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.
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.
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 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.
What Can You Drink If You Have Gout
Foods arenât the only thing that can affect uric acid. What you drink matters, too.
Itâs a good idea to drink lots of fluids — 8 to 16 cups a day. At least half of what you drink should be water. Vitamin C also can help lower uric acid, but studies also show that the high fructose in OJ may boost uric acid levels, so drink it in moderation. Caffeinated coffee can cut uric acid, too, as long as you donât overdo it.
Stay away from sugary drinks like soda and fruit juice. You also may need to limit or avoid alcohol as well. Talk with your doctor to find out whatâs right for you.
While a healthy diet can help control how much uric acid is in your system, you may still need medicine to prevent future attacks. Talk with your doctor about all your treatment options.
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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.
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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Instead Of Organ Meats Try Eggs
Consumption of organ meats has increased with the popularity of the Paleo Diet. Animal organ meats, such as sweetbreads , tripe , liver, brains, and kidneys are very high in purine and should be avoided if you suffer from gout. Consider substituting eggs, which are nutritionally comparable to organs but lower in fat. Eggs are good sources of vitamins A, D, and B12 choline, iron, selenium, and zinc.
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.
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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).
The Ultimate List Of 14 Foods To Avoid With Gout
You may have come across the word Gout quite frequently in your life, but never really understood what it refers to. Gout is in fact an agonizing form of arthritis which aim at and attack any joint of a persons body and cause trouble, mostly the joints of the feet. What happens is that uric acid crystals tend to grow and form a home in the joints which is one of the primary causes since it calls for swelling as well as an unbearable pain.
What may cause the birth of such an unimaginable situation would be certain foods that carry a higher concentration of purine in them ultimately causing your uric acid level to shoot up. This, as a result leads to gout, a condition caused due to intake of certain nutrition.
Even if you are suffering from this condition or you happen to digest certain foods that have gotten you close to gout being a part of your life, you can still make some necessary changes in your life right now that help you fight this disease in no time without having to go through any trips to the doctor.
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What To Eat And Avoid For Gout
Food choices plays an important role in managing gout, the most common form of inflammatory arthritis in the United States. Gout occurs when uric acid builds up in the blood and gets deposited as crystals in one or more joints, triggering sudden swelling and pain. Uric acid is a by-product of the breakdown of purines, naturally occurring compounds in the body and in certain foods, which is why diet can be important for controlling gout attacks.
We asked rheumatologist Hyon K. Choi, MD, a gout expert and Professor of Medicine at Harvard Medical School, what people with gout should know about diet.
What foods can trigger a gout attack?
alcohol and purine-rich foods, particularly red meat and seafood.
If I have gout, should I avoid high-purine foods or are they OK in moderation?
Generally, moderation is sufficient, particularly if you are effectively treated with a uric acid-lowering medication.
What is a healthy diet for people with gout?
Are there specific foods or nutritional supplements I should add to my diet if I have gout?
The foods in the DASH diet are all expected to have an antigout as well as cardiovascular benefit. A piecemeal approach to modifying dietary factors has often been ineffective and impractical. In contrast, a healthful dietary pattern, such as the DASH diet, reflects the way foods are consumed. Moreover, unlike the conventional low-purine approach, another important advantage of the DASH diet is its palatability, which is important for sustainability.
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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Foods You Need To Avoid
The foods that should not be eaten during a gout crisis are:
If you are not having a gout crisis, these foods are not forbidden, but they should be limited. Therefore, please eat these in moderation, preferably according to a nutritionist guidelines.
Weight Management And Exercise
The Arthritis Foundation emphasize how important it is for people with gout to manage their weight.
- reduce pressure on painful joints
- lower the risk of heart disease
- build up strength and flexibility
- To achieve this, the person should ask their doctor about:
- a suitable diet to help them manage their weight
- an exercise plan
Anyone who smokes should also ask their doctor to help them with a plan to quit.
The Mediterranean diet contains plants, grains, and healthful fats. It may help people manage their weight while eating healthfully.
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What Foods Are Good For Gout
Dietary management of gout focuses on reducing the amount of uric acid in the system and attaining and maintaining a healthy body weight.
Foods that may help keep gout in check are
- Fresh fruits and vegetables such as berries, oranges, bell pepper and pineapple
- Low-fat dairy products, such as yogurt and skimmed milk
- Nuts including nut butters such as almond butter and peanut butter
- Whole grains
Tips For A Healthy Gout Diet
- Choose plant-based proteins, such as beans, tofu, or lentils, instead of red meat and organ meat.
- Low-fat dairy products, such as yogurt and cheese, are also good protein sources.
- Eating fruit instead of dessert or sugar-sweetened snacks can help reduce sugar consumption and increase vitamin C consumption.
- Most refined grains have whole-grain counterparts, such as whole-grain breads, oatmeal and whole-grain breakfast cereal, whole-grain pasta, and brown rice.
- It is easy to get an extra serving of vegetables by piling them on sandwiches or adding them to soups or stews.
- Caffeine can interfere with sleep, so it is best to avoid consuming caffeinated coffee and other caffeinated beverages within six hours of bedtime.
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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.
Things To Cut Down On
Meat and seafood
High intakes of red meat and seafood are associated with a greater risk of gout because of their high purine content and impact on uric acid production.
Foods that contain yeast, such as Vegemite and Marmite, are also high in purine.
Fructose is a simple sugar found in honey, fruit, some vegetables and sweeteners. Fructose increases purine metabolism, raising blood uric acid levels.
Avoid sweeteners high in fructose such as honey, brown sugar, high-fructose corn syrup, golden syrup and palm sugar. Check your tolerance for fruits, vegetables and other foods high in fructose.
Uric acid levels tend to be higher in people who regularly consume sugar-sweetened drinks. Those drinking one to two sugar-sweetened soft drinks a day are almost twice as likely to have gout as those who drink only one a month.
When it comes to whole fruit, results are not clear. While one study found a higher risk of gout with higher fruit intakes, another found a lower risk. The opposing results are partly confounded by the variation in fructose content of different fruits.
The effect of specific alcoholic beverages on blood uric acid levels varies. Beer is high in purine and increases uric acid more than spirits, while moderate wine intake appears neutral.
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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
- Processed meats, such as salami and prosciutto