How Does The Alkaline Diet Help Gout
So what does the alkaline diet have to do with gout? It raises the pH of urine, which increases the elimination of uric acid from your body 2.
So what does the alkaline diet have to do with gout?
- It raises the pH of urine, which increases the elimination of uric acid from your body 2.
- Less sodium and more potassium in the alkaline diet tends to prevent high amounts of uric acid 1.
- It contains substantially less purines, the compounds found in high amounts in animal products that form uric acid.
- It eliminates animal products, which decreases uric acid excretion in urine 3.
- It benefits kidney function the kidneys are responsible for processing uric acid 4.
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Does Avoiding Alcohol Help
There are only a few studies looking into the influence of alcohol on gout. They suggest that people with gout are more likely to have an attack if they have had more than one or two alcoholic drinks in the last 24 hours. One alcoholic drink is equivalent to a small bottle of beer , a small glass of wine or a double schnapps .
There are various reasons why alcohol can trigger gout attacks. On the one hand, it increases uric acid production and reduces the amount of uric acid expelled by the kidneys. On the other, the diuretic effect of alcohol can increase the risk of gout. Uric acid crystals form more readily in joints if the surrounding tissue doesnt contain enough fluid. Beer in particular contains a relatively high amount of purines too, which could also be a factor.
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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What Else Can I Eat With Dairy
Dairy is beneficial for gout sufferers, but if consumed in combination with other gout-friendly foods, it can help amplify its effects. For example, taking cherries and milk on the same day can enhance the benefits.
Other gout-friendly foods you can take along with your daily consumption:
- Eggs
- Vitamin C rich foods like orange, papaya, cherries and tangerines
- Apples, pears, avocados, pineapples
Its also good to mix up your meals, so your taste buds do not get bored. Consider experimenting with different gout-friendly foods and create your own recipe.
Plenty Of Starchy Carbohydrates
These may include rice, potatoes, pasta, bread, couscous, quinoa, barley or oats, and should be included at each meal time. These foods contain only small amounts of purines, so these along with fruit and vegetables should make up the basis of your meals. Wholegrain varieties are better choices as they contain more fibre and nutrients.
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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.
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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How Can I Self
The methods of managing an acute attack of gout differ from the ongoing methods for managing gout. If youve been diagnosed with gout, youll benefit in the long term from making healthy changes to your lifestyle, such as:
- maintaining a healthy body weight. If you do need to lose weight, make sure your weight loss is gradual as crash diets can increase uric acid levels
- drinking alcohol in moderation and avoiding binge drinking
- drinking plenty of water, and staying hydrated
- avoiding, or eating in moderation, foods that are high in purines. Talk with a dietitian for tips and advice
- exercising regularly aim to complete at least 30 minutes of physical activity most days of the week
- working closely with your GP to prevent further attacks and actively manage your condition.
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
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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.
Purines The Root Cause Of Hyperuricemia
A purine is an organic compound usually found in the same foods that contain protein. To break down purines the liver must produce uric acid. When there is a large presence of purines, the liver tends to produce more uric acid than the kidneys can filter out of the body. Hyperuricemia is the condition when uric acid levels are above normal levels. The excess uric acid builds up at a joint and causes inflammation and pain, which are symptoms of gouty arthritis or gout.
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Foods To Eat When You Have Gout
Gout is a metabolic disorder that manifests as a type of extreme inflammatory arthritis. Often beginning with a sharp pain in the big toe, gout occurs when the body cannot properly process uric acid, leading to painful uric crystals accumulating in the joints.
When you have a condition as strongly influenced by diet as gout is, it becomes easy to get caught up in what you cant eat, instead of focusing on the things you can. Purines are an organic compound associated with gout flare-ups because they cause the body to produce higher amounts of uric acid. Foods that contain purines tend to be high-fat or yeasty products. While managing your diet can help control your gout, your food choices should not be centered only around avoiding purines. You should be trying to eat proactively at the same timefinding foods that will help keep your gout in check.
These 15 foods could help fight off gout attacks to live a happier life.
What Food To Eat
Now that you know what foods to avoid, how do you know what foods are safe to eat? Your gout diet should include plenty of the foods on this list as they produce no or very little uric acid when digested.
- Fruits and vegetables: all fruits and vegetables are fine and cherries could even help prevent attacks of gout as it lowers uric acid levels
- Whole grains: oats, barley, brown rice, others
- Dairy: low-fat dairy products provide many benefits as part of a gout diet
- Legumes: beans and lentils are great proteins as are soybeans and tofu
- Nuts: nuts and seeds like almonds and sunflower seeds
- Drinks: coffee and tea
- Oils: when cooking, stick to plant-based oils like olive oil or canola oil
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Am I At Risk Of Having Gout
Youre more likely to have a gout attack if you:
- are male
- have a family history of gout
- have elevated levels of uric acid in the blood
- drink too much alcohol
- eat a diet high in purines such as meat, sweetbreads, offal, shellfish, and fructose
- are overweight or obese
- use diuretics
- have type 2 diabetes, high blood pressure or high cholesterol these conditions can mean that your kidneys are less able to flush out the urates
- have kidney disease
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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Alcohol Is The Biggest Risk Factor For Gout
It is well-established that frequent alcohol intake dramatically increases risk of gout .
The Framingham Heart Study of over 4,500 participants provides some perspective.
Researchers found that regular alcohol use was associated with three times greater risk of gout in women compared to those who have less than 2 standard drinks per week. For men, regular drinkers had double the risk of non-drinkers .
Beer seems to be the worst, followed by hard liquors such as spirits. Interestingly, moderate wine consumption is not linked with any risk .
The reason why alcohol increases uric acid levels is still not well-understood. Some forms, particularly beer, can be high in purines but they are certainly not the richest source of purines in our diet.
Additional theories propose that excessive alcohol may also reduce the bodys ability to excrete uric acid. Others state that alcohol especially beer increases the chemical breakdown of purine-containing ATP nucleotides, which is a precursor of uric acid production .
Summary: Regular alcohol intake severely raises uric acid levels in the blood. It doubles, if not triples your risk of gout.
How Does Drinking Alcohol Affect Gout
Alcoholic drinks tend to be high in purines and consuming more than the recommended amount can increase the risk of a gout attack. It is therefore recommended to limit alcohol intake, avoid binge drinking and avoid all alcohol if you have painful gout or are having a gout attack. Try limiting alcohol to a maximum of 14 units per week for both men and women and 1-2 units per day with a minimum of two alcohol-free days a week. Beer, stout, port and fortified wines tend to be higher in purines and should be restricted. Moderate consumption of wine is not associated with a significant increased risk.
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Dont Be Scared Of Beans Legumes Vegetables
The most inconsistent recommendations are for beans, legumes and certain vegetables. No source indicated to avoid these food groups. However, many state they are high risk like some seafood.
From this particular purine table, beans, lentils and peanuts have far less purines than the other food groups mentioned previously. Therefore, they are not as high-risk for gout. Keep in mind, cured or dried food, such as beans, will have a higher purine concentration per weight because of shrinkage.
Some sources caution eating asparagus, cauliflower, peas, chickpeas, spinach and broccoli because it contains more purines than most vegetables. However, the purine amounts for asparagus, spinach and broccoli are less than half of pork or beef. Lastly, a recent study concluded purine-rich vegetables are less of a risk than animal based purines.
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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Vitamin C Loaded Foods
Foods to eat with gout list ends with vitamin C loaded options. Some examples include grapefruit, oranges, and also red peppers. But, dont forget about broccoli. It is loaded with this vitamin as well. Some will say that the same perk can be obtained from vitamin C supplements. Yes, this is possible, but too much of it will actually spike up the uric acid. Try to be careful and consume vitamin C loaded foods rather than taking the supplements. On average, a person who consumes 1500mg of vitamin C daily has almost 50% lower risk from a flare!
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These were the best foods to eat with gout. You will get various benefits and perks, there are no complications and you can consume any of the foods as much as you like. Ideally, you will create a diet plan that matches your needs the best. This will have a positive effect on your life, decrease, or even completely eliminate gout attacks. Dont forget that there is a second part of this story. There are foods which must be avoided at all costs.
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Should I Cut Out Purine
There is very little scientific proof that avoiding the purine-rich foods listed above can successfully reduce gout attacks. You may miss out on important nutrients and vitamins by completely cutting these foods from your diet.
If you notice certain foods trigger your gout attacks, you may benefit from cutting down the amounts of those foods in your diet. However not all purine-rich foods are thought to cause gout. For example, a number of vegetables are also rich in purines but appear less likely to cause gout than diets containing meat and shellfish.
Dairy foods, which can contain purines, actually appear to lower the risk of gout. For most people with gout, a healthy balanced diet is all that is needed, alongside medicines to reduce uric acid levels. Most people taking medicines to reduce uric acid levels find they can still eat purine-rich foods without attacks of gout by being careful with the quantity they eat.
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