Gout is acute inflammation and pain caused by the deposition of uric acid crystals in the tissues. Some individuals are susceptible to gout attacks because, for various reasons, they tend to have higher than normal levels of uric acid in their blood. Some foods – those that contain high levels of purines – tend to raise blood uric acid in susceptible individuals. Uric acid crystals which deposit in the tissues stimulate the immune system to release inflammatory substances. Gout attacks, which can be extremely painful, typically occur during the night, moist commonly in the joints of the large toes and ankles.
Maintaining a healthy body weight is generally considered the single most important non-pharmacological preventive measure for gout in susceptible individuals.
Excess adipose (fat) tissue:
- Increases uric acid production
- Reduces uric acid excretion by the kidneys
- Is strongly associated with high uric acid levels and recurrent gout attacks
Among lifestyle factors, sustained weight reduction in overweight individuals has the strongest and most consistent effect on lowering serum uric acid and reducing gout risk.
If the individual is already lean and at a stable healthy weight, then the next most important measures are usually:
- Limiting alcohol (especially beer and spirits)
- Avoiding large fluctuations in weight (crash dieting, fasting)
- Maintaining good hydration
- Moderate low-impact exercise
- Reducing excessive intake of high-purine foods and sugar-sweetened beverages, particularly those containing fructose.
For specific advice, please get in touch.
Robert Hale 