09 November, 2015

Healthy Eating and Menu Planning: Gout diet changes


After being diagnosed with an acute gout attack (NIH defines gout here) for the first time during the 2014 holiday season, I continue to learn about and adopt healthy lifestyle habits as a key part of an effective gout treatment plan (click for the Arthritis Foundation summary).

What started as gathering Thanksgiving menu "gout diet" ideas introduced me to updated gout management information. In this post, I provide important resource links (and list here) so you can read the materials and discuss them with your healthcare providers. You'll need free Adobe® Acrobat Reader® DC software to display and download PDF files. Download it directly from the Adobe® web site here.



In early 2015, the widely-circulated "gout diet" information consisted of hierarchical lists categorizing foods by purine content. Frankly, I found those lists awkward and hard to manage, when on another restricted diet, and even a bit confusing (so much, I synthesized my own reminder list and asked my physician to review and approve it). I suspect others had similar experiences.

In light of research results, and perhaps patient feedback, today's online resources have changed considerably in recent months. My first clue was discovering the venerable Mayo Clinic updated its Gout diet: what's allowed, what's not in July 2015.

The predominant approach I see physicians and other professionals taking now is placing healthy lifestyle as the focal point of gout management, rather than a regimented diet of counting servings of particular foods.


While avoidance of high purine foods is still encouraged, here is a list of lifestyle changes recommended by the Gout & Uric Acid Education Society ("GUAES"):

  1. Know Your Uric Acid Level (Check 2x year. Maintaining a healthy serum uric acid (sUA) level is vital to minimizing risk. At this writing, the goal is below 6 mg/dL. Download brochure (PDF file) here.)
  2. Exercise regularly
  3. Maintain a Healthy Body Weight
  4. Stay Hydrated
  5. Take Vitamins (especially Vitamin C in the 500 to 1000 mg per day range).




Research, particularly by Hyon K Choi, MD, DrPHProfessor of Medicine at Harvard Medical School and Massachusetts General Hospital, challenges some past beliefs.
Higher levels of meat and seafood consumption are associated with an increased risk of gout, whereas a higher level of consumption of dairy products is associated with a decreased risk. Moderate intake of purine-rich vegetables or protein is not associated with an increased risk of gout.

Translation?

Adding protein to your diet with low-fat or fat-free dairy products, specifically skim milk and low-fat yogurt which are associated with reduced uric acid levels may actually decrease the risk or provide some protection against gout.
Protein, purine-rich vegetables and moderate wine drinking were found not as harmful to gout sufferers as once believed. Gout & Uric Acid Education Society
A healthy diet based on lots of fruits and vegetables can include high-purine vegetables, such as asparagus, spinach, peas, cauliflower or mushrooms. You can also eat beans or lentils, which are moderately high in purines but are also a good source of protein. Mayo Clinic, emphasis added.

Also, the Gout & Uric Acid Education Society encourages patients to follow a low-fructose diet, because there is a correlation between a diet high in fructose content and gout. We may accomplish this by "limiting table sugar, table salt and any products with high-fructose corn syrup, including:
  • Soft drinks and juices
  • Cereals, 
  • Store-bought baked goods, 
  • Ice cream and candy,
  • Processed foods at fast food restaurants."

Disclaimer:  As always, consult your physician before beginning any fitness or nutrition program. The information provided on this site is not meant to treat, cure, prevent or diagnose any illness or disease. The information provided is for general and educational purposes only and includes the opinions and views of the author and should not be substituted for medical advice given by your physician.


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