Can Changing Your Diet Prevent Gout Flare
If you have gout, your rheumatologist has probably already explained that its a form of arthritis caused by an accumulation of uric acid crystals in the tissues of your big toe joint and possibly other joints. Where did those crystals come from?
When you eat foods that contain a substance called purines, your body breaks the purines down into uric acid, which it then eliminates. But when you eat too many purines, your body cant process them all completely. They start to pile up in the soft tissues of your joints, forming painful and needle-like crystals.
Our expert rheumatologists at the Rheumatology Center of New Jersey diagnose and treat gout and other forms of arthritis at our three New Jersey offices. If you want to control your gout flares by changing your diet, heres what you need to know.
Achieve A Healthy Weight
Obesity may be a primary consideration to reduce levels of uric acid in the blood. Insulin resistance is commonly seen in those who are obese and it may be involved in the development of gout. Insulin resistance has been shown to decrease the amount of uric acid that is cleared in the urine. A condition known as the ‘metabolic syndrome’ is a cluster of symptoms which includes insulin resistance, along with tummy obesity, high blood pressure and abnormal blood fats – for example, high cholesterol. This condition is strongly associated with high uric acid levels, which can be improved with slow, gradual weight loss.
Weight loss has been shown to improve insulin resistance and therefore reduce uric acid levels in the blood. However, it is important to avoid strict diets such as low-carbohydrate and high-protein diets. These may increase consumption of purines, a compound that breaks down into uric acid. Additionally, rapid weight loss through strict dieting can result in breakdown of tissue. This can temporarily cause a rise in uric acid levels. A gradual, safe weight loss of 1-2 lbs a week can help to achieve an optimal body weight.
What Are The Signs And Symptoms Of Gout
Gout flares start suddenly and can last days or weeks. These flares are followed by long periods of remissionweeks, months, or yearswithout symptoms before another flare begins. Gout usually occurs in only one joint at a time. It is often found in the big toe. Along with the big toe, joints that are commonly affected are the lesser toe joints, the ankle, and the knee.
Symptoms in the affected joint may include:
- Pain, usually intense
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Using Tart Cherry Juice For Gout
Tart cherry juice may help decrease uric acid levels and inflammation in gout. Research is limited, with often small numbers of study participants and short-term follow-up.
Nevertheless, a 2019 review of six studies that looked at the effect of cherry juice or cherry extract intake on gout concluded that cherry intake was associated with a reduced risk of gout attacks. Researchers did note that larger, more long-term studies are needed to clarify this association.
When choosing tart cherry juice, be sure to look for unsweetened varieties to help reduce the amount of added sugar in your diet.
Do Certain Foods Cause Gout
There are many misconceptions about diet and gout. For example it is commonly thought that foods such as citrus foods cause gout. There is no evidence that this is true. However several studies have shown that people with gout are more likely to eat certain foods. These foods tend to contain high levels of purines, a substance that can be made into uric acid in the body. Purine-rich foods include:
- meat particularly red meat and offal, such as liver, kidneys and heart
- seafood particularly shellfish, scallops, mussels, herring, mackerel, sardines and anchovies
- foods containing yeast such as Vegemite and beer.
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Eating To Prevent Gout
Gout is a painful form of arthritis caused by an excess of uric acid. This is a waste product made by the body. It builds up in the body and forms crystals that collect in the joints, causing a gout attack. Alcohol and certain foods can trigger a gout attack. Below are some guidelines for changing your diet to help you manage gout. Your healthcare provider can work with you to determine the best eating plan for you. You can learn which foods affect your gout more than others. Reactions to different foods can vary from person to person. Know that diet is only one part of managing gout. Take your medicines as prescribed and follow the other guidelines your healthcare provider has given you.
But Some Fish Can Be High In Purines So Its Important To Know Which Kind Of Seafood Is Best For Gout
Eating plenty of fish has long been associated with health benefits like a lower risk of heart disease, cancer, and age-related memory problems. Now research suggests that loading up on fish may help people with gout slash their risk of a flare.
The study, published in the journal Arthritis & Rheumatology, relied on data from the Boston University Online Gout Survey, an internet-based study that ran from 2003 to 2012. In this new analysis, researchers determined that gout patients who ate fatty fish in the previous 48 hours were 33 percent less likely than those who hadnt to have a gout attack.
The more fish people ate, the better, as increases in the number of servings were associated with a lower risk of gout flares.
Although the study authors initially hypothesized that eating omega-3 rich fish or taking an omega-3 supplement would have a protective effect, it turned out that the real thing was best: Supplements did not appear to help. That said, the authors noted that supplements might be beneficial if taken at higher doses. High-dose omega-3 supplements might even have an edge over eating fish, because certain kinds of fish contain purines, natural substances that get converted to uric acid in the body. The build-up of uric acid crystals in the joints is what triggers gout flares.
Supplements would bypass this obstacle, offering a pharmacological benefit without the gout-inducing features of purines, they wrote.
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What Can You Drink If You Have Gout
Foods arenât the only thing that can affect uric acid. What you drink matters, too.
Itâs a good idea to drink lots of fluids — 8 to 16 cups a day. At least half of what you drink should be water. Vitamin C also can help lower uric acid, but studies also show that the high fructose in OJ may boost uric acid levels, so drink it in moderation. Caffeinated coffee can cut uric acid, too, as long as you donât overdo it.
Donâts
Stay away from sugary drinks like soda and fruit juice. You also may need to limit or avoid alcohol as well. Talk with your doctor to find out whatâs right for you.
While a healthy diet can help control how much uric acid is in your system, you may still need medicine to prevent future attacks. Talk with your doctor about all your treatment options.
Keep Track Of Your Triggers
Gout triggers differ from person to person. Some people can eat a steak or drink an occasional beer with no problems. Others canât tolerate a bite or a sip without a flare. So you need to learn what yourtriggers are.
Keep a diary of what you eat for a while. That way, you can go back and see whether you can link flares with specific foods. Then youâll know what you really need to avoid.
Along with avoiding triggers, here are other things you can do to stay healthy and prevent flares:
- See your doctor regularly. You may need adjust your dose of gout medication over time.
- Always have medicine on hand for flares. The faster you take it, the sooner you can control the symptoms.
- Eat a heart-healthy diet full of vegetables, fruits, whole grains, low-fat dairy, and plant proteins . Cut down on processed foods .
- Get regular exercise.
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Signs And Symptoms Of Joint Inflammation
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By now, youve probably received the memo: Certain types of fish are great sources of heart-healthy omega-3 fatty acids, lean protein, and essential vitamins and minerals, including antioxidants in vitamins B2, B12, and vitamin D.
However, eating seafood, including fish, is also a well-recognized risk factor for increased uric acid levels in the blood, which can lead to a gout attack. And this is the last thing you want if you already live with gout.
This article explains the connection between the uric acid found in fish and gout. It also provides a breakdown of fish that contain low, medium, and high levels of a chemical substance known as purines .
Processed Foods And Refined Carbs
The modern Western diet is often high in processed foods and refined carbohydrates. In addition, processed foods and refined carbohydrates have been linked to an increased risk of type 2 diabetes, heart disease, and weight gain.
A 2017 study looked at gout incidence in people who followed either a Western diet or the Dietary Approaches to Stop Hypertension diet. The researcher found the DASH diet was associated with a lower risk of gout, whereas the Western diet was associated with a higher risk of gout.
To help prevent gout symptoms, its best to limit highly processed foods and beverages and foods high in refined carbohydrates, such as sweets, baked goods and pastries, chips, crackers, cookies, candies, soda, ice cream, white breads, and some pre-made frozen meals.
Eating highly processed foods and refined carbohydrates in moderation will not only help with your gout, but your overall health as well.
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Warning Signs Of A Gout Flare
Some people with gout, also known as gouty arthritis, say an attack begins with a burning, itching, or tingling feeling in a joint maybe an hour or two before the flare-up starts. The joint may feel a little stiff or a bit sore. Not long after, the telltale signs of gout begin. If you get repeated attacks, you’ll learn your body’s signals that one is about to begin.
Sometimes, people with gout have no early signs that a flare is about to start. They may just wake up in the middle of the night with a very painful joint.
When the flare starts, most people have redness, swelling, and severe pain, usually in one joint. The most common place for gout is the base of the big toe, but it can happen in other joints such as the elbow, knee, wrist, ankle, and instep.
I Had A Gout Attack What Should I Be Eating
This article was published more than 8 years ago. Some information may no longer be current.
The question: I recently had my first gout attack. What foods should I avoid?
The answer: There are certain foods you should avoid in order to manage gout. There are also foods you should eat and drink because they can help prevent a future attack. Like standard medication prescribed for gout, dietary changes are aimed at reducing levels of uric acid in the blood.
Gout is a form of arthritis marked by sudden attacks of painful, inflamed joints, usually the big toe, but your feet, ankles, knees, hands and wrists can also be affected. Either the body makes too much uric acid or it doesn’t excrete enough, which causes uric acid crystals to form in the joints. More than half of people who have had a gout attack will have a recurrence within a year.
It’s important to reduce your intake of foods rich in purines, natural compounds that, once consumed, are broken down into uric acid. Purines are found in organ meats, beef, pork, lamb, sardines, anchovies, mackerel, clams, asparagus, mushrooms, spinach, green peas, cauliflower, beans and lentils.
Historically people with gout were told to avoid all purine-rich foods. However, a 2004 Harvard University study involving 47,150 men found that high intakes of meat and seafood increased the odds of developing gout, but purine-rich vegetables didn’t.
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What Role Do Purines Play
An estimated 70% of uric acid in the blood is made inside the body. This means that even by following a strict low-purine diet, it will only be possible to lower uric acid levels by 30% at the most. But not all foods are the same: Our bodies absorb purines differently from different foods, so it might not make sense to avoid all foods that contain purines especially if you already eat a balanced diet. There are no high-quality studies on the effectiveness of strict low-purine diets. Besides, they can be quite difficult to stick to.
Can Dietary Supplements Help
People with gout are sometimes advised to take vitamin C supplements because they are believed to lower uric acid levels. But there has only been one good-quality study on the effectiveness of vitamin C in gout. That study found that vitamin C had a weak effect on uric acid levels, but the researchers didnt look into whether that also lowered the risk of gout attacks.
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Which Foods Are Safe For Gout
Find out which foods to eat and which to avoid if you have gout.
Question: I havegout. Can you tell me which fruits, vegetables, meats or seafoods I should eat or avoid? Is there any type of alcohol wine, beer, spirits that is better or worse for me than others?
Answer: Dietary management of gout is very restrictive and doesnt always work to control gout, so a combination of medication and diet may be the best way to treat your gout. In addition to medications that treat the inflammation and other symptoms that occur during a gout attack, medications exist that can treat the underlying metabolic condition of hyperuricemia too much uric acid in the blood.Hyperuricemia can occur either when the body produces too much uric acid or when the body does not excrete enough uric acid. Drugs exist to treat both causes.
Purine compounds, whether produced in the body or from eating high-purine foods, can raise uric acid levels. Excess uric acid can produce uric acid crystals, which then build up in soft tissues and joints, causing the painful symptoms of gout. Dietary management focuses on reducing the amount of uric acid in the system and attaining and maintaining a healthy bodyweight.
The primary dietary modification traditionally recommended is a low-purine diet. Avoiding purines completely is impossible, but strive to limit them. You can learn by trial and error what your personal limit is and which foods cause you problems.
High-Purine Foods Include:
Nutrition
Foods That May Trigger A Gout Attack
Physicians recommend avoiding or limiting consumption of14:
- Alcoholic beverages, especially beer
- Sugary foods and beverages, particularly those made with high fructose corn syrup, such as sodas15
- Meat, particularly organ meat or sweetmeats, such as liver, and game meats6
- Seafood, particularly scallops, anchovies, and herring16
Alcohol increases the amount of uric acid in the blood and limits the bodys ability to process and eliminate uric acid.17
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Gout And Diet: Foods And Drinks To Avoid
Gout is an arthritic condition that can cause sudden, severe joint pain. If you are experiencing symptoms of gout, the NHS recommends that you see a doctor for treatment during an attack and to help prevent further attacks.
We asked Emer Delaney, a dietitian who has worked in some of London’s top teaching hospitals, to explain how diet and lifestyle can affect the condition.
What Effect Do Your Weight And Diet Have
Some studies suggest that certain foods are linked to gout attacks. Gout attacks are apparently more common in people who have eaten a lot of meat, fish or seafood a few days before. That matches many people’s experiences. On the other hand, purine-rich plant-based foods such as peas, beans, lentils, spinach, mushrooms, oats, cauliflower and broccoli were found to have little to no effect on the risk of a gout attack. Overall, there hasnt been much good quality research into the link between certain foods and gout attacks.
Eating cherries is sometimes recommended to prevent gout attacks, but theres no scientific proof that it can help prevent gout.
Because not everybody has the same metabolism, its a good idea to try out for yourself what helps you and what doesnt and how much of different foods your body tolerates. Some people feel better after changing their diet, while others successfully lower their uric acid levels with medication and cope just fine without any changes to their diet.
Individual studies also suggest that losing weight can help if you’re very overweight. People with gout should be careful not to go without any food, though fasting can itself trigger a gout attack.
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What Can I Do On My Own To Prevent Gout Attacks
Gout is caused by high uric acid levels. If theres too much uric acid in our bodies, it can build up in joints and cause an acute gout attack. Some people manage to keep their levels of uric acid down by eating less meat, fish and seafood and drinking less alcohol.
Uric acid is released when substances called purines are broken down. Purines are mainly produced inside the body, but they are also found in many different types of foods that we eat. Fish, meat and seafood are especially rich in purines. People with gout are sometimes advised to stick to a strict low-purine diet. But its not clear exactly how effective that kind of diet is.