Gout is similar to arthritis and attacks joints, most often at the base of the big toe. It causes intense pain and swelling; when Monk's first attack happened, he thought he'd broken his foot.
What Causes Gout? From NIH.gov:
"Gout is caused by the buildup of too much uric acid in the body. Uric acid comes from the breakdown of substances called purines. Purines are found in all of your body’s tissues. They are also in many foods, such as liver, dried beans and peas, and anchovies. Normally, uric acid dissolves in the blood. It passes through the kidneys and out of the body in urine. But uric acid can build up in the blood when:
- The body increases the amount of uric acid it makes.
- The kidneys do not get rid of enough uric acid.
- A person eats too many foods high in purines."
For Monk, the gout-friendly foods he's learned to eat more of are:
- fresh, unrefined, and unprocessed foods. Include fruits, vegetables, whole grains, soy, beans, seeds, nuts, olive oil, and cold-water fish (salmon, tuna, and halibut)
- unsweetened cherries (canned, fresh, or frozen); cherries lower uric acid levels and can prevent gout attack
- blueberries, blackberries, and other deeply pigmented berries are also helpful as is pineapple
- lemon water, apple cider vinegar
Gout-aggravating, high-purine trigger foods that he needs to avoid:
- organ meats like kidneys, liver, and sweetbreads
- red meat
- oily fish like sardines, anchovies, and herring
- certain vegetables, including asparagus, artichokes, spinach, and cauliflower
He's been managing his symptoms very well, despite a few occasions where he knew he wanted to eat trigger foods despite the consequences and he planned ahead by taking preventative measures for it. Life's no fun if you can't break the rules once in a while.