For the past half month, Lao Zhang's big toe joint has repeatedly been red, swollen, hot, and painful, especially at night when the pain was severe. After a hospital check-up, his blood uric acid level was found to be much higher than normal, and an X-ray showed asymmetric swelling in his first metatarsophalangeal joint. The doctor diagnosed him with gout.
Lao Zhang was very depressed: he rarely drank alcohol and didn't particularly love seafood, so how on earth did he get this disease? During a detailed inquiry by Associate Chief Physician Qiu Lianqun, a specialist in gout from the Second Traditional Chinese Medicine Hospital of Guangdong Province, it was learned that Lao Zhang had a long-term habit of stewing soups and enjoyed drinking rich and savory meat broths. Physician Qiu pointed out that this habit was most likely one of the important causes of Lao Zhang's gout. Rich meat broths and fish broths are high in purines.
Physician Qiu explained: The human body needs a nutrient substance called nucleotides, which have two sources: one is from food, and the other is synthesized by the body's cells, with the latter being the main source. Therefore, nucleotides are not essential nutrients. The main chemical component of nucleotides is purine. Purine nucleotides are metabolized into uric acid in the body. In normal people, the actions of the liver, small intestine, and kidneys maintain plasma uric acid at a certain level. When a large amount of nucleic acids break down in the body or high-purine foods are consumed, the blood uric acid level rises above 480 umol/L. At this point, urate becomes overly saturated and forms crystals, which deposit in joints, soft tissues, cartilage, and the kidneys, leading to arthritis, urinary tract stones, and kidney diseases. This condition is called gout.
Physician Qiu stated that from the root cause of gout formation, although endogenous factors such as genetics and kidney dysfunction are the main reasons, diet is also an aspect worthy of our sufficient attention. After consuming a large amount of purine-containing foods, the exogenous purines cannot be utilized by the tissues. After oxidative metabolism, they produce a large amount of uric acid, which exceeds the kidneys' excretory capacity, leading to elevated blood uric acid levels. This is especially true for patients who already have defects in kidney excretory function, as they have a lower tolerance to exogenous purines.
Experts point out that all kinds of meat dishes contain some purine components, especially various animal organs such as brains, livers, kidneys, and hearts, as well as meat broths, which have extremely high purine content, containing 150~1000 mg of purines per 100 grams. The purine content in foods from highest to lowest is: internal organs, meats and fish, dried fruits and nuts, leafy vegetables, grains, starches, and fruits.
According to Physician Qiu, recent epidemiological surveys show that the incidence of gout is on a straight upward trend, and this trend is more pronounced in the south than in the north. This difference reflects the correlation between the incidence of gout and economic development, daily living standards, and people's dietary structures. In coastal areas, many people enjoy drinking rich and savory meat and fish broths year-round, which are high in purines. Lao Zhang is one of them. Over time, it is not surprising that he developed gout. Delayed treatment of gout can damage kidney function.
However, this does not mean that rich meat and fish broths can never be drunk again; it depends on the situation. Physician Qiu pointed out that those who already have gout and are in an acute attack phase, such as with joint redness, swelling, heat, pain, hyperuricemia, or kidney diseases, should best avoid drinking them. Those with a family history of gout, obesity, or high blood sugar should drink them less.
Physician Qiu reminds patients that once diagnosed with gout, timely and regular treatment is necessary. If treatment is delayed or improper, it may lead to serious complications such as kidney damage. In recent years, traditional Chinese medicine (TCM) for treating gout has gradually gained favor among experts and patients. Based on syndrome differentiation and treatment, there are various methods such as oral Chinese medicine, external washing with herbal medicine, and external application of medicinal plasters, with significant effects and few side effects.
In summary, for both prevention and health maintenance for gout patients, the dietary approach advocates controlling total calories and weight loss as the main methods. It is important to follow the doctor's advice, pay attention to nutritional protein intake, eat more mushrooms, milk, and various fruits and vegetables, and combine with physical exercise to make the body healthier and life more fulfilling.