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Obesity and gout in young adults
Last Updated 29 October 2010, 12:16 IST

Our country is facing an epidemic of diabetes and obesity. Among the diseases related to  obesity, a previously not so common disease — gout — is being diagnosed more often.

Gout is a painful inflammatory condition, resulting from crystals of uric acid that accumulate in joints and other areas of the body.
Purine is a chemical that is present in all cells of the body. As cells divide and multiply, the body breaks down purines. Uric acid is a waste product of purine metabolism that is passed out in urine.

When there are abnormally high levels of uric acid in the blood, uric acid crystallises into needle-sharp urate crystals. These crystals then stay in the soft tissues and in the joints of the extremities, classically, the big toe and cause inflammation, swelling and an excruciating pain that has been vividly described as “like walking on one’s eyeballs.”

Who is at risk?

People are more likely to suffer from gout if they are overweight or obese, have high blood pressure and consume alcohol regularly. Patients with gout are more likely to develop diabetes and high cholesterol levels later in life, putting them at increased risk of heart disease and strokes.

What causes gout?

Gout is most likely the result of a combination of hormonal, genetic and dietary factors. It may also be due to drugs and/or some medical disorders.

Overweight people are more likely to have high blood levels of uric acid than those who maintain a healthy weight. Children who are obese may have a higher risk in adulthood.

Foods to avoid

Increased consumption of purine-rich foods such as meat and fish increases the risk of gout. Interestingly, vegetarian sources of protein such as peas, beans and lentils, although rich in purines, do not increase the risk. Low-fat dairy products may actually protect against gout.

Drinking too much alcohol, especially beer, increases the risk. Alcohol consumption, especially binge drinking, is associated with gout in young adults. Limited consumption of wine has not been shown to increase the risk.

How are obesity and gout related?

Compared with people of normal weight, overweight or obese people have a higher (three or four times higher) risk of developing gout. In obese patients, there is increased production of uric acid and decreased excretion of the same in the urine. So, it is easy to see that a young, overweight, hard working individual, unwinding on a Saturday night with a few glasses of beer, is at high risk.

What are the lifestyle modifications  recommended?

Weight control, limited consumption of red meat, beer and alcohol, and daily exercise are recommended. Control of high blood pressure, without the thiazide group of drugs, is also important. These modifications help in reducing the risk of heart disease, diabetes and some types of cancer.

What is the recommended diet?
It is a diet that helps to reduce production and promote excretion of uric acid. It is not a treatment for gout. A gout diet, combined with weight loss, can lower the risk of gout attacks.

* Avoid red meats and some kinds of fish.
* Get your daily requirement of protein from vegetarian sources like beans and legumes.
* Increase consumption of low-fat/ skim milk and curds.
* Avoid beer and alcohol.
* Drink plenty of water.
* Avoid sugar and sweets.
*Eat plenty of fruits and vegetables.

(Published 29 October 2010, 12:16 IST)

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