What is Gout?

Gout is a type of arthritis characterized by painful, stiff and inflamed joints. The stiffness and swelling are a result of excess uric acid forming crystals in your joints, and the pain associated with this disease is caused by your body’s inflammatory response to the crystals.2

So What is Uric Acid?

Uric acid is a normal waste product found in your blood. High levels of uric acid are associated with gout, which is a type of painful arthritis and inflammation, and about half the time, targets the base of the big toe.  Uric acid functions both as an antioxidant and as a pro-oxidant once inside your cells. So, if you lower uric acid too much, you lose its antioxidant benefits. But if your uric acid levels are too high, it tends to increase to harmful levels inside your cells as well, where it acts as a pro-oxidant. When the metabolic processes that control the amount of uric acid in your blood fail to do their job effectively, gout occurs.

The Causes of Gout:

Diet, lifestyle and genetics to a lesser extent.  If either or both of your parents had gout, you have a higher predisposition to getting it.5 That means your children also are at risk for gout. But simply reducing your intake of sugar-sweetened beverages during childhood could lessen the risk of gout as an adult. At the most basic level, a gout attack usually results from years of having high levels of uric acid in your blood, a condition called hyperuricemia.7 While uric acid normally dissolves in your blood and passes harmlessly through your kidneys, it’s possible for your body to either produce too much uric acid or excrete too little in your urine. The resulting buildup of uric acid forms needle-like crystals in your joints and surrounding tissues that causes the intense pain.

Main Food Causes:

Although gout is commonly blamed on eating too many high-purine foods, such as organ meats, anchovies, herring, asparagus and mushrooms, there is another clear culprit: high-fructose corn syrup (HFCS).10Countless health problems have been linked to the consumption of HFCS, not the least of which is gout. A recent study showed that consumption of sugar-sweetened soft drinks is strongly associated with an increased risk of developing gout.11

The study, done by U.S. and Canadian researchers, indicated that men who drank two or more sugary soft drinks a day had an 85 percent higher risk of gout than those who drank less than one a month. In fact, the risk significantly increased among men who drank five to six servings of sugary soft drinks a week. Fruit juice and fructose-rich fruits, such as oranges and apples, also increased the risk.12 This makes sense on many levels, but first and foremost because fructose is known to inhibit the excretion of uric acid.   Fructose also reduces the affinity of insulin for its receptor, which is the principle characteristic of type 2 diabetes.13 Further, HFCS has been implicated in elevated blood cholesterol levels, and it has been found to inhibit the action of white blood cells in your immune system.14

Cut back on the alcohol.  Gout is often seen in association with hypertension, excessive alcohol consumption,30 and coronary artery disease,31 so alcohol is a strong risk factor for this disease.

Best and worst foods to eat if you have Gout:

For those who are particularly sensitive to fructose, Dr. Johnson has developed a program to help people optimize their uric acid levels, and the key step in this program is complete elimination of fructose, until your levels are within the ideal range of 3-5.5 mg/dl. The chart below is excerpted from Dr. Johnson’s book, The Sugar Fix, which contains more details on the fructose content of common foods. You can use it to help you cut back in your diet:

Fruit Serving Size Grams of Fructose
Limes 1 medium 0
Lemons 1 medium 0.6
Cranberries 1 cup 0.7
Passion fruit 1 medium 0.9
Prune 1 medium 1.2
Apricot 1 medium 1.3
Guava 2 medium 2.2
Date (Deglet Noor style) 1 medium 2.6
Cantaloupe 1/8 of med. melon 2.8
Raspberries 1 cup 3.0
Clementine 1 medium 3.4
Kiwifruit 1 medium 3.4
Blackberries 1 cup 3.5
Star fruit 1 medium 3.6
Cherries, sweet 10 3.8
Strawberries 1 cup 3.8
Cherries, sour 1 cup 4.0
Pineapple 1 slice (3.5″ x .75″) 4.0
Grapefruit, pink or red 1/2 medium 4.3
Fruit Serving Size Grams of Fructose
Boysenberries 1 cup 4.6
Tangerine/mandarin orange 1 medium 4.8
Nectarine 1 medium 5.4
Peach 1 medium 5.9
Orange (navel) 1 medium 6.1
Papaya 1/2 medium 6.3
Honeydew 1/8 of med. melon 6.7
Banana 1 medium 7.1
Blueberries 1 cup 7.4
Date (Medjool) 1 medium 7.7
Apple (composite) 1 medium 9.5
Persimmon 1 medium 10.6
Watermelon 1/16 med. melon 11.3
Pear 1 medium 11.8
Raisins 1/4 cup 12.3
Grapes, seedless (green or red) 1 cup 12.4
Mango 1/2 medium 16.2
Apricots, dried 1 cup 16.4
Figs, dried 1 cup 23.0


What Should You Eat?

Limiting fructose in your diet is one of the most important parts of managing and preventing gout attacks, and you can find a simple guide for doing so using my nutrition plan. You’ll want to be sure to cut out soda, fruit drinks, and other sweetened beverages, as these types of drinks are a primary source of excessive fructose. Instead, drink plenty of pure water, as the fluids will help to remove uric acid from your body. Other top tips include:

Limit Alcohol Consumption, Especially Beer: Gout is more likely if you drink too much alcohol but beer in particular may be problematic. It turns out that the yeast and all that’s used to make beer work together to make beer another powerful uric acid trigger. While this concept is still new, pilot studies support Dr. Johnson’s findings, so beer consumption is also something to definitely consider when you’re watching your weight and trying to improve your health.

Eat Tart Cherries in Moderation: Cherries contain powerful compounds like anthocyanins and bioflavonoids, which are known to fight inflammation and may help lower your uric acid levels.5 If you eat cherries for their therapeutic value, 10 sweet cherries or 1 cup of sour cherries contain about 4 grams of fructose, so be sure to take that into account for your total daily fructose consumption.

Avoid Soy Milk: There is some research showing it may increase uric acid levels by about 10 percent.6

Consider Therapeutic Herbs: Certain herbs and spices, including ginger,7 cinnamon,8 and ashwaganda,9 have been shown to potentially help relieve gout symptoms and its associated inflammation.

Eat More Potassium-Rich Foods: Potassium deficiency is sometimes seen in people with gout, and potassium citrate preparations, which are known to alkalize your urine, may help your body to excrete uric acid.10 A proper balance of potassium both inside and outside your cells is crucial for your body to function properly, but if you eat a highly processed diet (the same type often associated with gout), you may not be getting enough. Potassium is widely available in fruits and vegetables, but I’ve included some of the most beneficial sources below. If you want to supplement, consider using potassium bicarbonate, which is probably the best potassium source to use as a supplement. I personally use it every night in my dental irrigator.

Swiss chard (960 mg of potassium per 1 cup) Avocado (874 mg per cup) Spinach (838 mg per cup)
Crimini mushrooms (635 mg in 5 ounces) Broccoli (505 mg per cup) Brussels sprouts (494 mg per cup)
Celery (344 mg per cup) Romaine lettuce (324 mg per 2 cups)


Exercise Will Help:

While exercise is not recommended while your joints are in pain or when it might cause further injury, once your gout is under control, exercise is needed as a necessary adjunct to a healthier lifestyle. Exercise will even help prevent further attacks by increasing circulation and normalizing your uric acids levels, which it does primarily by normalizing your insulin levels.39 An exercise routine has other advantages as well. Studies have shown that it works as an effective antidepressant,40strengthens your immune system so it can fight off diseases like cancer,41 and it can even improve insulin resistance and reverse pre-diabetic conditions.42


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