An Eating Plan for Gout

2 people enjoying a healthy meal

For many Americans, healthier eating was a top New Year’s resolution this year.1,2 Some started diets on January 1 and never looked back. For others, however, it hasn’t been so easy. If you suffer with gout and find that a gout diet is too restrictive, consider following an eating plan for gout. Read on to learn more about the connection between food and gout, as well as two popular healthy eating plans.

The connection between food and gout

Research has shown that your family history can have more of an impact on your chances of developing gout than what you eat.3,4 That said, your diet choices can still affect your risk of flares.5 The reason is because some foods and drinks contain higher levels of purines (naturally occurring chemicals found in foods and drinks like red meat, organ meats, shellfish and beer) than others.5 When you consume purines, your body converts them to a waste product called uric acid.5 When there is too much uric acid in your body, it can build up in your bloodstream and cause urate crystals to form around a joint.5 These crystals can trigger the painful attacks you probably know as gout flares.5

 

The benefits of an eating plan

If you feel that a diet is too limiting, an eating plan may be a good alternative. Compared to a diet, which can be strict, an eating plan is a set of guidelines that allow you some flexibility as you work toward your healthy eating goals. The Gout Education Society recommends two eating programs for people with gout: DASH and the Mediterranean plan.6

 

DASH

DASH (Dietary Approaches to Stop Hypertension) is a healthy-eating plan that was originally intended to help treat or prevent high blood pressure.7 It builds nutrient-rich meals around whole grains, low-fat dairy products, vegetables and fruits, and includes fish, poultry, beans, nuts and healthy oils.8 DASH is a flexible and balanced plan that helps create a heart-healthy eating style for life, and it’s easy to follow using foods you can find at the grocery store.7

 

The Mediterranean Plan

As the name suggests, the Mediterranean plan is made up primarily of the foods traditionally eaten by people who live in the countries bordering the Mediterranean Sea (Greece, Italy, Spain, France and others).6,9 Researchers found that people who ate these foods were particularly healthy and had a low risk of many chronic conditions.10 According to the American Heart Association, the Mediterranean plan typically includes lots of vegetables, fruit, grains, potatoes, beans, nuts and seeds.9 Dairy products, eggs, fish and lean meats are eaten only in moderate amounts.9 The primary fat source is olive oil.9

 

Additional considerations

If you are thinking about changing your eating habits to improve your health and reduce your risk of flares, be sure to keep in mind the following:

  • Avoid crash diets. Rapid or extreme weight loss can cause the uric acid level in your body to go up, which has the potential to contribute to gout flares.6
  • Consider losing weight if you are overweight. If you are overweight, your body may produce more uric acid than your kidneys can remove.5 (Higher uric acid levels put you at risk for gout flares.5)
  • Drink plenty of water. According to a 2009 study, drinking more water may mean fewer gout flares.11
  • Be kind to yourself. If you fall off the healthy eating wagon, take a deep breath, remember that you are human and resolve to resume the good habits you’ve been working to maintain.

 

Taking the first step toward a gout diet plan

Be sure to talk with your doctor before you make changes to your eating habits (or begin an exercise program). If you still are suffering with gout attacks in spite of the lifestyle changes you’ve made, you might need gout medicine.12 Urate-lowering therapy (ULT) can help address the root cause of gout by reducing the uric acid level in your bloodstream.12 Your doctor may also prescribe a colchicine product to prevent gout flares, such as Mitigare® (Colchicine) 0.6mg Capsules.13

 

Mitigare® is a registered trademark of Hikma Pharmaceuticals USA Inc.

Colchicine 0.6 mg capsules are contraindicated in patients with renal or hepatic impairment who are currently prescribed drugs that inhibit both P-gp and CYP3A4. Combining these dual inhibitors with colchicine in patients with renal or hepatic impairment has resulted in life-threatening or fatal colchicine toxicity. Patients with both renal and hepatic impairment should not be given Mitigare®.

Fatal overdoses have been reported with colchicine in adults and children. Keep Mitigare® out of the reach of children.

Blood dyscrasias such as myelosuppression, leukopenia, granulocytopenia, thrombocytopenia and aplastic anemia have been reported with colchicine used in therapeutic doses.

Monitor for toxicity and, if present, consider temporary interruption or discontinuation of colchicine.

Drug interaction with dual P-gp and CYP3A4 inhibitors: Co-administration of colchicine with dual P-gp and CYP3A4 inhibitors has resulted in life-threatening interactions and death.

Neuromuscular toxicity and rhabdomyolysis may occur with chronic treatment with colchicine in therapeutic doses, especially in combination with other drugs known to cause this effect. Patients with impaired renal function and elderly patients (including those with normal renal and hepatic function) are at increased risk. Consider temporary interruption or discontinuation of Mitigare®.

The most commonly reported adverse reactions with colchicine are gastrointestinal symptoms, including diarrhea, nausea, vomiting and abdominal pain.

Please see the full Prescribing Information and Medication Guide for Mitigare® for complete product details.

 

NOTE: This article was not written by a medical professional and is not intended to substitute for the guidance of a physician. These are not Hikma’s recommendations for gout flare prevention, but rather facts and data collected from various reliable medical sources. For a full list of resources and their attributing links, see below.

References

  1. Top New Year’s Resolutions for 2022. Statista website. Available at: https://www.statista.com/chart/26577/us-new-years-resolutions-gcs.html. Accessed January 12, 2022.
  2. America’s Top 4 New Year’s Resolutions for 2022. MSN website. Available at: https://www.msn.com/en-us/money/news/america-s-top-4-new-year-s-resolutions-for-2022/vi-AASddj1.html/ Accessed January 12, 2022.
  3. Higashino T, Takada T, Nakaoka H, et al. Multiple common and rare variants of ABCG2 cause gout. RMD Open. 2017;3:e000464.
  4. J Chang S-J, Chen C-J, et al. ABCG2 contributes to the development of gout and hyperuricemia in a genome-wide association study. Nature/Scientific Reports. 2018;8:3137.
  5. Gout/Symptoms & causes. Mayo Clinic website. Available at: https://www.mayoclinic.org/diseases-conditions/gout/symptoms-causes/syc-20372897.html Accessed January 7, 2022.
  6. Diet & Lifestyle. Gout Education Society website. Available at: https://gouteducation.org/diet-lifestyle.html. Accessed January 7, 2022.
  7. Healthy Lifestyle/Nutrition and healthy eating/DASH diet: Healthy eating to lower your blood pressure. Mayo Clinic website. Available at: https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/dash-diet/art-20048456.html. Accessed January 7, 2022.
  8. NIH-supported DASH diet tops rankings for “heart-healthy” and “healthy eating.” National Heart, Lung, and Blood Institute website. Available at: "https://www.nhlbi.nih.gov/news/2021/nih-supported-dash-diet-tops-rankings-heart-healthy-and-healthy-eating.html Accessed January 7, 2022.
  9. What is the Mediterranean Diet? American Heart Association website. Available at: https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/mediterranean-diet.html. Accessed January 7, 2022.
  10. Mediterranean Diet 101: A Meal Plan and Beginner’s Guide. Healthline website. Available at: https://www.healthline.com/nutrition/mediterranean-diet-meal-plan - what-is-it.html. Accessed January 12, 2022.
  11. Neogi T, Chen C. Drinking water can reduce the risk of recurrent gout attacks. Arthritis Rheumatol. 2009;60:S762.
  12. Aung T, Myung G, FitzGerald JD. Treatment approaches and adherence to urate-lowering therapy for patients with gout. Patient Prefer Adherence. 2017;11:795-800.
  13. Mitigare® (Colchicine) 0.6mg Capsules [prescribing information]. Columbus, OH: West-Ward Columbus, Inc.; 2019.

Important Safety Information for Mitigare® (colchicine) 0.6 mg capsules

  • Colchicine 0.6 mg capsules are contraindicated in patients with renal or hepatic impairment who are currently prescribed drugs that inhibit both P-gp and CYP3A4. Combining these dual inhibitors with colchicine in patients with renal or hepatic impairment has resulted in life-threatening or fatal colchicine toxicity. Patients with both renal and hepatic impairment should not be given Mitigare®.
  • Fatal overdoses have been reported with colchicine in adults and children. Keep Mitigare® out of the reach of children.
  • Blood dyscrasias such as myelosuppression, leukopenia, granulocytopenia, thrombocytopenia, and aplastic anemia have been reported with colchicine used in therapeutic doses.
  • Monitor for toxicity and if present consider temporary interruption or discontinuation of colchicine.
  • Drug interaction with dual P-gp and CYP3A4 inhibitors: Co-administration of colchicine with dual P-gp and CYP3A4 inhibitors has resulted in life-threatening interactions and death.
  • Neuromuscular toxicity and rhabdomyolysis may occur with chronic treatment with colchicine in therapeutic doses, especially in combination with other drugs known to cause this effect. Patients with impaired renal function and elderly patients (including those with normal renal and hepatic function) are at increased risk. Consider temporary interruption or discontinuation of Mitigare®.
  • The most commonly reported adverse reactions with colchicine are gastrointestinal symptoms, including diarrhea, nausea, vomiting, and abdominal pain.

Indication

Mitigare® is indicated for prophylaxis of gout flares in adults. The safety and effectiveness of Mitigare for acute treatment of gout flares during prophylaxis has not been studied.

Mitigare® is not an analgesic medication and should not be used to treat pain from other causes.

For Full Prescribing Information please CLICK HERE and for Medication Guide CLICK HERE.

You are encouraged to report negative side effects of prescription drugs to the FDA.

Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Manufactured by: West-Ward Columbus Inc., Columbus, OH 43228

Important Safety Information for Mitigare® (colchicine) 0.6 mg capsules

  • Colchicine 0.6 mg capsules are contraindicated in patients with renal or hepatic impairment who are currently prescribed drugs that inhibit both P-gp and CYP3A4.