Overview of Gout
Gout is one of the most painful types of arthritis and is characterized by sudden, severe bouts of redness, swelling, warmth, pain, and inflammation in one or more joints. Most commonly, the big toe is involved but other joints may also be affected initially or become involved later during recurring gout attacks.
Gout results from the deposit of needle-like uric acid crystals in the connective tissue, the joint space between two bones, or both. Uric acid is the end-product caused by the breakdown of purines. Purines are naturally found in the body and in many foods. Excess uric acid in the body causes the formation of uric acid crystals. Excess uric acid (hyperuricemia) in the body can be caused by increased production of uric acid by the body, under-elimination of uric acid by the kidneys, or increased intake of foods high in purines.
Gout can progress through four stages, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS):
Asymptomatic gout - There is elevated uric acid levels in the blood but no other symptoms. Typically, at this stage no treatment is required.Acute gouty arthritis - Hyperuricemia causes deposit of uric acid crystals in the joint spaces. The intense symptoms of pain and inflammation are experienced. Early, acute attacks usually subside within 3-10 days even without treatment.
Interval gout - The period between acute gout attacks when there are no symptoms and there is normal joint function.
Chronic tophaceous gout - The most disabling stage of gout which occurs after many years, associated with permanent damage to the affected joints and sometimes the kidneys.
Gout is typically treated with diet and medications. Lifestyle recommendations are usually made to gout patients. People with gout are advised to avoid alcohol or drink alcohol in moderation, drink plenty of water and fluids, maintain an ideal body weight, lose weight if overweight but avoid fasting or quick weight loss schemes, and to avoid eating foods high in purines.
What to Eat if You Have Gout
Dietary restrictions suggest what people should not eat, but people want to know what they should eat. The American Medical Association recommends the following dietary guidelines for people with gout, advising them to eat a diet:
- high in complex carbohydrates (fiber-rich whole grains, fruits, and vegetables)
- low in protein (15% of calories and sources should be soy, lean meats, or poultry)
- no more than 30% of calories in fat (with only 10% animal fats)
Recommended Foods to Eat
- Fresh cherries, strawberries, blueberries, and other red-blue berries
- Bananas
- Celery
- Tomatoes
- Vegetables including kale, cabbage, parsley, green-leafy vegetables
- Foods high in bromelain (pineapple)
- Foods high in vitamin C (red cabbage, red bell peppers, tangerines, mandarins, oranges, potatoes)
- Drink fruit juices and purified water (8 glasses of water per day)
- Low-fat dairy products
- Complex carbohydrates (breads, cereals, pasta, rice, as well as aforementioned vegetables and fruits)
- Chocolate, cocoa
- Coffee, tea
- Carbonated beverages
- Essential fatty acids (tuna and salmon, flaxseed, nuts, seeds)
- Tofu, although a legume and made from soybeans, may be a better choice than meat
Foods considered moderately high in purines which may not raise the risk of gout include: asparagus, cauliflower, mushrooms, peas, spinach, whole grain breads and cereals, chicken, duck, ham, turkey, kidney and lima beans. It is important to remember that purines are found in all protein foods. But, all sources of purines should not be eliminated. Be reasonable with your choices.
