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Gout is an inflammatory condition known as hyperuricemia, elevated serum uric acid level. Uric acid is produced when the body breaks down purines and can be found in our bodies and the foods we eat. Crystallization of uric acid may occur when high levels of uric acid build up in the body, which then form needle-shaped crystals in and around the joint, leads to inflammation and arthritis of the joint. However, hyperuricemia doesn’t necessarily result in gout, and it may not require treatment if there are no gout flares present.

In the past, gout mainly occurred in middle-aged or elderly people, but in recent years, with changes in lifestyle and dietary habits, the incidence of gout among young people has gradually increased. According to the US Centers for Disease Control and Prevention (CDC), between 2007 and 2014, the incidence of gout in the 20-39 age group increased by nearly 60% in the USA. While in Hong Kong, the incidence of gout has risen from 1.56% in 2006 to 2.92% in 2016. These data show that the incidence of gout is on the rise.

Several studies have shown that consuming a diet high in purine is associated with an increased risk of gout. Purines can be found in many foods, including red meat, poultry, fish and seafood, such as sardines, trout, tuna, scallops, and mussels. When the body breaks down purines, it produces uric acid, which can lead to the formation of uric acid crystals in the joints. A study found that men who consumed higher levels of meat and seafood had a 50% higher risk of developing gout, whereas higher levels of consumption of low-fat dairy products, such as milk and yogurt, are associated with a reduced risk of gout by 44%.

Interestingly, some vegetables, legumes, and beans contain purine, yet research shows that high-purine plant foods do not trigger gout attacks. Eating plenty of vegetables, legumes, and beans is indeed good for health and may help lower uric acid levels, as these foods are rich in antioxidants and other nutrients that can help reduce inflammation and improve overall health.

Moreover, non-purine-rich food, such as fructose and sweetened beverage with added sugar can also increase the risk of gout attacks and have a higher risk of developing gout at an early age. Individuals who had 2 or more sugar-sweetened beverages a day had an 85% higher risk of gout than those who had less than one serving a month.

In addition to these dietary factors, it is also important to maintain a healthy body weight and limit alcohol consumption, as both factors can increase the risk of gout. Many people suffering from gout can benefit from following a balanced diet with low saturated fat and added sugars, and rich in vegetables and fruits. Much of the time, avoiding specific foods may be less important than the overall dietary pattern.

To conclude, a healthy lifestyle with healthy eating habits, regular exercise, moderate alcohol consumption, and not smoking, was enough to override the genetic risk of developing gout by at least one-third.

References:

1. Choi, H. K., Atkinson, K., Karlson, E. W., Willett, W., & Curhan, G. (2004). Purine-rich foods, dairy and protein intake, and the risk of gout in men. New England Journal of Medicine, 350(11), 1093-1103.

2. Dalbeth, N., & Merriman, T. R. (2015). The role of diet in the management of gout: a review. Journal of human nutrition and dietetics, 28(1), 3-15.

3. Choi, H. K., Willett, W., & Curhan, G. (2007). Fructose-rich beverages and risk of gout in women. Journal of the American Medical Association, 298(24), 2855-2864.

4. Zhang, Y., Chen, C., Choi, H., Chaisson, C., & Hunter, D. (2006). Purine-rich foods intake and recurrent gout attacks. Annals of the Rheumatic Diseases, 65(10), 1442-1447.

5. Choi, H. K., & Curhan, G. (2008). Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study. British Medical Journal, 336(7639), 309-312.

6. Dalbeth, N., Ames, R., Gamble, G., Horne, A., Wong, S., Kalluru, R., … & Merriman, T. R. (2014). Effects of skim milk powder enriched with glycomacropeptide and G600 milk fat extract on frequency of gout flares: a randomized controlled trial. Annals of the Rheumatic Diseases, 73(7), 1382-1389.