The Biology of Middle-Age Spread

"As we get older, biology sets us up for weight gain."
"By the age of 50, we could be burning nearly 400 fewer calories a day. If you're still eating the same amount of food as when you were 20, you'll gain weight."
"Bodies like to put on weight, but they don't like to lose it. A diet only works if you stay on it for the rest of your life. That's difficult since most diets are restrictive."
"[Government fails to recognize obesity as a chronic disease.] This would increase access to behavioural therapy and medications for obesity. Most health plans don't cover those things."
Arya Sharma, professor of medicine, University of Alberta, director, Obesity Canada

"Studies show that post-menopausal women store more fat."
"We also see that with a chronic decrease in testosterone, which occurs during andropause or male menopause, men also have an increase in body fat."
"[Monitoring weight can help maintain weight] or at least not gain too much."
"[Exercise alone seldom results in weight loss.] You need the dietary component."
Sylvia Santosa, professor, Department of Health, Kinesiology and Applied Physiology, Concordia University

There are health risks associated with failing to acknowledge what is familiarly referred to as "middle age spread". This, despite the very real scientific medical fact that among the 57 known comorbidities associated with obesity which include cancer, Type 2 diabetes, cardiovascular disease and dementia, ignoring the trigger that hastens the onset of these diseases, doesn't much help in tackling this problem of enormous proportions.

In Canada, the median age is a steady 41 in the population. At the same time obesity rates have been rising, and most particularly among people between the ages of 35 to 49. After age twenty the body begins to burn ten to fifteen fewer calories every single day. This is the impact of age on metabolism in the human body. And then there are hormones. Testosterone, the male sex hormone, manages a decrease in body fat, while the female sex hormone estrogen prevents weight gain as well.

Their positive weight effect, however, decreases with age. A decrease in estrogen leads women to gain weight on their hips and thighs, while a like decrease in testosterone causes weight gain in men, particularly around the stomach area. And while preventing weight gain with the use of hormone replacement therapy is an option in middle age, it is controversial therapy, given possible links to cardiovascular disease.

As a result of hormonal fluctuations that women experience, they are more likely to gain weight throughout their lifetimes. Dr. Sharma is a firm believer in behavioural measures, in medications and for some extreme cases, bariatric surgery for long-term effectiveness in the treatment of obesity. Last year, Canada banned the use of industrial transfats in processed foods. It became illegal for manufacturers to add PHOs -- partially hydrogenated oils -- to foods sold in Canada.

A federal government campaign through Let's Get Moving, a policy document was designed to inform Canadians of a need to move more frequently in view of the fact that only 18 percent of Canadian adults meet the guidelines for physical activity of 150 minutes of moderate-to-vigorous activity weekly. Dr. Sharma feels more is needed to motivate people to take command of their options in avoiding obesity.

Habits ideally, should be changed from those inimical to health to those with clear benefits such as eating nutritionally, sleeping adequately, maintaining a healthy weight, smoke cessation, moderate drinking and reducing sedentary time, to produce a good-habit-routine to live by. These, in combination with regular exercise, relate to healthy lifestyle behaviours.

An article in the BMJ Open Sport and Exercise Medicine open-access journal saw lifestyle reviews of statistics accumulated for 34,061 individuals participating in the Vitality program, an interactive online wellness platform, incentivizing health choices such as exercise, medical checks, sleep, healthy food choices and activities geared to stress-reduction.

"The improvements were greatest in those with the most to gain, those with low baseline physical activity levels."
"Our study extends previous findings that health behaviours such as physical activity, healthy eating and abstaining from alcohol and smoking tend to co-occur in individuals and the presence of one healthy behaviour is followed by other healthy behaviours."
Vitality health research team

Exercise after50  Global News

The Golden Mean: Moderation

"Studies suggest that a phalanx of health issues, like Alzheimer's, cancer, polycystic ovary syndrome and the 21st Century's top grim reaper, metabolic syndrome, respond positively to us eating less often. Blood tests indicate that many health markers including LDL and HDL cholesterol, blood sugar levels, inflammation, human growth hormone and a brain performance protein called BDNF can be positively impacted. Less scientific are claims that it will take the human body into a state where it starts to eat its own dead and damaged -- cancerous -- cells after about 16 hours. This state is known as autophagy, and the latest advances in understanding it won Yoshinori Ohsumi the Nobel prize in physiology or medicine. Yet despite promising animal studies, so far nothing has actually shown when and if it kicks in in humans."
Kate Spicer, The Daily Telegraph

"Within a week of doing OMAD, my brain had woken up, I was less depressed and foggy. I thought I was starting menopause but it turns out I was not, it was how my body was reacting to food."
"I know OMAD [One Meal A Day] is not for everyone. Having said that, it worked so well for me that I now have my 90-year-old father thriving on a two-meal-a-day protocol."
"I firmly believe everyone should fast for at least 12 hours [best often overnight]."
Annie Hart, 49, health coach 

"The metabolic flexibility in the hunger-gatherer lifestyle versus the metabolic inflexibility of the modern sedentary lifestyle is mimicked in the benefits of OMAD [One Meal A Day]."
"When we fast, when we stop eating for extended periods, which was very common for Paleolithic man, the brain is forced into pulling energy rather than storing energy mode, and that's good for us."
Petronella Ravenshear, nutritionist, author The Human Being Diet

"It is unsustainable long-term [extreme fasts], so it is a crash diet, which could potentially lead to gaining any weight lost, and more."
"It is a good idea to stop snacking and focus on meal times for breakfast, lunch and dinner."
Priya Tew, spokesperson, British Dietetic Association

"The kind of people attracted to these diets also have poor body image and although they claim that they are restricting their food for health, they're probably over-focused on appearance. People who live most happily are those who practise moderation, not extremes of any form. They do not impose pain on their bodies to achieve their life goals."
"It's well proven food-restricting diets lead to bingeing, and that rigid dieting systems have a negative impact on both self-esteem and the way we view, feel and behave around food."
"I believe they [autophagy claims] are based on pseudo-science because no one has taken into account the negative impact food restriction of any kind has on the neurochemicals in the brain that govern appetite and mood."
Deanne Goddard, National Centre for Eating Disorders, Surrey, U.K.

Shutterstock

One meal a day doesn't sound too wonderful. As for fasting, the human body normally does that in the period when we fall asleep one night and awaken the following morning, a generally-recommended seven-to-eight hour shift when the brain and the body go into rest mode, we awaken (presumably) refreshed, and prepare to eat our first meal of the day, breakfast. Lunch usually follows at mid-day, and in the evening, dinner; ergo, three meals a day, not one, and a 'fast' period accounted for.

But what about cutting out the middle meal, lunch, and have a normal day of two meals a day? That would give us two fasting periods, and if fasting is such a positive initiative as many claim it to be and we sacrifice only one meal to realize two fasting periods and two full meals, isn't that moderation? It happens to be, in point of fact, what my husband and I, both 82 years of age, soon to be 83, have practised for many years. Me, since our three children were born, and he for the past 30 years.

According to the International Food Information Council in its annual survey of dietary habits in the United States, Intermittent Fasting (IF) appeared to take top billing in 2018 as a new trend, topped slightly by the following year's "clean eating" trend, in 2019. People depend on a number of apps to help manage their chosen fasting lifestyles. The app Zero had 2.5 million downloads in the space of two years.

OMAD, its proponents insist, expressed in evolutionary terms makes sense. The diet recommends eating one meal only each day, and for that one meal, anything can be eaten in any amount, of the dieter's choice.

Arguments that are credibly backed by science suggest we are well suited to consuming more healthy fats much less frequently than what obtained in the late 20th Century and what most government sponsored dietary advice urges. Salk Institute scientists found the average individual's window for eating turned out to be around 15 hours in length from morning rising to night-time retiring.

Mice with access to food 24 hours a day carry four times the body fat of mice eating the same amount of food for eight hours daily. In 2018, a study conducted by the Salk Institute reached the conclusion that "eating in a ten-hour window can override disease-causing genetic defects and nurture health".

Dr.Jason Fung, whose Toronto Metabolic Clinic treats metabolic disorder with fasting and ketogenic (high fat) diets, is one of the most high profile of fasting proponents. He recommends high fat, medium protein and low carbohydrate meals, spaced well apart.

As we eat, the production of insulin rises, instructing the body to store food as body fat. When we aren't eating, insulin descends signalling the body to burn the fat that has been stored. Dr. Fung's A Complete Guide to Fasting recommends hunger be warded off with bone broth. Alcohol consumption in excess (over two glasses of wine) can spur hunger. And while some nutritionists and food scientists hale the advent of diet plans revolving around fasting, many of their counterparts definitely do not.

And of course there is the reality that in the age we live in, food is plentiful, it surrounds us everywhere, enticing us to eat, non-stop. And to eat foods that are not known for nutritional content beneficial to human health. It takes discipline, knowledge and regard for personal health to take the sensible route of moderation. Highly processed food, if it really appeals, on occasion, infrequently, but the major focus on whole foods, high in natural vitamins and minerals, a definite requirement for a healthy mind and body.

The side effects of restricting food for nearly an entire day can include:

• Lightheadedness
• Nausea
• Blood pressure destabilization
• Dizziness
• Confusion
• Hypoglycemia (low blood sugar)
• Dehydration

The Daily Weigh-In

"We were somewhat surprised since our instructions were to maintain weight and not lose weight."
"It is possible that [overweight and obese] adults were less aware of their actual body weights at the beginning of the study, and seeing their weight on the scale perhaps prompted them to make some healthier choices or behaviours which led to actual weight loss."
"Daily self-weighing is quick, easy, and relatively low cost."
"For example, if someone likes to exercise, they can use that and adjust exercise levels to maintain weight. For a different person who doesn't like to exercise, they can use a different strategy." 
"Maybe they exercise a little bit more the next day [after seeing a weight increase] or they watch what they're eating more carefully."
"The subjects self-select how they're going to modify their behavior, which can be effective because we know that interventions are not one-size-fits-all."
"Vacations and holidays are probably the two times of year people are most susceptible to weight gain in a very short period of time. The holidays can actually have a big impact on someone's long-term health."
Jamie Cooper, nutrition researcher, University of Georgia

"The fact that we have a US$70 billion weight-loss industry in the United States is a testament to the fact that weight loss is very hard."
"What works for one person may not work for another ... I would suggest that [daily weighing] is one more tool that can be added to the arsenal of behaviours people consider around the holidays to help prevent weight gain."
Sarah Bleich, Harvard T.H.Chan School of Public Health, Boston

"Having defined goals of metrics and feedback toward goal achievement is often motivating to those who are engaging in weight management."
Dr. Nanette Steinie, endocrinologist, nutrition expert, University of Maryland School of Medicine, Baltimore

Associate professor Jamie Cooper shows graduate student Liana Rodrigues how to take height and weight of a subject for clinical health measures with undergraduate Allison Jones in Cooper's clinical lab in Dawson Hall.  Photo: Andrew Davis Tucker/UGA

"People are really sensitive to discrepancies or differences between their current selves and their standard or goal."
"When they see that discrepancy, it tends to lead to behavioral change. Daily self-weighing ends up doing that for people in a really clear way."
"It works really well in the context of people's busy lives. The idea that people might already have all the resources they need is really appealing."
Michelle vanDellen, associate professor, UGA Department of Psychology

A newly-published study out of the University of Georgia has concluded that a daily weigh-in at home could prevent weight gain occurring during the winter holiday season, from mid-November to early January, coinciding needless to say with Christmas and New Year's  and just about everyone's tendency to over-indulge in holiday food of the season. What inspired nutrition researcher Jamie Cooper and her colleagues to examine the issue of seasonal weight gain was that it was known that this winter period disproportionately contributes to annual weight gain.

And even people who regularly exercise and who also indulge, are not spared. The results of their study published in the journal Obesity showed that participants who weighed themselves on a daily basis, thus receiving graphical feedback of weight changes, either managed to maintain, or even lost weight. Their study counterparts who failed to weigh themselves daily on the other hand, gained an average of around six pounds (2.7 kilograms) in that same period.

What their study emphasized was that people who began with a weight in the normal range for height remained within that range when they took the time to weigh in daily, to observe the results of their indiscreet eating during the holiday season. The study enlisted 111 adults between the ages of 18 and 65 who were instructed to maintain their weight throughout the 2017 - 2018 holiday season. Half of the study participants were randomly assigned to the weigh-in group, the other half abstained. After 14 weeks, researchers did a follow-up to determine who had succeeded.

According to Sara Bleich at Harvard, it would be difficult to ascertain whether the results owed entirely to daily self-weighing, since the instruction to maintain weight might have affected the behaviour of the participants. Though not involved in the study, she believes the data could represent a simple method whereby people could remain conscious of their weight during the holidays. And according to Dr. Steinle in Baltimore, the results suggest that using a scale daily could represent an intelligent way to boost adherence to a "healthy living" plan.

As for the study leader, Dr. Cooper feels the daily weigh-in could have popular appeal within the general public at large, since it is indeed a simple yet effective way to encourage people to remain fit during times when they are most likely to relax the standards of their normal eating patterns alongside their exercise regimen, leading them to consume more calories than they normally would at a time of seasonal lowered inhibitions. 

For many, the holiday season is synonymous with indulgence and overeating, which can lead to weight gain. (Shutterstock/File)

The paper, "Daily self-weighing to prevent holiday-associated weight gain in adults", can be viewed at https://onlinelibrary.wiley.com/doi/10.1002/oby.22454

Weight Loss? Work at It : Lifestyle of Physical Activity

Michelle Aguilar, Season 6 : She weighed 242 pounds at the beginning of the show and 132 pounds at the end to claim the prize.

"The high levels of physical activity energy expenditure and total daily energy expenditure observed in successful weight-loss maintenance suggest that the group relies on high levels of energy expended in physical activity to remain in energy balance [and avoid weight regain] at a reduced weight."
"Taken together, these results suggest that physical activity may play a relatively greater role in weight loss maintenance and chronic restriction of energy intake."
Research, University of Colorado

Matt and Suzy Hoover, Season 2 : He lost 157 pounds and she lost 95 pounds but have since gained some of the weight back

Weight loss experts have recently cautioned that depending on exercise alone as a remedy for losing unwanted weight is unreliable. To be sure, altering eating habits does go far in helping to lose weight, but studies have long shown that weight loss resulting from diets invariably ends with the lost weight being regained. The combination of changing what and how we eat and matching it with another lifestyle change; regular exercise, is the winning combination. On the other hand, sustainability remains a door-stopper for many people.

A physiological change occurs when someone loses a significant amount of weight and their body becomes lighter. A heavier body burns more calories than a lighter body, relying on the reduced effort involved in moving a smaller mass. Fewer calories are also burned during rest periods. So maintaining a lost-weight status becomes more difficult than attaining that lost-weight new-you, to begin with.

Popular reality show The Biggest Loser hosted overweight people featured in their struggle to lose weight. The popularity of the show may have tanked because many of the featured subjects regained all the weight they lost. A database of people who registered with the National Weight Loss Registry of those who lost a minimum of 30 pounds for at least a year provided a valuable source of weight-loss information. In both instances, the show and the registry subjects provided a view of how much exercise is needed to restrain lost weight from returning.

Self-reported data, however, such as that obtained from both those sources is not strictly reliable; people may have a tendency to overestimate the exercising they describe. And this is where a group of researchers from the University of Colorado stepped into the picture. They put together three groups: people who had succeeded in maintaining a substantial weight loss for at least a year (30 pounds or more); normal weight subjects with body mass indexes similar to the weight-loss maintainers; and overweight people with a BMI similar to the weight-loss group pre-weight-loss.

Bill Germanakos, Season 4 : He lost 164 pounds on The Biggest Loser and only gained 37 pounds back after the show

The researchers set about comparing calories expended during exercise, along with the total number of calories burned daily, and as they suspected, the successful weight-loss maintainers were considerably more active physically than the normal weight and overweight control groups. Weight-loss maintainers expended energy over the normal weight subjects, on par with the overweight group; the hypothesis is that this reflects the added effort required to move a heavy body.

As compared to the normal and overweight subjects, weight maintainers accumulated more steps per day, as well. The maintainers expended around 12 calories/kg/day in comparison to the normal weight (10 calories/kg/day) and overweight group (seven calories/kg/day. Compared to 8,900 steps taken by the normal weight subjects and 6,500 by the overweight group daily, the weight-loss maintainers logged 12,100 steps, according to the researchers.

The International Association for the Study of Obesity recommends individuals hoping to ensure lost pounds don't return should commit to 60 - 90 minutes of moderate intensity physical activity (walking) or 30 - 45 minutes of intensive physical activity (running) daily. The study made no effort to control for diet; the researchers suggesting the number of calories consumed daily would in all likelihood be close to the number of calories expended; energy balance typically associated with maintenance.

The end result appears to reinforce health researchers' advice to alter daily habits, starting with awareness of the food quality, quantity and nutrition one eats, and including more physical exercise. Move more, consume energy more.

Ali Vincent, Season 5 : She was the first female to win on the show with an 112-pound weight loss. She managed to maintain the weight after the show.

Recalibrating Calorie Intake and Energy Expenditure

"It's not only what we eat, but when we eat -- and rest -- that impacts how much energy we burn or store as fat."
"The vast majority of the calories that we burn every day [60 to 70 percent] are burned just to maintain our body functions."
"If you ate at the wrong biological time once, it wouldn't have much impact. [More frequently than occasionally] it could add up over time and lead to weight gain." 
"Let’s say we get up an hour or two hours early and eat breakfast an hour or two hours early. We may be eating that breakfast not only at a time when our body might not be prepared to deal with it, but at a time when we need less energy to maintain our functions. Therefore, the same breakfast might result in extra stored calories, because we don’t need those to maintain our body functions."
"Regularity of habits such as eating and sleeping is very important to overall health."
Dr. Jeanne Duffy, neuroscientist, sleep and circadian disorders, Brigham and Women's Hospital

"The fact that doing the same thing at one time of day burned so many more calories than doing the same thing at a different time of day surprised us."
Kirsi-Marja Zitting, study co-author, Brigham and Women's Hospital and Harvard Medical School

A new study finds that an imbalance between one’s circadian rhythm and eating and sleeping habits may contribute to weight gain. (Credit: Pakula Piotr/Shutterstock)

Biological sciences keep coming up with interesting items to explain processes that might otherwise forever appear inexplicable to us about how our bodies work. As was done when researchers from Boston launched their experiment with seven volunteers. The seven participants in the study were kept for 37 days in windowless rooms where there were no clocks, radios, televisions, phones or Internet. No distractions, nothing to inform the participants of what was happening in the world outside their temporary cocoon.

Everything was geared to perfect conformity in timing; bedtimes adjusted so that study participants went to sleep each night four hours later than they normally would, the effect disturbing their body's natural circadian rhythms in a manner they likened to the effect of an flight from England to Halifax one day then the following day on to Vancouver, followed by a trip to the Marshall Islands the third day and the fourth day on to Hong Kong.

The study, published in the journal Current Biology, found that at rest the human body burns ten percent more calories in late afternoon and early evening than it does in the early morning hours. A conclusion that explicates why night- or rotating shift-work can effect the risk of becoming overweight or obese. Resting energy expenditure (REE) was the focus to determine the number of calories the body burns simply to exist -- reflecting the minimum amount of calories required in the maintenance of physiological functions such as circulation of blood, breathing, body temperature and brain activity.

The researchers investigated whether resting energy expenditure rate varies with circadian rhythms representing the body's innate, 24-hour cycle set to control the body's awareness of day and night, and when to eat and when to sleep. The 37 days the volunteers -- aged 38 to 69 -- spent in chambers free of any distractions much less indications of time, enabled them to read, watch videos or DVDs, but enjoy no visitors. Contact with family or friends conducted through mail only.

All subjects were given the same proportion of protein, carbohydrates and fats; body temperatures monitored with rectal sensors (more calories are burned when the core temperature is highest).

For their time and willingness to surrender such a large amount of their time and free agency, study participants were given an award of $12,000 each. Each night for three weeks the assigned bedtime was moved four hours later than that of the night before to confuse the normal circadian rhythms. During scheduled "sleep opportunities" all lighting was switched off, the process enabling researchers to take measurements across each waking period for the duration of the three weeks.

"So that we could get an idea of whether resting energy expenditure was always the same no matter what biological time they woke up at, or whether it varied", explained Dr. Duffy. It was discovered that the amount of calories burned turned out to be lower during late night, corresponding to the dip in core body temperature, and highest 12 hours later which would relate to the equivalent of late afternoon or early evening.

While the study answered some questions, there are others yet to be approached by further studies. It is not known whether people should be timing meals to late afternoon-early evening peak, or whether they might be better off avoiding meals after early morning workouts at a time when resting calorie burn is at its lowest. The researchers estimated that about 130 calories per day is involved in the difference between peak and minimum calorie burn time.

Photo Taken In Bangkok, Thailand (Getty Images)

The Joint Affliction of Royalty

"Not for one second did I ever think I had gout because I knew it was for people double my age."
"This year in particular has been quite frustrating. I've had gout three or four times, and I don't really know what from. So for the last four or five weeks I've actually cut out most dairy [from his diet]."
"I think young people just don't really understand or appreciate what we're putting into our bodies."
Harry Tyndall, 28, London, England

A battle against the scourge of men who overindulge. Esquire

"What's not easy to describe is the pain gout inflicts. I remember my first attack as if it were just fifteen minutes ago rather than fifteen years. It was 3:00 a.m. I awoke, to paraphrase the first sentence of Thomas Pynchon's Gravity's Rainbow, to a screaming coming across my sky. The big toe on my right foot was cherry-red and as swollen as a clown's nose. It felt as if someone had taken a flat nail and driven it, like a Vulcan, through the toe's midpoint. If a small puff of wind blew over this toe or a sheet so much as grazed it, it was as if a gang of droogs had commandeered Hannibal's elephants and had them each step on that nail, one at a time. I woke small children and large pets with my howls. I whimpered like a baby."
Dwight Garner, 50, New York

Finding himself unable to walk one morning getting out of bed, he somehow made his way to a physiotherapist where the clinician informed him he had gout. And Harry Tyndall began learning a lot about a severe form of inflammatory arthritis -- causing limbs to swell -- called gout. Of course he knew vaguely something about gout; the infamous Henry VIII whose many wives and his disposal of them leading to his schism with the Catholic Church refusing to annul his marriages, famously suffered from gout.

But this was a man whom history records as a glutton in his mid-age, a man who is known to have over-indulged in meats, pasties, alcohol. And so it made perfectly good sense medically to someone with no medical training that old Hank would come down with the excruciating pain of recurring gout. When Harry Tyndall contemplated his future, he shrank in dismay at the very thought that long distance walks might be a thing of the past for him, a young man who thought he took good care of himself through a discriminating diet and who was recreationally action-oriented. 

Rare steaks and alcohol did not, in fact, form part of his normal diet. He was a health-conscious millennial, just like most of his generation who choose to abstain from both. Yet it is among this very group that gout is being seen to rise. And it is linked with sugar consumption and fatty foods making them vulnerable to gout -- and when it presents it is not something that can be tolerated and overlooked as an inconvenience; those arthritic attacks are beyond painful.

Between the years 1997 and 2012, a 64 percent rise in gout diagnoses has taken place. Now, one in 40 people are believed to suffer from the condition and although most gout patients are above sixty years of age, a growing number of 20s and 30s are complaining of symptoms consonant with gout, a 30 percent increase since 2012. Gout is triggered by a build-up of uric acid in the blood, which then progresses to become crystallized in bone joints, usually affecting the big toe which becomes enormously swollen.
 

According to Dr. Alan Silman, medical director of  of Arthritis Research UK, fizzy drinks and genetics play a large role in the onset of this condition; additionally, one in ten patients  end to inherit the condition from their parents. Despite which, experts fail to agree on how influential genetics is in gout onset, and how much is attributable to lifestyle. Dr. Silman describes a gout attack as "probably the most painful form of severe arthritis there is". His patients recount to him their difficulty in even sleeping under a bedsheet, pressing against their toe.

For Harry Tyndall both big toes in both his feet ended up swelling enormously, causing him at various points to be "on his hands and knees" in living agony. Yet what impresses him most is his forced change in entirely converting his diet. It's been two and a half years since he last had red meat or red wine. He did end up with his craving for sweet and fat compelling him to melt ice cream and drink it by the tub-full. But he's under treatment and his condition is now improving. He got married last year and was able to walk up the church aisle.

"The prevalence of gout in the U.S. has risen over the last twenty years and now affects 8.3 million (4%) Americans. Gout is more common in men than in women and more prevalent in African-American men than white men. The chances of having gout rises with age, with a peak age of 75. In women, gout attacks usually occur after menopause. Among the U.S. population, about 21% have elevated blood uric acid levels, a condition known as hyperuricemia. However, only a small portion of those with hyperuricemia will actually develop gout. If your parents have gout, then you have a 20% chance of developing it."
"Maintaining adequate fluid intake helps prevent acute gout attacks and decreases the risk of kidney stone formation in people with gout. Alcohol is known to have diuretic effects that can contribute to dehydration and precipitate acute gout attacks. Alcohol can also affect uric acid metabolism and cause hyperuricemia. It causes gout by slowing down the excretion of uric acid from the kidneys as well as by causing dehydration, which precipitates the crystals in the joints."
"Dietary changes can help reduce uric acid levels in the blood. Since purine chemicals are converted by the body into uric acid, purine-rich foods should be avoided. Foods rich in purines include shellfish and organ meats, such as liver, brains, and kidneys. Researchers have reported that meat or seafood consumption increases the risk of gout attacks, while dairy consumption seemed to reduce this risk. Weight reduction can be helpful in lowering the risk of recurrent attacks of gout."
"Certain medications reduce the pain and inflammation of gout attacks, such as anti-inflammatory drugs (ibuprofen and naproxen), colchicine, and corticosteroids. Other medications decrease the level of uric acid in the blood and prevent the deposit of uric acid in joints (gouty arthritis), the kidneys (stones), and in tissue (tophi), helping to prevent further attacks and complications. These drugs include allopurinol, febuxostat, lesinurad, and probenicid."
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