In a response to a TV episode on the show Royal Pains, I analyze the claims that a high fat diet will necessarily lead to the pain associated with gout and gout attacks. The conventional wisdom seems often analogous to popular, but wrong cholesterol theorem that dietary cholesterol leads to increased cholesterol in the blood. Is the popular theory right?
What is Gout?
Gout is a form of arthritis that occurs when abnormally high levels of uric acid build up in the body, causing crystals to form in joints. The crystals cause sudden, severe attacks of joint pain and swelling. Uric acid is a substance that is normally released by the kidneys when the body breaks down waste products called purines. When the kidneys are no longer able to flush uric acid out of the body properly, it crystallizes and accumulates around the joints.
Misconception that Atkins is only acidic foods:
Extremely Alkaline Forming Foods - pH 8.5 to 9.0:
Cantaloupe, Cayenne (Capsicum), Kelp, Melons, Watercress, Seaweed
Moderate Alkaline Forming Foods - pH 7.5 to 8.0
Alfalfa sprouts, Avocados, Berries, Carrots, Celery, Lettuce (leafy green), Peas (fresh sweet), Pumpkin (sweet), Spinach, Bell Pepper, Broccoli, Cabbage, Kale, Kohlrabi, Lettuce (pale green), Strawberry, Squash , Sweet corn (fresh), Sour Dairy
Slightly Alkaline to Neutral Forming Foods - pH 7.0
Almonds , Artichokes (Jerusalem), Brussel Sprouts, Coconut (fresh), Cucumbers, Egg plant, Onions, Tomatoes (sweet), Mayonnaise (home made), Millet, Olive oil,
"Red" meat and seafood on the Atkins diet
If you look at this table of high purine foods , you'll see that beef, lamb, pork, plus "white" meat chicken and turkey - all allowable on the Atkins diet - are not high purine foods, they are medium purine. And that fruits and vegetables, many of which are allowable, on the Ongoing Weight Loss phase of the Atkins diet, are usually medium or low purine. Moreover, a large study found that purines-wealthy vegetables do not increase the risk of getting gout (7).
Gout the missing chapter from Good Calories, Bad Calories Gary Taubes
"The actual evidence, however, has always been less-than-compelling: Just as low cholesterol diets have only a trivial effect on serum cholesterol levels, for instance, and low-salt diets have a clinically insignificant effect on blood pressure, low-purine diets have a negligible effect on uric acid levels. A nearly vegetarian diet, for instance, is likely to drop serum uric acid levels by 10 to 15% percent compared to a typical American diet, but that's rarely sufficient to return high uric acid levels to normality, and there is little evidence that such diets reliably reduce the incidence of gouty attacks in those afflicted.(4) Thus, purine-free diets are no longer prescribed for the treatment of gout, as the gout specialist Irving Fox noted in 1984, "because of their ineffectiveness" and their "minor influence" on uric acid levels.(5) "
Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study
Hyon K Choi
BMJ 2008; 336
In a huge study of 46,393 male health professionals in Canada, a survey was carried out and then they were followed every four years for 12 years. 2 cans a day consumption of HFCS-soda led to 85% greater risk to suffer gout.