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I read the pages on GoutPal concerning diet. It seems clear that if you eat alkaline foods you can occasionally indulge in acidic foods. Meats & game were listed as acidic and bananas were listed as alkaline. However, Beer was listed as neutral/alkaline. Isn’t beer bad for gout and if I drink it shouldn’t I balance it with other alkaline foods rather than acidic foods?
Please help me better understand the chart.
Alkaline Diet Lowers Uric Acid Chart This is a good topic as it causes much confusion.
Three main points..
Yes, alkaline diet does help but it has to be well over adjusted to alkaline to have any hope of affecting gout to the good. Diets are now reversed to what our bodies thrive on and it's hard going on modern diets ,which are predominently acid. Proteins in particular.
Beer is a definitely 'no' for gout and research confirms this- it's supposed to have purines in it but I never see the similarity with, say meat or fish ,tbh. I think it is because it's a diuretic and also dehydrates on the body getting rid of alcohol. Double whammy+ plus any purines of course 😉
The other thing mentioned in detail on here is the PRAL rating of the food- this indicates the actual ash resulting from digestion and can be alkaline from foods like lemon juice- highly acidic to take.
My rules of thumb, briefly are-
Good: Water, Fruit ,Veg, Soured milk products,Cottage Cheese, Almonds and nuts, Baked Potatoes ( the big ones)
Bad: Refined Carbs, Alcohol, Shellfish, Red meat,Hard Cheeses, Yeasty foods (see Beer)
If you like a food- it's probably on the Bad List!
Sods law- needless to say- I eat them ,but not too much. Everything in moderation they say-
I would add I've had a bottle of wine , prawns and mushrooms- a busted foot and still escaped an attack this week. I had to bring out the secret weapon, 'Black Bean Broth' from the freezer though, as I had a stab in the toe the other night and took notice!
Diet can definitely help with gout but you have to work on it it and may still need herbal treatment ( I use Goutcure) or medication to get high SUA into the right numbers ie: less than 6mg/dl on average. If you're starting above 8 you have a job on once an attack has hit in your body.
Hope this helps- just my own take.
Thanks. What about demonized green veggies like spinach asparagus, & broccoli? They have lower purine levels than many other foods but are always on the NO list.
The cruciferous vegs have a bad name- a shame, as Broccolli is called a wonder food for its vitamin content. I keep these down in amount & freq -but not banned completely. I would not risk much asparagus, as it has too much a bad reputatiion and not something I normally eat- though i like it, of course!
I think in these cases the actual chemical content of the food is the culprit (naturally enough) and therefore have to be treated as potential triggers, even if they don't add much urate from content. [Research backs this view]
If anywhere vulnerable on SUA level, tighten down the hatches and tread warily. This is why people find it hard to follow a diet regime as one needs to be totally connected to what you take in, good or bad- and how your body is reacting [with time lags to confuse the issue].
This isn't something people today like to be overbothered with, but gouties pay a price for their knowledge ;~0 – unless free meds are available…but even then I hope to avoid using, if possible.
Generally, the food lists are helpful, but not 'gospel' as we all vary – this is why a one shot meds solution is tempting, but can obscure the finer detail of what out bodies need -or can cope with.
new york1 said:
I read the pages on Goutpal concerning diet. It seems clear that if you eat alkaline foods you can occasionally indulge in acidic foods. Meats & game were listed as acidic and bananas were listed as alkaline. However, Beer was listed as neutral/alkaline. Isn't beer bad for gout and if I drink it shouldn't I balance it with other alkaline foods rather than acidic foods?
Please help me better understand the chart.
There are a lot of food lists on the main site, but they are simply there for reference purposes. They need to be used in the context of a proper gout management plan.
Food does play a part in gout, but that part is often overplayed. If you have a bad diet, then improving it might help your gout, but this depends on what is causing your gout.
Gout is a good indication that your metabolism is out of balance. A properly balanced alkalizing diet can help restore some of that balance, but you still need to consider reducing animal purine and iron content. If you take urate lowering medicines, you do not need to worry about purine intake, but avoiding excess iron and avoiding excess acidifying foods is still relevant as they affect other aspects of health.
The food tables give endless opportunity for calculating diet options, but there is a much simpler approach. Before I describe that, you should understand the acid/alkali (pH – power of Hydrogen ion concentration) process.
Forget about direct measurement of food pH. That is only of interest to the canning industry. Forget about ash. That is only of interest to people who like to study ash. The key term, and the basis for the tables, is PRAL – Potential Renal Acid Load. This is a simplified formula, but perfectly valid for most food items. In fact, any calculation is only ever an approximation of the pH load on the kidneys – the true test is to measure urine with a pH test strip. Leaving aside the New Age claims of the miraculous effects of an alkalizing diet, for gouties the biggest benefit is that the alkalizing diet will lower the risk of urate kidney stones.
Now, all we are doing is counting hydrogen (or hydroxide) ions of total food intake. This is only juggling with numbers, and takes no account of how well balanced your diet is nutritionally. The danger is that you get obsessed with numbers, and forget to eat properly.
The simple approach is to take a 3 – 4 ounce portion of protein then balance your meal with twice as much vegetables. Fruity snacks between meals complete the deal. No individual food item should form such a high part in your diet that you need worry about it unduly. If you are in a place where spinach, asparagus or broccoli are likely to significantly alter your uric acid level then use a smaller plate or take allopurinol. If you are in a place where a couple of beers are likely to significantly alter your uric acid level then switch to wine or take allopurinol.
Very few people can control their uric acid and thus their gout with diet.
Back before the drugs, gout was often a slow death sentence.
I wonder if anyone has ever compiled a list of uricosuric foods…there MUST be some?????????
I get the strong feeling Zip- that though it would be great to be otherwise, the process of urate build up is relentlessly one way through life.The genetic weakness in gouties seems to override a lot of counter efforts to the better.
Don't forget it's only in established gouties that moderately high UA causes the problem- otherwise it has been stated to be quite useful to have higher levels of the wretched stuff!
A recent poster mentioned staying away from infection sources if on AlloP- due , I suppose to the reduced efficiency of the immune system brought on by UA lowering.
On the diet issue again- I feel the main plus of alkalizing by diet is to get the median acid level down so that ' blips' due to indiscretions with food/drink don't clip over the line TOO LONG and trigger a flare, or worse. It would be easier to show on a graph, but time spent in the danger zone has to be reduced. I think the immune system needs a certain time on triggers to get ramped up , basically.
I've had some sudden vicious stabs in toe joints at odd occasions at night but so far, my policy on diet has held good.
Though it would be nice to have ideal alkaline water leaving us, later in the day particularly, showing how balanced we are -for anyone trying to lose urate, ph will never go much over 7 ish from what I've seen and frequently extremely acid @ 5.5 !
zip2play said:
Post edited 1:23 pm – March 21, 2010 by zip2play
Very few people can control their uric acid and thus their gout with diet.
Back before the drugs, gout was often a slow death sentence.
Again I agree with you. The amount of Gout people I am bumping online who keep saying that they are “completely cured” is unbelievable. These people are not on any SUA lowering meds but think they are cured. They have absolutely no idea what their SUA readings are either.
trev said:
The cruciferous vegs have a bad name- a shame, as Broccolli is called a wonder food for its vitamin content. I keep these down in amount & freq -but not banned completely. I would not risk much asparagus, as it has too much a bad reputatiion and not something I normally eat- though i like it, of course!
I think in these cases the actual chemical content of the food is the culprit (naturally enough) and therefore have to be treated as potential triggers, even if they don't add much urate from content. [Research backs this view]
What do you make of this?
Consumption of purine-rich foods. A 2004 study showed that higher consumption of purine-rich foods such as meat and seafood was associated with a significantly increased risk of gout. However, purine-rich vegetables did not increase gout risk. Interestingly, the same study showed that consumption of dairy products had a protective effect against gout. A 2005 study confirmed these results and found that total protein intake was not associated with increased uric acid levels
@ VG What do you make of this?
Yes, this is my point. Both protein and veg don't have to push [longterm] overall levels of UA up but the surge in day to day use can give immune system chance to kick in, and then the focus goes on the bad joint.
A non linear reaction- but researchers are trained to think linearly!
Think about the relatively low level of gout in the often high SUA general population -and the relative ease that gout kicks in around 7mg/dl in confirmed cases.
A hair trigger effect almost buried in mega data…!
It's just a matter of timing!
And alas, of course any uricosuric will eliminate uric acid in all its forms. Too bad for us that allopurionol and it's most active metabolite, oxypurinol, are almost identical to uric acid…that's why they work.
So out goes the baby with the bathwater…AGAIN!
Why is nothing EASY!
But then for those NOT on allopurinol, the uricosurics are a good idea.
(And you DID remiind me to boil up a pound of dried figs I've had since the FLOOD, and they are always DELICIOUS….with a good squirt of lemon in the boilwater.)
The food lists were designed, poorly I might add, for a time when there were no drugs to control gout except colchicine to stop pain.
Probably the ONLY decent dietary advice is to completely give up meat and fish but that is heretical in any country where meat production is a major industry, so the lists are congloms of half truths and twaddle that really don't do anything to help people with gout.
They are anachronisms just like bloodletting to cure infectious diseases (before penicillin) and prayer and enemas to cure cancer (before surgery,) and chicken soup for influenza and pneumonia.
A doctor on another board said that in cases of incurable disease doctors must still DO SOMETHING. My feeling is just the opposite (that topic was about useless treatments for influenza.) I guess our major difference was that HE got to bill for doing nothing…patients get to PAY for it.
Mankind HATES to be helpless so we invent nonsense to SEEM like we are doing something. Alas, too often the nonsense lasts LONG after the cure. And in the really sad cases the nonsense takes the place of things that actually WORK.
And I guess now, in the age of the Internet, the OLD useless nostrums will be bandied about AND SOLD until the end of time.
For those that doubt me, do an intensive study on the web and see if you can find a SINGLE disease for which treatment with an alkalyzing or acidifying diet isn't given as the cure.
Might as well go back to the 4 HUMOURS or the PHLOGISTEN theory…or check your CHAKRAS, your CHI, or sacrifice a virgin to BAAL.
There are excellent and cheap drugs that treat gout very effectively. There are also a myriad of ancient and useless “cures” touted on the web.
So we all make the choice when our foot begins to ache or crucify every couple months or weeks.
Eat a dollar's worth of cherries every day and give up sweeetbreads (dumbest recommendation in history) , or pop a pill for a dime.
Newly diagnosed, and very confused. I don't drink alcohol, maybe a glass of wine at Christmas. But, I've eaten a lot of shellfish, plus salmon. 2 weeks after eating crab legs and salmon, I had a horrible attack in the middle of the night. I'll add, thatday I also was out walking in a snowstorm and got cold feet. From what I've read on here, all No-No's. Actually, I thought I had sprained my foot, even though it started in the toe, my whole foot swelled. Not knowing anything about gout, I never thought of that possibility and went to a poditrist first. He gave me a blood test and it showed an acid level of 10. Painful, Painful! Cellulitis had started up my leg, and my first prescription was Indomethacin (12 days) plus Sulfamethoxazole (only for 4 days). Next visit was to myfamily doctor prescribed Colchicine and Allopurinol, took me off my Niaspan and Furosemide. Then my feet swelled badly and BP went up. Doctor took me off of Colchicine, and I'm back on Furosemide again, and feet are back to normal. I can WALK now! How confusing this has been. Now I'm trying to lose weight…maybe lose 15 lbs. more after losing 12lbs. in 5 weeks. Yes, this started Feb. 20th, and today is the best I've felt, still not perfect. I know this is a book I'm writing, but I really need to talk to people so I can learn more. One site said no bagels, another said bagels are o.k. A blueberry bagel is calling me, and I'm afraid to eat anything. A bowl of oatmeal with Splenda and a little Light & Fit Yogurt (low sugar, low carb) are all I've eaten today. I live in fear of getting another attack, and every once in awhile, I feel pain in my toe joints. Now I'm going back to other posts to see if I can learn more. Thanks for this site. I'm really dumb about all of this.
Sounds like a rough time alright. The speed you have become aware of Gout will mean a quick take uip on ways and means to contol it.
You're already on the first stage with the meds -and that is most important to stick with.
A reading of 10 and the fast onset sounds like you may have a backlog of UA to clear- but that is conjecture without a scan ,you're unlikely to get.
You have had good management by your Dr so far but you will know from reading here that you may have a few bad periods over the next few months while SUA comes down to <6.
Steady up the weight loss a bit- untill you have got over the bringing down of SUA level. You may be doing 'too much at once' , otherwise.
Do get a diet sorted and on the right one, weight should lower more easily- but it will take some weeks / months to get it right.
Concentrate on lowish meat/fish (especially prawns etc) protein for a bit and fill up on fruit and veg and soured milk products.
It will help to get on an alkaline diet in my view. There's a lot to read up…
Don't forget plenty of water in small amounts through the day- probably double what you normally do. I struggle myself a lot on this , too.
I reckon you have a good positive approach , anyway. Good luck!
Trev, your response really means a lot to me, as I feel really alone with this new found problem. I haven't talked with anyone but my husband, and doctor about this, and never heard of, or talked with anyone having gout. Thanks for your suggestions and encouragement. This has been bad, and still, after 5 weeks, my foot swells by evening if I'm at the computer too long. Just had a bowl of strawberries which lifted my spirits some. April 2nd (at close of week 3 on Allopurinol) I go for another blood test, then back to the doctor on April 9th. In the meantime, I'm learning from you all. Thank you again!
Hey- you must keep posting- Your moniker looks like Goutpal so you will get a lot of readers 😉
On the sitting at PC- this won't help gout.
Keep more mobile- and maybe try those new foot massagers to help circulation?
Walk round the block before retiring, too! If you smoke tobacco- desist!
Yes, I've noticed I have to keep moving. 2 problems here: I run a business from my home, and use the computer about a half day or more. I prop my foot up under an afghan, which helps a little. 2nd thing, I'm still in bedroom slippers, almost 6 weeks. Can't put a shoe on because I'm scared to death to put pressure on my toe and joint and there's still some swelling on top of my foot. I can walk in bedroom slippers, but not around the block. I went shoe shopping, and nothing feels good. Probably my age doesn't help….69. Don't smoke or drink and have been, otherwise, very healthy and active. Been working out at the gym (for ladies) for 3-4 years. This has changed my lifestyle significantly. But I will work on it!
Well to stay on topic- I must reiterate that an alkaline diet will help from my recent attempts, and allied to that is the idea that water 'intake' actually reduces water 'retention' which your meds not be strong enough, due to gout reactions to diuretics. Your body stops saving it!
As your story is ongoing -why not start your own thread as case studies, however limited , are a great help to others and put experiences into perspective. A 10 reading is high enough to watch progress with interest!
Bearing in mind this is a public forum- but general experiences are more useful than personal details as the amount of real day to day research on gout seems limited- hence a lot of worried sufferers.
This alkaline diet for gout topic is now closed.
It covers several variations on an alkalizing gout diet menu theme, including:
- alkaline diet gout
- uricosuric foods
- acid-alkali (ph) balance in gout
- alkaline food for gout
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