Should I Drink Lots Of Water
Dehydration may be a risk factor for gout although this is not well proven in research. Drinking 1 1.5 litres of fluids a day is recommended for general health benefits. However if you are taking diuretics or have heart or kidney problems, talk to your doctor about the right amount of fluids for you to drink.
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.
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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Treatment For Gout In The Foot
The Big Toe And The Heel Prime Targets For Gout
Does your toe swell with gout? Is your heel a pain with gouty arthritis? We offer independent expert advice on specific treatments for gout in the foot. No vagueness, just specific advice for exactly how to treat a painful foot with gout.
This is part of our series looking at specific treatments for gout in detail. Not just listing exercise, but which exercises for each part of your body affected by gout? Where so many big websites seek to offer generic advice that doesnt help at all, we seek to get to the heart of the issue.
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How To Prevent The Next Gout Attack
If youve ever experienced a gout attack, youre not likely to forget it. The sudden, severe inflammatory pain may have woken you up in the middle of the night or even sent you to the ER.
You may be at high risk for another attack if you havent made any changes to your diet, lifestyle, or medication regimen. Taking precautions against future attacks can spare you from gout pain and limit long-term damage to your joints.
If youve had a gout attack, your likelihood of having another is unpredictable. Thats why its important to take preventive steps. SeeGout Prevention
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Plenty Of Fruit And Vegetables
The recommendation is five portions per day, but try to include as many as possible. Bulking out meals, such as Bolognese, casseroles and stews with vegetables can help to reduce the meat content. Fruit and vegetables contain vitamin C. Although evidence is unclear, high intakes of vitamin C may help to reduce uric acid levels in the blood. Cherries may be particularly useful to include in the diet, as they have also been found to reduce levels of uric acid in the blood.
What Foods Should You Avoid If You Have Gout
A medical professional should advise on the best course of treatment for someone diagnosed with gout.
But to prevent gout from coming back, the NHS website suggests some lifestyle changes may be able to help reduce or stop further attacks.
Things like getting to a healthy weight while avoiding crash diets, eating a healthy balanced diet and having some alcohol-free days every week may help reduce further attacks of gout.
Drinking plenty of fluids to avoid getting dehydrated, regular exercise , stopping smoking, and asking a GP about vitamin C supplements may also help.
There are some foods and drinks which people with gout should avoid to stop or reduce further attacks of gout.
As per the NHS website, people with gout should avoid:
- offal, such as kidneys or liver, or seafood
- lots of sugary drinks and snacks
- fatty foods
The NHS also recommends people with gout “do not drink more than 14 units of alcohol a week”, and that people spread their drinking “over three or more days” if they drink “as much as 14 units”.
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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.
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Who Can Benefit From A Low Purine Diet
Anyone with high uric acid levels in their blood can benefit from reducing high-purine foods. This may help to prevent gout in people with hyperuricemia who havent yet developed the disease. It may also help prevent existing gout from progressing and prevent other complications of hyperuricemia, such as kidney stones.
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Dietary Causes Of Gout And Gouty Arthritis
Some people with gout find it helpful to eliminate specific high-purine foods from their diet. Certain high-purine foods may trigger gout attacks in some people.
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:
- Peas
- 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.
Which Other Lifestyle Factors Can Affect Gout
While there are no controlled studies or evidence on the effect of lifestyle changes on the incidence of gout, expert opinion is that positive changes in lifestyle can be beneficial to the management of gout. Being overweight is not recommended for gout suffers and the available evidence indicates that losing weight may helpful. Dietary modifications to achieve a healthy body weight are recommended, however the use of crash, high-protein and low-carbohydrate diets should be avoided. Slow and steady weight loss is ideal and support from a dietitian should be sought to help develop a sustainable and balanced weight loss plan. Rapid weight loss is not recommended as it can increase the amount of uric acid in the body leading to an increased chance of a gout attack.
Regular exercise such as swimming or walking is also recommended as it may help reduce the frequency of gout attacks. In addition, it may have a beneficial effect on associated co-morbidities such as type 2 diabetes, hypertension and insulin resistance.
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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
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.
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You Cant 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.
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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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What Gout Foods To Avoid
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Foods You Can Eat In Moderation
Aside from organ meats, game meats and certain fish, most meats can be consumed in moderation. You should limit yourself to 46 ounces of these a few times per week .
They contain a moderate amount of purines, which is considered to be 100200 mg per 100 grams. Thus, eating too much of them may trigger a gout attack.
- Meats: These include chicken, beef, pork and lamb.
- Other fish: Fresh or canned salmon generally contains lower levels of purines than most other fish.
Summary: Foods you should eat with gout include all fruits and vegetables, whole grains, low-fat dairy products, eggs and most beverages. Limit your consumption of non-organ meats and fish like salmon to servings of 46 ounces a few times weekly.
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List Of Gout Diet Foods To Eat And Gout Foods To Avoid
A correct diet for gout is needed to help prevent gout from seriously damaging your health. Here youll find a list of gout diet foods to eat and foods to avoid.
WHY YOU NEED A GOOD GOUT DIET
Your agonising symptoms of gout are caused by uric acid crystals that have formed in your joint, which can form when you have high uric acid in your blood. This usually occurs when your kidneys either cant excrete excess uric acid from your body effectively enough, or, your body is manufacturing too much acid for your kidneys to be expected to handle.
Uric acid is produced as a result of the natural breakdown of chemical compounds in your cells called purines, but, they also exist in our foods at varying concentrations or levels. Some have high / very high levels, others have moderate, and others relatively low purine levels.
The trick is to identify those foods that have high / very high purine levels and avoid those. And supplement with those foods that have relatively low levels. And to help you do this Ive listed the foods you can eat with gout, and, the foods to avoid for gout
GOUT DIET FOODS TO EAT LIST
These are some of the low-purine foods that go to make a good gout diet:-
Complex carbs Low fat dairy produce High vitamin C foods Essential fatty acids Vegetables Fruit
LIST OF GOUT DIET FOODS TO AVOID
These are some of the foods, that are high / very high in purines, and should be avoided:-
OTHER ISSUES AFFECTING YOUR GOUT
Be Choosy About Carbs
Carbs can be helpful or harmful to your gout health. The most helpful carbs are found in whole grains, fruits, vegetables, and legumes. Sweet potatoes, beans, apples, and popcorn can all be served in wholesome and delicious ways as part of a healthy gout diet.
Other carbs come as natural and refined sugars. Candy, sports drinks, some breakfast cereal, and some pasta sauces all contribute to dietary sugar from unhealthy carbs.
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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.
Is There A Test For Gout
There is no one test for gout, and its symptoms are similar to several different conditions. To see if you have gout, your health care provider may:
- Ask you to provide your medical history, including:
- Your symptoms.
- Any other medical problems you have.
- Any medications you are taking.
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Gout: Dr Rosemary Leonard Advises On Symptoms And Treatment
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People with gout are also advised to avoid foods high in purines, such as organ meats, red meats and seafood, including unfortunately certain oily fish such as sardines and anchovies, which are generally good for our health!
Anything that helps to bring down inflammation can also help.
Diet
Cassandra said a diet in fresh vegetables – preferably seven to nine servings a day – could help ease symptoms.
Unrefined carbohydrates such as whole oats and brown rice, and with adequate but not excessive protein from white meats, white fish, eggs, seeds and nuts is a good start, she explained.
Think about supplements that can help bring down inflammation too.
Omega-3 fish oils containing EPA can help . Id also suggest an anti-inflammatory blend such as Natures Plus AgeLoss First Day Healthy Inflammation Response tablets.