Ask the Doctor: Reducing Hypothermia Risk; Low-Purine Diet for Gout

Q: During the winter months, what is the best way to reduce the risk of hypothermia?

A: Hypothermia is a condition that occurs when your body temperature drops below 95°F because it loses heat faster that it can produce heat.

Most cases of hypothermia are triggered by outdoor temperatures below 59°F. If there’s a wind chill factor, or if your clothes are wet, your body temperature will fall faster. Frail, older adults may become hypothermic indoors in temperatures as warm as 60°F to 70°F because of an impaired ability to generate body heat in response to cold.

Some health conditions, such as hypothyroidism (underactive thyroid), Parkinson’s disease, severe arthritis, and any medical condition that restricts or impairs normal blood flow, also can make you more susceptible to hypothermia.

Symptoms of hypothermia, such as shivering, dizziness, rapid breathing, lack of coordination, fatigue, rapid heartbeat, drowsiness, and confusion, can come on gradually, so hypothermia often goes unnoticed.

In general, avoid going out into cold weather, particularly if it’s windy. If you do go out, dress appropriately in several light layers (each layer traps warm air, helping to retain body heat) and stay out for as brief a time as possible. Always wear a hat and gloves or mittens. If you are inside and you are cold, put on more clothing or cover up with a blanket, and wear socks. And, eat a balanced diet that includes adequate protein, healthy fats, and whole grains, because your body burns calories to generate body heat.

Q: I’ve been diagnosed with gout, and my doctor has told me to avoid foods containing “purines.” What are purines, and which foods contain them?

A: Purines are compounds that yield uric acid when they are broken down in the body. Gout, a form of arthritis, is a result of excess uric acid, which forms into crystals and is then deposited in your body. Excess purines also can result from an overproduction of uric acid by the body or the insufficient excretion of uric acid by the kidneys.

Many foods and beverages contain purines; the ones highest in purines include:

• Beer and other alcoholic beverages
• Anchovies, sardines, herring, mussels, cod, scallops, trout, and haddock
• Organ meats, such as liver, kidneys, and sweetbreads
• Beef, pork, lamb, veal, and bacon.

Smaller amounts of purines are found in all meat, fish, and poultry, so limit your consumption to a maximum of six ounces daily. Saturated fat limits your body’s ability to eliminate uric acid, so avoid fatty meats, processed meats, and full-fat dairy products, including butter. Fructose can increase uric acid production, so limit your consumption of sugar-sweetened soft drinks that contain high-fructose corn syrup. And, drink plenty of fluids, especially water—they can help your body eliminate uric acid.

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