When you mention the condition “gout”, a picture seems to flash up of a crusty
old man with a glass of port and his foot on a stool, as he nurses an extremely
painful big toe. That’s not a bad description, but unfortunately a little
limited. You don’t have to drink port and you can get it in other joints.
However, if you are a sufferer, then you join some famous
people such as Henry VIII, Benjamin Franklin and Thomas Jefferson. They were not
as lucky as you, as there was no real treatment in their day.
Gout is indicated in around five percent of all cases of
arthritis and is present in around three to five percent of the population, with
males outnumbering women around nine to one. Afro-Americans and many Asian races
also have higher incidence than Caucasians.
Gout is in its simplest fashion, a recurrent form of
arthritis, and which generally affects just one joint. This arthritis, or
inflammation, occurs in association with high uric acid levels in the blood, and
is described by patients as ‘exquisitely painful’.
The higher your concentration of serum uric acid (SUA), the
more likely you are to get an acute attack. The ‘normal’ range for SUA is taken
as being between 3.5-7 mg/dl. And if you are at the high end of the scale you
are five times more likely to get gout.
What happens is that with high concentrations of uric acid it
crystallizes out into the joint, leaving very sharp, needle-like crystals
crunching inside the articular surface of the joint. Very painful!
So who does get gout? The typical gout sufferer is male in
his 50’s, overweight, with high blood pressure, carnivorous and consumes large
quantities of alcohol. Is that you?
Gout affects almost four million men in the USA. It has long
been thought that purine-rich foods and a high protein intake are risk factors,
and sufferers were advised to avoid meats, seafood, purine-rich vegetables, and
animal protein. One of the newer studies began on over 50,000 men from health
professions in 1986. Food-frequency questionnaires were sent out at baseline,
and in 1990 and 1994. Weight, medications, and medical conditions were recorded
every two years.
The participants were assigned to groups according to the
total intake of meat, their consumption of seafood, purine-rich vegetables,
dairy products, low-fat dairy products, total protein, and animal protein.
During the study, there were 730 new cases of gout during the
12 years of follow-up. Most of them were aged 55 to 64.
When total meat consumption was analyzed, the risk of
acquiring gout was 1.41 times greater in the high meat eaters; in other words,
eating more meat was a risk factor for gout. Similarly, high seafood eaters were
1.51 times as likely to develop gout. (Grass should be fairly safe to eat!)
In contrast, gout was less common in those taking more dairy
products. Men who drank two glasses a day of skim milk, or ate a serving of
low-fat yogurt more than twice a week, halved their risk of developing gout.
In this study at least, purine-rich vegetables, and total
protein had no influence on the chances of getting gout.
This large study confirmed that a diet high in meat and
seafood increases the likelihood that a susceptible person will develop gout. It
also showed that milk proteins increase the excretion of uric acid in the urine.
So, to avoid developing gout, try to limit your intake of
meat (beef, pork, lamb, and offal) and seafood, while increasing your intake of
low-fat dairy produce (skim milk, yogurt).
This is all very important, as the long term outlook is not
good for the unrepentant gout sufferer. Constant high levels can lead to
diabetes and even uric acid ‘stones’ being deposited in the kidneys (producing
renal problems) and discharging lumps (called ‘tophi’) around joints, on the
forearms and even on the outer ears. Really a most bleak and depressing future,
and not one I’d like to have.
Note too, that it is low-fat milk that is being proposed, as
high fat milk introduces the cholesterol problems again! It really is a fine
line that we must all tread! The Buddhist “middle way”.
