Sort out your gout, with cherries on top

Historically, gout was referred to as the rich man’s disease. Images of a rotund gentleman feasting at a banquet of game and guzzling his port spring to mind.

Thankfully the strict administration of barley water and barley bread, aka the Gout Diet, is a thing of the past too.

Gout is a type of arthritis. It occurs when high levels of uric acid in the blood causes crystals to form and accumulate around a joint. These crystals cause swelling, inflammation and acute pain.

The joint between the ball of the foot and the big toe is the one most usually affected, but gout can also occur in fingers, ankles and knees.

Uric acid
The amount of uric acid in the body depends on the amount your body makes on its own, the amount your body gets rid of and the amount your body produces when it breaks down purines. Purines occur naturally in your body, but you also get them from eating certain foods.

More often than not, high uric acid levels occur because the body has difficulty getting rid of uric acid. Gout is principally managed with medications that are anti-inflammatory and reduce uric acid levels.

However, what you eat can also lower the amount of uric acid your body makes and may even help your body to excrete uric acid.

While there is no need to avoid particular foods completely, it is recommended you limit foods that are high in purines while taking gout medication. There is some evidence to suggest that this may help prevent further gout attacks.

If you are overweight, losing some excess weight is important too. Abdominal obesity can be accompanied by insulin resistance and high insulin levels. When insulin levels are high, the kidneys excrete less uric acid and it builds up in the blood, increasing the risk of a gout attack.

Diet changes
Making changes to your diet can help manage your weight and other medical conditions such as high blood pressure, high cholesterol and metabolic syndrome that generally co-exist with gout.

Your doctor or dietitian will take into account your own medical history when tailoring a suitable approach to help limit your body’s uric acid production and increase its elimination.

Diet is not likely to lower the uric acid concentration in your blood enough to treat your gout without medication, but it may help decrease the number of attacks and limit their severity.

Following the guidelines in the panel below and limiting your calories, particularly if you add moderate daily exercise, can improve your overall health by helping you achieve and maintain a healthy weight.

Paula Mee is a dietitian at Medfit Proactive Healthcare and a member of the Irish Nutrition and Dietetic Institute.

pmee@medfit.ie; @paula_mee