How to prevent gout | Science| In-depth reporting on science and technology | DW | 18.07.2018
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How to prevent gout

"Love, fire, cough, scabies, gout cannot be hidden" — so an old German saying goes. And while it may be difficult to conceal the painful effects of swollen, inflamed joints, you can conceal it by not getting it at all.

For a long time, gout was considered a disease of the wealthy. For only they could afford lavish feasts.

Nowadays, meat and alcohol are available to far more people. And if you want to avoid gout yourself, you should try to remember the term "purine."

Our bodies produces purine on their own. There's a lot of purine in the skin — and also in the innards — of animals. When we eat such foods, our body converts these purines into uric acid.

Uric acid at increased concentrations is what leads to gout. The technical term for increased uric acid concentrations in the blood is "hyperuricemia."

Those at risk of gout should therefore try to consume foods with low levels of purine and avoid the stuff that's loaded with it.

But unlike other diseases that come with the accompanying recommendation to eat "lots of fruit and vegetables," gout doesn't quite work that way. Spinach and asparagus, for example, contain relatively high levels of purine. Pulses, like peas, lentils, or beans, also contain a lot of the stuff. 100 grams (just under a quarter pound) of these pulses contain roughly 150 to 200 milligrams of purine.

Popeye (Imago)

What Popeye probably didn't know: Spinach has high levels of purine

Other foods that should be completely removed from your diet inclue pork cutlets, roast chicken, veal liver, veal tenderloin and salami. Nor should herring, trout, or anchovies be on your shopping list — let alone eating them. Beef liver is especially bad: It contains 360 milligrams of purine per 100 grams.

Not everything's bad, but beer sure is

But what you can — and should — definitely eat is a kind of noodle called durum wheat semolina. They're very low in purine. Rice, potatoes and mixed-grain breads also have hardly any purine, with the same holding true for carrots, cauliflower, tomatoes and apples, yogurt and cheese. Tomatoes and apples, for example, contain about 15 milligrams per 100 grams, with cauliflower and mushrooms also coming in low on the purine scale.

If possible, you should avoid that after-work beer, as well — due to the yeast content. As pleasantly intoxicating as a glass of beer or wine may be in the evening, alcohol increases the concentration of uric acid in the blood. In the long run, alcohol consumption can, entirely on its own, directly lead gout attacks. Hence, wine also makes the "avoid" list, with no exception for either red or white.

And fruit juices? Most of them are taboo, too, because they contain such high concentrations of much sugar. That also promotes gout.

So, what can you drink? Water, of course, and also tea. Amongst the hundreds of tea flavors out there, surely there's one for you. Herbal and fruit teas even ensure that the body breaks down purine more quickly, so you should aim to drink about two liters of the stuff every day.

BdT mit Deutschlanbezug - Weltrekord im Maßkrugtragen (picture alliance/dpa/M. Balk)

"Excuse me, gout delivery coming through!"

Prevention is better than a cure

Gout attacks are extremely painful. You wouldn't wish them on anyone.

That's another way of saying that it's probably better to avoid the issue entirely beforehand — or to, at the very least, try to reduce the likelihood of it cropping up.

So here's another tip: Do without fat, if possible. Fat makes it harder for your body to get rid of uric acid through your kidneys and thus increases uric acid levels. Cook with a coated pan, and you'll need virtually no oil or other fats. There are many, many ways to cook almost fat-free.

Finally, exercise regularly. Go for a walk, swim or cycle. Try doing an athletic activity you already like. But most importantly, do something!

Exercise helps supply your joints with nutrients. If you have a BMI, or body mass index, above 25, you're considered overweight. If your BMI is over 30, you're categorized as "obese." The sooner you lose weight, the better. (Body Mass Index = divide your weight by the square of your height).

Exercise works wonders on gout, as it does on many other diseases. But don't overdo it — you don't have to become a professional athlete or a fitness freak. Try less radical methods like walking or cycling to work, or take up hiking or swimming. This advice applies not only to those suffering an illness like gout, but to everyone — and on every day of the week.

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