The Gout Diet
by Ellen Blake
Gout? Really?
My husband woke up one night in severe pain that seemed to come out of nowhere. His second toe on his right foot was an angry red color and grotesquely swollen. He said he felt like it was on fire. We learned he had gout when we went to see the doctor.
Gout? Really? When I think of gout, visions of King Henry VIII gnawing on a giant turkey leg fill my mind. My husband is active, thin, eats healthfully and has few medical issues. Gout didn’t even cross our minds. How did he get it?
What is gout?
Gout is the most common type of inflammatory arthritis among middle-aged and older men and, increasingly, women. This affliction is widely considered one of the most painful conditions for humans. Some women say it’s worse than childbirth in severe cases. It comes on suddenly with severe attacks of pain, swelling, redness and tenderness in one or more joints, most often in the big toe. Famous sufferers include Alexander the Great, Charlemagne and, of course, King Henry VIII.
Our bodies make uric acid during the breakdown of purines, chemicals both produced in the body and found in certain food and drinks. The kidneys generally process the normal byproduct, uric acid, which then exits your body when you pee. Sometimes the body makes too much uric acid, leading to high levels in the bloodstream, or hyperuricemia. Sharp, needle-like uric acid crystals can concentrate in the joints causing gout, though many people with high uric acid levels never actually develop this problem.
What causes gout?
Obesity and a sedentary lifestyle can contribute to the development of gout. Lead exposure, diuretic medications to eliminate excess fluid from the body, and other medications, even aspirin, also increase your risk. Additionally, health problems such as diabetes, high blood pressure, and hypothyroidism can prevent the kidneys from eliminating excess uric acid from the body, again, leading to gout. The two biggest dietary factors that increase your risk include the consumption of large amounts of animal protein and an excessive alcohol intake.
My husband has none of the risk factors and consumes limited amounts of animal protein and alcohol. Nonetheless, he has gout. And his condition was severe enough to need the tophi, the pasty liquid that accumulates around the joints and tissues affected by the gout, drained from his toe. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), as many as 80 percent of people with gout have a family history of the disease. We did not know of any family history, but after asking around, we surprisingly learned my husband’s brother has gout for which he takes Allopurinol, a medication commonly used in treatment.
The gout diet: What’s allowed, what’s not
- Beer and distilled liquors (ie vodka and whiskey)
- Large quantities of red meat, lamb, and pork
- Organ meats, such like liver and kidneys and glandular meats like pancreas (often referred to as sweetbreads)
- Shellfish such as shrimp, mussels, lobster, anchovies and sardines.
- High-fructose products like soda and juices high in natural sugar (ie grape juice), sugary cereals, baked goods and candy.
- Low-fat and nonfat products, such as yogurt and skim milk
- Fresh fruits and vegetables (Some evidence exists that eating cherries reduces the risk of gout attacks)
- Potatoes and rice
- Nuts, peanut butter (without added sugar)
- Fat and oil
- Eggs (in moderation)
- Meats like fish, chicken, and red meat are ok in moderation (4 to 6 ounces per day).
- Vegetables (Some vegetable, like spinach and asparagus, are high in purine, but studies show they don’t raise your risk of gout or gout attacks).
You can decrease your risk of a gout attack further by achieving and maintaining a healthy weight, and staying hydrated to help remove excess uric acid in the blood through urination.
The bottom line
Gout is the most common inflammatory arthritis in adults worldwide and as the population becomes older and heavier, the incidence is increasing. Following a gout diet makes good sense to help minimize your risk of attacks. However, it’s not magic. Even those who carefully adhere to the dietary recommendations often still need medication to manage pain and lower their uric acid levels.
As for my husband who already eats healthfully, hydrates often and maintains his ideal body weight, there wasn’t a whole lot he needed to change to adopt a gout diet. However, he did increase his intake of cherries since they are thought to perhaps reduce the risk of a gout attack. Why not? He loves cherries – and even if they don’t help, they won’t hurt.
DISCLOSURE: This article is not meant to be construed as medical advice. See your personal physician if you have concerns about gout or related issues.
