About all

Fish with low uric acid: Salmon and Gout: Here’s what to Avoid

Содержание

Which fish is good for uric acid? – MVOrganizing

Which fish is good for uric acid?

“Salmon appears to be an exception and a better choice of seafood for someone with gout,” Sandon says. Most people find they can also eat limited amounts of certain shellfish — crab, lobster, oysters, and shrimp, which contain just a moderate amount of purine.

What fish is low in uric acid?

Some fish, including salmon, sole, tuna, catfish, red snapper, tilapia, flounder, and whitefish are lower in purine than other types of fish, and can be included in your diet in moderation (two to three times per week) if you are not consuming other purine-rich foods.

Does fish increase uric acid?

Seafood. Some types of seafood — such as anchovies, shellfish, sardines and tuna — are higher in purines than are other types. But the overall health benefits of eating fish may outweigh the risks for people with gout. Moderate portions of fish can be part of a gout diet.

What seafood is high in purines?

High-Purine Foods Include: Some fish, seafood and shellfish, including anchovies, sardines, herring, mussels, codfish, scallops, trout and haddock.

Is tea not good for uric acid?

The researchers found that coffee consumption, but not tea consumption, was associated with lower uric acid levels and hyperuricemia risk.

How can I lower my uric acid without medication?

Natural Ways to Reduce Uric Acid in the Body

  1. Limit purine-rich foods.
  2. Avoid sugar.
  3. Avoid alcohol.
  4. Lose weight.
  5. Balance insulin.
  6. Add fiber.
  7. Reduce stress.
  8. Check medications and supplements.

What raises uric acid?

Most of the time, a high uric acid level occurs when your kidneys don’t eliminate uric acid efficiently. Things that may cause this slow-down in the removal of uric acid include rich foods, being overweight, having diabetes, taking certain diuretics (sometimes called water pills) and drinking too much alcohol.

Is pineapple good for gout?

Adding pineapple to your daily diet may help prevent gout flare-ups and reduce the intensity of your gout symptoms. Aim for one serving of pineapple, which is equal to one cup of fresh pineapple chunks. Avoid sugary drinks containing pineapple, or pineapple desserts. Pineapple is delicious when eaten fresh.

Are onions bad for gout?

If you have gout, dishes like chopped liver and liver and onions are best avoiding, along with other organ meats like kidney, heart, sweetbread, and tripe, since they’re high in purines.

Is Catfish Good For Gout

Is Catfish Good For Gout

Which fish contain purines?

The worst for people with gout are anchovies, cod, haddock, herring, mackerel, clams, roe (fish roe), sardines, scallops, and trout. Salmon appears to be an exception and a better seafood choice for gout sufferers, Sandon says.

People are also wondering: What types of meat are low in purines?

some seafood such as tuna, sardines, anchovies, herring, clams, cod, scallops, trout and haddock. Offal such as liver, kidney and thymus gland, known as sweet bread.

And is tilapia fish bad for gout?

Some fish, including salmon, sole, tuna, catfish, snapper, tilapia, plaice, and whitefish, are lower in purines than other fish and can be included in the diet in moderate amounts (two to three times per week. ) if not use other opaque fish rich in purines.

Also, the question is, is white fish bad for gout?

Some types of seafood such as anchovies, shellfish, sardines and tuna contain more purines than others. However, the overall health benefits of eating fish may outweigh the risks for people with gout. Moderate portions of fish can be part of a gout diet. Vegetables rich in purines.

Is mackerel rich in purines?

Rich in purines: anchovies, cod, haddock, herring, mackerel, mussels, sardines, scallops, trout. Average purine content: ■■■■■, lobsters, oysters, shrimp. Meat: Although no longer part of a normal diet in the United States, offal, such as liver, sweet bread, and brain, are the most dangerous for people with gout.

Can Tomatoes Cause Gout?

A group of researchers from the Otago Institute of Biochemistry has found that many people with gout believe that tomatoes are among the foods that cause gout. These data showed that tomato consumption was linked to higher levels of uric acid in the blood, the main cause of gout.

Is peanut butter bad for gout?

Best Foods For The Gout Diet

Can You Eat Treats With Gout?

Purines occur naturally in your body, but you can also get them by eating certain foods like offal (elaborate breakfasts like mortadella, sausage, ham), anchovies, herring, shellfish like crab and lobster, asparagus, and mushrooms.

Are walnuts bad for gout?

To avoid a gout flare-up, limit your fish intake to one serving per day as it still contains purines. A suitable diet for arthritis should include two tablespoons of nuts and seeds every day. Good sources of low-purine nuts and seeds are walnuts, almonds, flax seeds, and cashews.

Is lemon good for uric acid?

Is pineapple good for gout?

Pineapple contains an enzyme called bromelain, which is known to reduce inflammation and aid digestion. Although no studies have linked bromelain directly to gout, research suggests that bromelain supplements can reduce the inflammatory symptoms of gout.

Is there a lot of purine in potatoes?

Many Strengths

Are Bananas Good For Gout?

Bananas are low in purines and high in vitamin C, making them ideal for eating with gout. Changing your diet to include more low-purine foods like bananas can reduce the amount of uric acid in your blood and reduce the risk of recurring gout attacks.

Is it good for fighting gout?

During a gout ■■■■■■, when you have swollen and sore joints, the last thing you think about may be exercise – and that’s okay. You want to avoid affected joints as much as possible. Applying ice to sore joints for about 20 minutes at a time will help reduce swelling.

Can we eat fish with gout?

Is dark chocolate good for gout?

Chocolate that isn’t full of sugar and sweeteners can be beneficial for people with gout. According to a 2018 study, chocolate can reduce uric acid crystallization. The antioxidants in chocolate can lower blood pressure, according to a 2007 analysis. High blood pressure may be a risk factor for gout.

Is chicken good for gout?

Turkey and goose contain more purines than other foods, so they are best avoided. Those prone to gout should also minimize gambling consumption. Chicken and duck are, according to Dr. Zashin, the safest alternatives.

Is ice bad for gout?

Whole milk products like whole milk and ice cream are often not recommended for people with gout. However, studies have shown that increasing the amount of dairy products you eat, including cheese, yogurt, and ice cream, can reduce the risk of developing gout.

Are onions bad for gout?

If you have gout, avoid dishes like minced liver and liver and onions, as well as other offal like kidneys, hearts, sweet bread, and pancakes as they are high in purines.

Can you eat salmon with gout?

Is avocado good for gout?

Apples, pears, pineapples and avocados are low-purine fruits and can therefore be eaten in moderation. Drink at least 8 glasses of water a day, unless your doctor’s advice tells you to limit your fluid intake. Coffee and tea are safe for people with gout.

Does oatmeal cause gout?

Is Catfish Good For Gout

Is tilapia good for those with gout? : Ask Dr. Gourmet

 

It’s easy to get answers about health and nutrition! Just send your question by email
to [email protected] and Dr. Harlan will respond to selected questions of general interest. Answers will be posted in the Ask Dr. Gourmet newsletter (sign up now!) and archived in the Ask Dr. Gourmet section of the website.

Please note that the Ask Dr. Gourmet feature is restricted to questions
regarding food and nutrition. Due to the many questions we
receive, not all questions may be answered. For more specific
questions about your individual health, please contact your
doctor. About Timothy S. Harlan, MD, FACP, CCMS | Terms
of Use | Privacy
Policy

Is tilapia good for those with gout?

I’m suffering with gout and wondering if tilapia is good for me to eat?

Dr. Gourmet Says…

Gout is caused by the conversion of certain proteins to uric acid. For some of us we produce too much uric acid and a few of us cannot excrete the uric acid well enough. Either way, when there are higher levels of uric acid circulating in the bloodstream, it can form small crystals which get lodged in joints, causing gouty arthritis.

The key is to reduce the amount of purine rich foods, and the current recommendations are to reduce the amount of red meat and poultry. While some vegetables are high in purines, these seem to have less effect than animal based proteins. Fish fall somewhere in the middle and some seafoods may provoke gout as they are higher in purines — shrimp and mussels, for example. Fin fish are less likely to be high in purines, so eating those in moderation are generally a better choice than consuming red meat, pork or poultry.

Here is a brief guide to purine levels in foods.

Since they are fin fish, tilapia is an OK choice for your gout, but we are not a big fan of that fish here at Dr. Gourmet. Because most tilapia is farmed and fed on a diet of soy or corn products, they will often have higher levels of Omega-6 fats. If you are going to choose seafood for your gout, you would be better off with seafood that is lower in Omega-6 fats and higher in Omega-3 fats. When replacing your land animal protein with seafood, you should be cautious about your intake of mercury as well. Here’s an article about mercury in fish vs. the omega-3 levels in fish.

It is best for your gout to consume mostly vegetable sources for your proteins (legumes, vegetables, nuts, seeds, and whole grains) first, then some seafood (being careful of those very high in purines, such as tuna, mackerel, sardines, mussels, and scallops), and only then consuming sparing amounts of red meat, poultry, and pork.

Thanks for writing.

Timothy S. Harlan, MD, FACP
Dr. Gourmet

 

Best and Worst Uric Acid Foods

Do you frequently suffer from painful kidney stones or gout? If so, you may be eating too many uric acid foods. Uric acid is a natural byproduct of metabolic processes. Having small amounts of this substance in the body is normal. Higher amounts, however, can have a damaging effect on your health.

What is Uric Acid?

Meats, medications and alcoholic beverages are considered high uric acid foods because they contain compounds called purines. When purines are digested, they are broken down into uric acid by the intestines and liver. The acid is then transported to the kidneys to be expelled through urine.

Most people can pass out uric acid easily. Others, however, are not so lucky. People with kidney problems usually have high levels of uric acid, a condition known as Hyperuricemia. Those at risk also include pregnant women, diabetics, cancer patients and men 65 years and older.

You can also suffer from hyperuricemia if your diet consists mainly of purine-rich foods. Overconsumption of foods like meats and seafood can produce an overwhelming amount of uric acid. When this happens, the acid crystalize and causes kidney and joint problems.

Symptoms of High Uric Acid

When uric acid crystals get deposited in the joints, they cause a condition called gout. People with gout can experience pain, swelling and stiffness in the joints. Other common symptoms are tenderness in the big toe and peeling, itchy skin around affected joints.

Excessive amounts of uric acid can also trouble the kidney. When kidneys are affected, you may experience changes in urination, fatigue, muscle cramps, vomiting and pain. Kidney stones may form and cause pain in the abdomen as well as cloudy, brown, pink or red urine.

High Uric Acid Foods

As mentioned earlier, uric acid levels can be increased by certain foods. High uric acid foods include organ meats like animal liver and kidneys. Some seafood also has high purine content, particularly sardines, scallops, anchovies and herring. Beer-lovers should consider scaling down their intake as well.

Low Uric Acid Foods

Fortunately, there are foods you can eat to normalize your uric acid levels. Citrus fruits like lemon, lime and oranges contain both citric acid and vitamin C, which help dissolve uric acid crystals. Other great fruits for treating hyperuricemia include blueberries, apples and cherries.

Vegetable juices are also excellent remedies. Because they are alkaline, they help neutralize the acidic environment. If you are not a fan of vegetable juice, try a smoothie instead. Throw in some low-fat dairy, fresh apples, a handful of whole grains and sunflower seeds for a potent drink.

To keep uric acid levels under control, start your day with a cup of green tea or lemon water. Adding pinto beans, lentils, tomatoes and green leafy vegetables to meals is also a great way to load up on low uric acids foods.

Keeping your uric acid levels in check can protect your body from kidney malfunction, gout and many other conditions. Watch your meat, seafood and alcohol intake, and try to fill your diet with as many vegetables, fruits and seeds as you can.

A Cross-Sectional Analysis in the EPIC-Oxford Cohort

PLoS One. 2013; 8(2): e56339.

Julie A. Schmidt

Cancer Epidemiology Unit, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom,

Francesca L. Crowe

Cancer Epidemiology Unit, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom,

Paul N. Appleby

Cancer Epidemiology Unit, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom,

Timothy J. Key

Cancer Epidemiology Unit, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom,

Ruth C. Travis

Cancer Epidemiology Unit, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom,

Olga Y. Gorlova, Editor

Cancer Epidemiology Unit, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom,

The University of Texas M. D. Anderson Cancer Center, United States of America,

Competing Interests: The authors have declared that no competing interests exist.

Consultation for statistical analysis: PNA. Recruitment of EPIC-Oxford participants: TJK. Interpretation of results and review of the manuscript: JAS FLC PNA TJK RCT. Conceived and designed the experiments: JAS FLC TJK RCT. Analyzed the data: JAS. Contributed reagents/materials/analysis tools: PNA. Wrote the paper: JAS.

Received 2012 Nov 8; Accepted 2013 Jan 8.

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.

This article has been cited by other articles in PMC.

Abstract

Introduction

Circulating concentrations of uric acid may be affected by dietary components such as meat, fish and dairy products, but only a few studies have compared uric acid concentrations among individuals who exclude some or all of these foods from their diet. The aim of this study was to investigate differences in serum uric acid concentrations between meat eaters, fish eaters, vegetarians and vegans.

Subjects and Methods

A sample of 670 men and 1,023 women (424 meat eaters, 425 fish eaters, 422 vegetarians and 422 vegans, matched on age and sex) from the European Prospective Investigation into Cancer and Nutrition Oxford cohort were included in this cross-sectional analysis. Diet was assessed using a semi-quantitative food frequency questionnaire and serum concentrations of uric acid were measured. Mean concentrations of uric acid by diet group were calculated after adjusting for age, body mass index, calcium and alcohol intake.

Results

In both men and women, serum uric acid concentrations differed significantly by diet group (p<0. 0001 and p = 0.01, respectively). The differences between diet groups were most pronounced in men; vegans had the highest concentration (340, 95% confidence interval 329–351 µmol/l), followed by meat eaters (315, 306–324 µmol/l), fish eaters (309, 300–318 µmol/l) and vegetarians (303, 294–312 µmol/l). In women, serum uric acid concentrations were slightly higher in vegans (241, 234–247 µmol/l) than in meat eaters (237, 231–242 µmol/l) and lower in vegetarians (230, 224–236 µmol/l) and fish eaters (227, 221–233 µmol/l).

Conclusion

Individuals consuming a vegan diet had the highest serum concentrations of uric acid compared to meat eaters, fish eaters and vegetarians, especially in men. Vegetarians and individuals who eat fish but not meat had the lowest concentrations of serum uric acid.

Introduction

Uric acid is the end product of purine metabolism, generated from the breakdown of DNA, RNA and ATP [1]. The ability to further metabolise uric acid has been lost in humans due to two mutations that silence the gene coding for the enzyme uricase, which can further degrade uric acid. Therefore, humans are prone to a high concentration of serum uric acid. High circulating concentrations of uric acid can lead to gout, a common form of arthritis [1], and have also been linked to chronic kidney disease [2], cardiovascular disease [3], [4] and cancer [5]–[7]. However, given that uric acid is also related to a number of other factors such as age and body mass index (BMI), the causal nature of these associations is not clear [6], [8].

High uric acid concentrations can result from low rates of excretion, primarily through the kidneys, and from overproduction of uric acid due to an excess of purine precursors from synthesis, cell turnover and diet [1]. Certain dietary components are thought to affect concentrations of uric acid. For instance, meat and fish may increase the concentration of uric acid because of the high purine content of these foods [9], [10], and dairy products may lower uric acid concentrations [10], [11] by increasing the excretion of uric acid and its precursor xanthine [11]. Thus, individuals who avoid consuming one or more of these foods groups might be expected to have different circulating concentrations of uric acid. Some small studies have observed a lower concentration of uric acid in vegetarians compared to meat eaters [12]–[14]. However, none of these studies clearly differentiated between meat eaters and fish eaters or between vegetarians and vegans. Therefore, the aim of this study was to investigate differences in the concentration of uric acid between meat eaters, fish eaters, vegetarians and vegans in the Oxford arm of the European Prospective Investigation into Cancer and Nutrition (EPIC-Oxford).

Materials and Methods

Study population

The EPIC-Oxford cohort includes 65,429 men and women aged 20 years or older who were recruited from around the United Kingdom between 1993 and 1999. The study was designed to investigate diet, lifestyle and risk of cancer among people with different dietary habits and thus aimed to recruit vegetarians and vegans as well as participants from the general population. A detailed description of the recruitment process has been published elsewhere [15]. In brief, participants from the general population were recruited through general practice surgeries, whilst postal recruitment was targeted to recruit a large number of vegetarians and vegans but also resulted in a high number of non-vegetarians. In the current study, 71%, 97%, 99% and 100% of meat eaters, fish eaters, vegetarians and vegans, respectively, were recruited via post. The protocol for the EPIC-Oxford study was approved by a multi-centre research ethics committee (MREC/02/0/90), now called “Scotland A Research Ethics Committee”, and all participants gave written informed consent.

The present cross-sectional analysis includes men and women who (i) had provided a blood sample at recruitment, (ii) had a known smoking and diet group, (iii) had responded to ≥80% of the relevant questions in the FFQ (130 questions for meat eaters and fish eaters, and 113 questions for vegetarians and vegans) and had an energy intake between 3. 3 and 16.7 MJ (800–4,000 kcal) for men or between 2.1 and 14.7 MJ (500–3,500 kcal) for women, (iv) did not have prior cancer (excluding non-melanoma skin cancer) or cardiovascular disease, (v) were not receiving treatment for any long-term illness or condition, (vi) were not pregnant or taking oral contraceptives or hormone therapy for menopause (women only), and (vii) were younger than 90 years at time of blood collection. In order to maximise the heterogeneity of dietary exposure, approximately equal numbers of participants in each of the four diet groups were randomly selected from participants who were stratified by sex and by 10 year age categories. This resulted in 424 meat eaters, 425 fish eaters, 422 vegetarians and 422 vegans being included in this study.

Assessment of diet and lifestyle

At recruitment, participants completed a validated semi-quantitative food frequency questionnaire [16], [17] (FFQ) with additional questions relating to prior disease, anthropometry and lifestyle factors such as smoking.

Participants were categorised into one of four diet groups based on their answers to the questions: “Do you eat any (i) meat, (ii) fish, (iii) dairy products and (iv) eggs?” The derived diet groups were: meat eaters, fish eaters (do not eat meat but do eat fish), vegetarians (do not eat meat or fish) and vegans (do not eat meat, fish, dairy products or eggs).

In the FFQ, participants were asked to report their average intake of 130 food items over the preceding 12 months in nine categories ranging from “Never or less than once per month” to “6 or more times per day”. The mean daily intakes of food items were estimated by multiplying the frequency of consumption by a specified portion size (mostly taken from Ministry of Agriculture, Fisheries and Food, Food portion sizes [18]). The mean nutrient intake was estimated by multiplying the amount of food consumed by the nutrient content of the food item (mainly based on the fifth edition of McCance and Widdowson’s The Composition of Foods and its supplements [19]–[28]). The individual food items were categorised into food groups where appropriate, e.g. total meat (red meat, processed meat, liver and poultry) and fructose-rich drinks (fruit juice and sugar sweetened soft drinks).

In the questionnaire, all participants were asked to report their weight and height. Weight and height were also measured in a sub-sample (n = 4,808) of the cohort, and self-reported data showed good agreement with the measured data (r>0.9) [29]. Either self-reported or measured height and weight were used to calculate body mass index (BMI; weight (kg)/(height (m))2). Smoking was categorised as “never”, “former”, “current light” (<15 cigarettes/day) and “current heavy” (≥15 cigarettes/day), and age of the participants was recorded at time of blood collection.

Laboratory method

At recruitment or shortly after, participants attended their local general practice surgeries where a blood sample was taken (participants were not required to fast). Blood was transported overnight to a laboratory in Norfolk by mail at ambient temperature, where samples were centrifuged and serum was aliquoted into 0.5 ml plastic straws. These were heat-sealed at both ends and stored in liquid nitrogen (−196°C) until 2011 and subsequently in electric freezers (−80°C) until analysis. A Beckman Synchron DxC autoanalyser (Beckman Coulter, High Wycombe, UK) was used to measure serum uric acid in 2011. Pooled serum samples (n = 196) were included in each run (blinded) and the overall coefficient of variation for uric acid was 0.9%.

Statistical analysis

All analyses were performed for men and women separately. The distributions of dietary and non-dietary characteristics were compared between the four diet groups; Pearson’s χ2 test was used for categorical variables, and for continuous variables one-way ANOVA was used for normally distributed variables and the Kruskal-Wallis test for non-normally distributed variables.

In order to facilitate comparability between results with different levels of adjustment, participants with missing data on BMI were excluded (30 men and 34 women) leaving 408 meat eaters, 405 fish eaters, 404 vegetarians and 412 vegans for further analysis. Partial correlation coefficients between uric acid and dietary and non-dietary characteristics, respectively, were examined adjusting for age (20–29; 30–39; 40–49; 50–59; ≥60 years) and BMI (<20; 20–<22.5; 22.5–<25; 25–<27.5; ≥27.5 kg/m2).

Means and 95% confidence intervals (CI) of uric acid concentration were calculated for each diet group adjusted for age (20–29; 30–39; 40–49; 50–59; ≥60 years) and alcohol intake (sex-specific fifths) and then further for BMI (<20; 20–<22.5; 22.5–<25; 25–<27.5; ≥27.5 kg/m2) and calcium intake (sex-specific fifths) using multiple linear regression.

All p-values were two-sided and p<0.05 was considered statistically significant. All analyses were performed using the STATA statistical package version 12 (StataCorp., Texas, USA).

Results

Characteristics and intake of food and nutrients for men and women subdivided by diet group are shown in and . The average age at blood collection was 45 years (standard deviation (SD) 11) in men and 40 years (SD 11) in women.

Table 1

Characteristics and intake of certain foods and nutrients by diet group among men.

Meat eaters (n = 168) Fish eaters (n = 168) Vegetarians (n = 167) Vegans (n = 167)
Characteristics Mean SD Mean SD Mean SD Mean SD p1
Age (years) 44. 8 10.5 44.8 10.8 44.8 10.3 45.0 11.1 >0.9
BMI (kg/m2)2 24.9 3.1 23.2 2.9 23.3 2.6 22.4 3.2 <0.0001
Current smoking (n)3 23 16 8 10 0. 1
Median IQR Median IQR Median IQR Median IQR
Total meat (g/d)4 77.6 40.0–109.0
Fish (g/d) 29. 4 19.8–41.8 29.5 15.7–47.3 0.7
Eggs (g/d) 7.0 3.5–21.5 7.0 3.5–21.5 7.0 0.5–21.5 0.1
Dairy milk (g/d)2 293 293–439 293 146–439 293 146–439 0. 01
Dairy yoghurt (g/d) 18.9 2.5–55.4 18.9 10.1–63.0 35.3 10.1–63.0 0.05
Dairy cheese (g/d) 15.2 5.4–23.0 23.0 13.9–34.6 27.5 15.2–38.2 0. 0001
Vegetables (g/d) 183 142–239 254 182–345 249 182–347 306 217–426 0.0001
Fruits (g/d) 181 99–311 206 114–312 213 128–320 275 151–422 0. 0001
Beer (ml/d) 124 20–228 82 20–228 124 3–228 20 3–124 0.0001
Wine (ml/d) 17.5 8.8–53.8 17.5 8.8–98.8 17.5 8.8–53.8 8.8 1.3–53. 8 0.0001
Fructose-rich drinks (ml/d)5 78.2 40.8–135.6 69.6 21.6–125.0 97.2 36.0–134.4 96.8 36.0–123.0 0.4
Coffee (ml/d) 477 95–502 272 84–665 477 152–625 84 4–477 0. 0001
Tea (ml/d) 475 475–855 475 150–855 475 82–855 82 2–475 0.0001
Mean SD Mean SD Mean SD Mean SD
Energy (kJ/d) 9248 2348 9042 2320 9096 2371 8001 2339 <0. 0001
Protein (% of energy) 15.5 2.4 14.0 2.4 13.0 1.9 12.8 1.8 <0.0001
Dairy protein (% of energy) 3.6 1.5 3.6 1.8 3.8 1.7 0. 5
Soy protein (% of energy) 0.1 0.5 0.7 1.1 0.8 0.9 2.6 1.6 <0.0001
Fat (% of energy) 31.8 5.6 31.3 6.2 30.9 6.0 29.4 7.4 <0. 01
Carbohydrates (% of energy) 51.0 6.4 53.3 7.6 54.6 7.4 57.4 7.2 <0.0001
Total sugar (% of energy) 24.4 5.8 25.4 6.6 25.5 5.8 25.5 7. 9 0.4
Alcohol (g/d) 14.7 16.5 15.4 18.4 15.2 17.3 10.6 16.2 0.0001
Englyst fibre (g/d) 18.8 7.1 22.6 7.6 23.0 7.5 27.3 8. 6 <0.0001
Calcium (mg/d) 1043 310 1110 392 1126 385 569 209 <0.0001
Vitamin C (mg/d) 114 49 126 59 134 74 155 71 <0. 0001

Table 2

Characteristics and intake of certain foods and nutrients by diet group among women.

Meat eaters (n = 256) Fish eaters (n = 257) Vegetarians (n = 255) Vegans (n = 255)
Characteristics Mean SD Mean SD Mean SD Mean SD p1
Age (years) 40. 4 11.1 40.7 10.7 40.4 10.8 40.2 11.4 >0.9
BMI (kg/m2)2 23.7 3.6 22.3 2.7 22.8 3.8 21.8 3.0 <0.0001
Current smoking (n)3 21 23 16 17 0. 3
Median IQR Median IQR Median IQR Median IQR
Total meat (g/d)4 61.8 35.4–96.5
Fish (g/d) 34. 9 23.4–55.9 23.6 12.9–39.5 0.0001
Eggs (g/d) 7.0 3.5–21.5 7.0 3.5–21.5 7.0 3.5–21.5 0.6
Dairy milk (g/d)2 293 146–439 293 146–439 293 146–439 0. 5
Dairy yoghurt (g/d) 22.7 10.1–63.0 35.3 10.1–71.8 35.3 10.1–101.0 0.2
Dairy cheese (g/d) 15.2 6.6–30.6 23.0 15.2–38.2 27.5 15.2–40.4 0. 0001
Vegetables (g/d) 250 192–331 255 189–353 279 219–375 311 237–410 0.0001
Fruits (g/d) 230 158–366 276 173–421 248 168–411 267 155–452 0. 2
Beer (ml/d) 2.9 2.9–40.3 20.2 2.9–40.3 2.9 2.9–40.3 2.9 2.9–40.3 0.02
Wine (ml/d) 17.5 8.8–53.8 53.8 8.8–98.8 17.5 1.3–53.8 8.8 1. 3–53.8 0.0001
Fructose-rich drinks (ml/d)5 59.2 23.6–122.4 54.0 15.6–122.4 93.6 24.4–122.4 56.4 19.2–122.4 0.06
Coffee (ml/d) 475 29–512 192 15–488 203 15–502 84 4–477 0. 0001
Tea (ml/d) 475 150–855 475 150–855 475 27–855 190 2–475 0.0001
Mean SD Mean SD Mean SD Mean SD
Energy (kJ/d) 8139 2056 7603 2080 7940 2118 7076 2096 <0. 0001
Protein (% of energy) 17.0 2.8 15.0 2.1 14.1 2.1 13.3 2.2 <0.0001
Dairy protein (% of energy) 3.7 1.7 4.2 2.0 4.3 2.1 <0. 0001
Soy protein (% of energy) 0.3 0.6 0.9 1.0 1.0 1.0 3.0 1.9 0.0001
Fat (% of energy) 31.2 5.9 29.8 6.1 30.2 6.3 29.0 6.9 0. 001
Carbohydrates (% of energy) 52.0 6.5 54.9 6.6 56.0 6.6 58.9 7.6 <0.0001
Total sugar (% of energy) 25.9 6.2 27.6 6.6 27.5 6.7 26.3 8. 8 0.01
Alcohol (g/d) 7.9 9.9 9.4 12.6 8.0 10.4 5.6 9.2 0.0001
Englyst fibre (g/d) 19.9 6.7 21.9 8.3 23.0 7.7 25.7 8. 8 <0.0001
Calcium (mg/d) 979 315 1034 349 1081 372 570 233 <0.0001
Vitamin C (mg/d) 142 70 149 76 154 76 161 85 0. 03

In men, there were significant differences between the diet groups in mean BMI; meat eaters had the highest BMI followed by vegetarians, fish eaters and vegans (lower by 2.5 kg/m2) (). In men, the diet groups also varied significantly in their intake of most food groups. Among the three diet groups consuming dairy products, meat eaters had a slightly higher intake of milk and the lowest intake of cheese. The vegans had the highest intake of vegetables and fruits, whereas the meat eaters had the lowest intake of these foods. Vegans had the lowest intake of beer, wine, coffee and tea. The four diet groups also differed significantly in their nutrient intakes. Meat eaters had the highest intake of energy and percent energy from protein but the lowest intake of dietary fibre. Vegans had the highest percent energy from soy protein and carbohydrates and the highest intake of dietary fibre and vitamin C, whereas they had the lowest alcohol intake, percent energy from fat and a markedly lower intake of calcium (approximately half that of the other diet groups).

In women, the pattern of differences between the diet groups was in general similar to that observed in men. In women however, the meat eaters had the highest intake of fish and the lowest percent energy from dairy protein and sugar; fish eaters had the highest intake of beer but the intakes of milk (among the three diet groups consuming dairy products) and fruit did not differ significantly by diet group ().

The correlations between dietary and non-dietary variables and uric acid concentrations are shown in and were in general low (|r|<0.3). There was a significant positive correlation between uric acid concentrations and BMI (r = 0.28 and 0.26 in men and women, respectively) and a significant inverse correlation with percent energy from dairy protein (r = −0.10 and −0.11 in men and women, respectively) and calcium intake in both men and women (r = −0.17 and −0.16, respectively). After excluding the vegans from the correlation between uric acid concentrations and calcium intake, the correlation was attenuated and was no longer statistically significant in men (r = −0. 03 and −0.11 in men and women, respectively). In men, there were significant positive correlations between uric acid concentrations and intakes of beer, alcohol and energy from soy protein. In women, uric acid concentrations and age were significantly positively correlated, whereas the uric acid concentrations were inversely correlated with intake of dairy milk. Smoking status was not associated with uric acid concentrations in either men or women (p = 0.7 and 0.2 in men and women, respectively).

Table 3

Partial correlation coefficients between serum uric acid concentrations and characteristics, food intake and nutrient intake adjusted for age and BMI.

Men (n = 640) Women (n = 989)
Characteristics Partial correlation1 p Partial correlation1 p
Age (years) −0. 06 0.14 0.08 0.01
BMI (kg/m2) 0.28 <0.0001 0.26 <0.0001
Total meat (g/d)2 0.07 0.36 0.10 0.11
Fish (g/d)3 0.02 0.71 0.06 0.19
Eggs (g/d)4 −0. 03 0.47 0.02 0.65
Dairy milk (g/d)4,5 −0.03 0.57 −0.08 0.04
Dairy yoghurt (g/d)4 −0.06 0.23 −0.06 0.11
Dairy cheese (g/d)4 −0.06 0.17 −0.01 0. 81
Vegetables (g/d) 0.08 0.05 0.02 0.46
Fruits (g/d) 0.06 0.12 0.04 0.27
Beer (ml/d)6 0.15 0.0006 0.03 0.48
Wine (ml/d)6 0.02 0.69 0. 05 0.13
Fructose-rich drinks (ml/d)7 0.02 0.68 0.05 0.15
Coffee (ml/d) −0.04 0.30 −0.01 0.65
Tea (ml/d) 0.02 0.63 −0.05 0.12
Energy (kJ/d) −0.05 0. 25 −0.02 0.57
Protein (% of energy) −0.06 0.14 −0.06 0.05
Dairy protein (% of energy)4 −0.10 0.04 −0.11 0.004
Soy protein (% of energy) 0.12 0.002 −0.01 0.75
Fat (% of energy) −0. 08 0.05 0.02 0.45
Carbohydrates (% of energy) <0.01 0.92 −0.04 0.23
Total sugar (% of energy) −0.02 0.70 −0.05 0.10
Alcohol (g/d)6 0.13 0.002 0.06 0.09
Englyst fibre (g/d) 0. 06 0.10 0.03 0.36
Calcium (mg/d) −0.17 <0.0001 −0.16 <0.0001
Calcium (mg/d) excluding vegans4 −0.03 0.47 −0.11 0.004
Vitamin C (mg/d) 0.07 0.07 0.04 0. 23

The results in and show concentrations of serum uric acid by diet group for men and women separately. The age and alcohol adjusted concentration of uric acid was approximately 35% higher in men than in women but differences in uric acid concentrations between the diet groups followed a similar pattern in men and women. Vegans and meat eaters had the highest concentrations of uric acid, whereas fish eaters and vegetarians had the lowest concentrations of uric acid. After additional adjustment for BMI and calcium intake, the differences in concentration of uric acid became more pronounced in men; vegans had a significantly higher mean concentration than each of the other three diet groups. The largest difference in uric acid concentration for men was between vegans and vegetarians; the uric acid concentration in vegans being on average 37.6 µmol/l (95% CI 22.6–52.6) (12%) higher than in vegetarians. For women, the differences between the diet groups were slightly attenuated after the additional adjustment, and vegans and meat eaters had the highest concentrations of uric acid. The largest difference in mean uric acid concentration was 13.8 µmol/l (95% CI 4.2–23.4) (6%) between vegans and fish eaters.

Adjusted serum uric acid concentrations by diet group and sex.

The figure shows the adjusted means and 95% CIs of serum uric acid concentrations in meat eaters (163 men and 245 women), fish eaters (159 men and 246 women), vegetarians (156 men and 248 women) and vegans (162 men and 250 women). Serum uric acid concentrations were adjusted for age (20–29; 30–39; 40–49; 50–59; ≥60 years), alcohol intake (sex-specific fifths), BMI (<20; 20–<22.5; 22.5–<25; 25–<27.5; ≥27.5 kg/m2) and calcium intake (sex-specific fifths).

Table 4

Mean (95% CI) concentrations of serum uric acid by diet group among men and women.

Meat eaters Fish eaters Vegetarians Vegans p
Men
n 163 159 156 162
Adjusted serum uric acid (µmol/l)1 322. 8 (314.1–331.5) 306.5 (297.7–315.3) 301.3 (292.4–310.2) 336.0 (327.1–344.8) <0.0001
Adjusted serum uric acid (µmol/l)2 315.0 (306.1–324.0) 308.8 (299.9–317.6) 302.7 (293.8–311.5) 340.2 (329.4–351.1) <0.0001
Women
n 245 246 248 250
Adjusted serum uric acid (µmol/l)1 238. 8 (233.0–244.7) 224.2 (218.3–230.0) 228.2 (222.4–234.0) 242.7 (236.8–248.6) <0.0001
Adjusted serum uric acid (µmol/l)2 236.6 (230.7–242.4) 226.8 (220.9–232.6) 229.9 (224.1–235.8) 240.6 (233.8–247.4) 0.01

Discussion

The results of this cross-sectional analysis showed that vegans had the highest concentrations of uric acid followed by meat eaters, and that fish eaters and vegetarians had the lowest uric acid concentrations. These differences by diet group were more pronounced in men than in women.

The higher uric acid concentrations among vegans might be due to their lack of consumption of dairy products, which are thought to lower uric acid concentrations [11]. Also, the low calcium content of the vegan diet might contribute to higher uric acid concentrations. While no previous studies have compared uric acid concentrations in vegans with other diet groups, previous cross-sectional studies have shown an inverse association between the intake of dairy products and circulating concentrations of uric acid [9], [30]. Moreover, results from small (n≤158) intervention studies have shown lower circulating concentrations of uric acid after the consumption of dairy products [31], [32]. This could be due to the low purine content and increased excretion of uric acid and its precursor xanthine in response to the protein in dairy products [11], [32]. Dairy products are the primary source of calcium and in the current study calcium was significantly inversely correlated with uric acid concentration, though this was partly due to the low intake of calcium among vegans. This result is in accordance with other cross-sectional analyses showing inverse correlations between calcium intake and circulating concentrations of uric acid [33], [34]. A randomised controlled trial did not, however, show an effect of calcium supplement (either 600 or 1200 mg/d) on uric acid concentrations after two years of treatment compared to placebo [34]. The mean intake of calcium at baseline in this intervention study (867 mg/d) [35] was higher than that of vegans in the present study (570 mg/d). Thus, it is possible that calcium supplement could reduce uric acid concentrations in individuals with low habitual calcium intake. Therefore, the lack of dairy products and the low calcium intake in the vegan diet might to some extent account for the observed differences in concentrations of uric acid between vegans and the other three diet groups.

Soy, other legumes and some vegetables are rich in purines [36], but it is possible that purines of vegetable origin have a different effect on uric acid concentrations than those of animal origin due to the different bioavailability and types of purines from these sources [1]. In the present study, vegans had the highest intake of soy protein and a significant positive correlation was observed between uric acid concentrations and soy protein in men. However, in other studies, purine-rich vegetables [33] or soy [37] were not associated with circulating concentrations of uric acid.

The high purine content of meat might explain the lower concentration of uric acid in vegetarians and fish eaters who both exclude meat from their diet. In accordance with our results, a small (n = 45) study did not find a difference in uric acid concentrations between vegetarians and fish eaters [38]. Other small (n≤114) studies have compared the uric acid concentration in vegetarians and meat eaters (also referred to as omnivores in some studies). Some [12]–[14] but not all [39] studies support our finding of lower uric acid concentrations in vegetarians than in meat eaters. In general, larger differences between diet groups were found in the prior studies compared with the current study. This may partly be explained by some of these studies [12], [13] not adjusting for BMI, which in the present study was the strongest confounding factor. The finding of similar uric acid concentrations in meat eaters and vegetarians in one of the prior studies [39] could be due to the fact that vegans (n = 6) were included in the vegetarian group (n = 31), which may have led to an overestimation of uric acid concentration among vegetarians.

The present study has some limitations. The finding of weak correlations between dietary variables and serum uric acid concentrations might be due to measurement error in the assessment of dietary intake [40] or because the FFQ measures usual diet over the past year, whereas uric acid concentration might only reflect a short period of time prior to blood collection [32]. We also performed a large number of statistical tests for correlations of serum uric acid with dietary and non-dietary variables, thus some of the significant correlations may be due to chance. Finally, some individuals with gout might have changed diet group, which could have led to reverse causation in this cross-sectional analysis. However, the prevalence of gout is low in individuals under the age of 50 (≤2.2% and ≤0.6% in men and women, respectively [41]), which was the age of most participants. Reverse causality is thus unlikely to account for the differences in uric acid concentration observed between diet groups. We were not able to exclude participants with gout because such information was not available.

As other studies have reported [14], [30], our results showed higher concentrations of uric acid in men than in women and we also observed more pronounced differences between diet groups in men than in women. Estrogens affect the renal excretion of uric acid positively; this might explain the sex difference in uric acid concentrations, but the mechanisms are not well understood [42]. Why the relationship between diet group and uric acid concentration is stronger in men than in women is not known. However, women might be less sensitive to the effect of diet on uric acid concentrations, possibly due to estrogens, but this needs investigation.

In conclusion, the results of the present study show that individuals consuming a vegan diet had the highest serum concentrations of uric acid compared to meat eaters, fish eaters and vegetarians, especially among men. Vegetarians and individuals who eat fish but no meat had the lowest serum uric acid concentrations. These findings highlight the importance of distinguishing between vegans and vegetarians in future studies of diet groups and uric acid concentrations. The potential effects on circulating uric acid concentrations of excluding dairy products and of low intake of calcium in the vegan diet deserves further investigation, as does the influence of different types and quantities of purines in the diet.

Acknowledgments

The authors thank all participants in the EPIC-Oxford cohort for their invaluable contribution to the study. We also acknowledge Wolfson Laboratories, Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, for measuring serum concentrations of uric acid.

Funding Statement

This work was funded by Cancer Research UK, grant number: C570/A11692 (www.cancerresearchuk.org). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

References

1.
Choi HK, Mount DB, Reginato AM (2005) Pathogenesis of gout. Ann Intern Med
143: 499–516. [PubMed] [Google Scholar]3.
Gagliardi AC, Miname MH, Santos RD (2009) Uric acid: a marker of increased cardiovascular risk. Atherosclerosis
202: 11–17. [PubMed] [Google Scholar]4.
Zoppini G, Targher G, Bonora E (2011) The role of serum uric acid in cardiovascular disease in type 2 diabetic and non-diabetic subjects: a narrative review. J Endocrinol Invest
34: 881–886. [PubMed] [Google Scholar]5.
Strasak AM, Lang S, Kneib T, Brant LJ, Klenk J, et al. (2009) Use of penalized splines in extended cox-type additive hazard regression to flexibly estimate the effect of time-varying serum uric acid on risk of cancer incidence: a prospective, population-based study in 78,850 men. Ann Epidemiol
19: 15–24. [PMC free article] [PubMed] [Google Scholar]6.
Strasak AM, Rapp K, Hilbe W, Oberaigner W, Ruttmann E, et al. (2007) Serum uric acid and risk of cancer mortality in a large prospective male cohort. Cancer Causes Control
18: 1021–1029. [PubMed] [Google Scholar]7.
Strasak AM, Rapp K, Hilbe W, Oberaigner W, Ruttmann E, et al. (2007) The role of serum uric acid as an antioxidant protecting against cancer: prospective study in more than 28 000 older Austrian women. Ann Oncol
18: 1893–1897. [PubMed] [Google Scholar]8.
Wheeler JG, Juzwishin KD, Eiriksdottir G, Gudnason V, Danesh J (2005) Serum uric acid and coronary heart disease in 9,458 incident cases and 155,084 controls: prospective study and meta-analysis. PLoS Med
2: e76. [PMC free article] [PubMed] [Google Scholar]9.
Choi HK, Liu S, Curhan G (2005) Intake of purine-rich foods, protein, and dairy products and relationship to serum levels of uric acid: the third national health and nutrition examination survey. Arthritis Rheum
52: 283–289. [PubMed] [Google Scholar]10.
Lee SJ, Terkeltaub RA, Kavanaugh A (2006) Recent developments in diet and gout. Curr Opin Rheumatol
18: 193–198. [PubMed] [Google Scholar]11.
Dalbeth N, Palmano K (2011) Effects of dairy intake on hyperuricemia and gout. Curr Rheumatol Rep
13: 132–137. [PubMed] [Google Scholar]12.
Kuo CS, Lai NS, Ho LT, Lin CL (2004) Insulin sensitivity in Chinese ovo-lactovegetarians compared with omnivores. Eur J Clin Nutr
58: 312–316. [PubMed] [Google Scholar]13.
Szeto YT, Kwok TC, Benzie IF (2004) Effects of a long-term vegetarian diet on biomarkers of antioxidant status and cardiovascular disease risk. Nutrition
20: 863–866. [PubMed] [Google Scholar]14.
Pan WH, Chin CJ, Sheu CT, Lee MH (1993) Hemostatic factors and blood lipids in young buddhist vegetarians and omnivores. Am J Clin Nutr
58: 354–359. [PubMed] [Google Scholar]15.
Davey GK, Spencer EA, Appleby PN, Allen NE, Knox KH, et al. (2003) EPIC-oxford: lifestyle characteristics and nutrient intakes in a cohort of 33 883 meat-eaters and 31 546 non meat-eaters in the UK. Public Health Nutr
6: 259–268. [PubMed] [Google Scholar]16.
Bingham SA, Gill C, Welch A, Day K, Cassidy A, et al. (1994) Comparison of dietary assessment methods in nutritional epidemiology: weighed records v. 24 h recalls, food-frequency questionnaires and estimated-diet records. Br J Nutr
72: 619–643. [PubMed] [Google Scholar]17.
Bingham SA, Cassidy A, Cole TJ, Welch A, Runswick SA, et al. (1995) Validation of weighed records and other methods of dietary assessment using the 24 h urine nitrogen technique and other biological markers. Br J Nutr
73: 531–550. [PubMed] [Google Scholar]

18. Ministry of Agriculture, Fisheries and Food (1993) Food portion sizes. London: HMSO.

19. Holland B, Welch AA, Unwin ID, Buss DH, Paul AA, et al. (1991) McCance and Widdowson’s the composition of foods. Cambridge, UK: The Royal Society of Chemestry.

20. Holland B, Unwin I, Buss D (1988) Cereals and cereal products: third supplement to McCance and Widdowson’s the composition of foods. Cambridge: Royal Society of Chemistry.

21. Holland B, Unwin I, Buss D (1989) Milk products and eggs: fourth supplement to McCance and Widdowson’s the composition of foods. Cambridge: Royal Society of Chemistry.

22. Holland B, Unwin I, Buss D (1991) Vegetables, herbs and spices: fifth supplement to McCance and Widdowson’s the composition of foods. Cambridge: Royal Society of Chemistry.

23. Holland B, Unwin I, Buss D (1992) Fruit and nuts: first supplement to McCance and Widdowson’s the composition of foods. Cambridge: Royal Society of Chemistry.

24. Holland B, Welch A, Buss D (1992) Vegetable dishes: second supplement to McCance and Widdowson’s the composition of foods. Cambridge: Royal Society of Chemistry.

25. Holland B, Brown J, Buss D (1993) Fish and fish products: third supplement to McCance and Widdowson’s the composition of foods. Cambridge: Royal Society of Chemistry.

26. Chan W, Brown J, Buss D (1994) Miscellaneous foods: fourth supplement to McCance and Widdowson’s the composition of foods. Cambridge: Royal Society of Chemistry.

27. Chan W, Brown J, Lee S, Buss D (1995) Meat, poultry and game: fifth supplement to McCance and Widdowson’s the composition of foods. Cambridge: Royal Society of Chemistry.

28. Chan W, Brown J, Church S, Buss D (1996) Meat products and dishes: sixth supplement to McCance and Widdowson’s the composition of foods. Cambridge: Royal Society of Chemistry.

29.
Spencer EA, Appleby PN, Davey GK, Key TJ (2002) Validity of self-reported height and weight in 4808 EPIC-Oxford participants. Public Health Nutr
5: 561–565. [PubMed] [Google Scholar]30.
Loenen HM, Eshuis H, Lowik MR, Schouten EG, Hulshof KF, et al. (1990) Serum uric acid correlates in elderly men and women with special reference to body composition and dietary intake (Dutch nutrition surveillance system). J Clin Epidemiol
43: 1297–1303. [PubMed] [Google Scholar]31.
Ghadirian P, Shatenstein B, Verdy M, Hamet P (1995) The influence of dairy products on plasma uric acid in women. Eur J Epidemiol
11: 275–281. [PubMed] [Google Scholar]32.
Dalbeth N, Wong S, Gamble GD, Horne A, Mason B, et al. (2010) Acute effect of milk on serum urate concentrations: a randomised controlled crossover trial. Ann Rheum Dis
69: 1677–1682. [PubMed] [Google Scholar]33.
Zgaga L, Theodoratou E, Kyle J, Farrington SM, Agakov F, et al. (2012) The association of dietary intake of purine-rich vegetables, sugar-sweetened beverages and dairy with plasma urate, in a cross-sectional study. PLoS One
7: e38123. [PMC free article] [PubMed] [Google Scholar]34.
Dalbeth N, Horne A, Gamble GD, Ames R, Mason B, et al. (2009) The effect of calcium supplementation on serum urate: analysis of a randomized controlled trial. Rheumatology (Oxford)
48: 195–197. [PubMed] [Google Scholar]35.
Reid IR, Ames R, Mason B, Reid HE, Bacon CJ, et al. (2008) Randomized controlled trial of calcium supplementation in healthy, nonosteoporotic, older men. Arch Intern Med
168: 2276–2282. [PubMed] [Google Scholar]

36. McCarthy GT, editor (2002) Caring for children with Lesch Nyhan disease. 2nd ed. London: PUMBA, The Purine Metabolism Patient’s Association.

37.
Messina M, Messina VL, Chan P (2011) Soyfoods, hyperuricemia and gout: A review of the epidemiologic and clinical data. Asia Pac J Clin Nutr
20: 347–358. [PubMed] [Google Scholar]38.
Poornima K, Cariappa M, Asha K, Kedilaya HP, Nandini M (2003) Oxidant and antioxidant status in vegetarians and fish eaters. Indian J Clin Biochem
18: 197–205. [PMC free article] [PubMed] [Google Scholar]39.
Haldar S, Rowland IR, Barnett YA, Bradbury I, Robson PJ, et al. (2007) Influence of habitual diet on antioxidant status: a study in a population of vegetarians and omnivores. Eur J Clin Nutr
61: 1011–1022. [PubMed] [Google Scholar]

40. Bates CJ, Nelson M, Ulijaszek SJ (2005) Nutritional assessment methods. In: Geissler CA, Powers HJ, editors. Human Nutrition. 11th ed. Edinburgh: Churchill Livingstone. pp. 573–595.

41.
Kramer HM, Curhan G (2002) The association between gout and nephrolithiasis: the national health and nutrition examination survey III, 1988–1994. Am J Kidney Dis
40: 37–42. [PubMed] [Google Scholar]42.
Stockl D, Doring A, Thorand B, Heier M, Belcredi P, et al. (2012) Reproductive factors and serum uric acid levels in females from the general population: the KORA F4 study. PLoS One
7: e32668. [PMC free article] [PubMed] [Google Scholar]

Food To Eat And Avoid On A Gout Diet

Over 8.3 million Americans might benefit from the gout diet and a change of lifestyle. Find out why below.
In this article:

  1. What to Avoid on a Gout Diet
  2. What to Eat on a Gout Diet

Gout Diet: What to Eat, What to Avoid, and How to Live with It

What Is Gout?
Gout is a kind of arthritis that is characteristic with an inflammation of the joints. It comes with sudden and severely painful attacks of swelling that can last 3-10 days.
Gout attacks occur when uric acid levels rise in the blood and form crystals around the joints. Uric acid is a by-product the body processing specific foods.
Fortunately, taking medications and following a gout diet can control severe symptoms.

What to Avoid on a Gout Diet

1. Alcoholic Beverages

Studies have shown that the consumption of alcoholic drinks, especially beer, can cause the development and/or worsening of gout. The reason for this is that alcohol has a very high purine content, and beverages such as beer are rich in brewer’s yeast which increase the risk of a gout attack.
What Is Purine?
Purine is a substance in both animal and plant foods that, that your body converts into uric acid upon consumption. Purine-rich foods include all kinds of alcoholic drinks, organ meats, veal, turkey, anchovies, sardines, mussels, and veal.

2. Organ Meats

The consumption of animals’ internal organs also has a high correlation to the occurrence of gout. Organ meats include livers, kidneys, hearts, sweetbreads, and offal.

3. Certain Kinds of Seafood

Though Omega-3 is beneficial for gout, most fish and seafood are high in purine content. High-purine fish and seafood include herring, anchovies, tuna, trout, herring roe, scallops, and clams.
Other types of seafood that are lower on the purine scale and should be eaten in moderate amounts are lobster, eel, crab, and shrimp.

4. Red Meat

Red meat is on the lower side on the purine content scale of foods gout sufferers should avoid. But, it still should be eaten in moderation.
Many people are often concerned about their protein intake when restricted from eating red meat. But, dietitians say that an average person actually needs much less protein than they are probably consuming in a day.
Dietitians recommend eating more alkaline proteins, which are present in plant-based foods.

5. Turkey and Goose Meat

Not all poultry are equal for those suffering from gout. Turkey and goose meat are particularly high in purine content compared to other purine-rich foods such as red meat and fish.
RELATED: How To Reduce Inflammation Of Joints At Home

6. Sugary Drinks

Beverages like soda and juices should also not be on a gout sufferer’s grocery list. Not only will excessive consumption of sweet drinks lead to fast and unhealthy weight gain, but it can also provoke the body into producing uric acid.
High fructose corn syrup, a sweetener commonly found in large amounts in many easily available drinks, has been found to increase the risk of gout. Purine is released when the body processes fructose, which causes the production of uric acid.

What to Eat on a Gout Diet

1. Cherries

Cherries are rich in antioxidants and have been linked to lower levels of uric acid. While it is unsure whether cherries impact signs and symptoms of gout itself, a 2003 study has shown that eating cherries regularly reduces inflammation markers, thereby lowering the risk of gout.

2. Vegetables

A diet rich in vegetables is a must for those suffering from gout. While vegetables like asparagus, spinach, and mushrooms contain purine, research shows that there is no correlation between eating them and getting gout, thanks to its other compounds that offset the purine content which is lower than in meats, to begin with.

3. Coffee

Studies have shown that drinking coffee reduces the risk of gout. Data suggests that long term consumption of coffee — caffeinated or decaffeinated — is associated with lower risks of gout incidents.
While the caffeine present in coffee is related to lower uric acid levels, decaffeinated coffee also shows similar capabilities. Studies conclude that there may be other components of coffee that contribute to its beneficial properties.

4. Berries

Berries are full of anti-inflammatory properties that ease major symptoms of gout. Blueberries, for one, contain anthocyanins, a potent flavonoid found in dark berries.
Anthocyanin reverses the free radical damage in damaged kidney cells. It can also provide relief from the painful swelling, as well as lower uric acid levels.
Blackberries are also rich in anthocyanins and are even have the nickname “gout berry” because of its popular use as a treatment for gout. The same could also be said or raspberries, which are especially tasty as an addition to smoothies.
Strawberries are also a recommended berry for those with gout. Not only do they contain flavonoids, but also copious amounts of vitamin C, which has been linked to gout relief.
Strawberries are also 90% water, making them a great addition to a gout diet, which requires ample hydration to combat the dehydration that often triggers gout attacks.

5. Vitamin C

Increasing vitamin C intake not only protects you from colds, but also from gout. According to research, men who took vitamin C from both food and supplements were 45% less likely to develop gout.
Studies show that a higher intake of vitamin C reduces uric acid levels in the blood. Since vitamin C is present in natural sources such as fruits and vegetables, those suffering from gout may find their symptoms alleviated by eating more of them.

6. Milk Products

Milk and its products, particularly those of the low-fat variety, are known to reduce risks of gout development. Calcium and lactose, in particular, are associated with low concentrations of uric acid.
Studies also suggest that the milk proteins lactalbumin and casein have potent uricosuric properties. This means that they encourage the expulsion of uric acid from the body through the passing of urine, thereby reducing the uric acid concentration present in the blood plasma.

7. Water

Water is present in most health and diet lists, and for good reason. It hydrates the body, eases dehydration, and helps flush out toxins that include excess uric acid in the bloodstream.
Water also lubricates the joints, as well as helps dilute uric acid. It helps the kidneys process uric acid better and more efficiently, leading to less uric crystal formation in the joints, which is what causes the painful inflammation.
 
Find out more about how you can prevent gout with a healthy diet in this video from Lee Health:

Gout can be extremely painful, even to the point of incapacitating sufferers for days and weeks at a time. Inflamed joints can balloon to twice their size, are tender to the touch, and can cause regular activities such as typing, walking, or even reaching out, extremely painful and difficult.
In the past, gout has had the alternative nickname, “the rich man’s sickness,” since only the wealthy had access to rich foods and proteins back in the day. Now, anyone–men and women from all walks of life can have gout, especially with many gout-inducing foods so easily available.
Avoid gout attacks by eating low-purine foods. But, to completely eliminate symptoms, a lifestyle change will make more of a difference than just following a gout diet.
Ever had a really bad gout attack? How did you deal with it? Share your experience with us in the comments section below.
Up Next: Degenerative Arthritis Causes, Symptoms, and Treatments

Low-purine Diet: Foods to Eat or Avoid

A low-purine diet is an eating plan that limits foods with high purine. Purines are a natural substance found in some foods. Purines aren’t all bad, but you want to avoid high amounts. When your body digests purine, it produces a waste product called uric acid. A buildup of uric acid crystals in the joints can cause certain health issues. The main ones are kidney stones and a type of arthritis known as gout.

The purpose of a low-purine diet is not to fully avoid purines. Instead, the goal is to manage how much purine you consume. Below, you will find what types of food and drink to avoid and limit. It helps to learn how your body responds to foods that contain purine.

Path to improved health

Your family doctor may recommend that you follow a low-purine diet. This applies if you have gout or kidney stones. It also can help people who have hyperuricemia. This is a condition caused by high levels of uric acid. You also can choose to keep a low-purine diet as part of living healthy.

To get started, increase your liquid intake. Each day, drink 8 to 16 eight-ounce cups of liquid. At least half of the liquid you drink should be water. Water and other liquids help your body get rid of uric acid.

Next, learn what foods and drinks contain purine. You should avoid eating high-purine foods. Try to limit the amount of moderate-purine foods you eat. See the chart below for some suggestions.

Avoid high-purine foods Limit moderate-purine foods Enjoy low-purine foods
Wild game, like veal, venison, and duck Meat and poultry Peanut butter and nuts
Anchovies, sardines, herring, mussels, codfish, scallops, trout, tuna, and haddock Crab, lobster, oysters, and shrimp Low-fat and fat-free dairy products, such as milk, cheese, and yogurt
Organ meats, such as liver, kidneys, and sweetbreads Lunch meats, especially high-fat versions Eggs (in moderation)
Foods high in fat (red meats, fatty poultry—dark meats and skin, high-fat dairy products) Beans, peas, and lentils Fat and oil
Gravy Vegetables, such as spinach, cauliflower, asparagus, and mushrooms Other vegetables
Yeast Oatmeal and oats Potatoes, bread, rice, and pasta
Beer Liquor Wine (in moderation)
Fruits and fruit juices
Coffee (in moderation)

Things to consider

People react to food in different ways. Over time, you will learn what foods affect you. You might find that certain foods make your gout or other health issues affected by high purine levels flare up. This exercise/practice allows you to avoid those foods and enjoy others.

A low-purine diet can reduce your symptoms. However, dietary changes alone do not get rid of gout and similar medical conditions. Talk to your doctor about a full treatment plan. If you are also taking medicine, continue to take it unless your doctor tells you to stop.

It’s also important not to lose weight too quickly. Rapid weight loss and fasting actually can increase the amount of uric acid in your body. Discuss the diet plan with your doctor before starting. Check in with them to manage progress and health issues.

Questions to ask your doctor

  • Is a low-purine diet meant to be short-term or long-term?
  • Are there vitamins or supplements I can take that help reduce uric acid?

Copyright © American Academy of Family Physicians

This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.

90,000 Best Diet for Gout

Gout is a type of arthritis. It is caused by the accumulation of excess uric acid in the blood. When its level rises, crystals form from it, which are deposited in the joints, causing inflammation, swelling and pain. There are several possible reasons for the accumulation of excess uric acid in the blood:

  1. Failure of the kidneys to excrete excess acid from the body,
  2. Increased production of compounds called purines,
  3. Combination of the first and second.

Although medication is a key factor in treating gout, dietary factors also play an important role. The gout diet is one of the most effective tools to help stabilize the level of uric acid in the blood. If you follow the guidelines in this article, the frequency of attacks can be significantly reduced.

Before providing specific nutritional advice, consider a key factor that makes a significant contribution to the development of the disease.This factor is overweight and obesity.

Get rid of excess

Overweight and especially obesity are associated with the accumulation of excess amounts of uric acid in the blood. This phenomenon is mediated by insulin resistance, which is often observed in overweight people. Research shows that insulin resistance reduces the concentration of uric acid that is excreted in the urine. The less acid leaves the body, the more chances of excess acid accumulation in the blood.

Another condition that is associated with the accumulation of uric acid is metabolic syndrome. This is a group of disorders that include:

  • Insulin resistance,
  • Abdominal obesity,
  • Hypertension,
  • Increased blood sugar,
  • Abnormal lipid levels, such as high cholesterol.

Nutrition for gout, which allows you to lose extra pounds, improves the sensitivity of cells to the action of insulin.Thus, the weight loss itself helps to lower the level of uric acid in the blood.

It is important to avoid low-carb and high-protein diets. Following these diets will only make matters worse. This is because low-carb and high-protein diets increase the likelihood of consuming high amounts of purines. And these are precisely the substances that you should absolutely not overeat with gout.

In addition, very rapid weight loss is not recommended, because in this case the risk of destruction of body tissues increases.The breakdown of tissues can temporarily cause an increase in the level of uric acid. Nutritionists advise you to lose weight gradually. The optimal weight loss rate is 0.5-1 kg of adipose tissue per week.

Gout: Low Purine Diet

Purines are natural substances found in many foods. When they are metabolized, they break down to uric acid. Thus, cutting back on purine-rich foods is a staple of the gout diet. If you regularly eat foods high in purines, restricting them can prevent bouts of illness.

The most popular sources of purines are red meat (beef, pork, lamb), poultry and fish. Your goal is to eat no more than 1 serving of meat or fish per day. Periodic refusal of these products will not hurt either. For example, British doctors recommend 2 days a week to do without meat and fish altogether.

Meat and fish can be replaced with dairy products with a low percentage of fat, as well as eggs, nuts and legumes. They are excellent sources of protein, which our bodies need in moderation.

It used to be that the diet for gout should contain a minimum of any foods with a high concentration of purines. Some vegetables were also included. However, scientific evidence in recent years has shown that eating vegetables that are high in purines does not increase the risk of developing gout or cause flare-ups. Enjoy all vegetables without exception. Asparagus, spinach, peas, cauliflower and mushrooms, which are high in purines, are fully rehabilitated.

What should not be eaten with gout?

Certain foods have an extremely high purine content. Their use must be significantly limited, if not avoided altogether:

Meat products

Liver, heart, kidneys and other offal, wild meat (venison, hare meat, pheasant), bouillon cubes, meat gravies.

Fish and seafood

Anchovies, crab, caviar, herring, mackerel, trout, sardines, shrimp, sprats, mussels, scallops, haddock and tuna.

Other products

Yeast and yeast extracts, beer.

It is also recommended to limit foods high in “simple” sugars, including fructose. This includes all sweet soda, juices, honey, cookies, cakes, candy and other sweets. Eating large amounts of fructose increases uric acid levels and also contributes to the development of insulin resistance.Both of these factors only aggravate the patient’s condition.

Also, food for gout should not include a large number of foods with “hidden” fructose. These include:

  • Store sauces and dressings,
  • Mayonnaise and ketchup,
  • Frozen pizza,
  • Cereal bars,
  • White bread.

Keep track of the amount of alcohol

In case of gout, it is absolutely impossible to abuse alcoholic beverages.Drinking too much alcohol has long been associated with the development of this disease. Although it is still not clear why such a connection is observed. An indirect cause may be drinking high purine beverages, especially beer. Also, alcohol is able to contribute to gaining excess weight due to the high calorie content of alcohols. 1 gram of this substance contains 7 kcal.

What can you eat with gout?

A healthy and balanced diet is the key to success not only in preventing attacks of illness, but also in losing weight.Below we will look at what foods should be included in the diet for gout.

  • Lots of vegetables and fruits

Official guidelines recommend at least 5 servings of fruits and vegetables daily. Pay special attention to legumes, which are a great alternative to meat products. They are high in protein, as well as vitamins and minerals. And remember, vegetables are not dangerous for gout – even if they are high in purines.

Fruits and vegetables also contain vitamin C. Although this data is still being verified, supplementing with 500-1500 mg of vitamin C per day can lower blood uric acid levels.

Fruits contain a lot of fructose, but you shouldn’t be afraid of them. They are not a source of concentrated fructose and are also high in fiber, vitamins, minerals, antioxidants, and water. All of these nutrients are essential for maintaining health.Cherries deserve special attention. Their use has been shown to be effective in reducing the concentration of uric acid.

  • Sufficient starchy carbohydrates

This includes rice, potatoes, durum wheat pasta, couscous, quinoa and oatmeal.

  • Some meat, fish, eggs and legumes

Eat these foods in moderation. For portion control, it is recommended to focus on the size of your palm.One serving should be the same size and thickness as one palm. For meat and fish, eat no more than one serving a day and arrange for yourself 1-2 fasting days a week.

  • Some milk and dairy products

The menu for gout should include a moderate amount of dairy products with a low percentage of fat. Milk, kefir, yogurt, cottage cheese are all wonderful sources of protein that replace meat and fish.Despite the animal origin, these foods contain small amounts of purines.

  • Monitor your body’s hydration

Drinking plenty of fluids helps to avoid excessive crystal deposition in the joints. Try to drink at least 2 liters of fluid a day. During hot periods or on the day of training, you need to drink 3 or more liters of fluid. The best way to track your hydration status is by looking at the color of your urine.If it is very light, everything is in order.

By the way, coffee lovers can sleep peacefully. Drinking this drink in moderation has been associated with a reduced risk of seizures. Scientists attribute this effect to the presence of substances in coffee that reduce the concentration of uric acid.

Sample menu for gout:

Breakfast:

  • Milk porridge made from whole grain cereals and low fat milk,
  • 1 cup of fresh strawberries,
  • Cup of coffee.

Lunch:

  • Portion of stewed chicken without gravy,
  • Couscous,
  • Vegetable salad with balsamic vinegar and olive oil,
  • Water.

Snack:

  • 1 cup fresh cherry,
  • Herbal tea.

Dinner:

  • Poached egg with boiled legumes,
  • Serving durum wheat pasta with olive oil,
  • Low fat yogurt,
  • 2 pieces of melon,
  • Water.

Following a gout diet is a very important tool in the fight against disease. Be sure to follow these guidelines, but only after consulting a dietitian doctor.

Sources :

  1. All about gout and diet, UK Gout Society,
  2. Gout diet: What’s allowed, what’s not, Mayo Clinic,
  3. Gout Diet Sheet, Patient.info.

Serum uric acid

Uric acid is a degradation product of nucleic acids and purine bases under the influence of enzymes.Most of it is excreted into the gastrointestinal tract, and a smaller part is excreted through the kidneys in the urine.

Synonyms Russian

Purine-2,6,8-trion, product of purine base metabolism, trihydroxypurine, 2,6,8-trioxypurine, heterocyclic urea ureide.

English synonyms

Uric acid, UA, Uric A.

Research method

Colorimetric photometric method.

Units

Mcmol / L (micromole per liter).

Which biomaterial can be used for research?

Venous blood.

How to properly prepare for the study?

  • Do not eat for 12 hours before testing.
  • Eliminate physical and emotional stress 30 minutes before the study.
  • Do not smoke for 30 minutes prior to examination.

General information about the study

Uric acid is a product of catabolism of purine bases, which are part of the DNA and RNA of all cells of the body.Purines appear mainly after natural cell death, and a smaller part of them comes from food (with liver, red meat, legumes, fish) and liquids (with beer, wine). Uric acid is transported by the blood from the liver (where the enzyme xanthine oxidase interacts with it) to the kidneys, where about 70% of it is filtered and excreted in the urine, the rest enters the gastrointestinal tract and is removed in the stool.

If too much uric acid is produced or not excreted enough in the urine, it accumulates in the body, which is manifested by its high concentration in the blood (hyperuricemia).Persistently high uric acid levels can cause gout, an inflammation of the joints in which uric acid crystals are deposited in the joint (synovial) fluid. In addition, the deposition of urate and the formation of stones in the urinary system is also a consequence of the high level of uric acid in the blood.

An increase in uric acid levels is caused by increased cell death (due to anticancer therapy) or, less commonly, an innate tendency to increased production of uric acid.Insufficient excretion of uric acid is usually caused by decreased renal function when renal failure occurs. In many cases, the exact cause of excess uric acid build-up remains unknown.

Accelerated processes of cell death, as well as a decrease in the rate of excretion of uric acid by the kidneys, causes hyperuricemia – an increase in the concentration of uric acid in the blood. As a result, it is deposited in the joints and soft tissues, the inflammation passes to the intra-articular urate crystals. In addition, stones are formed in the urinary system.

What is the research used for?

  • For the diagnosis of gout.
  • For periodic monitoring of the condition of people undergoing radiation and chemotherapy – frequent cell death with these treatments can lead to an increased concentration of uric acid.

When is the study scheduled?

  • If gout is suspected (the main symptom is joint pain, most often in the big toe).
  • When carrying out anticancer therapy.
  • When monitoring the results of gout treatment.

What do the results mean?

Reference values ​​

Floor

Reference values ​​

Male

202.3 – 416.5 μmol / L

Female

142.8 – 339.2 μmol / L

Causes of high uric acid levels

The most common mechanisms for the development of hyperuricemia:

1) frequent death of a large number of cells and their no less intensive renewal (in this case, there is an active exchange of genetic information, and hence of nucleic acids, the degradation products of which are nitrogenous bases, and then uric acid, which is formed in large quantities),

2) a decrease in the rate of filtration and excretion of uric acid by the kidneys.

Based on this, the main reasons for the increase in uric acid levels are:

  • malignant neoplasms with metastases, multiple myeloma, leukemia – almost all oncological diseases are characterized by uncontrolled cell growth and division,
  • radiation and chemotherapy of neoplastic processes in the body,
  • chronic renal failure.

Other, less common causes of increased uric acid levels:

  • acute heart failure,
  • hemolytic and sickle cell anemia,
  • hypoparathyroidism,
  • hypothyroidism,
  • diabetic ketoacidosis,
  • hyperlipidemia, obesity,
  • exacerbation of psoriasis,
  • lead poisoning,
  • Down syndrome,
  • Lesch-Nyhan syndrome.

Causes of low uric acid levels:

  • liver diseases (disturbances in the process of metabolism of uric acid due to a lack or decrease in the activity of enzymes),
  • Fanconi syndrome (decreased tubular reabsorption of uric acid due to a defect in the development of renal tubules),
  • toxicosis,
  • alcoholism,
  • Wilson-Konovalov disease,
  • xanthinuria (little uric acid is formed due to a deficiency of the xanthine oxidase enzyme),
  • syndrome of pathological secretion of antidiuretic hormone.

What can influence the result?

  • Falsely increased indicators can lead to:
    • Stress, vigorous exercise and a diet rich in purines,
    • anabolic steroids, nicotinic acid, epinephrine, thiazide diuretics, beta-blockers, furosemide (table), ethacrynic acid (table), caffeine, vitamin C, cyclosporine, cisplatin, small doses of acetylsalicylic acid, calcitriol, clopidacenogrelase , isoniazid, ethambutol, ibuprofen, indomethacin, piroxicam.
  • False-reduced indicators are promoted by:
    • low-purine diet, coffee and tea,
    • allopurinol, glucocorticoids, imuran, azathioprin estrogens, warfarin, large doses of acetylsalicylic acid, chlorprothixene, levodopa, methyldopa, contrast agents, amlodipine, verapamil, vinblastine, methotrexate, spironolactone.
  • The concentration of uric acid fluctuates during the day: it is higher in the morning than in the evening.

Nutrition and herbal infusions for gout.

Gout is a chronic disease characterized by high levels of uric acid in the blood (Hyperuricemia).

Uric acid is formed during purine metabolism from nitrogen compounds that make up DNA. Uric acid is excreted primarily by the kidneys, as well as through the digestive juices. Therefore, Hyperuricemia can be the result of either decreased excretion of uric acid (insufficient excretion of it from the body), or increased synthesis.

Accumulation of uric acid in joints causes pain and acute inflammation (arthritis).

If you have gout or hyperuricemia, it is important to eliminate foods rich in purines and limit the amount of animal protein. Below is a table of purine content in different types of food:

Foods with a high purine content

(from 150 to 800 mg / 100 g)

pork, beef, liver, brain, fatty fish (sardines , Herring, mackerel), mussels, anchovies

Food with an average purine content

(50 to 150 mg / 100 g)

poultry, lean fish, shrimp, crabs, shellfish, peas, beans, lentils, asparagus, spinach, cauliflower, mushrooms, peanuts, whole grains

Low purine foods

(0 to 50 mg / 100 g)

milk, eggs, cheeses, vegetables ( except those listed above), fruits, pasta from durum wheat, cereals

A diet rich in complex carbohydrates (fruits and vegetables of all types) promotes the elimination of uric acid.A diet high in fat and sugar promotes uric acid retention.

Therefore, the ideal diet for people suffering from hyperuricemia should include a lot of fresh fruits, vegetables, cereals, dairy products and exclude foods rich in purines, as well as alcohol (especially beer, since it has a high purine content, especially when compared to dry wine ).

It should be noted that people who are overweight tend to have higher levels of uric acid.Therefore, slow weight loss, combined with moderate physical activity, a reasonable diet and plenty of fresh drinking water (at least 1.5 – 2 liters per day) can significantly improve well-being, heal joints and prevent kidney stones.

Herbal infusions can be a good help in solving the problem, helping to eliminate excess uric acid from the body and lowering blood pressure. Here are examples of some of them:

  • Birch leaves, black currant leaves, ash leaves – mix in equal parts.Use 2-3 tbsp. l. mixture for 1 liter of boiling water (this is a portion per day). Insist for 30-40 minutes. Drink during the day between meals or 20 minutes before meals.
  • Alba birch leaves – 2 parts, ash leaves – 1 part, meadowsweet flowers – 1 part. Brew and drink in a similar way.
  • Alba birch leaves – 2 parts, ash leaves – 1 part, cherry leaves with petioles – 1 part. Brew and drink in a similar way.

Uric acid in serum: research in the laboratory KDLmed

Uric acid is a degradation product of nucleic acids and purine bases under the influence of enzymes.Most of it is excreted into the gastrointestinal tract, and a smaller part is excreted through the kidneys in the urine.

Synonyms Russian

Purine-2,6,8-trion, product of purine base metabolism, trihydroxypurine, 2,6,8-trioxypurine, heterocyclic urea ureide.

English synonyms

Uric acid, UA, Uric A.

Research method

Colorimetric photometric method.

Units

Mcmol / L (micromole per liter).

Which biomaterial can be used for research?

Venous blood.

How to properly prepare for the study?

  • Do not eat for 12 hours before testing.
  • Eliminate physical and emotional stress 30 minutes before the study.
  • Do not smoke for 30 minutes before donating blood.

General information about the study

Uric acid is a product of catabolism of purine bases, which are part of the DNA and RNA of all cells of the body.Purines appear mainly after natural cell death, and a smaller part of them comes from food (with liver, red meat, legumes, fish) and liquids (with beer, wine). Uric acid is transported by the blood from the liver (where the enzyme xanthine oxidase interacts with it) to the kidneys, where about 70% of it is filtered and excreted in the urine, the rest enters the gastrointestinal tract and is removed in the stool.

If too much uric acid is produced or not excreted enough in the urine, it accumulates in the body, which is manifested by its high concentration in the blood (hyperuricemia).Persistently high uric acid levels can cause gout, an inflammation of the joints in which uric acid crystals are deposited in the joint (synovial) fluid. In addition, the deposition of urate and the formation of stones in the urinary system is also a consequence of the high level of uric acid in the blood.

An increase in uric acid levels is caused by increased cell death (due to anticancer therapy) or, less commonly, an innate tendency to increased production of uric acid.Insufficient excretion of uric acid is usually caused by decreased renal function when renal failure occurs. In many cases, the exact cause of excess uric acid build-up remains unknown.

Accelerated processes of cell death, as well as a decrease in the rate of excretion of uric acid by the kidneys, causes hyperuricemia – an increase in the concentration of uric acid in the blood. As a result, it is deposited in the joints and soft tissues, the inflammation passes to the intra-articular urate crystals. In addition, stones are formed in the urinary system.

What is the research used for?

  • For the diagnosis of gout.
  • For periodic monitoring of the condition of people undergoing radiation and chemotherapy – frequent cell death with these treatments can lead to an increased concentration of uric acid.

When is the study scheduled?

  • If gout is suspected (the main symptom is joint pain, most often in the big toe).
  • When carrying out anticancer therapy.
  • When monitoring the results of gout treatment.

What do the results mean?

Reference values ​​

Floor

Reference values ​​

Male

202.3 – 416.5 μmol / L

Female

142.8 – 339.2 μmol / L

Causes of high uric acid levels

The most common mechanisms for the development of hyperuricemia:

1) frequent death of a large number of cells and their no less intensive renewal (in this case, there is an active exchange of genetic information, and hence of nucleic acids, the degradation products of which are nitrogenous bases, and then uric acid, which is formed in large quantities),

2) a decrease in the rate of filtration and excretion of uric acid by the kidneys.

Based on this, the main reasons for the increase in uric acid levels are:

  • malignant neoplasms with metastases, multiple myeloma, leukemia – almost all oncological diseases are characterized by uncontrolled cell growth and division,
  • radiation and chemotherapy of neoplastic processes in the body,
  • chronic renal failure.

Other, less common, causes of increased uric acid levels:

  • acute heart failure,
  • hemolytic and sickle cell anemia,
  • hypoparathyroidism,
  • hypothyroidism,
  • diabetic ketoacidosis,
  • hyperlipidemia, obesity,
  • exacerbation of psoriasis,
  • lead poisoning,
  • Down syndrome,
  • Lesch-Nyhan syndrome.

Causes of low uric acid levels:

  • liver diseases (disturbances in the process of metabolism of uric acid due to a lack or decrease in the activity of enzymes),
  • Fanconi syndrome (decreased tubular reabsorption of uric acid due to a defect in the development of renal tubules),
  • toxicosis,
  • alcoholism,
  • Wilson-Konovalov disease,
  • xanthinuria (little uric acid is formed due to a deficiency of the xanthine oxidase enzyme),
  • syndrome of pathological secretion of antidiuretic hormone.

What can influence the result?

  • Falsely increased indicators can lead to:
    • Stress, vigorous exercise and a diet rich in purines,
    • anabolic steroids, nicotinic acid, epinephrine, thiazide diuretics, beta-blockers, furosemide (table), ethacrynic acid (table), caffeine, vitamin C, cyclosporine, cisplatin, small doses of acetylsalicylic acid, calcitriol, clopidacenogrelase , isoniazid, ethambutol, ibuprofen, indomethacin, piroxicam.
  • False-reduced indicators are promoted by:
    • low-purine diet, coffee and tea,
    • allopurinol, glucocorticoids, imuran, azathioprin estrogens, warfarin, large doses of acetylsalicylic acid, chlorprothixene, levodopa, methyldopa, contrast agents, amlodipine, verapamil, vinblastine, methotrexate, spironolactone.
  • The concentration of uric acid fluctuates during the day: it is higher in the morning than in the evening.

Important Notes

  • People with gout and / or urolithiasis should avoid foods high in purine (meat, fish, mushrooms, etc.)). It is worth significantly limiting the intake of alcohol, because it slows down the excretion of uric acid from the body.
  • The results of a test for uric acid in the blood cannot serve as a 100% basis for a diagnosis of gout.
  • Normally, one third of all uric acid is processed by bacteria of the intestinal biocenosis.
  • During pregnancy, an increase in the content of uric acid is an alarming sign of the possible development of preeclampsia and eclampsia in the near future.
  • A high level of uric acid in the blood does not always lead to severe symptoms; in 10% of adults, hyperuricemia is asymptomatic. People with a hereditary predisposition to gout, stone formation, or kidney damage should be prevented despite the absence of symptoms.
  • Some studies show that too much uric acid increases the risk of heart disease. It is thought to play a role in the course of diabetes mellitus, impairing lipid metabolism, increasing blood pressure and increasing the likelihood of stroke and eclampsia.But the direct consequences of hyperuricemia are 2 conditions: gout and urolithiasis.

Also recommended

Who orders the study?

Therapist, rheumatologist, gynecologist, hepatologist, oncologist, nephrologist.

90,000 what is it, symptoms, causes, treatment, diet

“The disease of aristocrats” has become a marker of a monotonous, not entirely healthy diet and began to affect more and more people. In this article, we’ve compiled the most important facts about gout.

Content

What is gout

Gout is a condition that affects the joints of the limbs. In half of the cases, the joint of the big toe is the first to suffer. With gout, crystals of urates or uric acid salts accumulate in the joints and connective tissue. They cause inflammation, fever, and bouts of pain.

The very name of the disease means “foot trap”. Pathology worsens the quality of life of patients and is often accompanied by concomitant diseases.Gout may sound like an exotic condition from the past, but it is still with us. Most of the patients are men, usually overweight.

The disease is characterized by acute nocturnal attacks that can last for days or even weeks. Artists of the 18th century portrayed gout as a demon stuck in a swollen joint and causing unbearable pain to a person.

Thomas Sydenham, the famous English physician, wrote that “the pain is so strong that it is impossible to endure even the weight of one’s own clothes or the steps of a person in the next room.”He himself suffered from gout for over 30 years.

Crystals can accumulate in tissues slowly and without symptoms. It is not yet clear what triggers acute attacks.

What Happens With Gout

Purine compounds enter our body with food. Normally, they are processed into uric acid, which is partially excreted in the urine and partially destroyed in the intestines. If too much uric acid is produced, the blood serum is oversaturated with it.Then crystals of sodium monourate begin to form and be deposited in the tissues.

We need uric acid in small concentrations. It works as an antioxidant and is able to activate the immune response in infections.

A persistently high level of uric acid (more than 6 mg / dL or 360 μmol / L) is hyperuricemia . The accumulating crystals in the joints and soft tissues trigger an inflammatory response that is responsible for the characteristic symptoms of gout.

It happens like this:

  1. Inflammasomes, special cells that “organize” the inflammatory response, react to the presence of crystals.
  2. Inflammasomes stimulate the production of inflammatory proteins such as interleukin-1β, a major mediator of inflammation in gout.

A neglected disease develops into tofus gout. Topuses are gouty nodules, dense formations that look like swollen joints. At first, they give the patient psychological discomfort, then they interfere with wearing the usual clothes and even limit mobility.

What Causes Gout

A combination of factors is usually behind the development of the disease. Environment, nutrition, health, metabolic abnormalities, and genetics determine how gout manifests itself in a particular person.

Genetics

The risk of developing gout is influenced by genes that determine the concentration of uric acid and the excretion of uric acid by the kidneys and intestines. The concentration of uric acid also depends on genes associated with glucose metabolism.

A total of 38 genetic loci have been identified that can control the development of hyperuricemia and, most likely, gout.Research shows that several genetic variants influence the inflammatory response of inflammasome to the presence of uric acid crystals.

Certain variants of the SLC2A9 and ABCG2 genes can increase the risk of developing gout by up to 50%. These genes play a key role in regulating uric acid levels. You can do the Atlas Genetic Test to examine your genetic variants and find out how likely it is to develop gout in the future. This is especially important if you have a family history of gout.

Lifestyle and nutrition

Gout is more common in those who eat a lot of meat, shrimp and shellfish, mushrooms, and also constantly consume beer and sugary drinks. In about 12% of cases, it is nutrition that leads to hyperuricemia and the development of gout.

Alcohol consumption can cause an attack in a person with gout, and its intensity depends on the amount of alcohol consumed.

Physical trauma and surgery can also trigger the development of gout.Other risk factors include decreased insulin sensitivity, obesity, and high blood sugar levels. Metabolic disorders occur in approximately 75% of cases of gout.

Hyperuricemia does not mean that a person eats only sausages and sausages and drinks them with beer. Uric acid levels can also rise from the consumption of high quality meat, seafood and fats, such as those on the paleo or ketogenic diet.

Chronic renal failure, hypothyroidism, acidosis, lead poisoning, organ transplants, anemia, psoriasis and certain congenital diseases can also lead to hyperuricemia and gout.

Even pulmonologists describe a possible connection between a lack of oxygen during sleep and insomnia with an increased accumulation of uric acid crystals due to impaired metabolism.

Medication

The following drugs may increase the risk of gout and acute attacks:

  • diuretics;
  • aspirin;
  • ACE inhibitors;
  • immunosuppressants;
  • nicotinic acid.

Chemotherapy is another risk factor.

Elevated serum uric acid levels can be determined using a biochemical blood test. A concentration above 6 mg / dL (360 μmol / L) is considered dangerous. Some sources cite 7 mg / dL for men (420 μmol / L).

For the study of joints, X-ray, ultrasound and computed tomography are used, which allow visualizing the affected areas and exclude an erroneous diagnosis. Your doctor may order an analysis of the synovial fluid from the affected joint to confirm gout.

Various forms of arthritis are sometimes mistaken for gout. There is also pseudogout caused by the deposition of calcium pyrophosphate crystals (CPPC) in the joints.

How to treat gout

For gout, therapy is complex, not symptomatic. The goal is not only to get rid of seizures, but also to bring uric acid levels back to normal. This creates conditions for the dissolution of crystals accumulated in tissues. In rare cases, surgery is required to remove gouty tophi.

For relief of symptoms, nonsteroidal anti-inflammatory drugs, corticosteroids, colchicine and interleukin-1β blockers are prescribed. Febuxostat and allopurinol are used to lower uric acid levels. Therapy is always individually tailored to the needs and condition of the patient.

Uricase preparations can also be used as therapy. It is an enzyme that converts uric acid into the harmless compound allantoin. Such an enzyme is present in many animals, but in humans it has ceased to be produced in the course of evolution.

Gout: prognosis and comorbidities

Hyperuricemia can adversely affect health. Excess uric acid increases salt sensitivity and may affect swelling. Also, uric acid increases fat storage and lipogenesis – the more fructose a person eats, the more he gains weight.

Gout cannot be ignored. In more than half of the cases, the first attack during the year is followed by the second. Patients with gout and a predisposition to it, as suggested by scientists, have a higher risk of developing kidney and cardiovascular diseases, and the formation of stones.

How to prevent gout and relieve symptoms

Foods with a high purine content increase the concentration of uric acid in the blood, so it should be eliminated. The best diet for gout is low protein and low calorie, especially if you are overweight. At the same time, food should remain varied, healthy and tasty.

For gout, meat, sausages and sausages, offal (tongue, liver, heart, and other organs), pates, fish and seafood, crustaceans, legumes are excluded.Also banned drinks with fructose and alcohol, especially beer, wine and liqueurs.

In case of gout, it is undesirable to eat honey, desserts, fatty dairy products, oil sauces. Instead of meat and fish broths, it is better to choose vegetable broths: purines from meat go into the water during cooking. Many vegetables also contain purines, but do not increase the risk of gout attacks.

Sources of protein for a person with gout can be:

  • eggs;
  • hard and soft cheeses;
  • curd;
  • whole grains;
  • seeds;
  • nuts.

You need to be careful with nuts, seeds and their pastes (urbechi) – excess fat in case of gout is dangerous. As a minor source of protein, you can occasionally eat tofu, tempeh and other soy products, without exacerbations – boiled chicken or beef, salmon, tuna in moderation.

Recommendations for the consumption of coffee and other beverages vary. The current guidelines for patients report that coffee, tea and cocoa should not be excluded from the diet: they do contain purines, but they do not affect the concentration of uric acid in the blood.

The main thing is to drink plenty of water to help the body eliminate uric acid. Frozen water also helps. For acute attacks, local ice packs can be applied to relieve inflammation.

The benefits of increased intake of vitamin C for gout have not yet been clearly proven, so it is not necessary to take it separately. But increasing the proportion of fresh fruits and berries in your menu is very important, and not only for gout. You also need to lead an active lifestyle and engage in a pleasant sport for yourself in order to maintain normal weight and health.

To find out how genetically predisposed you are to gout and what metabolic features you should take into account in order to stay healthy, the Atlas Genetic Test will help.

90,000 Purine content in food.

The table below presents data on the content of purines in food. People with gout should refrain from eating foods high in purines. Please note that the purine content is indicated in 100 grams.product, that is, what is 100 gr. tea contains the most purines, does not mean that you need to give it up. Indeed, only a few grams of tea are used during the day, which corresponds to the amount of 100-150 mg of purines. But all the same, you should not abuse strong tea and coffee!

Purine content in food (in mg / 100g)
Product Name Purine content Product name Purine content
Tea 2800 Veal 48
Cocoa 1900 Peas 45
Coffee 1200 Beans 44
Chocolate 620 Beef 40
Sardines 120 Chicken 40
Animal liver 95 Rabbit 38
Sprats 92 Goose 33
Herring 79 Oat groats 30
Skinny pork 70 Spinach 23
Lentils 70 Rice 18
Animal tongue 55 Asparagus 14
River fish 48-54 Wheat bread 8
Fatty pork 48 Radish 6

The above table has been presented with data from outdated sources.The results of modern research show that the risk factors for the development of gout include only those purines that, as a result of metabolism, are converted in the body into uric acid. These include: adenine, guanine, xanthine, and hypoxanthine. Other substances, such as caffeine, theobromine and theophylline, contained in coffee, tea, cocoa and chocolate and also belonging to the purine series, are not dangerous in this regard.

Most purines are found in tissues of animal origin with high metabolic activity (offal: liver, kidneys, calf thymus) and in cells dividing at a high rate (yeast).

The tables below show the revised data, with the middle column showing the purine content in 100 g of the raw product, and the right one – the amount of uric acid that is formed from it in the body.

Purine content in bakery products (in mg / 100g)
Product Name Purine content Uric acid
Buns 9.0 21.0
Cracker 25.0 60.0
Mixed flour bread 19.0 45.0
White bread 6.0 15.0
Wholemeal bread (rye bread) 25.0 60.0
Rusks 12.0 29.0
Purine content in meat and offal (in mg / 100g)
Product Name Purine content Uric acid
Veal thymus 525 1260
Veal 63 150
Veal liver 182 460
Calf Kidney 88 210
Lamb 61 146
Lamb 76 182
Beef Heart 107 256
Beef liver 231 554
Beef lung 166 399
Beef kidney 112 269
Beef tongue 67 160
Beef 58 140
Pork 63 150
Pork liver 125 300
Pork kidneys 139 334
Purine content in meat products (in mg / 100g)
Product Name Purine content Uric acid
Blood sausage 38 90
Hunting sausage 54 130
Liver pate 73 175
Boiled sausage 54 130
Ham 83 198
Sausages 46 110
Purine content in poultry and eggs (mg / 100g)
Product Name Purine content Uric acid
Duck 64 153
Pheasant 62 150
Goose 69 165
Chicken 125 300
Turkey meat 50 120
Egg 2.0 5.0
Purine content in fish products (in mg / 100g)
Product Name Purine content Uric acid
Smoked Eel 48 115
Anchovies 108 260
Herring 88 210
Salmon caviar 60 145
Smoked salmon 100 242
Smoked mackerel 76 182
Sardines in oil 146 350
Sprats 223 535
Tuna in oil 121 290
Purine content in vegetables (in mg / 100g)
Product Name Purine content Uric acid
Eggplant 8 20
White cabbage 13 30
Broccoli 21 50
Brussels sprouts 25 60
Zucchini zucchini 8 20
Potatoes 6 15
Chinese cabbage 10 25
Kohlrabi 13 30
Leek 17 40
Onions 4 9
Carrot 6 15
Cucumbers 2 6
Bulgarian pepper (green) 4 10
Bulgarian pepper (red) 6 15
Bamboo shoots 6 15
Tomatoes 4 10
Rhubarb 2 5
Radish 4 10
Radish 4 10
Savoy cabbage 17 40
Beet 8 20
Celery (root) 13 30
Asparagus 10 25
Green beans (fresh) 18 42
Fennel 7 16
Cauliflower 19 45
Chicory 6 15
Purine content in berries and fruits (in mg / 100g)
Product Name Purine content Uric acid
Apricots 8 20
Avocado 13 30
Pineapple 8 20
Oranges 8 20
Watermelon 8 20
Bananas 11 25
Grapes 8 20
Pears 6 15
Blackberry 6 15
Strawberry 11 25
Dried apricots 32 75
Raspberry 8 20
Peaches 8 20
Dates 21 50
Cherry 6 15
Blueberry 8 20
Prunes 8 20
Apples 6 15
Purine content in cheeses (in mg / 100g)
Product Name Purine content Uric acid
Camembert (45% fat) 13 30
Ementaler (fat content 45%) 4 10
Gouda (fat content 45%) 7 16
Sheep cheese 13 30
Processed cheese (60% fat) 5 13
Processed cheese (20% fat) 11 26
Purine content in yeast (in mg / 100g)
Product Name Purine content Uric acid
Dry yeast 754 1810
Fresh yeast 312 750
Purine content in legumes (in mg / 100g)
Product Name Purine content Uric acid
Beans (dry) 75 183
Peas (dry) 70 168
Green peas 62 150
Lentils (dry) 84 200
Soybeans (beans) 92 220
Purine content in cereals (in mg / 100g)
Product Name Purine content Uric acid
Buckwheat 62 149
Semolina 23 55
Coarse flour 35 84
Wheat flour, premium quality 8 20
Oatmeal 42 100
Millet 35 85
Rice 15 35
Rye 20 47
Barley 34 82
Purine content in nuts and seeds (in mg / 100g)
Product Name Purine content Uric acid
Peanuts 42 100
Walnuts 10 25
Hazelnuts 13 30
Almond 13 30
Poppy Seeds 70 154
Sesame Seeds 37 88
Sunflower seeds 65 157
Purine content in mushrooms (in mg / 100g)
Product Name Purine content Uric acid
Porcini mushrooms 34 80
Chanterelles 13 30
Champignons 25 60
Purine content in freshwater fish (in mg / 100g)
Product Name Purine content Uric acid
Carp 63 150
Salmon 71 170
Pike perch 46 110
Pike 58 140
Trout 83 200
Purine content in sea fish (in mg / 100g)
Product Name Purine content Uric acid
Flounder 58 140
Mackerel 60 145
Salmon (salmon) 68 163
Sea bass 100 241
Halibut 123 294
Haddock 54 130
Sardine 144 345
Herring 79 190
Cod 63 150
Tuna 107 257
Purine content in seafood and crustaceans (in mg / 100g)
Product Name Purine content Uric acid
Shrimp 61 147
Mussels 154 370
Lobster 73 175
Crayfish 25 60
Oysters 38 90

Wheat flour, premium quality

.