QUESTION: "What is gout? Who is most likely to experience it? And what dietary changes can help to reduce its occurrence?"

ANSWER: For some people, arthritis is a pain in the big toe.

These people experience gout, a form of arthritis characterized by sudden bouts of intense, burning pain, often accompanied by stiffness and swelling. Oddly, the joint in the big toe is the most common site of an attack, but gout can also affect the ankles, knees, hands, and wrists.

Gout is more common in men than women and most frequently develops between 40 and 50 years of age. Typically, attacks last from a few days to more than a week.

The source of the pain associated with gout is a build-up in the blood of uric acid, which can form sharp crystals that collect in the joints. People who are overweight or heavy drinkers of alcohol are more likely to have high uric acid levels. Certain medications, such as aspirin and thiazide diuretics, and some medical conditions, including high blood pressure and hypothyroidism, are also associated with increased blood levels of uric acid.

Fortunately, there are ways to reduce the symptoms associated with gout in some people. Simple dietary changes are often a good place to start:

  • Consume fewer animal proteins. All animal proteins raise uric acid levels, so reducing the amount of animal products in your diet or eliminating them completely may help to ease symptoms.
  • Consider limiting plant-based foods that raise uric acid levels. Asparagus, mushrooms, and dried beans and peas are high in purines, which break down into uric acid in the body. However, you should focus on avoiding other foods that raise uric acid levels, such as animal products, before you consider limiting these otherwise healthful foods.
  • Drink plenty of fluids. Water is the best choice. Staying well-hydrated helps to dilute blood uric acid levels.
  • Avoid alcohol. Men should limit drinks to two per day; women should not have more than one a day. Less is better. Avoid alcohol completely if you are experiencing an attack of gout.

Lifestyle changes can also reduce symptoms of gout:

  • If you are overweight, work at losing those extra pounds to reduce the pressure on your joints. Establish a habit of regular physical activity, and cut back on the amount you eat.
  • Avoid fasting or low-carb, high-protein diets if you are trying to lose weight. Both approaches can raise uric acid levels.

If you'd like to learn more about gout, visit the National Institute of Arthritis and Musculoskeletal and Skin Diseases, a unit of the National Institutes of Health, online at

Adapted from Sue's weekly newspaper column and republished online at