For many people, gout is a misunderstood disease. There are many misconceptions about what it is, how you get it, and who it affects. It can even confuse doctors! A friend of mine was first diagnosed with a spider-bite when he went to see his General Practitioner about his swollen ankle, it wasn’t until years later (and no cool spidey-powers to show) that he found out he had been suffering from gout in his ankle. If you know someone who has it, or have it yourself, then you understand how detrimental it can be to a person’s life. It affects over 8 million Americans, and hence, it is time to break the stigma and clear up the confusion so that people with gout can get the help they need!
What is Gout?
According to the Mayo Clinic, gout is a complex form of arthritis. Those who suffer from it often have severe flare-ups characterized by pain, swelling, redness, and sensitivity in a specific joint. The most common body part affected is the big toe, though it may affect ankles, elbows, wrists, knees, and fingers. Unlike regular arthritis, which tends to get gradually worse and can cause consistent pain, a gout flareup is often triggered by something specific and leads to several days or weeks of pain. Those who suffer from gout may go months without pain in an affected joint, only experiencing pain when a flare up occurs. In fact, some people have even gone years without a gout attack, while others experience them several times a year.
Gout used to be known as the “disease of kings” because the foods that can trigger it were associated with money and luxury in the past. It just so happens that the foods kings loved to indulge in were high in purine – the ultimate cause of gout. Now, gout is more common, affecting millions of Americans each year, with men being more likely to develop it than women. Moreover, it typically does not tend to develop until later in life – most women do not present symptoms until after menopause. This does not indicate that gout cannot strike earlier in life; while uncommon, gout can affect young adults. If a parent has gout, then a child has a 20% chance of developing gout as well.
What Causes Gout?
Gout occurs when urate crystals form in the body’s joints, which leads to inflammation. These needle-shaped urate crystals are formed when there are high levels of uric acid in the blood. This uric acid can come directly from foods, but is often the by-product of breaking down purine in the body. Not everyone who has high levels of uric acid will develop gout.
Urate Crystals: formed in the joints when there is too much uric acid in the bloodstream.
Uric Acid: a waste by-product created when the body breaks down purines. Uric acid typically gets processed by your kidneys and is released safely from the body as urine. When there is too much uric acid to be disposed of, it can lead to the creation of urate crystals.
Purines: these are organic compounds found in foods. Purines produce uric acid as a waste product when they metabolize.
Purines metabolized → Uric Acid released as by-product → Urate Crystals form in joints.
Life With Gout:
Not only is gout painful, but it can affect a person’s quality of life. Here are some of the ways gout can affect a person’s life.
- Limited mobility: one of the majority symptoms of gout is swelling. The affected joints (often toes, ankles, and fingers) can swell to the point where the joint cannot be utilized. Ankles the size of a tennis ball become too painful to walk on, and swollen fingers lose dexterity. This can leave a person immobilized or bedridden depending on the severity of the attack. People may have to miss work or put off errands while they wait for an attack to subside. In one survey, 73% of people with gout surveyed said they had limited physical activity due to gout.
- Physical Pain: the pain associated with gout is often immense and unbearable. One study in 2010 found that 37% of people with gout would trade a winning lottery ticket to never experience gout pain again!
- Emotional Stress: living with gout can take a toll on a person’s mind as well as their body. Due to the suddenness of which a gout attack can occur, people’s lives are often disrupted by an attack. Social events may have to be postponed, and those affected often have to reach out to loved ones for additional help while they wait out a flare-up. This can leave some people feeling stressed about missing work, embarrassed about having to ask for help, or even depressed by their lack of freedom. One survey by the Men’s Health Network found that, “64% of patients reported feeling stressed during an attack of the disease, 47% are angered, 40% become depressed, 16% feel embarrassment, and 38% said they feel overwhelmed”.
- Long Term Issues: improper treatment of gout can cause chronic problems in surrounding tendons, joints, and tissues.
Foods to Avoid:
There are certain foods that are best to avoid if you want to minimize gout symptoms. These foods are high in purine, which the body converts into uric acid, which leads to gout flare-ups. Fortunately, you do not have to cut out any food groups completely, the key is knowing what to have in moderation, and limiting your intake of potentially triggering foods.
- Red Meat: beef, pork, and lamb, all have high purine levels. If you decide to eat these meats, do so in moderation only occasionally, but avoid making them the center of every meal.
- Shellfish: not all seafood is high in purine, mainly just shellfish and cold water species. Try to minimize your consumption of trout, crab, anchovies, lobster, shrimp, tuna, mackerel, and sardines. Similar to red meat, if you decide to indulge, do so in smaller portions to minimize side effects.
- Alcohol: as the body breaks down alcohol, uric acid is formed, which can then form urate crystals. Beer is especially high in uric acid, thus making it a hazard for gout sufferers. Even non alcoholic beer has been shown to increase the body’s levels of uric acid. On the bright side, most studies show that wine is okay to drink in moderation.
- High Fructose Foods: unfortunately, sugar is in almost everything these days. When you have gout, even the naturally occurring fructose in fruits can be harmful. Be cautious of high-fructose corn syrup hiding in cereals, yogurts, breads, and sodas.
- Organ Meats: liver, kidney, and sweetbreads are high in purines and should be eaten conservatively.
9 Foods That Help:
Thankfully, not all foods are packed with harmful purines, here are the best foods to eat when you have gout, and some that may even help reduce symptoms. And don’t worry – coffee is totally okay! Just try not to get that extra pump of high-fructose caramel sweetener.
Whether you prefer fresh cherries or want to take a cherry extract supplement, having the equivalent of 10 cherries a day can reduce the risk of gout attacks by 35%! Cherries have anti-inflammatory properties that help reduce the swelling associated with gout.
While whole grains contain some amount of purines, the benefits of whole grains in a diet outweigh the moderate levels of purine. Even simple carbohydrates such as white rice and pastas have a minimal impact on gout. So don’t worry, having gout doesn’t mean you have to live without starches – though it is always best to stick with the whole grain option when you have the chance.
Legumes are a great protein alternative if you are cutting back on your red meat consumption due to gout. When reducing one food group (such as red meats) it is vital to make sure you are still getting the proper nutrients you need by adding in another food group.
The vitamin C and antioxidants in fresh fruit are key to any healthy diet. Again, just be cautious of fruits high in fructose. Citrus fruits are best, because they often have lower levels. Stick to grapefruit, oranges, pineapples and strawberries when possible.
Apple Cider Vinegar
Diluting a small amount (about 1 tablespoon) of apple cider vinegar in a glass of water can help reduce uric acid levels in the body. It may take a while to get used to the strong taste – but you only need a little bit to reap the benefits!
Drinking water helps flush uric acid from your body. The average person should drink 8 glasses of water a day, but a person suffering from a gout flare-up should double that amount to help their body flush out as much uric acid as possible.
Some vegetables, like cauliflower, spinach, and mushrooms are high in purines, so you would think to avoid them; however, studies have shown that high-purine vegetables have little effect on gout and are safe to eat! Bell peppers, squash, and cabbage are a few examples of low-purine vegetables.
Ginger has natural anti-inflammatory properties that can help reduce gout inflammation. In fact, applying ginger topically (onto the skin) was found to reduce the pain associated with gout. If you have sensitive skin, it is just as beneficial to take the ginger internally as tea.
The hard truth is that there is no one magical food that will make gout go away. It often takes a combination of changes – medicine, diet, exercise, and rest, to manage gout. Resting, elevating the affected area, and applying ice to the affected area are simple but effective ways to reduce your gout symptoms. Knowing what foods trigger your gout can help you take back some control over your disease.
If you know someone with gout, share this article with them to empower them to take back some control over their life with gout! As always, consult your doctor before making any serious diet changes.