Posted on October 23, 2015 by Jenny Cromack
What is Gout?
Gout is a rheumatic disease that results from the deposit of urate crystals in and around the joint often caused by chronic hyperuricaemia (high levels of uric acid). It is the most prevalent inflammatory disease in developed countries. The old tale of rich food and alcohol being the cause of gout is not too far from the truth. In recent scientific reviews several nutritional risk factors associated with gout have been identified (Sing et al., 2011).
This blog is going to look at what lifestyle factor affect gout.
The BAD!
Gout and Alcohol!
Alcohol has been linked to gout in several scientific studies and increases the risk of gout 3-fold in women and 2-fold in men but appears to be linked to the type and amounts of alcohol consumed.
An intake of 15g (approx 15ml) of alcohol per day increases the risk of gout by 93% compared to those who do not drink. Drinking over 50g per day increases the risk by 250%. The type of alcohol consumed does appear to have an influence of the risk factor.Even as little as a shots worth of these types of alcohol can increase the risk of gout by 250%. Obviously we don’t (or we would hope most don’t) drink a shot a day, but if you consider how much some people will binge on a weekend or the odd beer on a weeknight it all adds up. Despite no evidence for the effects of binge drinking my guesses would be that there will be a similar effect.
As the old tale goes red wine and port has been said to cause gout. However, there is no evidence for any link between wine and the risk of gout. Beer appears to increase the risk of gout by 250% and spirits appear to increase the risk by 160%. This is a large risk factor for such a widely consumed product. It is unclear why different beverages have different effects but it has been suggested that it is due to the combination of the alcohol with the differing non-alcoholic ingredients in each of the drinks.
Sugary Drinks
Simply drinking 2 or more sugary drinks per day increases the risk of gout by 85%, diet drinks however have not been shown to have any link with gout, however they may not be the best option when it comes to any health or weight management goals you may have.
Fruits, or fruit juices, that are high in fructose (such as pears, apples, grapes) produce an increased risk of 81% and eating one apple or orange a day can have an increased risk of 64%. It is the metabolism of the fructose that appears to speed up the generation of uric acid.
Meat and Fish
Excessive ingestion of meat, especially red meat, has been shown to increase the risk of gout by 21% whereas fish and seafood has a slightly lower risk of 7%. The purine content in these foods is linked to the increase in uric acid hence increased risk of gout.
There is little evidence for any relationship between vegetable or soy based meat alternatives and gout. However, these alternative often have other metabolic effects on the body which again may not be suitable for your weight management or fitness goals.
Medications
Several medications have been associated with gout. Their connection is thought to be due to a rise in serum concentrations of urate as a result of the drugs. Diuretics have received a lot of attention and appear to increase the risk of gout. Despite the limited existing evidence for the use of aspirin and gout there is some evidence that low dose aspirin alters renal function and increase uric acid retention which is thought to be a contributor to the development of gout.
Other medications have been said to increase the risk of gout such as the following:
- Diuretics
- Tacrolimus
- Ciclosporin
- Ethambutol
- Pyrazinamide
- Cytotoxic chemotherapy
- Ethanol
- Salicylates (low dose)
- Levodopa
- Ribavirin and interferon
- Teriparatide
The GOOD!
Dairy
Dairy products have been shown to have a protective effect on the risk of gout aided by the proteins present in dairy products, especially milk and yogurt, which increase the excretion and processing of uric acid. This lowered build up of uric acid then reduces the risk of developing gout. Low fat dairy products appear to have an especially protective effect on gout development but again may not be ideal for any weight management goals.
Veg
Few studies have looked at vegetable intake and gout but vegetables high in protein have not been shown any association with gout. From the limited evidence however the intake of vegetables such as carrots, mushrooms, peas, beans, lentils, spinach, and cauliflower appears to be associated with a decreased risk of gout.
Coffee
Coffee intake has been associated with lower risks of gout. Drinking 4-5 cups of coffee a day appears to reduce the risk of gout by 40% and drinking over 6 cups a day produces a further reduction to 59% lower risk. Tea does not appear to have the same associated reduction in gout risk as there is no evidence for an association between tea and gout. This suggests that caffeine may not be the influential factor in the relationship between coffee and gout and it may be due to the other ingredients that differ between the two drinks.
Vitamin C
Total vitamin C intake has been linked to a lower risk of gout and specifically ingesting 1000-1500mg/day of vitamin C appears to reduce the risk of gout by 45%. Even a consumption of less than 250mg/day has a 17% reduced risk. The benefits of vitamin C appear to be related to their lowering of serum uric acids levels.
The above is based upon the current evidence and is by no means a set in stone guide of definitively bad or good foods. It is aimed to give you an idea of which foods may be more likely to contribute to gout and which may have beneficial effects.