This question was submitted by a friend of mine:


I suffer from Gout and have attacks on occasion. I have tremendously changed my eating habits and alcohol intake but still suffer from mild to moderate attacks from time to time. Diet, exercise and moderation can control gout – but what can be done to prevent it?


What is gout?


Gout is a medical condition usually characterized by recurrent attacks of acute inflammatory arthritis—a red, tender, hot, swollen joint. The joint at the base of the big toe is the most commonly affected (approximately 50% of cases). However, it may also present as kidney stones. It is caused by elevated levels of uric acid (UA) in the blood which crystallizes and the crystals are deposited in joints, tendons, and surrounding tissues. (Source: Wikipedia)


Uric acid is an organic compound produced in the body by the liver and mainly excreted by the kidneys (65 to 75 percent) and intestines (25 to 35 percent). Uric acid is an antioxidant and it can be responsible for up to two-thirds of total plasma antioxidant capacity.


Who is at risk for developing gout?

The ratio of men to women is about 5:1 and the disease is rare in premenopausal women.


About 10 percent of people with high levels of uric acid develop gout at some point in their life.The risk, however, varies depending on the degree of elevation. When levels are between 415 and 530 μmol/L (7 and 8.9 mg/dL), the risk is 0.5% per year, while in those with a level greater than 535 μmol/L (9 mg/dL), the risk is 4.5% per year.1 (Gout: an update”. Am Fam Physician 76 (6): 801–8).


That said, people with normal level of uric acid can develop gout, and some people with high levels of uric acid levels will never develop.


What causes gout?

Studies have shown that diets high in sweetened drinks (fructose) can elevate levels of uric acid, contributing to the development of gout.


Alcohol and especially beer also elevate levels of uric acids.


Several studies suggest iron plays a role in triggering flares of gouty arthritis by increasing levels of uric acid. Individuals with hyperuricemia should not ingest a large amount of purine-rich food (for instance, veal, bacon, kid meat, mutton, turkey, pork, duck, goose, etc.).


How to prevent gout and flare-ups:

Phlebotomy (blood drawing) to reduce iron stores to near-iron-deficient levels was shown to improve flares of gouty arthritis in 12 hyperuricaemic patients with active disease. Relapse was prevented in 56 percent; the remaining patients had a reduction in the frequency and severity of attacks. The mechanism of this benefit remains unclear, but may be related to a decrease in urate-complexed iron, decreased oxidative stress or possibly an immunosuppressive effect of relative iron deficiency.* (Have your iron levels checked and if they are elevated, making a blood donation would likely be beneficial).


Eat a h