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Gout diet advice
July 9, 2012 11:51 AM   Subscribe

I just had my first attack of gout, and I'm looking for trustworthy sources of information on the purine levels of different foods.

I intend to generally cut back on meat and beer, but I've read conflicting information on things like mushrooms, broccoli, whole grains, etc. I don't want to over-react and cut out too many things (as I won't be able to stick to it), but I'd like to get a consistent picture of what to avoid and what's okay. I'm interested in online or printed sources with decent references.

If I can add a rider: does anyone have any specific information on purine levels of no-alcohol beer or is it pretty much the same as ordinary lager?
posted by crocomancer to Health & Fitness (10 answers total) 4 users marked this as a favorite
 
This is a crackpot link, but also consider fructose in your diet:
http://wiki.answers.com/Q/What_is_the_importance_of_fructose_in_gout

If you google you can find real references.
posted by zeek321 at 11:55 AM on July 9, 2012


My friend with gout swears by GoutPal.com, and their food information seems very detailed.
posted by Sidhedevil at 11:57 AM on July 9, 2012 [1 favorite]


Sidhedevil's list looks pretty good. My dad had gout and anything that had even a whiff of liver would prompt an episode. Shellfish too, he could eat one shrimp and would later pay the price.

Nothing else really seemed to bother him, I'm sure metabolisms reactions etc are different for everyone. Those were just his 2 big no no's.
posted by Max Power at 1:16 PM on July 9, 2012


Note that, according to Wikipedia (so be sure to read the references), foods high in purine have recently been found to not affect gout symptoms.
posted by maxim0512 at 1:18 PM on July 9, 2012 [1 favorite]


As a person with gout, let me nth the statements of everyone in here that (1) the levels of purine in foods I have found to have no effect on my gout symptoms and flareups, but that (2) the level of fructose I eat definitely and directly does.

Flying specifically in the face of all mainstream gout health recommendations, I've started eating a paleo diet, and found that not only have my gout symptoms stopped, there was a kind of baseline pain/inflammation in my feet that I didn't even know I had which has also gone away. My feet feel 15 years younger.

Some people have gout that seems to be triggered by classic, purine-rich foods. Aged meat, organs, aged whiskey, etc. But many people who are getting gout now seem to be more sensitive to fructose metabolism. Resources are out there which explain it better, but basically: when you eat food that's rich in purines, your body secretes the substances it needs to to deal with the uric acid that the purines break down into (unless you have old-school gout). When you eat fructose, it metabolizes into uric acid without your body producing what it needs to to deal with the extra uric acid. That uric acid, if it can't be processed, crystallizes in your joints. Voila, you have gout.
posted by penduluum at 1:26 PM on July 9, 2012 [1 favorite]


Purine levels are a good place to start, but gout is a very individual disease. If you wind up having a bad case it may be best to work with a doctor, preferably one who has gout, and slowly figure out your triggers by process of elimination.

Some take a daily pill of colchicine as a preventative and eat and drink whatever they want. Others take it during or in advance of an attack, and some will not take it at all because it is considered a toxin.

With a little luck you will only have one or no more attacks. Or at worst you will be able to sensitize yourself enough so that you can feel subtle pain well before a full on attack happens and fend it off.
posted by snaparapans at 1:39 PM on July 9, 2012 [1 favorite]


Another long-time gout sufferer here -- got my first attack at 24. Purines don't affect me so much, but carbs (especially fructose) do. Beef and chicken in moderation seem fine, but shellfish is still a problem. All the high-purine vegetables (tomatoes!) are also fine, which was a big relief. I have pretty much cut out bread and beer (sadness), and go easy on fruit. And I take 300 mg allopurinol every day.
posted by phliar at 3:39 PM on July 9, 2012


I could only find one credible study of diet and gout, which concludes that absolute purine levels are not what's important, that red meat and seafood are dangerous and that low-fat dairy products are protective. The study also says that high-purine vegetables are just dandy.

I find that oily fish, dehydration and inactivity are my nemeses. I drink a fair amount of beer, and I'm pretty sure it's not causing me problems.

So, much as other people here are saying, try to look past purine levels and find out what's bad for you personally. It's very likely that many high-purine foods are harmless, and it would be a shame to eliminate them.
posted by nowonmai at 3:57 PM on July 9, 2012


Ugh, diet advice on the internet for gout sufferers is incredibly contradictory and unhelpful, so I share your pain. Nthing everyone saying that you have to figure out what your own triggers are.

For me, one beer is enough to trigger a gout attack (as a result, I haven't had more than a few sips of beer for years). I can drink white wine occasionally. Maybe even red wine, though I tend to avoid it (this is probably irrational). Dehydration is the other big trigger for me, so I'm careful to drink a lot of water during the day. Shellfish I can eat just fine. Red meat is problematic only if I eat a lot of it. I've never found veggies to be a trigger. I don't think fructose has been an issue for me -- I certainly eat a lot of fruit -- but given the number of people above talking about it, I think reexamination is warranted.
posted by odin53 at 5:01 PM on July 9, 2012


Thanks for broadening my horizons. I can see I'm going to have to do some experimenting to see if there are specific triggers.
posted by crocomancer at 1:57 AM on July 10, 2012


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