Are Some Types Of Alcohol Better Than Others
It seems that gout attacks are more common in beer and spirits drinkers than in people who drink wine. Many beers contain large amounts of purines, which can lead to elevated uric acid levels in the blood. However, there is no scientific proof that only certain types of alcoholic drinks can lead to gout attacks.
Gout And Sugar: The Role Of Fructose In Gout Flare
The consumption of natural sugar fructose and the man-made sweetener high fructose corn syrup appear to increase the risk of gout, most people with high uric acid levels will never develop gout.Sugar, leaving uric acid to build up in your body, A gout-friendly diet combined with a few lifestyleAuthor: Scott FrothinghamDoes sugar aggravate gout? Overdoing it on one type of sugar in particularthe high fructose corn syrup found in sodas and processed foods can also set off painful gout , regardless of other diet and lifestyle factors, This is more common in adults who are overweight or obese, In fact, The breakdown of purines produces uric acid the substance that forms painful crystals in the joints and causes gout .In short,Excess sugar intake specifically can contribute and exacerbate arthritic conditions and an inflammatory state, obesity, and foods with high fructose corn syrup should be limited because of their connection to And while everything from a joint injury to major surgery can trigger gout, sugar and gout wont be linked, I currently have been on 100mg Allopurinol for about 2 months, Please let me know if you need more information
The Four Stages Of Gout
Gout is best understood by seeing it as having four phases or stages :
Stage 1: High uric acid
Elevated uric acid without gout or kidney stone, this stage has no symptoms and is generally not treated.
Stage 2: Acute flares
This stage is marked by acute gout attacks causing pain and inflammation in one or more joints.
Stage 3: Intercritical periods
These are periods of time between acute attacks, during which a person feels normal but is at risk for recurrence of acute attacks.
Stage 4: Advanced gout
This is a stage of chronic gouty arthritis, in which there are lumps of uric acid, or tophi , frequent attacks of acute gout, and often a degree of pain even between attacks .
Figure 1: Stages of Gout
Figure 2: Illustration of Toe Joint with Gouty Tophus. normal toe joint Urate crystals, shown in white, at the âbunion joint,â represent a gouty tophus.)
Figure 3: Progression of Gout
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First Foods That Can Help
- There are actually several types of foods that may help protect against gout attacks. These include low-fat dairy foods, complex carbohydrates, coffee, and fruits, especially citrus fruits. You should also be sure to get 12 to 16 cups of fluid daily.
- You don’t necessarily have to drink only wateryou can choose non-sweetened juice, tea, and coffee too.
- Any kind of fluid that keeps that blood flowing and urine flowing is a good choice, says Lona Sandon, PhD, RDN, an assistant professor of clinical nutrition at the University of Texas Southwestern Medical Center in Dallas.
Next up: The foods to avoid. Read on for a list of potentially problematic eats.
Scallops are okay for an occasional indulgence, but you should cut back on themand all types of meat and seafoodduring a flare-up, says Sandon. These animal foods are rich in purines, which your body breaks down into uric acid.
You have a little more freedom in your food choices when your gout is at bay, but its still a good idea to keep meat and seafood intake to a minimum4 to 6 ounces daily at most.
All meat is not created equal when it comes to purine content: White meat is generally better than red.
But it is okay to eat some types of red meat once in a while. Youre a bit better off if your occasional indulgence is beef or pork rather than lamb, says Dr. Zashin.
And lamb chops are a better choice than leg meat.
Organ meats, such as liver, kidneys, and sweetbreads, are a major no-no.
Diuretics Lower Blood Pressure But Raise Uric Acid Level
Diuretics, or water pills, are medications that increase urination to remove salt and water in the body. They can treat mild hypertension because less salt and water lowers blood volume.
However, diuretics increase uric acid levels and the risk of gout. Excessive depletion of water, or dehydration, can leave a high concentration of toxins like uric acid in the blood.
Remember to stay well hydrated when taking diuretics. If you are on diuretics and experiencing more gout flares, it would be wise to discuss alternative medication with your doctor.
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Treating A Gout Attack
As is true for many painful conditions, the first-line treatment for a gout attack is taking one of the nonsteroidal anti-inflammatory drugs , such as diclofenac, ibuprofen, or indomethacin. For people who can’t take NSAIDs, a drug called colchicine is an alternative. It’s been used for centuries maybe even longer specifically for gout. The trouble with colchicine is its side effects, especially the copious diarrhea. If neither an NSAID nor colchicine is an option, then gout attacks can be treated with an oral corticosteroid, such as prednisone, or with corticosteroid injections into the joints.
Fight Gout With Good Balance
Since an acidic body sets the stage for flare-ups, aim to maintain a neutral pH level. Ask your doctor for advice on diet and research the pH of different foods, then choose those foods that are more alkaline, such as:
- Most vegetables
- Many high-fiber orchard fruits, like apples, pears and nectarines
- Plant-based protein
- Fermented dairy products and probiotic cultures
You may want to buy some pH testing strips at your local pharmacy theyre cheap and easy to use, and will help you maintain a healthy blood balance to ward off gout attacks. Remember, you dont necessarily have to eliminate everything sweet from your diet, but its imperative that you choose the right sorts of sweet and eat it in the right amounts. Get used to reading labels and keep a food diary to track flare-ups, which will help you to pinpoint problem foods and fine-tune your diet.
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Do I Need To Stop Drinking Alcohol With Gout
Yes, its a good idea to cut out alcohol. Alcohol molecules in your body tend to increase uric acid levels, so drinking can push you over the edge and into a flare-up. If youre newly diagnosed and start taking medication, try cutting out alcohol at first. Your doctor may allow you to add a small amount back into your diet over time as your uric acid levels come down. But even then, its best to avoid beer and liquor and stick to safer choices such as red wine, Dr. Burg says.
All myths aside, the best advice for people with gout is to eat fresh, unprocessed foods. Choose complex carbohydrates over refined carbs from packaged or processed foods. And always drink plenty of water because dehydration is a risk factor for an acute attack.
A Good Diet For Gout Should Not Include Soft Drinks Or Fruit Juice
Added sugar is a big problem in the modern diet.
Generally speaking, the sugar that is added to our food and drink products are 50% glucose and 50% fructose.
While glucose molecules are metabolised in the cell, fructose is metabolised in the liver. Further explanation is out of the scope of this article, but they behave very differently in the body.
Fructose intake, and not glucose intake, is strongly linked with gout.
Soft drinks and fruit juices tend to have the greatest amount of added sugar, and therefore the greatest amount of added fructose.
In fact, gout occurrence in the US has risen in line with fructose consumption since 1970 .
In a large study of over 46,000 men, researches found that two or more sugar-sweetened soft drinks a day was associated with an 85% increased risk of gout .
The largest consumers of sugar-sweetened soft drinks actually had a risk of gout comparable to the risk seen with three to five servings of alcohol.
Unfortunately the researchers did not account for family history of gout, which may or may not have changed their findings somewhat.
The strange thing out of all this, however, is that soft drinks dont typically contain purines.
Fructose is thought to be the culprit linking added sugars with gout. It appears to share the same mechanism as alcohol: fructose accelerates the breakdown of purine-containing nucleotides like ATP. This in turn drives up uric acid levels 90120-5/abstract” rel=”nofollow”> 13, 14, 15).
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Avoid Sweets And Sodas
Unlike fruit with its natural sugar, artificial sugars are widely recognized as gout flare dangers. Consuming too many sugary sodas has been found to provoke attacks, but no association has been found with artificially sweetened sodas. Other foods loaded with high-fructose corn syrup can also bring on gout pain.
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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Orange Juice And Gout Risk
Many sugar-sweetened juices can increase your risk for gout, but naturally-sweetened juices like orange juice may also be a gout risk trigger. “In the last 10 years, there has been some evidence from some studies that high fructose in fruit juices may be associated with a higher risk of gout,” says Dr. Freeman. Fructose is a sugar that is added to soft drinks, but it occurs naturally in orange juice, so drinking too much OJ could be as risky as drinking a sugary soft drink.
Things To Cut Down On
Meat and seafood
High intakes of red meat and seafood are associated with a greater risk of gout because of their high purine content and impact on uric acid production.
Foods that contain yeast, such as Vegemite and Marmite, are also high in purine.
Sugars
Fructose is a simple sugar found in honey, fruit, some vegetables and sweeteners. Fructose increases purine metabolism, raising blood uric acid levels.
Avoid sweeteners high in fructose such as honey, brown sugar, high-fructose corn syrup, golden syrup and palm sugar. Check your tolerance for fruits, vegetables and other foods high in fructose.
Uric acid levels tend to be higher in people who regularly consume sugar-sweetened drinks. Those drinking one to two sugar-sweetened soft drinks a day are almost twice as likely to have gout as those who drink only one a month.
When it comes to whole fruit, results are not clear. While one study found a higher risk of gout with higher fruit intakes, another found a lower risk. The opposing results are partly confounded by the variation in fructose content of different fruits.
Alcohol
The effect of specific alcoholic beverages on blood uric acid levels varies. Beer is high in purine and increases uric acid more than spirits, while moderate wine intake appears neutral.
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Chicken Beef And Other Meats Appear To Be Foods To Avoid With Gout
The conversion of purines to uric acid, in theory, causes gout.
Therefore high-purine foods are often suspected to trigger symptoms.
Meat, and to a lesser extent seafood, are prime suspects. This includes all the most common meats like beef, chicken, pork and lamb.
The data available somewhat confirms suspicions.
Each additional daily serving of meat or seafood is associated with a 21% or 7% increased risk of gout, respectively . This implies meat could be three times worse than seafood.
There was another similar study that found even greater risks associated with meat intake, but none for seafood. Overall this suggests seafood is far less of a concern than meat .
For those who already have gout, the impact of meat intake on symptoms is even worse. This is likely due to sharper increases in blood uric acid, as well as poorer clearance by the body .
Therefore if you have a history of gout, it is best to dramatically reduce your meat intake, and seafood as well to a lesser extent. Anecdotal evidence suggests avoiding dark part of salmon, and de-veining prawns/shrimp before eating.
You should also buy your meat direct from the butcher where possible, or at least the better quality choices in the supermarket. Sausages and low-quality ground beef may contain traces of organ meat that can cause big problems .
Summary: Frequent consumption of meat is strongly linked with gout risk. The impact of seafood appears far less severe, but there is a link.
Are Tomatoes High In Purines
The answer is no. We all know that food rich in purines can cause gout attacks, so we must avoid them, but this isnt the case with tomatoes.
Of course, all of this refers to the fresh tomatoes from the grocery shop or from your own garden. The situation is slightly different when it comes to the cooked tomatoes. In that case scenario, the acid levels will be more than just high, so then they should be avoided. Of course, a small amount of cooked tomatoes wont harm you and there wont be any side effects, but still, it is a smart idea to avoid them.
Keep in mind that there are a lot of different types of tomatoes. Almost all types of them except standard tomatoes have high pH levels. As such, it is a smart decision to avoid them. You should know that vegetables with high pH levels should be avoided if you suffer from gout and it is the best thing you can do to avoid them. Still, chances are low that this food will cause you gout attacks, but there is a higher risk.According to a study, different types of tomatoes can reach 20% of the risk to cause a gout attack when consumed in high amounts.
Try to remember that tomatoes should be an addition to your diet. Do not eat them frequently and there wont be any issues. I like them in a salad, and I consume them in this way. In addition: Please avoid tomato cream soup. It is high in acid and has a high pH level, so it isnt wise to consume it.
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What Can Trigger A Gout Attack
Several things can cause the crystals to shake loose into your joint cavity, triggering an attack. These include:
- a knock or injury to the joint
- an illness that may make you feverish
- having an operation
- having an unusually large meal, especially a fatty meal
- drinking too much alcohol
- dehydration
- starting urate lowering therapy, especially at a high dose, or not taking your treatment regularly each day.
Should You Consume Tomatoes
The answer to this question is more than just complicated. Lets start from the beginning. Tomatoes are 90% water and we all know that water is more than just essential for all us, gout sufferers. But, what with other ingredients? Well, there are no many ingredients in tomatoes. As a matter of fact, 100 grams will contain 237 mg of potassium and about 18 calories. This is less than many other vegetables, so they are not dangerous.
In a nutshell, tomatoes are not toxic for gout sufferers. You are free to consume them and they dont affect the uric acid levels in our bodies. As a matter of fact, tomatoes are very healthy.
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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.
Instead Of Organ Meats Try Eggs
Consumption of organ meats has increased with the popularity of the Paleo Diet. Animal organ meats, such as sweetbreads , tripe , liver, brains, and kidneys are very high in purine and should be avoided if you suffer from gout. Consider substituting eggs, which are nutritionally comparable to organs but lower in fat. Eggs are good sources of vitamins A, D, and B12 choline, iron, selenium, and zinc.
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Gout Purines And Animal Protein
First of all, its important to recognize that there actually is some support for the advice to cut down on meat and seafood.
For one thing, theres the problem of association. Gout is a classic disease of civilization: ever since it was first named and described, its been recognized as a problem for people who have plenty of luxury food. Until very recently, meat was a luxury food, so its not hard to see how eating a lot of meat looked like the cause of gout.
With modern population research, we know that gout is indeed associated with meat intake. In this study, for example, each additional daily serving of meat was associated with a 21 percent increase in the risk of gout, and each additional weekly serving of seafood was associated with a 7 percent increase in risk.
And whats more, theres actually a reasonable explanation of why eating meat could make gout worse. Meat especially organ meats and seafood contains purines, chemical compounds that are broken down into uric acid. So eating more purine-rich food means more uric acid which means more goutright?
Unfortunately, there are a few inconvenient problems with this theory:
- First of all, theres the problem of vegetables. Even though most vegetables are low in purines, a few have a significant amount. But in the NEJM study linked above and in this one , purine-rich vegetables werent associated with gout at all.
This suggests that maybe focusing on purines is looking in the wrong place.