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Improve
your diet to reduce gout
May 27, 2009
Suzanne Havala Hobbs
For
some people, arthritis is a pain in the big toe.
They’ve got 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 build
up 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 Diet has largely been replaced by drug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 now.
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 fewer animal proteins. Purine-rich organ meats and oily
fish are a good place to start. All animal proteins raise
uric acid levels, though, and reducing your 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. Less is better. 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. Since dried beans and peas are
otherwise so good for your health, focus your purine-reduction
efforts primarily on other dietary measures first.
Other lifestyle measures can also reduce symptoms of gout.
If you are overweight, work at losing extra pounds to reduce
the pressure on your joints. Establish a habit of regular
physical activity and cut back on the amount you eat.
Resist the temptation to try fasting or low-carb, high-protein
diets to lose weight, though, because they can raise uric
acid levels.
Find more information about gout online at the National Institute
of Arthritis and Musculoskeletal and Skin Diseases, a unit
of the National Institutes of Health at http://www.niams.nih.gov/.
Maximize diet and lifestyle changes that may help bring relief
to your big toe. The benefits will likely extend to all of
you.
Suzanne
Havala Hobbs is a licensed, registered dietitian and clinical
associate professor in the Department of Health Policy and
Management and the Department of Nutrition in the UNC Gillings
School of Global Public Health. Send questions and comments
to suzanne@onthetable.net.
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