Gout Diet Blog

Can drinking spirits ie: Vodka trigger an attack?or is it just beer & wine!I am on Allo…..Basically will spirits aggravate gout

When you look at the factors that are associated with gout andcompare them to the factors that are associated with diabetes thereis too much overlap to be coincidence. I am writing about thiscoincidence of risk factors from pure intuition here but the medicalcommunity is also aware of the overlap. They often comment about itinformally in conversation as well as more formally in writing.

I want to focus on the recent post by “tony8167″ who lost 14 poundsin two weeks on the Atkins diet. From many of the discussions we havehad on here we can conclude that if Tony is indeed a gout sufferer,and his overall uric acid level is above what his body is able toexcrete, we would conclude that losing that much weight that fast, asfat mind you, will surely induce a gout attack if you are prone togout. With uric acid being stored in the fat tissues and that tissuebeind depleted by 14 pounds, that will leave a lot of uric acid thathis body has to remove. If you think about it, he may not even be areal gout sufferer long term and he simply overloaded his excretioncapability while on the “fat burn”.

This is a critical point we need to look at and understand. I finallygot Dr. Atkins new book, sort of new, at least some of the statisticsare new. I read his first edition about 10 years ago. When it firstcame out I was maybe 2 pounds over weight, in great shape and figuredthat I didn’t need to pay attention to it. However, there are somevery important points covered in his book that I believe affect allof us and I am ready to conclude, in my own mind, that the root causeof my gout, is that I live in a “glycogen excess” state, all thetimes. My body never has depleted glycogen levels, unless I am losingweight, and in my normal operation mode, I keep my glycogen level,that is my blood sugar level, at or over the max level it can orshould be. I am definitely not diabetic yet but I am doing abouteverything I can to move myself into being a diabetic and it is areally, really stupid thing to be doing.

I suspect that many of you are doing the same thing. Each and everyday, when your blood suger gets even slightly low, you put acarbohydrate in your mouth and voila, you fix the hunger symptombefore it gets too bad. The older I get the worse this seems to getand although I feel I am living in a perpetual state of hunger, Istill manage to gain weight, albeit slowly, month after month andyear after year. I seem to be gaining about 2 pounds a year andalthough that may not seem like much, after 10 years now, the 20pounds are here and it is ever so hard to get motivated to get rid ofit.

Moreover, remember that the #1 risk factor associated with gout istoo much weight. Clearly there are gout sufferers who are skinny as arail, my grand father was skinny and he was wracked with gout painalmost all the time. However, most of us are not skinny and we knowthat if we could lose the weight, we would reduce the rate of, andseverity of, our gout attacks.

It will take a while to get this all organized so that it is easy tounderstand but I’ll start with a simple fact that Atkins covers inhis first few chapters.

When you have excess glycogen, your body makes insulin to get rid ofthe glycogen and from that glycogen the body makes as much energy asyou need to live on and then it turns the rest into fat. The riskfactors associated with this kind of behavior, with keeping a highblood sugar level all the time, are astonishing and it can bepredicted-with absolute certainty by the way-that it will lead us toan early grave. High blood pressure, heart disease, diabetes,arterial schlerosis and all the other problems associated with beingover weight-much higher cancer risk, etc., etc., etc..

If there is not enough blood sugar in your system to live on, thatis, if there is not enough blood sugar there to generate the energyit takes to go through the day, your body turns to the fat andprotein in your body for energy. If you have excess protein from yourdiet it will leave your mscles alone, and then it will then turn toyour stored fat and convert your stored fat into energy. The energycycle from “FAT BURNING” does not involve insulin and this is what Iwant to focus on. As I said in the beginning of this post, theoverlap with diabetic factors is just too great for me to believethat insulin is not the main culprit in triggering my gout.

For those of you that need a mechanism, or a proof of details, Iain’t gonna even try but my belief is that I can go on a controlledatkins diet-yes higher protein intake, much higher in fact, and Ibelieve I will not increase my gout probability unless I do it tooquickly.

In simple terms, I am going to target 1 pound a week, not 7 pounds aweek, and I will drink lots of water, and I plan to reduce mycarbohydrate level to where I am getting most of my energy to liveon, from either the fat I eat or from the fat I already have stored.I’ll stay on allopurinol, watch my BP and go back to my exercizeroutine.

As Atkins says, it is very hard to live when you are hungry all thetime and high carbohydrate intake but insufficient calories makes youhungry and keeps you hungry…

Oh yes, one thing I didn’t mention but Atkins does cover, and I haveknown it since graduate school and my biochemistry work in the late60’s. When you eat one spoon full of sugar, that sugar will triggerinsulin release and the insulin will work on reducing your bloodsugar. It will take about an hour to deplete your system of that onespoon full of sugar. The problem is that when the blood sugar levelreaches normal, there is still insulin in the system and that insulingets eaten up by completely depleting your system of blood sugar.The low blood sugar level sets off bells in your brain that say toyou-FEED ME- it says-FEED ME- FEED ME-FEED ME- and, if it fails toget food it will then start to shut the system down and you willprobably take a nap.

After another hour, your system will have been able to restore theblood sugar level by burning some fat, if it has to, and your hungerwill go away.

My proposal, based on nothing other than intuition, is that theconstant cycling of my glycogen-insulin system-causes my gout.Clearly this is not the case for all people with gout,but I am smackin the middle of this “too much sugar” thing and my gout attacks seemto correlate well with having been in that cycle too long.

I went on Allo 9 days ago — 100 mg daily for a week, now up to 200,up to 300 next week. I have never had a gout attack but I did havesome mild tenderness swelling of the ball behind the big toe (leftfoot) about 3 months ago.

My foot/ankle (on left foot) starting giving me problems two daysago (day 7 on Allo - Just before dose increase) . It is not tenderor red, and there is very little swelling - but it becomes verypainful when I walk. If can’t walk without a limp.

I have never had this type problem with this foot. My uric acid was9.4 (8.2 is my high ref range) - hence the Allo.

Could the Allo be causing this ?

just an interesting note.i was talking with someone, who suffers with rhumotoid arthritis.she was saying, that if she eats, some of the foods, that, the goutpeople are not suppose to eat, she can hardly walk, or use her handsthe next day.just thought i would mention that, thought it was interesting.

So would it be the sweetener in these drinks that is the culprit? Doyou know which sweetener it is? Could well be in other products ifit’s the sweetener rather than the drink itself?

I thought my gout would get worse as the weather got colder, butwe’re now in the depths of winter here in Australia and haven’t hada twinge - no aches and pains that I’ve had since last Sept -nothing for three weeks. I haven’t changed my diet/lifestyle oranything else that I can think of during these weeks. The onlychange is the cold weather. I thought this was supposed to make itworse?

I am newly diagnosed and amhaving a bad bout right now. My feet, ankles, knees, hands, wrists,and elbows are all burning and painful. I have been on the couch for3 weeks now as walking for too long doesn’t work. I think I have hadsmall attacks in the past but just put them off to body stress. I am35 and found out my grandmother had her gout come on about the sametime. Some questions?? Pain relief:..I can’t use Ibuprofen so whatworks for anyone? Asprin? Hydrocodein? Ice packs on feet and handsseem to give me some relief from the burning for 30 minutes or so.Time frame:..how long do the acute attacks last? I keep thinking I canmentally get through the pain if I just have some realistic time frameto adjust to. The ten day mark someone told me about has long goneand some areas feel worse now. Attacks:…Does exercise bring this on?I walked alot for a few days(miles) before this came on and I amwondering how long after this goes down do I have to wait before I cando light or moderate exercise…will activity always bring it on?..Ieat organic and healthy as I have already survived one major illnessat 25 and I don’t drink. My reg. doctor diagnosed this just before sheleft for a month but we both thought it might be something I couldjust wait out and rest through. I see a lot about medications listedthough she and I just set up cherry juice and a naturalantiinflammatory herb. Any help with any of these many area’s ofquestions is greatly appre

Lower your salt intake when you are having an attack. If possiblemake it go as nearly to zero as you can.

I am suggesting that you should put yourself onto a low salt intakediet at least when you are having any kind of pain from gout. It isoften very hard to do that but it should allow the crystals to re-dissolve and allow them to be properly processed by your body. Solidsodium urate cannot be excreted. It must be dissolved first ant thenexcreted so the higher the level of salt in your system, the lowerthe threshold level for crystallization.

Long term I’m not sure yet but, there is a wealth of data suggestingthat a low salt diet should be used by people who have high bloodpressure. You can raise your blood pressure from 120/18 to 140/90,albeit temporarily, by eating a very salty meal. One of the tried andtrue treatments for high blood pressure is reduce salt.

Same goes for a gout attack. It will be good for your blood pressureand it will improve your margin to redissolve the crystals.

The next attack will probablly be determined by whether you havesuccessfully and CONSISTENTLLY lowerred the amount of urate in yoursystem(body)..over the period of time.

A series of tests..both blood uric acid level,/24 hr urine testsfor total urate are required.These tests must be done beforeattacks,during, and after.The tests must be done over a long enoughtime that an accurate baseline is established.I’ld say a good severalmonths.During this time do not make any drastic changes todiet/exercise/lifestyle..this is VERY important!Accept yourcondition,life..take a GOOD look at it..DO NOT change it drasticallynow.You will have plenty of time for that later.

Now that you have your baseline..your goal is to GRADUALLY loweryour blood uric acid level/and your urate level in your urine.Areduction in the blood uric acid level of 20% to 30% isrequired.Example..if it is 8..you get it down 30% to 5.5.And you keepit there.

Many experts in thefield..rheumatologists,researchers,scientists,other medical personellsay this is flat out impossible..indeed there is plenty ofinformation right here..or at your fingertips on the net to look at.

Take a good look at the diet I posted the other day.Adjust itaccordingly to your own height,weight,fitness,activity level.

If you can not attain this 20% to 30% reduction it is pretty muchguaranteed that you are still adding uric acid/urate(WASTE) to yourbloodstream,joints,fluid,area.Even if you can attain this figure itis absolutely no guarantee that this reduction will lead to not onlythe elimination of future deposits..BUT getting rid of the olddeposits.

But..fair enough..a substantial reduction is good.

Try this..

One final point:Gout attacks can/do damage ..permanently..after 2or 3 attacks..go on allopurinol.

Do I think the above will work? No..but GOOD LUCK!

My first attack was more or less ‘classic’:Nightime, in April, in the great toe and about aweek later migrating to the contra-lateral greattoe. However the pain and redness seemed centeredone-joint away from the ‘classic’ position.

My doctor was seeing his very first case of goutand being a young resident just starting out onhis career, he called his attending to supervisehis aspiration of synovial fluid. Despite theadvice the attending gave him he was unable toaspirate synovial fluid and therefore made only atentative diagnosis of gout since he could notobtain the confirmatory bichromatic confirmationof uric acid crystals. This made him a bithesitant to Rx any allopurinol and was a causefor much suffering by me and probably damage tome.

A recent poster’s “ankle gout” that for 30 yearshas not struck the great toe or anyplace else andis limited to only one ankle, the one with aprior injury does not “sound like” gout. However,it certainly could be gout. Not everyone has aclassical case or a classical progression. Ithink ‘avoiding attacking a weakened joint with afine needle to aspirate some fluid’ is notproper, but some doctors are very conservativeand really do not want to “do something wrong”.Its legal to treat you for gout even though thereis no confirmatory test establishing that you dohave gout. I think an infectious agent hasprobably taken up residence in the injured ankleand is giving some problems that just might begout but could well be something else.

Allopurinol and Colchicine, the two most oft usedanti-gout medications, are each also fungicidaldrugs and one researcher maintains that theirmanner of functioning is to kill the P. multocidathat causes gout. Certainly the classical onsetpattern and classical skin manifestations doindicate an infectious agent. His theory is notproven but it is biologically plausible and doesfit known observations in man and animals. Indeedhis theory originally was developed fromveterinary journals.

Does allopurinol really work in this mode?Perhaps.

If I had thirty years of ankle pain I would haveinsisted on an attempt at aspiration of synovialfluid during an acute attack. Or I’d haveinsisted on a different doctor. But we all haveto make choices and deal with uncertainty.

I have been a gout sufferer for a decade now. last attack lasted 4 months. When I went to my Dr. last, he had concerns about my blood pressure and my cholestral (both very high) and I do not like taking meds or having procedures if avoidable, so i created my own diet, with my being prone to gout in mind. so far, so good, I lost 20 pounds in 6 weeks and lowered my cholesterol by 30 points, and have not ant any gout warnings. After 6 weeks, had my blood tested for uric acid, a small rise, but not bad. I have taken 2 weeks off the severe aspects of the diet (but not returned to my normal eating patterns, kinda halfway back to my norms) and will be resuming the diet again for another 4 weeks.

OK, here is my diet- First the To-Do’s, then the No-no’s, then the products.

It may get boring, but it works.

Although, if you are creative, you can make it less boring.

 Its also easily portable to work

The To Do’s

Read the labels on all foods. (you will be surprised) For example, on some foods, you will note it is a certain percent fat, but no or little saturated fat. This is a good thing. In the reverse, you will find products with higher cholesterol than the fat percentages would cause you to expect. This is because in these foods, the carbs get changed to fat after ingesting.

make sure to watch the saturated fats especially.

expect to eat 1/2 your normal volume per day, BUT Eat more small meals per day, 4-5 little meals works out better. Makes your body burn off better. Its like stoking a furnace

Eat as much produce as you care for in which the edible parts are Green or brown in color, then orange/reds, then yellows 

At least one salad per day, But I recommend 2 per day. with 1 tablespoon of no-fat or low fat dressing. (For myself I, water it down to spread it further) Or I make my own dressing. (one of many examples would be-citrus juice, certain spices & herbs & water make a great, tasty & refreshing no fat dressing) 

Eat a minimum of 2 servings of Soluble fiber per day (helps eliminate fats & Cholesterol from the blood) and more if you can/want.  Soluble fiber is found in oats, oatmeal, oat bran, wheat bran, barley; beans, legumes, barley, citrus fruits and certain fruits, psyllium, vegetable gum include konjac gum, pectin, guar gum and gum arabic, to name a few. Oats have the highest proportion of soluble fiber among cereals.

Beans are good sources of both fiber types. The cereal containing highest level of soluble fiber is oat bran, which has about 14% soluble fiber. All other food grains contain much less soluble fiber than oat bran. A common entree for me is Hormels vegeterian chili. They use vegetable protiens to make it seem like it has meat, for the purpose, its good and inexpensive. To create variety, I add in various veggies, spices, herbs, etc.

Bake, Broil or Boil meats. No frying. You can eat ground beef,

IF you “brown” it, and then rinse (with HOT water) all the fat off

immediately while the meat is still hot. As to flesh based protien (beef, poultry & fish)

For myself, because of gout I limit my protein to 60-70% of the RDV,. If you are not gout prone, you can eat 100% or more protein, but it should be mostly fish (salmon,Tuna, swordfish- very high in the good fat that actually helps lower cholesteral), then white meat chicken (no skin).  maybe once a week, for a treat, a little bit of very lean red meat. (Dark meat chicken & most beef, very high in fats- after you eat this way for a few weeks, if you eat some regular red meat or dark meat chicken, you will be surprised at how much grease you will notice. It will be on your tongue & mouth for hours, and be unpleasant) My most common protien is one 7 ounce no drain bag of Tuna per day (spread over several meals). One bag is 70% of the RDV of protien, so your not overdoing it, if like me, you are gout prone. I use the 7 oz bag instead of the 6 oz can of tuna, because they include the water weight in the can. In the bag, you get twice as much Tuna. Plus i buy mine at the 99 cent store, so thats not bad ! For variety I flavor with various no/lo fat suaces, relishes, herbs, spices etc. 

Make your own low fat / no-fat sauces for your food to replace the flavor (mostly comes from fat) that we are used to, for meats & produce. Learn to use spices to make good flavors with the goal of minimal sugar & fat (percieved) needs in foods. Use water, or fruit / vegetable juices as your base liquid, not oil.

Take a good multi-vitaman daily

Beverage of Choice should be water. between a half gallon to 3/4 of a gallon per day to flush out your system. You can flavor with a little fruit juice (but no sugar) No Sodas (including diet) & limit coffee & tea to once a day

the No-No’s

No more than 1 plain baked potato or one serving (small) of Pasta per week, if any at all.

No more than one small serving of rice per week

No shellfish 

No oils, except when really a necessity, then a little Extra virgin Olive oil only

Limit Bread to one or 2 small servings a week at the most, if at all

Limit intake of carbs to 35% at the most, of the RDV per day

Limit intake of Saturated fat to 15 - 20% at the most, of the RDV per day.

Limit intake of Cholesterol to 10-20% at the most, of the RDV, EXCEPT for Fish (Tuna & Salmon) Cholesterol. The Fish cholesterol is Omega-6, it is the good fat. Lowers your bad fats.

Limit sugar to tea & coffee only, and cut that amount of sugar in half

Limit eating processed foods, especially those with made with Corn syrup (very bad) & High fructose syrup. we do not process/digest corn syrup well, it acts as a carb, gtransforms to fat.

Only one “normal” (small) snack per week, if any at all.

NOTE: Before eating those so called “Low-fat” frozen dinners (including the big name brands), read the labels. For the amount of food you get, vs. the cost, they are higher fat than you are thinking. I compared. Some were low (6 grams sat fat) but most of the flavors ranged as high 15-22% fats, and it would take 2 of these to make one meal. You are better off (both in terms of fat, carbs & cost) eating otherwise (see my shopping list) 

Basic rule of thumb is If its produce & its white (potato, banana, etc) limit severely as it is higher in carbs. Eat a lot more produce that are Green or brown in color, then orange/reds.

My Shopping List - From the 99 cent store and / or The Dollar tree

7 oz bag (no drain) Tuna- You get better value than the can, because a 6 oz can of Tuna, they are including the water weight in the can. You only get half as much actual tuna with the can. - You can eat a whole bag per day. A whole bag a day gives you 75% RDV of protien, No saturated Fat, No Carbs & 30% of choesteral-However, much of this is the good fat, not the bad fat.

Hormel vegetarian Chili - 99% fat free-you can eat a half can to a full can per day

Any low fat & No-fat soup products (especially Haines & Westbrea brands)- depending on the fats & carbs, you can eat half a can to 2 cans per day. Tomato soups are good too, use the crackers I will mention below.

 

Varied & products such as Haines Breakfast bars (only 1 bar per day) & some of their crackers, also healthy valley crackers (cracked pepper, vegetable, etc) which are very low in carbs, no sat fat etc. You can eat 1/3 of a box of the health valley crackers per day.

 

Red Peppers in the jar - Because red peppers are out of season, by the time you buy & roast, its just as easy & frugal to buy the 12 oz jar of roasted peppers. also other jarred/frozen produce without fats and low carbs

 

Good & Hearty (or any other brand w/ out added sugars, corn syrups etc) of Oatmeal 

Sometimes they have organic cereals with no added sugars or corn syrups

Ryecrisp fat free crackers (great source of soluble fiber-even if they do have the texture of cardboard)

Low fat or no fat (and low sodium) Beef broth (Healthy Valley brand) use in place of Hot choc, tea & coffee when you want a hot drink (it sounds odd, but it works & you adjust quickly-it tastes good)

any other food products that fit the guidelines concerning fats (especially saturated) & carbs

Extra virgin Olive oil

Spices & herbs for flavoring

My Shopping List - Produce store

anything green, brown, red, yellow, orange, that you enjot the taste of. Eat raw, baked, boiled or roasted. No frying. If you boil, save the water, use for soup etc, as vitamins & other nutritional needs leach out into the water.

Beans, lentils, etc etc.