Written by Helen Chu, MS RDN, Registered Dietitian
Gout is one type of arthritis that affects the joints -- ankles, wrists, hands, knees, elbows and most often in the big toe. Gout attacks occur when the level of uric acid in the body builds up and crystals are formed in the joints. This leads to inflammation, swelling and severe pain.
Most uric acid is produced by body; the rest from food in the form of protein compound - purine. Some food contain purine. When the body breaks down purine, uric acid is formed. Uric acid builds up in the blood especially when little is excreted by kidneys. Medication is needed to manage the symptoms and to lower the uric acid level.
Daily eating habits and lifestyle can help to lower the chance of attacks. Here are some suggestions:
* Avoid overweight
Research suggests losing weight even without a purine restricted diet, the level of uric acid can be lowered. Keeping the weight down reduces pressure on joints. However rapid weight loss by adopting a low-calorie high-protein diet is not recommended as it may increase the uric acid level. Choose a plan that provides a steady 1 - 2 pounds weight loss per week. Regular exercise can help control weight.
*Drink plenty of fluids
Drink 8 to 12 cups of liquids (preferably water) daily helps body remove excessive uric acid.
*Limit take-in of alcohol
Beer is closely associated with increased risk of gout attack. Talk to the doctor to find out how much alcohol is right for you.
* Moderate protein intake
Choose lean meat. Can have fish, poultry, eggs and low fat cheese at 4-6 oz per day. If experiencing recurring attacks, avoid red meat, such as beef, pork and lamb.
* Choose the right vegetables and legumes
Although beans, peas, lentils, soy beans, mushroom, cauliflower, spinach contain purine, they are not linked with the increase in uric acid or the flaring up of gout.
*Avoid high purine protein foods
High purine protein foods increase the level of uric acid in the blood. Below are examples of high purine protein foods which should be avoided:
Anchovies, organ meats, such as liver, kidney, brains, sweet breads, tongue
Game meats, such as duck, rabbit, venison
Seafoods, such as herring, sardine, scallop, mackerel, mussel
*Avoid fructose corn syrup beverages
Sweet drinks, such as soda, specialty coffee/tea, fruit drinks, may not contain purine, but in some cases fructose corn syrup is found and it increases the flaring of gout flare. Check carefully the ingredients on the label of beverages of the drinks contain fructose corn syrup.
*Dash eating plan to keep the heart healthy
Dash (dietary approach to stop hypertension) diet emphasizes high intake of fruits, vegetables, nuts, legumes, low fat dairy product, low sodium and avoid red meat and processed food. The Dash eating guidelines helps prevent hypertension and heart disease and is highly recommended.
In a recent large-scale study (published in British Medical Journal May 2017), the findings show that Dash diet is associated with the lowering of uric acid level. Thus the authors of study suggest that Dash Eating Plan may offer a preventive measure for risk of developing gout. The study also highlights the added benefit of DASH diet beyond heart health.
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