Gout is a type of arthritis. It is an inflammation of the joints caused by uric acid crystals. Often brought on by dietary indiscretions, it was once considered a disease of the rich.

Nowadays, anyone may be at risk due to our fast foods and sugary drinks.

Gout is characterised by sudden, severe attacks of pain, redness and tenderness typically affecting the big toe, but can involve other joints, such as the ankles, knees, fingers, wrists and elbows as well. The condition is more common in men, although women are increasingly susceptible after the menopause.

WHAT CAUSES GOUT?

When there are high levels of uric acid in the blood, it forms crystals that can deposit in the joints to produce a severe inflammation. This excess of uric acid can result from the breakdown of dietary substances called purines, which are mostly found in red meat, organ meats like liver and kidneys, shellfish and in beer.

Gout is also a red flag for the metabolic syndrome. This is the name used by the World Health Organisation to describe a combination of diabetes, high blood pressure, obesity and cholesterol and triglyceride imbalance. Sixty per cent of those with gout also have the metabolic syndrome. So having gout may be a sign of other serious medical conditions.

The metabolic syndrome is due to high blood levels of the hormone insulin, which also raises uric acid. Eating fewer carbohydrates will lower both insulin and uric acid levels in blood. In one study, patients on a carbohydrate-restricted diet significantly reduced uric acid, cholesterol and triglycerides levels and lost weight. Alcohol, refined sugar and starches, bread, crackers, potatoes, rice, pasta and breakfast cereals are the carbohydrates that often cause elevated insulin levels.

Certain medications, like diuretics, aspirin and chemotherapy drugs, can raise your uric acid levels.

PREVENTION AND TREATMENT

Changing your lifestyle reduces symptoms and also can prevent recurrence of gout altogether.

LOSE WEIGHT

Being overweight is the most important of all the risk factors. Increased fat cells increase uric acid production, decrease uric acid excretion and increase the risk for the metabolic syndrome. I recommend the cellular nutrition programme for weight loss.

EAT WISELY

Limit sugar, starch and other simple carbohydrates while eating less purine-rich foods, such as animal proteins.

DRINKING WATER

This is one of the best and cheapest remedies for gout. By drinking water you will dilute uric acid, making it easier for the kidneys to excrete it. It will also prevent dehydration, a potent gout trigger.

ALCOHOL

Alcohol commonly triggers gout. It speeds up the breakdown of purines into uric acid and it reduces uric acid excretion. Alcohol is also a diuretic, increasing water excretion, making you more dehydrated. If you seriously want to defeat gout, alcohol must best be avoided or severely curtailed. You may be fortunate enough to cure gout simply by doing this. Beer is considered the highest in purines, followed by whiskey, rum, vodka, gin, and then wine.

DRINK JUICES

The juices of cherries, strawberries, blackberries, cranberries, blueberries, bilberries and black currants are highly recommended.

GREEN TEA

Green tea contains antioxidants called polyphenols. A green tea polyphenol called epigallocatechin-3-gallate (EGCG) inhibits the body's production of inflammatory compounds that aggravate joint pain. Studies show that drinking green tea reduces the risk of certain types of arthritis like gout. People in countries that drink a lot of green tea, such as China, India, and Japan, have much lower rates of arthritis.

SUPPLEMENTS

Large quantities of the omega-3 fatty acids in fish oils help relieve inflamed joints as do the antioxidants, especially vitamins C and E. Dandelion, as well as apple cider vinegar, is helpful in promoting the removal of excess uric acid in the urine.

DRUG TREATMENTS

Though lifestyle changes are always helpful, they may not control severe cases of gout. The medication most commonly used to treat and prevent gout attacks is Allopurinol, which works by reducing the uric acid level in the blood. However, only about half of patients get satisfactory relief from this drug.

Please remember that just lowering your uric acid level with a drug will not protect you from the other serious associated diseases mentioned above if you do not make the lifestyle changes I have listed. When next you check your blood-sugar and cholesterol levels, have your uric acid levels done as well.

You may email Dr Tony Vendryes at vendryes@mac.com or listen to 'An Ounce of Prevention' on Power 106FM on Fridays at 8 p.m. The programme streams live on the Internet.