Q: I recently had my first experience with gout. I had blood work done, which showed high levels of uric acid. I was given a list of many foods I should avoid, but the list is so extensive! I'm not sure what to eat besides fruits and vegetables. What do you recommend to balance my diet? I want to be strict with my intake and get better results in my next blood work in three months.
A: Personally, I don't recommend strict dietary modifications after an initial attack of gout. Here's why.
Gout is a condition in which uric acid deposits in joints, causing inflammation. A gouty joint is an unhappy joint! It's painful, swollen and does not move well.
People with gout almost always have high blood levels of uric acid, one of the body's normal waste products. Most uric acid is removed from the body by the kidneys, so people with kidney disease typically have high levels of it. But gender, genetics, body weight, and other factors go into making a person’s level of uric acid what it is.
A unique property of uric acid is that it cannot always dissolve well in the blood and tissues. When the blood levels are even slightly high, uric acid can get deposited as solid crystals in the joints (causing arthritis), kidneys (causing kidney stones), and other tissues.
Recent research suggests that a diet high in meat, seafood, and alcohol increases the risk of newly diagnosed gout. In addition, dairy products and coffee may be protective, lowering the risk of gout. However, these studies looked at people who had not had gout before. They did not assess the effect of diet on people who already had gout.
The list that you got of foods to avoid was probably a list of foods that are high in purines, a building block of protein that is broken down into uric acid. Most of the foods with the highest purine content are not ones that people eat often. These include thymus, pancreas, anchovies, liver, kidneys, brains and game meats.
It turns out that following a strict diet to avoid purines doesn't usually accomplish much. There are better ways to help lower uric acid and decrease the risk of further gouty attacks. It's much more effective to:
- Limit alcohol intake (alcohol is known to trigger gout attacks)
- Lose excess weight (being overweight increases the risk of gout)
- Avoid foods that seem to trigger attacks of gout for you
Ask your doctor if there are medications you are taking (especially diuretics) that can cause uric acid buildup, and see if you can switch to something else.
When needed, there are medications (especially allopurinol) that can effectively lower uric acid and markedly decrease the risk of gouty attacks. They are much better at doing so than following a strict diet.
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