|
Gout
is a condition in which uric acid level in serum of
the blood is raised and this results finally in urates
or uric acid crystals forming and getting deposited
in the cartilages of the joints. Swelling and attacks
of pain results and joints subject to trauma like elbows,
wrists, knees, ankles and toe joints are commonly affected.
 Gout
is usually an inherited disease but also seen in those
who consume large amounts of protein rich foods like
fish, seafood, mutton, chicken, beef, glandular meat
like liver, kidney or vegetarians who eat a lot of beans,
spinach and pulses. Those who are regular heavy drinkers
of alcohol may also suffer with gout. Men are more prone
to it than women. Women usually get it after menopause.
The normal uric acid levels are below 6mg/dl for
men and below 5mg/dl for women.
Athletes and sportsmen
like tennis, badminton, cricket, etc. players are also
seen to be quite susceptible to gout. This could be
due to increased perspiration during training and insufficient
water consumption. Also players seem to be in and out
of special training camps where lots of non-veg food
is available. They eat large amounts of it thinking
it will build their body. You need the protein but try
to consume milk, egg and dhals, along with the non-veg
so that you eat lesser quantities of it.
Weight
Control
Obese
persons may be more prone to gout. Therefore if you
are over weight the first step would be to reduce weight.
This will not only prevent recurrence of attacks of
pain and gout, but also give relief to the weight bearing
joints of the body. A word of caution those  suffering
from gout should not go on a drastic weight reduction
programme, which involves starvation, skipping of meals
or diets like only fruit juices or only vegetables throughout
the day and cabbage soup diet etc. which do not contain
any form of protein. This causes breakdown of protein
within the body, leading to the formation of large amounts
of uric acid, which will get deposited in the joints
and result in acute pain suddenly. Over indulgence or
feasting in rich fatty foods, meats and alcohol will
also bring on an attack of pain over night. Therefore
it is very important to follow a balanced regular diet
and all party eating and drinking must be in moderation.
Besides pain in
joints, uric acid crystals can cause stone formation
in the urinary tracts and kidneys. Therefore it should
not be taken lightly. This shooting pain of gout may
be seen more frequently in summer, as the normal water
intake may be insufficient.
Dietary
Restrictions
Many animal foods
contain high amounts of a substance called purine. In
the body uric acid is derived from these purines. Foods
with high purine content are fish roe (eggs) or caviare,
fish like herring, salmon, mackerel, sardine, pomfret,
shellfish- like prawns and lobster. Organ meats like
liver and kidney are very high in purine and should
be avoided completely. Extracts of beef, pork and mutton
are most dangerous. So soups of meats and gravies should
be strictly avoided. Chicken may be eaten occasionally,
two-three times a week. But here too avoid chicken soups
and gravies. You may consume chicken but restrict it
to only 2 pieces at a time. Try to avoid it at night
and have it only at lunch. Please note that 100gms chicken
is all you need to eat at a time to get your protein
supply. 100gms gives you 20-25gms protein and excess
of this in one meal may only get converted to fat and
also tax your kidneys. The protein requirement in the
diet should be met by milk, egg and dhals. Also make
it a rule to eat less non-veg in the summer days. Try
to eat it only once a day and preferably only at lunch
so that there is time to digest it. Soups and gravies
of meat or fish produce high levels of uric acid, so
please avoid. In a restaurant never order a non-veg
soup as it will be made of stock which contains all
cuts of meats which are available in the restaurant
kitchen namely pork, mutton, beef and chicken
Pulses like channa,
rajma, moong, bean sprouts, French beans and green peas
are high in their purine content, so after an attack
of pain or high recording of uric acid in the blood
try to avoid these foods completely for atleast a month.
Thereafter they may be eaten once or twice a week in
moderate portions (half a cup). Palak (spinach) and
other green leafy vegetables are also high in purine
and must be similarly restricted. Green chutneys must
be avoided on a daily basis. Many believe that tomatoes
should be avoided by those with gout but this is not
true. Tomato is safe to consume as it does not have
a high purine content. However those who have kidney
stones which are of the oxalate form must avoid tomatoes
as tomatoes are high in oxalates. Chickoo and custard
apple are fruits with high purine content and must be
restricted. All other fruits are safe to eat for a gout
patient.
Alcohol
 Consumption
of alcohol is a major issue in gout. Alcohol has the
effect of decreasing excretion of uric acid or urates
through the urine. If large amount of alcohol is consumed,
uric acid is retained and blood levels will shoot up.
Stay away from beer and red wines. White wine or whiskey
30+30ml=60ml is all that is allowed at a time. More
than that can be dangerous. We have also observed sudden
gout attacks of pain after the consumption of too much
alcohol, so please avoid alcohol binges.
Water
The most effective
and immediate mode of treatment for a gout attack of
pain or if you have suddenly seen a high blood level
of uric acid is to pump water into your body. 2 and
a half liters of water is the minimum health requirement
for an adult. So a gout patient should be drinking atleast
3 liters daily and if you are a sportsman then 4 liters
is a must. Sports people working heavily with weights,
please note that there will be more muscle breakdown
when you train so if you have a tendency for gout be
very particular about keeping your water intake very
high.
|
