Q. I?ve been on a low-carb, high-protein diet and I recently experienced an attack of gout. Could my diet be to blame?
A. Possibly. Diet is one of several factors linked to gout. Family history, age, gender, certain drugs, obesity, alcohol, high-purine foods and quick weight-loss diets may increase your chances of getting gout. Plus, there is growing concern that extremely low-carb diets, which are high in animal protein and fat, may exacerbate gout.
What Is Gout? Gout is a painful form of arthritis that occurs when the body produces too much uric acid or is unable to excrete it properly. Uric acid results from the breakdown of purines, substances found in all the body’s tissues and in certain foods, such as meat and seafood. Excessive uric acid builds up in the blood, which in itself is not a problem. But if uric acid crystals form in the joints, gout develops. An acute attack of gout most often first affects the big toe, causing redness, swelling and intense pain. Over time, uric acid crystals may also form in other joints, soft tissues and the kidneys.
The prevalence of gout is on the rise. That fact should come as no surprise since it is associated with obesity, high blood pressure, abnormal blood lipids and diabetes, conditions which are also on the upswing. Gout is most likely to strike men over 30 and, less frequently, postmenopausal women. It is treated primarily with medications to control the pain and inflammation of acute attacks, to reduce high blood uric acid levels and to help prevent future attacks and complications. However, proper diet may complement drug therapy and aid in the management of gout.
The Diet Connection. A high-purine diet is known to increase blood uric acid levels, but whether eating a diet low in purine-rich foods, like meat, seafood, mushrooms, spinach, asparagus and beans, reduces the incidence of gout is unclear. In a 12-year study of more than 47,000 male health professionals with no prior history of gout, researchers found that the risk was greatest in men who ate the most seafood and meat and lowest in men who ate the most dairy products, especially low-fat dairy. Surprisingly, total protein intake did not affect the incidence of gout.
EN‘s Bottom Line. EN, with the help of Robert Terkeltaub, M.D., chief of rheumatology at the VA Medical Center in San Diego, offers these tips to manage gout and keep blood uric levels in check:
? Eat meat, seafood and alcohol in moderation; cut down on refined carbohydrates and foods high in saturated fat; cut back on portion sizes.
? Drink plenty of fluids, especially water, to help flush out excess uric acid.
? Maintain a healthy weight, but avoid extremely low-carb, ketogenic and rapid weight-loss diets, which may increase uric acid levels and worsen your gout.
? Take the medications prescribed by your doctor’they?re your best defense against an attack of gout.
?Adrienne Forman, M.S., R.D.