Question

Please settle an argument. I love shellfish (lobster, especially) but my wife says it will precipitate an attack of gout (which I've had at three times in the last two years).

I think lobster would be OK. Who's right?
 

Answer

You have not mentioned whether shell fish have or have not precipitated your previous gout attacks. It is understandable that you and your wife are in disagreement about what precipitates gout attacks, as many misconceptions abound about gout, among both laymen and medical professionals, but perhaps after reading our answer you will be able to understand a little better that it is really a "trial and error" with foods eaten to see which ones are harmful to you, as a particular food can precipitate a gout attack in one person and not in another.
 

Gout is a disease in which a defect in uric acid metabolism causes an excess of the acid and it's salts (urates) to accumulate in the joints and sometimes in the blood stream. Uric acid is a waste product left over from metabolism of chemical compounds called purines that can be found in some of the foods commonly consumed by many people today. Perhaps your wife has read or heard about foods high in purines (Beef, Pork, Bacon, Lamb, Seafood to name some) being the cause of gout attacks. Well, there are new findings which represent a challenge to the "low-purine, high-carbohydrate" diet usually advised for gout patients. Each person is different and reacts differently to each condition, and the most important thing for any person with gout to know is to AVOID FOODS that TRIGGER YOUR ATTACKS. If the first attack can be traced to a particular food or irritant, continued exposure to it should be avoided. There is no positive evidence that so-called "anti-gout" diets affect the course of the disease. Preventive medications are more effective in the management of this disorder than following a purine-free diet. Treatment with drugs that increase the excretion of urates (uricosuric drugs) or with Allopurinol which slows their formation, can control the disease. Acute attacks are treated with antiinflammatory analgesics.
 

This excerpt is from our web site on results of recent studies done - "The right diet for Gout Victims". "These findings represent a challenge to the "low-purine, high-carbohydrate" diet usually advised for gout patients. Perhaps we need to re-think our recommendations regarding the most appropriate diet for gout patients. Certainly, further research should be done to substantiate these results. For those gout sufferers who want to try to follow the diet used successfully by the South African investigators, you can come close to it by following the dietary recommendations in "How to eat if you have cardiovascular disease" - Plenty fruits and vegetables, wholemeal breads, cereals and grains- which are the complex carbohydrates and high in fiber, free of saturated fat such as animal fats.
 

*Diet:: It is important to AVOID FOODS that TRIGGER YOUR ATTACKS, but there are other factors which should also be considered.
*Alcohol. Avoiding (or at least limiting) alcohol can be helpful for individuals with gout, since alcohol can cause both overproduction and under excretion of uric acid .
*Fluid Intake. Because dehydration can trigger acute gout attacks, it is important that persons with gout consume adequate amounts of fluids. Being well hydrated also helps to prevent kidney stones, which can develop as a result of high uric acid levels. *Food Intake at Regular Intervals. Plasma uric acid levels rise during starvation. Therefore, individuals with gout should avoid going for extended periods of time without eating. *Weight. Research has shown that blood uric acid levels are higher in overweight individuals, and that moderate weight loss can reduce uric acid levels. However, it is a total health benefit to attain and maintain an appropriate weight for height , whether one has gout or not. *Repetitive Joint Trauma: Persons with gout should avoid repeated trauma in areas susceptible to gout attacks. For example, tight-fitting shoes should be avoided.
 

Related Links
How to eat if you have cardiovascular disease
Diet and Gout - A New Approach
Gout treatment