Gout attack after diving

[danvolker]

Agree. This may be what it takes to get me on a better diet. Ironically, the doc had previously suggested a low carb diet which is opposite of what I'll be going for now due to purines. Controlling uric acid seems like a catch 22 situation though because you are to limit meats and carbs. That doesn't leave too much other than vegetables, fruits, and a small amount of whole grain. I've tried to 'learn to love' salad but that's not worked out so we'll see what I can come up with.

Suggestions?

Read this on the diet issue and the problem of too much carb ( sugars)..
Low Grain and Carbohydrate Diets Treat All Chronic Illness - Part 1

 

[uncfnp]

Gout:

Is associated with Metabolic Syndrome
Lose weight (if applies)
Avoid sweet sodas (and any products with high fructose)
Coffee, diet sodas and diary may help
Dark berries, tofu and fatty acids (like flax seeds, salmon and olive oil) may help

OTC nsaids like Motrin may help but OTC strength may be too low. Aleve may be a better choice since only twice a day but OTC is still lower than prescription.

I know one gentleman that could not jump from the bed of his pickup truck without triggering a flare.

 

[Butchbs1985]

Read this on the diet issue and the problem of too much carb ( sugars)..
Low Grain and Carbohydrate Diets Treat All Chronic Illness - Part 1

But the conclusion of that article states:
"The one dietary program that addresses these principles in full, is the so called "evolutionary diet." The modern inception of this prehistoric lifestyle would favor the consumption of lean meats (preferably wild game or non-grain fed, free-range domesticated animals), fish, seafood, vegetables, fruits, raw nuts, and seed. Notably absent from this dietary genre are dairy products, cereal grains, beans, legumes and concentrated sweets (except for perhaps the occasional foray into raw honey!)."

Quite literally all other 'gout diets' that I've been reviewing frown upon:
- Excess Protein from meat. Particularly Wild Game, Fatty fish, scallops, and others

And promote:
- Legumes
- Low Fat dairy (milk / yogurt)
- Whole Grain (complex carbs) - Which the article you sent actually discourages.

With the exception of discouraging complex carbs, the article that you provided pretty much describes the proposed 'low carb' diet that had been recommended to me. Doesn't seem a good option though due to the high purine content of the protein that is proposed as the primary nutrient source.

---------- Post added January 15th, 2013 at 01:49 PM ----------

Gout:

Is associated with Metabolic Syndrome
Lose weight (if applies)
Avoid sweet sodas (and any products with high fructose)
Coffee, diet sodas and diary may help
Dark berries, tofu and fatty acids (like flax seeds, salmon and olive oil) may help

OTC nsaids like Motrin may help but OTC strength may be too low. Aleve may be a better choice since only twice a day but OTC is still lower than prescription.

I know one gentleman that could not jump from the bed of his pickup truck without triggering a flare.

Any resources indicating the 'dark berries'? I love fruit but if I could target it even further that would be great!
Lose weight is definately in the works. My wife and I have been going to the gym for a couple months and trying to watch what I eat. (The owner of my LDS has actually referred to a 'midwest cut' for wetsuits due to the sizeable bellies of some of the divers who frequent the shop) :-/

Hopefully this is the only flare that I'll experience. I'd hate to be that guy.

 

[danvolker]

But the conclusion of that article states:
"The one dietary program that addresses these principles in full, is the so called "evolutionary diet." The modern inception of this prehistoric lifestyle would favor the consumption of lean meats (preferably wild game or non-grain fed, free-range domesticated animals), fish, seafood, vegetables, fruits, raw nuts, and seed. Notably absent from this dietary genre are dairy products, cereal grains, beans, legumes and concentrated sweets (except for perhaps the occasional foray into raw honey!)."

Quite literally all other 'gout diets' that I've been reviewing frown upon:
- Excess Protein from meat. Particularly Wild Game, Fatty fish, scallops, and others

And promote:
- Legumes
- Low Fat dairy (milk / yogurt)
- Whole Grain (complex carbs) - Which the article you sent actually discourages.

With the exception of discouraging complex carbs, the article that you provided pretty much describes the proposed 'low carb' diet that had been recommended to me. Doesn't seem a good option though due to the high purine content of the protein that is proposed as the primary nutrient source.

---------- Post added January 15th, 2013 at 01:49 PM ----------



Any resources indicating the 'dark berries'? I love fruit but if I could target it even further that would be great!
Lose weight is definately in the works. My wife and I have been going to the gym for a couple months and trying to watch what I eat. (The owner of my LDS has actually referred to a 'midwest cut' for wetsuits due to the sizeable bellies of some of the divers who frequent the shop) :-/

Hopefully this is the only flare that I'll experience. I'd hate to be that guy.

Everything I have been reading ( research related) over the last year, has been pushing toward sugars and grains ( breads and cereals....whole Wheat being essentially equally horrific for your body to white bread) as being the real villains in heart disease, NOT fat or protein. In fact, the best evidence so far is that we actually need cholesterol for brain health, and the problems with heart disease did not relate in anyway with a high cholesterol diet, but rather to high sugar and grain diets....
Low fat milk is actually far worse for you than whole milk, as the Glycemic Response of skim or 1 percent is much higher than the whole milk--the fast slows down the release of sugar into the blood with whole milk. Sugar causes the inflamation.... You need only to read up on AGE...

1. Advanced Glycation Endproducts
2. Why Avoiding Sugar is a Good Anti-Aging Strategy
3. Glycation and Crosslinking Proteins - Legendary Pharmaceuticals ( good description, even though they prefer to fix AGE with drugs, rather than just limiting/ preventing it with diet
4. I would supply the more involved medical journal studies, but most require a log-in and or cost $$ to view...For several good sources you have to show them you are a Researcher for a known institution to view their studies.

 

[Butchbs1985]

Everything I have been reading ( research related) over the last year, has been pushing toward sugars and grains ( breads and cereals....whole Wheat being essentially equally horrific for your body to white bread) as being the real villains in heart disease, NOT fat or protein. In fact, the best evidence so far is that we actually need cholesterol for brain health, and the problems with heart disease did not relate in anyway with a high cholesterol diet, but rather to high sugar and grain diets....
Low fat milk is actually far worse for you than whole milk, as the Glycemic Response of skim or 1 percent is much higher than the whole milk--the fast slows down the release of sugar into the blood with whole milk. Sugar causes the inflamation.... You need only to read up on AGE...

1. Advanced Glycation Endproducts
2. Why Avoiding Sugar is a Good Anti-Aging Strategy
3. Glycation and Crosslinking Proteins - Legendary Pharmaceuticals ( good description, even though they prefer to fix AGE with drugs, rather than just limiting/ preventing it with diet
4. I would supply the more involved medical journal studies, but most require a log-in and or cost $$ to view...For several good sources you have to show them you are a Researcher for a known institution to view their studies.

Understood. I'm not saying that the resource you provided would be quite good for the heart. Like I said, a similar diet had been provided to me before. Issue is that since gout can and likely will be a recurring issue, I would need to do everything I can do avoid purines which are plentiful in meats. Especially wild game, red meat, fatty fish. All of which I love by the way. I was quite happy to be on a high protein but it doesn't seem to be an option any longer.

 

[uncfnp]

One study that I know of

Cherry consumption and decreased risk of recurrent gout attacks - Zhang - 2012 - Arthritis & Rheumatism - Wiley Online Library

There is very limited evidence that I am aware of that directly studies the effect of anthocyanins (the substance in dark berries including cherries, blackberries and blueberries) in the reduction of gouty flares but there is some limited evidence suggestiing it does inhibit IL-6 thus reducing inflammation. I figure, can't hurt.

According to a lecture I attended by Dr Peng Fan (at that time he was a Clinical Professor of Medicine, Division of Rheumatology at UCLA) that even 10 lbs weight loss is associated with improved gout, that small amounts of wine (2 glasses of wine a day) is not associated with increased gout and that a strict purine diet is "unpalatable with poor long-term compliance-lowers serum urate by only 1 mg/dl."

Also from Medscape:

"Purines are found in all protein foods. All sources of purines cannot and should not be eliminated, but a low-protein diet may be helpful.
Overall, purine restriction reduces serum uric acid levels by only 1 mg/ml, at significant psychological impact. Diet modifications are rarely able to lower uric acid levels sufficiently to prevent further attacks and accumulation of urate.
Patients with gout should avoid beer and hard liquor because they elevate levels of uric acid and therefore can precipitate attacks of gout. Indeed, heavy drinkers are much more likely to have recurrent gout attacks, even with allopurinol therapy. Moderate wine intake is not associated with an increased gout flares.^[11]
Increasing dairy intake, folic acid intake, and coffee consumption may reduce gout flares.^[116]
Particularly because of the association of gout with atherosclerosis, the diagnosis of gout may be a good time to advise a low-cholesterol, low-fat diet if otherwise appropriate for the patient. While such a diet may help uric acid levels, such advice should be given primarily to help prevent atherosclerosis.
Weight reduction in patients who are obese can improve hyperuricemia. Ketosis-inducing diets (eg, fasting) should be avoided, however.
Ingestion of fructose-containing beverages should be reduced, and ingestion of milk and calcium should be increased.^[117] If hyperphosphatemia is present, phosphate-binding agents should be used. Maintaining a high level of hydration with water (at least 8 glasses of liquids per day) is helpful in avoiding attacks of gout."

If you need the listed references, PM me.

Hope this helps

Edited: Dr Fan does recommend eating less red meat and fish while reducing calories and saturated fats and increasing complex carbs. All mentioned in other posts.

 

[Butchbs1985]

One study that I know of

Cherry consumption and decreased risk of recurrent gout attacks - Zhang - 2012 - Arthritis & Rheumatism - Wiley Online Library

There is very limited evidence that I am aware of that directly studies the effect of anthocyanins (the substance in dark berries including cherries, blackberries and blueberries) in the reduction of gouty flares but there is some limited evidence suggestiing it does inhibit IL-6 thus reducing inflammation. I figure, can't hurt.

According to a lecture I attended by Dr Peng Fan (at that time he was a Clinical Professor of Medicine, Division of Rheumatology at UCLA) that even 10 lbs weight loss is associated with improved gout, that small amounts of wine (2 glasses of wine a day) is not associated with increased gout and that a strict purine diet is "unpalatable with poor long-term compliance-lowers serum urate by only 1 mg/dl."

Also from Medscape:

"Purines are found in all protein foods. All sources of purines cannot and should not be eliminated, but a low-protein diet may be helpful.
Overall, purine restriction reduces serum uric acid levels by only 1 mg/ml, at significant psychological impact. Diet modifications are rarely able to lower uric acid levels sufficiently to prevent further attacks and accumulation of urate.
Patients with gout should avoid beer and hard liquor because they elevate levels of uric acid and therefore can precipitate attacks of gout. Indeed, heavy drinkers are much more likely to have recurrent gout attacks, even with allopurinol therapy. Moderate wine intake is not associated with an increased gout flares.^[11]
Increasing dairy intake, folic acid intake, and coffee consumption may reduce gout flares.^[116]
Particularly because of the association of gout with atherosclerosis, the diagnosis of gout may be a good time to advise a low-cholesterol, low-fat diet if otherwise appropriate for the patient. While such a diet may help uric acid levels, such advice should be given primarily to help prevent atherosclerosis.
Weight reduction in patients who are obese can improve hyperuricemia. Ketosis-inducing diets (eg, fasting) should be avoided, however.
Ingestion of fructose-containing beverages should be reduced, and ingestion of milk and calcium should be increased.^[117] If hyperphosphatemia is present, phosphate-binding agents should be used. Maintaining a high level of hydration with water (at least 8 glasses of liquids per day) is helpful in avoiding attacks of gout."

If you need the listed references, PM me.

Hope this helps

Edited: Dr Fan does recommend eating less red meat and fish while reducing calories and saturated fats and increasing complex carbs. All mentioned in other posts.

Lots of info. Thanks!

 

[tridacna]

Absolutely wrong..
I would put Mercola's ideas on nutrition over the last 15 years up against any "traditional Pharmaceutical Symptom treating MD", and I would win

Dan, I hate to say this but your are FOS. Mercola is a known BS artist. Right up there with Madoff. You have bought his garbage hook, line and sinker. I have no doubt that you can outswim, outfin and outdive almost anyone on this board half your age or even quarter of your age while you're barefoot and they use a scooter - god knows, you've reminded us of that often enough. But you are spouting complete and utter tripe when it comes to nutrition. Anyone who buys into Mercola's balderdash cannot be taken seriously. He has been discredited by the establishment many times. He is a marketing genius and has become very rich because of ignoramuses and suckers buying his products and nonsensical "science". There is ample evidence online by countless legitimate critics. Stick to teaching people how to use long fins and leave nutrition advice especially regarding gout to those who are qualified to do so.

 

[danvolker]

Dan, I hate to say this but your are FOS. Mercola is a known BS artist. Right up there with Madoff. You have bought his garbage hook, line and sinker. I have no doubt that you can outswim, outfin and outdive almost anyone on this board half your age or even quarter of your age while you're barefoot and they use a scooter - god knows, you've reminded us of that often enough. But you are spouting complete and utter tripe when it comes to nutrition. Anyone who buys into Mercola's balderdash cannot be taken seriously. He has been discredited by the establishment many times. He is a marketing genius and has become very rich because of ignoramuses and suckers buying his products and nonsensical "science". There is ample evidence online by countless legitimate critics. Stick to teaching people how to use long fins and leave nutrition advice especially regarding gout to those who are qualified to do so.

Obviously you have insufficient understanding of nutrition to be in this conversation. I care about results and "cures", and you sound like the type that is happy dealing with symptoms. I pitty the people that would listen to you.

 

[TSandM]

I was taught that it is impractical to restrict gout patients from all meats, but they should avoid those with a bigger ratio of nucleus to cell mass -- i.e. organ meats. I don't think it is a great deprivation to tell most people to avoid eating liver, kidney and brains

I would suspect, if there is any correlation between diving and gout, it's from the immersion diuresis and subsequent relative volume depletion, perhaps augmented by the increased alcohol intake typical of people on dive trips . . .