What should I eat if I have gout? What can't I eat?

Gout is pretty common - you may have heard of it. What is gout? It is when uric acid, a substance in blood that generally stays dissolved, begins to make crystals in joints. A common favourite area of gout is where the big toe meets its sister bone.

One of the main diets for gout is a low purine diet. What are purines? Purines are something found in foods that change uric acid in the body. Common sources of purines are seafood and organ meats. Animal protein in general is rather high in purines and may try to acidify the blood, leading to pressure on the kidneys. The amount of meat you eat is also important. Each additional serving of meat raises gout risk by 21%. This means if you have 2 chicken breasts per day and begin eating 3, your chances are raised by 21%. The purines in vegetables cannot be absorbed well by the body, so these don’t have an impact.

A low purine diet works to reduce the chances of a gout attack by 10-20%, therefore other management is necessary. Here are some other factors that may contribute to gout:

Sugar sweetened beverages:

If you know me, you know that I’m pro-sugar in moderation. It is clear that sugar in foods, especially fruit, come packaged with many other different nutrients, which completely alters how it hits the body. Sugar sweetened beverages, such as soft drinks, sweetened coffees and sweetened juice, enter the body entirely differently. First, it leaves the stomach very quickly for intestinal digestion. Then, as it’s stripped of all its goodness, the flow through the body is different. Research on sugar sweetened beverages indicates people who consume a lot of these drinks have a 35% higher chance to develop gout.

Fructose:

You may have heard the word fructose in a product called high-fructose corn syrup. Fructose is a type of sugar that tastes very sweet. It’s also cheaper than juice, so companies like to add it to drinks. Fructose is found in both fruit juices and sugar sweetened beverages. Inside the body, the breakdown of fructose leads to the production of more uric acid. This response is shown in studies to be dose-dependent. This means the more fructose you drink, the higher chances you are to have a gout attack. A high fructose diet (from drinks) can double your risk of gout. Be careful with your mango matcha lattes!

Extreme weight-loss:

Extreme diets are also another culprit for gout attacks. When you lose weight quickly, the body’s muscle stores break down. This is because muscle can be changed over to sugar quicker than fat. Muscle store breakage pumps uric acid into the bloodstream. Also, if you do a very low carbohydrate diet, the body may start producing ketones as energy (think ketogenic diet) If you lose weight too fast, you may overload your body with uric acid before the kidneys are able to get rid of it.

Alcohol:

The digestion of alcohol makes the body produce more uric acid. Studies found that this is true for beer and liquor. Beer is often cited to be a main culprit, but studies show that liquor produces almost as much as beer. Also, the studies are done on shots of liquor. If you mix liquor with sugar sweetened beverages, you may have a problem. One study found that wine doesn’t increase uric acid levels in the blood. Wine does have some antioxidants that slightly help with the alcohol. However, one study may not be enough to make decisions about drinking wine.

What foods are helpful?

• Coffee - coffee has specific antioxidants that target gout (green tea doesn’t).

• Vitamin C - this helps the kidneys remove uric acid and dump it in pee.

• Cherries - the antioxidant that gives them their red colour helps.

• Water - water keeps the uric acid dissolved. Think about if you put too much sugar in a drink, eventually it doesn’t dissolve. It builds up so that there is sugar in the bottom of the cup. Same with uric acid, we want it to stay dissolved so it doesn’t attack the joints. Water also makes you pee more so the body does get rid of it better.

• A plant-based diet - fruits and vegetables are rich in antioxidants and fibre. This totally changes the way uric acid is handled in the body.

• Dairy is said to be helpful but the studies aren’t great. The studies are done more on rats (obviously rats are different than humans).
  

The point of this post is to show that a low purine diet may not be enough to reduce gout risk. The body does make its own uric acid. You need to make your body produce less uric acid and remove more uric acid.

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AI may be used in some writing for sentence structure and paragraph organization. However, all ideas are based on my own clinical judgement and evidence-bases such as scientific studies and professional guidelines.