessment and diagnosis based on the patient’s symptoms and other reference data (such as joint swelling, pain or tenderness, uric acid values, etc.).
Considering the relationship between purine and uric acid as upstream and downstream products in the body, in the past health education, patients with gout or hyperuricemia were often advised to reduce their intake of purine-rich foods. Dietary adjustments often have ineffective results and may result in a small gain (due to too many types of foods that cannot be eaten, which may lead to nutritional imbalance). However, as clinical research becomes more and more abundant, we have a different understanding of gout. .
In 2018, two international journals (Journal 1,Journal 2) both pointed out that even though they are all high-quality foods, different food types have different effects on gout or hyperuricemia. In the first paper, the results point out the impact on gout or hyperuricemia:Alcohol > Fructose > Seafood > Red meat,andDairy products, soy products, and kaolin vegetables even have improved effects; In the second paper, the research results are similar, regarding the impact of gout or hyperuricemia: alcohol > beverages ≒ red meat, and also pointed out that potatoes and poultry are also potentially relevant.
Although the above papers still have many limitations (such as the influence of cooking methods, differences in processing levels, etc.), we can know from the similar results of the two papers that for dietary recommendations, ifIn order to reduce uric acid and avoid gout, priority should be given to reducing the intake of alcohol and sugary drinks. The intake of red meat and seafood should also be appropriately reduced and replaced with plant-based protein (such as soy products).
Of course, in addition to dietary habits, the risk factors for gout and hyperuricemia also need to consider factors such as genes, obesity, chronic diseases, etc. In recent years, more and morestudiesUsing Multiomics, discoverThere are dozens of genes related to hyperuricemia, which means that the pathogenesis of the disease is extremely complex.; In clinical practice, for high-risk patients, doctors will recommend regular treatment with uric acid-lowering drugs to reduce the risk of recurrence. Overall, drug treatment is indeed an effective method, but a poor dietary pattern is like constantly adding firewood to the fire. Therefore, the author believes that improving diet is the foundation of the foundation, and only when necessary can it be combined with drugs. Really get healthy.
〈The author is former Attending Physician in National Taiwan University Hospital, and Master of Science from National Taiwan University〉