Royal riches: Gout
By Ashlyn Dickinson, Student Pharmacist and Karen Kier, Pharmacist
On behalf of the ONU HealthWise team
In the 5th century B.C., the “Father of Medicine” Hippocrates referred to a disease known as the “arthritis of the rich.” He noted that a life of luxury, including idleness and heavy drinking and eating, resulted in this condition that today we know as gout. In the 16th-18th centuries, gout was known as the “disease of kings.” Monarchs such as Henry VIII were known to have gout as a result of his rich diet and this was culturally glorified to show your wealth. In the United States, Benjamin Franklin is known to have a history with gout.
Gout is a common inflammatory joint disease. The global prevalence is around 4% of the population, with men more likely to get gout with a ratio of 3 men to every 1 woman. The risk of gout increases with age with the highest risk between 50 and 69 years. Individuals diagnosed with gout often have an increase in blood pressure and cholesterol at the same time.
Gout forms due to the buildup of uric acid, which gets into joints and causes inflammation, pain, and joint damage. It is more common in men because their blood uric acid concentration does not change throughout their life. Women can get gout particularly after menopause because uric acid concentrations increase at this stage in life. Some important risk factors for gout include diet, being overweight, high blood pressure, and certain medications.
FOODS
Uric acid concentrations will increase in the blood with certain food groups containing purines. This includes organ meats such as liver. Certain seafoods can be high in purine including anchovies, sardines, herring, mussels and scallops. Meat products of beef, lamb, veal, pork, venison and duck are high in purines. Beer is very high in purine plus the alcohol component prevents the kidneys from eliminating purines into the urine and this increases uric acid blood levels. High-fructose corn syrup and yeast extracts can raise uric acid levels.
MEDICATIONS
One of the most common medications to raise uric acid levels and gout is thiazide diuretics often used for reducing blood pressure. A common thiazide diuretic is hydrochlorothiazide found in combination with other drugs to lower blood pressure. Low-dose aspirin (under 300mg) increases uric acid levels, which can result in gout. The use of low-dose aspirin or baby aspirin is common in managing heart disease. Other medications can include cyclosporine for immune diseases, levodopa for Parkinson’s disease, and some cancer chemotherapy drugs.
DIETARY CHANGES STUDIED
A 2026 study from the American College of Rheumatology shows that a simple dietary change can lower the risk of gout when consuming more lignans in your diet. Lignans are natural chemical compounds found in foods providing antioxidant and phytoestrogen activity. Lignans can be found in plant-based foods including whole grain boxed cereals, cooked oatmeal, bran, and flaxseed.
This study interpreted data from subjects in the Health Professionals Follow-Up Study
and the Nurses’ Health Study. The scientists sent the participants, which were white men and women, a survey about how often they ate certain foods to determine if there was a link between these foods and the risk of gout?
The results showed that eating plant-based foods with the lignans matairesinol and secoisolariciresinol reduces the risk of gout despite any other risk factors. Matairesinol is found in sesame seeds, flaxseeds, and rye. It has antioxidant and anti-inflammatory effects and potentially some anti-cancer benefits. Secoisolariciresinol is found in the same seeds as matairesinol as well as sunflower seeds and other whole grains.
Adding some of these plant-based ligands may help reduce uric acid in the blood and reduce the risk of developing gout. Other helpful diets can include the Mediterranean diet and the DASH diet, which includes fruits, vegetables, whole grains, and low-fat dairy products. Avoiding beer and other purine-based alcohol while increasing water intake are other good options for reducing uric acid. Talk to your healthcare professional or consult a dietician for more advice on dietary options for reducing uric acid and gout.
Do not eat like the royals and avoid gout!