Restricted diet helps prevent gout attack
DEAR DOCTOR: I’ve had gout three times in the last three years. I was prescribed Colcrys and indomethacin, but I’m finding confusing information about foods and beverages. Any advice would be appreciated.
DEAR READER: The correlation between gout and elevated uric acid in the bloodstream was discovered in the mid-19th century. The problem is that in joints, where the temperature is cooler than in the bloodstream, elevations of uric acid cause the formation of monosodium urate crystals. This is most common in the big toe joint and ankle. White blood cells engulf the uric acid crystals, creating more inflammation. The result is an extremely painful joint.
A low-purine diet is often touted as a way to decrease gout attacks. Foods that are high in purines — a type of chemical compound — include sardines, anchovies, herring, mackerel, scallops, liver and other organ meats. Beer is also high in purines. If you have gout, you’d be wise to severely restrict such products in your diet. A variety of meats and fish have moderate purine levels, but won’t make a big difference in your uric acid level, so there’s no need
to be overly restrictive toward them.
Protein found in dairy, soy and other beans have been shown to lower uric acid levels when compared to protein found in meat and fish. Cherries have been shown to reduce the risk of gout attacks. Vitamin C — at a daily 500 milligram dose — can slightly lower uric acid levels.
Lastly, check your medications. Hydrochlorothiazide (a diuretic), aspirin and niacin can all increase the uric acid level within your bloodstream and increase your chance of a gout flare.
My essential advice is: If you’re overweight, try to lose weight. The most simple way to start is to avoid desserts and sugary drinks. Second, if you drink alcohol, either eliminate it or limit yourself to not more than one drink per day. Third, stay away from foods that are very high in purines.
Each of these steps will lower your risk of a new painful gout attack — and put you on the road to an overall healthier lifestyle.
Send questions to askthedoctors@mednet.ucla. edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA 90095.