Recently, the Austrian Society of Rheumatism and Rehabilitation published the “2022 Update on Acidemia”: 10 Recommendations for Patient Lifestyle and Nutritional Management”, an expert consensus based on the latest evidence to provide clinical guidelines for the management of gout/hyperuricemia. Among them, in terms of diet, it is recommended to consume more milk, coffee, and cherries, which can help reduce uric acid levels.
The 10 Tips
Suggestion 1: Prefer “healthy eating pattern”, at least 2L of water per day
Consensus states that a healthy dietary pattern, such as the DASH diet, combined with weight loss (if the patient is overweight), can positively impact gout incidence, SUA levels, and cardiometabolic risk. It is recommended to drink at least 2L of water per day.
Recommendation 2: “Weight management is important to prevent gout”
The consensus states that, Weight gain and obesity can lead to elevated serum uric acid (SUA) levels and gout attacks, with a target BMI of <25kg/m^2. Gradual weight loss in obese patients (at least in men) can help reduce SUA levels and prevent gout attacks.
Recommendation Three: “Exercise regularly, at least 3 hours a week”
span>Consensus states that gout and hyperuricemia are associated with cardiometabolic and renal comorbidities. Therefore, in addition to weight control and dietary measures, regular physical exercise/cardiovascular function training and 150-300 minutes of moderate-intensity exercise per week are recommended.
Suggestion 4: “Eat less red meat and more vegetables”
span>Consensus points out that products such as red meat, organ meats and sausages rich in “animal purines” can increase SUA levels and increase the risk of gout. Therefore, it is recommended to eat less (eg 2 times/week) and strictly limit the intake. Although vegetables are also rich in purines, they belong to “plant purines”, which have less effect on gout, and intake is encouraged.
Suggestion 5: “Don’t eat seafood, eat freshwater fish in moderation”
< /span>Consensus points out that seafood (especially shellfish) can increase SUA levels and increase the risk of gout, so it should be consumed with caution. Considering that the purine content of freshwater fish is relatively low and helps prevent cardiovascular disease, it is recommended to eat it regularly and in moderation, such as 1-2 times a week. But be careful to avoid skin and fatty fish such as mackerel and sardines.
Suggestion 6: “Quitting alcohol” is very important and needs to be repeatedly emphasized
span>Consensus points out that the risk of gout is positively related to the amount of alcohol consumed, especially beer and spirits should be avoided, while red wine is the least likely to increase the risk of gout. A large prospective observational study in the United States that followed 44,654 men with no history of gout for 26 years showed that the risk of gout increases with alcohol consumption and increase. According to recent literature, among the different types of alcohol, the strongest association with gout risk is beer, followed by spirits.
Recommendation Seven: “Fructose is everywhere, stay away from it as much as possible”
Consensus states , fructose is almost ubiquitous, sugar-sweetened soft drinks, fruit juices, and foods high in fructose (fructose) can increase SUA levels and should be avoided; fresh fruit and fructose-free “light drinks” generally do not increase the risk of gout, but be careful not to Eating too much sweet fruit (such as oranges or sweet apples).
Suggestion 8: “Milk/dairy products can help lower uric acid, except soy milk”
Consensus states that regular consumption of (low-fat) milk/dairy products can reduce SUA levels and is recommended for all gout sufferers. Some randomized trials have demonstrated positive effects of milk in reducing SUA levels or preventing gout itself. A daily intake of 250ml of milk can reduce the risk of gout in men by 50%. Regular consumption of low-fat milk and yogurt can reduce SUA levels by 10%, and this positive effect is due to the SUA-lowering effects of milk protein, casein, and milk protein. However, soy milk may cause a 10% increase in SUA levels.
Recommendation No. 9: “Coffee not only refreshes the mind but also lowers uric acid”
Consensus points out that regular coffee consumption, combined with proper diet and medicine, can reduce Help to reduce SUA levels, it is worth advocating. The mechanisms underlying the effects of coffee on uric acid levels are not well understood. There are several possible explanations:
➤Caffeine (1,3,7-trimethylxanthine) in coffee inhibits xanthine oxidase, Increase renal blood flow and improve urinary uric acid excretion;
➤Chlorogenic acid contained in coffee can improve insulin resistance, thereby reducing SUA levels.
Suggestion Ten: “Cherry, helps lower uric acid”
Consensus points out that cherries can reduce SUA levels by promoting urinary excretion. However, the optimal form (juice, concentrate, extract) and intake is unclear. In addition, studies have shown that the combination of tart cherries and allopurinol may have complementary effects in lowering uric acid. Yimaitong compiled and compiled from: Sautner J, Eichbauer-Sturm G, Gruber J, Lunzer R, Puchner RJ. 2022 update of the Austrian Society of Rheumatology and Rehabilitation nutrition and lifestyle recommendations for patients with gout and hyperuricemia. WIENER KLINISCHE WOCHENSCHRIFT. 2022 Jul 11. DOI: 10.1007/s00508-022-02054-7, PMID:35817987
>>>click directly Read:2022 Nutrition and Lifestyle Recommendations for Patients with Gout and Hyperuricemia (Updated)