For many people, gout seems like a disease of the past. Cartoons 200 years ago depicted it as a condition that affected the wealthy (“the disease of kings”), whose gluttonous consumption of food and drink was thought to bring on the debilitating arthritis attacks.

All these years later, much of gout is still not understood. Shame, ridicule and the belief that the gout sufferer deserves the condition persist. And rather than being a disease of the past, gout is quite common and rates are increasing. Estimates suggest that gout affects nearly 4% of the adult population in the U.S., an increase from previous decades. And it is not a disease that is limited to the affluent; it affects people of all economic classes.

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The most likely explanations for the rising rates of gout are an aging population and excess weight. Both are major risk factors for the disease. The expanding waistline of the average American probably plays a more important role than age, as overweight and obesity have increased faster than the average age of Americans in recent decades.

When uric acid levels in the blood are very high, the body is unable to eliminate this excess through the urine so it is deposited in the form of crystals in some joints, causing gout disease. This deposit causes intense pain, swelling, redness accompanied by a great sensitivity to the touch and increase of the local temperature that affects, frequently, the first toe although it can also affect knees, ankles and other joints. Most of the times the elevation of uric acid in the blood is accompanied by other conditions such as: overweight, obesity, diabetes, arterial hypertension, among others.

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A study of Gout suggests Ways to avoid it

Although research has identified some preventable risk factors for gout, the impact of modifying them is uncertain. Now, a new study published in JAMA Network Open has found that more than three-quarters of gout cases affecting men may be entirely preventable. And given that gout affects men more often than women, this finding is remarkable.

The researchers analyzed data from nearly 45,000 men who completed detailed surveys about their health, habits, and medications every two years for 25 years. When comparing those who developed gout (nearly 4%) with those who did not, four factors were identified as protective:

• Normal body mass index (BMI), a measure of weight and height.
• No alcohol consumption
• No use of a diuretic medication (a drug that increases urination, commonly used to treat high blood pressure and other conditions)
• Following a DASH-style diet, a heart-healthy diet originally developed to counteract high blood pressure.

The analysis suggested that 69% of all cases of gout in men could be avoided by these four measures. Most of this benefit applied to men who were not obese. Obese men (BMI of 30 or more) saw little benefit. According to the researchers, this suggests that losing excess weight is necessary to get the benefits of the other three protective factors.

As with all research, this study has limitations. For example, the analysis relied heavily on self-report, which can be inaccurate. This included information on diet, alcohol consumption, medication use, and even gout diagnosis. And it is possible that other unmeasured contributors to gout risk (such as genetic factors) could have contributed to the findings. The study participants were all male health professionals (dentists, optometrists, osteopaths, pharmacists, podiatrists, and veterinarians), and 91% were white, so the findings may not apply to all people at risk for gout.

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The prevalence has been increasing in recent decades and increases substantially with age and blood uric acid levels. Gout is the most common cause of arthritis in men over 40 years of age, while in affected women it usually occurs after menopause. In view of this situation, the Secretary of Health of the State of Queretaro called on citizens to go to the nearest medical unit where they will be diagnosed and, if necessary, receive the appropriate treatment. A timely treatment reduces the uric acid levels below the crystallization level, the urate crystals will slowly dissolve until they disappear and, with them, the possibility of suffering new gout attacks.

It has been identified that heredity is a fundamental factor in the development of this condition. People with family members who have suffered from gout are more at risk of developing it. Dietary excesses or alcohol consumption favor the increase of uric acid and its complications in genetically predisposed people. The state agency informs that diagnosed patients should avoid fat intake, not eat excessive amounts of protein foods (meat, fish, eggs) and exercise regularly.

Final Message

The idea that a painful and sometimes disabling condition like gout can be prevented without medication is certainly appealing. But knowing how to prevent gout and actually preventing it are two different things. At the very least, this new research adds one more reason to adopt a healthy diet, moderate alcohol intake and maintain a healthy weight: not only could this improve your overall health, but it may also save you from gout.

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