Foods That Cause Gout
Its thought that foods and drinks high in purines can directly increase the uric acid and increase the risk of gout attacks. Part of the recommended treatment and prevention of future flairs is to consume a low purine diet.
And its just as important to avoid foods that contribute to the many other risk factors of the disease in daily meal planning.
Purine Rich Foods
While some of these foods can be healthy in people who do not have gout, it is recommended that they are in general minimized in people who suffer from the disease. For example, fish can be a very healthy part of a balanced diet. Gout diets may include fish lower in purines or small amounts of purine rich fish mentioned above.
Weight Management And Exercise
The Arthritis Foundation emphasize 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 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.
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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What Foods Should You Eat
Although a gout-friendly diet eliminates many foods, there are still plenty of low-purine foods you can enjoy.
Foods are considered low-purine when they have less than 100 mg of purines per 3.5 ounces .
Here are some low-purine foods that are generally safe for people with gout (20,
- Fruits: All fruits are generally fine for gout. Cherries may even help prevent attacks by lowering uric acid levels and reducing inflammation (
- Vegetables: All vegetables are fine, including potatoes, peas, mushrooms, eggplants and dark green leafy vegetables.
- Legumes: All legumes are fine, including lentils, beans, soybeans and tofu.
- Nuts: All nuts and seeds.
- Whole grains: These include oats, brown rice and barley.
- Dairy products: All dairy is safe, but low-fat dairy appears to be especially beneficial (
- Beverages:Coffee, tea and green tea.
- Herbs and spices: All herbs and spices.
- Plant-based oils: Including canola, coconut, olive and flax oils.
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
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What Is Gout And What Causes It
Before we can look at foods to avoid with gout, it is necessary to briefly understand what it is.
Gout is a form of joint inflammation, caused by excessive uric acid in circulation .
When the bodys natural uric acid threshold is exceeded, painful crystals can form in and around the joints. These crystals trigger the characteristic symptoms and pain.
Not everybody with high uric acid levels will get gout, but those who do always have high uric acid levels. This indicates there are other factors at play, but from a dietary perspective uric acid is the focus.
Excessive uric acid in the blood stream is typically driven by two factors: genetic predisposition and the ingestion of high-purine foods. Obviously, the dietary factor we can control.
When purines we eat are broken down and metabolised by the body, uric acid is formed as a by-product of this process. Its normal and healthy for uric acid to be formed, but excessive amounts are problematic.
Therefore, consuming less purine-rich foods should lower uric acid levels in your blood, lowering gout risk.
At least, in theory.
Its actually not that clear-cut because other nutrients appear to aggravate gout symptoms too
Heres a list of foods to avoid if you have gout, based on real scientific evidence.
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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The Best Diet For Gout
Gout, which is a form of arthritis that occurs when uric acid builds up in blood and causes inflammation, affects more than 8.3 million people in the United States.
Whats the reason? People are getting bigger and theyre eating too much of the wrong thing, says Robert Hiltz MD, a rheumatologist at Group Health.
If youre prone to gout attacks, Dr. Hiltz says eating the right foods can stave off attacks or, at the very least, help manage flare-ups.
- Related post: Why Do I Have Gout?
Where Does A Gout Attack Occur
Gout often attacks the largest joint in your big toe. However, it can also attack the foot, ankle knees, hands, or wrists. Intense pain, redness, and swelling can start with no warning, although you may have warning signs of an impending attack. If you start to feel tingling, burning, or itching in a joint, your body is giving you a warning signal that a flare-up is imminent.
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Should I Avoid All Rich Foods
No. Patients often ask me about desserts, as well as entrees with rich sauces, says Dr. Burg. Its a common myth that these foods cause gout. When eaten in moderation, desserts and other rich foods do not affect gout flare-ups. But moderation is the key word. Rich foods may not cause flare-ups directly, but they can cause weight gain. And obesity is a major risk factor for gout attacks.
At some point, the misconception spread that people with gout should avoid dairy. But in fact, certain dairy products especially milk can help you remove uric acid from your body, he adds.
Sodas And Sugary Drinks
Sodas and sugary drinks are considered empty-calorie foods, because they contain no beneficial nutrients while contributing a lot of calories to your diet.
For example, a 12-ounce can of cola contains about 150 calories and 40 grams, or about 9.5 teaspoons, of added sugars. In addition, sugar-sweetened beverages have been associated with an increased risk of heart disease, type 2 diabetes, weight gain, and dental caries.
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Take Your Gout Medication Regularly
In addition to the strategies described above, a doctor will usually recommend taking a prescription medication, such as allopurinol, that is proven effective in preventing gout attacks.
Allopurinol and other medications that lower the uric acid can have several benefits, including reducing gout flares, improving function and quality of life, increasing productivity at work, decreasing sick-days from work, and reducing gout-associated cost. Like most drugs, the long-term use of prescription gout medications carries a small potential of side effects and health risks.9 You should discuss the potential benefits and risks with your provider.
Fruit Fructose And Gout
Fructose is what gives some fruits their natural sweetness. Researchers report a correlation between foods high in fructose and gout symptoms, which can include chronic pain. These fruits include apples, peaches, pears, plums, grapes, prunes, and dates. Its okay to eat these fruits if you have gout as long as you do so in moderation. Limit yourself to one to two cups per day. More importantly, avoid soda or soft drinks and juices that are sweetened with high-fructose corn syrup. Drink water or real fruit juices instead .
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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
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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Vegetables For Gout Patients
If you have gout, you need to be more careful in choosing the foods or drinks you consume. Because if not, then the pain you feel can get worse.
Taking drugs to treat gout is the right step to reduce uric acid levels and overcome pain. But maintaining a healthy diet for gout sufferers is also important to help minimize attacks and limit the severity of gout you may experience.
The following is a list of vegetables for gout sufferers that are recommended, namely:
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.
Sugars
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.
Alcohol
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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How Can I Manage My Gout And Improve My Quality Of Life
Gout affects many aspects of daily living, including work and leisure activities. Fortunately, there are many low-cost self-management strategies that are proven to improve the quality of life of people with gout.
For gout in particular:
- Eat a healthy diet. Avoid foods that may trigger a gout flare, including foods high in purines , and limit alcohol intake .
CDCs Arthritis Program recommends five self-management strategies for managing arthritis and its symptoms. These can help with gout as well.
Holiday Eating Guide: Food And Beverages That Can Trigger Gout
By Dr. Rock Positano and Dr. Allan Gibofsky
With the holiday season upon us, its important for people suffering from Gout to be aware of the risks associated with traditional meals served at Thanksgiving and during the holidays. Gout flare-ups are especially true this time of year as people tend to consume larger portion sizes than usual.
People are more likely to eat and drink alcohol in excess during the holiday season, and the next thing you know, your knee, ankle, or big toe starts throbbing in the middle of the night, says Dr. Rock G. Positano, Founder and Director of the Non-surgical Foot and Ankle Service and the Joe DiMaggio Sports Medicine Center at HSS. You get out of bed and your foot is red, hot, swollen and you cant place any weight on it.
Gout is a form of inflammatory arthritis that is genetic in nature, and results from an excess of uric acid in the blood. In people with gout, uric acid crystallizes in the joints causing painful attacks in the affected body part often, initially, a big toe, but other joints such as the ankle, foot or knees, may also be susceptible.
In 85 to 90% of first attacks, a single joint is usually involved with the big toe being the most commonly affected site, says HSS rheumatologist, Dr. Allan Gibofsky.
The following is a guide so that when you gather with friends and family for a festive meal, you will be aware of the foods and beverages that have high amounts of purine in them and can increase risk.
Meat
Soft Drinks
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