Was it something you ate? Rheumatologist Dr. Alan Matsumoto discusses the role that diet plays in triggering an attack of gout, a form of arthritis marked by joint inflammation and intense pain.
Gout is one of the most painful yet treatable forms of arthritis, but it’s often not treated properly. With Americans living longer and growing stouter -- both of which are linked to gout’s prevalence -- it’s important that gout be diagnosed promptly and accurately, and treated effectively, to prevent disability, joint damage, lost workdays, and diminished quality of life.
Q. Is gout an “old man’s disease?”
A. Gout is that rare example where the myth is true, though for reasons that people throughout history could not have known. It is true that gout remains predominately a disease of men (it is eight times more prevalent in men than women), and that gout prevalence increases with age.
Men over 30, for instance, represent one percent of all attacks, while men over age 65 account for approximately 10 percent of all attacks. The male predominance has to do with elevated uric acid levels in the bloodstream. In men, uric acid levels begin to rise after puberty, while in women, uric acid levels do not begin to rise until after menopause. This suggests that the hormone estrogen may have a protective effect in women.
Q. Are dietary overindulgences and increased alcohol consumption the main
causes of gout?
A. For most people, dietary indulgence is not the main cause of gout. As with many diseases, the problem is the underlying genetic condition that predisposes certain people to experience the accumulation of too much uric acid (a condition known as hyperuricemia).
Diet, however, does exert an influence for those predisposed to gout. If you have a genetic predisposition for gout and have higher than normal levels of uric acid to begin with, a poorly-balanced diet (low consumption of fruits, vegetables, and dairy products, and high consumption of fatty meats) will add to the problem, increasing your risk for a gout attack by about three percent.
