[Popular Science Nutrition] Why are there so many young people with high uric acid? 25 questions and 15 suggestions for improvement

2024-08-21

Author: Fan Zhihong

Researcher at the Department of Nutrition and Health, China Agricultural University, post scientist at Beijing Advanced Center of Food Nutrition and Human Health, PhD in Food Science, and registered dietician.

"Fan Zhihong_Original Nutrition Information" self-media author;Director of the Chinese Society of Food Science and Technology; Vice Chairman of the Food and Culinary Nutrition Branch of the Chinese Nutrition Society; Vice Chairman of the Geriatric Nutrition and Food Branch of the Chinese Society of Gerontology and Geriatrics, etc.

He teaches courses such as food chemistry and food nutrition. His main research direction is foodblood sugarThe impact of food reaction, cooking and processing on the nutritional and health value of food, nutritional environment evaluation, etc. He has edited 6 textbooks, participated in the editing of 12 textbooks, published 133 scientific papers as the first author or corresponding author, published 25 popular science books on food nutrition, and written more than 6,000 popular science articles on food that have been reprinted in newspapers and magazines.

Source:Fan Zhihong_Original Nutrition Information

Authorized to be published by China Clinical Nutrition Network

I started noticing the problem of high uric acid in young people last year.

Our school's physical education department offers a fat-loss class every semester, which includes dozens of students who have reachedobesityStudents who have difficulty meeting the standards and physical fitness tests will be given weight loss exercise guidance.

Since these students are in different physical conditions from other students, it is not appropriate for them to do the same physical exercise programs. Therefore, the teachers of the Physical Education Department gathered the obese students together and arranged fat-reducing courses for them according to their special conditions, using exercise methods to help them lose weight. In this way, the students not only improved their physical fitness and the standard-reaching rate, but also received credits for physical education.

In order to better help students lose weight, the teachers from the Physical Education Department came to me, hoping to provide students with more guidance on diet.

After looking at the physical examination results of these obese students, I found a strange problem:That's the students.Uric acidThe level is generally very high.

Although their body fat percentage was above the standard and their weight reached the obesity standard, the students' blood sugar and blood pressure were only above the standard by a few percent.insulinOnly 7.5% exceeded the standard, butThe proportion of uric acid exceeding the standard has reached 90%!

After 10 weeks of exercise intervention three times a week, the students lost an average of 3 kg in weight, 5.4 cm in waist circumference, and their LDL andTriglyceridesHowever, the uric acid level was only reduced by 6.5 μmol/L, which was not a significant effect (they did not take medication).

Why are students' uric acid levels so high and so difficult to lower? This is something worth pondering.

Logically speaking, young people should not have such high levels of uric acid, and girls should not have too high uric acid levels, because of the protective effect of estrogen. Before menopause, women have high uric acid andgoutThe incidence rate is much lower than that of men.

Although hyperuricemia has a familial clustering, such a high rate of excess cannot be explained by genetics. It is impossible that 90% of students have it because of their family.Genetic factorsThis problem occurs.

I checked the information and found thatIn recent years, the incidence of hyperuricemia among young men in my country has been rising, and even more and more young women have excessive uric acid levels.

The general trend of rising uric acid levels must be related to unhealthy physical constitution and wrong lifestyle. So, what factors may causehematuriaWhat about elevated acid levels?

Please check yourself first to see if you have any of the following genetic conditions that are likely to cause elevated uric acid:metabolism, pathological and non-dietary lifestyle factors.

1. There is a family history of hyperuricemia and gout.
2. Have a family history or medical history of kidney disease.
3. Have a family history or medical history of hypertension.
4. Have diabetes or insulin resistance.
5. Have thyroid dysfunction.
6. Have chronic joint diseases.
7. Having long-term insomnia or staying up late problems.
8. Obesity or high body fat percentage.
9. Taking certain medications for a long time.
10. Infectious diseases, including COVID-19 infection.

answer"yes"The more problems you have, the more likely you are to have abnormal uric acid.

Of course, an unreasonable diet is also an important factor causing elevated uric acid.Are there any of the following dietary factors that may easily lead to elevated uric acid levels?

1. Love to drink sugary drinks. This includes drinks containing sucrose, fructose syrup, and fructose. Fruit juice drinks, sweetened milk tea, etc. are also within the scope of sugary drinks.
2. Drink lots of juice (100% fruit juice).
3. Love to eat all kinds of sweets, desserts, candies, sweet baked goods (sweet biscuits, sweet bread, cookies, etc.).
4. Love to drink, including beer, liquor, and excessive red wine.
5. I like to eat seafood, including shellfish, oysters, fish roe, crabs, shrimps, sardines, anchovies, etc.
6. Love to eat animal offal with high purine content.
7. Eat lots of grilled and barbecued meats.
8. Eating too much beef, mutton, pork, etc. on a daily basis.
9. Eating too much processed meat products, such as ham, bacon, bacon, sausage, etc.
10. Eating too few vegetables, potatoes, whole grains, and dairy products, resulting in insufficient intake of potassium, calcium, and magnesium.
11. Eating too much salt and consuming excessive sodium for a long time.
12. EatcarbohydrateToo little, or long-term ketosis weight loss.
13. Frequent dieting to lose weight puts one in a long-term semi-starvation state.
14. Lack of exercise and weak muscles.
15. The intensity of exercise/labor is too high and you are often in a state of stress.

Let’s take a look and see how many of these conditions apply to you or your family members with hyperuricemia?

If we summarize,From the perspective of diet and exercise, there are several mechanisms that can easily lead to increased blood uric acid levels.

The first important dietary reason is eating too much sugar.Studies have shown that excessive intake of fructose can not only lead to insulin resistance, but also cause uric acid metabolism disorders.

The sucrose (white sugar, rock sugar, brown sugar, etc.) we eat daily will be digested into 1 molecule of glucose and 1 molecule of fructose in the body. If you drink sweetened drinks sweetened with fructose syrup, most of the sweet substances are fructose, because fructose brings a sweet taste and tastes particularly good. Drinking large bottles of sweet drinks is the "best" way to consume too much fructose.

In ancient my country, people did not have the habit of drinking sweet drinks. They only drank soup or tea during meals, not sweetened drinks. They only drank water and tea between meals, not sweet drinks. After the 1990s, foreign sweet drinks gradually entered China. Under the influence of strong commercial promotion, the perception that "children should drink sweet drinks" was gradually formed. Especially when dining in restaurants and adult gatherings, children would be given some sweet drinks. Because children naturally like sweetness, they are easily obsessed with sweet drinks.

As a result, children began to compete with each other in drinking sweet drinks.It seems that drinking plain water is out of fashion, and drinking light tea is the habit of the elderly.Only sweet drinks are for children. Doting parents and grandparents will be happy to satisfy their children's desire for sweet drinks.

I must say one more thing here.The sugar content of pure fruit juice is higher than that of many sweet drinksOne glass of juice often contains the sugars from two or three apples/pears/peaches/oranges. Drinking two glasses of juice is very relaxing and enjoyable. Therefore, replacing fruit with juice can easily lead to excessive sugar intake.

In addition, in recent years, due to the development of the starch sugar industry, the production of fructose has increased, and many desserts and sweets are happy to use "crystalline fructose" directly.

Fructose has good hygroscopicity and a pleasant sweet taste. It quickly entered various starch foods and soft pastries, and is also used by milk tea shops and dessert shops.
Honey, which is not easy to crystallize, is also a dense source of fructose. Some sweet foods use honey as a sweetness source, which also introduces fructose.

Therefore, the amount of fructose consumed from various sweet foods other than beverages is also showing an increasing trend.

The second big problem is that we eat more and more fish, meat and seafood, but less and less vegetables, potatoes and whole grains.Studies have confirmed that eating too much aquatic animals and red meat is positively correlated with the risk of hyperuricemia and gout.

Since children are the darlings of the family, they are adequately supplied with various animal foods from an early age, and many children eat meat/fish/shrimp as meals.

The purine content of fish, seafood, and freshwater food is much higher than that of staple foods and vegetables and fruits.This is well known. At the same time, they also put a higher acid load on the body. Recent studies have found that food acid load is associated with the risk of hyperuricemia (Zhang et al, Nutrients, 2023).

at the same time,Foods that provide a lot of potassium to the diet, such as vegetables, potatoes and whole grains, are seriously insufficient.Many children do not like to eat vegetables and eat very small amounts at each meal. In addition to fried and baked foods such as French fries and potato chips, there are very few potatoes such as sweet potatoes, potatoes, and yams that are steamed or cooked. They only eat white rice and white flour. This makes it impossible to achieve a balanced nutrition.

Some people may ask: Can we still eat the fruit? Yes.

Dietary guidelines recommend200~350gConsuming fruits within this quantity range will not introduce too much fructose and will not cause high uric acid levels.

However, if you eat two or three pounds of fruit a day, the total amount of fructose will be too much, which is probably also worth worrying about.

The third big problem is too few carbohydrates, which leads to insufficient energy in the body and even hunger.

When food is insufficient, the body can only break down its own tissues to supply energy, and the decomposition of tissue cells will produce purine, causing an increase in endogenous uric acid production.

When there is a lack of carbohydrates, the body quickly degrades fat but cannot oxidize them into carbon dioxide and water, which will produce too many ketone bodies, resulting in a decrease in the body's ability to process and excrete uric acid.

People who are not obese but adopt a very low-carbohydrate diet, including a ketogenic diet, may be at risk of hyperuricemia.

In the obese state, a temporary low-energy diet or a low-carbohydrate diet may reduce the obesity level, and fat loss itself is beneficial for preventing metabolic disorders.If a person does not meet the obesity standard and does not have obvious metabolic disorders, then low-carbohydrate weight loss will do more harm than good and will disrupt purine metabolism.

We often see cases like this: some girls were originally healthy, just normal and plump, not obese, but they adopted starvation or very low carbohydrate diet, drastically reduced staple food, or even stopped eating staple food, which resulted in decreased disease resistance, irregular menstruation, insulin resistance, and even hyperuricemia. After returning to normal staple food and doing moderate exercise, uric acid levels gradually returned to normal.

The fourth problem is insufficient or excessive exercise.

Lack of exercise leads to muscle flab, low metabolic capacity, high body fat percentage, overweight and obesity. It is well known that obesity and hyperuricemia often go hand in hand. Epidemiological surveys have also found thatObesity significantly increases the risk of hyperuricemia.

But on the other hand, exercise consumes energy. Excessive exercise and insufficient nutrition from food are also the causes of hyperuricemia, which many people do not understand.

On the one hand, excessive exercise puts stress on the body, and stress itself is a factor that causes metabolic disorders.Large amounts of high-intensity exercise often cause short-term muscle damage and increase endogenous uric acid levels.Therefore, exercise and rest must be balanced. After a lot of physical activity, you need to rest enough to allow your muscles to repair and grow and your physical strength to recover.

It is particularly important to note thatIf there is insufficient nutrition supply during exercise, it will cause muscle tissue damage that is difficult to repair, and may even lead to tissue breakdown and muscle loss.As mentioned earlier, excessive degradation of tissue cells will produce excessive endogenous uric acid.

The dietary guidelines tell us that eating and exercising should be balanced. Exercise consumes energy, muscle building requires nutrition, and more exercise requires more eating. However, many people now blindly pursue a skinny figure, exercise a lot, but dare not increase their food intake. This creates a disguised state of hunger, causing body tissues to be degraded and damaged.

In addition, there are studies suggesting that eating too much salt may also promote the rise of uric acid and obesity by increasing the production of endogenous fructose in the liver and hypothalamus. For related content, please see the previous article link:Will a love of salty food really lead to weight gain and obesity? Seven tips to prevent "salty obesity"。

Now let’s look back at the students in the fat loss class, why do they have such high uric acid levels?

Let’s first look at the issue of sweets and sweet drinks.According to the dietary survey, only 43% of students drank sweet drinks, and most of them only drank one bottle. This does not seem to fully explain the problem of elevated uric acid. But there is another possibility, that is, they drank a lot of sweet drinks and ate a lot of sweets when they were young. It was only after entering college that they drank/ate less, or stopped drinking/eating. In short, further investigation is needed in terms of dietary history.

Let’s look at the issue of eating meat and eating vegetables.At present, few people eat a lot of meat and seafood, because the supply of fish and meat "hard dishes" in school cafeterias is relatively limited, and seafood and river fish are even less. But when they are at home, they may have eaten more meat since childhood.

These students eat significantly less vegetables, especially green leafy vegetables, and generally prefer meat to vegetables.

Let’s talk about the issue of eating staple foods.Many of them eat less staple food, and most of them do not eat the normal amount. A teenage boy only eats 200-300 grams of staple food every day, which is far from the 200-300 grams of dry weight of grains recommended by the Food Pagoda. At the same time, they basically do not eat whole grains, and do not often eat potato foods. These are also factors that are not conducive to improving uric acid levels.

fromMetabolic factorsFor them, although their family history and thyroid function were not investigated, they were obese, some of them had problems with their blood sugar and blood pressure, and were generally in a state of metabolic disorder.

fromOther lifestyle factorsIt seems that they have a hard time going to bed early, and some of them often stay up late. They didn't like sports before going to college. Although the current sports fat loss class takes their physical condition into consideration, arranges exercises to reduce joint injuries, controls exercise intensity, and has teachers to provide special guidance, after all, exercise will cause certain fatigue and stress.

They control their diet and increase exercise. The reducing effect of fat loss is offset by the increasing effect of stress and hunger. As a result, uric acid levels do not change much.

According to their actual living conditions of eating in the cafeteria and having heavy study tasks every day, IThe following dietary measures are recommended:

1. Try not to eat snacks that contain oil, salt, or sugar.
2. Eat more vegetables cooked with less oil, and eat two servings of green leafy vegetables every day. You can buy some tomatoes, cucumbers, lettuce and other edible raw vegetables outside the canteen and eat them directly with meals without adding oil or salt.
3. The amount of staple food can be controlled, but at least 50 grams of dry weight should be eaten at each meal (the so-called"One tael of rice"). When you feel particularly tired after a lot of exercise, you can increase the amount of staple food to promote muscle recovery.
4. Try to eat staple foods in their original flavor, do not eat cakes, biscuits or other pastries with added oil and salt, and do not eat baked goods such as bread and snacks.
5. Eat breakfast at a fixed time every day. Drink a box of milk you buy yourself.(Milk is more beneficial for controlling uric acid than soy milk).
6. Do not drink sweet drinks (including sugar-free drinks), fruit juice, milk tea, or coffee with sugar.
7. When eating, focus on feeling full with food instead of looking at your phone.
8. Try not to eat after dinner.
9. If you feel hungry between meals, you can drink skim milk and eat a small amount of fruit, but the amount of fruit should not exceed 400 grams per day (including skin and core).
10. Do not sit down within half an hour after a meal, but take a walk or do standing work.
11. Give priority to dishes with less oil and salt. If you eat a strong-flavored dish, balance it with less oil and salt, such as the lettuce you bring with you.
12. Do not eat fancy staple foods that have been added with oil, salt or sugar, just eat them in their original flavor.
13. Eat whole grain staple foods such as oatmeal, whole grain rice, and whole wheat steamed bread every day. The purine content of whole grains such as millet, brown rice, and oats is not high. It is recommended to buy instant oatmeal and make a bowl for breakfast instead of white rice porridge.
14. Drink a bowl of unsalted soup or a glass of water before the meal, eat a small bowl of vegetables first, then eat half a portion of other dishes, and finally eat rice or steamed buns as the staple food.
15. Reduce stress, avoid staying up late, and try to go to bed early at night.

If the uric acid level is seriously high or even leads to gout attack, it is recommended to seek medical treatment.Regardless of whether or not you take medication, diet and lifestyle are important measures. While your joints and organs have not been substantially damaged, and while you are young and have a strong ability to recover, you must stick to a healthy diet and moderate exercise to get your uric acid levels back to normal and your body metabolism back to a full and energetic state.

Editorial Department of China Clinical Nutrition Network

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[Popular Science Nutrition] Why are there so many young people with high uric acid? 25 questions and 15 suggestions for improvement

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