Gout is an inflammatory form of arthritis that usually affects one joint at a time, usually the big toe joint . It occurs when uric acid builds up in the blood, leading to the formation of uric acid crystals in the joints and other parts of the body.
Symptoms of gout include severe pain, swelling, and redness in and around the affected joint. Gout flares usually last a few days to two weeks after treatment. If left untreated, gout flares can last from several weeks to months.
What is uric acid?
Uric acid is a byproduct of the breakdown of purines in the body. Purines occur naturally in the body and are also found in some foods. As purines break down, uric acid is formed. Uric acid is usually reabsorbed into the body or excreted in urine and feces.
When the body has more purines than it can handle, uric acid builds up in the bloodstream. This is called hyperuricemia. In some people, hyperuricemia can cause gout and / or kidney stones, while others have no signs or symptoms .
Treatment for gout often includes medications, dietary changes, and lifestyle changes , such as weight control and smoking cessation. The foods you eat can have a direct effect on gout attacks.
During a gout attack, changing your diet can help reduce the duration of the flare. Continuing a gout-friendly diet , especially a low-purine diet, can help prevent the risk of future gout attacks up to five times .
The role of cherries in the prevention and treatment of gout has been studied. Its intense red color is due to natural compounds called anthocyanins, which have antioxidant and anti-inflammatory properties.
Studies have shown that consuming cherries can help lower uric acid levels, thereby reducing inflammation and reducing the risk of future gout attacks. The most commonly studied cherries for treating gout are tart cherries. More precisely, the Montmorency or Balaton varieties.
Usually fresh, frozen juices or extracts are consumed, however there is no specific amount to eat per day to prevent gout. Studies vary widely based on the amount of cherries tested, such as a 1/2 cup serving of fresh cherries or 1 cup of cherry juice per day. For cherry extract supplements, it is best to follow the recommended dosage on the label.
Using tart cherry juice for gout
Tart cherry juice can help lower uric acid levels and reduce inflammation in gout. Research is limited, often with few participants and short-term follow-up.
However, a 2019 review of six studies that looked at the effects of drinking cherry juice or cherry extract on gout concluded that consuming cherries was associated with a reduced risk of gout attacks. The researchers noted that larger, longer-term studies are needed to clarify this link .
When choosing tart cherry juice, be sure to look for sugar-free varieties that can help reduce the amount of added sugar in your diet.
Foods rich in vitamin C
Vitamin C is an antioxidant known but less well known for its potential role in treating gout. It can help lower the level of uric acid in the blood.
A prospective study published in 2009 over 20 years involved about 47,000 men and examined their risk of gout based on vitamin C intake. Researchers concluded that higher intake of vitamin C was associated with a lower risk of developing gout, which is a 45% lower when consuming 1,500 milligrams or more of vitamin C per day .
An analysis of 13 randomized controlled clinical trials in people with high blood uric acid levels in 2011 found that supplementation with vitamin C at an average dose of 500 milligrams per day for an average duration of 30 days did not significantly reduce serum levels of uric acid. uric acid. More studies are needed to determine if this amount is significant in reducing the risk of gout .
Foods rich in vitamin C include citrus fruits such as oranges, lemons, and grapefruits, cherries, spinach, kale, broccoli, strawberries, bell peppers, and tomatoes. If you are at increased risk for kidney stones (especially calcium oxalate stones), regular high doses of supplemental vitamin C are not recommended.
Coffee is one of the most consumed beverages in the world, so its effects on health have been studied. Early research suggests that coffee may reduce the risk of gout. However, research shows that it can vary by gender.
A 2015 review of studies found that men who drank 4 to 5 cups of coffee a day had a 40% lower risk of gout, and those who drank 6 or more cups a day had a 59% lower risk compared to lack of coffee. consumption .
Women who drank 1 to 3 cups of coffee a day had a 22% lower risk of gout, and those who drank 4 or more cups a day had a 57% lower risk, compared with no coffee. From this review, the researchers concluded that drinking 4 or more cups of coffee a day lowered uric acid levels and reduced the incidence of gout .
However, there have been no studies examining the effect of coffee consumption on the risk of recurrent gout attacks.
One of the most widely accepted and recommended dietary approaches to treating gout is to reduce your intake of purines from food. By choosing low-purine foods over high-purine foods, you can prevent too high levels of uric acid in your blood .
Additionally, the DASH diet , which encourages the consumption of many low-purine foods, is associated with a lower risk of developing gout. Low -purine foods include certain fruits like cherries and citrus fruits, low-fat dairy products, and plant protein. foods like nuts, seeds and legumes, whole grains, and vegetables.
What are purines?
Purines are natural chemical compounds. There are two types of purines: exogenous and endogenous. Those found in food are called exogenous purines. The purines produced by our body are called endogenous purines.
It is normal for the body to have constant levels of purines. Generally, when the body processes purines, uric acid is produced as a by-product and is reabsorbed into the body or excreted as waste. Eating high purines from foods can raise the level of uric acid in the body, increasing the risk of gout.
Many plant foods are low in purines, making them a great choice for a proper gout diet. Plant-based vegetarian diets reduced the risk of gout in two separate prospective cohort studies .
Some vegetables are higher in purines, although studies have shown that the body can digest them differently and therefore they do not increase the risk of gout and may actually reduce the risk .
A 2019 review of plant-based diets and their relationship to gout found that healthy people can safely tolerate the wise consumption of high-purine foods in plant-based diets. The researchers noted that more research is needed in people with elevated uric acid levels, especially those with chronic kidney disease.
Many plant foods contain many healthy nutrients, such as vitamins, minerals, and fiber, that are beneficial for overall health. Plant-based foods include whole grains, nuts, seeds, beans and other legumes, soy proteins like tofu, fruits, vegetables, nuts, and vegetable oils.
Low-fat dairy products
Dairy products have been found to reduce the risk of gout. In particular, low-fat or low-fat dairy products can protect against recurring attacks of gout. Low-fat dairy products can lower uric acid levels and also have certain anti-inflammatory properties that reduce the inflammatory response to monosodium acid crystals. within the joint .
The Dietary Guidelines for Americans suggest 3 servings of dairy products a day for healthy adults, including low-fat milk, yogurt, cheese, or cottage cheese.
Hydration has many health benefits, even for people with gout. A prospective study from 2017 examined the relationship between water intake and uric acid levels .
After reviewing the data, the researchers determined that water intake was associated with lower uric acid levels in people with gout, possibly due to increased uric acid excretion with increased water intake. However, more research is needed to investigate the more direct effects of drinking water on gout.
A review published in the American Journal of Lifestyle Medicine found that increased sweating, such as after exercising or bathing in a sauna, decreases urinary uric acid excretion, leading to higher uric acid levels. Therefore, researchers recommend drinking plenty of water to avoid elevated serum uric acid levels after sweating activities.
Additionally, the researchers also found that adequate water intake in the 24 hours prior to a gout flare was associated with a significant reduction in recurrent flare-ups of gout .
Water is the best source of hydration, but other beverages such as coffee and foods such as some fruits and vegetables contain water and can contribute to overall hydration. It's best to drink before you're thirsty, but some experts suggest drinking half your body weight in ounces each day for optimal hydration.
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Foods to avoid
Knowing what foods to add to your gout-friendly diet is just as important as knowing what foods to avoid. Below is a brief overview of some of the foods to avoid for gout .
Gout has been associated with alcohol use for centuries. High and frequent alcohol consumption is known to cause chronic hyperuricemia, which increases the risk of gout and gout attacks. For this reason, it is recommended that you completely avoid drinking alcohol, including beer, spirits, and other grain alcohols .
However, recent studies have shown that alcohol consumption should not always be avoided for gout. Wine consumed in moderation and with food may not contribute to an increased risk of gout. Moderate wine consumption is 2 servings (5 ounces) per day for men and 1 serving per day for women .
Foods rich in purines
Avoiding or limiting foods high in purines can help shorten the duration of a gout attack, as well as reduce the risk of recurrent gout attacks. According to a 2014 study, acute use of purines increases the risk of recurrent gout attacks up to five times in people with gout .
High-purine foods include meat substrates such as beef, pork, and chicken liver, game, some seafood such as sardines and anchovies, alcoholic beverages such as beer and spirits, yeast, and some high-fructose foods and beverages, and fructose. fructose corn syrup.
Fructose rich foods
Fructose is a natural form of sugar found in certain foods, such as fruits. Studies have shown that fructose, including high-fructose corn syrup added to certain foods and beverages, can increase serum uric acid levels. Avoiding or limiting foods high in these sugars can help reduce the symptoms and severity of gout.
One of the main natural sugars in many fruits is fructose. However, the link between gout and fruit consumption is unclear. You don't need to avoid all fruits on a gout-friendly diet, although you may need to avoid or limit some fruit juices.
Sugary drinks can increase uric acid levels in the blood. Consumption of sugar- sweetened beverages is significantly associated with an increased risk of gout and hyperuricemia in adults, according to a 2020 review of studies. Should be avoided in case of gout.
Yeast foods and yeast extracts are rich in purines and should not be included in your diet for gout. Foods such as yeast and vegemite supplements should be avoided to lower uric acid levels.
Yeast extract can sometimes be found in convenience foods such as frozen meals, canned soups and stews, soy sauces, and savory snacks.
Get the word of drug information
A healthy, balanced diet based on a variety of colorful whole foods with a restriction of highly processed foods is beneficial not only for gout, but for overall health as well. Identifying individual gout triggers by trying certain foods and how many foods you eat can go a long way in making your diet more flexible.
As always, be sure to speak with your doctor before making changes to your diet or treatment plan.