30 HEALTHY FOOD GUIDE JUNE 2019
OMEATincludingbeef,
lamb,chickenandpork
OPOULTRYsuchas
chickenandduck
OPEAS, beansand
legumesincluding
bakedbeans,soya
andkidneybeans
andpulsesOMUSHROOMS
ANDMYCOPROTEIN
suchasQuorn
OSOMEVEGETABLES,
includingasparagus,
cauliflowerandspinach
OWHOLEGRAINS
includingbran,oatbran
andwholemealbreadODAIRY – milk, cheese,
yogurt and butter
OBREAD AND CEREALS
OEGGSOPASTA AND
NOODLES
OFRUIT AND
VEGETABLESHow your dietcan affect gout
within 24 hours in terms of pain, and
62% of gout sufferers will have another
attack within a year. Attacks may be
triggered by any injury if there’s
a big enough knock, or by infection
or dehydration.
‘Lumps or growths formed from
crystals, called tophi, can also appear
on the tops of tendons or joints or
the edge of the ears,’ says Alastair.
Not surprisingly, it can lead to walking
difficulties – in fact, sufferers say they
can’t bear any pressure on the affectedjoint at all, including wearing socks
and shoes or having the bed covers
touching them.How is it treated?
As it’s a chronic inflammatory condition,
gout needs drug treatment to control it
and remove the crystals that are building
up in joints and organs,’ says Alastair.
Changing your diet won’t cure it, he
explains. Yet GPs usually offer advice
about diet and lifestyle rather than
prescribing drugs, continues Alastair,so gout often goes under-treated.
It’s a situation he finds frustrating,
considering effective and cheap
treatments are readily available (see
below). Even when patients are offered
medication, it’s common for the dose
to be too low to be really effective. ’We
know the medication works and can
result in a therapeutic cure, provided
you’re given the correct dose,’ he says.
Nor can you treat it once and be
certain that you’re cured. ‘People
wrongly assume they’re OK if they’re
not having an attack. In fact, if your
uric acid levels are high, the crystals
are still building up in your joints, under
the skin or even in the kidneys, causing
progressive, inflammatory damage.
This is why it’s important to have regular
blood tests to check your levels are
under control,’ he explains.
Having treatment will mean less pain,
reduce your need for painkillers and
improve your quality of life and your
life expectancy. But it may also prevent
you developing other conditions such
as high cholesterol – or lessen the risk
of heart attacks, stroke and diabetes- by reducing inflammation and
preventing blockages formed by
urate crystals in the kidneys.
What medication
is available?
OTO REDUCE URIC ACID IN
THE BLOOD, the most commonly
prescribed drug is allopurinol (or
if that doesn’t work, you may be
offered febuxostat). Dosage will
depend on your case. ‘We have an
internationally recognised treat-to-
target (T2T) strategy for gout,’ says
Alastair. ‘We aim for a target of under
300 micromoles (300μmols) of urate
per litre of blood in gout patients. You
need regular blood tests to check your
levels are under control.’
OTO HELP WITH ACUTE ATTACKS,
you’ll be advised to take colchicine
(these days, this is prescribed in
preference to anti-inflammatory
drugs such as ibuprofen and diclofenac)
when you’re actually having an acute
attack. Steroids may be used, too.
Other specialist drugs are available
on prescription from consultantOOFFAL – liver and
kidney, heart and
sweetbreads
OGAME – pheasant,
rabbit and venison
OSHELLFISH such
as mussels, crab and
shrimps, along with
fish roe and caviarOOILY FISH such
as anchovies,
herring, mackerel
and sardines
OMEAT AND
YEAST EXTRACTS
such as Marmite,
Bovril, commercial
gravy and beerUNLIKELY TO TRIGGER AN ATTACK
These foods are low in purines:FOODS TO EAT IN MODERATION
The following have moderate amounts of purines,
so people with gout shouldn’t overindulge in:O
FOODS TO AVOID IF YOU’RE AFFECTED
Although diet isn’t the cause of gout in
most people, and changing it can only
reduce urate levels by 25%, avoiding certain
foods, in combination with the right medication,
may lessen the risk of an attack. High levels
of purines are found in: