Gout
Risk Factors, Prevention and Wellness Tips

Gout is caused by the presence of too much uric acid in the blood. While having high uric acid levels is not a disease in itself, it becomes a problem when uric acid crystals are deposited in the joints and surrounding tissues.

WHAT ARE YOUR RISK FACTORS?

• Genetic factors. Approximately one in four people with gout have a family history of the disease. In some families, the enzyme that helps the body break down purines is missing.
• Consuming a steady diet of foods that are high in purines. (Foods that are high in purines break down in the body to uric acid.) Purine-rich foods include organ meats, herring, mackerel and trout (beans and peas also contain purines; however, at lower levels).
• Eating to excess. Habitual heavy eaters often develop gout because large quantities of food increase the amount of uric acid produced by the body.
• Taking certain medications. Drugs that reduce the body’s ability to remove uric acid, such as diuretics (water pills), salicylates (ASA, Aspirin®), cyclosporine (Neoral®) and levodopa (Prolopa®) contribute towards the development of gout. Since the vitamin B3 (niacin) raises uric acid levels, it may also contribute toward the condition when used in excess.
• Having certain degenerative conditions that give rise to excessive breakdown of cells. This can increase serum purine levels which in turn increase the amount of uric acid in the body.

Acute symptoms of gout (flare-ups) seem to happen more frequently under certain conditions. These include:

• Having an infection
• Having sustained a joint injury
• Having surgery or being hospitalized
• Overindulgence in alcohol or purine-rich foods
• Being stressed
• Being dehydrated

WELLNESS TIPS

The following tips will help you manage gout more effectively:

• Avoid purine-rich foods. Purines are found in many animal products with the exception of low fat dairy goods and eggs. Organ meats (liver, heart, kidneys, sweetbreads), herring, mackerel, anchovies and trout are particularly rich sources. Broths and gravies are also to be avoided. (Beans and peas contan a moderate amount of purine and should be limited to 1-2 servings per day).
• *Although a peanut is technically considered a legume, its purine content is relatively low (less than 50 mg per 100 grams) compared to other more common legumes such as lentils, peas & beans which has 50 - 150 mg purine per 100 grams
• Control your weight but avoid crash diets and rapid weight loss which can give rise to acute flare-ups.
• Increase your fluid intake. Drinking plenty of fluids helps to dilute uric acid in the urine. This helps prevent the formation of kidney stones made from uric acid. Drink 2 to 3 litres (8 to 12 cups) of fluid each day. Water, herbal teas, vegetable juice, milk, unsweetened fruit juices and soup all contribute to your daily fluid intake.
• Limit alcohol and caffeine. Alcohol contains purines and also interferes with the body’s excretion of uric acid. Beer is particularly bad as it is rich in purines. Heavy drinking also increases body weight and blood triglycerides, two factors also implicated in the development of gout. Speak to your doctor about the use of alcohol. Moderate, drinking (one drink a day) is unlikely to increase your risk of a gout attack.
• Consider vitamin B12. If you take the medication colchicine for gout, consider taking a vitamin B12 supplement, since this drug impairs the body’s ability to absorb B12. Vitamin B12 is found exclusively in animal foods such as meat, poultry, eggs, and dairy products. With the exception of eggs and dairy produce, these foods should be limited due to their purine content. Fortified soy and rice beverages also contain B12.
• Consume black cherries. Recent studies have suggested that intake of black cherries may benefit people suffering from gout (the gout preventative qualities of cherries seem to be the result of plant compounds found in cherries called anthocyanins).
• Add hemp seeds, pumpkin seeds and flax seeds to your diet; these foods contain health promoting omega 3 fatty acids, to reduce joint inflammation; these foods contain health promoting omega 3 fatty acids, to reduce joint inflammation. Increase your intake of fresh fruit and vegetables; cut down on foods rich in hydrogenated oils (trans fats), animal fats, particularly fatty meats (beef, pork) and high-fat dairy products.
• Consult your doctor / healthcare professional about new food-based non-drug supplements formulated to help improve quality of life* such as Recovery with Nutricol®.

The following is a more complete list of purine rich foods:

• Organ meats such as liver, kidney, heart, brain, etc.
• Selected fish and shellfish ie. ikan bilis, sardines, mackerel (including selar, tenggiri & kembong), herring, salmon, fish roe, cockles and mussels
• Meat & yeast extracts such as Bovril, Marmite, Vegemite, essence of chicken, brewer's and baker's yeast
• Meat soups & stock cubes especially Bak Kut Teh
• Game meat ie. venison, black chicken, pigeon, goose, etc.
• Beans & lentils such as tofu, soya bean, bean fillings, etc.
• Selected vegetables ie. spinach, rhubarb, asparagus, cauliflower, mushrooms & peas
• Strawberry, strawberry jam, durian, tomato & tomato products