Several of the major characters in Charles Dickens’ novels suffer from inflammatory arthritis.
As Dickens described it, an attack of this arthritis would last for several days, would be very painful with a high fever and a red, swollen joint – usually the big toe, but sometimes the ankle or knee. Almost always this character would be rich, overweight, and gluttonous, consuming large amounts of meat, rich desserts, and alcohol. Common among the rich and affluent, it was known as “the rich man’s disease,” “the king of diseases,” and “the disease of kings,” a disease we call gout.
Modern medicine has discovered that genetics plays a large part in developing gout. The disease occurs nine times more frequently in males, peaking at age 70-75. The underlying cause is an elevation in uric acid in the blood stream, usually as a result of the inability of the kidney to excrete uric acid in the urine. The excess uric acid crystallizes in the joints of the body, sometimes in the tendons and occasionally under the skin. In the joints the uric acid crystals cause an immune inflammatory reaction that results in a hot, red, painful joint, ultimately leading to the crippling total destruction of the joint. Uric acid can also crystallize in the kidney causing blockage and/or kidney failure.
Where does the uric acid come from? Look at the description of the character in the Charles Dickens’ novel. High meat intake, especially the “sweetbreads” (kidney, liver, brains, and other internal organs), seafood (both crustaceans as well as fish), and high-fructose products contribute to the increase in uric acid. (Interestingly, high protein vegetable sources do not cause an elevation of uric acid.)
Large alcohol intake decreases the kidney’s ability to excrete the uric acid and causes dehydration, increasing the concentration of the uric acid in the blood and the joints.
As in our Dickens’ character, gout occurs more frequently in those who are overweight, have high blood pressure, and increased insulin resistance (known as metabolic syndrome and the major cause of Type II diabetes.)
To be sure, not every case of gout occurs in an obese, gluttonous consumer of alcohol (since 60% of the problem is a genetic dysfunction). In addition, the medical management of gout involves the judicious use of several kinds of medications to manage the acute flair-up and the long-term control of the level of uric acid.
However, the major lifestyle interventions recommended to decrease uric acid levels and decrease the frequency of gout attacks include discontinuing the use of meat (including poultry) and sweetbreads, seafood, and alcohol, increasing the use of Vitamin C foods, and avoiding obesity.
Are you getting the Dickens’ picture? Living the lifestyle of a pauper – a lacto-vegetarian diet low in rich foods and high in Vitamin C, sufficient exercise to maintain ideal body weight, and avoidance of alcohol – will help to control “the rich man’s disease” in those whose genetics predispose them to the gout.