Much is being written lately about healthier eating habits and lifestyle to prevent and manage chronic diseases such as diabetes, hypertension and heart disease, but could it also be the answer preventing acute gout flare-ups and permanent damage to joints.
Current research is increasingly demonstrating a relationship between lifestyle and high levels of uric acid in the blood and therefor supports the idea that you can manage gout with a healthy lifestyle.
The pillars of healthy living include:
– A nutritious and balanced diet
– Weight reduction to achieve a normal BMI
– At least 20 minutes of medium intensity exercise on at least five days a week
– Relaxation to reduce stress, including relaxing with family and friends, hobbies and activities such as meditation
– Sufficient sleep of about 7-8 hours per night for adults
– Avoiding smoking
– Avoiding excessive alcohol intake
Nutritious and balanced diet
If you suffer from gout you are probably aware of the need to avoid foods high in purine, and you have most likely identified which foods and drinks trigger flare-ups.
However, even a very strict low purine diet does not reduce uric acid levels by more than about 1mg/dL. Purines are important building blocks in the body and when they are broken down uric acid is formed.
Uric acid is however also a waste product of other metabolic processes, including the breakdown of sugar.
Statistical analyses have shown that there is a close association between the incidence of gout and metabolic syndrome which is now recognized as a risk factor for many chronic diseases.
Metabolic syndrome is characterized by insulin resistance, obesity, high blood pressure and high cholesterol – all of which are associated with a diet high in carbohydrates and processed foods.
Significantly, a study which followed up 46 000 men over a 12 year period found that sugar sweetened soft drinks and a high consumption of fructose were strongly associated with an increased risk of gout.
The take-away here is that a healthy balanced diet could go a long way in avoiding build-up of uric acid and thereby acute attacks of gout.
Your diet should include daily portions of protein, healthy fats and at least five portions of vegetables and fruit per day and, most importantly, you should avoid excessive sugar intake.
Portions of protein, especially red meat, should not be excessive and fruit juice and fruits high in fructose (including apples and oranges) should be limited. Dairy products, coffee and vitamin C seem to decrease uric acid levels.
You should also drink enough water throughout the day to assist with the excretion of uric acid. It is particularly important to guard against dehydration in very hot weather.
Obesity appears to be a significant risk factor for gout, particularly because of its link with metabolic syndrome and insulin resistance, both of which lead to higher levels of uric acid.
Research has shown that the risk for gout rises as the BMI – which is the ratio of body weight to height – increases. Weight gain appears to be associated with both increased levels of uric acid in the blood as well as decreased excretion of uric acid by the kidneys.
Strict low calorie diets, with fasting and near fasting should however be avoided as they can provoke gout attacks. These diets lead to breakdown of muscle protein for energy, causing increased levels of uric acid.
A healthy balanced diet with moderate restriction of carbohydrates, as well as increased activity, will lead to gradual, natural weight loss.
A recent study found that this type of diet also significantly reduced the number of gout flare-ups.
Exercise and fitness
Most of the advice for gout sufferers does not include any reference to exercise and fitness but it could be useful to take note of the recent findings related to gout risk factors in physically active men.
The study, which followed up a large group of male runners for self-reported incidents of gout over a period of nearly eight years, found that the most active and fit runners had a 50%-60% lower risk of developing gout than those who were the least active or fit.
As can be expected, this risk reduction was also associated with a lower BMI.
Relaxation and sleep
High levels of stress, coupled with insufficient relaxation and sleep, are strongly associated with the increase in chronic diseases over the past decades although the exact mechanisms are not quite clear.
Researchers have now found that high levels of psychological stress interfere with the process whereby the body regulates the inflammatory response – of definite importance to those afflicted by gout!
While no specific studies have been done on the links between gout and stress, the associations between gout and metabolic syndrome, diabetes and hypertension have been well demonstrated.
There are also a considerable number of reports on gout forums where sufferers themselves connect their gout flare-ups to stressful events.
This information should be enough to encourage you to incorporate relaxation as well as sufficient sleep in managing gout with a healthy lifestyle.
Smoking is known to have a serious negative impact on health but, surprisingly, men who smoke appear to have a lower risk of gout as it reduces the levels of uric acid in the blood.
This was demonstrated in study of over 50 000 Asian participants. These findings however applied only to men, and particularly to men who were not overweight.
Because of all the other health risks associated with smoking it would not be a good idea to take up this habit to lower your levels of uric acid!
Drinking a lot of alcohol is associated with increased uric acid in the blood and therefore it is a risk factor for gout and acute flare-ups.
In the above-mentioned study of risk factors for gout among athletes one of the findings was also that the overall risk for gout increased with higher daily alcohol intake, irrespective of the type of alcohol.
In another investigation it was found that beer, which has a high purine content, appears to raise levels of uric acid more than spirits, whereas moderate consumption of wine (1-2 glasses per day) did not increase the risk of gout.
As for other metabolic diseases, it is becoming clear that there are various risk factors associated with gout besides eating foods high in purine.
You can manage gout with a healthy lifestyle and reduce or prevent acute flare-ups through making changes that are inexpensive and safe while at the same time improving your overall health and preventing other chronic conditions.
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