Should I Cut Out Purine
There is very little scientific proof that avoiding the purine-rich foods listed above can successfully reduce gout attacks. You may miss out on important nutrients and vitamins by completely cutting these foods from your diet.
If you notice certain foods trigger your gout attacks, you may benefit from cutting down the amounts of those foods in your diet. However not all purine-rich foods are thought to cause gout. For example, a number of vegetables are also rich in purines but appear less likely to cause gout than diets containing meat and shellfish.
Dairy foods, which can contain purines, actually appear to lower the risk of gout. For most people with gout, a healthy balanced diet is all that is needed, alongside medicines to reduce uric acid levels. Most people taking medicines to reduce uric acid levels find they can still eat purine-rich foods without attacks of gout by being careful with the quantity they eat.
Whats The Outlook For People With Gout
Untreated gout can lead to permanent joint damage. The buildup of uric acid in the joints and soft tissue is called tophus. Some people with gout can also develop other health problems, such as severe arthritis, kidney stones and heart disease. Its important to discuss your symptoms with a healthcare provider.
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.
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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.
Get Tested For Sleep Apnea
Untreated sleep apnea can increase the risk of gout.12,13 Sleep apnea is a sleep disorder that causes the body to take in less oxygen while sleeping, which in turn causes the body to produce more purines.12,14 Sleep apnea is typically treated with a continuous positive airway pressure machine or other device that increases oxygen intake while sleeping.
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Tired Of Regular Gout Flare
If so, Ive got some goods news
The cause of gout is simply too much uric acid buildup in your joints. Before you rush to the doctor, you can take steps to fight back against too much uric acid, the safe and natural way!
Nutritionist Evan Burns reveals a dozen ways to fight excess uric acid — without prescriptions or steroids –in his FREE report!
Youll also get to read about which foods actually help reduce uric acid levels.
Vegetables Cooked In Animal Products
Similar to how you might think okra is good for gout simply because it is a vegetable, you might assume animal products are good for gout because they are sources of protein. However, there is a reason why many animal products fall into the list of foods to avoid with gout: they are high in purines and animal fat. While some animal products are allowed such as low-fat dairy products, poultry and some seafood many high-fat animal products are to be avoided on a diet to reduce gout.
Vegetables cooked in animal products may have higher purine content, which can lead to more uric acid in the body. According to Cleveland Clinic, high uric acid levels can also be attributed to genetics. If the increased risk of gout is hereditary, they still recommend adopting a healthy diet.
Avoid cooking vegetables in the following animal products:
- High-fat butter
- Gravy
- Fish sauce
For example, mashed potatoes and gravy are a popular combination. While potatoes themselves are compliant on a gout-reducing diet, potatoes doused in gravy are not. Many people also consume vegetables cooked in butter or grease, which are both discouraged. If you have gout, season your vegetables with herbs, spices and other low-fat sources of flavor.
According to Mayo Clinic, high-fat animal products are limited because of their saturated fat content. While fats are important for overall health, people with gout should stick to sources of healthy dietary fats and avoid consuming too much saturated fat.
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Frequent Consumption Of Certain Fruits May Trigger Recurrent Gout Attacks
High sugar drinks may not be the only stimulant of gout flare ups.
Certain fruits which are a natural source of fructose have also been linked with gout.
This is a highly contentious area, because several studies have linked higher fruit intake with less incidence of gout. This is probably due to their high fibre content .
And unlike fruit juice and other sugar-sweetened drinks, whole fruits are nutritious and generally good for health. There is no disputing this.
However, if you continually have gout attacks despite cutting out alcohol and sugar-sweetened drinks then Im not convinced a large amount of fruits are safe for you. Especially if you are overweight and eat a Western diet.
So cutting back on certain very high-fructose fruits is like a Plan D, if you will.
The link comes back to fructose, which stimulates uric acid production in a similar manner to alcohol. Fructose is naturally found in fruit and honey.
One study found that the consumption of apples or oranges the most popular fruits in this study was linked with an increased risk of gout compared to those who consume less than one serving of fruit per month. No link was found with other fruits however .
While most fruits are very low in fructose, a few are very high. Frequent consumption of these could theoretically causes problems for gout sufferers.
Foods Highest in Fructose per 200 Calories :
Note this list is ranked on a per calorie basis, not per serving.
Where Can I Get Advice About My Diet
An accredited practising dietitian can provide you with personalised advice to give you the confidence to eat in a way that is best for you. APDs are university-qualified experts in nutrition and dietetics and are committed to the Dietitians Association of Australias Code of Professional Conduct, continuing professional development and providing quality services.
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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?
Alcohol And Gout Risk
Although beer may be the worst drink for gout, any alcoholic beverage can trigger gout symptoms in people who are prone to the disease. “Alcohol causes the kidneys to excrete alcohol instead of excreting uric acid. That increases the amount of uric acid in the blood, which could provoke a gout attack in about one or two days,” warns David Freeman, MD, a rheumatologist at the Lahey Clinic in Burlington, Mass.
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Foods You Must Avoid If You Get Gout
If you have gout, you know all too well what it feels like to have attacks of pain in your joints.
The pain can be sudden and severe. Sometimes, sufferers wake up in the middle of the night feeling like their joints are on fire.
You want your joints to be flexible, strong, and painlessly aid the movements of your body. But gout steals all that from you. Youre left with stiffness and pain.
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.
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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.
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.
- Low-fat dairy products .
- Whole-grain products .
- Plant oils .
- Vegetables.
- Cherries.
- Vitamin C supplements .
- Coffee .
- Water bottles .
Pass Up
- Red meat and organ meats .
- Shellfish such as shrimp and lobster.
- Refined carbohydrates .
- Processed foods .
- Sugary beverages.
- Alcohol .
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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.
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 The Best Thing To Drink If You Have Gout
With this in mind, you should try to cut out beer and stick to wine since it still does provide some health benefit if drank moderately.
Studies have shown that people who drank less than two wines per day got some protective effect though not statistically significant. This is because people who only drink wine tend to have healthier lifestyles compared to those who drink just beer. They eat healthily, exercise regularly, and smoke less compared to beer and liquor drinkers.
As for beer, you should know that most of the stuff you buy from the store probably contains harmful ingredients not reported on the label. This is because alcohol companies have lobbied the industry for years, giving them the ability to use unsafe ingredients in their formula without including them in the label.
For example, theres Newcastle beer contains coloring made from ammonia which is cancer-causing. Then theres Corona beer which contains GMO corn syrup. Its an evil substance similar to high fructose corn syrup which is metabolically risky for you. The fructose is absorbed immediately and goes directly to your liver. Any gout sufferer who has done his research will know that liver and digestive health are important factors in managing gout symptoms.
If you can, try to stay away from American beers since theyre filled with GMO and go for organic beers instead. Theyre brewed locally using organic ingredients and wont have as bad effects as more popular beers do.
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
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Aspirin And Diuretics Significantly Increase Gout Risk
Not exactly foods to avoid with gout, but the ingestion of some common medications sharply raise the risk of a gout attack.
Specifically, low doses of aspirin, which one in three middle-aged Americans takes regularly to help prevent heart disease .
The emphasis is on low doses because aspirin has a dual effect on uric acid levels. Very high doses above 3,000 mg promotes excretion of uric acid , whereas low doses prevent excretion .
In a study of 49 elderly patients, just 75 mg of aspirin per day increased blood uric acid levels by 6% within one week. A daily dose of 150 mg kept levels high during the second week, before coming down with 300 mg doses in the third week .
Considering the typical dose for heart disease prevention is 81-325 mg per day, it is no real surprise this dosage is associated with a doubling in gout risk. In fact, even the use of a low-dose aspirin for two consecutive days increases risk of recurrent gout attacks .
Another type of medication known to trigger gout is diuretics. They are typically used to treat high blood pressure and oedema, and if feasible should be discontinued in gout sufferers.
Im by no means recommending you cease your medications if you have gout, but its important to understand the pharmaceutical triggers. First speak with your doctor and closely monitor uric acid levels before making any changes.
And if you need a temporary painkiller, choose paracetamol or ibuprofen. No aspirin.