Gout, a painful form of arthritis, is on the rise. Avoiding red meat and alcohol can help.
Gout sounds like a disease that shouldn’t exist anymore, especially since it’s referred to as the “disease of kings” because of its connection to royal leaders like Henry VIII, who lived with the condition due to overindulging in food and alcohol. However, this ancient condition is on the rise across the globe.
A recent study found a rise in the incidence (the number of new cases) and prevalence (the number of existing cases) of gout from 1990 to 2019. Increases in gout were most significant in the U.S., Canada and Australia for both men and women. Researchers noted that reasons for the increase include obesity, insulin resistance, metabolic syndrome, hypertension and renal diseases.
“Gout is a common type of arthritis that can be extremely painful,” Dr. Tochi Iroku-Malize, board chair of the American Academy of Family Physicians, tells Yahoo Life. “Symptoms include swelling and pain in joints like your feet, ankles, wrists, and elbows.”
What causes gout?
The condition is caused by a buildup of uric acid in the body. Uric acid forms when the body breaks down purines, a chemical compound that cells use to form DNA and RNA. Meat and meat products contain purines.
Uric acid forms crystals around joints in the body, most commonly in the big toe or knee, but can be found in any joint. When this occurs, the affected joint results in severe pain, swelling and redness.
“These crystals do not belong in the joints and when there is something found where it doesn’t belong, especially in tight spaces, the area gets inflamed and painful,” Dr. Eric Ascher, family medicine physician at Northwell Lenox Hill Hospital, tells Yahoo Life. “Even a bedsheet over the area infected could cause someone a large deal of pain and discomfort.”
Who is at risk for having gout?
There are some factors that make people more predisposed to the condition than others. While anyone can get gout — including in very rare cases, children — people between 40 and 60 years old are more likely to have the condition. Gout most often affects middle-aged and older men. In fact, men are three to 10 times more likely to have gout than women.
However, younger men and women of all ages can have gout. In the last 20 years, gout has more than doubled among women, affecting more than 3 million, but the symptoms may be different. Rather than a sudden occurrence in the big toe, gout may affect women slowly over time in several joints like the knees, wrists, fingertips and toes — areas that may already be affected by osteoarthritis, according to the Arthritis Foundation.
“While men develop gout more often than women, women are more likely to develop gout after menopause,” says Iroku-Malize.
This is due to the drop in estrogen in perimenopause. “Less estrogen means more uric acid,” Amanda Dewees, a family nurse practitioner at Norton Mobile Primary Care, tells Yahoo Life.
One study published in the journal Arthritis Research & Therapy, found that earlier menopause and a shorter reproductive span were associated with a high risk of gout.
Certain racial and ethnic minority groups are also at higher risk of having gout, including Asians, who are two times more likely to have gout than white people.
“Gout is genetic and can run in families,” says Iroku-Malize.
How is gout treated and prevented?
A doctor can diagnose gout by examining the joints and looking for a pattern of swelling. “We will also look for uric acid crystals either in your joints or through a blood test,” says Iroku-Malize.
Medications that can help treat symptoms of pain and swelling include over-the-counter or prescription varieties. Colchicine can also help manage pain from gout when taken immediately after symptoms occur, and corticosteroids can help with inflammation, swelling and pain. Doctors may also prescribe a medication to treat elevated uric acid.
Practicing certain lifestyle habits can help lower the risk of having gout and prevent future flare-ups. “First, it’s important to limit or avoid foods that are rich in purines as is possible depending on your cultural background, family cuisine or current nutrition needs,” says Iroku-Malize.
Foods to avoid include:
Red meat, such as beef, lamb, pork and bacon
Organ meat, such as liver and sweetbreads
Alcohol, especially red wine and beer
Shellfish, such as shrimp and scallops
High-fructose corn syrups, such as those found in sugary beverages
Ascher recommends eating bananas since “high potassium, low purines, will actually help reduce uric acid levels,” he says. Consuming coffee, dairy and eggs in moderation can also lower uric acid levels.
Staying well-hydrated is also helpful. “Lots of water can help flush uric acid from your body,” says Iroku-Malize.
The National Institutes of Health recommends the Dietary Approaches to Stop Hypertension (DASH) eating plan, especially for people with high blood pressure and gout because it can help lower blood pressure and urate levels and thus prevent gout flares. The plan includes:
Lots of vegetables, fruits and whole grains
Eating low-fat or fat-free dairy products, poultry and oils
Keeping foods high in saturated fats to a minimum
Limiting foods and drinks with sugar in them
In addition to changing eating habits, an active lifestyle can reduce stress and pressure on joints and decrease risk of developing gout.
“I highly recommend getting daily exercise, such as a 30-minute walk to reduce flare-ups. Being overweight increases the risk of gout, so maintaining a healthy weight can help lower the risk,” says Dewees.
