Keto And Gout - Can Sugar Cause Gout?

What Exactly is Gout?

OK, so, aside from our intro alluding to it being an overall party pooper: what is gout?

Like many diseases and disorders, the root cause of gout is inflammation. It's an expression of dysfunction along the spectrum of oxidation associated with arthritis, that indicates an imbalance of uric acid in the joints, tendons, and extremities—disproportionately affecting the hands and big toe.

Like most forms of the disease, gout is progressive and leaves clues of its development along the way.

For instance, the forming of too many uric acid crystals in the body is often a precursor to gout, or at the very least indicative of a persons' increased risk of the disorder.

In addition to being a painful disorder, elevated levels  of uric acid in our bloodstream can cause comorbid disorders like hyperuricemia, which usually hints at the probability of one developing gout—although only about 5% of those with elevated levels develop the disease.

There was a time in ages of old when gout was referred to as “the disease of kings” or a “rich man’s disease”.

Now, it's not that the affluent were oddly afflicted with the inflammatory disorder by some genetic tether.

Rather, what the wealthy often did have in common, centuries ago is a taste for decadent and sugar-laden fare to the point of excess—not at all something coincidental because sugar is now a well-documented risk factor for gout.

The disheartening news is that instances of gout in modern times are on a steady incline, disproportionately affecting men almost three times as often as women (at about 3-6% of men and 1-2% of women), with overall instances of the disorder comprising about 1.4 percent of the total cases of disease, within our population.

But why are those who follow a Standard American Diet so disproportionately impacted by gout?

Although there is a genetic component to one's risk for developing gout, many of the elements that contribute to a higher risk of the inflammatory disorder are linked to our lifestyle choices.

Eating foods filled with refined sugars and carbs, or trans fats, continue to contribute to the worsening dietary habits of those on a Standard American Diet, further leading to instances of gout.

Coupled with the benefits of exercise to combat increasing rates of obesity and metabolic syndrome in our culture, diet is our biggest ally to achieve holistic health—a powerful tool to ward off gout and other disorders.

What Causes the Condition of Gout?

Gout is the result of an excess of uric acid in our muscle tissue that leads to physiological disorders, as mentioned above, with associated symptoms like joint pain, swelling, redness, and inflammation.

With that being said, reducing our levels of uric acid in the body to avoid gout and other disorders is a worthy goal and one naturally supported by following a low-carb, high-fat ketogenic diet.

Fortunately, since certain lifestyle choices can make us more susceptible to gout, converse behaviors that reduce uric acid and boost alkalinity can effectively act as a non-invasive approach to mitigate the proliferation of this inflammatory disorder.

There are a few potential lifestyle triggers that may spike uric acid production. We'll cover some points to consider to keep your acid levels balanced with lifestyle choices on a ketogenic diet, below.

The Connection Between Gout & Protein

A standard ketogenic diet advises eating a macronutrient composition that's moderate in protein, high in fat, and low in carbs—something beneficial to those looking to limit the consumption of protein to prevent gout.

Well, at least that's the protocol often asserted as ideal per the instruction of conventional dietary wisdom, set forth by regulatory agencies like the Food and Drug Administration (FDA).

Although, we'd be remiss if we didn't mention that feelings are mixed within the health community regarding the impact of consuming protein, due to the purines present in many protein-rich foods we commonly eat on a ketogenic diet, like grass-fed beef, fish and seafood, and organ meats.

 

Another word on purines: these are compounds we ingest when we consume most forms of protein. When digested, purines are distilled down to uric acid in the body, and this has led some in the health community to advise abstaining from eating protein to avoid gout.

However, in the context of a low-carb, high-fat, ketogenic protocol, studies have recently shown that eating in this style lowered uric acid levels in participants who were either overweight or obese—promising news.

In the absence of refined carbs, eating primarily fat supported by moderate levels of animal protein showed lower uric level acids, while vegans participating showed slightly higher uric acid levels.

This is something that hints to a need to look deeper into how phytonutrient-sourced proteins behave differently from animal-based proteins in the body, in relation to the processing of purines and subsequent production of uric acid.

Interestingly enough, purines and uric acid appear to behave similarly to the way the body either retains or releases water.

The more regularly we drink and flush the body with water, the more it's ready and willing to release water from the body—there's an established expectation of continual replenishment that creates a flow.

A steady and moderate level of quality protein intake can provide benefits in the development and repair of muscle tissue, and the state of metabolic ketosis achieved on a ketogenic diet offers a reparative effect to the body and brain tissue, as well—highly advisable.

Does Dairy Cause Gout?

As is the case with many 'health facts' espoused by the broader food-based health and wellness community, the painting of dairy as a detrimental food that increases one's risk of gout, is just unfounded.

Granted, hormone-filled dairy options are a bad choice for anyone, so as a general rule, you'll want to stick to organic varieties whenever possible.

Almost in complete contrast, a study conducted in observation of more than 40,000 participants for more than a decade showed an opposite effect in those who consumed dairy: with gout cases presenting less frequently in comparison to their control group.

While the study mentioned does not offer definitive causation for which foods spike uric acid, it at least seems to clear dairy as a culprit compound in the contribution of increased risk.

Again, opt for organic heavy cream, cheeses or yogurt whenever possible, to avoid chemicals and preservatives that can adversely impact free radical production and promote damage in the body.

Can Sugar Cause Gout?

Sugar is directly linked to causing inflammation in the body, and the oxidation and free-radical damage sugar can cause are at the root of virtually all forms of illness and disease.

Besides, you know we are 'team sugarfree' in general over here. We are chasing ketones and ditching fructose, and virtually all the '-toses,' as a general rule.

Sugar may not directly cause gout, but it's linked to increasing levels of inflammation, and oxidative stress increases the risk of all forms of disease as it deteriorates the immune system.

We also want to be particularly careful about our intake of fructose because of the way it's processed in correlation to the metabolism of proteins in our system, which can negatively impact levels of ATP (cellular energy).

We get it, "Why does ATP matter?" you might ask. We're so glad that you're curious!

When ATP is depleted in the presence of excess sugar in the body, we see an increase in uric acid production—and we've already established that a spike in uric acid is not at all helpful to improving our health and vitality.

Ditch the fructose, high-fructose corn syrup, and even artificial sweeteners like aspartame, and instead opt for keto-friendly options like stevia, monk fruit, erythritol, or xylitol so that you can enjoy sweetness in foods and drinks from time to time, or just in your morning keto coffee while keeping it completely sugarfree.

Insulin & Gout

Insulin and glucose regulation are imperative to our health and well-being, as all of our hormones play a significant role in keeping us balanced and running in an optimal state.

Subsequently, when insulin levels are askew, all other hormonal systems (e.g., metabolic, neurological, sexual, etc.) are susceptible to imbalance.

We need a certain amount of glucose to live: our bodies and brains cannot function in the complete absence of sugar. However, our bodies are proficient in producing an adequate amount of endogenous glucose for us to survive, without any external support.

Many in the western world, particularly those following a Standard American Diet (SAD), who rely on foods that destroy healthy gut microbiome and damage communication between our neurological pathways, will find themselves plagued with metabolic dysfunction in the body, over time.

Flooding the body with sugar throughout the day, as is the case for many following a SAD diet, continually spikes glucose and begins to wear down the proper function and communication between the liver and pancreas concerning the adequate production and utilization of insulin.

So those who are sugar-burners, eating lots of carbs and sugar each day with chronically high sugar levels are often unwittingly furthering the breakdown of communication between vital pathways in the body, leading to metabolic disorders like insulin resistance and eventually type 2 diabetes—or just more difficulty shedding weight.

Why You Should Avoid Alcohol

Consuming alcohol is an established risk factor for developing gout and is also known to exacerbate commonly experienced symptoms of the condition with regular or excessive consumption.

A recent study conducted on more than 45,000 participants showed that the consumption of all forms of alcohol was directly linked to a higher risk of gout. This risk of a gout-related flare-up continued for up to 24-hours, post indulging in the chosen adult libation.

You'd be hard-pressed to find any health expert promoting alcohol as healthy. Even red wine, one alcoholic beverage that has made its way into the realm of healthier food spheres, is advised to be consumed in moderation.

Plan to limit alcohol consumption to avoid increasing the risk of gout or the likelihood of experiencing adverse symptoms, if you already have the disorder.

Plus, an extra serving of plain H2O or bone broth is a much more useful set of options to hydrate and heal the body on a ketogenic diet, so choose your beverages wisely.

How to Avoid Getting Gout

The good news here is that again, our lifestyle choices are the primary factor in our likelihood of developing or suffering from gout.

With that being said, it's important to note that sugar is the primary cause of gout, along with alcohol—also being a form of sugar in its most basic state—and the consumption of both are at the root of the development and expression of gout and many other diseases.

Remove sugar, particularly fructose and high-fructose corn syrup, from your diet to prevent gout and avoid many other health issues caused by the consumption of the broadly marginalized sweetener.

Again, there is a fantastic variety of keto-friendly sugar alternatives and snacks on the market that are absent of artificial ingredients and still help to maintain blood sugar levels, as well as support elevated ketones and nutritional ketosis.

Many metabolic issues like obesity, metabolic syndrome, type 2 diabetes, high insulin levels, or elevated blood pressure all contribute to gout—and all are directly linked to the consumption of sugar!

Surprise, surprise, right? The takeaway? Limit sugar whenever possible to promote overall health and prevent gout.

Can Keto Reduce the Risk of Gout?

The negative impact of sugar on the causation and proliferation of gout is significantly diminished with the use of a ketogenic diet. The high-fat, low-carb dietary protocol prescribed, turns off specific actions and activates other alkalizing functions in the body, helping to improve total health and mitigate disease.

Focus on eating healthy fats like avocado, fatty and affordable fish like mackerel, or add MCT powder into a simple fat-filled smoothie—and, of course, omit sugar wherever possible to promote vitality and prevent disease.  

Summary

A ketogenic diet, mainly because of its guidelines that advise the removal of sugars and refined carbs, limiting alcohol, and establishing metabolic ketosis, all work together to promote optimal states of health in the body.

Utilizing practices like regular meal prep (outlined in detail in our recent post, here) or incorporating a delicious and keto-friendly exogenous ketone to boost deeper levels of ketosis, like Keto Activate, further help to support an alkaline and balanced state in the body—a state that acts as a natural repellent to disorders like gout.   

Plan meals ahead of time, keep it simple, find delicious sugar replacements, and turn down the shot glass a bit more often to shift the tide of good health in your favor.

In addition to preventing or reversing the symptoms of gout: a sugarfree, ketogenic eating style is also established as a means of efficiently losing body fat and helping to balance our hormones.

Keto nourishes every cell of our body and helps keep us in our bodies' preferred metabolic state of ketosis.

So, increase the fat intake and incorporate moderate amounts of protein into your meal plan, throughout the week, for an ideal nutritional composition to avoid gout and even support weight loss on a ketogenic diet.

Studies

Choi, H. K., Atkinson, K., Karlson, E. W., Willett, W., & Curhan, G. (2004). Purine-Rich Foods, Dairy and Protein Intake, and the Risk of Gout in Men. New England Journal of Medicine, 350(11), 1093-1103. doi:10.1056/nejmoa035700

Clifton, P., & Gallagher, C. (2016). Effect of fructose on meal triglyceride response. Journal of Nutrition & Intermediary Metabolism, 4, 9. doi:10.1016/j.jnim.2015.12.179

Crone, C., & Lassen, U. V. (2009). The Effect of Salicylic Acid and Acetylsalicylic Acid on Uric Acid Excretion and Plasma Uric Acid Concentration in the Normal Human Subject. Acta Pharmacologica Et Toxicologica, 11(4), 355-361. doi:10.1111/j.1600-0773.1955.tb03270.x

Karasawa, Y. (1977). Stimulatory Effect of Intraportal Ammonia on Plasma Uric Acid Concentration and Urinary Uric Acid Excretion in Chickens Fed a Low Protein Diet. The Journal of Nutrition, 107(7), 1147-1152. doi:10.1093/jn/107.7.1147

Löffler, W., Gröbner, W., Medina, R., & Zöllner, N. (1982). Influence of dietary purines on pool size, turnover, and excretion of uric acid during balance conditions. Research in Experimental Medicine, 181(2), 113-123. doi:10.1007/bf01852188

Neogi, T., Chen, C., Niu, J., Chaisson, C., Hunter, D. J., & Zhang, Y. (2014). Alcohol Quantity and Type on Risk of Recurrent Gout Attacks: An Internet-based Case-crossover Study. The American Journal of Medicine, 127(4), 311-318. doi:10.1016/j.amjmed.2013.12.019

Schmidt, J. A., Crowe, F. L., Appleby, P. N., Key, T. J., & Travis, R. C. (2013). Serum Uric Acid Concentrations in Meat Eaters, Fish Eaters, Vegetarians, and Vegans: A Cross-Sectional Analysis in the EPIC-Oxford Cohort. PLoS ONE, 8(2). doi:10.1371/journal.pone.0056339