The Truth About Gout and Diets
Researchers say gout rates typically fall in times of hardship, such as during World War II, and rise in times of prosperity and indulgence. This means it would come as no surprise to many that gout rates are very likely increasing in the U.S. as the nation faces an epidemic of obesity.
"Gout tends to be associated with obesity and high blood pressure," says John Klippel, MD, president and CEO of the Arthritis Foundation. "Those are two common health problems in this country, and obesity certainly seems to be increasing.
"If someone were to study it, that might mean that there might actually be more gout [in the U.S.], but one would speculate that's because we're dealing with a society that is by and large overweight," Klippel tells WebMD.
But losing weight too quickly might also increase the risk of gout.
"As you lose weight, you start to metabolize body tissues, and there is an increased flux of purines that the body has to deal with, which leads to increases in uric acid," says Klippel. "Crash diets where people are losing weight very rapidly are going to increase the risk of gout."
Nuki says that's where the link to high-protein diets like Atkins comes in. Any diet that produces rapid changes in weight raises the risk of gout, but he says low-carbohydrate diets may carry an additional risk for two reasons.
First, many of the foods promoted by these diets, such as bacon, organ meats, and some types of seafood, are high in purines and cause uric acid levels to rise. Second, low-carbohydrate diets put stress on the kidneys, which might make them more sensitive to changes in uric acid levels.
Even so, Nuki says diet is only part of the picture.
"Gout in almost all cases is a combination of having an underlining genetic predisposition and then being faced by a challenge, either something like an Atkins diet or generally the challenge of over-nutrition and alcohol," says Nuki, who is also a trustee of the UK Gout Society.