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Gout

Gout is a type of chronic disease with intermittent painful arthritis that occur predominantly in the toes, foot, ankles or knees. Gout attacks are episodes of sudden pain in the joint, which can cause severe limitation in joint function (e.g. walking, climbing, etc). Initially, gout attacks usually affect one joint with complete resolution of symptoms between attacks. However, gout attacks can involve multiple joints at a later stage.1

What causes Gout?

Uric acid is produced when purines, which are chemical compounds naturally found in your body (component of DNA found in cells), food and drinks are broken down. Gout is caused by a build-up of an excess of uric acid in the blood (i.e. hyperuricemia), which would form crystals at the joints and tissues, resulting in pain and inflammation.1


Dietary tips to manage Gout

The general principles of a gout diet is similar to healthy-diet recommendations:2


Choose unrefined carbohydrates

Consume more fresh fruits, vegetables and wholegrains (e.g. brown rice, oats, quinoa, etc). These foods not only help to improve your bowel movement and provide a steady source of energy, it can also help to lower the occurrence of gout attacks. Avoid food that contains high-fructose corn syrup (e.g. ketchup, snacks, candies, etc) and limit the consumption of sweetened beverages. 


Limit intake of bad fats (e.g. saturated fat)

Minimise your intake of saturated fat from red meat, fatty poultry and high-fat dairy products (e.g. butter). Instead, opt for foods that are high in good fats (e.g. fatty fishes, unsalted baked nuts, chia seeds, chia seed oil, sacha inchi seed oil, sacha inchi seeds, etc).2


Choose plant or lean protein

Opt for lean meat or skinless poultry. If you are vegan and require a convenient source of protein, you can also consider obtaining it through natural plant protein powder too. 


Minimise intake of high-purine foods 

Food such as liver, kidney, beef, lamb and pork. anchovies, shellfish, sardines, tuna, beer and distilled liquors are relatively high in purine and can contribute to high level of uric acid.2


Drink more water

Drink at least 2L of plain water per day.


Vitamin C

Some studies have shown that Vitamin C may help to lower uric acid levels. Hence, individuals with gout may benefit by adding citrus fruits and foods that are high in Vitamin C (e.g. camu-camu berry powder, strawberries, sun-dried mulberries, goji berries, etc) into their diet.3


Weight loss

Being overweight/obese increases one’s risk of developing gout. By reducing your weight to a healthy level (i.e. BMI = 18.5 to 22.9 kg/m2), the number of gout attacks can be reduced even without a purine-restricted diet. Furthermore, losing weight also help to reduce the overall stress on joints.

Conclusion

Following a gout diet can help to limit uric acid production and increase its elimination, thus reducing the number of gout attacks and limiting their severity. However, a gout diet isn't likely to be adequate to lower the uric acid concentration in your blood enough to treat your gout without medication. 

If you have gout, it is essential to seek treatment to lower the uric acid levels in your blood. Consult an orthopaedic surgeon to consider suitable treatment options for you.


References


  1. Ministry of Health Singapore. 2019. Gout: Causes and Treatment. Available at: https://www.healthhub.sg/a-z/diseases-and-conditions/753/What-is-gout [Accessed 29 April 2021] 


  1. Mayo Clinic. 2020. Gout diet: What’s allowed, what’s not. Available at: https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/gout-diet/art-20048524 [Accessed 29 April 2021]


  1. Harvard Health Publishing. 2019. Lifestyle changes to reduce the risk of gout attacks. Available at: https://www.health.harvard.edu/pain/lifestyle-changes-to-reduce-the-risk-of-gout-attacks  [Accessed 29 April 2021]


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