Managing Gout: Dietary Tips and Frequency of Attacks

Gout-related issues

I have had gout attacks three times so far, once a year, and was diagnosed last month.
My uric acid level is 7.2.
I would like to know: if I do not control my diet, will the attacks become more frequent? I drink 300ml of 10% fruit juice from a cooperative every day at noon, which includes passion fruit, peach, orange, and grape.
Do I need to limit these juices? I eat shrimp about once every three days (shared by classmates); is that acceptable? Can I eat beef noodles? Is it true that I need to limit all red meat? Can I drink wood ear and lotus seed soup? What about legumes? I take 5mg of Allopurinol once a day.

Ming, 10~19 year old female. Ask Date: 2020/06/13

Dr. Zeng Guosen reply Internal Medicine

The online medication "Kang Hsu Su Long 5mg" is a steroid and should not be taken daily for an extended period.
If gout is not managed, most individuals will experience increasingly frequent flare-ups.
It is recommended that you consult a rheumatologist, rather than an orthopedic or family medicine doctor, as there are many lifestyle and dietary considerations that cannot be adequately addressed online.
Thank you for your question.

Reply Date: 2020/06/13

More Info

Managing gout effectively requires a comprehensive understanding of dietary choices and lifestyle modifications. Gout is a form of inflammatory arthritis characterized by recurrent attacks of severe pain, swelling, and redness in the joints, primarily due to elevated levels of uric acid in the blood. Your current uric acid level of 7.2 mg/dL indicates that you are at risk for more frequent gout attacks if dietary and lifestyle changes are not implemented.

Dietary Recommendations for Gout Management
1. Limit Purine-Rich Foods: Foods high in purines can lead to increased uric acid levels. These include:
- Red meats: Beef, lamb, and pork should be limited. While you may enjoy beef noodle soup, it’s advisable to consume it sparingly.

- Seafood: Shellfish, particularly shrimp, crab, and lobster, are also high in purines. Eating shrimp every three days may be acceptable, but moderation is key.

- Certain fish: Anchovies, sardines, and mackerel should be avoided.

2. Fruits and Juices: While fruits are generally healthy, some juices can be high in sugar, which may contribute to increased uric acid levels. The 10% fruit juice you mentioned, especially if it contains high-fructose corn syrup or is overly sweetened, should be consumed in moderation. Opt for whole fruits instead, as they provide fiber and can help lower uric acid levels.

3. Dairy Products: Low-fat dairy products can actually help lower uric acid levels. Incorporating yogurt or skim milk into your diet may be beneficial.

4. Vegetables: Most vegetables are low in purines and can be consumed freely. Foods like spinach, asparagus, and mushrooms are moderate in purines but are generally safe in normal portions.

5. Legumes and Pulses: Beans, lentils, and peas are moderate in purines but can be included in your diet. They are also a good source of protein and fiber.

6. Hydration: Staying well-hydrated is crucial. Aim for at least 8-10 glasses of water daily to help flush uric acid from your system. Avoid alcohol, especially beer, as it can raise uric acid levels.

7. Weight Management: If you are overweight, losing weight can significantly reduce uric acid levels and the frequency of gout attacks. Aim for gradual weight loss through a balanced diet and regular exercise.

Frequency of Attacks
Without dietary control, it is likely that your gout attacks will become more frequent. Each attack can cause joint damage, leading to chronic gout and more severe symptoms over time. By making the necessary dietary adjustments and maintaining a healthy lifestyle, you can help prevent future attacks.

Medication
You mentioned taking 5 mg of Colchicine (康速龍), which is commonly used to treat acute gout attacks and prevent future ones. It’s essential to follow your healthcare provider's recommendations regarding medication and to discuss any changes in your condition or symptoms.

Conclusion
In summary, managing gout effectively involves a combination of dietary modifications, hydration, weight management, and adherence to prescribed medications. By being mindful of your food choices, particularly regarding purine intake, and maintaining a healthy lifestyle, you can significantly reduce the frequency and severity of gout attacks. Always consult with your healthcare provider or a registered dietitian for personalized advice tailored to your specific health needs.

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