Gout is a clinical disorder that can result from the deposition of urate crystals (monosodium urate monohydrate), a form of uric acid, into your joints. Gout has been recognised as a disease since ancient times, and a link with nutrition has always been assumed. Journals from the 16th century, for example, describe gout as a disease of ‘overindulgent lifestyle’.

Urate crystals form either because of an excess production of uric acid, or because of a decrease in its removal as waste from the kidneys.

Purine-rich foods. The most significant nutritional factor that increases uric acid levels is the consumption of purine-rich foods, such as: meat (especially organ meats); seafood; yeast products (including alcoholic products like beer); legumes (peas and beans); oatmeal and wheat bran; some vegetables (spinach, cauliflower, asparagus, mushrooms); and cola drinks.

It may be an oversimplification to advise gout sufferers to keep away from excess protein, even though the foods mentioned above are mainly proteins. Recent studies have not established a direct relationship between uric acid levels and protein intake; indeed dairy foods appear to lower blood urate levels.

Alcohol. That excess alcohol consumption is involved in gout has been known since ancient times. Alcohol both increases production and decreases excretion of urates. The more you drink alcohol, the higher the risk of gout attack. Among alcoholic beverages, beer has a greater association, probably because it is a source of purine (from yeast).

Antioxidants. There are some indications that gout is a pro-oxidant condition for which antioxidant nutrients may have a role. The evidence for this is not yet clear and there is yet nothing definitive supporting the use of antioxidants for treating gout. A diet with plenty of fruits and vegetables, which are rich sources of antioxidants, appears to help lower the risk of gout, but this could also be because such diets help to reduce consumption of uric-acid-contributing foods; such diets are also alkalinising.

Xanthine Oxidase Inhibitors. Some nutritional elements inhibit the enzyme xanthine oxidase, which is involved in converting xanthine to uric acid. Folate is seen as an inhibitor, albeit weak. Curcumin, an active component of the spice turmeric, is clearly an inhibitor to xanthine oxidase.

Calcium and Vitamin D. The relationship of gout to calcium and vitamin D is complex. Gout is associated with insulin resistance, low vitamin D levels, and inflammation, all of which interfere with muscle synthesis. One study has found that patients with gout have lower vitamin D3 levels correlated with higher urate.

Dietary approaches to gout have focused on secondary prevention, i.e., minimising the risk of further attack in persons who have already had one. Most medical recommendations on gout include: increasing fluid intake, moderating intake of alcohol and purine-rich foods, and reducing weight where appropriate. Research may someday pinpoint the role of free radicals and antioxidants and vitamin D.

Gout Treatment

Gout is one of the most treatable forms of arthritis, and with proper treatment, you need not have any long-term consequences. Medications are available to relieve the pain and inflammation of acute bouts of gouty arthritis. For long-term care, you may need to take medications to treat the underlying metabolic disorder along with making such lifestyle changes as avoiding alcohol (primarily beer) and foods high in purines and increasing intake of dairy foods.

If you have a gout attack, many doctors recommend oral doses of ibuprofen or naproxen, available in both prescription and nonprescription versions, or other anti-inflammatory drugs. If you are taking aspirin, your doctor may recommend that you stop it temporarily. Aspirin can slow the elimination of uric acid and make gout worse. But if you take a low dose of aspirin to prevent other problems such as a heart attack, check with your doctor before stopping it.

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