Gout

By Barbara Gordon, RDN, LD
Gout

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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 waken you. Sometimes the gout episode is tied to a stressful event or an illness. For most people, gout episodes clear up in three to ten days without any treatment. 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 the result of a breakdown of purines, which is a substance found naturally in body tissues and many foods. For most people, uric acid dissolves in the blood and travels out of the body in urine. However, for people with gout, the uric acid builds up in the blood and hardens into small crystals. The crystals collect in the joints and under the skin, which causes gout.

There are many reasons someone might get gout:

  • Their body may make too much uric acid.
  • Their kidneys may not be working correctly, and the uric acid is not being transported out of the body.
  • They may be eating too many high-purine foods, which can lead to a buildup of crystals of uric acid in their joints.

Who is at Risk for Gout?

Gout is more common among men than women. The risk for developing gout increases with age — 10 percent of men and 6 percent of women 80 years or older have gout. Having an "obese" body mass index and inactivity also are risk factors. And, with an increase in body mass index and inactivity among younger men and women, gout is becoming more common among individuals in their thirties and forties.

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 major health problem that requires long periods of bed rest can provoke a gout attack.
  • Medicines: Certain drugs also increase your risk, such as diuretics, aspirin, niacin, tuberculosis medicines, chemotherapy and some Parkinson’s drugs.

 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. Self-management is the key to staying healthy. Treatments include both medicines and lifestyle changes.

The first 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.

The second 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. Foods to restrict include:

  • Alcoholic beverages, especially beer.
  • Some fish, seafood and shellfish.
  • Some meats and organ meats.

Certain vegetables, grains and dairy products also contain purines. Research shows that these foods do not cause gout attacks. In fact, low-fat dairy foods may help prevent gout attacks.

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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