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Last Updated
Tuesday 15 June 2021, 15:11 pm.
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Food for the soul

Arthritis, gout post easter? don't suffer in silence
By Boitshepo Giyose (GMT +2)
Mmegi Online :: Food for the soul








For those of you that have had a brush with gout - the big toe disease - know exactly how excruciating the pain can be. I have seen some people (especially men) almost give up shoes completely as a result of this seemingly small condition that pops out of the blue. Today, more people, because of the shifts in diets, are affected by arthritis and gout.

What is gout exactly? Gout is a common type of arthritis caused by an increased concentration of uric acid in biological fluids. Uric acid is created by the breakdown of purine, a molecule found in DNA and RNA. In gout, uric acid crystals are deposited in joints, tendons, kidneys and other tissue where they cause significant inflammation and damage, not to mention the resultant pain. Deposits of uric acid in the kidneys may result in kidney failure.

That's why at the first signs of gout, one must be diligent to modify their diet and lifestyle as kidney failure is a serious condition that must be prevented. The first attack of gout is usually characterised by intense pain usually involving only one joint - the first joint of the big toe is affected in nearly half of the cases and probably up to 90 per cent of the individuals affected. First attacks usually occur at night and are usually triggered by specific events such as changes in the diet, dietary excesses, alcohol consumption, trauma, certain diuretics and surgery. In these situations, there is an overproduction and under-excretion of uric acid.

Several dietary factors are known to trigger gout; these include intake of alcohol, high purine content foods such as organ meats, meat, yeast and poultry, fats, refined carbohydrates, and excessive calorie intake.  The old mantra of moderation can't be over emphasised. These are the same reasons that inspired me to write this piece for the week, as I know coming from the long weekend, all of the above dietary pitfalls applied to a lot of folks out there. Gosh I feel your pain (and guilt), and hence would like to ease it with some simple nutritional guidelines and basic dietary wisdom.

If you are already forced to wear sandals or are even going barefoot, you need some heroic measures; an anti-inflammatory drug

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is a must - usually colchicine does the trick. However long term use of this drug is not recommended as it might lead to liver damage, seizures and respiratory depression amongst the side effects.Thus dietary management for long term and sustained relief is best.

What not to eat and what to eat? The dietary treatment of gout involves the following; a low purine diet, elimination of alcohol, achievement of ideal body weight, increased consumption of complex carbohydrates, low fat intake, low protein intake, higher fluid intake, and liberal consumption of celery, cherries and blueberries.

Foods that are high in purine and to be eliminated or taken in much smaller amounts include anchovies, herring and mackerel fish, fish eggs (roe), sardines, yeast, meat and meat extracts, organ meats including brains, kidneys, liver and offal. Come to think of it, there might be a direct link to the fact that men tend to suffer more from gout; that in Setswana culture they are the ones to usually eat the head of the animal, kidneys and all the other good bits. Hmm makes you think!

Low-Purine foods include fruits, whole grains, nuts, olives, noodles, milk and eggs. Moderated Purine foods to be taken in moderation are legumes, mushrooms, shellfish, dried peas, asparagus and spinach. So much for gourmet cooking with asparagus and other exotic ingredients... Liberal fluid intake appears to keep the urine diluted and promotes the excretion of uric acid. Furthermore dilution of urine reduces the risk of kidney stones - certainly another excruciating condition you want to avoid at all costs. Drink at least 8-10 glasses of water per day.
Overweight and obesity are strongly associated with an increased risk of gout. Weight reduction significantly reduces the levels of uric acid. Use of high-fibre, low fat, with more focus on fresh fruits and vegetables give a lot of benefit. Simple sugars, fats decrease uric acid excretion. Specific foods such as celery and cherries have been shown to be effective in lowering uric acid levels due to their high polyphenol and flavonoid content. So there you have it; there's indeed a grand reason to grab those celery sticks and fruit kebab instead of the barbeque steak or chop.

Bye-bye big toe, hello life! Thanks to good nutrition.

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