On the Table

Diet can help you avoid painful gout

CorrespondentMay 27, 2009 

For some people, arthritis is a pain in the big toe.

They have gout, a form of arthritis characterized by sudden bouts of intense, burning pain -- usually at night -- often accompanied by stiffness and swelling. Oddly enough, the joint in the big toe is the most common site of the attack, but gout can also affect the ankles, knees, hands and wrists.

Gout is more common in men than women and most commonly develops between 40 and 50 years of age. Attacks last from a few days to more than a week.

The source of the pain and other symptoms of gout is a buildup in the blood of uric acid, which can form sharp crystals that collect in the joints. People who are overweight or heavy drinkers of alcohol are more likely to have high uric acid levels.

Certain medications, such as aspirin and thiazide diuretics, and medical conditions such as high blood pressure and hypothyroidism are also associated with increased blood levels of uric acid.

What you eat may make a difference, too.

Some foods are rich in purines, substances that break down into uric acid in the body. Examples include organ meats such as liver, brains and kidneys. Some oily fish, including mackerel, herring and anchovies, are also high in purines.

At one time, treatment of gout included strict adherence to a low-purine diet. Diet has largely been replaced by drug therapy.

But diet and lifestyle changes may still make a difference in reducing the symptoms of gout for some people. Several of those changes are good for your health regardless of whether or not you have gout.

Specific diet advice includes:

Drink plenty of fluids. Water is the best choice. Staying well-hydrated helps to dilute blood uric acid levels.

Eat less animal protein. All animal proteins raise uric acid levels, and reducing meat intake is good for overall health.

Avoid alcohol. Men should limit it to two drinks per day; women to not more than one a day. Avoid it completely if you are having an attack of gout.

Eat a diet high in fiber-rich carbohydrates. A few plant foods -- asparagus, mushrooms, and dried beans and peas -- are high in purines. But beans and peas are otherwise good for you, so focus your efforts on other dietary measures first.

If you are overweight, work at losing extra pounds to reduce pressure on joints. Resist fasting or low-carb, high-protein diets to lose weight, though, because they can raise uric acid levels.

Send questions and comments to suzanne@onthetable.net.

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