Can we blame gout’s resurgence on ketosis? —
Over the past decade, the number of people developing gout and related complications has risen dramatically. This increase has been linked to the popularity of carbohydrates as a source of fuel. For example, the recent shift towards low carbohydrate diets, such as the keto diet, can be thought to have contributed to the increase in gout and related complications.
All of us remember, fondly or not, the fabulous “Rocky” movie with its iconic fight scene featuring the boxer against the Russian, Ivan Drago, and his henchman: Apollo Creed. The fight scene, obviously, is nothing more than the opposite of the ketogenic diet, in which the body burns fat for fuel. For this movie, however, the diet had to be represented by the character of Rocky, played by Sylvester Stallone.
For years gout has been known as a disease caused by alcohol, but it’s been recently discovered that gout has a high correlation with a diet that centers around high fat intake like ketogenic diets. So, how much truth is there to this claim?
“My toe aches so much that just looking at it hurts!” When I heard the fat 50ish-year-old guy crying in the emergency department about his agony, I was a third-year medical student. At first, I assumed he was exaggerating in order to obtain greater pain medication. But then I recalled all the texts that said gout is very painful. My attendance verified that, indeed, this was a frequent gout presentation, which I will never forget. Gout is a painful condition.
Gout has long been linked with the upper class aristocrats’ “opulence” and “indulgence.” Gout, on the other hand, is now a disease that affects people from all socioeconomic backgrounds.
Gout is making a return, according to The Cut.
In fact, according to a storey in The Cut, gout is on the rise again, not only among fat Americans, but also among young, otherwise healthy people who begin a ketogenic diet:
This increase is mainly attributed to the rising incidence of obesity and hypertension, according to doctors. However, Dr. Leigh Vinocur, an emergency physician, has observed a new crop of young, trim individuals presenting with signs of the illness; patients who do not have pre-diabetes, high blood pressure, or hypertension. She thinks that trendy diets like keto, which promotes a low-carb, high-protein diet, have something to do with it. “Quick-fix diets like keto and paleo, where you eat a lot of fat and protein,” she adds, “may lead to gout.” “It’s ironic: contemporary life has resulted in an increase in one of the world’s oldest illnesses, from the food industrial complex to brand-new diets like keto .”
Is this possible? Is a ketogenic diet linked to gout flare-ups?
For starters, no solid studies explicitly looking at the incidence of gout after beginning a keto diet exist. In fact, most gout nutritional research focuses on uric acid levels in the blood, which is the primary component of gout crystals seen in afflicted joints. As previously stated, ketogenic diets may induce a short-term increase in uric acid levels, which can lead to an increased risk of gout. Low-carb diets, on the other hand, seem to lower uric acid levels over time and therefore may be helpful for avoiding gout rather than causing it.
Gout is more likely to be linked to metabolic syndrome, alcohol use, and excessive fructose consumption, and less likely to be linked to meat eating. Aside from a heavy meat consumption, what did rich aristocrats with gout have in common? They were obese, drank alcohol, and ate a lot of sweets and simple carbohydrates. Sounds like a typical American eating a typical American meal to me.
What conclusions can we draw based on the little information we have?
- Gout is seldom, if ever, recorded as a side effect of a low-carb ketogenic diet
in large size studies.
- In the early phases of switching to a ketogenic diet
- , there may be a slight increase in the risk of gout.
- Preventing gout while on a ketogenic diet
is likely to provide a long-term benefit.
Concerns about gout, based on what we know, should not prevent someone from exploring the many potential advantages of a ketogenic diet. However, if just glancing at your toe causes pain, see your doctor immediately away!
Thank you for taking the time to read this.
Dr. Bret Scher, FACC Previously, there was a case report on a low-carb diet: Patrick The keto diet: “My health has never been better”
I don’t refer to this as a diet, but rather a fresh start.
I’ve written before on my blog about the gout and ketosis connection, but I think it’s a conversation worth having again because a lot of people are talking about it. Last week I had a patient come in with an interesting story about her husband. He has been diagnosed with gout, and in the past was a long-standing soda and beer drinker. After his diagnosis, he switched to a low carb diet and now is the only ketonearian in his family. She asked me if I thought this was significant, and I wondered the same thing.. Read more about can mct oil cause gout and let us know what you think.
Frequently Asked Questions
Can ketosis trigger gout?
No, ketosis does not trigger gout.
How do you prevent gout in Keto?
There are a few ways to prevent gout in Keto. The first is to avoid foods that are high in purines, which can cause gout. Foods that contain high levels of purines include organ meats, seafood, and some vegetables like asparagus and mushrooms. Another way to prevent gout is by maintaining a healthy weight.
Why is maltodextrin bad for Keto?
Maltodextrin is a carbohydrate that is made from starch. It is a white powder that can be used as a food additive, and it has the ability to absorb water. Maltodextrin can also be used as an energy source for athletes and people who are physically active. Maltodextrin is not a keto-friendly food because it can cause blood sugar spikes and insulin release.