Gout is a joint condition and a type of arthritis. It attacks single joints, especially the big toe. If left untreated, an acute attack will subside in a week or two, but gout is prone to recurrence.

1. High blood uric acid levels
2. High blood pressure
3. Obesity
4. Alcohol Consumption

Gout is usually associated with an excessive intake of “rich” foods and alcohol. It is associated with high blood uric acid levels. Both genetic and environmental factors appear to influence the incidence of gout. About a quarter of gout patients’ relatives will also have high uric acid levels.

Uric acid is a metabolite of purine. Purine can be found in foods. High levels occur in the blood when the body produces too much uric acid and/or the kidneys cannot eliminate enough of it. Uric acid levels will also increase if you are fasting.

Uric acid is not very soluble in water and can crystallise in the joints, casing inflammation and gout.

Men	232-494MMOL (3.9-8.3mg/L)
Women	140-340MMOL (2.3-5.7mg/L)

Gout is more likely to occur at uric acid levels greater than this. However, a person may have normal uric acid levels and still develop gout.

1. Kidney damage
2. Kidney or urinary tract stones

1. Low purine diet
2. Low purine diet with medication

Suitable Foods

• Fresh fruits and vegetables (except those listed below)
• Nuts (except peanuts)
• Milk and milk products
• Eggs (in moderation)
• White bread, white rice and plain noodles

• Meat
• Fish
• Poultry
• Scallop, lobster, mussel, oyster, crayfish
• Sunflower seeds
• Dry lentils, chickpeas, peanuts, peas, oatmeal
• Dried fruits
• Banana, jackfruit
• Spinach, capsicium, sweetcorn, cauliflower, chives, parsley, bean sprouts, leeks, broccoli

• Yeast extracts (e.g. Marmite)
• Animal organs such as liver, kidney, heart, brains
• Small fish, e.g. sprat, ikan billis, sardine, herring
• Trout, tuna, canned fish
• Fish roe
• Dried mushrooms
• Broths, meat stocks eg. chicken essence, Bak Kut Teh, gravies, stock cubes
• Soy bean and related products e.g. beancurd, bean paste, soya bean milk, tempeh

• Please eat balanced meals that include a variety of food.
• Decrease the amount of fat and oil used in your meals as the items will increase uric acid production.
• Get most of your energy from starchy foods.
• Use sugar in moderation especially if you are overweight.
• Avoid alcohol as it will increase uric acid production. If you wish to drink, please discuss alcohol consumption with your doctor.
• Take prescribed medications according to your doctor’s instructions.
• Maintain your ideal body weight and be more active as far as possible. Do not follow a crash diet even if you are very overweight, as it can bring on an attack of gout. Avoid a high protein diet to lose weight as this may trigger or aggravate a gout attack.
• Drink 2 – 3 litres (10 – 15 glasses) of water daily.
• Do simple movements to prevent stiffness but do not over exercise or strain the affected joint.

Proper dietary management with or without medications is essential to avoid further attacks and prevent complications.