Who should eat gout?

Gout is a form of arthritis, a result of the deposition of crystals urat (monosodium urate) in some organizations.

Our country in recent years due to the economic development, the life of the people are raised, besides appear some people have habits and eating unreasonable makes gout more and more. increase.

According to statistics from the Bach Mai Hospital for 10 years from 1978 to 1989, gout arthritis accounted for 1.5% of arthritis and ranked the 4th most common arthritis.

Gout is most likely to occur in middle-aged men (ages 40 to 50), and people at high risk for obesity, alcoholism, coffee, people with a family history of gout. It usually occurs after menopause.

The clinical symptoms of gout include one or more of the following: 
- Arthritis and joints: acute or chronic. 
Urate in joints, bones, soft tissues, joint cartilage called tophi. 
- Crystallization of kidney crystals causes gout kidney disease (interstitial nephritis, acute renal failure, chronic renal failure). 
- Urinary stones urate urinary tract.

Symptoms of gout.

Causes of the disease

Hyperuricemia is a common feature of gout. Uric acid development is the result of two processes that increase uric acid synthesis in the body and decrease uric acid excretion through the kidneys. Patients with gout usually have a combination of these two processes: both increased biosynthesis and reduced uric acid excretion. 
Mechanisms to synthesize uric acid are the purines found in foods such as meat, fish, seafood, poultry, liver, oval, bean, beer, coffee, tea. Reduce the possibility of uric acid excitability through the kidneys, resulting in hyperlactatemia due to alcohol. 
Uric acid is formed by oxidizing alkaline purified nuclei to form adenine and guanine. The alkaline purine nucleus is part of the cell nucleus acid, which is derived from endogenous (exogenous) or exogenous (food).
Normal plasma concentrations of uric acid: male: 5 ± 1 mg / dl and female: 4.0 ± 1 mg / dl. 
Acid plasma levels vary with age, gender, and method of testing. Uric Acid Level: Uric Acid Levels Higher than Normal Limit for Men> 7.0 mg / dl (> 420 mmol / l), women> 6 mg / dl (> 360 mmol / l). 
Uric acid is excreted in the urine (2/3) and through the gastrointestinal tract (1/3), uric acid levels are excreted in the urine more or less depending on the diet with more or less human purines. Uric acid levels in the urine> 600 mg / day have been reported to have the potential to synthesize uric acid in the body. 
Acid uric acid can be caused by three mechanisms: increased uric acid synthesis in the body, decreased uric urinary excretion, eating too much food with purines.
Elevated uric acid: due to complete or partial HGPRT deficiency (Hypoxanthin-guanine-phosphoribosyl-transferase) is a hereditary disease, in men or increased activity of PRPP (phosphoribosyl-pyrophosphat synthetase).

Gout is primary and secondary

Gout primary type accounts for the vast majority of cases, the cause is unclear, disease depends on the locality, the family, the synthesis of endogenous purine increased, causing increased uric acid. 
Gout form secondary to: 
- Increase the breakdown of purines contain endogenous (destroy cells and organizations) such as blood disorders (polycythaemia, leukemia of myelogenous, hemolytic anemia), ... 
- Reduction of kidney uric acid excretion: Chronic kidney disease, kidney failure due to poisoning. 
- Do not eat too many foods containing purin (covered with poison, red meat, seafood ...), drink a lot of alcohol, this is the cause of disease rather than a direct cause.
For the early detection of gout, we need regular blood uric acid tests, people with hyperuricemia to have appropriate diet and treatment to limit the course of the disease and improve the quality of life. 
People at high risk for uric acidosis and gout: have a family history of gout, obesity, alcohol and coffee problems, taking diuretics, aspirin, cyclosporin.

Treatment of gout

Principles of basic treatment to limit the causes of uric acid (3 mechanisms). 
Medication: As directed by a physician: 
- Reactive inhibitors form uric acid: xanthin oxydase enzyme inhibitors such as allopurinol (Zyloric). The drug should only be used to prevent recurrence. 
- Remover kidney uric acid: Probenecid (benemid), Sulfinpyrason (antiran). 
- Pain relief in colchinery. 
Proper dietary treatment: Both reduced uric acid synthesis and increased excretion of uric acid through the kidneys. Diet plays a very important role in the treatment of acute, chronic gout and has the effect of reducing the level of chronic gout.

Principles of dietary diet in gout

Use low-fat foods such as whole grains, nuts, butter, fat, sugar, eggs, milk, cheese, vegetables. Limit foods high in uric acid such as meat, fish, seafood, poultry, liver, liver, oat, beans. 
- Absolutely no alcohol, beer, coffee, tea as it reduces the ability to excrete uric acid through the kidneys resulting in increased blood lactate. 
Maintain a healthy weight, if overweight and obese people should not lose weight too fast but should lose weight slowly. 
- Increased excretion of uric acid through the kidneys by drinking plenty of water, not eating sour foods (sour, pickles, salted ...). 
- Do not drink: alcohol, beer, coffee, tea. 
- Do not eat foods (vegetables) are sour because of increased blood acid. 
- Do not eat animal organs, boiled water, ribs, canned fish, canned meat.
- Do not eat cocoa, chocolate. 

Foods to eat:
- Drink enough water: 2-2.5 liters / day, should drink mineral water, vegetable juice. 
- Milk, vegetables, cooked fruits, cereals (rice, corn, potatoes ...) can be used at a slightly higher rate than normal. 
- Reduce the amount of protein in the diet: the total amount of meat or fish ... (animal protein, beans 150 g / day. 
Eat a variety of foods to supplement the nutrients needed. 
The calculation of food equivalent as follows:
the amount of protein per 100 g of meat = 180 g tofu = 70 g peanut particles = 100 g fish = 100 g shrimp. 
sample menu for patients with an acute:
Total energy included: 1,600 kcal / day, for people weighing 50 kg 
Protein: 10% of total energy = 40 g = 160 kcal.
Powdered sugar: 75% of total energy = 300 g = 1,200 kcal. 
Fat: 15% of total energy = 27g = 240 kcal. 
Vegetables are optional (but do not eat sour vegetables - such as tomatoes). 
Menu for patients with chronic gout : as usual diet but need food choices: limited to high purine foods, protein should not exceed 1 g / kg weight. Thus, animal protein and beans should not exceed 100 g / day.