Gout & Diet: Eat Smart, Feel Better!

Gout is a type of arthritis. It occurs when uric acid crystals form in the joints, most commonly at the base of your big toe. Redness, swelling, and intense pain are common symptoms of gout. It develops in people who have high levels of uric acid in their blood.

Gout is typically associated with high levels of meat consumption. However in recent years we have seen an increase in cases, but a decrease in meat consumption. Recent research has revealed gout is more likely related to metabolic syndrome and eating a highly processed diet full of grains, sugar, industrial seed oils, and alcohol consumption – all of which makes up a large part of the typical standard Western diet. In contrast, we can see from research that gout is rarely associated with a low carbohydrate or ketogenic (keto) diet.

Gout patients can see immense and long term relief from their symptoms when they follow a low purine diet, and lower or eliminate inflammatory foods known to aggravate gout and raise uric acid levels. By lowering the uric acid in your blood to more normal levels, you can help prevent more crystals from forming, therefore reducing attacks.

What are purines?

Purines are naturally found in food and drink. They are vital building blocks of our DNA and essential to life, but in excess can become an issue. When your body breaks down purines, uric acid is the byproduct.

What is a low-purine diet?

A low-purine diet involves reducing intake of foods and drinks with high purine levels to help lower uric acid levels in your blood. It also encourages consuming foods that may further reduce uric acid levels in your body.

Oxalates and gout

Most gout patients would do well to avoid high oxalate foods as well as follow a low-purine to get the most effective relief.

Oxalate is an organic compound found in many plant foods and is also produced as a waste product by the body. When we eat oxalate-rich foods, the oxalate molecules pass through the digestive system, where some will bind with calcium molecules to form tiny crystal-like structures.

Foods high in oxalates include nuts, potatoes, bran and wheat cereals, legumes, soy, spinach, raspberries, and stevia sweeteners.

But what has oxalate got to do with gout?

Gout is a form of inflammatory arthritis caused by higher than normal levels of serum uric acid. Monosodium urate crystals from uric acid settle in the joints and connective tissue, and our own inflammatory response against these sharp crystals presents as exceedingly painful gout attacks.

Uric acid is a natural byproduct of purine metabolism, and gout patients are advised to follow a low-purine diet to lower uric acid to healthy levels. But many low-purine foods include many plant-based foods high in oxalates and this is where gout and oxalate issues collide.

What are low-purine and low-oxalate foods?

For those who choose to follow a low purine and low oxalate lifestyle, here is a list of foods that contain the lowest levels of both compounds.

Vegetables: artichokes, kale, broccoli, brussels sprouts, cabbage, lettuce, corn, onions, and bell peppers.

Fruit: apples, apricots, avocados, bananas, grapefruit, black grapes, melons, nectarines, peaches, strawberries and pineapple.

Dairy: whole milk, butter, yoghurt, cheese, and eggs.

Prioritising these low-oxalate, low-purine foods can lower the risk of gout.

What foods to avoid on a low-purine diet:

Alcohol: Alcohol prevents your kidneys from eliminating uric acid. Instead it cycles it back into your body, where it continues to accumulate and form uric acid crystals in your joints.

Certain fish and seafood: herring, scallops, mussels, codfish, tuna, trout, and haddock, are all high in purines.

Organ meats: While extremely nutrient-rich, they should be limited for anyone suffering from gout.

Sugary drinks and sweets: One of the main culprits for uric acid formation. Any food or drink with a high sugar content can trigger gout.

What about gout and red meat?

Many label red meat as a high-purine food but, in fact, it only has medium levels of purines. You shouldn’t cut out red meat because it offers too many health benefits to discount.

Red meat is a fantastic source of many bioavailable nutrients, including vitamins, minerals, and healthy fats. Because of insulin’s effects on uric acid retention in the body, those suffering from gout can benefit from eating a low-carb or keto diet rich in red meat and keep high-purine and high-oxalate foods to a minimum.

Contrary to conventional advice for gout, there’s no need to avoid animal protein. Modern research indicates that increasing animal protein intake could benefit gout as long as carbohydrates are reduced or eliminated. People who stick to keto or animal-based diets long-term often see no more flare-ups, less inflammation and improved insulin resistance.

Those switching to a keto diet prone to gout flares may initially experience increased symptoms. This is because uric acid competes with ketones for excretion, but this is only temporary. Once through adaptation, people see gout attacks decrease over time as uric acid levels lower and are excreted normally.

What are the best foods to eat when you have a gout attack?

Whole milk: Some research suggests that drinking milk may lower uric acid levels and gout flare-ups. Drinking milk can help speed up uric acid’s excretion in your urine and reduce the body’s inflammatory response to uric acid crystals in the joints.

Cherries: Some research supports the consumption of cherries to help manage gout symptoms.

Ground coffee: Drinking coffee daily can help to reduce uric acid levels in the blood. It slows the breakdown of purine into uric acid and speeds up the rate at which we pass it from the body.

Water: Staying hydrated with water is essential for gout patients. Your kidneys use water to excrete uric acid in your urine, so drinking water is good for flushing out uric acid and boosts your kidney function. Impaired kidney function is a factor that contributes to gout.

Treatment

You can get relief for your gout symptoms with medical treatments from a medical doctor. As always, you should always consult with a doctor or pharmacist before taking medication.

Unfortunately, Chiropractic care is not suitable for the treatment of gout, although we can help manage other ailments alongside gout. We can offer advice and discuss the nutritional advice provided here to help you manage your symptoms.

Read onto our last blog, “Is Yoga Right For You?” by Chiropractor Lottie Whitmarsh.