Prevent painful gout attacks by eating right
According to experts, around one million people in Germany are affected by gout. With this metabolic disorder, the joints can become inflamed. Many patients are treated with medication. But the painful gout attacks can often be prevented naturally. Proper nutrition is particularly important here.
According to the German Rheumatism League, around 950,000 people live with gout in Germany. About eight out of ten people affected are male. The disease usually only occurs after the age of 40 and in women usually only after the menopause. The disease is often treated with medication, but nutrition also plays an important role in gout.
Insufficient uric acid is excreted
As the Swiss Society for Nutrition (SGE) reports on its website, the predisposition to gout is mostly inherited. It is the decreased ability of the kidneys to excrete uric acid.
Uric acid is the metabolic product of purines, which, according to experts, are found in all cell nuclei. The purines come from food on the one hand, but also from the body's own production.
If uric acid is insufficiently excreted, it concentrates in the blood. If the uric acid concentration in the blood exceeds a certain limit, it crystallizes and then deposits in the joints. This can lead to a very painful attack of gout.
According to the Rheumatism League, a third of those affected first develop the disease on the foot, usually at the base of the big toe. The joint ignites, becomes very hot, swells and turns red to bluish and is extremely sensitive to touch.
Other joints such as the knee, ankle, metatarsal, hand or finger joints can also be affected.
After the first attack of gout, further acute attacks can occur again and again at irregular intervals. In between, months or even years may pass. Gout attacks can also be more frequent.
Scientifically proven risk factors for gout
The Institute for Quality and Efficiency in Health Care (IQWiG) explains on the portal "gesundheitsinformation.de" that all factors that increase uric acid levels can also promote gout.
In patients who already have gout, they increase the risk of further attacks. The risk factors for gout that have so far been proven in scientific studies include:
- Medicines that increase uric acid levels: These include, in particular, drainage medications (diuretics), as well as acetylsalicylic acid (ASA) and certain medications that are used after an organ transplant. The Parkinson's drug levodopa and cancer drugs can also promote gout.
- Meat, fish and seafood contain many purines. If these foods are consumed in large quantities, they easily increase the risk of developing gout. Some plant-based foods are also rich in purine, but studies have shown that they have no influence on the development of gout.
- Alcohol: Alcoholic beverages promote the formation of uric acid and also have a draining effect. Alcohol also causes the kidneys to excrete less uric acid. In addition, beer in particular contains a relatively large number of purines. Scientific studies have shown that beer and high-proof alcohol can promote gout. Wine (consumed in moderation) apparently has no influence.
- Sugary drinks: Even drinks that contain a lot of (fruit) sugar can increase the risk of gout somewhat. This applies to sweetened drinks such as soft drinks as well as fruit juices. Lemonades that contain sweeteners instead of sugar are not associated with gout.
- Overweight: The risk of developing gout is increased if you are overweight - and increases with an increasing body mass index (BMI).
But even if certain foods and other factors can slightly increase the risk of gout or gout attacks: According to the IQWiG, it is particularly important that the kidneys function well and can reliably excrete an excess of uric acid.
Prevent painful gout attacks
Many sufferers take uric acid-lowering medication to prevent further gout attacks. However, changing your diet can also help prevent gout attacks - or not as often. The SBU summarizes what needs to be considered when it comes to nutrition:
- Increase the amount of drinking to two to three liters per day. This lowers the blood uric acid concentration. Mainly drink water, mineral water and herbal tea and avoid drinks that are sweetened with fructose.
- Avoid alcohol, because alcohol has two negative effects: firstly, as described above, it draws water from the body and reduces the kidneys' ability to excrete uric acid, and secondly, alcohol stimulates the body's own uric acid production.
- Fasting is dangerous for gout patients because it increases the uric acid concentration in the blood; the risk of a painful gout attack increases.
- Eat lots of vegetables, whole grains and legumes. Foods rich in dietary fiber contain more purines than foods low in dietary fiber, but they do not lead to an increased risk of gout and even improve purine excretion. An isolated intake of bran, however, does not make sense.
- Limit the purine intake from animal foods if the measures mentioned do not provide relief. That means: Avoid foods that contain a lot of purine, such as meat extract, offal, tuna and anchovy, as much as possible; eat meat or fish at most once a day; turn on meatless days; remove the skin from poultry and fish.
The right diet can also be discussed with a doctor or dietitian. (ad)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.