Atkins and Gout. How gout sufferers
                should modify the Atkins diet

Page 4 of 10 about gout and the Atkins diet

Referenced studies and study abstracts, the numbers in brackets, are listed on page 10 of the pages about Gout and the Atkins diet.

The Atkins diet for gout articles are across ten pages.

Navigation for these pages - Use the links at the bottom of the articles to go to each page, or return to a formerly viewed page.

This page about Atkins and gout was last reviewed, or updated, on 2 July 2016.


1. Use the Atkins Ongoing Weight Loss (OWL) phase to lose weight on 35 - 40 net carb grams a day. Be an owl.....and be a turtle on a beach. Or adjust carb intake to lose around two lbs a week, not more. This is true whatever your age, sex, and the amount you need to lose. Rapid weight loss might cause a big uric acid reduction which could trigger a gout attack. You want weight loss to be slow and consistent.

2. Try to lower LDL cholesterol if you think insulin resistance is your cause of gout. Eat foods reported to lower LDL cholesterol, within your daily 35 - 40 net carb grams budget. You may lower LDL cholesterol on Atkins but eating these foods on Atkins should help more.

3Meat and fish If eating amounts of meat and fish helps you stay with the diet, then eat moderate amounts of meat, 3 - 4 ounces per serving, and a similar amount of fish. But seafood not more than twice a week unless it is medium purine fish. You won't find low purine fish. We explain the pros and cons of fish for gout here.

There is a risk of gout from this amount of meat and fish, in many people's diets (7) but not if you are on the Zone diet. (See below). And perhaps not if you follow some natural remedies for gout. But I should say, the Atkins diet is NOT about eating huge amounts of meat.

But success with any diet (except crash diets) is more important than fretting about the number of moderate portions of meat and seafood you eat. Probably as long as you eat 
meat not more than 3/4 times a week  (less for beef, lamb and pork) and twice a week for fish. This is because if these are favourite (favorite) foods that help you to stay on a diet - that's the most important thing.

Why do I think ir's OK? Success with a diet and reaching  your ideal weight is very important. There's a much bigger risk of gout if you aren't at your ideal weight; or if you have insulin resistance (including high uric acid) and metabolic syndrome; or if you simply have high uric acid (UA).

Higher uric acid increases the risk of metabolic syndrome In a 2008 study, men with blood uric acid of just 6.5 mg/dL or higher had a 60% increase in risk of getting the metabolic syndrome compared to those whose blood uric acid was less than 5.5 mg/dL; in the same study with women the risk of the metabolic syndrome was at least double when blood UA was more than just 4.6 mg/dL.(11).

In the study Relationship between hyperuricemia and metabolic syndrome (21) men who had hyperuricemia (usually defined as blood uric acid above 7.0 mg/dL, in men) had a 1.634 fold (63%) increased risk of metabolic syndrome  compared with men without hyperuricemia. 

Women too. In the same study, women with hyperuricemia (defined in this study as  6.0 mg/dL or higher) had a 1.626 fold (63%) increased risk of metabolic syndrome compared with those without hyperuricemia. There is more about insulin resistance and metabolic syndrome and gout on this topic-dedicated page

In the South African study (using the Zone diet) there was no change in meat and fish consumption and yet uric acid levels fell and so did gout attacks, to zero in some cases, after a year.(8) See page 1 of our Atkins and gout pages - link below). Furthermore, beef, lamb and pork are medium purine, not high purine.

But, like some other foods that are low, or medium purine, there are people who think meat and fish have triggered their gout attack. Mushrooms are another example that people suspect. Some mushrooms are low purine, but others have been found to be high in the two purines that cause most uric acid.

4. Alcohol As usual, I regret to say, avoid/reduce alcohol, especially beer and spirits. There is hardly a relevant study that hasn't concluded alcohol causes gout, and subsequent gout attacks, after you've had your first. Beer is the biggest cause, then spirits. Least is wine. Beer is quite high carb, spirits are generally low carb – consult your carb counter.

But it's not all bad news about alcohol. A glass (or two) of wine can be fitted into your daily carbs budget, since wine is not high purine. Here are some examples. A 5 flozs glass of Burgundy has 5.46 carb grams; 5 flozs of Cabernet Sauvignon has 3.82 carb grams; 5 flozs of Merlot has 3.69 carb grams; 5 fl.ozs of white table wine has 3.82 carb grams; 5 flozs of Riesling has 5.54 carb grams. You can look up more wines in the USDA National Nutrient database. How? See the link below.

5. Frying When you fry, use olive oil. Use extra virgin - it's the purest. Its monounsaturated fat is thought to aid weight loss and lower LDL cholesterol levels. And use olive oil as a salad dressing. You can use mayonnaise as a salad dressing because it's low carb. Check the amount on the nutrition label.

6Purines Avoid high purine foods completely. No ifs, no buts.

7. Constipation may occur. To avoid this, boost fibre (fiber) intake. That means more fruits and vegetables or high fibre (fiber) supplements such as psyllium husks. High fibre (fiber) foods are thought to  reduce LDL cholesterol.

8. Take dietary supplements reported to lower blood glucose and LDL cholesterol. 
For blood glucose and LDL cholesterol - chromium nicotinate or chromium polynicotinate. 

Also for LDL cholesterol and other markers of the metabolic syndrome - pantothenic acid (Vitamin B5). Dr.Atkins reported  pantothenic acid lowered uric acid.

9. If you can drink anything else after 8 glasses of water daily,(about two litres/liters) note that milk has been reported to lower uric acid levels.  Two proteins in milk are reckoned to do it. (7) There are about 11.7 carbs in an 8 oz glass of reduced fat 2% milk fat milk. Same in 3.25% milk fat whole milk.

10. Take a good quality multi-vitamin at the frequency described on the bottle. This is not a modification, but a reminder. Dr.Atkins always recommended it. 

Glycemic Index (GI) /Glycemic Load (GL)  There is one way of boosting weight loss on the Atkins diet, although it was never suggested by Dr. Atkins in his books. That is, by the further selection of low carbohydrate foods which are also low on the Glycemic Index and Glycemic Load. You choose your low carb foods, then from that choice, you further select those with low GI/GL numbers. This should reduce blood sugar further,  thereby forcing the body to use more stored fat for energy. So far one study has shown reduced uric acid by eating GI/GL foods – your can also see the effect of carbs  in this study. But note, weight was not designed to be lost.

Find out about the GI/GL in detail here

Read about the first study to demonstrate reduced uric acid by eating GI/GL foods.

ESSENTIAL You must drink plenty of water on the Atkins diet. At least eight glasses a day - about two litres (liters). Don't cheat ! And 35-40 grams of carbs a day means what it says. Or modify net carbs intake to lose no more than two lbs a week.

If you don’t have a carb counter booklet look up carbs in foods and beverage at the USDA National Nutrient database. It can also be downloaded free.

Other Atkins and gout pages

Go to page 1 of 10 about gout and the Atkins diet, where I explain why it might be good for your gout.

Go to page 2 of 10 about the Atkins diet and gout. What Robert Atkins said about his diet and the uric acid level

Go to page 3 of 10 of our  Atkins diet for gout section. What Robert Atkins himself said about his diet and gout.

Go to page 5 of 10. The Atkins diet and the insulin resistance cause of gout.

Go to page 6 of 10   My Atkins diet success story.

Go to page 7 of 10   Meat and gout on the Atkins diet

Go to page 8 of 10  for free Atkins diet resources

Go to page 9 of 10. What has been said about ketosis and uric acid.

Go to page 10 of 10 which lists the gout studies, study abstracts, other relevant studies and books used as background whilst preparing the pages on the Atkins diet and gout.

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