Gout Prevention: Lifestyle and Diet Changes to Reduce Your Risk of Gout - MalaysiaChronic Conditions

Gout Prevention: Lifestyle and Diet Changes to Reduce Your Risk of Gout

Lifestyle changes and dietary choices can help to prevent gout. Here are some changes you and your loved ones can make to reduce the risk of painful attacks.

What is gout?

Goutis the most common type of inflammatory arthritis. Gout pain can be very intense. A gout attack usually includes local swelling, heat, redness, and tenderness in a joint, especially in the foot, ankle, or knee. Some patients have fever and chills as the first warning that an attack of gout is coming on. The pain is caused by the crystals that form in and around the joints.

Gout is more common in men and the risk factor increases with age. It occurs in people who have high levels of urate (uric acid) in their blood. Despite this, having some uric acid in your bloodstream is no cause for concern. Our body creates urate daily as it breaks down purines. Purines are chemicals that are naturally created in our body but they are also present in some food that we eat. It is where uric acid originates from.

As urate increases, our body gets rid of all the excess through the kidneys and in our urine. The problem will only occur when our body is making too much uric acid or our kidneys are unable to get rid of enough of it. As the body fails to stabilise the level of urate, the crystals will begin to form. They mainly occur in and around firm joint tissues such as the cartilage. Crystals can also appear under the skin and may even occur in internal organs such as the kidneys.

Lifestyle choices are not the main reason why most people get gout. People always mistake overeating and drinking too much alcohol to be the main causes of gout. While this can make attacks of gout more likely, it is not always the case. On any day, about three-quarters of the uric acid in our system comes from the breakdown of purines produced within our body, while only about a quarter comes from the breakdown of purines in the food and drink we consume.

Risk Factors of Gout

Even though not all people with hyperuricemia (high level of urate or uric acid in the blood) have gout, it is still considered as the main risk factor for this condition. There are a lot of different factors that lead to gout causing hyperuricemia:

Overweight – Excessive food intake increases the body’s production of uric acid. The kidneys will have to work extra hard to eliminate it and increase the risk of a gout attack. A patient diagnosed with gout will be advised to make lifestyle changes that will enable him or her to lose weight
Consuming a diet high in purines – Purines can be found in red meat, shellfish, sugary soda, and alcohol, especially beer. When you are eating too many fatty meals like burgers and cola from fast-food chains, for instance, the body will struggle to eliminate uric acid naturally and gout can occur. Having more than two alcoholic drinks per day also increases your risk
Recent hospital stay – Recent surgery or trauma has been associated with an increased risk of gout. This is because fluid levels often fluctuate during hospital stays, and patients might also be put on diuretics depending on the nature of their illnesses
Medications – Diuretic medications taken to help lower high blood pressure can raise uric acid levels. Patients with rheumatoid arthritis or psoriasis who take drugs that suppress the immune system also have an increased risk of getting gout,. If a patient is diagnosed with gout, a doctor might change their medications to ensure lower levels of uric acid. The use of other medications such as salicylates, cyclosporine, niacin and levodopa can also lead to gout.
Genetics/Gender/Age – If you have family members with gout, you have higher chances of getting it but gout is more common in men until the age of 60. It is fairly rare in women until they reach menopause It is believed that estrogen protects women until that point.

How Can A Gout Attack Be Prevented?

The key element to gout prevention is diet. Gout patients are advised to monitor their daily food intake. They should avoid foods that are more likely to induce attacks. Losing weight can also be very helpful which is why physical activities are highly recommended. However, proper diet and weight loss are not enough to keep gout complications at bay, medications will still be needed to get to their uric acid goal.

Role of Diet

Dietary control in gout patients is most helpful for those who were just starting medication to lower their level of uric acid. They should try to avoid eating large quantities of foods that are high in purines. These foods are not to be removed completely from the diet but consumed in moderation:

Red meat, game and offal such as venison, kidneys, rabbit and liver
Seafood, particularly oily fish such as anchovies, herrings and sardines as well as shellfish like mussels and crabs
Foods rich in yeast extracts such as Marmite, Bovril and Vegemite
Processed foods and drinks such as nuggets, sausages and carbonated drinks
All types of alcohol cause more uric acid to be reabsorbed by the kidneys, raising blood uric acid levels. Beer, in particular, has a high purine level and so contributes to blood uric acid elevation. However, drinking a bit of wine does not appear to increase the risk of triggering an attack.

While the foods that contain a high level of purines will put you at a high risk of gout, there are so many other foods in different categories that can help you keep gout complications in check:

Water – Drinking at least two litres of water a day will help decrease the chance of stones forming if you have gout and a history of kidney stones,
Fruit – While fruit and fresh fruit juices contain sugar, the benefits of eating fruit outweigh the negatives. Instead, try reducing how much sugar you consume from other sources
Protein-rich foods – Protein is an important part of your diet commonly sourced from meat and fish. Just stick to your diet and get your protein from other sources like soybeans, eggs, lentils or dairy products instead.
Vitamin C – Make sure your diet includes plenty of fruit and vegetables.Researchhas shown that vitamin C may slightly reduce uric acid levels in people with gout. If you are considering taking vitamin C supplements, ask your doctor if the vitamin C supplements could interact with other medications.
Cherries – Research has shown thatcherriesmay reduce the risk of having an acute attack of gout, particularly when taken with allopurinol.
Skimmed milk and low-fat yoghurt – Drinking skimmed milk and eating low-fat yoghurt may help to prevent attacks of gout.
Oatmeal, wheat germ, and bran – These particular sources of carbohydrates contain moderate levels of purine but are not significant gout risk factors.

Physical Activity

Gout has been associated with being overweight. Physical activity accompanied by diet is highly recommended in keeping the risk of this condition in check. Exercising won’t just reduce the chances of an attack but is also good for your general health and well being. A low-impact exercise program is reasonable for patients with well-established gout, especially if X-rays have demonstrated joint damage in the foot. Gradually build up how much you do until you are doing regular sessions.

As your confidence increases, you can increase the length and intensity of what you’re doing. Just remember that it is never a good idea to exercise during a flare-up of gout, as it could worsen the pain. It is important to rest and recover before you start exercising again after the pain and swelling has subsided.

Exercises that get you out of breath are particularly good for burning calories. Extreme weight loss or starvation diets are not encouraged as it increases cell breakdown in your body, which can raise urate levels. Instead, try fun physical activities like dancing, brisk walking or doubles tennis. It helps to find a sport or exercise which you enjoy and can commit to. Some people find joining a sports club or the gym to be fun and motivational while the rest prefer to be outdoors surrounded by nature and breathing the fresh air.

For gout patients, the emotional effects of this condition can be just as impactful as the physical symptoms. Long term damage and severe pain from the attacks of gout can affect your daily life, resulting in insomnia and affecting mental health. From time to time, your gout may get on top of you. With the help of aprofessional carerin the comfort of your own home, you can recover better and maintain your wellbeing for much longer.

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References

What is gout?. Versus Arthritis website. Available at: https://www.versusarthritis.org/about-arthritis/conditions/gout/. Accessed June 26, 2021.

7 Gout Symptoms and Risk Factors You Should Know. The Healthy website. Available at: https://www.thehealthy.com/arthritis/gout-symptoms/. Updated May 14, 2021. Accessed June 20, 2021.

Gout: Risk Factors, Diagnosis and Treatment. HSS website. Available at: https://www.hss.edu/conditions_gout-risk-factors-diagnosis-treatment.asp. Updated May 18, 2021. Accessed June 20, 2021.

Gout – Causes and Risk Factors What causes Gout? National Heart Center Singapore website. Available at: https://www.nhcs.com.sg/patient-care/conditions-treatments/gout/causes-risk-factors. Updated April 20, 2018. Accessed June 20, 2021.

Possible Risk Factors For Developing Gout. In Stride website. Available at: https://www.queencityfootandankle.com/blog/possible-risk-factors-for-developing-gout. Accessed June 20, 2021.

Vitamin C May Help Prevent Gout. Arthritis Foundation website. Available at: http://blog.arthritis.org/gout/vitamin-c-gout/. Updated June 15, 2021. Accessed June 20, 2021.

Can Cherry Juice Treat or Prevent Gout Flare-Ups?. Health Line website. Available at: https://www.healthline.com/health/cherry-juice-for-gout. Updated October 10, 2018. Accessed June 20, 2021.

How Dairy Products Like Milk, Cheese and Yogurt Can Help With Your Gout. Gout And You website. Available at: https://goutandyou.com/how-dairy-products-like-milk-cheese-and-yogurt-can-help-with-your-gout/. Accessed June 20, 2021.

J.A. Singh, S.G. Reddy, J Kundukulam Risk factors for gout and prevention: a systematic review of the literature Curr Opin Rheumatol, 23 (2011), pp. 192-202

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