Organization: Nina
Source: Medical Endocrinology Channel
(with common foodspurine content table)Hyperuricemia is a metabolic abnormality caused by purine metabolism disorder sign. Whether male or female, blood uric acid level exceeds 420umol/L twice on different days, which is called hyperuricemia. Gout and uric acid nephropathy secondary to this are very common in clinical practice.
According to the data in the “White Paper on the Status Quo of Gout in China” released in 2017, the number of hyperuricemia patients in my country has reached 170 million, and the number of patients with gout has exceeded 80 million. people. Gout and hyperuricemia have become public health problems that cannot be ignored…
hyperuricemia The high incidence of hyperuricemia is closely related to bad living habits, especially eating habits. Therefore, medical nutritional therapy (MNT) is the basic therapy for hyperuricemia and gout.
About “Dietary Guidance for Patients with Hyperuricemia and Gout“
The “Dietary Guidance for Patients with Hyperuricemia and Gout” promulgated by the National Health Commission is mainly used for dietary guidance for patients with hyperuricemia and gout.
“Dietary Guidance” aims to through MNT to reduce exogenous purine intake and reduce blood uric acid load in patients , reduce the risk of gout or reduce the number of acute gout attacks; delay the occurrence and development of related complications; promote and maintain an appropriate nutritional state of the body, prevent and cooperate with the treatment of related diseases, and improve clinical outcomes.
It is worth mentioning that this standard is not suitable for adult hyperuricemia and gout patients with renal insufficiency and other diseases .
Dietary guidelines for patients with hyperuricemia and gout
1. Suggested Foods to Avoid You should avoid eating animal offal such as liver and kidney, shellfish, oysters and Shelled seafood such as lobster and thick broth and gravy, etc. Alcoholic beverages should also be contraindicated in patients with acute gout attacks, poor medication control, or chronic tophi arthritis. 2. Foods recommended to limit consumption 1) Animals with high purine content Food, such as beef, lamb, pork, etc. 2) Fish food. 3) Foods containing more fructose and sucrose. 4) Various alcoholic beverages, especially beer and distilled spirits (liquor). The overall alcohol consumption should not exceed 2 alcohol units/day for men and 1 alcohol unit/day for women (1 alcohol unit is about 14g pure alcohol). Note: 1 alcohol unit is equivalent to 145mL of red wine with 12% ABV, 497mL of beer with 3.5% ABV or 43mL of distilled wine with 40% ABV.
3. Recommended food choices 1) Skim or low-fat milk and its products, 300 ml per day. 2) Eggs, 1 egg per day. 3) A sufficient amount of fresh vegetables should reach 500g or more per day. 4) Encourage the intake of low glycemic index (GI) cereals. 5) Adequate drinking water (including tea and coffee, etc.), at least 2000 ml per day. 4. Other Precautions 1) Weight Management Patients who are overweight or obese should Slow weight loss to achieve and maintain normal body weight. 2) Eating habits Establish good eating habits; eat regularly or eat small meals frequently, do not overeat or eat a lot of meat in one meal; use less irritating seasonings; seafood, meat The amount of purines can be reduced by discarding the soup after cooking such and high-purine plant foods. The specific operation of MNT
1. According to the height and weight of the patient, calculate the Body mass index (BMI)BMI<18.5kg/m2 is underweight, 18.5kg/m2≤BMI <24.0kg/m2 means normal weight, 24.0kg/m2≤BMI<28.0kg/m2 means overweight, BMI≥28.0 kg/m2 is obesity. 2. Ask the patient’s physical activity level, and refer to the BMI value to select the appropriate energy coefficient (Table 1)
If the patient is engaged in a job with a static lifestyle, such as white-collar workers, teachers, drivers, etc., they can choose according to the standard of light physical strength; jobs that require standing or walking, such as electricians, housewives, salespersons, etc. , can be selected according to the standard of medium physical strength; for people who are engaged in heavy physical occupation or mainly engaged in heavy physical activities, such as construction workers, miners, stevedores, athletes, dancers, fitness coaches, etc., can be selected according to the standard of heavy physical strength.
Table 1 Energy Coefficient Range Selection3. Plan the patient’s daily dietary composition according to the energy coefficient:<
strong>1) Carbohydrates: The energy provided by carbohydrates accounts for 50% to 60% of the total energy. The intake of added sugars should be limited. Low GI foods should be selected. Whole grains are encouraged to account for 30% of the daily staple food. Above. The daily dietary fiber intake should reach 25g～30g.
2) Protein: The dietary intake of protein is 1g/kg/d, and the energy provided accounts for 10% to 20% of the total energy. The recommended food sources are dairy products and eggs.
3) Fat: The energy provided by fat accounts for 20% to 30% of the total energy in the whole day. Those with obesity or metabolic syndrome should strictly limit the total daily intake of fat to account for no more than 25% of the total energy in the whole day, and Saturated fatty acids account for no more than 10% of total energy throughout the day.
Note: If the combined plasma low-density lipoprotein cholesterol is elevated (≥2.59mmol/ L), the intake of saturated fatty acids should be less than 7% of the total energy. Trans fatty acids should be less than 1% of the total energy throughout the day. The daily intake of linoleic acid and alpha-linolenic acid should account for the total daily intake, respectively. 5% to 8% and 1% to 2% of energy. The daily intake of monounsaturated fatty acids should account for 10% to 15% of the total energy.
< strong>Purine Content Table of Common Foods
Table 2: Purine Content of Common Animal Foods
Table 3: Purine Content of Common Plant Foods
References:
1. “Dietary guidance for hyperuricemia and gout patients” WS/T 560-2017″, National Health Commission, 2018
2. Liu Songli. Dietary precautions for patients with hyperuricemia and gout[J].Physician Online, 2020,10(11):35.
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