Can you still get gout after a light diet?

*It is only for medical professionals to read.
Standardized drug treatment is the key to the treatment of gout.
Many people know that a high-purine diet can easily cause hyperuricemia and gout.
If you choose a light diet, whether uric acid can be reduced to normal, and gout is also Can it heal itself? Sorry, the result may disappoint you
.

A light diet certainly occupies a very important position in the treatment of gout
.

However, hyperuricemia and gout itself are a group of diseases that cause purine metabolism disorders caused by the combined effects of genetic factors, life>
.

The reason why a disease can become a disease is just like "success can be achieved" in a textbook.
More effort is an important factor for success, but it does not mean that success can be achieved by this factor alone
.

The adjustment of the diet is an element of getting rid of the disease, but it does not mean that the disease can be cured by it
.

-01-If you don’t eat seafood or meat, why do you get gout? Patients at high risk of gout are always called to reduce the intake of purines, but they often overlook the fact that in addition to purines, gout patients should also pay attention to fructose
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Epidemiological investigations have found that the incidence of gout in developed countries represented by the United States has increased significantly in the past few decades, which is significantly related to the widespread use of industrialized fructose and the excessive intake of fructose
.

A large number of studies have shown that fructose has the potential to induce an increase in human uric acid levels
.

Fructose is not a purine.
Why can fructose induce an increase in human uric acid levels? Let me tell you the truth seriously: as a simple sugar, fructose can be quickly absorbed by the intestinal mucosa into human cells by its smart body
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As the "privileged class" of the sugar family, fructose will not be restricted by the sugar metabolism rules of the "glucose effect".
It can quickly deplete the body's ATP (adenosine triphosphate) and deplete a large amount of phosphate
.

The consumption of phosphate limits the regeneration of ADP (adenosine diphosphate) into ATP, which increases the substrate AMP (adenosine monophosphate) produced by uric acid
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A large amount of rapidly absorbed fructose → induce metabolic abnormalities → cause hyperuricemia; a large amount of rapidly absorbed fructose/sucrose → stimulate the synthesis of long-chain fatty acids → cause hypertriglyceridemia → cause the body to resist insulin → cause hyperuricemia
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Nowadays, various processed non-staple foods-sweet drinks (including fruit juice, cola and other sugary drinks), candies, pastries, etc.
are the richest sources of fructose.
The harm is small
.

In addition, although honey has high nutritional value, its fructose content is as high as 70%; fruits are rich in nutrients, but they also contain fructose
.

The normal consumption of the above foods is good for health.
If you are too "greedy", ingesting a large amount of fruits and honey with high fructose content at one time can also easily cause gout
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Therefore, even if the intake of high purine is controlled, but the intake of fructose is not controlled, it is easy to cause gout
.

-02-How does obesity cause gout? In the impression of clinicians, a typical gout patient often has the following two characteristics at the first visit: one is accompanied by bad living habits such as drinking and overeating, and the other is the presence of varying degrees of obesity
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Many studies at home and abroad have shown that the higher the BMI (Physique Number), the greater the possibility of hyperuricemia
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Excess fat in the body of obese people can affect the metabolism of purine and uric acid in the body in many ways
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For example: the accumulation of abdominal fat can increase the total amount of nucleic acids in metabolism, leading to increased synthesis of uric acid; fats can be broken down into fatty acids, promoting the synthesis of uric acid and triglycerides in the liver, increasing blood uric acid and blood lipids; ketone bodies produced by fatty acid metabolism And other substances, will also reduce the excretion of uric acid by the kidneys
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Perhaps some patients may wonder: they don’t look fat, their body mass index is normal, why is blood uric acid still high, or even gout? In fact, this kind of non-fat looking is not really not fat, they often wear a small belly, which is "abdominal obesity
.
"
It seems that the weight is not large, but there is a lot of visceral fat, which should also be paid attention to! -03-Wasting vegetarians: Genetic factors/gene defects can also cause gout.
Some gout patients with a light diet and weight loss tend to be more confused: I am very self-disciplined in my diet and living habits, and my body is not fat.
Gun"? Because genetic factors/gene defects are also one of the important factors that cause gout
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It should be noted that there are two main causes of gout related to genetic defects: one is heredity.
Such patients often have a family history of gout
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Another type of gene defect is difficult to find the basis of family history.
At this time, it is necessary to consider whether there is a gene mutation
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Current research has found that some genetic defects will affect purine metabolism and uric acid excretion, and eventually lead to hyperuricemia and gout
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From the perspective of uric acid excretion, mutations in the human SLC22A12, SLC2A9, and ABCG2 genes will reduce uric acid excretion
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MTHFR (methylenetetrahydrofolate reductase) and RGPRT (hypoxanthine guanine phosphoribosyl transferase) gene mutations will increase the body's uric acid production
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If the patient has gout susceptibility genes BCAS3, RFX3, KCNQ1, they may participate in inflammation pathways, regulate the immune system and other different mechanisms to promote the deposition of uric acid in the joints and thus promote the onset of gout.

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-04-Gout cannot rely solely on diet control.
Standardized treatment is essential in the human body's uric acid pool.
The main source of uric acid is endogenous, accounting for about 80% of the total uric acid, while food-derived uric acid only accounts for 20%
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Except for a small part of the purines in food that are absorbed by cells, most of them are further decomposed into purines in the intestinal mucosal cells, and these purines are mainly degraded into uric acid and excreted from the body
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More than 90% of hyperuricemia have varying degrees of uric acid excretion disorders.
Any genetic diseases, drugs, and metabolic disorders that affect glomerular filtration or reduce renal blood flow and impair renal tubular excretion can cause uric acid excretion.
Reduce
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Can diet control reduce uric acid? The answer is yes
.

Can diet alone cure gout? The answer is often not the case
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The basal uric acid value of most gout patients is 500μmo/L~800μmo/L or even higher
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However, what is the upper limit of the target for uric acid control in adult gout patients? 360μmo/L or less (for patients with tophi, the guidelines recommend less than 300μmo/L)
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So, how much uric acid can be reduced by a strict low-purine diet? Yang Cong et al.
conducted a 2-year follow-up study of 186 patients with hyperuricemia/gout in plateau areas and showed that regular exercise and diet control can reduce blood uric acid by an average of 120 μmol/L after 1 year, and blood uric acid by 220 μmol/L after 2 years.
L
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At present, there is still no systematic research on this in the world, and in the real world, even if the majority of patients strictly control their diet, they are still far from the recommended continuous uric acid compliance requirements
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In fact, even with an extremely strict low-purine diet, the body will continue to produce purines and metabolize them into uric acid
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In patients with uric acid excretion disorders and endogenous metabolic disorders, the uric acid after a light diet is still overwhelming
.

For many young patients, excessive diet control can cause nutrient imbalance and social and family activities
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Standardized drug treatment is the key to the treatment of gout, and diet, weight control and good living habits are important links in the prevention and treatment of gout
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In the course of treatment, patients should actively cooperate with the attending doctor to formulate and adjust the plan
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Standardize the medication on time and in sufficient quantities, control the uric acid level at an ideal level, maintain a positive attitude of optimism and relaxation, and review regularly for more comprehensive control of the condition
.