What is gout?
Gout is a type of arthritis. It is caused by having too much of the chemical, uric acid, in your bloodstream.
Uric acid is the waste product created when the body breaks down purines (a type of
protein found in many foods and all of your cells).
Increased levels of uric acid in your blood may occur if, for example, your kidneys cannot efficiently remove it, you have a rare genetic abnormality, or because your diet and lifestyle increase the amount of uric acid that you produce.
If levels of uric acid are high for prolonged periods, needle-like crystals can start to form in your tissues, resulting in swollen, painful joints.
Your diet plays an important role in both causing gout and reducing the likelihood of suffering further painful attacks of gout.
If you already suffer from gout, eating a diet that is rich in purines can
result in a five-fold increase in gout attacks.
Are other illnesses associated with the development of gout?
Elevated uric acid is seen in many other conditions, and people who have gout may also have raised cholesterol, raised triglycerides (a type of fat in your blood), high blood pressure and poor glucose tolerance.
This may make it more likely that you have (or will develop) type 2 diabetes, metabolic syndrome and kidney disease.
In addition, approximately half of all gout sufferers are overweight.
Central obesity (carrying weight around your middle) also increases certain inflammatory substances in your blood. This can further exacerbate gout attacks, as well as putting you at risk of developing heart disease, diabetes and metabolic syndrome.
Can losing weight help my gout?
Losing weight alone can reduce blood uric acid levels, and the number of acute attacks suffered.
Weight-loss will also help to reduce the stress on weight–bearing joints e.g. hips, knees, ankles and feet.
However, it is important to avoid any type of crash dieting, as going without food for
long periods and rapid loss of weight can increase uric acid levels and trigger painful gout attacks.
A combination of balanced healthy eating and regular physical activity is the best way to lose weight safely and maintain a healthy weight
Which foods should be avoided?
As uric acid is made in the body from the breakdown of purines that
come from your diet, it is advisable to reduce the amounts of foods
that you eat that are high purines.
High purine foods include: (avoid)
•Offal – liver and kidneys, heart and sweetbreads
•Oily fish -anchovies, herring, mackerel, sardines, sprats, whitebait
Seafood – especially mussels, crab, shrimps and other shellfish, fish roe, caviar
Moderate purine foods (eat in moderation)
•Meat- beef, lamb chicken, pork
•Poultry- chicken and duck
•Dried peas, beans and legumes- baked beans, kidney beans, soya beans and peas etc.
•Some vegetables- asparagus, cauliflower, spinach
•Wholegrains- bran, oatbran,wholemeal bread
Low purine foods
•Dairy- milk, cheese, yoghurt, butter
•Bread and cereals- (except wholegrain)
•Pasta and noodles
•Fruit and vegetables
How much protein do you need?
Generally you need about 1g of protein per kg of body weight (70kg man only requires 70g of protein daily), unless you on a protein restricted diet e.g., some people with kidney disease may need to restrict their intake.
Are there any foods that are good for gout?
Studies have shown that men whose diet is higher in vitamin C are less likely to develop gout.
Also, taking additional vitamin C as a dietary supplement (500 to 1500mg/day) can reduce blood uric acid levels.This is achieved by helping to remove uric acid from the
body via the kidneys.
If you’re considering supplementing your diet, always discuss this with your doctor as vitamin C can (rarely) interact with prescribed medications.
High doses of vitamin C can also cause loose stools in some people.
Eating healthily is key
Eating a balanced diet is important for everyone. A healthy diethelps to control weight and provides all the necessary nutrients needed for maintaining good health.
A variety of foods from the four main food groups should be eaten every day, this means:
•Plenty of fruit and vegetables
– it’s very important to achieve at least 5-a-day, as fruit and vegetables provide fibre, vitamins, minerals and phyto nutrients essential for good health
• Plenty of bread, other cereals and potatoes
– try to eat some whole grains, and use the skin on potatoes to ensure you get the vitamins, mineral and fibre you need
•Moderate amounts of meat, fish and alternatives
– avoid eating large portions – beware restaurants often serve 8oz of meat
for a main
•Moderate amounts of dairy products
– the recommended amount is three portions of dairy products daily e.g. 200 ml glass of milk, a pot of yoghurt and a 30 mg (matchbox-sized) piece of hard cheese
•Reduce or eliminate highly processed foods and drinks
Should I drink lots of water?
Yes, drinking fluids reduces the likelihood of crystals forming in the kidneys. As a general rule, drinking 8 large glasses of fluids a day (1.5 litres) is recommended. All drinks, except alcohol, count towards your fluid intake, including caffeine-containing drinks such as tea and coffee. Caffeine can act as a mild diuretic, which means it causes you
to pass urine more often.
Can I drink alcohol?
Drinking alcohol can increase your risk of developing gout and can bring on a sudden attack if you are already a gout sufferer. Alcohol can raise the level of uric acid in the blood in a number of ways and so trigger a gout attack. Many beers contain large quantities of purines from the fermenting process and alcohol stimulates the production of uric acid by the liver. More importantly, however, alcohol is converted in the body to lactic acid which interferes with the removal of uric acid from the body by the kidneys.
While it is certainly possible for people with gout to remain well without becoming teetotal, reduction in alcohol consumption is very important particularly if you are drinking more than the recommended healthy limit of 21 units per week for men or 14
units per week for women.(Recommended by UK society for Gout)
1 unit of alcohol is provided by:
•½ pint of standard strength (3-4% alcohol by volume) beer, lager or
•125ml glass of wine (11%, 100ml glass of stronger wine)
•Single measure of spirits (25ml)
•Single measure of sherry or fortified wine (50ml)
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