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Your diet and you

​Gout is a common medical condition among patients at Bright Vision Hospital (BVH). It happens when there is an abnormally high level of uric acid in the blood, causing crystals to form in the joints.

 

Facts about gout
  • Gout affects predominantly older men, with a male to female ratio of 3:1 above 65 years
  • Too much uric acid in the blood will cause monosodium urate crystals (MSU) to form in the joints
  • MSU will trigger an inflammatory response when dislodged from the cartilage and fibrous tissues
  • Persistent accumulation of MSU crystals causes joint damage, leading to arthritis
  • MSU crystals when deposited in small joints and surrounding tissues can cause an acute gout
  • Classic sites for chronic gout are the big toe, wrists and finger joints, elbow, ankle, knee and the helix of the ear

To help our patients with their condition, the Dietetics and Nutrition Services (DNS) department started an initiative to educate them about gout and their diet on 25 April 2018. 

The program's key objective was to reach out to all patients with gout, including those who are not referred to the Dietitians for dietary advice.

The gout programme is the first of a six-part education series to increase awareness and health literacy among BVH patients.


What causes gout?

"Gout comes and goes. The ideal way to deal with the condition is for them to take their medication and abide to a healthy diet that is low in purine content," explained Senior Dietitian, Lock Poh Leng.

It becomes challenging when patients are not compliant or have underlying kidney disease.

"Most of my patients have kidney problems, which restricts them from fluid intake. They are unable to drink a lot of water to excrete out the excessive uric acid from the kidney," shared Poh Leng.

To help patients control their gout, doctors reduces their uric acid with medication while Poh Leng counsels them on their diet.


 Ms Lock Poh Leng explaining to patients on what is Gout

Gout is also link to excessive intake of red meat, with purine being the main culprit. The chemical compound is part of a normal diet and is broken down into uric acid. Food such as red meat (beef, pork and mutton), seafood (sardine, anchovies and scallops), and meat extract contain high amount of purine.

"I have patients who like to eat mutton and beef. It is an excessive intake of red meat, which adds to their gout problems," said Poh Leng. However, a diet high in purine-rich vegetables (beans, peas and lentils) and low fat dairy products does not increase the risk of gout.

Another contributing factor to gout is alcohol. Alcoholic beverages such as beer have high purine content and it is important for people with gout to limit or avoid alcohol intake. Beverages that contain fructose such as soft drinks, sugar-sweetened beverages and fruit juices can also increase uric acid level.

Edward Chan, Dietitian at BVH, shared, "A patient of mine loved to eat duck meat and drink alcohol. He was admitted to the hospital when he started to suffer from a swollen toe and was unable to walk.

"The doctors started medication to control his symptoms and I advised him to avoid alcohol whenever possible."


 Mr Edward Chen conducting the talk on Gout in Mandarin

So what can one do to prevent or treat gout?

Choose a healthier lifestyle. Consume a balanced meal with limited intake of meat and beer. Avoid high purine food and limit your consumption of drinks that contain fructose.

"Drinking at least 2 litres of water daily helps to eliminate the uric acid in your body. If you have heart or kidney problems, or are on diuretics, consult with your doctor to check if there is any fluid restriction," advised Poh Leng.

Next, aim to stay at a healthy weight. If you are overweight, target for 5% - 10% of weight reduction from your starting weight. Being overweight increases uric acid production and inhibit uric acid excretion. 

Last but not least, if your doctor gave you medication to control your gout, please be diligent in taking them.

Edward has one final advice for our patients, "We must always remember that staying healthy will not only prevent gout but other illnesses too!"