Gout is an inflammatory disease of the joints, with particular involvement of the peripheral joints, especially the first toes. An excess of uric acid in the blood is necessary (but not sufficient) to trigger it: so-called hyperuricemia occurs when the body produces too much uric acid or fails to expel it sufficiently via the kidneys. Hyperuricemia is a very frequent condition, but only a subgroup of these subjects will develop gout.
Uric acid is the end product of the metabolism of purines, nucleic acids that are both produced by the body and introduced through nutrition. If excessive, uric acid can deposit in the joints causing attacks of arthritis (gout in fact). In men, uric acid values in the blood should not exceed 7 mg/dl, in women 6.5 mg/dl while we know that with values below 5mg/dl it is impossible to suffer from gouty arthritis, which can also occur in women before menopause.
Gout has a sudden onset and manifests itself with acute arthritis (especially at the level of the first toes, but can also affect ankles, knees, wrists and elbows), swelling, pain and redness, often experienced at night.
A diet low in purines: foods to be limited
As Professor Carlo Selmi, Head of Clinical Rheumatology and Immunology at Humanitas, explains: “Patients suffering from gout are advised to reduce their purine intake through diet, in order to avoid further increasing uric acid levels in the blood and its subsequent deposit in the joints and to increase the water supply to encourage kidney excretion”.
Therefore, foods with a high and medium concentration of purines such as: blue fish (e.g. sardines, anchovies, herring), offal (liver, sweetbreads, kidneys, brain), meat (including extracts and sauces), poultry, crustaceans, cured meats, legumes, asparagus, spinach, dried nuts, mushrooms and cauliflowers should be limited.
Attention should also be paid to the consumption of alcohol – especially beer and spirits – because it promotes an increase in uric acid and hinders its expulsion through renal activity; and to fructose, which is also responsible for the retention of uric acid in the body.
Tips to counteract gout
On the other hand, products such as cheese (preferably lean), milk, eggs, vegetables, pasta and other cereals can be consumed (preferring non-integral products and excluding wheat germs).
It is also good to drink a lot of water, even if it is more than two liters a day, to favor a correct expulsion of uric acid, and to maintain the weight in shape, also thanks to a constant physical activity.