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Changing your diet can prevent gout flare-ups

By Lilian Anekwe

Cutting down on certain types of food can reduce your chances of having a flare-up of gout, a new study shows. It also suggests that eating some foods - such as nuts and legumes - are less likely to trigger flare-ups.

What do we know already?

Gout is a fairly common condition that can cause bad pain and swelling in your joints. It happens when tiny crystals of a chemical called urate build up in your joints. It usually affects the big toe joint but you can also get gout in any of the joints in your feet, wrists, ankles, elbows, knees, and fingers.

We know that people are more likely to get gout if they eat certain foods or drink alcohol that contains lots of a substance called purine. Purine is thought to increase the amount of urate in the blood. But until now there's not been much research to show whether changing your diet can help, if you already have gout.

Researchers studied 633 people with gout who answered an online questionnaire about their illness. Over the course of a year, people were asked what they had eaten in the two days leading up to their most recent flare-up of gout.

What does the new study say?

People who had eaten the most purine-rich foods in the two days before a flare-up were more than four times as likely to have a flare-up of gout than people who had the least.

But the risk was different depending on what type of purine people had. Purine from plants - such as beans, peas, lentils, oats, spinach, asparagus, and mushrooms - was less strongly linked to gout flare-ups than purine from meat or fish.

Compared with people who had the lowest amounts of animal purine, people who had the most animal purine were more than twice as likely to have a flare-up. But people who had the most plant purine had a 40 percent higher risk than people who had the least plant purine.

How reliable is the research?

The researchers say this study is the first to confirm that eating foods with lots of purine could be a trigger for flare-ups of gout.

The researchers took into account things that could affect whether people had a gout flare-up, such as whether they were taking medications, how much alcohol they drank, and how many of each group were men - as we know that gout is far more common in men than in women.

The researchers used a questionnaire to find out what people had eaten or drank in the two days before their flare-up. Relying on people to record their diet can affect the reliability of the results. Also, the researchers calculated how much purine people had from their questionnaires, but we don't know if this was an accurate measure. For example, the amount of purine in foods can vary depending on how it is cooked. This could also have affected how reliable the results are.

What does this mean for me?

This study shows a clear link between eating foods that contain a lot of purine, over a two-day period, and an increase in the risk of an attack of gout.

It's common for people with gout to have flare-ups, so it's helpful to know which foods to avoid to try to reduce the chances of this happening. All meats, meat extracts and gravies, and seafood contain large amounts of purine. All alcohols - beers, wines, and spirits - also contain large amounts of purine.

Source:

Zhang Y, Chen C, Choi H, et al. Purine-rich foods and recurrent gout attacks. Annals of the Rheumatic Diseases. Published online 30 May 2012.

May 31, 2012