Insulin resistance and gout - dealing with it using the Atkins diet

This page about insulin resistance and gout was last updated or reviewed on 2 July 2016.

It is Page 5 of 10 about the Atkins diet and gout.

Referenced studies and study abstracts, the numbers in brackets, are listed on page 10 of the Atkins diet for gout section.

The Atkins diet for gout articles are across ten pages.

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The metabolic syndrome, insulin resistance and gout. Dealing with it using the Atkins diet.

Dr.Atkins was emphatic that his diet would deal with insulin resistance and the metabolic syndrome.  So the Atkins diet could give you a double whammy advantage - you may both reduce uric acid production through lost weight and improve its excretion if insulin resistance is your cause of gout. This, not purines overload, may now be the leading cause of gout. So what is insulin resistance and the metabolic syndrome ?

On the road to an unfriendly place called "gout-betes." 

Insulin resistance and the metabolic syndrome is a pre type 2 diabetes, heart disease and stroke condition which some studies have shown also means high uric acid,  or a rising trend towards it, because, for one reason, high levels of insulin inhibit uric acid excretion.(1) - (6).

Just about all markers of the metabolic syndrome have also been correlated with uric acid levels. These marker-signs on the road to gout-betes (and heart attack and stroke) are: obesity; high total cholesterol; high LDL cholesterol; high triglycerides (hyperlipidemia); high blood pressure (hypertension), insulin resistance leading to high insulin levels and high blood sugar (hyperglycemia), and a poor HDL/LDL cholesterol ratio.(Too little HDL, and simply put, too much LDL). 

If you suffer from all these conditions, or just three of them (there are actually two definitions, so discuss this with your doctor) you are not only more likely to get heart attack, stroke and diabetes, you also have a much higher risk of gout,and the latest disease-on-the-march, non alcoholic fatty liver disease (NAFLD).

In Low-carbohydrate nutrition and metabolism  a results’ summary of low carb studies between 2003 and 2007, (12) the researchers concluded carbohydrate restricted diets reduced cardiovascular (heart) markers of the metabolic syndrome. And they concluded clearly that low carb diets have been found to lower insulin, and insulin resistance. This is an important positive for the Atkins diet for gout. It is elevated insulin that impedes uric acid excretion, so this is an Atkins advantage.  

However, no-one has studied either the Atkins diet or low carb diets in gout patients except the carbohydrate and calorie restricted diet, described below - See a gout diet which had significant success (below).

Any doctor can arrange for blood tests for these markers and tell you what the results mean. If you have all, or three of these, and have had a gout attack, and don't drink much alcohol, or eat high purine foods, or have gout in the family this could well be your gout cause.

Dr.Atkins was convinced that his diet is good for insulin resistance and the metabolic syndrome. He explained that readings of these factors will go in the right direction i.e. fall, on his diet, except perhaps LDL cholesterol since  many studies of low carb diets do not find reductions in LDL cholesterol.  LDL cholesterol may rise. If LDL cholesterol is one of these markers you need to reduce, I would research which kind of diet is likely to do this. There are plenty of medications to lower LDL if you wish to use that route.

But the other markers should all improve on the Atkins diet, including a fall in the number of triglycerides in your blood, which is very desirable.

However, if there are stronger rises in HDL cholesterol, (very desirable) which is likely on the Atkins diet, the HDL/LDL ratio improves. But the dangerous LDL cholesterol (or to be more precise VLDL cholesterol - the tiny particles which get deposited on heart artery walls - atherosclerosis) - should fall too if the ratio improves. 

This section on gout and Atkins lists on Page 4 (see the link below), foods and vitamins reported to help lower LDL cholesterol, and which can be part of the Atkins diet if you use it, but you must discuss lowering LDL with your doctor. Dr.Atkins did not treat high LDL cholesterol only with his diet. He used vita nutrients too.

The Atkins diet isn't the only diet for insulin resistance and the metabolic syndrome. Other diets (and not only restricted carbohydrate diets) deliver benefits against insulin resistance and the metabolic syndrome. Here’s one…..


In their books  Protein Power and The Protein Power Lifeplan, the Doctors Eades noted that gout occurs in people with insulin related problems. They thought people with gout would benefit from their Protein Power diet. They reported that symptoms of gout improve, or go away, when weight is lost on their diet. In fact, they noted improvements before much weight was lost - improvements due to metabolic changes brought about by cutting carbs. Two improvement examples are falling blood pressure and falling blood insulin.

Like the Atkins diet, the Eades’ diet restricts carbohydrates. When you restrict carbohydrates you get better control over insulin - less is made. And more insulin sensitivity - a better response to insulin.

The Eades thought those who dieted at their Phase 1 Intervention level, 7-10 carbs per meal or snack, could reduce their uric acid.

More details are in their Protein Power, and The Protein Power Lifeplan books. Recommended if you wish to pursue this further. Make sure you check with your doctor before you try this diet.


Even if the Atkins diet does not lower your uric acid level, or by not enough to bring it down to the critical  6.0 mg/dL in men, and about 5.0 - 5.5mg/dL in women, the fall in the markers of the metabolic syndrome will definitely have made the diet worthwhile and they should go in the right direction. The markers can improve even in the very unlikely event of no weight loss. (Make sure you do Atkins correctly).

And if all these markers of insulin resistance and the metabolic syndrome improve, you will not have to take cholesterol lowering meds such as the statins. It may take six months for all markers to improve, but for some only a couple of weeks.

Have studies shown that weight loss itself improves metabolic syndrome markers?  Yes. The effect of Weight Reduction on Metabolic Syndrome in Korean Obese Patients study (9) demonstrated this, and this study also found reductions in uric acid from weight loss.


And now something about a study that in my opinion is one of the best gout diets. (8).

It is widely quoted in gout scientific literature. It is a specific test of how a diet performs on gout sufferers. Targets were features of insulin resistance and the metabolic syndrome.

And in this study many of the frequently publicised gout diet rules were broken !

Study participants ate purines without counting them - they were even encouraged not to eat some low purine foods - some high purine fish were eaten. Fish itself was eaten probably four times a week, and meat consumption was not decreased. Intake of monounsaturated fat (olive oil, canola oil, certain nuts high in this fat and other foods with a high amount of this fat) was empathised (empathized). However, participants didn't drink much alcohol, but they weren't asked to avoid it. 

The study's diet was significantly successful. Uric acid levels fell in all, and so did gout attacks in 12 of the 13 participants. At the end of the study only four had had a gout attack, in the previous six weeks. Other features of insulin resistance and the metabolic syndrome also improved.

And they lost weight (median weight loss 7.7 kgs - almost 17 lbs - in 16 weeks) - only one participant didn't. But the researchers did not think the weight loss had caused the uric acid level drop. In this study, insulin resistance may have been the participants' cause of gout, and it may have led to high uric acid.  They thought that an improvement in insulin sensitivity (i.e. the way insulin was working improved), was the factor that caused UA to fall. So why the improvement in insulin sensitivity?

One of the diet's features was carbohydrate control, but a higher level was allowed than on the Atkins diet Ongoing Weight Loss (OWL) phase. Participants were allowed 1,600 calories daily, 40% from carbs, 30% from protein, 30% from fat.

They ate 160 carbohydrate grams daily, and more protein (120 grams) than average. The researchers thought that increased proportional protein, the reduction in carbohydrates and the mono and polyunsaturated fats - all contributed to the improved insulin sensitivity. And protein has been reported in studies to lower uric acid levels (22-23), and not be a gout risk (7). Whatever it was, something had clearly worked.

Why do I mention this ? To show that on this diet meat and fish were eaten and to explain that a non low purine diet, one which restricted carbohydrate, can work to improve insulin sensitivity and improve a gout sufferer's condition. The Metabolic Syndrome (aka Syndrome X), and insulin resistance, which this diet tackled, leads to high levels of insulin, which means less uric acid is excreted and therefore uric acid level rises (1)-(6). 

Visit our page about this study.

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.

Read about the GI/GL here

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

Related 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 about the Atkins diet and gout. More about what Robert Atkins said about his diet and gout.

Go to page 4 of 10 about the Atkins diet and gout where I explain our modifications to the Atkins diet for gout sufferers.

Go to page 6 of 10 where I explain my Atkins diet success.

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.

Dealing with insulin resistance. ? Avocados are a good food for gout sufferers.

Want to read the menu and recipe ingredients for five courses of low/medium purine dishes which are also restricted carbohydrate?

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