What is Gout?

Gout is a type of arthritis characterised by sudden and painful bouts of redness, tenderness, and swelling around the joints. More common in men than women, it tends to affect the joints in the big toe but can also impact other parts of the foot as well as knees, wrists, fingers, and elbows. The first bout of gout usually lasts a week or two and although the pain and swelling usually subside, another attack often follows.

What Causes Gout?

Gout is caused by an excess of uric acid in the blood, a condition known as hyperuricemia. Uric acid is a normal waste product when the body breaks down purines—substances that are a natural part of all human tissue and which are also found in many foods. The kidneys process uric acid and excrete it through urine, but when there are elevated levels, the kidneys cannot eliminate it efficiently, and it turns into hardened, needle-like crystals that appear in the joint fluid and lining.

During an acute attack of gout, these crystals invade surrounding tissues and cause the immune system to react by flooding the joints with white blood cells to remove the injured tissue. This influx of white blood cells is what causes the painful swelling. Hardened crystals can accumulate in the joint over time and trigger repeated bouts of inflammation that can eventually destroy the joint.

Risk Factors for Elevated Uric Acid

Many factors cause elevated levels of uric acid, including:

• Increased intake of foods high in purines
• High alcohol consumption, particularly beer and spirits
• Kidney disease
• Obesity
• High blood pressure
• Dehydration
• Certain medications (such as diuretics, aspirin, and chemotherapy for cancer treatment)
• Hereditary propensity towards gout

Uric acid levels tend to increase in men at puberty, whereas women experience this more at menopause, so men usually develop gout at an earlier age (after puberty) than women.

Diet and Gout Management

Foods to Avoid

Certain foods that are high in purines, such as red meat, offal, shellfish, and yeast, appear to trigger gout and should be avoided. However, not all purine-containing foods cause gout. For example, asparagus, spinach, cauliflower, peas, and mushrooms have moderate levels of purines but are less likely to cause an attack of gout than shellfish or red meat.

Foods That May Help

Foods that are thought to be helpful for gout sufferers include:

• Cherries, strawberries, blueberries
• Bananas
• Celery
• Tomatoes
• Parsley
• Kale
• Red capsicum
• Oranges
• Red cabbage
• Pineapple

Low-fat dairy foods, such as skim milk, and essential fatty acids found in flaxseed, nuts, seeds, and oily fish such as tuna and salmon are also considered beneficial for reducing and preventing gout.

Dietary Recommendations

Since purines are found in all protein foods, gout sufferers should aim for a diet high in complex carbohydrates (wholegrains, fruits, and vegetables) and low in proteins (about 15% of total calorie intake).

Remember also to drink plenty of fluids throughout the day and consume alcohol in moderation. If you are overweight, be sensible with weight loss, as crash dieting or fasting can actually increase uric acid levels and trigger an attack of gout.

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