Gout is a common issue for many of our patients and is becoming increasingly more prevalent in the population.
It is one of the oldest diseases recorded in medical history, with 70,000 people being affected each year.
When we consume foods high in purines, high levels of uric acid (hyperuricemia) occur in the blood.
What is Uric Acid?
Your body makes uric acid when it breaks down purines. Uric acid normally dissolves in your blood, is processed by the kidneys and leaves the body in urine.
While uric acid is a normal waste product formed in the breakdown of food, high levels of uric acid in the blood can cause crystals to form in the joints which can cause the severe pain and swelling. The most common areas affected include; fingers, hands, elbows, feet, heels
Urate levels can be elevated due to:
- Decreased renal excretion (this is the most common)
- Increased production of uric acid
- Increased purine intake
However, having hyperuricaemia doesn’t mean that you will develop gout. In fact, many people with hyperuricaemia don’t often go on to develop gout.
Due to this, it is often thought that there are other factors that might contribute towards the development of gout, such as your genes being involved.
The disease usually occurs after the age of 35 years and predominantly affects men.
There are a number of lifestyle factors that may trigger the onset of gout, such as:
- Being overweight or obese
- Ketosis associated with fasting or low carbohydrate diets
- Having high cholesterol, diabetes or insulin resistance
- Hypertension (high blood pressure) or the use of diuretics
- Consuming a large amount of alcohol
- A diet high in purines (such as meat, sweetbreads, offal, shellfish, and fructose)
- Have high levels of uric acid in the blood
- Medical Treatment
Common Symptoms of Gout
- Intense joint pain
- Joint swelling
- Skin over the joint may look red and shiny
- Affected joint may be hot to touch
- Tophi (lumps of crystal that form under the skin) may occur in people who have repeated attacks.
Treatment of Gout
The first step in treating your gout is to control the pain and inflammation of the attack.
This may involve the use of medication, cold packs on the swollen joint, and resting.
Once you have the attack under control, your doctor may prescribe medications that lower the levels of uric acid in your blood.
The goals of treatment are then to prevent future gout attacks, manage the pain of current acute attacks and prevent the formation of tophi.
Lifestyle Strategies to reduce gout onset/symptoms:
Reduce and maintain weight within healthy range
As gout is more common in individuals who are overweight, losing some excess weight can help to reduce the risk of further attacks.
However, rapid weight loss can increase uric acid levels and may trigger an attack.
In order to maintain weight loss, weight loss of 0.5-1kg per week is recommended.
By losing some weight, it will assist in your gout management long term.
Drink alcohol in moderation and avoid binge drinking
Alcohol can increase uric acid in the blood, particularly beer and spirits.
If you choose to drink, keep the amount alcohol you consume to 1-2 standard drinks per day.
During flare-ups of gout, it is best to avoid alcohol altogether. To try and prevent future gout attacks from occurring, try to stick to the Australian Alcohol Guidelines.
The guidelines recommend consuming no more than 2 standard drinks per day, with 2 alcohol-free days per week.
Eat regular meals
Skipping meals or fasting can increase uric acid levels, therefore you should eat small-portioned and regular meals or snacks throughout the day. Also, we recommend that you should limit your intake of high sugar and high fat foods and drinks to assist with gout management. By doing so, this will also help to lose some excess weight if necessary.
purine containing foods and drinks
Purines in certain foods break down into uric acid, therefore we recommend that it is wise to limit your mean intake of meat, poultry
low fat dairy
If you are consuming 2-3 serves (1 cup) of
If you are consuming 2-3 serves of low fat Dairy per day as part of a balanced diet, this has been linked with a decrease in uric acid levels and consequential reduction in the risk of gout.
Increase fluid intake
Increase fluid intake to 2- 2 ½ L per day to help dilute the uric acid levels that are removed in urine as if you have too much uric acid in your urine this can cause kidney stones, and nobody wants those!
Recent studies suggest that eating 1-2 serves of cherries per day can help to reduce the risk of gout flare-ups.
1 serve = ½ cup (10-12 cherries). It is best to stick to around 2 serves of fruit (most importantly including cherries of course!) in your daily intake.Bethany Bambrick, Exact Physiology, Dietitian
If you would like more information regarding gout or would like a more tailored meal plan to suit your lifestyle, contact us today to arrange an appointment.
Aim to complete at least 30 minutes of physical activity on most, if not all days of the week. It is important to follow the recommended Australian Physical Activity Guidelines which include 150-300 minutes of moderate physical activity, or 75- 150 minutes of vigorous physical activity. This should be in the form of any cardiorespiratory (i.e. walking, jogging, cycling, swimming or dancing) and muscle strengthening exercises. It is also further recommended that you perform strength-based exercise on at least two days each week.
Gout is not fun in any way, but by small modifications to your lifestyle, it is certainly something that is avoidable.
If you think you might have Gout and would like some help treating it, please click the Make an appointment button at the top of this page.
PEN: the global resource for nutrition practice: Gout, Krause’s Food & the Nutrition Care Process by L. Kathleen Mahan, Janice L Raymond, Sylvia Escott-Stump