Gout and diet
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.
Can losing weight help gout?
If you are overweight, gradual weight loss can help lower uric acid levels and reduce the risk of gout attacks. However, it is important to avoid fasting or ‘crash’ dieting, where you go without adequate food for long periods and lose weight rapidly. This type of dieting can actually increase uric acid levels and trigger a gout attack. A combination of balanced healthy eating and regular physical activity is the best way to lose weight safely. Talk to your doctor or see a dietitian for advice.
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.
Should I cut out purine-rich foods?
There is very little scientific proof that avoiding the purine-rich foods listed above can successfully reduce gout attacks. You may miss out on important nutrients and vitamins by completely cutting these foods from your diet.
If you notice certain foods trigger your gout attacks, you may benefit from cutting down the amounts of those foods in your diet. However not all purine-rich foods are thought to cause gout. For example, a number of vegetables (asparagus, mushrooms, cauliflower and spinach) are also rich in purines but appear less likely to cause gout than diets containing meat and shellfish.
Dairy foods, which can contain purines, actually appear to lower the risk of gout. For most people with gout, a healthy balanced diet is all that is needed, alongside medicines to reduce uric acid levels. Most people taking medicines to reduce uric acid levels find they can still eat purine-rich foods without attacks of gout by being careful with the quantity they eat.
Does fructose cause gout?
Fructose is a sugar that is found in fruits and vegetables. It is also found in high levels in foods sweetened with corn syrup, such as bread, cereal, soft drinks (not Australian-made soft drinks) and fruit juices. An American study found that men who drank five to six servings of fructose-sweetened soft drinks per week were more likely to have gout. However there is no research showing that fructose actually causes gout. Cutting down the amount of food artificially sweetened with high fructose corn syrup may be beneficial for your overall health. However naturally occurring fructose in fruit and vegetables also provides general health benefits and should not be completely avoided without advice from your doctor or dietitian.
Can I drink alcohol?
Drinking alcohol can increase your risk of a gout attack as it can raise the level of uric acid in your blood. While it is possible to control gout attacks without completely cutting out alcohol, try to reduce the amount of alcohol you drink and avoid binge drinking (drinking a lot of alcohol at one time). Talk to your doctor or read the Australian government guidelines on recommended alcohol intake.
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.
Should I drink lots of water?
Dehydration (not drinking enough water) may be a risk factor for gout although this is not well proven in research. Drinking 1 – 1.5 litres of fluids a day is recommended for general health benefits. However if you are taking diuretics (also known as ‘water pills’ or tablets which help the body get rid of water) or have heart or kidney problems, talk to your doctor about the right amount of fluids for you to drink.
Where can I get advice about my diet?
An accredited practising dietitian (APD) 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 Australia’s (DAA) Code of Professional Conduct, continuing professional development and providing quality services.LOCAL ARTHRITIS OFFICE FOR MORE INFORMATION AND SUPPORT SERVICES.
To find a dietitian, talk to your doctor, contact the Dietitians Association of Australia on 1800 812 942 or use the ‘find a dietitian’ service at www.daa.asn.au
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