Once known as the ‘disease of kings’ or ‘rich-man’s disease’, gout is one of many types of arthritis which is on the rise.

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In most cases gout is a result of lifestyle and nutritional choices, which means that to a certain degree you can control your condition by making different lifestyle choices. Gout affects on average almost 5% of the population in the developed world.  However, it is possible that in fact the number of sufferers is greater where people do not report incidence of gout which is none-chronic (occurs from time to time). Gout is more common amongst men than women and often develops between the age of 40 and 50. 

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Symptoms of gout include: warmth, redness and swelling of the affected area, pain (often in the big toe at night), tenderness in the affected joint, limited movement of the affected joint and skin itches or even peels as the conditions resolves.

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These symptoms are the product of uric acid crystal deposits in the joint. Possibly also related to a condition known as metabolic syndrome.  When the metabolic processes which control serum uric acid malfunctions, it can result in over production of uric acid and crystalline deposits in the space of certain joints.

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Conventional treatment is medication but like with many other chronic conditions, it is not an ideal long term solution, but since gout can be a life-long condition side effects from the medications is a risk you would want to avoid.  Common gout medications include:

• Colchicine – blocks inflammation caused by uric acid crystals

• Allopurinol – reduces uric acid production

• Non-steroidal anti-inflammatory medication (NSAIDs) – to control pain.

Gout symptoms are often misdiagnosed and alternative treatments are also available for prevention.

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These include:

• Reduce your fructose intake – Uric acid is a by-product of metabolising fructose. Out of all the sugars, fructose is the only one know to increase uric acid levels (it acts very quickly).  As a general rule, I recommend limiting the total daily fructose intake to 25 grams (the average person consumes about 120-150 grams of fructose every day. If you’re insulin resistant or have gout, you would be wise to limit fructose to 15 grams per day or even less, until the symptoms have subsided.

• Daily exercise – which can reduce build-up of uric acid as well as normalise insulin and leptin levels[ug1] .  However, if you have an active episode of gout you may wish to exclude the affected joint form your exercise routine.  Good exercise is strength training combined with High-intensity interval training (HIIT).

• Make sure your Vitamin D levels are balanced – Vitamin D is a wonder vitamin which can not only reduce the risk of cancer but can also be very effective in the prevention of gout, diabetes, cardiovascular disease and metabolic syndrome.

• Have enough sleep- not sleeping enough compromises your immune system (as well as speeds up the aging process and increases appetite)

• Reduce your stress – enough said!

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Other dietary considerations:

• Can’t stress this enough: reduce your fructose intake!

• Cherries: are well known as a folk remedy for gout but remember that approximately 10 sweet cherries  contain about 4-5 grams of fructose. So don’t overdose on cherries.

• Potassium-rich foods: Potassium citrate helps alkalise our urine and improves the elimination of uric acid. Potassium is available in fruits and vegetables of which the most beneficial sources include broccoli, celery, avocado, and spinach and romaine lettuce.  As a supplement, I recommend using potassium bicarbonate.

• Extract of celery seeds: There is some recent scientific evidence which found a positive association between 3-n-butylphthalide (a compound which gives celery its distinctive taste) and a reduction in pain and inflammation.

• Stay away from soy milk: There’s some evidence that it can increase the concentration of serum urate.

• Avoid foods high in Purines because food high in purines breaks down to uric acid.  These foods include organ meats, brewer’s yeast, sardines and tuna packed in oil, chicken livers and beef fillet. These all have over 100 mg of purine per 100 g of product.

• Less alcohol / more water: Regular use of alcohol has long been associated with the development of gout. Beer is considered worse than spirit whilst red wine seems to have little effect on the development of gout. Nonetheless, consumption of wine should be in moderation. On the other hand, liberal consumption of water reduces the concentration and promotes the excretion of waste products in the urine.  It also reduces the risk of kidney stones.  If your urine is dark, you’re not drinking enough. If it’s colourless, you possibly might be drinking too much (which I’m yet to see with any clients of mine).