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Dr. K: Watch what you eat to prevent painful gout attacks

Dr. K explains the link between gout attacks and diet.
BY Anthony L. Komaroff, M.D. Modified: June 25, 2012 at 5:35 pm •  Published: June 26, 2012

DEAR DOCTOR K: Could my diet be triggering my gout? If so, what foods and beverages should I avoid to prevent future episodes?

DEAR READER: Your diet absolutely can trigger attacks of gout. As you know all too well, gout causes redness, swelling and extreme tenderness in one or more joints. Very often the attack occurs in the big toe, and when an attack hits, it really hurts. I know from personal experience: I have gout.

Some people have gout attacks every few weeks. Others go years between attacks.

Gout occurs when there is too much uric acid in the blood and tissues. Crystals of uric acid form in the joints. They also can form in the kidneys, where they can cause kidney stones.

There are three main causes of the high levels of uric acid that lead to gout:

•  Your diet is rich in chemicals called purines, which the body breaks down into uric acid.

•  Your body chemistry produces more uric acid than that of most people.

•  Your kidneys do not get rid of enough uric acid, so it builds up in the blood. This can happen with any kind of kidney disease. Also, drinking a lot of alcoholic beverages and taking certain blood pressure medicines can reduce the amount of uric acid that the kidneys expel.

You can't do anything about your body chemistry, but you can control your diet. To decrease your risk of gout, avoid purine-rich foods like anchovies, sardines, oils, herring, organ meats (liver, kidneys and sweetbreads), legumes (dried beans and peas), mushrooms, spinach, asparagus, cauliflower, and baking or brewer's yeast.

Also limit how much meat you eat at each meal. Avoid fatty foods. Stay hydrated. Don't drink too much alcohol, and especially avoid binge drinking.

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