- Gout and Lentils
- What causes gout?
- Who is at risk for gout?
- What are the symptoms of gout?
- How is gout diagnosed?
- How is gout treated?
- What are the complications of gout?
- Living with gout
- When should I call my health care provider?
- Key points about gout
- Blood pressure diet improves gout blood marker: Effect on uric acid levels nearly matches impact of gout medicines
Gout and Lentils
Gout is one of the most painful types of arthritis, according to Johns Hopkins Medicine, and affects an estimated two to five million Americans.
It develops when your uric acid levels become excessive and form deposits in a joint, triggering pain, swelling, warmth and redness.
In addition to medical treatment, a diet low in purines — natural substances that trigger uric acid production — may help manage your symptoms. Lentils may benefit your diet in multiple ways.
A bowl of lentils on a wood table.
Image Credit: Teleginatania/iStock/Getty Images
Lentils are rich in fiber, which promotes fullness between meals. Improved appetite control may ease the process of weight management, guarding against joint symptoms caused or worsened by excess pounds.
Lentils also provide low-fat, cholesterol-free alternatives to fatty protein sources, such as red meat and high-fat cheese.
And because lentils contain fewer purines than meat and oily fish, they provide a gout-friendly protein alternative.
In the past, gout patients were advised to avoid all foods with significant purine content. Although lower in purines compared to animal products, protein-rich vegetables, including lentils, are considered moderately-high in purines.
But while a diet rich in animal protein increases your risk for gout and gout flareups, a vegetable-rich diet does not. In other words, lentils are not linked with same gout risks as meat. The notion that gout is caused by dietary factors is also a myth.
Your overall dietary habits may contribute to your symptoms, however, particularly if you have family history of the disease.
In a study published in the “New England Journal of Medicine” in March 2004, researchers analyzed the relationship between the dietary habits and gout occurrences of 47,150 men with no history of gout for 12 years. During the study, 730 new gout cases were recognized. Men who consume diets rich in seafood and meat were the most ly to develop gout, while moderate intake of purine-rich vegetables was not.
To reduce the frequency or intensity of gout symptoms, the March 2006 issue of “Current Opinion in Rheumatology” recommends limiting alcohol, meat and seafood but increasing low-fat dairy products and vitamin C. Have lentil soup instead of chicken noodle, for example, and curried lentils instead of beef atop rice.
Because lentils contain more purines than low-protein vegetables, do not choose lentils as your main or only vegetable each day. Viewing lentils as your protein source is a safer option for managing gout. Lower-purine vegetables include string beans, carrots, mushrooms, bell peppers, onions, asparagus, water chestnuts and squash.
Additional plant-derived protein sources include beans, tofu, soy milk, soy yogurt and quinoa.
To reduce the risk of spreading COVID-19 infections, it is best to call your doctor before leaving the house if you are experiencing a high fever, shortness of breath or another, more serious symptom.
Linkedin Pinterest Bones and Joints Gout-friendly Recipes
Gout is a health problem that causes inflamed, painful joints. The symptoms are caused by deposits of urate crystals at the joints.
Gout used to be associated with kings who overindulged in rich food and wine. In truth, anyone can get gout. Gout affects more men than women.
It is often linked with obesity, high blood pressure, high levels of lipids in the blood (hyperlipidemia), and diabetes.
This condition is a form of inflammatory arthritis that results in painful attacks in the joints. It can cause swelling and redness, and in some cases, it can lead to lumpy deposits that can be seen under the skin. It can also lead to the development of kidney stones.
What causes gout?
Gout is caused by monosodium urate crystal deposits in the joints. This is due to an excess of uric acid in the body. Too much uric acid may be caused by several things.
It may be caused by the body making too much uric acid. Or the kidneys may not get rid of enough uric acid. It may also be caused by eating a lot of foods that are high in purines.
Purines turn into uric acid in the body.
Foods high in purines include:
- Alcoholic drinks and sugary drinks high in fructose
- Certain meats, such as game meats, kidney, brains, and liver
- Dried beans and dried peas
- Seafood, such as anchovies, herring, scallops, sardines, and mackerel
Gout attacks may be triggered by any of the following:
- Drinking alcohol
- Eating a lot of protein-rich foods
- Emotional stress
- Minor surgery
Who is at risk for gout?
You are at higher risk for gout if you:
- Are a man
- Are a postmenopausal woman
- Have kidney disease
- Have high blood pressure, high cholesterol, or diabetes
- Have family members with gout
What are the symptoms of gout?
Gout causes sudden, recurrent attacks of symptoms that often occur without warning. Severe, chronic gout may lead to deformity. Symptoms can occur a bit differently in each person. Common symptoms include:
- General feeling of illness
- Hard lumps of urate crystal deposits under the skin (tophi)
- Severe, sudden pain in one or more joints, most often the joint in the big toe
- Skin that is red or purple, tight, and shiny over the joint
- Swollen joint(s)
- Warmth in the joint area
Some symptoms of gout can be other health conditions. Make sure to see your healthcare provider for a diagnosis.
How is gout diagnosed?
The process starts with a medical history and a physical exam. A fluid sample may be taken from the joint and checked for urate crystals.
How is gout treated?
Treatment will depend on your symptoms, your age, and your general health. It will also depend on how severe the condition is. Treatment may include:
- Avoiding alcoholic drinks
- Colchicine, an oral or IV medicine to relieve pain and inflammation
- Corticosteroids to reduce inflammation
- Drinking more nonalcoholic fluids
- Eating less protein-rich foods
- Medicine to block production of uric acid in the body
- Medicine to lower the uric acid level in the blood
- Nonsteroidal anti-inflammatory medicines to relieve pain and inflammation
- Surgery to remove extremely large tophi
- Weight loss, if obesity is an issue
Talk with your healthcare provider about the risks, benefits, and possible side effects of all medicines.
What are the complications of gout?
People with gout have a higher risk for kidney stones, due to crystal deposits in the kidneys. They can also have kidney damage. Crystal deposits in the joints can cause some disability due to stiffness and pain.
Living with gout
You can reduce the risk of future flare-ups of gout and decrease their severity by taking medicine as prescribed. If you are given medicine to take when a flare-up occurs, it is best to start taking it at the first sign of symptoms. Or get medical attention at the first sign of symptoms. To help prevent episodes of gout:
- Talk with your healthcare provider before taking any new medicine, including over-the-counter medicines
- Drink plenty of water
- Don’t drink alcohol
- Exercise regularly
- Lose weight if needed
- Don’t eat foods that are high in purines
When should I call my health care provider?
If your symptoms get worse or you have new symptoms, let your healthcare provider know.
Key points about gout
- Gout causes inflamed, painful joints due to urate crystal deposits at the joints.
- Gout can also cause urate crystal deposits that cause lumps under the skin.
- Gout can be triggered by eating foods high in purines and drinking alcohol.
- Treatment of gout is aimed at reducing pain and the risk of future flare-ups.
- Gout can be managed with medicines and lifestyle changes.
Blood pressure diet improves gout blood marker: Effect on uric acid levels nearly matches impact of gout medicines
A diet rich in fruits, vegetables, low-fat dairy and reduced in fats and saturated fats (the DASH diet), designed decades ago to reduce high blood pressure, also appears to significantly lower uric acid, the causative agent of gout. Further, the effect was so strong in some participants that it was nearly comparable to that achieved with drugs specifically prescribed to treat gout, a new study led by Johns Hopkins researchers shows.
The findings — derived from a randomized clinical trial — could offer an effective, safe and sustainable dietary approach to lower uric acid and possibly prevent gout flare-ups in those with mild to moderate disease and who can't or don't want to take gout drugs.
Dietary excesses, such as consuming a lot of red meat and alcohol, have long been associated with gout, a disease marked by high levels of uric acid in the blood and whose causes remain somewhat of an enigma despite centuries of investigation.
The Hopkins researchers noted that while symptoms of gout outbreaks — severe inflammation and sharp pain in the joints, particularly the base of the big toe — have been linked to elevated uric acid, it's been unclear exactly what type of diet might lower uric acid and decrease the risk of flare-ups.
In an effort to find out, Stephen P. Juraschek, M.D., Ph.D.
, research and clinical fellow in general internal medicine at the Johns Hopkins University School of Medicine, and his colleagues used data from the DASH (Dietary Approaches to Stop Hypertension) clinical trial, a widely popular and often-cited study whose results were first published in 1997.
These results showed that the DASH diet — which emphasizes reduced salt, whole grains, fruits, vegetables, low-fat dairy products and reduced intake of red meats, sweets and saturated fats — had a marked positive improvement on blood pressure and cholesterol.
In the original DASH-sodium trial, 412 participants ate either the DASH diet or a typical American diet for three months.
For each month of the study, the participants' diets provided a different level of sodium in a random order, including low (1.2 grams per day or about half a teaspoon), medium (2.3 grams per day or about one teaspoon), and a high level (3.
4 grams per day or about 1.5 teaspoons). The high sodium level was comparable to the average daily intake in a typical American diet.
At baseline and at the end of each sodium intake period, the researchers conducting the original study also took blood samples, which were analyzed for a variety of blood markers, including uric acid.
In this new study, Juraschek and his colleagues examined these data to determine whether and how each intervention affected uric acid blood concentrations. They found that the DASH diet led to a modest 0.
35 milligrams per deciliter decrease in uric acid concentrations overall. However, the higher participants' baseline uric acid levels, the more dramatic the decrease.
For those with the highest baseline uric acid levels — more than 7 milligrams per deciliter — for example, the decrease was as high as 1.3 milligrams per deciliter.
In the context of what is known about levels of uric acid linked to gout flare-up risk, “That's a large reduction in uric acid,” explains Juraschek.
Gout-treating medications, such as allopurinol, often reduce patients' blood uric acid concentrations about 2 milligrams per deciliter.
“When you get as high as the reduction we believe occurred with the original DASH diet in this study, the effect starts being comparable with gout medications.”
Juraschek noted that the effect of sodium on uric acid concentrations was small, but significant and quite the opposite of what the researchers expected. Specifically, during the part of the DASH trial in which participants were given the least sodium, their uric acid concentrations were the highest, with slight decreases achieved during the medium and high sodium portions of the trial.
Although high sodium levels appear to slightly decrease uric acid concentrations, Juraschek cautions against jumping to the conclusion that to reduce blood uric acid it's a good idea to purposely consume lots of sodium. “More than 70 percent of people with gout have high blood pressure,” Juraschek says. “If one was to consume more sodium to improve uric acid, it could worsen blood pressure.”
The researchers caution that further research is needed to more clearly establish the link between the DASH diet and uric acid in patients with gout and to directly explore whether the DASH diet might reduce or prevent gout flare-ups.
But, they conclude, the new study, described in the August 15 issue of Arthritis and Rheumatology, could offer patients a viable way to control uric acid concentrations — and presumably gout flare-ups — through a diet already shown to have positive effects on blood pressure, a well-established risk factor for cardiovascular disease.
There are about 8.3 million people in the United States with gout, costing the health care system an estimated $7.7 billion.
“Results of this trial are good news to patients with high blood levels of uric acid or those at risk for gout. A dietary approach to prevent gout should be considered first line therapy.
This study suggests that standard dietary advice for uric acid reduction which is to reduce alcohol and protein intake, should now include advice to adopt the DASH diet,” says senior author Edgar R. Miller III, M.D. Ph.D.
, professor of medicine at the Johns Hopkins University School of Medicine.
Materials provided by Johns Hopkins Medicine. Note: Content may be edited for style and length.