"Especially of animal origin"
"Five times as likely to have a gout flare-up"

Risk of gout flare-ups greatly increased by purine rich foods
Published on May 31, 2012
Foods rich in purines, particularly those found in meat and seafood,
quintuple the immediate risk of a gout flare-up, finds research
published online in the Annals of the Rheumatic Diseases.

While the anecdotal evidence has suggested that purine rich foods can
trigger gout attacks, it hasn’t been clear whether they prompt flare-
ups in the short term, say the authors.

They base their findings on 633 people with confirmed gout, whose
health was tracked over a year, online. The average age of the
participants was 54, and most of them (78%) were men.

They were asked to provide details of history of gout attacks,
including the timing and symptoms of the attack; what drugs they were
taking to manage their condition; and to list any potential triggers
in the two days running up to an attack.

This included dietary sources of purines. Foods rich in purines
include meat, offal, seafood, beans, peas, lentils, oatmeal, spinach,
asparagus, mushrooms, yeast, and alcohol.

They were also asked to provide the same information over two-day
periods every quarter when they were not experiencing a flare-up, by
way of a comparison.

Over half drank alcohol (61%), a known risk factor for the condition,
while 29% used water pills (diuretics) and almost half took allopurinol
—a drug used to prevent gout attacks.

Over half used non-steroidal anti-inflammatory drugs, while one in
four (25%) took colchicines, another class of anti-gout drug.

During the 12 month monitoring period, 1,247 gout attacks were
recorded, most of which occurred in the toe joints, causing intense
pain and redness.

The average amount of dietary purine during a two-day period without
gout attacks was 1.66 g, while that consumed in the two days before an
attack was 2.03 g.

Compared with those in the bottom 20% of purine consumption, those in
the top 20% were almost five times as likely to have a gout flare-up.

Animal sources of purines carried a significantly higher risk than
plant sources of triggering an attack.

These findings held true, irrespective of age, gender, alcohol intake
and use of medications to control symptoms/pain.

The fact that plant sources of purines had significantly less impact
than animal sources can be explained by lower purine content in those
foods, say the authors, who emphasise that plant sources contain other
important nutrients and contribute to lowering insulin resistance—long
advocated as a measure to control gout.

“Avoiding or reducing purine-rich food intake, especially of animal
origin, may help reduce the risk of recurrent gout attacks,” they

Source: www.ard.bmj.com

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