Gout is the most common crystal-induced joint disorder, which is caused by the deposition of monosodium urate monohydrate crystals, mainly in the joints. Gout is one of the oldest diseases in the medical literature, known since the time of the ancient Greeks.
Gout develops in the setting of excessive stores of uric acid in the form of monosodium urate. Uric acid is an end-stage by-product of purine metabolism. Humans remove uric acid primarily by renal excretion. When excretion is insufficient to maintain serum urate levels below the saturation level, urate can crystallize and deposit in soft tissues.
In about 90% of cases, the underlying cause of gout is the inability to excrete uric acid by the kidneys. This could be due to acute or chronic kidney disease, Starvation or dehydration, certain drugs, & chronic abuse of ethanol, especially beer & hard liquor.
Sometimes, gout can occur due to overproduction of uric acid in our body. Especially in disorders with high cell turnover, such as leukemia and lymphoma, psoriasis, and hemolytic anemias. And sometimes, overproduction of uric acid could be due to a genetic cause.
Another instance where excessive deposition of uric acid crystals occur is overconsumption of purine rich foods. These include organ meats, red meats, seafood, alcohol, and beer. And they contain a moderate-to-high amount of purines.
In addition, fructose and sugar-sweetened beverages can increase the risk of gout and gout attacks, even though they are not purine-rich.
Certain comorbid conditions are also associated with a higher incidence of gout, including high blood pressure, diabetes, high cholesterol and high triglyceride levels in blood, obesity, anemia, and kidney disease.
In most cases, the crystals initially deposit in the metatarsal-phalangeal joint of the great toe, as you can see in this picture. This will cause inflammation of the joint, leading to an intense, excruciating pain and swelling. Other than the great toe, the most common sites of gouty arthritis are the instep, ankle, wrist, finger joints, and knee.
When we talk about the diet for a gout patient, it should not contain the foods that we discussed above, because they can increase the level of uric acid in blood, and trigger gouty attacks.
In addition, certain foods are beneficial in reducing the chances of gout attacks, because they contain only little amounts of purine.
Some of them include the following.
Fruits. All fruits are generally fine for gout. Cherries may even help
prevent attacks by lowering uric acid levels and reducing inflammation.
Vegetables. All vegetables are fine, including potatoes, peas, mushrooms,
eggplants and dark green leafy vegetables.
Legumes. All legumes are fine, including lentils, beans, soybeans and tofu.
All types of nuts and seeds.
Whole grains, including oats, brown rice and barley.
Dairy products. All dairy is safe, but low-fat dairy appears to be especially beneficial.
Eggs.
Beverages such as Coffee, tea and green tea.
Herbs and spices.
Plant-based oils. Including canola, coconut, olive and flax oils.

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