Managing High Uric Acid and Cholesterol Levels: Dietary Tips and Concerns

Q: Managing High Uric Acid and Cholesterol Levels: Dietary Tips and Concerns

Dear Ms. <br>Kiki： <br>1. <br>Elevated uric acid levels primarily refer to high concentrations of uric acid in the blood. <br>When uric acid precipitates in joint tissues (such as the big toe joint, the back of the foot, or finger joints), it can trigger an inflammatory response,

Health check shows elevated uric acid and cholesterol levels?

Hello Doctor: I recently had a health check, and my uric acid level is 7.1, which is above the normal range.
Isn't the normal value for women supposed to be less than 6.6? I currently do not have any symptoms of gout, but my calf muscles are sore.
I usually do not eat much meat, so why is my uric acid level high? Is it due to an abnormal metabolism of uric acid? My kidney function tests are normal.
Additionally, my cholesterol levels are also high; my high-density lipoprotein (HDL) is 40, which is below the normal range for women, and my low-density lipoprotein (LDL) is as high as 192, with a total cholesterol level of 240.
My atherosclerosis index is 6, which exceeds the standard value of 1-5.

Could you please advise me on how to manage my diet: (1) Almonds and salmon can lower LDL cholesterol and increase HDL cholesterol, but these two foods are relatively high in purines.
Can I still eat them? (2) Soy products can also lower cholesterol, but they contain high purine levels.
Should I avoid all soy products? (3) I have bruising around my arm and the surrounding area after the blood draw.
Is this related to my higher atherosclerosis index? (4) Can I eat out if my cholesterol is high? Should I also limit my carbohydrate intake? (5) Does exercise really help lower cholesterol levels? I had high cholesterol levels about ten years ago as well.
Thank you, Doctor! ^_^

Kiki, 30~39 year old female. Ask Date: 2017/11/25

Dr. Xiao Yongxun reply Internal Medicine

Dear Ms.
Kiki:
1.
Elevated uric acid levels primarily refer to high concentrations of uric acid in the blood.
When uric acid precipitates in joint tissues (such as the big toe joint, the back of the foot, or finger joints), it can trigger an inflammatory response, leading to gout.
Since uric acid is mainly produced from the metabolism of DNA, RNA, and nucleic acids, and is subsequently excreted through urine, it is advisable to avoid a high-purine diet (such as organ meats, legumes, meats, mushrooms, etc.) and alcohol consumption.
These foods can increase uric acid production, while alcohol metabolism generates acetate, which can hinder uric acid excretion in the kidneys.
On the other hand, it is important to drink plenty of water and consume fruits; the former can help dissolve uric acid for urinary excretion, while the latter can alkalinize urine and promote uric acid elimination.
Additionally, maintaining a healthy weight can further reduce the risk of developing gout.
2.
If total cholesterol and low-density lipoprotein (LDL) cholesterol levels remain elevated over time, the risk of cardiovascular diseases, cerebrovascular diseases, and peripheral artery diseases increases.
Clinical management primarily involves lifestyle modifications, including dietary control, regular physical activity, good weight management, and smoking cessation.
Practically, it is recommended to slow down the pace of eating, aiming for about 80% fullness at each meal.
It is important to consume a variety of foods without overindulging to maintain a balanced intake of nutrients.
Weekly egg yolk consumption should ideally be limited to less than two.
Avoid excessive intake of commercially available or convenience store products, which often contain trans fats (commonly found in creamers, butter, margarine, three-in-one or two-in-one coffee, milk tea, etc.) and high fructose corn syrup (often found in soft drinks, desserts, cola, pastries, etc.).
These types of foods may be more difficult for the body to metabolize or may be high in calories without providing satiety, leading to increased blood sugar levels and obesity.
Regular exercise contributes approximately 20-30% to weight and lipid control.
Therefore, moderate exercise and post-meal walks are also crucial for weight management.
This approach can effectively lower cholesterol and LDL levels, thereby reducing the risk of cardiovascular and cerebrovascular diseases.
4.
Additionally, excessive intake of sugars and triglycerides can lower high-density lipoprotein (HDL) cholesterol levels.
Therefore, it is advisable to reduce the intake of high-calorie foods or avoid overeating, combined with regular exercise; this will help increase HDL cholesterol levels.
5.
Sufficient sleep increases the secretion of leptin, making weight gain less likely.
Insufficient sleep decreases leptin levels, increases appetite, and leads to weight gain.
This aspect of weight management is often overlooked, yet it is essential for controlling cholesterol levels through weight management.
6.
In summary, it is recommended that you slow down your eating pace, chew thoroughly, and aim for 80% fullness; avoid excessive consumption of butter, bread, desserts, beverages, and cream products; drink plenty of water and eat fruits; engage in regular exercise or walking; and reduce work-related stress while ensuring adequate sleep.
It is advisable to follow up with your family physician or a family medicine clinic in 3 to 6 months.

Reply Date: 2017/11/25

More Info

Managing high uric acid and cholesterol levels can be quite challenging, especially when you are trying to balance dietary choices that may impact both conditions. Based on your health check results, it appears that you are facing elevated levels of uric acid and cholesterol, which can be concerning but manageable with the right dietary adjustments and lifestyle changes.

Understanding Your Conditions
1. Uric Acid Levels: Your uric acid level of 7.1 mg/dL is indeed above the normal range for women, which is typically below 6.6 mg/dL. Elevated uric acid levels can result from various factors, including dietary intake, metabolic issues, and kidney function. Since your kidney function is normal, it suggests that your body may be producing too much uric acid or not excreting enough.
2. Cholesterol Levels: Your cholesterol profile indicates high levels of low-density lipoprotein (LDL) cholesterol (192 mg/dL) and total cholesterol (240 mg/dL), with high-density lipoprotein (HDL) cholesterol at 40 mg/dL, which is below the recommended level for women. This imbalance can increase the risk of cardiovascular diseases.

Dietary Tips
1. High Purine Foods: Foods high in purines can increase uric acid levels. While almonds and salmon are known for their heart-healthy benefits, they do contain purines. However, the benefits of omega-3 fatty acids in salmon may outweigh the risks, especially if consumed in moderation. You might consider limiting your intake to a few servings per week rather than eliminating them entirely.

2. Soy Products: Soy products like tofu and edamame can help lower cholesterol levels. While they do contain purines, they are generally considered to be lower in purine content compared to animal proteins. You can include moderate amounts of soy products in your diet, but it’s wise to monitor your overall purine intake.

3. Bruising After Blood Draw: The bruising you experienced after your blood draw is likely unrelated to your cholesterol levels. Bruising can occur due to the needle puncturing the skin and blood vessels, especially if you have delicate veins or if the blood draw was challenging. If you have concerns about your vascular health, it may be worth discussing with your healthcare provider.

4. Eating Out and Carbohydrate Intake: Eating out can be tricky when managing cholesterol levels. Opt for grilled, baked, or steamed options rather than fried foods. Choose whole grains over refined carbohydrates, as they are better for heart health. While carbohydrates are essential, focus on complex carbohydrates like whole grains, legumes, and vegetables, and limit simple sugars and refined carbs.

5. Exercise and Cholesterol: Regular physical activity can significantly help in managing cholesterol levels. Exercise can increase HDL cholesterol (the "good" cholesterol) and lower LDL cholesterol and triglycerides. Aim for at least 150 minutes of moderate-intensity aerobic exercise each week, such as brisk walking, cycling, or swimming.

Additional Considerations
- Hydration: Staying well-hydrated can help your kidneys excrete uric acid more effectively. Aim for at least 8-10 glasses of water daily.

- Limit Alcohol: Alcohol, especially beer and spirits, can raise uric acid levels. It’s advisable to limit or avoid alcohol consumption.

- Weight Management: If you are overweight, losing even a small amount of weight can help lower uric acid levels and improve cholesterol profiles.

Conclusion
Managing high uric acid and cholesterol levels requires a comprehensive approach that includes dietary modifications, regular exercise, and possibly medication as prescribed by your healthcare provider. It’s essential to work closely with your healthcare team, including a registered dietitian, to create a personalized plan that considers your unique health needs and lifestyle. Regular monitoring of your levels will also help you track your progress and make necessary adjustments to your management plan.

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