Thursday, July 11, 2013

Arthritis Treatment: What Role Does Lifestyle Play in Gouty Arthritis?


There are more than 100 different types of arthritis. Arthritis is a term coined from the Greek, "arthron" meaning joint and "itis" meaning inflammation. Characteristically, the signature signs of arthritis include swelling, heat, redness, and pain.

Of the many different types of arthritis, gouty arthritis is the one most often associated with lifestyle. Picture the jolly fat old man with the swollen foot up on a pillow. In fact, one notable person who fits this description was Benjamin Franklin, a known gout sufferer. While this is the perception of the gouty patient, it is probably wrong. While gout preferentially affects men, it is also relatively common in postmenopausal women, particularly those who are taking thiazide diuretics.

Gout is a disease due to the deposits of monosodium urate (uric acid) crystals in joints and other organs. Although joints are the most visible areas where gout makes its presence known, gout also attacks other organ systems with potentially devastating consequences.

With proper diagnosis and therapy, it remains one of the few curable types of arthritis. While medicines play a major role in the proper management of the disorder, gout also responds to dietary and other lifestyles changes.

One lifestyle modification that is critical is maintenance of normal body weight. There is an association of gout with certain metabolic problems, such as obesity, diabetes, elevated blood lipids, and hypertension. This constellation of symptoms is often referred to as the metabolic syndrome.

Some studies have indicated that caffeine may be protective. The extent of protection is probably mild at best.

In another recent study, skim milk enriched with milk fat extract significantly reduced the risk of gout flares (Dalbeth N, Ames R, Gamble G, et al. Daily intake of skim milk powder enriched with glycomacropeptide and G600 milk fat extract may reduce frequency of gout flares; results from a randomized, controlled trial. In: ACR Conference Proceedings; abstract 207; 2011). In general, milk has been found to be somewhat protective in previous studies.

Vitamin C has also been found to be somewhat protective.

One the flip side, there are factors that been shown to be "pro-gout." Red meat and shellfish have long been known to trigger gout attacks. Alcohol in the form of beer also is a known trigger.

Finally, fructose containing beverages such as various soft drinks are implicated as public health menace since they contribute to obesity as well as to the development of gout.

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