However, the risk is short-term and improves once your body adapts to being in ketosis. Secondly, it should be stressed that all low-carbohydrate diets should have negligible amounts of sugar and refined carbohydrates. This is critical because there is growing evidence to suggest a strong association between sugar intake and gout risk. If this relationship is ultimately proven to be causal, low-carbohydrate diets would be considered a therapeutic tool to reduce the risk of gout, 3 Read on to learn the definition of gout, how to avoid it and how a low-carbohydrate diet can affect it.
Gout is a sudden and painful inflammation of a joint, most often at the base of the big toe (see picture). It can also affect other joints, such as the heels, knees, wrists and finger joints. Gout is caused by high levels of uric acid in the blood, which causes crystals to be deposited in the affected joint. Gout is more common in people who are overweight and have metabolic syndrome.
Given the increasing prevalence of these conditions in recent decades, gout now affects 6 per cent of adult men and 2 per cent of women (it is even more common in older people). In addition, there is real concern about healthy user bias in these studies, in that those who consume large amounts of meat as part of a typical Western diet may engage in other unhealthy behaviours that increase the risk of gout, 7 It is therefore important to note that epidemiological studies cannot demonstrate that meat directly increases the risk of gout. Furthermore, we must recognise that nutritional research often yields contradictory results for the same topic, such as a study that showed that vegans had higher uric acid levels than meat and fish eaters, 8 Does this mean that vegans have the highest risk of gout attacks? No, we cannot conclude that based on these data, and the bottom line is that we should view the results of nutritional epidemiology studies with a healthy dose of scepticism. In fact, there is a striking history of gout suddenly becoming common in populations just as sugar consumption began to rise sharply (e.g., in Britain during the 18th century).
In Britain during the 18th century, parallel to the birth of the country's sugar industry). It is well known that fructose (present in sugar-sweetened beverages, among other things) directly increases blood uric acid levels, 11 In addition, elevated blood insulin levels - associated with a diet rich in sugar and refined carbohydrates - have been shown to increase uric acid levels, 12 Furthermore, although such studies cannot prove that fructose causes gout, we believe that the combination of consistent mechanistic and observational data makes a compelling case for avoiding fructose to reduce the risk of gout. Short-term studies show a temporary increase in uric acid during the first few weeks of starting a strict low-carbohydrate diet (i.e., this effect seems to disappear after about six weeks, with uric acid returning to baseline or even lower, 14 After dozens of high-quality studies comparing low-carbohydrate diets with other diets, there appear to be none that note an obvious difference in gout risk, although no study has focused specifically on this question. Physicians who regularly treat patients on low-carbohydrate diets do not notice an abrupt increase in gout episodes, even during the initial period, 17 If there is an increase in risk during the first few weeks, it is probably small.
In addition, these lifestyle modifications have many other positive effects on weight and health. Since a temporary increase in uric acid may occur during the first few weeks of a strict low-carbohydrate diet, some recommend that people who have previously had problematic gout attacks consider using the drug allopurinol while starting to consume carbohydrates. Edward Skol of the Scripps Clinic cautions against the temporary use of allopurinol for this purpose; it is known to initially increase the risk of an acute attack when started (and when stopped) without the use of additional gout medications. This is supported by the official guidelines of the American College of Rheumatology, which strongly recommend only starting allopurinol in conjunction with a medication such as colchicine or ibuprofen to decrease this initial risk, 22 In Dr Skol's practice, if medication to prevent gout attacks is desired at the start of a low-carbohydrate diet, he most commonly uses only colchicine or ibuprofen without allopurinol.
He also summarises: "The best advice is probably to avoid dehydration when starting a ketogenic diet. Also, keep in mind that a low-carbohydrate diet doesn't have to be especially high in meat anyway. There are plenty of other foods to meet your protein needs. A well-formulated low-carb diet that reduces sugars and refined carbohydrates could potentially reduce the risk of gout in the long term, 24 Recipe Collection Whether you're looking for strict, moderate or liberal low-carb ketogenic recipes, here are more than 700 delicious low-carb recipes to choose from.
Do you have any suggestions - big or small - for improving this page? Anything you'd like to add or change? Any other issues you'd like to see addressed? How to follow a healthy keto vegetarian diet. How to eat low-carb as a vegan ↩ Very low-carb diets studied in the literature typically include less than 30 grams of carbohydrates per day, while moderate to liberal low-carb trials may include up to 50 or 100 grams of carbohydrates, respectively. Observational studies have found an association between sugar intake and gout risk. More evidence is needed to demonstrate a cause and effect relationship.
The following study showed a very weak association between certain sources of animal protein intake and gout risk. However, those with gout also drank more alcohol, were more likely to have hypertension and ate more total calories. This meta-analysis of observational studies showed that fructose and alcohol consumption correlated most strongly with gout risk, more so than meat and seafood consumption. Sugar is likely to be worse than other carbohydrates because of the potency of fructose to raise uric acid.
Beer contains not only alcohol, but also rapidly digested carbohydrates, which increases insulin and thus reduces uric acid excretion. Of lesser importance, beer also contains purines. This study showed that most types of alcohol, even in moderate amounts, increased the risk of gout. However, it is likely that none of the participants followed a low-carbohydrate diet.
We comply with the HONcode standard for reliable health information. So the ketogenic diet does not cause gout. You'll find that people with gout actually have fewer flares of their gal bladder and they have less severe flares of their gout. There are actually two things that cause gout.
It's the high insulin levels that occur because of chronic inappropriate inflammation in your joints, that's what causes gout. Insulin is the high inflammation that happens because of eating a high carbohydrate diet full of grains and full of vegetable oils. That's what causes gout, not keto. Proponents of the keto diet believe it can also be helpful in controlling diabetes, Alzheimer's, and more.
It is possible to do a vegetarian keto diet, but most people who keto get most of their protein from animal sources. There is no data available to suggest that the keto diet can help target the source of inflammation to prevent acute symptoms of gout. Overall, it appears that the ketogenic diet may increase the risk of gout in the first few weeks, while it may reduce the risk as the body burns more ketones for fuel. A ketogenic diet is typically high in purine-rich animal protein foods, which makes keto a counterintuitive choice for gout management.
Keto Breakfast Bars Best Keto Breakfast Bars Recap Breakfast can be a challenging meal to make time for when you're busy or on the go. However, there has been limited research that addresses long-held beliefs about diet and gout, suggesting that keto may help in the management of painful gout symptoms, but more research is needed. The results have been promising; however, scientists say more research is needed before a keto diet can be recommended to help keep gout under control. This also means that because the keto diet stimulates the production of BHB, it has the ability to alleviate symptoms and prevent gout attacks.
Interestingly, the keto diet is very effective in promoting weight loss, reducing inflammation and eliminating many of the foods and drinks that trigger gout. Although the data are positive, the researchers concluded that more trials are needed before the keto diet can be used as a therapy for gout.