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Gout Dugout.Issue #053 Alkalize urine to excrete more uric acid | make your cherry juice | Arcalyst
May 26, 2012
Hello and Welcome to the May 2012 issue of the Gout Dugout newsletter. The ten minutes' read that gives you ideas that may help you with your gout. If you have difficulty reading it from the screen, by all means copy and print it.
May 23rd was best-gout-remedies.com's 5th birthday and for this May issue I've found another study of a diet in gout that brought interesting results in a few days. It's not a low fat/low calorie diet, or a restricted carbohydrate diet or a low purine gout diet.
It is a diet study that supports what's been said on the websites' pH for gout pages which begin here, and on the potassium citrate for gout page. It is evidence that if you alkalize (alkalise), in this case your urine, you'll excrete more uric acid. There are many ways to alkalise (alkalize) but here it was done by alkaline foods, a cheaper
Basically what happened in this study is that 26 healthy female Japanese students went on a more alkaline diet, and a more acidic diet. When on the alkaline diet they raised their urine pH by around 0.6 on the pH scale, and this lead to a 37% increase in uric acid excretion. It occurred in only 5 days.
But there was a drawback. Blood uric acid levels were not measured. Of course we would like to see the blood uric acid level fall alongside the big rise in excretion, but this isn't known in this study. With pH test strips for urine pH and a uric acid meter you could test this diet and see if your blood uric acid level falls. Please keep your doctor informed if you do. Or, if any reader who is using a uric acid meter and pH test strips for daily (or very frequent testing) has noticed a connection between the two, I'd very much like to hear about it.
You can read about this study in detail on this new page about pH and gout on the website. And because it's an open access document, you'll find a link on the page to the study itself which can be downloaded free, courtesy of Nutrition Journal.
What exactly did they eat? Both the alkaline diet, and the acidic one, are itemized in the study's appendix at the end of the study report. Food types and quantities eaten per day are shown. An interesting point, which might not have occurred to you before, is that the alkaline diet was also fairly low purine. Despite this, more uric acid was excreted.
Tomatoes and gout If you read the lists of foods eaten, note participants ate tomatoes on the alkaline diet, (4.23 ounces/120 grams a day) and much more uric acid was excreted on this diet. True, we don't know how blood uric acid responded, but this is a suggestion that tomatoes are one of the alkaline foods for gout and are not a gout cause, at least not on this type of diet. Ignore that if you suspect tomatoes are one of your gout triggers.
There has been a follow up study which I shall be reporting on next month.
CHERRIES – CUT THEIR CARBOHYDRATE COST
I guess most people imagine, when they first have to consider a gout diet, that there's only one, the low purine gout diet. But I can think of at least four main types of diets for gout.
First, and the most obvious, is a low purine gout diet. This cuts out high purine foods, allows medium purine foods in moderation and encourages intake of low purine foods. Alcohol will be eliminated or severely restricted.
Secondly an alkaline foods for gout (pH) diet, as discussed above, maybe augmented with alkaline supplements, where you attempt to raise body pH (including urine pH) in order to make uric acid more soluble and better excreted.
Thirdly, a low calorie diet to lose weight and hopefully lower uric acid.
And fourthly a low or restricted carbohydrate diet to lose weight and improve insulin sensitivity. Variations of this diet include the Atkins diet whose Ongoing Weight Loss (OWL) phase restricts net carbs to 25 daily but building up in 5 grams increments to a level at which you lose 2-3 lbs a week.(There are different amounts in other phases); the Zone Diet, the 40-30-30 (4-3-3, a soccer formation) balance of protein, carbs and fat in meals, of which the carbs component (30%) is 160 grams daily based on 1,600 calories. In one of the rare studies of a diet for gout, the Zone diet reduced uric acid and gout attacks' frequency.
Protein Power, in which the Doctors Eades reported gout symptoms improve, or fade out, when weight is lost on their diet, and which limits carbs in its Phase 1 to 7-10 per meal or snack; the Paleo diet; and the South Beach diet which doesn't cut carbs to numbers per day or meal, but focuses on good carbs and those that affect blood sugar more slowly.
The Hong Kong diet? And I remember a yellow coloured (colored) A5 booklet I bought in Hong Kong way back in 1972, six months before the first Atkins diet book was published (which I also bought), when I first started to get interested in dieting. This one said you'd lose weight on 60 carbohydrates a day. I didn't, because in those days I didn't know how to follow a diet with the required diligence. I'd have to go to lower carbs than this to lose weight, but some people would on 60/day.
How to beat the carbohydrate problem of cherries
Cherries will soon be in season. They are of course, either in fruit or juice form, or even dried, the best known and maybe the most successful food for gout. But the problem with cherries and cherry juice is their carbs. Tart (sour) have fewer than sweet, as you'd expect:
100 grams (3½ ozs) tart(sour) red raw cherries: 10.5 net carb grams
100 grams (3½ ozs) sweet raw cherries: 14 net carb grams
Source: USDA National Nutrient Database. Net carbs = total carbs minus fibre (fiber)
A glass (8 fl.ozs/236 ml) of commercial cherry juice has around 36 carbs. When you restrict your daily carb grams to one of the numbers mentioned above in the carbohydrate diets' summary, these are significant chunks out of your daily allowance, except the Zone diet.
This is where making your own cherry juice for gout scores. You can make juice from cherries that have been frozen. You can control the carbs in the juice by using a low calories/ low carb sweetener like Splenda (sucralose) Stevia or Xylitol, not sugar, or no sweetener at all. You can control the type of cherries (sweet or sour/tart, but both have been reported to work on uric acid levels) and control the number of cherries you use to make the juice if you wish.
So you can make a glass of cherry juice containing fewer carbs. If you used 7 ozs (200 grams) of sour (tart) cherries (about 20 cherries with the stones in) and an artificial sweetener you would "use" about 21 carb grams of your daily allowance, or 28 grams for sweet cherries. It's not carb perfect when compared to say a glass of water, a lower carb fruit juice or diet cola, but no one has claimed diet colas help with gout. And better than the around 36 carbohydrate grams in an 8 ozs glass of commercial cherry juice.
Making your own cherry juice for gout isn't difficult. Click on the recipes below.
My Tips Remember, whatever the cherries colour (color) the darker the skin the higher their quality and the sweeter they are. There are more of the flavonoid antioxidants, the cherries' substances which are thought to be anti-inflammatory and lower uric acid. Growers and shops know about a darker colour (color), which is why they are more expensive. Don't cheapskate a gout remedy. Buy the best if you can afford.
When I make my own sweet cherry juice I need about 150 grams, (about 15 sweet cherries) to make an 8ozs glass with a good flavour (flavor). I am a little parsimonious because where I live (Philippines) fresh cherries cost US$32 (current: GB Pounds 20.40; Euros 25) per kilo - no kidding.
You might need 200 grams (20 cherries). One or 2 packets of an artificial sweetener to sweeten. I'll eat the used up cherry pulp for any extra nutrients and their taste. So the drink is about 21 net carbs. In my case I’ll lose weight on 40 net carbs a day, and put it on at about 80 plus per day. So I have about 20 a day to use after the cherry juice, if I am dieting. And about 60 if I am not.
If you use a low calorie diet note tart (sour) cherries have 50 calories and sweet 63 calories, per 3.5 ounces (100 grams), both not much. They are low purine.
Last year canakinumab (Ilaris) was turned down by the U.S. FDA who thought it wasn't safe enough as yet. Now another biologic drug (also an injection) for gout pain has likely suffered a similar fate. It had been hoped that Arcalyst (generic name, rilonacept) could be another alternative for gout sufferers who, for one reason or another, don't take colchicine, NSAIDs or corticosteroids.
However, earlier this month an Arthritis Advisory Committee of the FDA decided by an 11 – 0 vote they would not recommend the FDA approves it.
The main problem was that the drug's major trial lasted just 16 weeks, but many panel members pointed out most patients would need to take it for longer than this. When you lower uric acid it usually takes longer than 16 weeks, as you and many gout sufferers know. So if approved patients would take it for a period that hadn't been studied. And in the background there was also a
risk of cancer which requires more evaluation. Additionally, some panel members voiced concerns such as identifying precisely who should take it, which again requires more study.
The UASure is a DIY home uric acid test kit. It measures the level of uric acid in the blood. Click on the link below to visit a company who can ship it world-wide, including the United States and Canada, from Britain.
If you are not a subscriber to the Gout Dugout, this free monthly gout newsletter, you can sign up at this page - click on the link below.
Go to the www.best-gout-remedies.com home page by clicking on the link below.
Does fructose cause gout and if so how much can you eat and drink? The debate rumbles on. There's been an important new study about fructose and uric acid published recently. And what did the follow up alkaline urine study say? Among other items we'll look at these important gout topics.
Thanks for reading and all the best of health.
799, Infantry Street,
P.S. You may distribute this newsletter freely and free-of-charge, providing any links in it remain unchanged and it remains intact. Partial copying is not allowed.
NB. The contents of this newsletter contain medical information, not medical advice. Please always discuss gout remedies with a doctor, or other health care professional, before implementing any treatment.
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