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.
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 .
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.
What Can You Not Eat With Gout
Foods rich in purines must be avoided if you have gout. Purines are a type of chemical that produce uric acid in the body. They are naturally found in the body and can also be found in certain foods. The main modification in the diet traditionally involves eating a low-purine diet. Although avoiding purines completely is not possible, you should strive to limit them.
Both moderate and high-purine foods and drinks must be avoided if you have gout. These include
- Alcohol is a majortrigger for gout attacks. This is because when you drink alcohol your kidneys filter it out instead of uric acid. This leads to the build-up of uric acid in the body. All alcoholic beverages are bad for gout. Beer is especially bad for gout since it is rich in purines.
- Certain fish, seafood and shellfish, including anchovies, trout, sardines, herring, codfish, mussels, codfish, scallops and haddock
- Organ meats such as liver, kidney, sweetbreads and brain. People with gout, however, can have a moderate intake of lean meats such as chicken and turkey.
- Red meat including bacon, turkey, veal and venison
- Dried beans and peas
- Food products containing a high amount of fructose such as soda and some juices, cereal, ice cream, candy and junk food
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Achieve A Healthy Weight
Obesity may be a primary consideration to reduce levels of uric acid in the blood. Insulin resistance is commonly seen in those who are obese and it may be involved in the development of gout. Insulin resistance has been shown to decrease the amount of uric acid that is cleared in the urine. A condition known as the ‘metabolic syndrome’ is a cluster of symptoms which includes insulin resistance, along with tummy obesity, high blood pressure and abnormal blood fats – for example, high cholesterol. This condition is strongly associated with high uric acid levels, which can be improved with slow, gradual weight loss.
Weight loss has been shown to improve insulin resistance and therefore reduce uric acid levels in the blood. However, it is important to avoid strict diets such as low-carbohydrate and high-protein diets. These may increase consumption of purines, a compound that breaks down into uric acid. Additionally, rapid weight loss through strict dieting can result in breakdown of tissue. This can temporarily cause a rise in uric acid levels. A gradual, safe weight loss of 1-2 lbs a week can help to achieve an optimal body weight.
Risky Foods To Avoid With Gout
A gout attack is not pleasant.
The pain is so bad that sufferers are often hospitalised for days, if not weeks.
More importantly, gout is typically indicative of other more serious health issues behind the scenes Like a window into the state of an individuals metabolic health.
Unfortunately the occurrence, or recurrence of gout is only getting worse.
Rates are on the rise from China to the UK, and it is now the most common inflammatory arthritis in the US .
Information online about gout treatment can be particularly confusing, and even contradictory at times.
This is because we dont yet completely understand the mechanism behind gout But we do have a lot of big clues.
The following is a list of the top 6 foods to avoid with gout, explaining what we know and how it applies to you.
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Fish That Are Ok To Eat
Fish and seafood that are OK to eat when you have gout are those in the “low-purine category,” meaning they have less than 100 milligrams of total purines per 100-gram serving.
The best options include Japanese eel, monkfish meat, and sablefish. The purine content of catfish, flounder, red snapper, salmon, sole, and tilapia skew slightly higher but are good options, too.
These fish are typically served boiled, fried, steamed, or baked.
Sneaky Gout Triggers: Yeast Extract Msg Fructose Sauces
Yeast extract and MSGâYeast extract plus other additives is basically MSG . MSG powder contains purines that immediately metabolizes to uric acid. Although there is proof linking yeast to purine content via alcoholic beverages, only a few sources warn yeast extract as a high-risk gout trigger.
MSG and yeast extract are flavor-enhancers in several products such as processed meat, canned food, bouillon, sauces, soup mixes, gravies, and salad dressings. Since the ingredient percentages are not typically listed or shared, it is very risky for people with chronic gout .
Manufactures will camouflage MSG by listing these these sub-ingredients instead of yeast extract, protein isolate, hydrolyzed vegetable protein, hydrolyzed yeast, and soy extracts.
MSG is not only associated with gout. It is also linked to other health problems and allergies. Known side effects from MSG overconsumption are heart palpitations, headaches, numbness and drowsiness.
Fructose â Even though there is plenty of evidence that fructose causes the body to produce purines, most major sources did not account for it as a major gout trigger. Research from 2016 linked fructose consumption to increased uric acid levels which leads to gout flares.
Sauces â Popular sauces that may cause or contain purines are fish sauce, worcestershire sauce , oyster sauce, barbecue sauce , and Maggi seasoning .
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Purines The Root Cause Of Hyperuricemia
A purine is an organic compound usually found in the same foods that contain protein. To break down purines the liver must produce uric acid. When there is a large presence of purines, the liver tends to produce more uric acid than the kidneys can filter out of the body. Hyperuricemia is the condition when uric acid levels are above normal levels. The excess uric acid builds up at a joint and causes inflammation and pain, which are symptoms of gouty arthritis or gout.
What Type Of Food Is Bad For Gout
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Do Certain Foods Cause Gout
There are many misconceptions about diet and gout. For example it is commonly thought that foods such as citrus foods cause gout. There is no evidence that this is true. However several studies have shown that people with gout are more likely to eat certain foods. These foods tend to contain high levels of purines, a substance that can be made into uric acid in the body. Purine-rich foods include:
- meat particularly red meat and offal, such as liver, kidneys and heart
- seafood particularly shellfish, scallops, mussels, herring, mackerel, sardines and anchovies
- foods containing yeast such as Vegemite and beer.
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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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.
Bad Foods For Gout Oats
Oatmeal and some foods that have oats contain a moderate level of purines. Most experts recommend that all people who are having gout need to limit the intake of all oat-based foods or oatmeal.
This simple list can be discouraging if people are having gout, they can use these foods with small portions and they can eat them when they can control their gout.
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How Is Gout Affected By Diet
Gout is a type of arthritis that is associated with elevated levels of uric acid in the blood. High levels of uric acid can cause crystals to form in the joints, causing pain and swelling. Uric acid is a normal waste product formed from the breakdown of food, particularly compounds called purines. It is believed that lowering uric acid levels through small changes in your diet may help reduce the chance of future gout attacks.
A healthy, balanced diet may help reduce the risk of gout attacks.
Ten Tips For Beating Gout
If you have gout, use these nutrition tips to lower your risk:
See your GP to check or monitor gout risk factors
Drink up to four cups of regular or decaffeinated coffee a day
Have two to three serves of reduced-fat or skim dairy foods daily
Eat cherries regularly . Add to breakfast cereal and snacks, or mix with yoghurt
Avoid fasting and feasting. Both increase purine turnover and blood uric acid
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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.
Is Soy Bad For Gout
Soy and gout do not always work together. Generally speaking, you could have soy based meals occasionally. The moderate amounts of purines do not make soy a contraindicated food, but it does require special attention make sure you avoid heavy meals and pay attention to potential signs.
If you can avoid soy at all, it might be better to do so. An occasional treat every now and then may not always trigger a gout flareup, but why would you take the risk? Ideally, your diet should consist of foods low in purines loads of fruits and vegetables. Your gout treatment begins with your diet, so careful consideration and medical advice are mandatory.
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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.
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.
Bad Foods For Gout Turkey
Goose and turkey can have the higher level of purines than other kinds of foods, so people need to avoid them. And people who are gout-prone need to keep their own intake of turkey and wild game to a small amount. Duck and chicken can be the good choices for all gout-prone people. However, leg meat can be better choice than a breast or skin of chicken.
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