8 Dietary Rules You Should Know to Aim for Zero Gout Attacks
“What if that excruciating pain comes back again...”
If you have experienced gout, I think you understand this anxiety well.
I experienced my first gout attack when I was 29 years old.The base of my left big toe swelled up bright red, and the pain was so intense that even walking was agonizing.
Since then, I have lived with gout for a long time.
However, as I reviewed my eating habits, I realized one thing.
Gout management is not enough if you only 'avoid foods high in purines'.
Rather, what is important is to balance your entire daily diet and gradually change the lifestyle habits that tend to raise uric acid levels.
Gout leads to attacks when uric acid in the blood increases and urate crystals accumulate in the joints. The Japanese Orthopaedic Association also explains that overeating, excessive drinking, and obesity can be factors in hyperuricemia.
In this article, based on my own experience, I will introduce8 dietary rules to keep in mind to aim for 'zero gout attacks'.
These are not difficult methods.
They are all things you can change starting with tonight's dinner.
*This does not mean that improving your diet will guarantee zero gout attacks. For gout, tests for uric acid levels and kidney function, as well as drug treatment when necessary, are also important. If you are currently undergoing treatment, do not stop taking your medication on your own judgment, and prioritize the instructions of your attending physician.
Chapter 1: Gout management is more about 'how you eat' than 'what you eat'
When it comes to gout, people tend to talk in terms of specific foods, such as:
'No liver'
'No fish roe'
'Just stop drinking beer'
These are the kinds of things people tend to talk about.
Of course, purines are important.
However, in current gout management, it is considered important to look comprehensively atalcohol, fructose, body weight, and total energy intake, not just purines. The American College of Rheumatology also conditionally recommends that gout patients limit their intake of alcohol, purines, and high-fructose corn syrup.
Therefore, I believe,
'Instead of fearing a single food, change how you eat every day'
I recommend this way of thinking.
Let's take a look at the 8 specific rules from here.
Chapter 2: The 3 Basic Rules You Should Follow First
Rule 1: Avoid Dehydration
First, the thing you want to be conscious of is hydration.
In particular, be careful of dehydration on hot days, after exercise, after bathing, and when drinking alcohol. The day I had my first gout attack was also at dawn on a hot day in August. I don't think I had been drinking much water either.
In dietary guidance for hyperuricemia and gout, appropriate water intake according to kidney function is also recommended. From the perspective of preventing urinary stones, water intake is important, but if you have kidney disease or similar conditions, you need to adjust the amount of water.
In my case, I made it a habit to drink water or tea frequently.
The point is not to "drink it all at night," but to drink it in small amounts throughout the day, such as:
in the morning
before and after meals
when going out
before and after bathing
etc., dividing it into small amounts is key.
However, this does not mean that "everyone should drink X liters a day." If you are under fluid restrictions due to heart or kidney disease, please be sure to prioritize your doctor's instructions.
Rule 2: Don't Feel Safe Just Because Alcohol is "Purine-Free"
"If it's a purine-free beer, it's fine."
Some people might think that.
However, caution is required here.
The problem is not just the purines in the drink. Alcohol itself affects uric acid metabolism, so the Gout and Uric Acid Foundation also explains that you cannot judge alcoholic beverages solely by the amount of purines.
NICE (National Institute for Health and Care Excellence) also states that excessive alcohol consumption can worsen gout attacks and symptoms.
In other words,
"how much you drink" is more important than "what you drink"
is important.
Take days off from drinking alcohol.
Reduce the amount you drink.
Replace it with water or sparkling water.
These small adjustments are easier to maintain for a long time.
Rule 3: Do not make sugary drinks a habit
Surprisingly, what is easy to overlook is
juice
soft drinks
sweetened coffee
sweet carbonated drinks
drinks high in fructose
are.
Excessive intake of fructose can affect serum uric acid levels, so it is recommended to avoid consuming too many sweetened beverages and fruit juices.
"I'm abstaining from beer, but I drink juice every day."
If that is the case, your efforts are going to waste.
First, make your drinks
centered around water, unsweetened tea, and unsweetened coffee.
Even just doing this will significantly change your eating habits.
Chapter 3: How to Manage Purines Effectively
Rule 4: High-purine foods should be 'limited,' not 'forbidden'
When people get gout,
"Does this mean I can't eat meat or fish?"
some people worry.
However, extreme restrictions are not recommended.
The Gout and Uric Acid Foundation, a public interest incorporated foundation, introduces based on guidelines thatthe target for purine intake is about 400mg per day.The idea is to be mindful of the amount and frequency of foods high in purines, such as liver, milt, and certain types of seafood.
The important thing is,
not "absolute prohibition",
but rather,
"not eating large amounts for many days in a row"
is what matters.
Rather than fearing only high-purine foods, it is more realistic to keep your overall food intake at an appropriate level.
Rule 5: Be careful with "broth" as well
This is surprisingly little known.
Because purines have the property of dissolving in water, when high-purine foods are boiled, some of them transfer into the cooking liquid. The Gout and Uric Acid Foundation also introduces not drinking up the broth of high-purine ingredients as one way to suppress intake.
For example,
ramen soup,
leftover hot pot broth,
rich meat or fish cooking liquids
If you have a habit of drinking all of these every time, you also have the option to "leave them behind."
It is a small thing, but it adds up every day.
Chapter 4: "Not overeating" is powerful for gout prevention
Rule 6: Make eating until 80% full your baseline
In changing my eating habits, what I felt was particularly important wasnot overeating.
You do not need to think only about "adding healthy foods."
Rather,
Change large portions to regular portions.
Stop getting seconds.
Reduce late-night snacks.
Finish just before you feel full.
This is simpler.
Obesity and an increase in body fat percentage are associated with serum uric acid levels, and proper energy intake and weight management are considered important elements of lifestyle guidance for hyperuricemia.
NICE also states that being overweight or obese can potentially worsen gout attacks and symptoms.
However, there is no need to try to lose weight drastically in a short period of time.
Returning little by little to an amount you can maintain for the rest of your life
is more realistic.
Rule 7: Combine vegetables, soy products, dairy products, etc.
If you only focus on "avoiding things that are bad for gout," eating becomes a struggle.
Therefore, I believe that
thinking about what to eat at the same time as what to reduce
is important.
For example,
vegetables
seaweed
tofu
natto
eggs
fish
moderate amounts of meat
dairy products
and so on.
In dietary guidance for hyperuricemia, a well-balanced diet that incorporates vegetables and low-fat dairy products is a useful reference. Regarding dairy products, especially low-fat dairy products, reports suggesting a link to a reduced risk of gout have also been introduced.
There is no magic food that will prevent gout just by eating it.
Eat a variety of foods in appropriate amounts.
In the end, this basic principle is the strongest.
Chapter 5: The final rule is to "keep a record"
Rule 8: Check not only your diet but also your uric acid levels
This is the most important part.
"I haven't had an attack lately, so I'm fine."
That is not necessarily true.
Urate crystals, which cause gout, can remain a problem even during periods without symptoms.
The American College of Rheumatology strongly recommends a treatment target of maintaining serum uric acid levels below 6 mg/dL for gout patients who require urate-lowering therapy.
Therefore,
body weight
alcohol consumption
dietary content
presence of attacks
uric acid levels
should be checked regularly.
This is how to break free from "gout management based only on feelings."
I believe the most dangerous thing in gout management is
"thinking you are cured because the pain is gone"
to think that way.
Dietary improvement is important.
However, diet is only part of the treatment.
For those who need it, medication is also important. Do not discontinue urate-lowering drugs on your own, and please consult with your doctor while undergoing regular blood tests.
Summary: The shortcut to zero gout attacks is not "perfection" but "8 daily rules"
Here is a summary of the 8 points introduced this time.
Avoid dehydration
Reduce alcohol
Do not make sugary drinks a habit
Do not overeat high-purine foods
Do not drink up the broth or soup
Be mindful of eating until you are 80% full
Combine vegetables, soy products, dairy products, etc.
Check not only your diet but also your uric acid levels
Gout management is not about having a perfect diet for just one day.
It is better to maintain a 70% perfect diet for a year than a 100% perfect diet for three days.
I believe that is more important.
Having lived with gout for many years myself, I have come to value adding habits that can be sustained without strain one by one over a life spent counting 'things you must not eat'.
You don't need to change everything starting today.
To begin with,
'Switching from sugary drinks to water'
'Eating until 80% full at dinner'
'Leaving the ramen soup'
Just one of those is enough.
If you accumulate small choices over 365 days, your eating habits will change significantly.
And you will be able to gradually distance yourself from the daily fear of gout attacks.
On my note, I will continue to share my personal experience of living with gout for a long time, reviewing dietary habits, tips for not consuming too many carbohydrates, and ways to sustain a light diet without strain and more.
'I want to keep the next gout attack as far away as possible'
If you feel that way, please be sure to continue reading the related articles as well.
Reference Materials
The Japanese Orthopaedic Association's "Gout" page provides an explanation for the general public regarding the causes, symptoms, examinations, and treatments of gout.
The Japan Gout and Uric Acid Foundation introduces the purine content in foods and beverages, as well as a recommended daily intake guideline of approximately 400mg.
Patient information from the American College of Rheumatology explains management that combines diet and lifestyle habits with pharmacotherapy, as well as treatment goals for serum uric acid levels.
The NICE clinical guideline for gout provides lifestyle guidance regarding weight management and excessive alcohol consumption.
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#Hyperuricemia
#UricAcidLevel
#DietaryImprovement
#HealthyHabits