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Contributors: Sarah Klemm, RDN, CD, LDN and Barbara Gordon, RDN, LD

Published: May 05, 2022

Reviewed: May 02, 2022

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Gout, a type of arthritis, is a very painful condition that occurs in episodes or attacks. During an attack, joints become stiff, red, hot and tender. The inflamed joints swell, which limits function. Gout can affect any joints in the body including the feet, arms and legs. Often, the first joint affected is in the big toe.

Gout attacks typically come on suddenly. They tend to start at night and extreme pain and swelling may wake you. Sometimes the gout episode is tied to a stressful event or an illness. Gout episodes may last anywhere from a week or two. There can be long periods between gout attacks — months or even years. However, as the condition advances, so does the frequency of the attacks. Without treatment, gout can cause permanent damage to the joints and kidneys.

What Causes Gout?

Gout is caused by the buildup of uric acid crystals in the joints. Uric acid is naturally produced when certain foods are broken down by the body. For most people, uric acid can be removed from the body on its own. However, for people with gout, the uric acid builds up in the blood and hardens into small crystals. These crystals collect in the joints and under the skin which cause pain.

Who is at Risk for Gout?

Gout is more common among men than women. It’s also more common among those with an overweight or obese body mass index, certain health conditions, (such as diabetes, reduced kidney function, and heart disease), and more likely to develop after menopause.

Other risk factors include:

  • Genetics: If someone in your family has gout, you are at higher risk for developing this condition.
  • Dietary factors: People who eat lots of purine-rich foods, especially high intakes of meat, seafood and alcohol, are at higher risk.
  • Toxin exposure: Individuals who have been exposed to lead are at higher risk.
  • Illness or major surgery: A sudden illness, surgery, or joint injury can provoke an acute gout attack.
  • Medicines: Certain medications also increase your risk, such as diuretics, aspirin, and niacin.

Treatments for Gout

Gout cannot be cured. However, there are treatments that can help you manage the condition and reduce the frequency of the attacks. Treatments include both medicines and lifestyle changes.

One lifestyle change is to get moving and take care of yourself. Excess body weight leads to increased production of uric acid. Getting to and maintaining a healthy weight can help reduce your risk for gout flare-ups.

Another lifestyle change is to follow a well-balanced eating plan and to stay well hydrated. Limit foods and beverages high in purines, especially during an attack and refrain from drinking alcoholic beverages.

Certain vegetables, grains and dairy products also contain purines. However, research shows that these foods do not cause gout attacks. In fact, low-fat dairy foods may help reduce uric acid levels.

What to Eat

A low-purine diet should be personalized to fit an individual’s dietary needs and food preferences. Some people with gout may need to limit moderate-purine foods in addition to high-purine foods. A registered dietitian nutritionist can help design a gout-friendly diet that is nutritious and tasty. Find an RDN in your area.

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