Contents
Gout (also known as gout, gout or arthritis) is a common rheumatic disease in developed countries. It’s an inflammatory disease of the joints, caused by sodium urate crystals deposited in the synovial fluid, periarticular tissues and subcutaneous tissue.
| The disease of kings |
|---|
| Gout as a disease entity was known in antiquity. For centuries, it was considered a disease of kings and rich people, as it was more likely to suffer mainly from the aristocracy. |
The precipitation of these crystals occurs when the uric acid in the blood exceeds the saturation threshold – this condition is called hyperuricemia. Uric acid is the end product of the metabolism of purines and fructose in our body.
Hyperuricemia is the amount of uric acid that exceeds 6,8 mg / dl in the blood. This condition adversely affects the condition and functioning of blood vessels and other organs. Precipitation of sodium urate crystals in the kidneys can cause kidney stones.
Gout risk factors
Unfortunately, there are many risk factors that affect the appearance of gout. They include mainly:
- hyperuricemia,
- overweight and obesity,
- a diet rich in meat and seafood,
- alcohol abuse and smoking,
- genetic factors,
- hypertension,
- metabolic syndrome,
- male gender,
- postmenopausal women,
- taking certain medications,
- people after transplants.
Arthritis symptoms
The symptoms of a gout attack are:
- joint swelling and redness
- increasing severe pain in the joint / joints,
- fever.
The most frequently inflamed joint is (metatarsophalangeal) of the XNUMXst finger, inflammation may of course also appear in other joints. The seizure lasts from a few hours to two weeks (as a rule it is not treated), and there are no other complaints between seizures. Chronic gout causes changes in the joints that undergo remodeling. The gouty nodules formed in the joints impair the function of the joints and make it difficult to function in everyday life.
Factors that provoke a gout attack
There are also many risk factors influencing the appearance of a gout attack itself. We are able to control most of them ourselves, and they include:
- a diet rich in purines and fructose,
- alcohol,
- overweight and obesity,
- dehydration or insufficient fluid intake,
- excessive physical effort,
- sudden weight loss / fasting
- hypothermia.
Treatment of gout
Treatment is based on the relief of inflammation and pain therapy. The key is to prevent acute attacks, that is, to lower the uric acid levels in the blood. Education and everyday behavior are very important here – proper diet and elimination of triggering factors.
Dietary recommendations
In the prevention of gout, lowering the level of uric acid in the blood (prevention of hyperuricaemia) is recommended. The main pillar of prevention is a low purine diet. Meals should be steamed or boiled, and occasionally baked or grilled.
In addition, it is necessary to reduce fructose – especially from processed sources such as juices, sweets, sugar or glucose-fructose syrup.
It is also recommended to control the consumption of fruit (especially those with a high fructose content). They should not be completely eliminated as they are a source of antioxidants, vitamins and other compounds that help regulate uric acid metabolism in the body.
Milk and dairy products (low-fat) are sources of compounds that increase uric acid excretion. Eating one serving of milk or yogurt reduces uric acid levels. Gout attacks occur up to 40% less frequently in people with high dairy consumption. Milk and dairy products are also a good meat substitute for people suffering from gout.
It is worth noting that purines from plant products are characterized by lower bioavailability than from animal products. In view of the above the solution may be to introduce a vegetarian diet.
Contraindicated products: Meat: pork, beef, mutton, offal, meat products and preserves, broths, sauces and jellies, goose hare; Fish: salmon, cod, mackerel, carp, trout, pike, herring, sole, shrimp and other seafood; Mushrooms and mushroom preparations; Fruits with a high fructose content: raisins, dates, dried figs, cranberries and plums, grapes, pears, apples, kiwi; Yeast bread, breakfast cereals, sweets, honey
Limited quantity acceptable products: Dairy: full-fat dairy products; Eggs; Vegetables: pumpkin, green beans, white beans, lentils, red cabbage, kale, broccoli, leek, Brussels sprouts, corn; Fruits: banana, melon, mango, fresh plums, papaya
Recommended products: Dairy products: skim milk, low-fat dairy products (yogurt, buttermilk, kefir, cottage cheese and cheese up to 5% fat); Cereal products: bread, pasta, groats (preferably whole grains); Meat: lean poultry; Vegetables: cucumber, tomato, white cabbage, sauerkraut, beetroot, zucchini, carrots, vegetable juices, potatoes; Fruit: cherries, strawberries, mandarins, raspberries, pineapples, grapefruits, nectarines, peaches
liquids
Adequate hydration is very important in the case of gout, uric acid is excreted in the urine. An increased fluid intake of 2,5 – 3 liters per day is recommended. The aforementioned juices and fruit drinks are contraindicated in people with hyperuricemia. This is due to the fact that they are concentrated sources of fructose, which should be limited.
It is recommended to give up alcohol in any form, as it contributes to the reduced excretion of uric acid by the kidneys. Observations showed a very strong correlation between beer consumption and the incidence of gout attacks – daily beer consumption increases the risk by 50%.
Coffee is often cited as a contributing factor in the development of gout attacks, but the available studies have not confirmed these suspicions. Interestingly, epidemiological studies shed new light on this issue. Coffee drinkers were expected to experience fewer seizures and had lower uric acid levels – an effect that may be due to the presence of antioxidants.
Tea consumption, however, is still a moot point. Research describes the effects of tea as neutral or negative. At present, however, there is no evidence whatsoever regarding its positive impact in the context of gout. In these circumstances, limited consumption will not be a mistake.
Physical activity
Gout is not a contraindication to physical activity, except for exacerbations.
Regular physical activity is one of the key elements in maintaining a proper body weight. People who are overweight and obese are advised to normalize their body weight to reduce the risk of gout attacks. A weight loss of 5-10 kg reduces the uric acid concentration in the blood by about 0,6 mg / dl.
When taking up physical activity, remember that we must ensure adequate hydration.
Summation
Gout is a disease entity where in the vast majority of cases the course depends on the patient and his lifestyle. Maintaining a healthy body weight, hydration and following dietary recommendations contribute to lowering uric acid levels in the blood.
References
- Pliarski Ł, Bogdański P, Pupek-Musialik D. Gout – an ancient disease still problematic in the 2012st century. Metabolic Disorders Forum 4; 160: 6-XNUMX.
- Pęksa J, Karpiel-Malinowska A. Pharmacotherapy and dietary treatment of hyperuricemia and gout attacks. Private office. 2019; 26: 22-31.
- Frączek B, Krzywański J, Krysztofiak H. Sports Dietetics. PZWL 2019; 691-705.
- Widecka K, Szymański FM, Filipiak KJ, et al. Expert position paper on hyperuricemia.
- George C, Minter DA. Hyperuricemia. In: StatPearls. Treasure Island (FL): StatPearls Publishing; May 29, 2020.
- Zimmermann-Górska I. Gout. Interna Szczeklik. https://www.mp.pl/interna/chapter/B16.II.16.15.
- Borghi C et al. Expert consensus on the diagnosis and treatment of patients with hyperuricemia and high cardiovascular risk. Cardiology Journal 2018; 25 (5): 545-564