Gout and dietary management

Gout is caused by a build-up of uric acid in your blood. Uric acid is a waste product which the body produces when chemicals called purines are broken down in the body’s cells. The body then excretes uric acid mainly via the kidneys.

However if your body produces too much uric acid or excretes too little, a build-up of uric acid can occur and this can cause tiny crystals to form in and around your joints. These crystals can join together over time and cause the inflammation and pain experienced in gout.

Healthy Body Weight

Eating a healthy, balanced diet is important to provide our body with all the essential nutrients that it needs. Being overweight can increase uric acid levels in the body. Therefore maintaining a healthy body weight (BMI 20-25) can help reduce the incident of gout attacks.

You can calculate your Body Mass Index (BMI) using the web link below. If you are overweight aiming to lose 10% of your body weight can help. Weight loss should be a gradual process and you should set realistic goals that are maintainable. Crash or ‘FAD’ diets should be avoided.

Some helpful tips for weight loss include:

• Eat a healthy balanced diet and include 3 regular meals a day
  - Base your meals on starchy carbohydrates 
  - Aim for 5 portions of fruit and vegetables a day
  - Limit foods high in fat and/or sugar 
• Control your portion sizes
  - Look on www.bdaweightwise.com for guidance and tips 
• Increase physical activity – aim for 30 minutes a day

Ask your GP if you can be referred to Weight Watchers for additional support.

Dietary Management

Purines are part of our normal diet and cannot be avoided completely. However it may help to reduce dietary purine by limiting intake of foods that have high purine content. The table below suggests foods to avoid, limit and encourage to help reduce the incident of gout attacks.

Encourage	Vegetables • Vegetables do contain purines; however these purines do not have the same effect as purines from meat and fish • Aim for at least 5 portions of fruit and vegetables a day. 1 portion = 80g	Low Fat Dairy Products • Aim to have 2-3 portions a day • Portion size =  - 1/2 pint (200ml) semi-skimmed milk - Small pot (100g) low fat yoghurt/fromage frais - 30g hard cheese
Limit	Red meat • e.g. beef, lamb and pork • Eat in moderation (1-2 portions a week) • Portion size = 75g (cooked) – size of a deck of cards	Seafood • e.g. mackerel, shellfish, sardines and trout • 1-2 portions a week (as recommended by general healthy eating guidelines) • Portion size = 75g
Avoid	Offal • e.g. liver, kidney, sweetbread	High fructose corn syrup • found mainly in drinks and processed foods • Check labels: often named as HFCS or glucose-fructose syrup on ingredients lists

Fluid

It is important to drink plenty of water. Keeping yourself well hydrated may reduce the risk of crystals forming in your joints. Aim to drink at least 2 litres of water a day (8 glasses).

Alcohol

During periods of gout attack, alcohol should be avoided. Alcohol intake should be no more than the recommended allowance:

• 3- 4 units/day for men
• 2-3 unit/day for women

You should have at least 2-3 alcohol free days a week. Beer may present a higher risk for gout than wine and spirits but all should be consumed in moderation.

Be aware of what a unit is:

• 125ml glass of 9% wine, is 1 unit, most wine is 12%
• 1/2 pint of normal strength beer/lager
• 25mls spirits pub measure