Understanding The Risks And Pain Of Gout, The "Rich Man’s Disease"

June 8th, 2010

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Known through the ages as the “the disease of kings” or “rich man’s disease”, Gout has been recognized for at least 4600 years when the Egyptians first wrote about it. Even in terms of modern medical understanding, the condition was described, as early as 1848, to be the result of excess uric acid in the blood. Given that this form of arthritis was causing considerable pain to the powerful and wealthy, it is not surprising that it received as much attention as it did.

Today however, Gout is well known to the upper and lower classes alike. Individuals from all segments of society suffer from the very painful condition that results from the formation of crystals in the tendons, joints and surrounding tissues, followed by an immune system reaction to these crystals. The sharp crystals most frequently form in the knuckle joint of the big toe, but are also known to form in the fingers, wrists, the heels and the knees.

The crystals that are deposited during a case of Gout are made of uric acid, a waste product in our bodily processes that is carried by the blood to the kidneys. Gout is caused by an accumulation of this uric acid in the body that results when the kidneys do not remove as much of the uric acid from the blood as they should. In most people, the symptoms of Gout arise and persist for one to two weeks before disappearing for a while; the definition of a flare-up.

As one of the more painful forms of arthritis, Gout affects some 2.1 to 5.1 million Americans annually depending on the source of the information. In Britain and Canada, some 614 thousand and 555 thousand are affected respectively, although the British numbers may also be low.

Based on at least one study, the condition affects men 3 to 4 times more frequently than women though other studies have put the number has high as 7 to 9 times. As well, seniors have higher rates of Gout than younger individuals. African American men have double the risk of Caucasians to getting Gout and Polynesians are also at increased risk.

In addition to certain groups being at higher risk, research from the Mayo Clinic has found that the rate of the condition more than doubled between the late 1970s and the late 1990s and is still increasing.

With race being a risk factor in the development of Gout, it follows that the disease is at least partly dependent on genetics. In fact, this is definitely the case as researchers from the National Heart Lung and Blood Institute have identified 3 genes that together account for a 40 times increase in the risk of developing the disease. Additionally, from research carried out at Johns Hopkins University, it is now known that a genetic defect is the reason why the kidneys in many people with Gout are unable to extract the uric acid from the blood as effectively as they should.

While genetics is important, diet and other factors also play an important role, especially for those who carry the genetic defects that dramatically increase the risk of experiencing the condition.

With regard to diet, research from Massachusetts General Hospital found that there was 41% higher risk of developing the condition in people who ate the most meat as compared to those to eat the least. Similarly, the risk among those who ate the most seafood was 51% higher than in those who ate the least. This is due to a chemical in these foods called prurine that is known to increase the risk of Gout.

Though meat and seafood do increase risk, it is not just these foods that can cause the condition either. Beans, peas, lentils and even spinach have long been known to promote the flare-ups.

Other dietary contributors to Gout come in liquid form such as sodas or pops and alcohol. In a study led by the University of British Columbia, the scientists there found that consuming 2 or more sugar-sweetened soft drinks increased the risk of developing Gout by 85%. Even more moderate consumption of 5 to 6 soft drinks per week increased the risk by 29%.

In the case of alcohol, its contributions to Gout have been known for hundreds of years. However, in some cases, the link between drinking alcohol and developing Gout has been overemphasized. Of course, there is still a risk from alcohol and research published in both The Lancet and the New England Journal of Medicine found that drinking two or more beers per day increased the risk of Gout by 2.5 times while drinking two drinks of hard alcohol per day increased the risk by 60%.

Relate to, but separate from diet, another potential risk for developing Gout involves carrying excess weight. The risk almost doubles for those who are overweight as compared to those who are not and the risk is 2.3 times and above for people who are obese (BMI > 30). These results are also from research performed at Massachusetts General Hospital. Needless to say, the risk of significant pain from Gout offers yet another compelling reason to actively manage one’s weight.

This article quite intentionally provides only “the things to avoid” related to gout. However, aside from medication and avoiding the “bad behaviors” that are known to increase the risks for Gout, there are things that one can proactively do to limit the chances of developing the condition. These will be offered in another article.

Related Links

http://www.nyuhjdbulletin.org/Permalink.aspx?permalinkId=0c3ec9d1-8cc8-49d5-850d-4c5a55cb0669

http://www.arthritis.org/arthritis-in-african-americans.php

http://www.arthritis.ca/local%20programs/bcyukon/media/FAQ/default.asp?s=1

http://www.jclinepi.com/article/0895-4356(94)00244-K/abstract

http://www.jrheum.org/content/29/11/2403.short

http://www.jrheum.com/subscribers/04/08/tables/PDF/1582.pdf

http://www.ncbi.nlm.nih.gov/pubmed/18830092

http://www.endo.gr/cgi/content/abstract/350/11/1093

http://www.bmj.com/cgi/content/short/bmj.39449.819271.BEv1

http://www.foodnavigator.com/Science-Nutrition/Soft-drinks-linked-to-rising-gout-statistics

http://www.timesonline.co.uk/tol/life_and_style/health/expert_advice/article1075571.ece