Hubby and I have been happily low carbing now for six years. But recently (as in over the past 6 months of so) he has been having recurring gout issues. Very painful. He had had one or two, much more minor, gout flare ups previously but, all of a sudden, he seems to barely get past one flare up when another one occurs.



Needless to say, pretty much all the gout diet advice available "out there" seems to point 180 degrees away from low carb. Like every other "accepted" diet, gout diet advice seem to be all about "low fat" and "healthy whole grains." BAH! I don't buy it.



Hubby wants to stay low-carb (thank goodness) because LC has allowed him to handle his T2 diabetes all these years without medication. But, now he's also worried about eating any beef, bacon, organ meats, shrimp, sardines, trout, spinach, broccoli, cauliflower, mushrooms... anything that the various gout sites describe as "purine rich." And the list of banned foods for gout sufferers turns out to include a whole host of the foods that have been staples in my cooking for the past 6 years!



I've been trying to do combined ow-purine low-carb cooking for about a month now and I am at my wits end! And, I'm already SICK to death of chicken and lettuce salads.



Besides which, I found this research paper online where a group in Japan has actually measured the amount of purines in 100g samples of various foods. If I'm reading the charts correctly, it looks to me like 100g of chicken (breast, thigh or leg) has as much or more purine - including the xanthine form - as does 100 g of beef sirloin or 100g of BACON! Yet chicken is supposed to be safe for gout sufferers but beef is a huge no-no. What gives? Hoping maybe one of our scientist types can give me some insight.



Also, if you're also a gout sufferer, which foods actually trigger your attacks? And, what modifications have you made to your LC diet to avoid flare ups.


Honestly, I have a sneaky suspicion that Hubby's recent repeated gout attacks are due to something new that he has started eating - maybe when I'm not around - or to his increasingly sedentary ways and not anything in our long-time LC diet. But how to convince him?

Gout: The Missing Chapter from Good Calories, Bad Calories

https://tim.blog/2009/10/05/gout/

That's interesting



ps, I wonder if he is eating the sugar free candies?

Also, gout is traditionally known as a male disease which tends to target the big toe.

It is underdiagnosed in women, who tend have it appear in the upper extremities, especially the thumbs.

I don't think so. I don't buy 'em and he doesn't seem to have a huge sweet tooth. He has had a few more sugar-free desserts than usual over the last month (after all, we are dealing with the holidays) but gout attacks started back in the summer

I read Taube's missing chapter on gout several weeks ago but thanks for linking it anyway.

Hubby IS the classic gout patient, male, over 65, T2 diabetic, some arthritis, etc. And what he has IS very definitely gout. The ball joint of his big toe joints turn red and swell to the point where I can hardly bear to look at it. Can't begin to imagine how painful it must be to walk on. Result tho is that with recurring gout flare-ups, he is doing much less walking than formerly and I rather doubt being so sedentary is helping his insulin levels. So its a vicious circle.

Taking colchicine at the first sign of a flare up seems to lessen the intensity and duration of the flare... but it is KNOWN to be hard on the kidneys so, obviously, we'd like to avoid him taking it any more than absolutely necessary. Plus, if damaged kidneys make excreting uric acid even more problematic, it seems like taking colchicine could actually worsen the disease in the long term! (Kind of like taking exogenous insulin makes T2 diabetes worse over time!)

Yeah, I'm not convinced it's the meat and purine rich veggies causing his gout. But, I'm not the one suffering. So, other than sending info his way as I find it, ultimately, I feel like I need to feed him whatever way HE chooses to eat.

I may start clucking tho if I keep eating so danged much chicken. Maybe I'll start fixing myself a burger or steak or even some LIVER or Bacon while I fix his chicken. Just hate fixing two separate meals tho. <sigh>

Bev, this is a list I saved a couple of years ago. It may or not help but it's worth consideration.

HEALTH
Histamine-Rich Foods:
•Fermented alcoholic beverages, especially wine, champagne and beer
•Fermented foods: sauerkraut, vinegar, soy sauce, kefir, yogurt, kombucha, etc
•Vinegar-containing foods: pickles, mayonnaise, olives
•Cured meats: bacon, salami, pepperoni, luncheon meats and hot dogs
•Soured foods: sour cream, sour milk, buttermilk, soured bread, etc
•Dried fruit: apricots, prunes, dates, figs, raisins
•Most citrus fruits
•Aged cheese including goat cheese
•Nuts: walnuts, cashews, and peanuts
•Vegetables: avocados, eggplant, spinach, and tomatoes
•Smoked fish and certain species of fish: mackerel, mahi-mahi, tuna, anchovies, sardines

Histamine-Releasing Foods:
•Alcohol
•Bananas
•Chocolate
•Cow’s Milk
•Nuts
•Papaya
•Pineapple
•Shellfish
•Strawberries
•Tomatoes
•Wheat Germ
•Many artificial preservatives and dyes

DAO-Blocking Foods:
•Alcohol
•Energy drinks
•Black tea
•Mate tea
•Green tea

Whew! That was a long list. You might be wondering now what on earth you CAN eat, so I've made a list of low histamine foods as well. Remember that freshness is key when you have histamine intolerance!

Here's a list of low-histamine foods:
•freshly cooked meat, poultry (frozen or fresh)
•freshly caught fish
•eggs
•gluten-free grains: rice, quinoa
•pure peanut butter
•fresh fruits: mango, pear, watermelon, apple, kiwi, cantaloupe, grapes
•fresh vegetables (except tomatoes, spinach, avocado, and eggplant)
•dairy substitutes: coconut milk, rice milk, hemp milk, almond milk
•cooking oils: olive oil, coconut oil
•leafy herbs
•herbal teas

http://www.mindbodygreen.com/0-1117...ntolerance.html

Spices/sauces that might cause problems:
ascorbic acid
autolyzed yeast
BHA and BHT
benzoates
catsup (ketchup)
cayenne
cloves
chili powder
horseradish
hot curry powder
hydrolyzed protein
meat tenderizers
miso
mustard
oleoresin paprika
paprika
pickles
red pepper
soy sauce
tamari
vinegar
worcestershire sauce
MSG – monosodium glutamate
metabisulfites
sulfites
_______

I'm no fan of drugs, but apparently the one referenced in the Taubes article works well for attacks?

IF does wonders for insulin resistance. Is that possible?

How can no doctor have an answer or treatement for Gout? In
this day and age, it just doesn't make sense. It's been an ailment
humans have been suffering from for how long? I remember
stories about my GGGF suffering from it.

I just found this and I was thinking earlier about vitamin C.


https://www.sciencedirect.com/scien...090123217300450

Vinegar...........






*You might also check the acidity level of your water. I buy Mountain Valley Spring Water for that reason. 7.3-7.7PH

https://www.healthline.com/health/g...e-cider-vinegar

Saved these earlier:

Gout and low carb 9-21-2018 [ dietdoctor ]

LC and Gout 4-14-2017

Gout? 3-11-2013

vinegar--- use unpasturize type with the mother to get the good microbes.

Fasting....this popped into my head. Seems to have regenerative effects. A skip day is a 36 hr fast.

Thank you everybody for the suggestions and various links.

Hubby has decided to:
1) greatly increase his consumption of low carb veggies (except spinach and Brussels sprouts...which he doesn't really like anyway),
2) add in a bit more low-sugar high-vitamin-C fruits (cranberries, raspberries, blueberries, and strawberries)
3) increase his consumption of cheese and dairy
4) cut out all processed meats (except a little bacon now and then) and very high purine meats like shrimp and organ meats,
5) cut back on meat proteins in general, and
6) maintain or slightly increase his consumption of fats, especially omega 3s and omega 9s.

We'll try this for a few months and see how it goes.

To accomplish his new dietary plan, he has decided to have a low-carb vegetable salad every day for one meal...supplemented with some nuts or some hard boiled egg for a little very-low purine protein. Then, for his second meal, he'll eat whatever I choose to fix (as long as it isn't based on a very-high purine organ meat or shrimp). We've long been inthe habit of having salmon once or twice a week and he has decided that two or three servings per week of pork, hamburger, etc. should be "okay." So at least I'm no longer looking at fixing chicken-based meals seven days a week anymore!

Fortunately, since hubby knows I have never been a salad-lover and don't at all enjoy all the washing and drying and chopping and tearing that goes into making a decent salad, he says he'll make his own salads. HIP HIP HOORAY!!! In return, I have promised NOT to fix shrimp, sausage, or liver-based meals for him.

So far, from my point of view anyway, this is working out GREAT! I can fix my own steak, hamburger, shrimp or organ-meat based meal while he fixes himself a salad at lunch. Or, if I'm not hungry, I can just FAST without having to cook a meal at all. Since he has started fixing his own salads (usually at lunch time), I've been able to get in a number of 24 hr fasts.... something I could never manage when fixing two meals a day for him. As I'm sure y'all would agree, fasting isn't all that difficult when one simply stays out of the kitchen. But trying to do it WHILE cooking for someone else requires more will-power (won't-power?) than I have ever been able to muster!

Whether his new diet plan will solve hubby's gout issues, I don't know. He is still having his daily glass of wine in the evenings and he still likes to have a brew-pub beer every now and then with friends. Though he now limits himself to a single beer or glass of wine (due to his T2 diabetes) if Dr. Ken Berry is right, alcohol in any form exacerbates gout and craft beers can be the worst!

But, at least hubby IS sticking with his low-carb regimen. Six years experience with very successfully managing his T2 diabetes while watching several friends (who were diagnosed about the same time as he was) go rapidly downhill on their eat-whatever-you-want-and-take-medications plans has him 100% convinced that, gout or no gout, he simply HAS to stay low-carb! Gout is painful but diabetes KILLS.

BTW - I also ran across this video by Dr. Ken Berry about treating gout with diet. Except for his small amounts of alcohol, hubby is - and has been - following all Dr. Berry's suggestions. We'll see if also reducing his consumption of purine-rich foods will make the necessary difference. So far, after about 1 week, he says his foot feels great. I'll try to remember to update as his n=1 experiment continues.

Good luck. Fingers crossed.

Good video Dr Barry. I f we keep to keto, we have good control of gout. Its about keeping insulin levels low.

How many times have we heard this....

Glad to hear! For both of you Sounds like he's really motivated and that is crucial.