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Gout

Gout is a form of arthritis that causes sudden, severe episodes of pain, tenderness, redness, warmth and swelling of the joints. The most common joint affected is the first joint of the big toe. Other joints that may be affected are the ankle, foot, hand, wrist and elbow. Gout occurs more often in men than in women. However, uric acid levels in women increases after menopause, making them more susceptible to gout.

What causes Gout?

Gout occurs as a result of deposits of needle like crystals of uric acid in the joint spaces of soft tissues causing painful symptoms. Uric acid, a substance that results from the breakdown of purines in the blood passes through the kidneys into the urine. High uric acid levels (hyperuricemia) occurs when its production is increased eg. due to consumption of food rich in purines or when its excretion is reduced from the kidneys eg. renal impairment) Most people with gout have hyperuricemia although not all people with hyperuricemia has gout.

Risk Factors

  • High purine food
  • Overweight (Excessive food intake increases the body’s production of uric acid)
  • Excessive alcohol intake (Alcohol interferes with the excretion of uric acid from the body)
  • Genes
  • Insufficient water intake (Drink at least 2 litres per day to increase uric acid excretion)

Dietary Considerations

Food to avoid (highest in purine):
  • All internal organs – liver, kidney, brain
  • Rich games – venison, pigeon, black chicken
  • Meat extracts – gravies, chicken essence, bah kut teh
  • Certain fish/shellfish – salmon, herring, mackerel, anchovies, sardines, cockles, mussels, scallops, prawns
  • Certain vegetables – spinach, peas, beans, peanuts, carrots, tomato
  • Bean products – beancurd, soya bean milk, bean sprout, bean cake, moon cake, legumes
  • Fruits – strawberries, durian
  • Alcohol – beer, champagne, brandy, whisky, port
Food to restrict (moderately high in purine):
  • Certain vegetables – cauliflower, asparagus
  • Mushroom
  • Breads – wholegrain, wheat
  • Oatmeal
  • Red meat

Gout may also be associated with other problems like hypertension, diabetes, kidney diseases and obesity. Uric acid crystals can also form deposits in the kidneys or ureters leading to kidney or ureteric stones. Hence, it is important to ensure a healthy diet and maintain a normal uric acid level.

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