by Rachel Stockton

Created on: October 14, 2008   Last Updated: November 11, 2008

Gout has been around for as long as human beings have been able to overindulge. Hippocrates was the first to mention the condition in the 5th century BC. In antiquity, it was referred to as the patrician malady, or the disease of kings, because those who were susceptible to it were those possessing enough money to engage in raucous gluttony. Associated with rich, fatty meats and high levels of alcohol consumption, gout is no longer just a "high brow" problem.

GOUT: FORM OF ARTHRITIS

Gout is a form of arthritis; it's an inflammatory disease affecting the feet and legs and is associated with high levels of uric acid in the blood. Once the level of uric acid reaches the point where it can no longer remain fluid, it crystallizes around the joints in the feet (typically around the big toe).

A "bout of gout" typically starts during the night; sufferers typically describe the pain as "throbbing", "crushing", and/or "excruciating." The affected joint may appear red (sometimes a rash will be visible) and feel warm to the touch.

RISK FACTORS

Biologically, most mammals, with the exception of human beings and the great apes, produce an enzyme called uricase. This enzyme converts uric acid into a harmless substance called "allantoin", which is then secreted through the kidneys. Since as humans we lack this important enzyme, uric acid remains chemically unchanged.

However, the absence of uricase isn't the only factor determining gout susceptibility. Apes (who lack the same enzyme) do not suffer from the disease, primarily because their diet largely consists of plants and fruits.

Fatty, red meats (especially organ meats) contain a certain type of protein called purines, which break down into uric acid. Crystallization occurs when the kidneys are no longer able to eliminate the high level of acid from the blood stream.

Men are many more times likely than women to contract gout; women are largely protected from the disease because of the presence of estrogen, which helps empty excess levels of uric acid from the blood. However, postmenopausal women appear to be almost as much at risk as men.

Others at a greater risk for gouty arthritis are heavy drinkers, diabetics, and those with kidney disease. Consult your physician if you take blood pressure medication; some of them (especially the diuretics) can raise uric acid levels.

RISK REDUCTION

According to Prevention Magazine, a diet rich in red, blue, and purple fruits help reduce gout risk, as does consuming seafood containing omega-3s. Ironically, seafoods rich in fat contain purines also; however, the omega-3s make that point mute because they synthesize prostaglandins, which inhibit inflammation.

Coffee also appears to reduce risk. A study conducted by Dr. Hyon K. Choi of the University of British Columbia revealed that men who drank 4-5 cups of coffee a day significantly lowered uric acid levels in the bloodstream.

Finally, reducing intake of red meat will simultaneously reduce risk. A study of the native Maoris of New Zealand discovered that as their diet has evolved from consisting largely of sweet potatoes, taro, fern root and fish into one high in fatty meats and low in dairy, they have suffered an epidemic of obesity and gout.

While there is no cure for gout, naproxen or other pain relievers can relieve symptoms. Once an attack recedes, your doctor can prescribe an acid lowering drug if necessary. Several episodes of gout a year can result in uric acid deposits in the soft tissue, if precautions aren't taken.

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