THE ESSENTIAL
- In addition to alcohol and certain purine-rich foods, gout sufferers should avoid sugary drinks.
- Diet is not the only risk factor for developing gout, genetic factors may also be involved.
Gout is a chronic disease that affects approximately 0.9% of the French population, with older men being the most affected. It is caused by abnormally high levels of uric acid in the blood and the deposit of microcrystals of uric acid in the joints and surrounding tissues, which leads to inflammation. This condition results in flare-ups called “gout attacks”. The patients then suffer from joint pain, with redness, heating and swelling of the affected area. Most often, in men, it is the big toe that is most affected. In women, other joints can be abused. In addition to the pain it causes, inflammation also increases cardiovascular risks.
Lifestyle
During a gout attack, the doctor prescribes medication and often recommends lifestyle changes to the patient to keep the level of uric acid in the blood below a certain threshold. As this acid comes from the degradation of purines, molecules contained in many foods, it is generally necessary to modify your diet. Beer, strong alcohols and products such as red meat, organ meats, cold cuts, seafood, mackerel, sardines or herring should be avoided, as they are high in purines. Moreover, experts, in the medical journal Prescribe, warned that sugary drinks such as sodas, fruit juices and industrial nectars are also to be avoided. “The metabolism of fructose, like that of alcohol, tends to increase the production of uric acid”, according to the editorial staff.
To reach this conclusion, the experts base themselves on two studies carried out on tens of thousands of people. “After controlling for a variety of factors that can influence gout risk, including alcohol consumption and body mass index, these studies showed approximately twice the risk of gout in people who consumed more than a sugary drink per day compared to those who do not consume it”, is it written. Finally, “the patients with gout attacks are advised to reduce or even avoid drinks with added sugars, such as sodas“. Let’s not forget that in principle, sugary drinks, even “light”, are bad for your health. Scientists often associate them with an increased risk of diabetes, obesity or even cardiovascular disease.
Role of genetics
On its site, the Health Insurance already lists sugary drinks as a risk factor for gout. “Gout results from an abnormal and chronic increase in the level of uric acid in the blood, which is explained by a high dietary intake of purines and especially by a defect in the elimination of uric acid by the kidneys. When the uric acid concentration exceeds the solubility limit, uric acid crystals (sodium urate) form and settle in and around joints. uric acid comes from the degradation of purines present in many foods (foods rich in proteins, alcohol, beer, sugary drinks, etc.). It is then eliminated by the kidneys, in the urine”is it thus written.
However, diet is not the only risk factor for developing gout. In October 2018, a study published in the BMJ suggested that genetics plays an even greater role in the emergence of this common disease. During their research, the scientists studied the medical records of 8,414 healthy men and 8,346 women. By analyzing their blood uric acid levels, they noticed that each of the foods associated with high levels contributed less than 1% to the variation in urate levels. However, genetic analysis of the participants demonstrated common genetic factors that explained almost a quarter (23.9%) of the variation in the ratios.
“Our data challenges widely held perceptions that gout is primarily caused by diet, showing for the first time that genetic variants contribute far more to gout than dietary exposure.”, the scientists said. Therefore, “much of the preponderance of patients with hyperuricemia and gout is not modifiable“, they concluded, calling for no more blaming patients and for following more carefully the members of families where a person has gout.
