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>If 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, le

Health check shows elevated uric acid and cholesterol levels?

Hello Doctor: I recently had a health check-up, 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 don't 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, with high-density lipoprotein (HDL) at 40, which is below the normal range for women, low-density lipoprotein (LDL) at 192, total cholesterol at 240, and a vascular sclerosis index of 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 both of these foods are relatively high in purines.
Can I still consume them? (2) Soy products can also lower cholesterol, but they contain high purine levels.
Does this mean I should avoid all soy products? (3) I noticed bruising around my arm and the surrounding area after the blood draw.
Could this be related to my elevated vascular sclerosis index? (4) Is it possible to eat out if my cholesterol is high? Should I also limit my carbohydrate intake? (5) Does exercise really help lower cholesterol levels? I had elevated cholesterol levels about ten years ago as well.
Thank you, Doctor! ^_^

Kiki, 30~39 year old female. Ask Date: 2017/11/26

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.
If 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, and mushrooms) and alcohol consumption.
These foods can increase uric acid production, while alcohol metabolism generates acetic acid, 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 helps dissolve uric acid for urinary excretion, while the latter can alkalinize urine, promoting uric acid elimination.
Additionally, maintaining a proper weight can further reduce the likelihood 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 and aim 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, particularly those high in trans fats (often found in creamers, butter, ghee, three-in-one or two-in-one coffee, and milk tea) and high fructose corn syrup (commonly present in soft drinks, desserts, cola, and pastries).
Such foods may be harder 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 crucial for weight management.
This approach can effectively lower cholesterol and LDL levels, thereby reducing the risk of cardiovascular and cerebrovascular diseases.
3.
Furthermore, excessive intake of sugars and triglycerides can also 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.
4.
Sufficient sleep increases the secretion of leptin, making it less likely to gain weight.
Insufficient sleep decreases leptin levels, increases appetite, and leads to weight gain.
This aspect of weight management is often overlooked and is crucial for controlling cholesterol through weight management.
5.
In summary, it is recommended to slow down your eating pace, chew thoroughly, and aim for about 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: 2017/11/26

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. Your recent health check indicates elevated uric acid levels at 7.1 mg/dL, which is indeed above the normal range for women (typically under 6.6 mg/dL). Additionally, your cholesterol levels show high low-density lipoprotein (LDL) cholesterol at 192 mg/dL and total cholesterol at 240 mg/dL, with a low high-density lipoprotein (HDL) cholesterol level of 40 mg/dL.

Understanding Uric Acid and Cholesterol Levels
1. Uric Acid: Elevated uric acid levels can result from various factors, including dietary choices, metabolic issues, and even genetic predispositions. While you mentioned that you do not consume much meat, other dietary sources of purines (which break down into uric acid) include certain seafood, organ meats, and even some vegetables. The fact that you do not exhibit symptoms of gout is a positive sign, but it is essential to monitor your levels to prevent future complications.

2. Cholesterol: Cholesterol is a waxy substance found in your blood, and while your body needs it to build healthy cells, high levels can increase your risk of heart disease. The balance between LDL (often referred to as "bad" cholesterol) and HDL (the "good" cholesterol) is crucial. High levels of LDL can lead to plaque buildup in your arteries, while HDL helps remove cholesterol from your bloodstream.

Dietary Recommendations
1. Almonds and Salmon: While almonds and salmon are indeed beneficial for heart health, they do contain purines. However, the purine content in these foods is relatively moderate compared to other sources. You can include them in moderation, focusing on portion control. The omega-3 fatty acids in salmon can help improve your cholesterol profile, making it a good choice.

2. Soy Products: Soy products like tofu and edamame can help lower cholesterol levels. While they do contain purines, they are generally considered safe for individuals with elevated uric acid levels when consumed in moderation. You might want to limit your intake to avoid excessive purine consumption but not eliminate them entirely.

3. Bruising After Blood Draw: The bruising you experienced after your blood draw is likely not directly related to your cholesterol levels. It can occur due to the needle puncturing the blood vessel, leading to bleeding under the skin. If you have concerns about your vascular health, it would be wise to discuss this with your healthcare provider.

4. Eating Out and Carbohydrates: 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 higher in fiber and can help manage cholesterol levels. While carbohydrates are essential, focus on complex carbohydrates like whole grains, legumes, and vegetables, which can provide fiber and nutrients without spiking blood sugar levels.

5. Exercise: Regular physical activity is indeed effective in lowering cholesterol levels and improving overall cardiovascular health. Aim for at least 150 minutes of moderate-intensity aerobic exercise each week, such as brisk walking, cycling, or swimming. Exercise can help raise HDL cholesterol while lowering LDL cholesterol and triglycerides.

Conclusion
In summary, managing high uric acid and cholesterol levels requires a balanced approach to diet and lifestyle. Focus on incorporating heart-healthy foods while being mindful of purine intake. Regular exercise and maintaining a healthy weight are also vital components of your management plan. Always consult with your healthcare provider or a registered dietitian for personalized advice tailored to your specific health needs.

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