The overlooked 'fourth highest' is troubling nearly 200 million Chinese people
High uric acid "has become the" fourth highest "after" high blood sugar "," high blood pressure ", and" high blood lipids ".
Hyperuricemia (HUA) is the second largest metabolic disease after diabetes. Adults with normal purine diet, regardless of gender, who have fasting blood uric acid levels exceeding 420 μ mol/L twice on the same day, can be diagnosed with HUA. Patients with HUA who experience urate crystal deposition, leading to gouty arthritis, urate nephropathy, and kidney stones, are called gout, which generally refers to gouty arthritis.
1. Health problems faced by nearly 200 million Chinese people
According to publicly available data, the number of patients with hyperuricemia and gout worldwide is on the rise year by year, expected to increase from 740 million in 2016 to 1.42 billion in 2030. The number of patients in China is also increasing year by year. It is expected that by 2030, the number of patients will reach 240 million. Currently, nearly 200 million people in China are suffering from hyperuricemia and gout.
According to online user research, nearly 60% of young patients with hyperuricemia and gout aged 18 to 35 years old. Men are the main group with hyperuricemia. According to the monitoring data of chronic diseases and risk factors in China from 2018 to 2019, the incidence of hyperuricemia among adult residents in China was 14.0%, with male and female incidence rates of 24.5% and 3.6%, respectively. Men are also the main force in the consumption of uric acid products. According to CBNData consumption big data, from 2018 to 2020, the proportion of male consumers showed an upward trend, with a significant increase in the consumption proportion of post-95s.
2. Dietary recommendations for patients with hyperuricemia
The Multidisciplinary Expert Consensus on the Diagnosis and Treatment of Hyperuricemia Related Diseases in China (2023 Edition) provides dietary recommendations for patients with hyperuricemia.
1) Healthy diet: Encourage the consumption of fresh vegetables and eggs, moderate consumption of low-fat and skimmed dairy products, fish rich in omega-3 polyunsaturated fatty acids, beans, and soy products; Limit the intake of animal derived high purine foods.
2) Individuals with normal cardiovascular and renal function should drink more water and maintain a daily urine output of 2000-3000 mL
3) Edible fruits with low fructose content, such as cherries, strawberries, pineapples, watermelons, peaches, etc
4) Limit alcohol intake
5) Obese patients control their weight (BMI: 18.5-23.9)
6) Moderate exercise
7) Quit smoking and avoid passive smoking
3. Common uric acid lowering ingredients
Common uric acid lowering ingredients include vitamins (such as vitamin C, vitamin E, vitamin B6), polyphenols (such as apple polyphenols, bergamot polyphenols, gallic acid), flavonoids (such as luteolin, silibinin, quercetin, dihydromyricetin), tea (containing catechins, green tea polyphenols, etc.), curcumin, chitosan, celery seeds, sour cherries, probiotics, amino acids/peptides (such as L-arginine, goose myopeptide, etc.), N-acetylcysteine (NAC).
According to the 2021 White Paper on High Uric Acid and Gout Trends in China, celery seeds and sour cherries were commonly used "acid relieving" tools by European and American health product brands in 2020; According to the Japan Consumers' Agency, luteolin, goose muscle peptide, Lactobacillus plantarum PA-3 (PA-3 lactic acid bacteria), dihydromyricetin, chitosan, and elemene gallic acid are commonly used uric acid lowering ingredients in functional foods in Japan.
According to the Multidisciplinary Expert Consensus on the Diagnosis and Treatment of Hyperuricemia Related Diseases in China (2023 Edition), some medicinal and edible ingredients (including health food ingredients) can also improve hyperuricemia, such as Atractylodes macrocephala, Plantago asiatica, Turmeric, Astragalus membranaceus, Poria cocos, Codonopsis pilosula, Atractylodes macrocephala, Cornus officinalis, Plantago asiatica, Dandelion, Pueraria lobata, Gardenia jasminoides, etc. Kudzu root and turmeric can inhibit the activity of xanthine oxidase and reduce uric acid levels; Gardenia and Plantago asiatica can regulate the expression of urate transporters, reduce the reabsorption of uric acid, and promote uric acid excretion.
The main active ingredients of celery seeds include luteolin and apigenin. A 2019 study found that celery seed extract reduced serum uric acid levels and xanthine oxidase activity, which is the enzyme responsible for metabolizing purine into uric acid. Celery seeds can also reduce inflammatory markers, thereby reducing joint swelling and alleviating gouty arthritis.
Sour cherry
There are dozens of varieties of cherries, but they can be divided into two types based on their taste: sweet cherries and sour cherries. Currently, most research is focused on sour cherries. The study found that the efficacy of sour cherry in reducing uric acid and the incidence rate of gout was mainly attributed to its chemical composition, especially anthocyanins. The anthocyanins in sour cherries are much higher than most other fruits, and they can strongly inhibit key enzymes involved in inflammation (such as cyclooxygenase 1 and 2). Sour cherry extract can also reduce the levels of various cytokines (such as IL-1 β, TNF - α, IL-6, and IL-17) in affected joints.
Luteolin
Osmanthus extract is a common flavonoid compound found in various plants. Osmanthus extract is one of the flavonoids that can inhibit xanthine oxidase. In addition, it can also weaken the activation of NF - κ B in pancreatic beta cells induced by uric acid. Osmanthus extract can restore the decrease in MafA expression levels induced by uric acid in mouse pancreatic islet tumor cells (Min6 cells). It mainly inhibits the reduction of MafA through the NF - κ B-iNOS-NO signaling pathway, thereby improving insulin secretion in pancreatic beta cells damaged by uric acid. It is worth mentioning that magnolol does not affect the cell viability of Min6 cells at its effective concentration, indicating that magnolol can provide protection for pancreatic beta cells without causing cytotoxicity.
Quercetin
An experiment on rats with hyperuricemia found that treatment with quercetin inhibited xanthine oxidase activity, reduced oxidative stress levels, and improved hyperuricemia. The mechanism may be that quercetin reduces the production of serum uric acid by inhibiting the activity of xanthine oxidase and adenosine deaminase in the body, thereby lowering serum uric acid levels.
4. Insights from the development of uric acid lowering products abroad
At present, food products targeting "gout" and "uric acid lowering" are in a relatively awkward position in China. In the newly updated health food catalog, related effects such as "lowering uric acid" and "relieving gout" are not included. In addition, there is no targeted policy guidance or management regulation in the regulations related to special medical food, and ordinary functional foods cannot claim efficacy. In a market of nearly 200 million people, uric acid lowering foods are still a blank.
Unlike the domestic market, the development of uric acid lowering supplements in foreign countries is relatively mature. In the future, when domestic regulations are relaxed, foreign uric acid lowering products may provide us with some research and development inspiration.
1) Multiple raw materials+multiple scenarios
High uric acid is often accompanied by health problems such as obesity, kidney disease, hypertension, hyperglycemia, and joint pain. So foreign uric acid lowering products are often combined with other related health benefits.
2) Rich dosage forms
The dosage forms of uric acid dietary supplements on the Amazon platform mainly include capsules, tablets, gummies, and liquids.