GoutPal Interactive

Potential Renal Acid Load, usually called PRAL, is a quick, easy, way to estimate the acid / alkali balance of your food. Learn how to find it, how to calculate it, and what it means for your gout diet.

Friends frequently ask me, “What foods can I eat with gout?”
Please do not think that I have a huge circle of gouty acquaintances.
I see all gout sufferers as friends, especially the ones who comment here, post in the gout forum, or tell me about their gout by email.

When I started developing my gout diet plan, I deliberately shied away from creating a fixed menu, for two reasons:

1. It takes up more time than I have available.
2. I do not agree with telling other people what to eat.
3. I feel it is irresponsible to plan a diet for somebody if you know nothing about them

Despite being unable to count, I try to explain how food might affect your gout. Most published dietary guidelines for gout are based on disjointed scientific facts (occasionally fiction) by people who have never experienced the agony of gout.

For most gout sufferers, weight is a major factor, and for many of these, getting down to normal weight will cure their gout.

Many gout sufferers have a genetic tendency to gout, or other problem with uric acid metabolism. If getting down to normal weight, and maintaining a gout-friendly diet, doesn’t cure their gout, then uric acid lowering medications are the answer. With these, they should be able to eat anything, though I still recommend a well balanced healthy diet to avoid other health problems.

If anyone wants to pay me to prepare a personal diet, then I am happy to work for them. I really don’t expect anyone wants to do this, so I have not begun to think about what charges should be.

I have thought about a private club where I would give individual dietary advice for members to share with other similar members. I guess the cost of this would be around $17 (£10) per month. I have not taken this idea very far because, again, I doubt that enough people would be interested to make it worthwhile.

Now, I would love to be flooded with offers of money, to prove me wrong, but it aint gonna happen. Is it? Go on, you know you want to click that button.

I believe that most people do not adapt well to sudden changes in diet, therefore I recommend that gout sufferers assess their own situation and gradually exchange poor habits for good ones. I have tried to put enough information on the websites to allow all gout sufferers to make healthier choices.

Very soon, I will add some recipes to the GoutPal site that highlight key points about healthy eating for gout. These will go a long way to answer “What foods can I eat for gout?”

If you are still stuck with ideas for how to improve your diet, please post details in the gout forum about yourself, and what you currently eat. I need to know age, weight, height, gender, how much exercise you get each day, and details of your daily diet. The more information the better. I will suggest what foods you should think about changing to help your gout.

In my search for antioxidants for my previous message, I found an interesting approach to healthy gout food. The article about food is not specifically about gout, but a lot of the food listed is high antioxidant. Certainly, none of it should make gout worse, and the presentation gave me a new idea for healthy gout food.

Dr David Heber is well known for his “What Color is Your Diet?” book. I found some fascinating information from him about nutrition and antioxidants. He has grouped food by color, and I think the plan is to try and eat something from each color group every day. Well, if he can do it, why can’t I?

The color groups are Red, Green, Green/Yellow, Red/Purple, Orange, Orange/Yellow, White/Green. Before I continue with these groups, I’d like to share some of Dr Heber’s comments, as they are very relevant to healthy gout food.

The first is very relevant to those gout sufferers, like me, who are trying to lose weight:

Another advantage of a diet rich in fruits and vegetables is that it reduces the number of calories per bite or “energy density.” It is only possible to eat a certain volume of food until you get full (at least for most of us), but there is no increased fullness when sugar or oils are added to a given volume of food.

He also offers practical advice that is very much in-line with my approach to healthy gout food:

Visualize your plate and fill it two-thirds with vegetables from the above categories and one-third with low fat protein foods such as chicken or turkey breast, ocean-caught fish or seafood, or soy protein meat substitutes. Have a dark green leafy salad beforehand and when everyone else is going for the Creme Brulee ask for a dish of mixed fruits for dessert such as kiwi, blueberries and strawberries. This way you won’t feel deprived and you will be eating very healthy foods that are good for you as well as taste good.

The table is developed for cancer, not gout, but it still has some relevance to us. I believe the color coding system is probably as much to do with certain nutrients as it is with color. The Red/Purple and Green/Yellow groups are a particularly strong indication of this, as you can see from this table:

7 Colors of Health: Color Code
1. Red:	Tomato juices, soups, or sauces, tomato, watermelon, pink grapefruit. Lycopene inhibits breast cancer cell growth in the laboratory.
2. Green:	Broccoli, Brussel sprouts, cabbage, bok choy. Isothio-cyanates increase liver proteins that defend against carcinogens.
3. Green/Yellow:	Spinach, collard greens, kale, mustard greens, avocado. Lutein protects vision, the heart, and inhibits cancer cell growth.
4. Red/Purple:	Grapes, strawberries, cranberries, raspberries, blueberries. Proanthocyanidins protect against urine infections. Ellagic acid inhibits cancer cell growth.
5. Orange:	Carrots, butternut squash, cantaloupe, sweet potato. Beta carotene protects vision and immune function, and is an antioxidant.
6. Orange/Yellow:	Oranges, lemons, pineapples, peaches, nectarines. Flavonoids inhibit tumor growth and repair DNA. Limonoids in the skin of lemons and oranges inhibit tumor growth.
7. White/Green:	Garlic, onions, chives, leeks. Allyl sulfides inhibit tumor cell growth.

You might like to try color-coding some of the items from the table in my last post about gout and antioxidants. It is not necessary to be too precise about this – just try to get as much variety as you can each day.

Gout and antioxidants are closely related. Uric acid is an antioxidant that we produce to help protect our bodies from free oxygen (free radicals) that can harm our bodies. Though we need this antioxidant for life, too much of this particular good thing can lead to gout.

Gout research tells us that food high in antioxidants can help reduce uric acid. My logic tells me that it makes sense for our bodies to produce less of our own antioxidant, uric acid, when we can absorb what we need from our food. One pillar of my gout diet plan is that food rich in antioxidants will help lower uric acid.

Up to now, I have simply advised you to increase antioxidant rich foods. Many of you want more than this, and so I will shortly be publishing a series of free gout recipes that will help you plan your own gout diet. In my next newsletter, I will also introduce a more detailed gout diet planning service for those who want to be told what to eat. As gout affects everyone differently, I will also show you how you can see for yourself, which foods raise or lower your own uric acid.

Antioxidant measuring is a new part of nutrition. Better measurement techniques and new research studies are adding to our knowledge daily. I focus on a simple list of foods that have been generally accepted as being high in antioxidants.

TABLE 4 The 50 foods with the highest antioxidant contents per serving size¹

Product Antioxidant content mmol/serving Blackberries 5.746 Walnuts 3.721 Strawberries 3.584 Artichokes, prepared 3.559 Cranberries 3.125 Coffee 2.959 Raspberries 2.870 Pecans 2.741 Blueberries 2.680 Cloves, ground 2.637 Grape juice 2.557 Chocolate, baking, unsweetened 2.516 Cranberry juice 2.474 Cherries, sour 2.205 Wine, red 2.199 Power Bar, chocolate flavor2 1.875 Pineapple juice 1.859 Latino beverages, guava nectar 1.858 Juice drinks, 10% juice, blueberry or strawberry flavor, vitamin C enriched 1.821 Cranapple juice 1.790 Prunes 1.715 Chocolates, dark, sugar-free 1.675 Cabbage, red cooked 1.614 Orange juice 1.510 Apple juice, with added vitamin C 1.462 Latino beverages, mango nectar 1.281 Pineapple 1.276 Oranges 1.261 Bran Flakes, breakfast cereals3 1.244 Plums, black 1.205 Pinto beans, dried 1.137 Canned chili with meat and beans 1.049 Spinach, frozen 1.045 Canned chili with meat, no beans 1.040 Whole Grain Total, breakfast cereal4 1.024 Chocolate, sugar-free 1.001 Kiwi fruit 0.987 Molasses, dark 0.980 Potatoes, red, cooked 0.956 Cheese lasagna, frozen and cooked 0.942 Potatoes, white, cooked 0.918 Sweet potatoes, baked 0.900 Iced tea, brewed, unsweetened 0.881 Potatoes, russet, cooked 0.862 Baked beans, pork and beans in brown sugar sauce 0.852 Condensed tomato soup, one brand 0.826 Broccoli raab, cooked 0.823 Peppers, red, cooked 0.820 Broccoli, cooked 0.780 Latino beverages, tamarind nectar 0.761

¹ The antioxidant content per serving size was calculated as indicated in Table 6. Mean values are provided for products for which different brands are comparable.

² POWERBAR Co, Berkeley, CA.

³ Ralston Foods, Battle Creek, MI.

⁴ General Mills, Inc, Milwaukee, WI.

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Remember, antioxidant content varies widely with many factors including season, method of cooking, and variety. Do not get bogged down in the numbers, just use the list to try and improve what you are eating now.

There are several methods of measuring antioxidant values, and many different studies. These foods are only a selection, and do not cover all high-antioxidant foods. Another good list is the table of best sources of antioxidants in foods.

If you like a high antioxidant food that is not listed here, but you think it might help your gout, then add a comment, or, even better, discuss it in the gout forum.

The relationship of gout and alcohol is important to most gout sufferers. Do not get obsessed with this, but also do not forget to get your kidneys checked.

So many diets for gout restrict you and make you miserable. The GoutPal diet just makes me happy – and thinner

See how coffee and gout are related. The more coffee you drink, the lower your chance of getting gout.

I’ve just finished the third week of my gout food diet, and I’m very happy. There is still a long, long way to go, but the first three weeks have followed my plan almost exactly.

If you are new to the GoutPal diet it is very simple. A small improvement every few days means that there is no extra stress on your body from sudden excess weight loss. It really doesn’t feel as if you are dieting. Deliberately very simple, as long as you understand the need to balance (and improve) diet, exercise and metabolism, the GoutPal diet is focused on slowly losing weight where you need to, and improving the health of your diet.

You can read more about it on my gout diet pages. It is not a traditional diet where I start by telling you what to eat. It is more about improving diet and lifestyle so that the way you live helps your gout. If you have trouble adapting to this type of diet plan, just send me some details about your height, weight, activity levels, what you like to eat and when you eat it. I’ll offer some suggestions that will help your gout.

I’ve noticed this week, that my efforts to eat smaller portions are paying off. The idea is very simple – serve a smaller portion, promising yourself more later if you need it. It’s much easier to avoid overeating if you have to serve yourself more, rather than going to the kitchen for another helping – just don’t leave the serving dishes (or takeaway containers) near where you eat.

To help improve my alkalinity, I’ve deliberately concentrated on eating more vegetables. A typical example is a delicious gammon steak, which is something I love, when it’s well produced. This week, I had half a steak instead of a full one, liberally accompanied by cauliflower cheese, carrots and peas.

As I’ve said before, this is probably the most boring diet in the world. Not boring to do as I eat more or less what I like, just not much happening to write about. I have found that writing about my progress does help keep me focused. If you think writing about it will help you, why not give us a weekly update about your gout food diet on the gout forum?

I mentioned at the beginning that my diet is going almost to plan. The plan is to lose 1 pound per week. I lost 2 again this week, bringing the 3 week total to 5 pounds. Imagine how good it would feel to discard a 5 pound weight after carrying it everywhere for three weeks. Much less strain on the old knees, so I’ve found walking a little bit further, a little bit faster, has been no effort.

Gout foods make a gout diet, but how do you know which to eat? Eat them all if you want, but learn when less is more.

Just thought I’d take a moment out from answering emails to give you an update on my gout diet. If you’ve written in the last two weeks, I’m still working on the replies. If you are still waiting from before that, chances are that the message has got lost somewhere – please write again.

If you read about my gout diet plan in the last newsletter, you will know that one of the major points is to make gradual change. The good side of that is that you tend to make changes that matter, and you tend to keep to those changes and turn them into better habits. The downside is that there is nothing spectacular to tell you about.

By biggest change during Week One was to make sure I always had fruit available. I could have made this change even better by walking for it instead of shopping by car.

I cannot report that I ate fruit every day – well I could, but it wouldn’t be true. Fact is, I ate fruit as a snack between meals on most days, and as a dessert once instead of taking a second helping of dinner. OK, I know it’s boring, but that is the point – one or two easy, minor changes.

It’s far too early to report any benefits yet. I know that the gout benefits will be long term. For now, I must focus on weight loss. Please don’t expect any excitement here either. You may recall that my aim was to lose one or two pounds a week until I reach the normal weight band of the BMI index. I lost One Pound.