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.
How Is Gout Diagnosed
In a clear-cut case, a primary care physician can make the diagnosis of gout with a high level of confidence. However, often there are two or more possible causes for an inflamed toe or other joint, which mimics some of the symptoms of gout, so tests to identify the presence of uric acid is performed.
Since the treatment for gout is lifelong, its very important to make a definitive diagnosis. Ideally, the diagnosis is made by identifying uric acid crystals in joint fluid or in a mass of uric acid . These can be seen by putting a drop of fluid on a slide and examining it using a polarizing microscope, which takes advantage of the way uric acid crystals bend light. A non-rheumatologist, when possible, can remove fluid from the joint by aspirating it with a small needle and send it to a lab for analysis. A rheumatologist is likely to have a polarizing attachment on their microscope at their office. Gout crystals have a needle-like shape, and are either yellow or blue, depending on how they are arranged on the slide .
Figure 11: Uric Acid Crystals Under Polarizing Light Microscopy
There are many circumstances where, however ideal it would be, no fluid or other specimen is available to examine, but a diagnosis of gout needs to be made. A set of criteria has been established to help make the diagnosis of gout in this setting .2
Table 1: Diagnosing gout when no crystal identification is possible
Ideally, 6 of 10 features will be present of the following:
How Does Alcohol Affect People With Gout
Alcohol disrupts the removal of uric acid from the body. Its thought that high levels of purine in alcoholic beverages lead to this disruption.
Normally, purines would break down into uric acid and get flushed out of the body through urine. However, this process is interrupted when uric acid levels get too high. Crystals form around the joints, and gout develops.
To prevent further gout attacks, stick to these guidelines:
- avoid alcohol when having an attack
- limit wine consumption
- avoid beer
Keep in mind that you should avoid alcohol altogether unless your doctor says otherwise. Gout-friendly recipes take these alcohol restrictions into account as well.
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Can I Drink Alcohol
Drinking alcohol can increase your risk of a gout attack as it can raise the level of uric acid in your blood. While it is possible to control gout attacks without completely cutting out alcohol, try to reduce the amount of alcohol you drink and avoid binge drinking . Talk to your doctor or read the Australian government guidelines on recommended alcohol intake.
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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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.
The Connection Between Food And Gout Flare
Uric acid is produced when your body breaks down a chemical called purine. Purines are found in cells of all living things. Some enter your body through your diet when they are digested.
In healthy bodies, uric acid is easily removed from your body when it passes through the kidneys into your urine. However, when your kidneys cant process uric acid efficiently or if there is too much in the blood, you develop hyperuricemia, or high levels of uric acid, which can trigger pain, swelling and inflammation, Fowler said.
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What Is The Gout Diet
Gout is caused by high uric acid levels in your blood. Extra uric acid forms sharp crystals that settle in your joints, causing swelling and pain. But you can help reduce the amount of uric acid in your body by maintaining a low-purine diet. Reducing uric acid levels can help prevent new crystals from forming, reducing gout attacks.
Dietary Causes Of Gout And Gouty Arthritis
Most people with gout will still need medication even if they follow a diet for gout.
Dietary changes alone can lower your uric acid levels by up to 15 percent, according to the Institute for Quality and Efficiency in Health Care , an independent scientific institute that evaluates the benefits and harms of medical interventions.
Its not necessary to avoid all high-purine foods if you have gout. Studies have shown that purine-rich vegetables dont trigger gout. And certain high-purine foods can be a good source of lean protein to incorporate into your diet.
Purine-rich vegetarian foods to include in your diet are:
- Alcoholic beverages, especially beer, whiskey, gin, vodka, or rum
- Sugary drinks, including sodas, juices, energy drinks
- Coffee and other caffeinated beverages. While some studies show that caffeine can actually protect against gout pain, others find that sudden spikes in caffeine intake can trigger a gout attack.
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Foods With A High Glycemic Index
The glycemic index measures how specific foods affect blood sugar levels.
Some carbohydrate foods with a higher GI score can spike blood sugar and contribute to weight gain â a risk factor for gout.
A found that eating lower GI foods lowered uric acid, which may help prevent gout flares.
People can help to manage gout by avoiding or limiting the following high GI foods:
- refined carbohydrates, such as white bread, pasta, and rice
- cakes, biscuits, cookies, pancakes, and sweet treats
- higher GI vegetables and fruits, such as potatoes, bananas, and watermelon
- low-fiber, high-sugar breakfast cereals, such as puffed rice, cornflakes, and frosted flakes
An Overview Of Dietary Approaches To Manage And Prevent Gout
The main principles of a gout diet are usually the same as those of any healthy, balanced diet.
- If youre overweight, reduce the number of calories you consume.
- Choose unrefined carbohydrates like fruits, vegetables, and whole grains.
- Limit your intake of sugar-sweetened beverages and foods.
- Limit your intake of organ meats .
- Cut back on saturated fats.
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Gout Diet: What To Eat And What To Avoid
Written byMohan GarikiparithiPublished onJuly 1, 2016
Gout flare-ups can be triggered by food, so knowing what to eat and what to avoid can help you better manage your condition. Gout is a form of arthritis where uric acid crystallizes in small joints commonly the large toe causing redness, swelling, and severe pain. Uric acid is the product of the breakdown of purines, which are commonly found in many of the foods we eat. Eating large amounts of purine-rich foods can worsen your gout symptoms.
If you have gout, you can greatly benefit from following a gout-specific diet, as it can help you lower the rate of flare-ups and gout attacks and help you lose weight. Many gout patients are overweight, which is a risk factor for gout.
The basics of a gout diet include fruits and vegetables, whole grains, and occasional low-fat dairy. Essentially, these are the ingredients to an overall healthy diet that many of us should follow.
Here we will outline a gout diet and help you devise a better way of eating to manage your condition.
Which Foods Should You Avoid When You Have Gout
Purines are compounds that are found in specific food and drink and they change to uric acid in the body. Most meat and seafood are high in purine and can increase uric acid levels in the body. These therefore should be limited during episodes of a gout attack and portion size should be reduced. Common examples of foods high in purine include anchovies, sardines, offal foods such as liver, kidney, sweetbreads, game, goose, minced meat, mussels, partridge, roe, scallops, herring, gravies, stock cubes and meat and yeast extracts.
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Foods That Cause Gout
Youre a bit better off if your occasional indulgence is beef or pork rather than lamb, says Dr. Zashin. Remember that gout triggers can be individual, and what causes a flare-up for one person may not make noticeable difference to another. Have patience and keep your long-term goal of living a healthy life free of gout symptoms in mind. As a result, it’s recommended to avoid alcohol with gout.
The extent to which diet impacts risk for gout has been debated in the medical community. In addition to animal proteins and alcohol, sugar-sweetened beverages have been suspected as playing a role in the development of gout. Many people who experience gout also have another chronic condition, such as type 2 diabetes, kidney disease, or hypertension .
What Is Uric Acid
Uric acid is a waste byproduct of purine breakdown in the body. Purines are naturally produced in the body, as well as found in some foods. As purines are broken down, uric acid is created. Normally uric acid is either reabsorbed in the body or excreted via the urine and feces.
When there are more purines in the body than it can process, uric acid builds up in the bloodstream. This is called hyperuricemia. Hyperuricemia can cause gout and/or kidney stones in some people, while others have no signs or symptoms at all.
Verywell / Alexandra Gordon
Treatment for gout often includes medications, diet modification, and lifestyle changes, such as managing weight and quitting smoking. The foods you eat can have a direct impact on gout flares.
During a gout attack, modifying your diet may help decrease the length of the flare. Continuing to follow a gout-friendly diet, specifically a low-purine diet, may help prevent the risk of future gout attacks up to five fold.
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Tips To Cut Back On Alcohol
Order non-alcoholic drinks when youre out with friends or family. Iced tea, coffee, flavored seltzers or club soda with a lime wedge may be good alternatives to beer or booze.
Set goals. Pick days when you will drink and days when you wont drink. Keep track of it on your calendar. Set a limit for how much you will drink that night and stick to it. Dont save it up for one night per week and overdo it.
Dont keep alcoholic beverages in the house. If theyre on hand, its easy to reach for them when you want to unwind or if you feel stressed.
Sip, dont guzzle. Dont rush through your drinks so they last longer. Sip or nurse a drink while you enjoy talking to your friends or watching the game on TV. Dont let anyone else push you to drink faster or more than you want.
Avoid tempting scenarios. If you typically drink a lot of alcohol in certain settings or during certain activities, such as when you meet your friends to watch sports or after work for happy hour, its OK to skip those outings or cut way back on how many you attend.
Gout Diet: What To Eat And To Avoid To Prevent Flare
Do you have a bout with gout? You arent alone. Gout is a painful form of arthritis that affects millions of people. It causes flare-ups of joint pain when high levels of uric acid in the blood cause crystals to form around joints.
Its not all doom and gloom though. Most cases of gout can be prevented or managed with healthy lifestyle changes, such as a gout-friendly diet.
A proper diet can affect gout either positively and help control the disease, while it can be detrimental and contribute to flare-ups if a proper diet isnt followed, said Melissa Fowler, a rheumatology physician assistant at Banner Health in Tucson, AZ. Obesity and other common medical conditions, such as hypertension and diabetes, are also important in terms of a proper diet and managing these health conditions is extremely important to also controlling gout.
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Shopping List For Gout
What to put in your cart and what to pass up when planning your gout diet.
A diet to lower uric acid levels, along with medications prescribed by your doctor, makes gout one of the most controllable forms of arthritis. While you should always discuss the merits and drawbacks of specific foods with your doctor, use this shopping checklist as a general guide to food choices to improve your overall health, lower uric acid levels and reduce your risk of painful gout attacks. Put in Your Cart
- Skim milk.
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Vegetables Like Beetroot And Gout
Most vegetables fall into the low-purine category, so vegetables are not usually on the list of foods to avoid with gout. However, there are a few vegetables containing a moderate amount of purines that people with gout should be aware of.
According to the American Academy of Family Physicians, moderate-purine vegetables include:
Simply because these vegetables contain moderate amounts of purines does not mean that people with gout should avoid them altogether. According to Mayo Clinic, the purines in vegetables do not increase the risk of gout or recurring gout attacks.
Similar to purines, oxalates are another type of natural substance that increases the uric acid content in the body. Vegetable sources of oxalates include rhubarb, turnips, beets and okra. This is why there is speculation of a negative association between beetroot and gout. Since beets contain oxalates, beetroot and gout may not not be a good combination. The same is true of okra. Though it has many health benefits, it is not true that okra is good for gout.
If you have gout, you may choose to consume or avoid vegetables that contain purines and oxalates.
Read more:List of Foods That Raise Uric Acid
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Meal Plan To Reduce Uric Acid
The following table shows a 3-day meal plan that can help to control uric acid levels in the blood
1 slice of papaya + 1 tablespoon of peanut butter
1 cup of green juice made with cabbage and orange
Whole wheat rice with broccoli + a grilled tilapia fillet + 1 guava fruit
Sweet potato mash + 1 bass fish fillet, boiled in herbs + salad with lettuce, arugula, grated carrot and olive oil + 1 cup of cashew milk
Whole grain pasta with pesto sauce + 1 chicken breast, grilled + salad with cabbage and carrot, stir-fried in olive oil + 1 slice of melon
1 tapioca stuffed with cottage cheese + 3 walnuts + 2 small slices of pineapple
1 cup of coffee with skim milk + 1 slice of whole grain bread + 1 scrambled egg
1 Greek yogurt + 10 cashews + 1 slice of watermelon
This meal plan is just an example of what you can incorporate into your daily diet. To treat gout, you should be monitored by a doctor and consult a registered dietitian to formulate a personalized and balanced meal plan.
How To Get Rid Of Gout With Your Diet
Gout has literally been referred to The Disease of Kings because it has been associated with indulging excessively in food and alcohol, which was historically thought to be a privilege of royalty.
Acute flares of pain usually require anti-inflammatories and other medications in addition to diet.
Learning how to decrease flairs or prevent gout all together requires focusing on food.
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