JAKARTA - Gout is often associated with the habit of consuming red meat or alcohol excessively. However, this assumption is not entirely correct.
The treatment given to some patients is also considered not optimal because the dose is too low to effectively control the disease.
Citing Channel News Asia, Sunday (28/12), epidemiologist from the University of Alabama at Birmingham, Tony Merriman, explained that diet can indeed trigger gout, but it is not the main cause of the condition.
In the United States, gout affects more than 12 million people. The disease is four times more common in men than in women, which is thought to be related to higher estrogen levels in women that provide a protective effect.
Medically, gout occurs due to high levels of uric acid often called gout in the blood. This substance is mostly formed from the process of breaking down purines, chemical compounds that are naturally produced by the body.
In addition to being produced by the body, purines are also obtained from daily food. Red meat and seafood such as shrimp are known to contain high purines. However, some vegetables such as spinach and asparagus also have relatively high purine content.
Under normal conditions, the kidneys are able to filter and remove uric acid without problems. In gout sufferers, the excessive amount of uric acid makes the body overwhelmed, so that the substance forms crystals and settles in the joints, resembling pebbles in the engine's wheels.
These deposits can cause severe pain that lasts for several weeks. In the long term, uric acid crystals can also form lumps called tophus, which can potentially damage the joints and bones.
The study conducted by Merriman and his team in 2018 on 16,760 European-descent individuals showed that genetic factors play a much bigger role than diet in determining the risk of gout.
"The high-purine diet pattern only explains less than a third of the 1 percent difference in uric acid levels, but genetic factors explain about a hundred times more," he said.
Several ethnic groups, such as Polynesian and Hmong descent, are known to have a higher risk of gout. In addition to genetic factors, conditions such as obesity, high blood pressure, and heart disease also contribute because they affect the body's ability to regulate uric acid levels.
For a single gout attack, primary care physicians generally prescribe over-the-counter pain relievers or colchicine as an anti-inflammatory. However, for patients who experience two or more attacks per year or already have gout, the American College of Rheumatology recommends gout lowering therapy. This therapy is also recommended for patients with chronic kidney disease or those who have a history of bladder stones.
Hyon Choi, director of the Center for Gout and Crystal Arthritis at Harvard Medical School, said that a low-purine diet should be applied in a limited way.
"Avoiding purines in the long term often means eating more carbohydrates and fat, which can potentially worsen metabolic health," he said.
He gave an example that consumption of high-fructose corn syrup can actually increase uric acid levels in the blood. On the other hand, vegetables with high purine content have not been shown to increase the risk of gout.
Choi encourages gout sufferers to focus more on weight loss and implement healthy diets such as the DASH diet or the Mediterranean diet, which have been shown to be beneficial in lowering blood pressure and supporting overall metabolic health.
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