In Hong Kong, 3% of the population suffers from gout - also known as metabolic arthritis. Often considered as a male disease, gout occurs most frequently in men aged 40-60 and less often in pre-menopausal women. An episode of gout can last from a few days to 2 weeks - if left untreated. Some people encounter gout attacks frequently, or it could come back after years.
The term gout attack is very illustrative - it is sudden severe pain in a joint. An episode of gout usually lasts 5 to 7 days, then gets better. The pain is very intense. The encouraging news is that most gout cases are treatable and preventable, including a controlled diet, pain relief treatment, and monitoring uric acid.
Main causes of gout and symptoms
Gout occurs when surplus uric acid coalesces into crystals, which causes inflammation in the joints. Pain, swelling, and loss of joint motion are typical. Those of increasing age are more exposed to the disease. Usually it's because the kidneys aren't keeping up and excreting enough uric acid. Frequent occurrences of gout attacks can lead to lasting damage to joints and kidneys.
Gout diet objectives
A purine-restricted diet is a relatively straight-forward way to stave off gout attacks. Purines are a group of chemicals present in all body tissues and in many foods. Our bodies are continually processing purines, with uric acid being one of the waste products. A purine-restricted diet limits the intake of high-purine foods and ensures enough nutrition at the same time.
Gout diet plans
It is advisable to reduce the amounts of foods that you eat that are high in purines. A good starter is to understand the levels of purines that food and drinks contain. High purine food includes food that contains rich protein such as fish, offal; medium purine food includes meat and seafood, daily intake should not be more than 225 to 300g; low purine food such as eggs are recommended.
According to Nutritionist Ms. Cheng Chi Li Cherie, food can be categorized into high, medium, and low purine types. Gout patients must avoid consuming high purine food, including some seafood, offal, stew meat soup, and hot pot soup, etc. Meanwhile, moderate intake of low and medium purine foods, such as grains and cereals, root vegetables and fruits, milk and eggs, and even pork and beef (medium purine food) is acceptable.
Here is an example of a menu for gout patients:
- Breakfast: Yogurt, plain steamed bun/plain congee/salad, eggs
- Lunch: Shrimp vegetable noodle soup, stir-fried egg and tomato, stir-fried green peppers, and sliced lean pork
- Dinner: Plain rice, steamed fish, seaweed soup
Other guidelines include:
- Drink lots of water. 8 glasses of fluids is recommended, which helps to flood away the uric acid.
- Do not drink too much alcohol, especially beer that contains a lot of purines. The more the purines the bodies absolve, the higher the uric acid level.
- Eat a healthy, balanced diet. Do not eat lots of fatty food. Avoid crash diets.
- Exercise regularly. Staying physically active helps prevent future gout attack. Take moderate-intensity exercise 5 times a week, 30 - 60 minutes each time.
Experts also debunk several myths with facts concerning gout diet.
| Myths |
Facts |
| Avoid beancurd and soymilk. |
Much of the purines of ground soybean is lost in the process of its manufacturing. Moderate consumption is advised. |
| Do not eat any fungi. |
Fungi is listed as medium purines food; recommend taking less than half a cup per day. |
| Losing weight helps reduce uric acid. |
Being overweight increases the risk of developing gout. Reducing the number of calories can lower uric acid levels. |
| Avoid beer, while other alcoholic beverages are harmless. |
Alcohol triggers gout attacks. Beer is high in purines particularly. Nevertheless gout patients should avoid alcohol consumption. |
Home remedies for gout
While there’s no cure for gout; fortunately, we can relieve the pain and swelling with accessible, natural home remedies such as:
- Cherries or tart cherry juice: three servings every two day are considered most effective.
- Celery or celery seeds: popular home remedies for urinary issues.
- Warm water with apple cider vinegar, lemon juice, and turmeric: Apple cider vinegar is a proven solution for countless ailments, including gout. Try mixing 1-2 tablespoons of apple cider vinegar, a handful of lemon juice, and turmeric in 8 ounces of water.
Gout treatment: Western vs Traditional Chinese Medicine
Treatment is prescribed according to levels of pain. Cold therapy can offer significant pain relief. Apply ice to the joint if the pain is bearable. For patients who suffer from medium to severe gout attacks, medicines include colchicine, and non-steroidal anti-inflammatory drugs (NSAIDs) are often used to relieve pain. If you have frequent attacks and the pain becomes more acute, a uric acid test measuring uric acid levels that can collect in joint fluid might be recommended, which can exclude the likelihood of bacterial infection. Steroid injection is also a safe way to treat gout.
Traditional Chinese medicine approaches offer other treatments. According to TCM, gout is a form of rheumatism and is considered a bi-syndrome, contributed by pathogens that affect qi and blood flow. The spleen plays a key role too. Certain Chinese herbs will be prescribed to disperse heat and dampness and treat 'bi'. On top of the medicine, acupuncture is an effective treatment during an attack and aftermath.
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