What is Gout?
Gout is a type of arthritis or joint disorder that is associated with high blood uric acid levels or hyperuricemia. Uric acid is a product of metabolism of purines, a substance found in many foods, medicines and alcoholic drinks. An elevated uric acid level in the blood (hyperuricemia) leads to the deposition of this substance that form crystals in the joints and causes pain and inflammation.
The large toe is the most common site of deposition although other joints like the fingers, ankles and knees may also be affected. Symptoms of a gout attack include sudden swelling, tenderness, redness and sharp pain of the big toe, usually occurring at night. These can last for a day to many weeks. Aside from these, one may also experience fever, chills, loss of appetite and ill health.
Gout Attack Triggers
Hyperuricemia may occur without being accompanied by acute symptoms of gout. When the uric acid levels reach 7 mg/dL, crystallization and arthritis occurs. Gout attacks may be triggered by strenuous exercise, stress, infection, joint injury, as well as substances in the diet.
Foods that trigger gout are those with very high purine content such as:
- Organ meats such as animal liver, heart, mincemeat, kidneys and brains
- Red meats, including bacon, beef, pork and lamb
- Game meats
- Large amounts of any meat and meat extracts
- Seafoods and fish like anchovies, sardines, herring, mackerel and scallops
- Meat gravy
- Baker’s and brewer’s yeast
- Meat stock-based soups (such as bouillon, broth and consommé)
- Beer – when taken in large amounts, beer is the type of alcoholic drink most associated with gout attack. Binge drinking in young adults followed by other alcohol spirits can trigger gout. Moderate amounts of wine do not seem to cause acute attacks. Aside from containing high levels of purine, beer also decreases the ability of the kidneys to excrete uric acid, thus increasing blood levels.
- Other beverages with high fructose content
Other foods that contain moderate amounts of purines include oatmeal, wheat bran and wheat germ, although these may not necessarily cause gout attacks.
Other substances that may trigger gout are drugs or medicines like diuretics, aspirin, pyrazinamide and niacin.
It has also been observed that people who are overweight are more likely to develop hyperuricemia and symptoms of gout. This is because fats hold on to the uric acid and prevent excretion by the kidneys. Therefore, it is best to avoid a high calorie diet that is also high in fat. Examples of foods high in fat are salad dressings, ice cream, fried foods, gravies and other cream sauces. It is also best to limit high-fat breads like pancakes, French toast, biscuits, muffins and French fries.
In general, avoiding risk factors like heavy alcohol drinking, binge eating, high purine and high fat diet can help prevent hyperuricemia and gout. In addition, a healthy lifestyle with enough exercise and less stress helps maintain an ideal weight and decrease the risk for other diseases (for example, infection and kidney disease) that can lead to increased uric acid levels.
It is important to emphasize that aside from avoiding gout triggers, people with chronic hyperuricemia will need medical treatment to lower blood uric acid levels.
UMMC, “Gout – Triggers”, https://www.umm.edu/patiented/articles/how_serious_gout_000093_4.htm
UPMC, “Low Purine Diet”, https://www.upmc.com/HealthAtoZ/patienteducation/Documents/LowPurineDiet.PDF