Can a keto diet reduce the risk of gout?
Summing-up: Stay on a healthy keto diet and you will lower your risk of getting gout.
Gout and low carb
GoutIt’s occasionally claimed that low-carb or keto diets high in meat often cause gout.
This does not appear to be true (nor does a low-carb diet have to be high in meat).
New research examines the effects of a high-fat, low-carb ketogenic diet on both rodents and humans, and suggests that it can ease the symptoms of gout.
However, there may possibly be a temporary increase in the risk of gout during the first six weeks on a strict low-carb diet.
After this initial time period, a low-carb diet is likely neutral, or even protective, when it comes to gout.
Keep reading to find out what gout is and how to avoid it.
What is gout?
Gout is a sudden and painful inflammation of a joint, most often at the base of the big toe.
It may also affect other joints, like heels, knees, wrists and finger joints.
The cause of gout is elevated levels of uric acid in the blood, resulting in crystals depositing in the affected joint.
Gout is more common in people who are overweight and have metabolic syndrome and have therefore become more common in recent decades, affecting about 6% of adult men and 2% of women (it’s even more common in older people).
Historically, it was known as “the disease of kings” or a “rich man’s disease”, but now everyone can afford sugar.
Meat and gout.
Gout has often been blamed on excessive consumption of meat.
This is because the uric acid that causes gout is a breakdown product of purines, a building block of protein, that is highly concentrated in meat.
However, avoiding meat seems to have little effect on the risk of gout, and even vegetarians get gout much more often than would be expected if this was the main cause.
Eating more protein (like meat) seems to increase the excretion of uric acid from the kidneys, through the urine, thus not having much of an effect on the blood uric acid levels or the risk of gout.
Sugar and gout.
There is a very strong connection between gout, obesity, type 2 diabetes, and metabolic syndrome.
It is possible that they are all primarily caused by the same thing: sugar and other refined carbohydrates.
In fact, high blood levels of insulin – a consequence of a diet high in refined carbs have been shown to increase uric acid levels, probably by decreasing the excretion of uric acid by the kidneys.
There is a striking history of gout suddenly becoming common in populations just as sugar consumption started to rise sharply (e.g. in Britain during the eighteenth century, paralleling the birth of the country’s sugar industry).
There’s also experimental proof, showing that consuming fructose (a main component of sugar) sharply increases levels of uric acid in the body.
Alcohol and fructose are metabolized in similar ways in the body, and alcohol increases uric acid levels in the same way as fructose.
Low carb, uric acid, and gout.
Short-term studies show a temporary raise in uric acid during the first few weeks when starting a strict (i.e. keto) low-carb diet.
This effect seems to disappear after about six weeks, with uric acid returning to baseline or even lower.
Almost all of my patients who are successful in low-carb diets eventually become gout-free and have low uric acid levels.– Dr. Ted Naiman
Studies show no meaningful change in uric acid levels in people doing a low-carb diet over several months or years.
The exception is one study that actually showed uric acid going down significantly after 6 months on low carb, suggesting it may decrease the risk of gout.
After dozens of high-quality studies comparing low-carb diets to other diets, there seems to be none noticing any obvious difference in the risk of gout.
Although no study has focussed on this specific question in detail.
Doctors regularly treating patients with low-carb diets apparently do not notice an increase in gout episodes even during the first time period.
So if there exists an increase in risk during the first few weeks it is likely small or moderate.
Long-term uric acid levels tend to become low on a low carb diet, along with other markers of metabolic syndrome.
And even patients that used to suffer from gout can potentially become gout free.
However, it might take months or even years to completely reverse their insulin resistance and achieve normal levels.
How do you avoid getting gout?
- Minimize the intake of sugar.
- Reduce the intake of alcohol. Particularly avoid beer and other high-carb alcoholic drinks.
- Lose excess weight and reverse metabolic syndrome. Low carb is a good treatment, as is intermittent fasting.
As a bonus, these lifestyle changes have many other positive effects on weight and health.
However, if they are not enough, the drug allopurinol is highly effective in preventing gout.
Given that there may be a momentary rise in uric acid during the first few weeks on a strict low carb diet.
People who’ve previously had troublesome gout attacks may want to consider using the drug allopurinol while starting low carb, starting.
Taking the drug at least a week in advance, to minimize any risk of a new gout attack.
Should you eat meat or no meat?
Shunning meat should not be necessary or efficient when it comes to gout prevention.
Besides, please note that a low-carb diet is not supposed to be an especially high protein or high meat anyway.
An effective low-carb diet should be moderate in protein and instead of high in natural fat.
A well-formulated low-carb diet (i.e. a low-carb, high-fat diet) likely reduces the risk of gout long term.
Conclusion: Stay on a healthy Keto diet and you will lower your risk of getting gout.
A keto diet can be really simple, but it helps to learn some basic skills.
These tips and guides will help you answer all the common keto questions.
Click here for An Easy Detailed Guide to Follow for Beginners to The Keto Diet.