（央视财经《第一时间》）痛风性关节炎是困扰人们的一种常见疾病，它和饮食习惯息息相关，男性患病率更高，而且呈现年轻化趋 势。 正在问诊的陈先生今年30岁，他告诉记者，自己被确诊痛风性关节炎2年了，近几天，明显感觉到膝盖疼痛加剧、肿胀严重，于是前来医 院复诊。 首都医科大学宣武医院风湿免疫-变态反应科副主任医师 李雪梅：饮酒过多、高嘌呤饮食以及熬夜是痛风的好发因素。我接诊过一个小孩 才8岁， 就得了痛风性关节炎，对于小孩来说，更多的是喝饮料，比如果糖饮料特别容易导致高尿酸。 专家表示，痛风性关节炎本质是高尿酸血症引发的"关节炎症"，常见于男性，一般起病急骤，疼痛逐渐加剧，12小时内达到高峰，多数患 者在数天或两周内自行缓解。超过50%的病例首次发病在第一跖趾关节，受影响的关节及其周围软组织会出现红肿、皮温升高和触痛等症 状。 北京大学人民医院风湿免疫科主任医师 叶华：反复的关节肿痛不缓解，可能局部会出现骨侵蚀，骨头会发生破坏。另外可能出现局部的 痛风石，也会影响到关节功能。痛风石同样也可以沉积在肾脏，出现慢性痛风肾病的病人也不在少数。目前认为，高尿酸可能加速动脉 的粥样硬化，增加心血管病的发生率等。 专家表示，预 ...

金秋时节，螃蟹凭借鲜美的肉质成为餐桌上的"时令宠儿"。但对高尿酸血症患者和有痛风病史的人 群来说，这道美味却常常让人望而却步——担心嘌呤摄入超标，诱发痛风。 其实只要选对时机、控制方法，这类人群也能安全尝鲜，关键一要先明确"什么情况下能吃、什么 情况不能吃"，二要做好"吃蟹细节"。 两种情况绝对不能碰 螃蟹，以常见大闸蟹为例，每100g蟹肉嘌呤含量约81.6mg，属于中嘌呤食物。而高嘌呤食物指每 100g嘌呤含量超150mg，如动物内脏、沙丁鱼。所以，"能不能吃"核心看病情状态： 痛风急性发作期哪怕只是关节轻微红肿、隐痛，吃蟹会让嘌呤摄入增加，可能加重炎症，延长发作 时间； 吃蟹时注意五个关键细节 拒绝"危险搭配"吃蟹时别喝啤酒(会抑制尿酸排泄)、少喝甜饮料(果糖可能促进尿酸生成)，也别搭 配动物内脏、浓肉汤等其他高嘌呤食物；可搭配黄瓜、生菜、苹果等低嘌呤蔬果，帮助促进尿酸排出。 选择新鲜螃蟹不新鲜的螃蟹易滋生细菌，可能引发肠胃不适；而变质蟹肉中的有害物质，也会增加 身体代谢负担，对病情控制不利。 别贪多控制量建议每次只吃一只中等大小的螃蟹(约100-150克)，且优先吃蟹肉，少吃蟹黄、蟹膏 ——后者不仅嘌呤 ...

Group 1 - The article highlights the increasing trend of young people adopting extreme health practices, leading to chronic diseases such as gout, fatty liver, and diabetes [1][2][3] - It emphasizes the importance of balanced diets, moderate exercise, and regular routines as the foundation of true health [1][3] - Medical professionals warn that excessive exercise can lead to acute gout attacks due to elevated uric acid levels, with studies indicating that a single high-intensity workout can increase blood uric acid by over 30% [2][3] Group 2 - The phenomenon of "skinny fatty liver" is becoming more common, particularly among young women who engage in extreme dieting, leading to health issues despite weight loss [4][5] - The article discusses the mechanisms behind fatty liver development due to extreme weight loss, including insulin resistance and hormonal imbalances [4][5] - It advises that weight management should focus on balanced diets and gradual weight loss, recommending a maximum of 5% weight loss per month for safety [5] Group 3 - The article addresses the misconception that "sugar-free" drinks are entirely safe, as excessive consumption can still lead to health issues like diabetes [6][7] - It notes that the proportion of diabetes patients under 40 is increasing, linked to unhealthy lifestyles, including irregular eating and lack of exercise [7] - The article stresses the importance of early intervention during the "prediabetes" stage to prevent the progression to full diabetes [7] Group 4 - The "Three Reductions and Three Healths" initiative by the National Health Commission aims to lower chronic disease risks through scientific lifestyle interventions [8][11] - Recommendations include reducing salt intake to no more than 5 grams per day, oil intake to 25-30 grams, and added sugar to no more than 25 grams [8][10][11] - The initiative also emphasizes maintaining oral health, healthy weight, and bone health through proper nutrition and regular physical activity [12][13][14]

Core Viewpoint - The rising popularity of milk tea among young people has been linked to health risks, particularly concerning elevated uric acid levels and related conditions like gout [1][2]. Group 1: Health Risks Associated with Milk Tea - A case of a 23-year-old male who developed acute gout due to high uric acid levels from daily milk tea consumption highlights the potential health risks [2]. - High fructose content in milk tea and other sugary beverages is identified as a significant contributor to increased uric acid levels, overshadowing the low purine content of these drinks [3][4]. Group 2: Mechanism of Uric Acid Increase - Fructose metabolism occurs primarily in the liver and is not regulated by insulin, leading to direct production of uric acid [5][6]. - Unlike sucrose and glucose, fructose can inhibit the kidneys' ability to excrete uric acid, further exacerbating the issue [7]. Group 3: Associated Health Conditions - Chronic high uric acid levels can lead to various health issues, including gout, kidney damage, and metabolic syndrome, which increases the risk of cardiovascular diseases and type 2 diabetes [11][13][14]. - A study indicates that consuming sugary drinks more than four times a week is significantly associated with early onset of gout in men under 40 [10]. Group 4: Dietary Recommendations - To manage uric acid levels, individuals are advised to maintain a balanced diet, control caloric intake, limit alcohol consumption, and engage in regular physical activity [15]. - Specific food recommendations include choosing whole grains, lean meats, and low-fat dairy while avoiding high-fructose and high-purine foods [16][18].

Core Insights - The prevalence of gout and hyperuricemia in China is increasing, with adult rates at 17.7% and 3.2% respectively [1] Dietary Recommendations - Patients with hyperuricemia and gout should avoid high-purine foods, high-fructose foods, and alcohol to manage their condition [2] - High-purine foods include organ meats, certain seafood, and some fish, with purine content ranging from 150-1000mg/100g [2] - Fructose-rich foods, such as sugary drinks and fruit juices, can elevate uric acid levels, but moderate fruit intake is acceptable due to beneficial nutrients [2] - Alcohol consumption should be limited, especially during acute gout attacks, as it can increase uric acid production and decrease its excretion [2] Lifestyle Modifications - A balanced diet with a variety of low-purine foods is recommended, including grains, vegetables, fruits, and low-fat dairy [3] - Cooking methods should focus on steaming, boiling, or stewing, while avoiding frying and high-fat preparations [3] - Daily salt intake should not exceed 5g, and cooking oil should be limited to 25-30g [3] Hydration and Exercise - Adequate hydration is crucial, with a recommendation of 2000ml-3000ml of water daily to promote uric acid excretion [4] - Regular, moderate exercise is beneficial, with suggestions for aerobic activities and strength training, while avoiding excessive exercise during flare-ups [4] Traditional Dietary Therapy - Traditional dietary therapy focuses on strengthening the spleen and stomach, with recommendations for specific foods like white lentils and yam [4]

Core Viewpoint - The article addresses common misconceptions about gout and hyperuricemia, emphasizing the importance of proper management and treatment to improve the quality of life for patients. Misconceptions about Gout and Hyperuricemia - Misconception 1: Hyperuricemia equals gout. Hyperuricemia is defined as uric acid levels above 420 umol/L for men and 360 umol/L for women, but not all patients with high uric acid develop gout, with only about 10% progressing to the condition [2]. - Misconception 2: Asymptomatic hyperuricemia does not require attention. Even without symptoms, high uric acid can lead to gout flares and increase the risk of other metabolic diseases such as diabetes and hypertension [3]. - Misconception 3: Uric acid-lowering medications are harmful to the liver and kidneys. Medications undergo rigorous testing for safety, and the risks of untreated high uric acid are far greater than potential side effects from medications [4]. - Misconception 4: Patients can stop medication once uric acid levels are normal. Gout is a chronic condition, and most patients require lifelong treatment to maintain uric acid levels [5][6]. - Misconception 5: Uric acid medications should be taken during acute gout attacks. Anti-inflammatory medications should be used instead, as uric acid medications can worsen symptoms during an acute flare [7]. - Misconception 6: Normal uric acid levels are sufficient. Patients with a history of gout should aim for lower uric acid levels, ideally below 360 umol/L, and even lower for those with kidney stones [8]. - Misconception 7: Pain relief is the only concern. Continuous uric acid management is crucial to prevent recurrent gout attacks [9]. - Misconception 8: Lower uric acid levels are always better. Extremely low levels can pose health risks, and a target level above 180 umol/L is recommended [10]. - Misconception 9: Intense exercise helps lower uric acid. Moderate aerobic exercise is beneficial, but excessive intensity can trigger gout attacks [11][12]. - Misconception 10: Drinking soda or restricting high-purine foods is enough to manage uric acid. Most uric acid is produced internally, and dietary changes alone are often insufficient [13]. - Misconception 11: Gout patients must avoid all meat. Controlled consumption of certain meats is acceptable, focusing on lean poultry and fish while avoiding red meats and organ meats [14]. - Misconception 12: Vegetables and fruits can be consumed freely. Some vegetables and high-fructose fruits can elevate uric acid levels and should be consumed in moderation [15]. - Misconception 13: Beer is forbidden, but white liquor is acceptable. All alcohol can raise uric acid levels, and patients should ideally abstain from alcohol [16]. - Misconception 14: Soy products and dairy are harmful. In moderation, soy products and low-purine dairy can be beneficial for gout patients [17].

Core Viewpoint - The prevalence of gout is increasing annually, with a significant trend towards younger populations, as highlighted by the National Health Commission's 2024 guidelines on hyperuricemia and gout dietary management [1] Group 1: Prevalence and Demographics - Gout is increasingly affecting younger individuals, with cases reported in patients under 20 years old [3] - Approximately 20% of gout cases have a family history, indicating a genetic predisposition [5] Group 2: Risk Factors - Major risk factors for gout include obesity, alcohol consumption, hypertension, hyperlipidemia, and high-purine diets [6] - High uric acid levels in the blood can lead to crystallization in joints and tissues, causing inflammation and acute arthritis [6] Group 3: Symptoms and Dietary Impact - Typical symptoms of gout include redness, swelling, heat, and pain, often occurring in the big toe, ankle, and knee, usually at night [8] - Changes in dietary habits, such as increased meat and seafood consumption, along with lifestyle factors like stress, late nights, and low water intake, contribute to the rising incidence of gout among young people [8] Group 4: Dietary Recommendations - It is advised to limit high-purine foods, including organ meats, seafood, and alcoholic beverages, to mitigate the risk of gout [10]