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The question: I recently had my first gout attack. What foods should I avoid?

The answer: There are certain foods you should avoid in order to manage gout. There are also foods (and beverages) you should eat and drink because they can help prevent a future attack. Like standard medication prescribed for gout, dietary changes are aimed at reducing levels of uric acid in the blood.

Gout is a form of arthritis marked by sudden attacks of painful, inflamed joints, usually the big toe, but your feet, ankles, knees, hands and wrists can also be affected. Either the body makes too much uric acid or it doesn't excrete enough, which causes uric acid crystals to form in the joints. More than half of people who have had a gout attack will have a recurrence within a year.

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It's important to reduce your intake of foods rich in purines, natural compounds that, once consumed, are broken down into uric acid. Purines are found in organ meats, beef, pork, lamb, sardines, anchovies, mackerel, clams, asparagus, mushrooms, spinach, green peas, cauliflower, beans and lentils.

Historically people with gout were told to avoid all purine-rich foods. However, a 2004 Harvard University study involving 47,150 men found that high intakes of meat and seafood increased the odds of developing gout, but purine-rich vegetables didn't.

Cut back on your intake of meat and seafood. When you do consume these foods, eat a small three-ounce portion. Include poultry and legume-based meals in your diet more often.

Consume two servings of low fat dairy each day. The study also revealed that men who drank at least two eight-ounce servings of skim milk each day were 44 per cent less likely to develop gout compared to their peers who drank less than a serving per month. Proteins in dairy are thought to help reduce uric acid levels.

Be sure to drink two to three litres of water a day to help your body excrete uric acid. Avoid sugar-sweetened soft drinks and fruit juice, which have been linked to a higher risk of gout.

If you drink beer, cut back. Alcoholic beverages – especially beer and spirits – prevent uric acid from leaving your body. Unlike wine and spirits, beer also contains purines. What's more, alcohol may also interfere with gout medications. Speak to your doctor about alcohol consumption.

Finally, if you're overweight, losing weight may help prevent gout attacks. Excess weight puts more stress on your joints and can boost uric acid levels. But lose weight gradually. Rapid weight loss and fasting can increase acid levels in the blood. Avoid low carbohydrate, high protein diets since they also elevate levels.

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Leslie Beck, a registered dietitian, is the national director of nutrition at BodyScience Medical. She can be seen every Thursday at noon on CTV News Channel's Direct ( www.lesliebeck.com ).

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