Gout explained

Published January 3, 2021, 12:47 AM

by Dr. Jose Pujalte Jr.

IF SYMPTOMS PERSIST

Dr. Jose Pujalte, Jr.

“I tell you my blood runs out on the floor of this oak, gout upon gout.” – D.H. Lawrence (1885-1930), English novelist “Under the Oak” (1916)

In 2020, North Korean Supreme Leader Kim Jong-un was presumed dead when he disappeared from the public eye. In 2014, the same thing happened but state media reported he was merely suffering from “an uncomfortable physical condition.” He was seen again limping, with a walking stick. It must have been a bout of gout.

Gout. It is a form of arthritis that is very much related to the diet because of excessive uric acid in the blood. In an acute attack of gout, the joints become inflamed (especially the joint of the big toe) because uric acid crystals have already formed and deposited in them. Therefore, it makes sense to reduce the intake of food that will form high uric acid. These are food containing purine.

Avoid high purine food. These are very high in purine (150-100mg/100gm) and should not be eaten by the gout-prone:

  • Anchovies (dilis)
  • Sardines
  • Mackerel
  • Brain
  • Liver
  • Kidney
  • Heart
  • Scallops
  • Mussels

Also high in purines (50-150mg/100gm) are: crab, shrimp, asparagus, cauliflower, mushrooms, spinach. Lowest in purine (0-50mg/100gm) are: milk, nuts, eggs, cheese, pasta, bread and cereals, chocolate, and butter/margarine. The healthy average intake of purine-containing should be 200mg or less.

How about alcohol? Alcohol is bad news for gout sufferers for several reasons. The first is that alcohol is converted into lactic acid in the body and this interferes with the removal of uric acid by the kidneys. Second, many beers already contain a large number of purines from the fermentation process. Alcohol in fact stimulates the liver to produce uric acid. So it comes as no surprise that a night of heavy drinking may mean a gout attack the next day. The healthy recommendation is to limit alcohol to 21 units for men or 14 units for women, per week. A unit of alcohol is a half-pint (284ml) of beer, 125 ml of wine, 25 ml of spirits, or 50ml of fortified wine.

And water?The recommendation is 8 to 10 glasses of water each day (1-1.5 L) to flush the kidneys, reducing the likelihood of uric crystals from forming.

Eating healthy.Even if you are not suffering from gout, a healthy diet will still mean plenty of vegetables and fruits, moderate amounts of meat, chicken, fish and moderate amounts of milk and dairy products. Don’t forget bread and cereals. Recently, studies show that those with the highest intake of Vitamin C (both dietary and supplement) have the lowest risk of developing gout. Vitamin C helps remove uric acid from the kidneys.

You can learn more from gout from the UK Gout Society (http://ukgoutsociety.org)

E-mail [email protected]

 
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