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Medical Edge Newspaper Column from Mayo Clinic

NUTRITION, LIFESTYLE CHANGES CAN REDUCE SEVERITY OF GOUT

DEAR MAYO CLINIC: I have been diagnosed with gout. I am taking allopurinol, but I have not been given any advice about what I should or should not eat. Is there a particular diet for the prevention of gout? I am anxious to avoid any more pain. — Tucson, Ariz.

ANSWER: Gout — a form of arthritis that involves sudden, severe attacks of pain, redness and tenderness in joints — occurs when high levels of uric acid in the blood (hyperuricemia) cause the acid to build up and be deposited in the toe and other joints. Uric acid is a waste product formed when purines, a substance found naturally in the body and in certain foods, breaks down.

Keeping uric acid levels within a normal range is the key to preventing gout. In the past, this meant rigid dietary restrictions. Since the development of medications such as allopurinol that help keep uric acid levels in check, however, these dietary restrictions are not as stringent as they once were. Still, eating a diet low in purines may help reduce the frequency and severity of gout attacks.

Foods that have high levels of purines include: anchovies, game meats (such as venison and duck), gravies, herring, organ meats (liver, brain, kidney and sweetbreads), sardines and scallops. To keep your uric acid levels lower, try to avoid these foods. In addition, most experts advise eating no more than six ounces of lean meat, poultry or fish a day for nearly everyone, especially people who have gout, because these high-protein foods increase the blood level of uric acid.

For a more detailed list of foods high in purines that you may want to limit or avoid, talk with your physician or a dietitian. They can guide you on how to best meet your nutritional needs while reducing your risk of gout.

Other lifestyle modifications that can help prevent gout include avoiding or limiting alcohol consumption, maintaining a healthy weight, losing weight if you’re overweight and drinking plenty of fluids. Each of these measures can help lower your blood level of uric acid, which in turn may decrease the number of painful gout attacks you experience.

— Kevin Moder, M.D., Rheumatology, and Janelle Gonyea, R.D., Nutrition, Mayo Clinic, Rochester, Minn.

Additional Resources:
Gout
Appointment Informattion
More Information on Gout

READERS: Keeping a marriage happy can be hard work — no matter how long you’ve been together. Add in health issues that often arise with age, and the challenge is even greater.

The Mayo Clinic Health Letter offers suggestions to keep marriage on a positive track, whatever the source of conflict.

— Keep communication positive. Patterns of communication — likely firmly established if you’ve been married a long time — sometimes don’t reflect the caring that couples feel for each other. Ask yourself, “Are we as respectful to each other as we would be to a stranger?” If not, you’ll want to work on your communication skills by making a daily habit of being cordial and polite, choosing words with care.

— Recognize when a health issue is affecting your marriage. Memory loss, chronic pain, limited mobility, hearing loss and other health conditions can affect your relationship. Sometimes solutions are straightforward — for instance, a hearing aid. Sometimes, more far-reaching solutions are needed, such as moving into a single-level home or retirement community.

— Get help when you need it. If you’re in a long-lasting marriage, for better or worse, you care for each other in a deep and meaningful way. If the going gets difficult, seek out help through community resources, a therapist or your family doctor, or at your place of worship. The Web site for the American Association for Marriage and Family Therapy (www.aamft.org) provides information on how to choose a marriage therapist.
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Medical Edge from Mayo Clinic is an educational resource and doesn’t replace regular medical care. To e-mail a question, go to www.mayoclinic.org, or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave., Suite 114, Buffalo, N.Y., 14207. For health information, visit www.mayoclinic.com.