What Can Be Done About Gout
The best way to avoid gout is to stay away from triggers that lead to flare-ups. This is especially true if you have a history of the condition. One often overlooked aspect is the food you eat. This is related to gout because the condition is at its most basic makeup an excess and buildup of uric acid, which can be closely related to your diet. Therefore, monitoring what you put into your body via your diet can be an effective, natural way to reduce flare-ups of 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
Why Is Gout Known As The Disease Of Kings
You may be more likely to have gout because of your genes, but that’s not how gout earned its royal nickname. Historically, gout has been associated with a lifestyle full of rich foods and plenty of alcohol — the kind of diet that only kings and the wealthy could afford. While diet can trigger a flare, we now know that gout affects people regardless of their social status.
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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.
They include:
- 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.
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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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
What Foods Make Gout Worse
The top 10 foods and drinks that trigger gout are:
- Sugary drinks and sweets. Standard table sugar is half fructose, which breaks down into uric acid. Any food or drink with higher sugar content can trigger gout.
- High fructose corn syrup. This is a concentrated form of fructose. If you start looking at labels, youll find high fructose corn syrup in all kinds of packaged food products that you wouldnt necessarily expect.
- Alcohol. Even though not all alcoholic drinks are high in purines, alcohol prevents your kidneys from eliminating uric acid, pulling it back into your body, where it continues to accumulate.
- Organ meats. These include liver, tripe sweetbreads, brains and kidneys.
- Game meats. Specialties such as goose, veal and venison are among the reasons why gout was known in the Middle Ages as the rich mans disease.”
- Certain seafood, including herring, scallops, mussels, codfish, tuna, trout and haddock.
- Red meats, including beef, lamb pork and bacon.
- Turkey. This leaner meat is nonetheless high in purines. Especially avoid processed deli turkey.
- Gravy and meat sauces.
- Yeast and yeast extract.
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How Is Gout Treated
Gout can be effectively treated and managed with medical treatment and self-management strategies. Your health care provider may recommend a medical treatment plan to
- Manage the pain of a flare. Treatment for flares consists of nonsteroidal anti-inflammatory drugs like ibuprofen, steroids, and the anti-inflammatory drug colchicine.
- Prevent future flares. Making changes to your diet and lifestyle, such as losing weight, limiting alcohol, eating less purine-rich food , may help prevent future attacks. Changing or stopping medications associated with hyperuricemia may also help.
- Prevent tophi and kidney stones from forming as a result of chronic high levels of uric acid. Tophi are hard, uric acid deposits under the skin. For people with frequent acute flares or chronic gout, doctors may recommend preventive therapy to lower uric acid levels in the blood using drugs like allopurinol, febuxostat, and pegloticase.
In addition to medical treatment, you can manage your gout with self-management strategies. Self-management is what you do day to day to manage your condition and stay healthy, like making healthy lifestyle choices. The self-management strategies described below are proven to reduce pain and disability, so you can pursue the activities important to you.
Key Points About Gout
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Gout causes inflamed, painful joints due to urate crystal deposits at the joints.
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Gout can also cause urate crystal deposits that cause lumps under the skin.
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Gout can be triggered by eating foods high in purines and drinking alcohol.
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Treatment of gout is aimed at reducing pain and the risk of future flare-ups.
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Gout can be managed with medicines and lifestyle changes.
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How Does Food Affect Gout
If you have gout, certain foods may trigger an attack by raising your uric acid levels.
Trigger foods are commonly high in purines, a substance found naturally in foods. When you digest purines, your body makes uric acid as a waste product .
This is not a concern for healthy people, as they efficiently remove excess uric acid from the body.
However, people with gout cant efficiently remove excess uric acid. Thus, a high-purine diet may let uric acid accumulate and cause a gout attack (
10 ).
Foods that commonly trigger gout attacks include organ meats, red meats, seafood,alcohol and beer. They contain a moderate-to-high amount of purines .
However, there is one exception to this rule. Research shows that high-purine vegetables do not trigger gout attacks .
And interestingly, fructose and sugar-sweetened beverages can increase the risk of gout and gout attacks, even though theyre not purine-rich (
16 ).
For instance, a study including over 125,000 participants found that people who consumed the most fructose had a 62% higher risk of developing gout .
On the other hand, research shows that low-fat dairy products, soy products and vitamin C supplements may help prevent gout attacks by reducing blood uric acid levels (
Summary: Foods can either raise or lower your uric acid levels, depending on their purine content. However, fructose can raise your uric acid levels even though it is not purine-rich.
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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Theres More To Gout Than Too Much Uric Acid
Before we dive into the list of foods to avoid with gout, its important to get to the root of what causes too much uric acid and who is at a higher risk.
First, no one is exempt from getting gout. Some people are just more sensitive to purine-rich foods and drinks and thus churn out more uric acid. Genes can play a significant role, so if you have a relative with gout, you might be at a higher risk.
Second, putting on weight through adulthood is associated with a higher risk of gout, according to research published in 2021 in the journal Arthritis Research and Therapy.
In an earlier study published in Arthritis and Rheumatology, overweight people were 85 percent more likely to have higher uric acid levels than people at a healthy weight.
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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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.
Health Conditions And Treatments
Certain drugs, health problems, and lifestyle choices can trigger gout, too.
Medications. Aspirin, certain diuretics for high blood pressure , and drugs for people who had organ transplants can trigger gout. After a flare, go over all the medicines you take with your doctor. If needed, they should be able to find another option.
Being overweight. When you slim down, you can protect yourself from another flare.
Fasting or crash diets. If you lose weight too quickly or fast, you could raise your chances of an attack.
High blood pressure, kidney disease, diabetes, and heart disease. These health conditions make you more likely to have gout, especially if you donât get treatment. Work with your doctor to keep them under control.
Injuries or surgery. When your body is stressed or sick, youâre more likely to have a flare. Of course, you canât always avoid this trigger. But if you need to have an operation, make sure your doctor knows youâve had gout in the past.
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A Good Diet For Gout Should Not Include Soft Drinks Or Fruit Juice
Added sugar is a big problem in the modern diet.
Generally speaking, the sugar that is added to our food and drink products are 50% glucose and 50% fructose.
While glucose molecules are metabolised in the cell, fructose is metabolised in the liver. Further explanation is out of the scope of this article, but they behave very differently in the body.
Fructose intake, and not glucose intake, is strongly linked with gout.
Soft drinks and fruit juices tend to have the greatest amount of added sugar, and therefore the greatest amount of added fructose.
In fact, gout occurrence in the US has risen in line with fructose consumption since 1970 .
In a large study of over 46,000 men, researches found that two or more sugar-sweetened soft drinks a day was associated with an 85% increased risk of gout .
The largest consumers of sugar-sweetened soft drinks actually had a risk of gout comparable to the risk seen with three to five servings of alcohol.
Unfortunately the researchers did not account for family history of gout, which may or may not have changed their findings somewhat.
The strange thing out of all this, however, is that soft drinks dont typically contain purines.
Fructose is thought to be the culprit linking added sugars with gout. It appears to share the same mechanism as alcohol: fructose accelerates the breakdown of purine-containing nucleotides like ATP. This in turn drives up uric acid levels 90120-5/abstract” rel=”nofollow”> 13, 14, 15).
Soups Broths And Gravies
Meat-based soups, broths, and gravies could be a double-whammy for people with gout, Stefanski says. Thats due to their high sodium content and purines.
These types of foods might not be totally off-limits, however. Instead, swap meat-heavy soup and broth for veggie-heavy options. A hearty lentil soup with antioxidant-rich veggies is lower in purines and can help lower inflammation.
But what about that Thanksgiving gravy? Try this delicious mushroom-based gravy to pour over your mashed potatoes.
Contrary to popular belief, mushrooms are actually OK to eat if you have gout. Keep reading to find out why.
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Certain Meats And Seafood
Not all sources of purine are equal when managing gout, and research suggests certain purines can make gout worse.
Studies show that hypoxanthine purines, found in meat and fish, have a stronger effect on on purine production compared to other types of purine, says Nichole Dandrea MS, RDN, and author of The Fiber Effect: Stop Counting Calories and Start Counting Fiber For Better Health, referencing research in the BMJ.
Yet not all meats and seafood are off-limits. Some are just worse for gout symptoms than others.
Dr. Siaton recommends people with gout pass on red meats such as lamb, beef, and pork. Organ and glandular meats such as liver, tripe, and sweetbread have high purine content, too.
As for seafood, trout, haddock, codfish, anchovies, sardines, herring, mussels, and scallops are higher-purine options to avoid.
You might be able to tolerate moderately high-purine seafood such as crab, lobster, oysters, and shrimp. But make sure to limit consumption.
What Is A Low Purine Diet
Purines are chemicals that are naturally found in certain foods and drinks. When your body breaks down these chemicals, uric acid is the byproduct. A low-purine diet reduces the foods and drinks with the highest purine content to reduce uric acid. It also encourages some select foods that may reduce uric acid levels in your body.
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How To Prevent Gout
Above, we have discussed the top foods that cause gout. In order to prevent that dreaded gout flare, make sure that you avoid these foods as much as possible. It can be very difficult to do so if you are accustomed to eating them. Gradual change is key. Start small. Do not overwhelm yourself with many changes at once. This can lead to a perfectionist mindset which can quickly result in failure. This is not to discourage you. Its simply human nature to gravitate towards things we are accustomed to.
Lets say you enjoy orange juice during breakfast. Most fruit juice contains high fructose corn syrup which can raise uric acid levels. You can replace this with a healthier drink instead, such as green tea or coffee. Stick to doing that for a week until it becomes a habit.
Once you have adapted to that change, you can move on to other items in your diet, like alcohol, dessert, energy drinks, chips, etc. Youll begin to notice your symptoms slowly disappearing. To add, you might even feel better as a result of following a healthy diet.
But a healthy diet is not enough to combat gout. Here are more ways to prevent it:
Lose Weight
Most gout sufferers are overweight or obese when they get diagnosed with the condition. To fight gout, you need to lose that extra weight. This will allow that excess uric acid to get out of the body as well.
Drink Lots of Water
Get Moving
Manage Your Stress