Q: Is the Paleo diet alright for someone who has diabetes and gout?
A: The short answer is yes. Here’s the long answer. Gout is a painful condition that occurs when uric acid crystals accumulate around a joint, often the big toe, ankle or knee. According to the Mayo Clinic, “gout has long been associated with diet, particularly overindulgence in meat, seafood and alcohol.” Oh! So that’s why whenever I overindulge in salmon, with all its good fats, antioxidants and protein, my big toe usually starts throbbing… (You’ll have to excuse my cynicism with this one; conventional medicine’s take on this topic is SO off base.)
Anyway, sometimes people (often men and women over the age of 40) will just have one “gouty attack” and some people suffer frequent, debilitating pain in several joints. Either way, gout is due to high levels of uric acid in your body.
Conventional “Treatments”
The conventional treatment for gout is NSAIDS (like ibuprophen), strong pain killers, prescription meds for inflammation and swelling, corticosteroids, and of course, a pharmaceutical to reduce uric acid blood levels.
Doctors may also tell you to stop eating foods that are high in purines, since purines convert to uric acid in your body. High purine foods include anchovies, sardines, herring, organ meat (liver, kidney, and sweetbreads), legumes (dried beans and peas), gravies, mushrooms, spinach, asparagus, cauliflower, and baking or brewer’s yeast. Comparatively, meats and seafood all have only moderate amounts of purines, but the diet that conventional medicine practitioners prescribe to gout sufferers is low in all meat.
In fact, the diet they prescribe goes something like this: limit animal protein intake, eat more plant-based protein, don’t drink much alcohol, eat low-fat or fat-free dairy products, and eat more grains. The truth is that I don’t know anyone who overeats calf’s neck as their main animal protein source (one of the highest purine foods at 1260mg per 100g), but they’re telling you to eat soy beans (190mg of purines per 100g), which have MORE purines in them than beef sirloin (110mg of purines per 100g) or salmon (170mg of purines per 100g). It just doesn’t make any sense…
According to the Mayo Clinic, the “severe dietary restrictions made the gout diet hard to stick to. Fortunately, newer medications to treat gout have reduced the need for a strict gout diet.” Thank God. I mean, we wouldn’t want to look at the real causes of those high uric acid levels and try to work on those – we should just treat the pain and stifle the levels of uric acid, regardless of the side effects…
What we need to look at here is why uric acid levels are high. Is it because of the amount of uric acid that’s coming into your blood stream from your liver (a mere 1/3 from diet and 2/3 from your body’s turnover of cells)? Or is it because your kidneys aren’t excreting the uric acid as they should?
Kidneys’ Role
The fact that the person writing in has diabetes AND gout is not uncommon. In fact, gout is often associated with diabetes, metabolic syndrome and insulin resistance because all of the above decrease the kidneys’ ability to excrete uric acid from the body. Because the Paleo diet helps to reverse insulin resistance, metabolic syndrome and diabetes, it would therefore decrease the amount of uric acid that is in your body; your kidneys can’t do their job when they’re overloaded with an acid-forming, sugar-coated standard American diet. Diabetes is caused by eating too many refined, high-glycemic foods. You know the type – sugary sodas, refined flours in pastas, pastries, “sports” drinks, candy bars – sugar, sugar, sugar… The Paleo diet doesn’t have too many of those items on the menu.
Liver’s Role
So we’ve covered the excretion of uric acid by the kidneys; what about the liver’s role in creating too much uric acid? Will the Paleo diet help that? Consumption of sweeteners, including the ubiquitous high fructose corn syrup, increases the liver’s production of uric acid. The Paleo diet, which is incredibly low in sweet foods, much less sweeteners (really, it only allows for fruit and a tiny bit of honey), would help to decrease the amount of uric acid being produced by the liver.
So yes, go ahead and try out the Paleo diet if you have gout. Please. Since conventional medicine’s advice will be to eat foods like low-fat dairy products that may actually increase insulin resistance, and cut out meat, which actually helps to decrease insulin resistance, I think that Paleo is a far superior option.
![Pin It](http://pinterest.com/pin/create/button/?url=http://www.paleoplan.com/2011/04-01/qa-gout-and-paleo/&media=http://www.paleoplan.com/wp-content/uploads/2011/04/Screen-shot-2011-04-01-at-10.16.01-AM-300x254.png&description=Q: Is the Paleo diet alright for someone who has diabetes and gout?</p><p>A: The short answer is yes. Here's the long answer. Gout is a painful condition that occurs when uric acid crystals accumulate around a joint, often the big toe, ankle or knee. According to the Mayo Clinic, "gout has long been associated with diet, particularly overindulgence in meat, seafood and alcohol." Oh! So that's why whenever I overindulge in salmon, with all its good fats, antioxidants and protein, my big toe usually starts throbbing... Continue reading →){kind=link}
7 Comments
My Gout pain has been so bad in the past and I have been looking for information on relief for sometime. This post is just what I needed…Great information
Charles Zucker
I have been doing 80% paleo for about 5 months, and I’ve lost about 35 lbs since beginning (weight loss, and overall improvement in general health, were the main reasons I went on the diet). Unfortunately, I have a history of gout, and while I had few problems with gout during this diet, a couple of weeks ago I had a short-term flare-up, and now I am having the worst flare-up of my life. It’s really bad. I’m in no way ready to abandon paleo (particularly because this flare-up came after a weekend of not being on the diet – if anything, I’m ready to commit to 100% paleo), but I do wonder if I should take it easy on the meat consumption while I’m actually in the midst of an acute attack. I’m just trying to get through this, as the NSAIDs are only making the pain (barely) tolerable. I’ve switched to a diet where I’m getting my protein from aged cheese, cottage cheese, high-fat greek yogurt, eggs, and some meat (not a lot), I’ve added some sweet potato into the mix, more nuts than before, lots of salad and veggies – still trying to avoid processed sugars and grains and legumes. Anyway, do you think I should just stay on a traditional paleo diet while in the midst of an acute attack? I mean, I’d do just about anything to get rid of this pain right now.
Dara
Hi Dara,
I’d say go as strict Paleo as you possibly can, especially take out that dairy and see if you improve. Stay away from those high glycemic foods like grains, legumes and too many starchy veggies for now during this flare up. Please keep us posted.
Neely
Thank you for the comment, Neely. I have been staying away from most high-glycemic foods, same as before the attack, though I have added sweet potatoes (which I understand not to be high-glycemic, though not low either). The dairy is something I just started having instead of meat a few days ago when the attack struck me, so it certainly is not a cause (though high-fat yogurt is a common cheat for me). I doubt it’s making it worse, but who knows? I’ll try to stick with strict Paleo during the acute attack, but wow, these gout attacks pretty much make me fear afraid to eat any of the higher-purine foods. My foot still hurts like a @$#@%$@#. Ugh.
Dara
The gout attack is slowly improving, but lingering. I’m on NSAIDs for the pain, and I thought I could go off a few days ago, but bad mistake, so I’m back on them. I’ve been mostly paleo compliant (with some plain yogurt), and I’m continuing to lose weight, which is good, I guess, but also something that is known to aggravate gout (being slim is good, the process of losing the weight, however, is known to aggravate gout). I must say, this is the longest acute attack I’ve had (and unusually, it hit both feet, though one much less than the other, thankfully). Anyway, any advice from a fellow paleo/primal enthusiast on what s/he did DURING an acute attack would be much appreciated. Thank you!
Dara
To Dara:
Google up: gout and citric acid.
I started putting citric acid into my pot of tea every day to keep cups from getting stained, and my gout attacks stopped. I was puzzled. Then I googled it up. But nobody makes any money on citric acid. So much of our body chemistry is still to be discovered.
Mary Sunshine
After about three months of hell on my feet, the gout is gone. It’s fair to say I’ve reached a state of acute gout, and it’s fair to say that primary care physicians seem to know little about this condition other than what was taught 30 years ago and which has pretty much been disproven (e.g., don’t eat too much meat, eat a lot of whole grains, etc.). One common home remedy that seemed to help me a lot is to drink water with baking soda (bicarbonate). The theory is that this alkalinizes the body, allowing the uric acid crystals to dissolve, removing the cause of the inflammatory attack that causes pain in an acute gout attack. I didn’t try this until the end of my gout attack, when little attacks kept coming back every few days in different joints. This finally stopped the attacks for the most part. Of course, one should be careful not to try to glean too much from a non-controlled study with a sample size of one, but I’ll try it next time I get an attack. I was aware of citric acid being another home remedy, and this doesn’t surprise me. Occasionally you see advice out there saying not to take citric acid or citrus fruits with gout because they are acidic, and acidity facilitates gout. This is extremely poor advice and a good example of how a little knowledge can be a dangerous thing, because citric acid, when metabolized, actually produces byproducts that have an alkalinizing effect on the body. To this end, citric acid may be good for gout in the same way baking soda may be good. I’m not sure. Anyway, I’m back on a more fully paleo-compliant diet, and it’s working well. I’m trying to be careful not to lose too much weight quickly, because my doctor thinks that rapid weight loss triggered the gout, which seems like a reasonable conclusion to me. (Being slim and healthy is very good for gout, but the process of losing weight can certainly aggravate the condition.) Also, it seems that insulin sensitivity has been linked to gout, which would suggest that a paleo diet is a good way to go in dealing with the condition.
Dara