Frequent Consumption Of Certain Fruits May Trigger Recurrent Gout Attacks
High sugar drinks may not be the only stimulant of gout flare ups.
Certain fruits which are a natural source of fructose have also been linked with gout.
This is a highly contentious area, because several studies have linked higher fruit intake with less incidence of gout. This is probably due to their high fibre content .
And unlike fruit juice and other sugar-sweetened drinks, whole fruits are nutritious and generally good for health. There is no disputing this.
However, if you continually have gout attacks despite cutting out alcohol and sugar-sweetened drinks then Im not convinced a large amount of fruits are safe for you. Especially if you are overweight and eat a Western diet.
So cutting back on certain very high-fructose fruits is like a Plan D, if you will.
The link comes back to fructose, which stimulates uric acid production in a similar manner to alcohol. Fructose is naturally found in fruit and honey.
One study found that the consumption of apples or oranges the most popular fruits in this study was linked with an increased risk of gout compared to those who consume less than one serving of fruit per month. No link was found with other fruits however .
While most fruits are very low in fructose, a few are very high. Frequent consumption of these could theoretically causes problems for gout sufferers.
Foods Highest in Fructose per 200 Calories :
Note this list is ranked on a per calorie basis, not per serving.
What Are The Advantages Of A Low
- Reducing uric acid. People who are disposed to hyperuricemia may be able to manage their condition with diet to prevent complications such as gout and kidney stones from developing. People who have already been diagnosed with gout or kidney stones may be able to prevent new uric acid crystals from forming in their joints or kidneys or at least slow the process down.
- Reducing weight. Avoiding high-purine foods such as red meats and sweets may help you reduce weight as a secondary benefit. Gout is highly associated with excess weight gain and related metabolic syndromes such as obesity, diabetes and cardiovascular disease. Weight loss statistically lowers your risk of developing gout, and it helps relieve symptoms of gout by taking stress off your joints.
- Reducing medication. Diet is not as effective as medication for managing gout, and its not supposed to replace it. But paying attention to your diet may help minimize your need for medications.
Caffeine And Gout Risk
Studies show that caffeine may protect you from gout because caffeine is similar in chemical structure to a common gout medication. But other research shows that increasing your caffeine intake can actually trigger gout pain in fact, one study found that suddenly doubling your caffeine intake could increase the risk of gout symptoms by up to 80 percent. So if you are a coffee or tea drinker, caffeine could be helping protect you just remember that a sudden binge could bring on a gout attack.
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Look Forward Not Back
Give your taste buds time to adjust. Sugar is a big part of the modern American diet, and your body has become used to the taste, feeling, and consequences of a sugary snack.
It can be difficult to adapt to your new healthier diet, but if you stick with it, soon youll notice the natural sweetness in certain foods, and youll be able to satisfy your sweet tooth while you boost your health with wholesome ingredients.
Attitude and commitment are important parts of any healthy lifestyle change. Stay focused on your goal, appreciate every small gain you make, and keep your health and wellbeing firmly at the top of your priority list.
Realize that sugar is a drug, and cutting it out wont be a walk in the park, but your life will be a lot more comfortable and fulfilling once you reduce your gout risk by limiting your sugar intake.
Organ Meats Are Extremely High In Purines And Should Also Be Avoided
Organ meats, known as Offal, contain by far the most purines of any food in the human diet.
The most common forms of offal in the Western diet include liver , brain, heart, kidneys, and a mixture called Pâté.
Below is the purine content of a handful of foods. Note this is just an example Ive selected, and you can find much more extensive lists on Goutpal or here.
Purine Content of Food :
Consider that values listed are per 100 grams, so portion sizes must be taken into account Meat portions we eat tend to be heaviest.
Previous studies have not differentiated between intake of conventional meat and offal, so recommendations have to be the same. Given the strong link between meat intake and gout which is based on purine content alone offal should definitely be avoided too.
Somewhat contradictory to the purine-gout theory, consumption of purine-rich vegetables is not associated with an increased risk of gout .
Researchers speculate this could be due to a lower bioavailability of purines in vegetabes, as well as other nutrients which may offset the harmful effects of their purines.
Summary: Organ meats are some of the highest purine foods and should be completely avoided if you suffer gout attacks.
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The Cause Of Gout Is More Than Just Diet
While diet is critical, dont overlook other important factors that affect gout. These include family history, sleep apnoea, and lack of physical exercise to name a few.
Further discussion of best treatment for gout is outside the scope of this article. But there are foods thought to be protective namely dairy, cherries, and coffee, in decreasing order of evidence.
And as much as I prefer focusing on what you should eat to prevent health scares, there are just so many clear trigger foods for gout.
Its important to deal with these factors first and foremost.
About Joe Leech, Dietitian
Joe Leech is a university-qualified dietitian from Australia.
He graduated with a Bachelor’s degree in exercise science, followed by a Master’s degree in Nutrition and Dietetics in 2011.
Learn more about him on the About page.
Joe Leech, Dietitian
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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Most Soy Should Be Fine
Soy foods like tofu, soy milk, and edamame have moderate amounts of purines. Traditionally doctors have cautioned against eating too much soy for people with gout. One study found that soybeans, soymilk, and soy powder increased uric acid in the blood significantly. However, larger population studies have recently told a different story. Several have reported that not only are soy products harmless for gout patients, but also people who eat more soy tend to have a reduced gout risk.
Why Are Nuts Bad For Kidneys
Some nuts are bad for kidneys because they contain high amounts of phosphorus and potassium, which affect your kidneys ability to remove waste from your blood.
A kidney-friendly diet limits particular nutrients and minerals such as protein, potassium, phosphorus, and sodium.
Kidneys regulate your blood pressure, removing excessive protein and minerals from your blood.
To have healthy kidneys, you need to follow a suitable renal diet and avoid certain foods.
Another factor that makes nuts bad for kidneys is calcium oxalate, which can form calcium oxalate kidney stones and prevent calcium from being absorbed.
Peanuts and cashews contain high amounts of this mineral.
However, some nuts such as macadamia can be a suitable option for people with kidney problems.
Theyre low in phosphorus and contain healthy fats, B vitamins, copper, iron, and manganese.
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Sneaky Gout Triggers: Yeast Extract Msg Fructose Sauces
Yeast extract and MSGâYeast extract plus other additives is basically MSG . MSG powder contains purines that immediately metabolizes to uric acid. Although there is proof linking yeast to purine content via alcoholic beverages, only a few sources warn yeast extract as a high-risk gout trigger.
MSG and yeast extract are flavor-enhancers in several products such as processed meat, canned food, bouillon, sauces, soup mixes, gravies, and salad dressings. Since the ingredient percentages are not typically listed or shared, it is very risky for people with chronic gout .
Manufactures will camouflage MSG by listing these these sub-ingredients instead of yeast extract, protein isolate, hydrolyzed vegetable protein, hydrolyzed yeast, and soy extracts.
MSG is not only associated with gout. It is also linked to other health problems and allergies. Known side effects from MSG overconsumption are heart palpitations, headaches, numbness and drowsiness.
Fructose â Even though there is plenty of evidence that fructose causes the body to produce purines, most major sources did not account for it as a major gout trigger. Research from 2016 linked fructose consumption to increased uric acid levels which leads to gout flares.
Sauces â Popular sauces that may cause or contain purines are fish sauce, worcestershire sauce , oyster sauce, barbecue sauce , and Maggi seasoning .
Here Are 6 Serious Signs That You Are Consuming Too Much Salt
1. You need to urinate a lot
Frequent urination is a classic sign that you are consuming too much salt. Most of the time, you may feel an urgent need to wake up in the middle of the night to urinate. However, it is a symptom of many other conditions like UTIs, type 2 diabetes and an overactive bladder. Take a test be sure of what exactly the root cause is. Nevertheless, consuming too much salt could be a reason for it.
Also read: Pink Himalayan Salt – Does It Have Any Health Benefits?2. Persistent thirst
Consuming too much salt can leave you feeling thirsty most of the time. This happens because foods with high sodium content mess with your body’s fluid balance. The best way to make up for this is to drink lots of water. Your body continues to give you a signal that it needs more water to restore salt balance in your body.
3. Swelling in strange places
Consuming too much salt can give you swelling in different parts of the body. This could be a reason why you feel bloated in the morning. The swelling can be felt on the fingers and around the ankles. This swelling is caused by excessive fluids in the body’s tissues and is known as edema. Edema is believed to be a symptom of an underlying health condition or a sign of the fact that you are consuming too much salt. Simple solution for this is to cut down on your sodium intake.
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6. You crave for salty foods
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Avoid Sweets And Sodas
Unlike fruit with its natural sugar, artificial sugars are widely recognized as gout flare dangers. Consuming too many sugary sodas has been found to provoke attacks, but no association has been found with artificially sweetened sodas. Other foods loaded with high-fructose corn syrup can also bring on gout pain.
Preventing An Attack During Travel
Travel may increase the risk for gout attacks. Travel not only increases stress but eating and drinking patterns may change. Before traveling, patients should discuss preventive measures with their health care provider. The doctor may prescribe taking a corticosteroid at the first sign of a gout attack. In most cases, this stops the attack.
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Treatment: Acute Gout Attack
Acute attacks of gout and long-term treatment of gout and hyperuricemia require different approaches. Treatment usually involves medication. After the first attack, some health care providers advise patients to keep a supply of medicines on hand to take at the first sign of symptoms of a second attack.
Treatments are prescribed for conditions associated with gout, including uric acid nephropathy and uric acid nephrolithiasis.
Supportive measures include applying ice and resting the affected joint.
Many patients do not require medication. Often lifestyle and dietary measures are enough to prevent attacks. Measures include not eating foods high in purines, not drinking alcohol, and maintaining a healthy weight.
Medicines for gout attacks are aimed at relieving pain and reducing inflammation. These include:
- Nonsteroidal anti-inflammatory drugs
These medicines may be combined to treat a gout attack.
Higher Dietary Salt Intakes Reduce Gout Triggers: Study
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The findings, which appear in Arthritis & Rheumatology, a journal produced by the American College of Rheumatology , found that a high-sodium intake, such as that found in a typical American diet, effectively lowered uric acid levels.
The relationship between salt intake and uric acid is controversial, and these results do nothing to quell this debate.
However similar studies in the past have suggested similar findings. Despite the results the researchers did not support the idea of consuming excessive or even the typical levels of salt found in the American diet in order to lower uric acid levels.
Consuming excessive amounts of sodium could have harmful consequences on other aspects of health, like blood pressure, said Dr Stephen Juraschek of the Johns Hopkins University School of Medicine and lead author of the study.
However, as sudden changes in uric acid levels can trigger gout flares, knowing that sodium causes uric acid levels to fluctuate can help patients and physicians understand more about potential dietary causes of gout flares, he added.
Study criteria
The researchers adopted a randomised, crossover feeding trial in 103 adults diagnosed with pre- or stage 1 high blood pressure.
Subjects were randomly assigned to receive either a Dietary Approach To Stop Hypertension diet or a control diet .
The DASH diet emphasises fruits, vegetables, and low-fat dairy foods along with reduced consumption of saturated fat, total fat, and cholesterol.
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Examination Of Synovial Fluid
Synovial fluid examination is the most accurate method for diagnosing gout. The synovial fluid is the lubricating liquid that fills the joint space . This is the membrane that surrounds a joint and creates a protective sac. The fluid cushions joints and supplies nutrients and oxygen to the cartilage surface that coats the bones. This exam also helps detect gout between attacks.
A procedure called arthrocentesis is performed. The health care provider uses a needle attached to a syringe to draw out fluid from the affected joint. This is called aspiration. The fluid sample is sent to a laboratory. If crystals of uric acid, also called monosodium urate are found, this makes the diagnosis of gout. These crystals are very distinctive under the microscope using special polarizing filters. Aspiration sometimes eases symptoms by reducing swelling and pressure on the tissue surrounding the joint.
Synovial fluid analysis is a method to look at the fluid that cushions a joint. It is done to help diagnose and treat joint-related problems such as gout.
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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How Does Gout Occur
Gout occurs when high amounts of uric acid in the blood form crystals in and around a joint.
Uric acid is formed by a substance called purine, which exists in your body and in foods such as beer, sardines, shrimp, lobster, red meat, and organ meats.
Consuming too much uric acid can lead to gout.
Gout is a disabling type of arthritis, which occurs in the big toe and sometimes in the ankle, knee, wrist, and foot. The symptoms include:
- Severe pain
- Red, shiny skin over the affected joint
Males are usually diagnosed with the disease after age 40 and females after menopause.
To control the disease, make dietary changes to reduce your purine levels.
But theres no need to cut nuts from your diet since no research has proved nuts cause gout.
A gout-friendly diet includes fruits and vegetables, whole grain, low-fat dairy, seeds, and of course, nuts.
The best low-purine nuts walnuts, almonds, flaxseeds, and cashews contain less than 50 milligrams of purine per one ounce .
They can also lower uric acid levels in the blood.
Blood Test For Uric Acid Level
A blood test may be done to measure uric acid level in the blood. Since uric acid can fall during an attack, the uric acid may not be elevated at that time. Some doctors may wait until several days after the attack to order a blood test. Nearly all people with gout have elevated uric acid in this case, although not all people with elevated uric acid have gout. Therefore the blood uric acid is only one part of making the diagnosis.
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