How Our Insatiable Appetite for Alcohol and Nyama Choma Is Doing More Harm than Good

Anyone who has suffered from gout will tell you that it is a very painful experience. It is also very common especially among people who eat too much meat and drink alcohol, the popular nyamachoma culture in Kenya.

According to Dr Omondi Oyoo, Consultant Physician and Rheumatologist at Aga Khan University Hospital, gout is a condition characterised by pain and swelling of joints resulting from high concentration of uric acid in the blood.

He explained, “In people with gout, instead of the uric acid being excreted through the kidneys into the urine, a disorder in their bodies causes the uric acid level to increase forming crystals which are deposited in joints and other tissues. These needle-like crystals trigger an immune response that produces intense local inflammation with severe pain, swelling and tenderness especially in the big toe.”

“Gout has been described as one of the most painful rheumatic diseases. When left untreated, the condition often worsens due to excess build-up of uric acid in joints. Attacks may subside after a few days, but over time theycan keep recurring and cause severe arthritis, permanent joint damage, and even kidney disease.”

“Most people suffering from gout often have a diet rich in purines which includes red meat, some alcohols (including beer), sardines, mussels, mackerel, kidney, liver, meat extracts and yeast. Genetic predisposition only account for ten per cent of the root cause of the problem.”

Because of the ‘nyamachoma’ culture in Kenya, gout is one of the fastest growing problems and the age group of patients suffering from this condition has come down from 40s to affect people as young as those in their 20s. Gout mainly affects men as women are protected by estrogen until they reach menopause then they become equally vulnerable. The disease is further complicated by hypertension, diabetes and high cholesterol.

Dr Oyoo

The most effective way to treat gout is by the correct use of prescribed medication and dietary modification. Dr Oyoo explains that this involves reducing intake of proteins, especially red meat to a plum size serving not more than three times per week. When uric acid levels are very high, foods rich in purines should be avoided completely.

“Increase the intake of foods rich in Vitamin C as they increase the excretion of uric acid and this helps to reduce the formation of crystals. These include citrus fruits like oranges, lemons, limes, tangerines, mangoes and pineapples as well as grapes, apples and bananas.” Advices Dr Oyoo.

“More intake of Vitamin B complex is also recommended. Vitamin B boosts enzyme production and also breaks down the uric acid. It is important to consult a specialist to ascertain the best form of the complex for you and you should avoid over the counter supplements.”

Drinking plenty of non-alcoholic fluids is also recommended. These include water, fruit juices and tea. Take at least eight glasses of water per day. These fluids dilute the urine and promote excretion of uric acid through the continuous flushing of the kidneys.

For patients with high blood pressure (and those with a family history) it is important to regularly monitor uric acid levels as high levels of uric acid may cause the blood pressure to spiral out of control.

Other dietary measures for people prone to gout attacks include avoiding alcohol, eating a diet rich in carbohydrates and low in fat, maintaining ideal body weight,eating regular meals and not fasting.