Aspirin And Diuretics Significantly Increase Gout Risk
Not exactly foods to avoid with gout, but the ingestion of some common medications sharply raise the risk of a gout attack.
Specifically, low doses of aspirin, which one in three middle-aged Americans takes regularly to help prevent heart disease .
The emphasis is on low doses because aspirin has a dual effect on uric acid levels. Very high doses above 3,000 mg promotes excretion of uric acid , whereas low doses prevent excretion .
In a study of 49 elderly patients, just 75 mg of aspirin per day increased blood uric acid levels by 6% within one week. A daily dose of 150 mg kept levels high during the second week, before coming down with 300 mg doses in the third week .
Considering the typical dose for heart disease prevention is 81-325 mg per day, it is no real surprise this dosage is associated with a doubling in gout risk. In fact, even the use of a low-dose aspirin for two consecutive days increases risk of recurrent gout attacks .
Another type of medication known to trigger gout is diuretics. They are typically used to treat high blood pressure and oedema, and if feasible should be discontinued in gout sufferers.
Im by no means recommending you cease your medications if you have gout, but its important to understand the pharmaceutical triggers. First speak with your doctor and closely monitor uric acid levels before making any changes.
And if you need a temporary painkiller, choose paracetamol or ibuprofen. No aspirin.
What Are The 10 Worst Foods For Gout: What You Should Know
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Weight Management And Exercise
The Arthritis Foundation emphasizes how important it is for people with gout to manage their weight.
Obesity is a risk factor for developing gout. If a person with gout has excess weight, losing a few pounds can help them:
- reduce pressure on painful joints
- lower the risk of heart disease
- build strength and flexibility
To achieve this, the person should ask a doctor about a suitable diet to help them manage their weight and an exercise plan.
Anyone who smokes should also ask a doctor to help them with a plan to quit.
The Mediterranean diet contains plants, grains, and healthy fats. It may help people manage their weight while encouraging them to eat healthily.
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What Are The Symptoms Of Gout
Gout is a very painful condition and a typical gout attack usually develops over a two to three hour period and often resolves within two weeks. The NHS advises that you always see a doctor if you experience the symptoms of gout, which include sudden, severe pain in any joint or red, hot, swollen skin over any joint.
Does Fructose Cause Gout
Fructose is a sugar that is found in fruits and vegetables. It is also found in high levels in foods sweetened with corn syrup, such as bread, cereal, soft drinks and fruit juices. An American study found that men who drank five to six servings of fructose-sweetened soft drinks per week were more likely to have gout. However there is no research showing that fructose actually causes gout. Cutting down the amount of food artificially sweetened with high fructose corn syrup may be beneficial for your overall health. However naturally occurring fructose in fruit and vegetables also provides general health benefits and should not be completely avoided without advice from your doctor or dietitian.
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Who Is At Risk Of Getting Gout
High uric acid levels are caused by the following factors:
- Genetics some Mori and Pasifika people have genes that make it harder to get rid of uric acid from their bodies.
- Being overweight carrying extra weight slows down the removal of uric acid by your kidneys.
- Increasing age in about 90% of cases, gout affects men aged over 40 years and women after menopause.
- What you eat and drink you increase your risk if you drink a lot of sugary drinks or alcohol, or eat too much food that is rich in purines, such as liver, meat or seafood.
- Having high blood pressure .
- Taking certain medicines, such as water or fluid tablets for high blood pressure or heart failure. Read more about medicines that increase uric acid levels.
- Existing kidney problems and some other conditions.
In people with known gout, there are changes you can make to reduce the risk of developing gout.
Tip: Ask your doctor whether you need to change any medications you take for other health problems.
Chicken Beef And Other Meats Appear To Be Foods To Avoid With Gout
The conversion of purines to uric acid, in theory, causes gout.
Therefore high-purine foods are often suspected to trigger symptoms.
Meat, and to a lesser extent seafood, are prime suspects. This includes all the most common meats like beef, chicken, pork and lamb.
The data available somewhat confirms suspicions.
Each additional daily serving of meat or seafood is associated with a 21% or 7% increased risk of gout, respectively . This implies meat could be three times worse than seafood.
There was another similar study that found even greater risks associated with meat intake, but none for seafood. Overall this suggests seafood is far less of a concern than meat .
For those who already have gout, the impact of meat intake on symptoms is even worse. This is likely due to sharper increases in blood uric acid, as well as poorer clearance by the body .
Therefore if you have a history of gout, it is best to dramatically reduce your meat intake, and seafood as well to a lesser extent. Anecdotal evidence suggests avoiding dark part of salmon, and de-veining prawns/shrimp before eating.
You should also buy your meat direct from the butcher where possible, or at least the better quality choices in the supermarket. Sausages and low-quality ground beef may contain traces of organ meat that can cause big problems .
Summary: Frequent consumption of meat is strongly linked with gout risk. The impact of seafood appears far less severe, but there is a link.
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Whats The Outlook For People With Gout
Untreated gout can lead to permanent joint damage. The buildup of uric acid in the joints and soft tissue is called tophus. Some people with gout can also develop other health problems, such as severe arthritis, kidney stones and heart disease. Its important to discuss your symptoms with a healthcare provider.
Do I Need To Stop Eating Meat If I Have Gout
No, but practice moderation, Dr. Burg reiterates. Avoid organ meats such as liver, though, because they have higher levels of purines, which can cause flare-ups. Moderate intake of lean meats such as chicken and turkey should not affect your condition. Seafood such as shrimp and lobster tends to be higher in purines, as well, so dont make them a regular part of your diet.
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Are Some Types Of Alcohol Better Than Others
It seems that gout attacks are more common in beer and spirits drinkers than in people who drink wine. Many beers contain large amounts of purines, which can lead to elevated uric acid levels in the blood. However, there is no scientific proof that only certain types of alcoholic drinks can lead to gout attacks.
What Foods Should You Avoid
If youre susceptible to sudden gout attacks, avoid the main culprits high-purine foods.
These are foods that contain more than 200 mg of purines per 3.5 ounces .
You should also avoid high-fructose foods, as well as moderately-high-purine foods, which contain 150200 mg of purines per 3.5 ounces. These may trigger a gout attack.
Here are a few major high-purine foods, moderately-high-purine foods and high-fructose foods to avoid (
- meats: These include liver, kidneys, sweetbreads and brain
- meats: Examples include pheasant, veal and venison
- Fish: Herring, trout, mackerel, tuna, sardines, anchovies, haddock and more
- seafood: Scallops, crab, shrimp and roe
- Sugary beverages: Especially fruit juices and sugary sodas
- Added sugars: Honey, agave nectar and high-fructose corn syrup
- Yeasts: Nutritional yeast, brewers yeast and other yeast supplements
Additionally, refined carbs like white bread, cakes and cookies should be avoided. Although they are not high in purines or fructose, they are low in nutrients and may raise your uric acid levels (
Summary: If you have gout, you should avoid foods like organ meats, game meats, fish and seafood, sugary beverages, refined carbs, added sugars and yeast.
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Shellfish Crustacea And Mollusks
There are two groups of shellfish, crustacea and mollusks. Crustacea includes crabs, shrimp, crayfish and lobsters. Mollusks are oysters, clams, oysters, mussels, squid, scallops and snails.
Which shellfish group is higher gout risk? There is no big difference. A purine table from a 2014 Japanese study included a comprehensive list of different shellfish and seafood. It listed oysters, shrimp and certain squid with similar purine content.
The research also determined different species can have different purine concentrations. For example, a snow crab had more purines than a king crab.
Most of the medical experts recommend to limit the portions to an unfulfilling 4-6 ounces. An amount which most of us can easily eat more of if not aware.
Insight: Even after realizing different shellfish have different purine amounts, shellfish is still the most unpredictable food group to gauge gout for me. On some occasions, I would eat a small amount of crabs, and end up with a terrible flare up in my ankle. Then another time, I would eat about twice as calamari and not feel any symptoms. My uric acid level at the time may have been a factor, but he unpredictability made me reduce my shellfish intake. However, I learned to prepare myself when I want to satisfy a craving.
Worst Foods With Gout
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Worst Foods & Beverages For Gout
- At the top of the list of what to avoid is booze. Beer and liquor readily convert to uric acid and they slow down its elimination. Studies have shown mixed results about whether wine is OK in moderation.
- Drinking sugary beverages, such as sodas sweetened with high fructose corn syrup, fruit juices or other sugar-containing drinks, is associated with gout. Notable exception: cherries, especially tart cherries, may be beneficial for gout.
- Go light on red meats, particularly organ meats like liver, tongue and sweetbreads, which are all high in purines. Also avoid or minimize the amount of bacon, venison and veal you eat.
- Maybe surprising: Turkey and goose are very high in purines. Chicken and duck are better bets.
- Some seafoods also are high in purines, including anchovies, sardines, mussels, scallops, crabs, lobsters, oysters and shrimp.
- Some vegetables are on the watch list, too: Consider cutting back on mushrooms, asparagus and spinach but veggies of any kind are much less likely to trigger a gout flare than alcohol or organ meats.
Red Meat And Organ Meat
Red meat and organ meats are high in purines. Eating these foods increases the uric acid levels in the blood and the risk of gout and gout attacks.
Keep your red meat and organ meats intake low. Chicken has moderate amounts of purines, and therefore should be eaten in moderation.
Protein is important for the body, and though you may need to limit protein from some animal sources, you can still get protein from other sources. Low-fat dairy seems to decrease the risk of gout and is a good source of protein in the diet. Other protein foods you can eat include eggs, nuts and nut butters, beans, and tofu.
Meats to avoid:
- Beef, pork, and chicken livers
- Other organ meats, such as kidney or heart
- Wild game
- Red meat
- Poultry
- Processed meats, such as salami and prosciutto
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You Can’t Avoid All Purines
There are too many sources of purines to eliminate them all from your diet. You will stay healthier overall if you eat some foods with purines. Remember that vegetable purines have never been shown to promote gout attacks, and that low-fat dairy products are protein sources that lower your risk of gout pain. People with gout can still enjoy meat in moderation, but should limit meat, fish, and poultry to 4 to 6 ounces a day.
List Of Foods To Avoid With Gout
Its not always safe to cut certain foods from your diet and you should speak to a doctor before doing so. However, if you have gout, limiting high-purine foods is generally recommended. These include:
- oily fish, such as mackerel, herring or sardines
- shellfish, such as scallops, mussels, crab or prawns
- other seafood, such as trout, haddock, fish roe or caviar
- game meats like venison or rabbit
- offal , such as kidney, heart or liver
- foods containing yeast extract, such as pretzels or Marmite, or meat extracts, such as stock cubes or gravy granules
- refined sugar foods this includes biscuits and cookies, or cereal bars. Eating these foods can increase your risk of weight gain
Some vegetables, like asparagus and spinach, have a relatively high purine content. However, studies suggest a diet containing these vegetables doesnt increase the chance of a flare-up of gout.
You dont need to limit foods that are low or moderately low in purines.
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Who Is Affected By Gout
Gout can affect anyone. It usually occurs earlier in men than women. It generally occurs after menopause in women. Men can be three times more likely than women to get it because they have higher levels of uric acid most of their lives. Women reach these uric acid levels after menopause.
People are more likely to get gout if they have:
- Obesity, or a lot of extra weight.
You are also more likely to develop gout if you:
- Consume a diet high in animal proteins
- Consume a significant amount of alcohol
- Are on water pills .
How Does Food Affect Gout
If you have gout, certain foods may trigger an attack by raising your uric acid levels.
Trigger foods are commonly high in purines, a substance found naturally in foods. When you digest purines, your body makes uric acid as a waste product .
This is not a concern for healthy people, as they efficiently remove excess uric acid from the body.
However, people with gout cant efficiently remove excess uric acid. Thus, a high-purine diet may let uric acid accumulate and cause a gout attack (
10 ).
Foods that commonly trigger gout attacks include organ meats, red meats, seafood,alcohol and beer. They contain a moderate-to-high amount of purines .
However, there is one exception to this rule. Research shows that high-purine vegetables do not trigger gout attacks .
And interestingly, fructose and sugar-sweetened beverages can increase the risk of gout and gout attacks, even though theyre not purine-rich (
16 ).
For instance, a study including over 125,000 participants found that people who consumed the most fructose had a 62% higher risk of developing gout .
On the other hand, research shows that low-fat dairy products, soy products and vitamin C supplements may help prevent gout attacks by reducing blood uric acid levels (
Summary: Foods can either raise or lower your uric acid levels, depending on their purine content. However, fructose can raise your uric acid levels even though it is not purine-rich.
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What Happens If Gout Is Left Untreated
If gout is not treated, it can cause permanent damage to your joints and harm your kidneys. Attacks will happen again and more joints will be affected. Lumps can grow on your elbows, hands and feet. The lumps can become sore and swollen and they may cause skin ulcers. The natural padding between the bones will start to wear away and the joints will become sore and stiff. Kidney stones can form and cause pain and damage to your kidneys.