10 Dietary Improvements for Those Who Suffer from Recurrent Gout

"What if that excruciating pain comes back again..."

If you have ever experienced a gout attack, you know that fear all too well.

I experienced my first gout attack when I was 29 years old.

One day, suddenly, the base of my left big toe swelled up bright red, and I was struck by such intense pain that even walking was difficult.

Since then, I have lived with gout for over 30 years.

From that experience, there is one thing I feel strongly about.

That is,

"Gout management is not something you only think about when an attack occurs."

That is what I mean.

Change your daily diet little by little.

Reduce overeating and excessive drinking.

Stop drinking sugary beverages.

Do not overeat.

I believe that the accumulation of these small habits is very important.

Medically speaking, gout management emphasizes not only drug therapy but also lifestyle adjustments such as diet, weight, and alcohol consumption. The guidelines of the Japanese Society of Gout and Uric & Nucleic Acids also recommend dietary guidance, including refraining from excessive alcohol intake.

In this article, I will introduce 10 dietary improvements that people who suffer from recurrent gout should review, while incorporating my own experiences.

*This article is based on my own experience and general medical information and is not intended for diagnosis or treatment. If you have recurrent gout attacks, high uric acid levels, or underlying conditions such as kidney disease, please be sure to consult a doctor.

Chapter 1: First, Change Your "Drinks"

When people talk about dietary improvement, they often say,

"No liver,"
"No fish roe,"
"Let's reduce purines."

It is easy to focus only on food.

However, I believe you should first check what you drink every day.

1. Reduce intake of sweet juices and soft drinks

The first thing you want to review is

• cola

• soda

• sweet canned coffee

• energy drinks

• soft drinks high in fructose

, and so on.

The American College of Rheumatology (ACR) lists avoiding beverages high in sugar or fructose as a lifestyle precaution for gout patients. Furthermore, the 2020 ACR guidelines conditionally recommend limiting the intake of high-fructose corn syrup.

I consider not only "what to eat" but also what not to drink to be part of dietary improvement.

To start,

"Replace sweet drinks with water or unsweetened tea"

Even just starting with this is fine.

2. Do not make alcohol a "daily habit"

The relationship between gout and alcohol cannot be ignored either.

In particular, the ACR recommends limiting alcohol consumption, including beer. Japanese guidelines also recommend dietary guidance that limits excessive alcohol intake.

"If it's purine-free beer, I can drink as many as I want"

It is better not to think that way.

It is not just the "purine" content written on products that you should be looking at.

Reduce the amount of alcohol you drink itself.

This is the foundation.

Chapter 2: Changing How You Eat Meat and Fish Instead of "Banning" Them

When people get gout,

some people think extremely,
"All meat is bad" or "I can't eat fish either."

However, for a diet you can maintain for a long time, I think

the mindset of adjusting the amount and frequency rather than a complete ban is more realistic.

3. Do not make liver or organ meats a daily food

Representative examples of foods high in purines are

• liver,

• organ meats,

• and certain types of seafood,

and so on.

The ACR also lists refraining from organ meats, red meat, and certain seafood as a lifestyle precaution.

What is important is

not to memorize a list of 100 foods you must not eat.

First, it is to reduce foods that are clearly unbalanced.

If there is something you are eating in large quantities almost every day, reduce the frequency.

Even just this will change your eating habits.

4. Do not have 'large servings' of meat or fish

When I was young,

I had a diet of

'eating whatever I wanted, as much as I wanted.'

After experiencing gout many times, what I think is that more than the type of food,

revisiting overeating itself

is important.

If you are having yakiniku, do not pile up just the meat.

If you are having sashimi, do not eat several servings worth.

Do not rely on a single food item,

but combine it with vegetables, tofu, eggs, dairy products, and so on.

It is not about 'all or nothing,' but aboutlearning the appropriate portion size.

Chapter 3: Reviewing Staple Foods and Snacks

One of the things that triggered me to change my diet significantly was how I consumed carbohydrates.

However, I do not want you to misunderstand here,

it cannot be asserted that 'restricting carbohydrates will cure gout'

is the point.

In my case, by cutting back on carbohydrates and reviewing the amount of food I ate, I felt changes in my physical condition and the status of my attacks.

The same results will not necessarily happen for everyone.

5. Reduce 'doubling up on carbohydrates' such as ramen plus rice

For example,

Ramen and fried rice.

Udon noodles and a rice ball.

Sweet bread and a sugary drink.

These meals are easy, but as a result, they also tend to increase your total calorie intake.

I have, for some time now, become conscious of

not stacking main staples more than necessary

.

If you eat white rice, keep it to a small portion.

If you eat noodles, do not add rice.

Small adjustments like these are easier to maintain than extreme dietary restrictions.

6. Remove snacks from your 'habit of eating because I'm hungry' routine

Rice crackers.

Potato chips.

Sweet bread.

Chocolate.

Sweet snacks.

What is scary is not eating them once.

It is continuing to eat them unconsciously every day.

I recommend reducing the amount of snacks you keep in stock.

If it's in front of you, you eat it.

If it's not in the house, you don't eat it.

Improving your diet shouldn't rely solely on willpower; creating an environment where you don't eat is also important.

Chapter 4: Not just 'reducing what you eat,' but balancing it

When it comes to gout prevention, people tend to focus only on restrictions, but that won't last long.

At the same time as thinking about 'what to reduce,'

'what to eat'

should also be considered.

7. Add vegetables, seaweed, and soy products to your table

What I often incorporate are

• natto

• tofu

• wakame seaweed

• vegetables

• eggs

and so on.

Adding these foods makes it harder to finish a meal consisting only of meat and carbohydrates.

The point is

not to think,

'It's fine as long as I eat one healthy food.'

It is not about eating only natto in large quantities.

It is used to change the balance of your entire diet.

8. Aim for 80% full, not 'stuffed'

I personally feel that eating less is extremely important.

When I was young,

'eating until I was full'

was normal for me.

However, now,

I am conscious of 'stopping while I could still eat a little more.'

The ACR guidelines also conditionally recommend weight loss for gout patients who are overweight or obese.

However, there is no need to lose weight all at once in a short period of time.

Rather than trying hard for just one day and then overeating the next,

making your daily meals just a little lighter

is, I believe, more realistic.

Chapter 5: Creating a 'System' to Prevent Recurrent Gout

The most difficult part of improving your diet

'is not knowing'

what you should eat.

It is continuing to do what you already know.

9. Make water and unsweetened tea the foundation of your diet

I usually focus on drinking water and tea.

There is another benefit to this.

It makes it easier to replace

sugary drinks and alcohol with water or unsweetened tea.

There is no need to

buy special drinks for your health.

First,

It is not sweet.

It is not alcohol.

It can be continued on a daily basis.

Just choosing drinks based on these three criteria is enough.

10. Keep a record of what you eat, your gout attacks, and your uric acid levels

I highly recommend this.

For example,

"I drank a lot this week"

"I had ramen three times in a row"

"I've been eating more late-night snacks"

"My uric acid levels went up in my health checkup"

With records like these, you can look at your eating habits objectively.

Gout is not a condition that should be managed solely through self-judgment and diet.

The ACR indicates that gout treatment involves not only dietary and lifestyle improvements but also, when necessary, the combination of uric acid-lowering medications, and suggests a target serum uric acid level of 6 mg/dL or less.

If you are having repeated attacks,

“I just need to restrict my diet more”

is not enough; please visit a medical institution to check your uric acid levels and kidney function.

Summary: Dietary improvement for gout is about “consistency” rather than “perfection”

Here is a summary of the 10 dietary improvements introduced.

1. Reduce sugary drinks
2. Reduce alcohol
3. Do not make liver or organ meats a daily food
4. Do not eat large portions of meat or fish
5. Reduce the consumption of multiple carbohydrate sources at once
6. Review your snacking habits
7. Incorporate vegetables, seaweed, and soy products
8. Aim to be 80% full
9. Make water and unsweetened tea your primary beverages
10. Keep a record of your meals, attacks, and uric acid levels

Having lived with gout for over 30 years myself, I feel that

gout management is not as simple as saying, “As long as I don't eat this one food, I'll be fine.”

That is what I mean.

That is why,

I reduce my overeating just a little more than yesterday.

I cut out one sugary drink.

I stop eating late-night snacks.

I change large portions to regular portions.

I stack up these small improvements.

I believe that while it may seem like a roundabout way, it is the most sustainable method.

For those who suffer from recurrent gout, please do not return to your old lifestyle the moment an attack subsides.

It is precisely the diet on days when you are not in pain that is worth reviewing.

In my notes, I will continue to share "sustainable dietary habits" based on my many years of experience with gout and my practice of low-carb diets and eating in moderation.

Reference Information

Japanese Society of Gout and Uric & Nucleic Acid Metabolism, "Guidelines for the Treatment of Hyperuricemia and Gout, 3rd Edition"

American College of Rheumatology, "Gout" Patient Information

American College of Rheumatology, "2020 Guideline for the Management of Gout"

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