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Gout & Non-Alcoholic Fatty Liver Disease

By: Ann Marie Coppen

Anne Marie Coppen

PhD, FNP, Nurse Practitioner

For a personal response to your health question, Ask Ann Marie at askannmarie@lindora.com. Selected questions will be featured in future columns.

Let’s talk about two conditions, gout and non-alcoholic fatty liver, that can be prompted by unhealthy eating. There are many diseases that can stem from being overweight, obese, and having poor eating habits. In the past we have discussed many of them including high blood pressure, diabetes, high cholesterol, and coronary artery disease. However, there are many more health consequences that we have not yet discussed.

Two diseases brought up by your fellow drivers that we will address this issue are:

  • Gout
  • Non-Alcoholic Fatty Liver Disease
What is Gout?  I have been told that I have high uric acid and am at risk of developing gout and I am concerned.

Approximately 6 million Americans suffer from gout. More and more Americans are being diagnosed with this disease. This is due primarily to the increase in overweight and obese individuals; the fact that the ability to diagnose gout has improved and that more individuals are suffering from other medical conditions that can predispose them to gout such as:

  • High blood pressure
  • Diabetes
  • High cholesterol
  • High levels of fat in your arteries

In addition, certain medications such as those used for treating high blood pressure (diuretics) and taking aspirin can increase uric acid levels. Family history of gout can also predispose you to this condition.

 How do you know if you are likely to have gout? 

There is a blood test that can detect your uric acid level identifying if you are likely to develop gout. There is also a joint fluid test where your doctor can draw fluid from your joint and examine it. Uric acid is produced by our bodies to break down purine. Uric acid is important since it does act as an antioxidant and can protect our blood vessels.    When there is too much uric acid, however, uric acid crystals can seek refuge in your joints, tendons, and other surrounding tissue, especially in the feet.  The crystals cause pain, redness, swelling, heat, and stiffness. Many times the presenting symptom is pain at the base of the big toe.

Purines are natural occurring substances in the body and found in many foods. High purine foods contain a higher concentration of purine, advancing the likelihood of increased uric acid.

Some high purine foods to avoid include:

  • Sardines
  • Anchovies
  • Herring
  • Scallops
  • Mackerel
  • Sweetbreads
  • Gravy
  • Kidneys
  • Liver
  • Game meat
  • Alcohol

Other foods that you want to eat in moderation include:

  • Bacon
  • Beer
  • Ham
  • Kidney beans
  • Beef
  • Poultry
  • Seafood
  • Pork
  • Lentils
  • Beans
  • Green Peas

The good news is that you can control gout through proper treatment, diet, and exercise.

In summary, you can reduce the chance of developing gout by:

  1. Eating a healthy and balanced diet
  2. Decrease or cease alcohol use
  3. Limit high purine foods
  4. Drink at least 80 ounces of water a day
  5. Choose low fat dairy products over meat
  6. Maintain a desirable body weight
My doctor told me I may have Non-alcoholic Fatty Liver Disease.  What is that?

Non-alcoholic fatty liver disease (NAFLD) is a condition where there is  fat accumulation in the liver.  Although this condition is not prompted by excess alcohol use, it can result in a similar outcome—ultimately progressing to liver failure. In addition, NAFLD increases the risk of cardiovascular disease and malignancy.

Some risk factors that can prompt NAFLD include:

  • Obesity
  • High blood sugar
  • High blood pressure
  • High cholesterol
  • High levels of fat in your arteries
  • Enlarged waist circumference
  • Decreased good cholesterol

NAFLD is usually identified by a blood test and imaging studies. NAFLD is the most common cause of elevated liver enzymes correlating with increase of Americans that are overweight or obese.  Most individuals with NAFLD have no symptoms.

Management and treatment of NAFLD include:

  • Weight loss
  • Healthy diet consisting of lower fat and higher fiber
  • Exercise/be more active
  • Control your blood sugar
  • Lower your cholesterol
  • Avoid alcohol so as not to further stress your liver

In addition, your doctor may recommend some medication.  Prognosis depends on the extent of liver damage at the time of diagnosis.  If caught early, NAFLD can be reversed.  So make sure to be proactive and eat right, move more, and stress less.

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