Gout is form of arthritis (also called metabolic arthritis) and is a disorder of uric acid metabolism, which results in uric acid crystals building up under the cartilage of joints causing inflammation. It is a congenital disorder of purine metabolism. Purines are synthesised within the body, but can also be ingested from purine-rich foods.
Alcohol intake often causes acute attacks of gout and hereditary factors may contribute to the elevation of uric acid. Although often associated with alcoholism, alcohol is not a cause of gout, but alcohol intake can cause acute attacks with pain. The misconception that gout is directly linked to alcoholism comes from the fact that years ago lead sugar was used to sweeten wine, and that chronic lead poisoning is a cause of gout (saturnine gout), thus giving the association with alcohol excess and gout.
Typically, persons with gout are obese, predisposed to diabetes and hypertension, and at higher risk of heart disease, so it's important that they reduce other risk factors for cardiovascular disease, including eating a healthy diet. Gout is more common in affluent societies due to a diet rich in proteins, fat, and alcohol.
Drug therapy for gout will reduce the need for dietary restriction. However, people who suffer from repeated attacks of gout are advised to modify their diet;
- Reduce intake of foods high in purine:
- Meat Sources: Liver, kidney, sweetbreads, heart and meat extracts e.g. Oxo, Bovril
- Fish Sources: Seafood, anchovies, sprats, crab, herring, mackerel, fish roes, sardines, whitebait, shrimps
- Plant Sources: leaves of green veg, tomatoes, asparagus, cauliflower, peas, green beans, pulses, nuts, mushrooms, plums, groundnuts
- Other Sources: tea, chocolate, wholegrain breads and cereals, oats and oatmeal, yeast and brewer's yeast, ice cream, flavoured squash/fizzy drinks
- Meat and fish should not be consumed in excess, limit portions to around 100g per meal and do not consume every day. Cooked dried beans or pulses may be used as a meat substitute but not as a side dish.
- Limit fatty and fried foods as much as possible: pastries, oils, spread fats
- Enjoy low purine food choices: white bread, low fat milk and dairy products, processed cereals, potatoes, rice, pasta, fruit and fruit juices, other vegetables
- Drink plenty of fluid especially water
- Tea and coffee should be weak and limit to 2 cups per day
- Alcohol may be taken in moderation, but if it is known to precipitate an attack, it should be avoided
- If you are overweight it is advisable to sensibly reduce your weight
The following is an example meal plan which is low in purine foods, moderate protein, but supplying sufficient carbohydrates for energy, as well as a good intake of fruit and vegetables. It's nutritionally balanced to suit an average individual to maintain weight, but if you are overweight, adjust food portion sizes accordingly. Adapt this to suit an individual's own lifestyle, daily routine and nutritional requirements. Use this to give you an idea, but don't forget to vary your food choices and to drink plenty of water through the day.
Plans for people with illness or medical conditions in no way should override advice provided specifically for you by your doctor, clinical dietitian or other clinician. We advise that you seek the advice of a suitably qualified physician before commencing any exercise regime, following any dietary or nutritional regimen or beginning the use of any dietary supplements, legal or otherwise. The information provided on the Website is intended as information only and does not constitute advice. Therefore, it must not be relied on to assist in making or refraining from making a decision, or to assist in deciding on a course of action.