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Gout Dugout.Issue#048 Sweat uric acid out? | My gout conscious 5 course Xmas meal | Avoid at Xmas
December 21, 2011

Hello and Welcome to the December 2011 issue of The Gout Dugout newsletter. The 10 minutes' read that can give you good ideas for dealing with gout. A Merry Christmas to all readers.

A bouquet of Christmas berries. A reminder to eat berries over the Christmas period.


Past Christmas editions of the Gout Dugout carried a downbeat story. There has always been one about cautionary foods: foods to avoid with gout at Christmas. In fact there's another story about these below because there have been many new subscribers since last Christmas who may be unaware of the Christmas food traps. But this year I thought I'd try to brighten the Gout Dugout up with some delicious foods for gout recipes that are low purine and low carb.

Will it be a feast, or will it feel like a famine? I'll let you judge, but IMO it is a five course slap up lunch or dinner to savour (savor). When the day is finally over, it won't be a day that felt as though I had spent Christmas in a P.O.W. camp.

So please read on if you want to know how this gout conscious person, who is also dieting to lose weight, and lower uric acid, deals with the Christmas period food and drinks issues. But for the sake of not repeating myself, for the full details I'll ask you to visit the new website page (link below).

On this page, there is a menu and gout recipe ingredients for what I describe as a slap up, five course Sunday splurge feast for gouty folk who monitor purines. And they could be on a restricted carb diet (e.g. Atkins, Zone, Protein Power, South Beach, Heller, Holford GL) since it adds up to under 80 net carbs. Plus there's an eye out for excessive fructose. An 80 net carbs day for most would be a day-off day, which would not contribute to either weight loss or gain.

There are seven gout recipes (two courses have a choice of two gout recipe dishes). The menu is of the sort of food that is eaten in all native English speaking countries, and some others besides e.g. in Europe. It might appeal further afield too, but I don't know exactly.

It's what I'd eat myself to have a feast, and to stay on a low purine, restricted carbohydrate diet, but if these dishes appeal to you please see or call your doctor first if you have gout, and have his/her agreement to go on a restricted carbohydrate diet.

So click on this link to go to the webpage to read how easy it can be to have a 5 star meal that is low purine and carb restricted, with an eye out for the fructose content too.

If you have considered a low carb diet for gout, read's Atkins diet for gout pages, beginning here, and I suggest you discuss it with your doctor.


And now from a Christmas pleasure to a Christmas pain. What are the foods to avoid with gout over the Christmas period, if you are monitoring purine intake?

I'll bow to the testimony of those gout sufferers who think cranberry sauce has triggered their gout attacks, presumably by raising uric acid first. Could it be the fructose? One of my correspondents earlier this year thought so. So there is no cranberry sauce with the turkey, in the previous article, although the fructose content of raw cranberries is only 0.63 grams per 100 grams of cranberries.

Maybe I'll make some cherry sauce instead – cherries (as long as you don't use those artificial high carb Maraschino cherries, the ones that are put on cakes and small sticks in cocktails) are foods for gout of course, but watch the carb count from ingredients like corn flour, sugar and the cherries themselves if you make cherry sauce.

What else is on the avoid list? Because of my hyperuricaemia, and because I am still on a restricted carb diet, this is what I shall also avoid.

Mince pies No mince pies. Flour is high carb and the mincemeat filling is said to be high purine. Read more about mincemeat in the December 2008 edition of the Gout Dugout.

Back in December 2008, I couldn't really work out why it's supposed to be high purine, but I'm taking no chances because gout takes few prisoners.

Drinks No liquors, (spirits), liqueurs, or beers (ales and lagers). I'll drink two glasses of red wine, half a glass of cherry juice, (a great gout drink of course, but usually high carb, so it has to be watched) tea, coffee and water.

Honey No honey, it's just too high in fructose.

Christmas pudding Sadly no Christmas pudding ! It's probably not high purine, but it is definitely high carb – too many for my 80 carbs a day allowance for the Christmas period. A couple of these puddings I saw whilst shopping the other day, had 53-60 carb grams per only 100 grams of Xmas pud. For many low carb dieters on lifetime maintenance of maybe 80 net carbs a day, that's nearly a day's allowance! And if your carb intake has to be much lower, a Xmas pudding is sadly the kiss of dietary death for a few days.

Delicacies No sweets (candies) or chocolates. Way too high in carbs. Or I might say: “Just the one please.” And that slice of weakness is another 7 carbs out of my allowance.

Game, and offal (organ meat) These are high purine. Definitely avoid.

Alternative Health Research/Flamasil™


Christmas must be a time when most of us eat more chocolate, so I decided to run this piece in this month’s issue.

Nuts, orange juice, tomatoes, grapefruit juice, cranberry sauce; I've had correspondence this year about all of these as gout triggers from people who think they have been their gout trigger. And also, quite recently, about chocolate and gout.

It's dark chocolate, reckoned to be healthier than these milk chocs in a box, that some think has caused gout..... but you get the idea.

Is there a theoretical underpinning for chocolate as a gout trigger? Only a very slight one, as far as I know. Chocolate contains theobromine which is, on one purines table at least, the highest of all substances for purine content. So is chocolate guilty?

“No your honour (honor), because the amount of theobromine in chocolate is so small that the purine content is tiny.” It isn't likely to raise uric acid. And, at periods in history, cacao (chocolate's basic ingredient) has been used to treat gout. (1) I don't know whether it had any success.

Nevertheless, this year I have heard of three cases of people who think that dark chocolate, not milk chocolate which curiously is not thought to be as healthy as dark, causes gout. My fairly recent correspondents about this quoted their urologist, a five star witness, who attributed his gout to dark chocolate.

So what's the sentence on chocolate? Not a lifetime ban. If you've been eating chocolate and never had cause to think it might have been a gout trigger, I wouldn't pay much attention to this piece. But if you have, I am sure you want to. Until more evidence has been acquired, for chocolate as a cause of gout across large populations, the jury is still out.

Do you have a reason to think dark (or even milk) chocolate causes gout attacks? Please email me.

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.

I say this because it cannot be bought in many countries.


I have done some uncompleted work on this very appealing idea, the more so if the kidneys aren't doing too well with removing uric acid. i.e. if they weren't working well enough, maybe a gout sufferer could sweat a useful amount of uric acid out, thus by-passing the kidneys.

So far the research I've read is not very encouraging. It seems a quite small amount of uric acid will leave in sweat created by exercise and heat, but without lowering serum (blood) uric acid permanently. It's nothing like the amount that leaves in urine.

When I have finally finished the work on this, I'll put it on the website, since it's a very specialized gout topic. Should you wish to read it... I'll mention it's on the site in this newsletter.

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.

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That's the end of the 4th year of the Gout Dugout, whose first issue was in January 2008. In next month's issue, I'll begin it as usual in January, by looking at my gout crystal ball. I'll try to predict some events in the world of gout in 2012.

Wishing you a Merry and gout free Christmas 2011.

(1) Food of the Gods: Cure for Humanity? A Cultural History of the Medicinal and Ritual Use of Chocolate. Teresa L. Dillinger, Patricia Barriga, Sylvia Escárcega, Martha Jimenez, Diana Salazar Lowe and Louis E. Grivetti. The Journal of Nutrition 2000; 130:2057S-2072S.

John Mepham BA.(Econ).

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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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