There’s no doubt about gout

Do you suffer from gout? Lite n’ Easy Dietitian Ashleigh Jones explains what causes gout and how to prevent gout this festive season.

Are you one of the 1 in 20 Australians that suffer from gout? Historically nicknamed “the disease of kings”, a gout attack feels anything but regal. Debilitating and painful, gout is a form of inflammatory arthritis that most commonly affects joints in the big toe, ankles, knees, elbows, wrists and fingers. Gout occurs when there is too much uric acid in our blood. This causes crystals to form in certain joints, which causes them to become swollen, red and very sore.

What causes gout?

We all have uric acid in our blood, and a little bit is okay, but too much can put us at risk of experiencing gout. Uric acid comes from the breakdown of compounds called purines, which are natural products of metabolism, and also found in certain foods that we eat. The amount of uric acid in our blood is determined by how much our body produces naturally, how much we ingest through our diets, and how much is filtered out of our blood and into our urine.

There are lots of reasons a person might have too much uric acid in their blood – it’s more common in people who are overweight or have underlying medical conditions such as type 2 diabetes, high blood pressure, heart disease, poor kidney function and kidney disease.

How to prevent gout

Many of the factors that put people at increased risk of gout are out of our control – family, history, sex and age. Males are more likely than females to suffer from gout – in fact 79% of people with gout are male. It is thought that this is because females have higher levels of the sex hormone oestrogen, which reduces blood uric acid levels. Age is also an important factor -gout affects 0.2% of Australian men in their 20s, but increases to 11% of men over the age of 85.

While you can’t change your family history, sex or age, if you are susceptible to gout, there are things you can do to help prevent excess uric acid in your blood and thereby reduce your risk of developing gout.

Minimise alcohol

Beer and spirits are particularly high in purines, but all types of alcohol can increase the risk of suffering from a gout attack. Having more than one to two alcoholic drinks within a 24-hour period is associated with an increased risk of attack, and this risk continues to increase as you consume more alcohol. Alcohol can also contribute to weight gain, which is another risk factor for gout and should be completely avoided during a gout attack.

Keep hydrated!

Keeping hydrated will help dilute the uric acid in your blood. Water is always the best choice for keeping hydrated, but fluids such as tea and coffee also count. Sugary drinks, such as soft drinks and fruit juice, may increase your blood uric acid levels and your risk of gout. These beverages can also contribute to weight gain, which is another risk factor for gout, so are best to be avoided.

Aim for at least 2 litres of water per day, which is 8-10 glasses. If your struggle to drink water, you can make it more interesting by adding sliced citrus, berries, cucumber or even some fresh mint.

Keep an eye on meat and seafood intake.

Red meat, organs meats (such as liver and kidney) and seafood (especially shellfish, scallops, mussels and sardines) are all rich in purines, broken down to form uric acid. When consumed in large quantities, these foods have been associated with an increased risk of gout.

Of course, these foods are also very nutritious – they contain many essential nutrients such as omega-3 fatty acids, iron, zinc and protein. They should not be excluded entirely and certainly have their place in a healthy, balanced diet. However, if you have been eating more of these foods lately and noticed an increase in the frequency of your gout attacks, your portion size of these foods would be worth looking at.

Eat your veggies!

While animal sources of purines (meat, shellfish) are associated with increased uric acid levels and risk of developing gout, purine-rich vegetables do not have the same association. Choosing plant-based protein sources is a great way to reduce your intake of red meat and shellfish, if this is a problem for you. Considering that 95% of Australians do not consume enough fruit and veg, sneaking in some extra veg is something we should all be doing!

Low-fat dairy

Study has shown that the consumption of low-fat dairy products is associated with lower uric acid levels and reduced risk of gout. 2-3 cups of low-fat cow’s milk or equivalent seems to be the sweet spot. This just so happens to be in line with the Australia Dietary Guidelines recommendations for consumption of milk and milk alternatives, so it’s a good rule of thumb for all Australians, not just those with gout.

Maintain a healthy weight.

If you are overweight, losing weight can help reduce your risk of suffering from a gout attack. Rapid weight loss can increase the amount of uric acid in your blood, so slow and steady is the way to go – aim for around 0.5kg per week. Weight loss should be achieved through a balanced diet; very high protein, low carb or keto diets can increase the amount of uric acid in your blood and increase the risk of a gout attack.

People who exercise regularly are less likely to experience gout. Exercise is also good for keeping our bones, cardiovascular system and our minds healthy, plus it will help with weight maintenance. If you are susceptible to gout, it’s extra important you take care of your feet and ankles, ensuring that your shoes are supportive and fit well.

Cherries

Now the evidence here isn’t particularly strong, but any excuse to eat cherries will do! Some very early trials have found that consuming ¾ to one cup of cherries each day was associated with reduced serum uric acid levels and a reduced risk of gout in the short term. Given that cherries are only available for a few months of the year, and are very expensive, this isn’t what we would consider a sustainable long-term strategy. But it might be the excuse you needed to splurge on this very special fruit!

Put it all in perspective.

It’s important to keep in mind that while diet is important, diet alone may not be enough to completely prevent future gout attacks. As mentioned, there are many factors beyond lifestyle that also contribute – family history, gender, age and certain medical conditions. If you suffer from gout, it’s important to engage with a GP to help manage the condition, as you may require medications and other interventions. However, the dietary recommendations outlined in this article are beneficial for all aspects of health, not just prevention of gout. So you’ve got nothing to lose – and everything to gain – by giving them a go!

 

How Lite n’ Easy can help! 

The single most important dietary change you can make to be healthier is to eat five serves of veggies and two serves of fruit each day. But it can be hard, which is why Lite n’ Easy’s complete meal solutions are the way to go. You’ll get to eat the right foods in the right portions throughout the day and get your daily 5+2 simply by enjoying our complete solution with a huge range of delicious meals. Give us a call on 13 15 12 or click here to order now.

References

  1. AIHW https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/gout/contents/what-is-gout
  2. NEMO https://www.health.qld.gov.au/__data/assets/pdf_file/0033/148776/general_gout.pdf
  3. The Conversation https://theconversation.com/the-disease-of-kings-1-in-20-australians-get-gout-heres-how-to-manage-it-151759
  4. British Dietetic Association, Dietitians Association of Australia, Dietitians of Canada. Gout evidence summary. PEN: Practice-based evidence in nutrition. Available at pennutrition.com/KnowledgePathway.aspx?kpid=195 6&trcatid=42&trid=3247 [Accessed 9 October 2017].
  5. Khanna D, FitzGerald JD, Khanna PP, et al. 2012 American College of Rheumatology guidelines for management of gout part 1: Systematic non-pharmacologic and pharmacologic therapeutic approaches to hyperuricemia. Arthritis Care Res 2012;64(10):1431–46.
  6. Richette P, Doherty M, Pascual E, et al. 2016 updated EULAR evidence-based recommendations for the management of gout. Ann Rheum Dis 2017;76(1):29–42.
  7. Singh JA, Reddy SG, Kundukulam J, et al. Risk factors for gout and prevention: A systematic review of the literature. Curr Opin Rheumatol 2011 Mar;23(2):192–202.