Friday, April 11, 2008

Risk factors for gout

About once a month, some aging fellow (sorry guys, it's more prevalent in men than women) hot foots it into my office with a hot foot. Gouty feet do not like to be touched; that joint at the base of the big toe--the most commonly affected site--is red, hot, swollen, and strictly hands-off on exam.

Gout is an inflammatory arthritis caused by the precipitation of uric acid crystals in the tissues in and around the affected joint. Uric acid is a metabolic waste product produced during the breakdown of purines which are compounds present in foods such as meat and seafood.* High intake of these foods in susceptible individuals can increase the risk of a gout attack; one study of middle-aged health professionals found that those who chose beef, pork, or lamb as a main dish 2 or more times weekly doubled their risk of gout vs. the group that hardly ever ate meat. On the other hand, those old guys who drank low-fat milk thrice daily were half as likely to suffer from gout attacks compared to those who had none. No mention made of those individuals who both ate meat and drank low-fat milk.

I've just learned about another dietary risk factor for this painful condition, namely sugar-sweetened soda. Now no one ought to be drinking this garbage, and here's another reason why. Investigators made another pass at the health professional data with respect to pop preference. Compared to those who never drank the stuff, those who consumed one can daily were half again more likely to get gout and those who had two or more servings daily nearly doubled their risk.

I ask a lot of people about what they eat and drink, and, believe it or not, two sodas per day is not that unusual.
*Purine-rich vegetables such as peas, beans, and mushrooms do not increase risk of gout.


Anonymous said...

It's your brother here. What about sugary fruit juices? And is there a difference between the high fructose corn syrup added to cranberry juice and, say, the sugars in apple juice?

Femail doc said...

The authors of this study say that fructose rich fruits (apples and oranges) and fruit juice consumption were also associated with an increased risk of gout but less strongly so. Per Canada's Dr. Hyan Choi, "In humans, acute oral or intravenous administration of fructose results in a rapid increase in serum levels of uric acid through accentuated degradation of purine nucleotides and increased purine synthesis."

So fructose is fructose when it comes to gout risk. I assume the fructose of cranberry juice (our mother's favorite!) is as goutogenic as the fructose of apple juice (which near as I can tell, has no nutritional benefits whatsoever).

Cilicious said...

It certainly is difficult to find stuff that *doesn't* have high fructose corn syrup.
My mom once had gout. It looked awful. Isn't gout associated with heavy drinking, too?

Mauigirl said...

I hardly ever drink soda - sounds like that's a good thing.

Two friends of ours (both guys) are prone to gout; they've each had a few attacks and need to watch what they eat or drink.

Ruth said...

I see this fairly often, in men and women. It is not unusual for people to have a flare up or even first appearance of gout after joint replacement surgery. Why, I do not know, but I should ask them about their soft drink intake.