This page about the Glycemic Index in gout, its usefulness in gout treatment, was last reviewed or updated on 13 June 2016
You may want to read our page about the Glycemic Index and Glycemic Load first. It explains what they are.
There are many references to the Glycemic Index (GI) and Glycemic Load (GI) throughout best-gout-remedies.com but what exactly are they ? Simply put, the Glycemic Index measures how quickly an eaten food or drinks raises blood sugar (blood glucose) and its relative, the Glycemic Load, indicates how much blood sugar is produced by a measured food portion.
The Glycemic Index of foods can be used to give extra whammy to a restricted carbohydrate diet thus increasing your chances of being more successful. It encourages you to eat more of certain foods and less of others, those which will benefit blood sugar processing and insulin control. (It can also be used to help diabetics).
Both can be used as a diet themselves – there are books about this. But now there is something new about the Glycemic Index – the Glycemic Index in gout. For the first time, a study has found a direct and beneficial link between eating low GI foods and uric acid reduction.
FIRST STUDY ABOUT THE GLYCEMIC INDEX IN GOUT TREATMENT
The first study of its kind demonstrated that eating low Glycemic Index foods with high or lower amounts of carbohydrates (whilst participants ate sufficient food to maintain their weight), had desirable effects on blood uric acid levels.
Who were the trialists? 52% were women, 48% men. 50 % were non Hispanic, African Americans. 56% of all participants were obese and 26% had hypertension. The mean (average) age was 52.6 years. There were 163 participants. But trialists had neither high uric acid, nor gout.
Four groups of trialists, ate over about 6 months, four different Glycemic Index and carbohydrate controlled diets in random order. Each group ate all four diets. Five weeks per diet, with intervening periods of 2 weeks. The diets were:
High carbohydrate, high Glycemic Index
High carbohydrate, low Glycemic Index
Low carbohydrate, high Glycemic Index
Low carbohydrate, low Glycemic Index
High Glycemic Index meant 65 or more on the GI scale; low meant 45 or less. High carbohydrate meant 58% of the diet’s foods were carbohydrate; low meant 40% were carbs.
Stephen Juraschek MD, of Johns Hopkins Hospital, Baltimore, a famous hospital in the USA, reported the results of the study, (1), which used data from the Omnicarb trial, published in the December 2015 edition of Arthritis & Rheumatology. After the trial Dr.Juraschek recommended using a GI diet to assist in lowering uric acid.
The results of the study were that reducing GI, meaning eating foods at 45 or less on the GI scale, lowered blood plasma uric acid with either high or low carbohydrate in their diet. Uric acid fell by - 0.24 mg/dL when GI was reduced and the percentage of carbohydrate in their diet was low, (40%), and by - 0.17 mg/dL when GI was reduced and the percentage of carbohydrates in their diet was high (58%).
There was no significant effect on blood uric acid when GI was low and carbs were reduced. (+ 0.03 mg/dL). When GI was high (that is high GI foods eaten) and the percentage of carbohydrates were reduced (40%), uric acid increased by 0.10 mg/dL.
A slightly better effect was achieved by simultaneously reducing the GI while increasing the percentage of carbohydrates. i.e. changing both variables, not just one. This was done statistically, using the four diets results, not by trialists eating another diet.
Changing both factors simultaneously led to a drop of - 0.27 mg/dL. This was not much higher than GI low/low carbohydrate fall of – 0.24 mg/d. Just - 0.03 mg/dL more. But the reduction was a little higher, and you can do this yourself.
In fact changing the GI seemed to be more important than the proportion of carbs.
GLYCEMIC INDEX AND URIC ACID STUDY – OTHER RESULTS
Anyone do better? So far I have discussed average figures results for whole groups. But some types did well. Who were they? Those with cholesterol equal to/lower than 240 mg/dL did, (-0.25 mg/dL) but not those above 240 mg/dL (-0.7 mg/dL); And for the combined (simultaneous changes) effect: -0. 37 mg/dL at less than 240; and -0.16 mg/dL at 240 or more.
Those who consumed less than the median baseline amount of alcohol, (more than 1.045 grams) achieved -0.28 mg/dL when GI was reduced in a high carb diet. Not a surprise. Lowering the GI foods did not affect uric acid if participants drank just a small amount of alcohol regularly at the beginning of each measurement period (i.e. a new diet).
Dr. Juraschek concluded: "Whilst our study was not conducted in a population with hyperuricemia (high uric acid) or gout, we show that a low GI/high carbohydrate diet can modestly reduce uric acid levels. While similar studies are needed in patients with hyperuricemia or gout, it is reasonable for clinicians to recommend GI reduction as one aspect of a lifestyle based strategy to reduce uric acid."
And remember, when weight is not lost, because weight was not lost in the study.
This study can be read online without charge, courtesy of the Wiley Online library. It is called:
"Effects of Lowering Glycemic Index of Dietary Carbohydrate on Plasma Uric Acid Levels: The OmniCarb Randomized Clinical Trial." Details below. But I'd recommend you read my article here a couple of times, to whet your appetite and get some background before you get into a more complicated explanation and discussion. Read the study here
However, before we all get too pleased, keep in mind this is only the first such study about the Glycemic Index and uric acid. And the uric acid reductions, whilst useful, were not that much.
One study does not make a summer, but it was an interesting first time study that now needs follow ups.
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Glycemic index in gout references
(1) Effects of Lowering Glycemic Index of Dietary Carbohydrate on Plasma Uric Acid Levels: The OmniCarb Randomized Clinical Trial Juraschek SP, McAdams-Demarco M, Gelber AC, Sacks FM, Appel LJ, White KJ, Miller ER 3rd. Arthritis Rheumatology. 2016 May;68(5):1281-9. doi: 10.1002/art.39527.