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All About Gout

Karen Alexander, Licensed Registered Dietitian Nutritionist

September 22, 2021

Gout is the most common form of inflammatory arthritis, in which deposits of uric acid crystals accumulate in the joints as a result of high blood levels of uric acid (hyperuricemia). Gout usually affects one joint at a time. Accumulations of crystals in the joints can cause flare-ups (attacks) of painful inflammation in and around the joints, but there are also times when the symptoms disappear. If not controlled, gout can progress to gouty arthritis, which is a worsening form of arthritis. Gout cannot be cured but can be treated successfully and without complications with medication and nutrition therapy.

Common risk factors:
  • Family history: 20% of people with family history of gout will be diagnosed
  • Age and gender: More frequent in men than women, between the ages of 30 and 50
  • Other chronic conditions/comorbidities : Obesity, history of metabolic syndrome, hypertension, diabetes and chronic kidney disease, among other conditions
  • Medications: Thiazide and loop diuretics, low-dose aspirin, cyclosporine, niacin, tuberculosis drugs (ethambutol, pyrazinamide), didanosine, and some chemotherapy cancer treatments have been linked to risk of gout
  • Diet: High intake of alcohol- especially beer, high intake of meat and seafood, high intake of fructose (also known as high-fructose corn syrup). In addition, high consumption of foods that are rich in a chemical compound called purines, which the body breaks down into uric acid, are associated with risk
Lifestyle recommendations:
  • Limit consumption of purine-rich foods
  • Limit consumption of alcohol, especially beer
  • Limit consumption of foods or beverages with high-fructose corn syrup
  • If overweight or obese, slow weight loss is recommended. Rapid weight loss can trigger a rapid release of uric acid in the body, causing flare-ups
High-Purine Foods to limit or avoid:Β 
  • Beer and other alcoholic beverages
  • Gravies and sauces made with meat
  • Fish, seafood and shellfish- including anchovies, sardines, herring, mussels, tuna, codfish, scallops, trout and haddock
  • Meats- including bacon, turkey, veal, venison, wild game such as goose, and organ meats such as liver or kidney, tripe and sweetbreads
  • Yeast and yeast extracts (taken as supplements)
Moderate Purine Foods. Limit to the amount suggestedΒ 
  • Meat and Poultry
  • Crab, lobster, oysters and shrimp (limit to 1-2 servings, daily)
  • Dried beans, peas and lentils (limit to 1 cup cooked, daily)
  • Asparagus, cauliflower, spinach, mushrooms and green peas (limit to 1/2 cup of all vegetables, daily)
  • Oatmeal (limit to 2/3 cup uncooked, daily)
  • Wheat bran, wheat germ (limit to 1/4 cup dry, daily)
Low Purine Foods: You can eat any amount of foods that are low in purine
  • Eggs, nuts and peanut butter
  • All dairy foods (low-fat or fat-free types are best)
  • Bread, pasta, rice, cake, cornbread and popcorn
  • All vegetables except for asparagus, cauliflower, spinach, mushrooms and green peas (limit to 1/2 cup of these vegetables daily)
  • All fruits
  • Soups made without meat
  • Water, tea, coffee and cocoa
  • Salt, herbs, olives, pickles, relishes and vinegar
  • Sugars, sweets and gelatin
Facts about Gout:
  • Gout affects about 9.2 million adults (3.9%) in the US
  • Lifestyle choices can reduce gout flares and symptoms
    • Limit alcohol, especially beer
    • Limit fructose
    • Limit foods high in purines
Recipe of the Week

The recipe of the week comes via sallysbakingaddiction.com

110 Calorie Crustless Veggie Quiche

Ingredients

1 1/2 cups sliced yellow squashΒ (2Β small orΒ 1Β very large)

1 1/2 cups sliced zucchiniΒ (2Β small orΒ 1Β very large)

1Β large orangeΒ bell pepper, choppedΒ (or any color)

2Β clovesΒ roasted garlic, chopped

1 tablespoon thyme, groundΒ (or fresh chopped)

3Β largeΒ eggs

3Β largeΒ egg whites

3/4 cupΒ milk

3/4 teaspoonΒ salt

1/4 teaspoonΒ freshly groundΒ black pepper

2/3 cupΒ shredded cheese

2 tablespoons parmesan cheese, grated

Directions

  1. Heat a large skillet over medium-high heat. Spray with nonstick spray and add sliced squash and zucchini, chopped pepper, roasted garlic, thyme and a little pinch of salt and pepper (the rest of the salt and pepper called for in the recipe goes into the egg mixture, so just use a pinch here). Stirring frequently, cook for 6-7 minutes or until veggies are tender. Spoon into a bowl and allow to cool as you prepare the egg mixture.
  2. Preheat oven to 350Β°F (177Β°C). Spray a 9-inch pie pan or square pan with nonstick spray. Set aside.
  3. In a large bowl, whisk the eggs, egg whites, milk, salt and pepper together until thoroughly combined. Arrange veggies into the prepared pan. Top with shredded cheese, then pour the egg mixture on top. Sprinkle with grated parmesan cheese.
  4. Bake for 45 minutes or until filling is set and no longer jiggles. Cool for 10 minutes on a wire rack before slicing and serving. This quiche makes great leftovers! Store tightly covered in the refrigerator for up to 4 days.

Notes

  1. Freezing Instructions: Baked quiche freezes well, up to 2 months. Thaw overnight and bake at 350Β°F (177Β°C) and warm up for 20 minutes, give or take.
  2. Milk:Β Recipe tested with both skim milk and unsweetened plain almond milk. Any milk will be OK.
  3. Cheese: The author used a blended reduced fat shredded cheddar and mozzarella. Use your favorite cheese such as goat cheese, feta, gouda, etc. If you aren’t watching your calories,Β  increase to about 3/4 – 1 full cup.

(https://sallysbakingaddiction.com/110-calorie-crustless-veggie-quiche/#tasty-recipes-75018-jump-target)

References

  1. https://www.rheumatology.org/Portals/0/Files/Gout-Guideline-Early-View-2020.pdf
  2. https://www.merckmanuals.com/home/bone,-joint,-and-muscle-disorders/gout-and-calcium-pyrophosphate-arthritis/gout
  3. https://www.cdc.gov/arthritis/basics/gout.html
  4. https://www.medscape.com/answers/329958-10236/what-is-the-prevalence-of-gout-in-the-us
  5. nutritioncaremanual.org

 

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