Gout and Raw Vegetables

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Raw Vegetables

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The Claim

Eating raw green vegetables helps to reduce the severity of gout outbreaks.

The Overview

Raw green vegetables are known as complex carbohydrates, and they’re frequently high in fibre that can help to relive the painful symptoms of gout. Vitamin C may help reduce uric acid levels, and good sources of this include broccoli and kale, along with other leafy green veg. Magnesium rich foods are also recommended, with magnesium being present in spinach and potatoes. There have also been suggestions that lowering the pH value of the blood can help prevent the uric acid from dissolving into the blood, as well as reducing the production the acid in the first place.

The Evidence

A 2008 non-systematic review mentions that nutritionists often recommend that people with gout should reduce consumption of some green vegetables, particularly leafy vegetables such as spinach because they are high in purines.4 However, a large cohort study has found that “moderate intake of purine-rich vegetables … is not associated with an increased risk of gout”.5

It has been suggested that other beneficial compounds in these vegetable might offset the adverse consequences of their high purine content but this requires further research.4

The Conclusion

There is no strong evidence that raw green vegetables can reduce the severity of gout outbreaks, and one study has suggested that certain leafy vegetables should be avoided, as they are purine rich. This study has not been backed up by further reviews, and it is recommended that people should continue to eat a normal balance of raw green vegetables in their diet, irrespective of whether they suffer from gout.

Research evidence sources

1 Jordan KM, Cameron JS, Snaith M, Zhang W, Doherty M, Seckl J, et al. British Society for Rheumatology and British Health Professionals in Rheumatology guideline for the management of gout. Rheumatology (Oxford). 2007;46(8):1372-4.

2 Zhang W, Doherty M, Bardin T, Pascual E, Barskova V, Conaghan P, et al. EULAR evidence based recommendations for gout. Part II: Management. Report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis. 2006;65(10):1312-24.

3 Singh JA, Reddy SG, Kundukulam J. Risk factors for gout and prevention: a systematic review of the literature. Curr Opin Rheumatol. 2011;23(2):192-202.

4 Pillinger MH, Keenan RT. Update on the management of hyperuricemia and gout. Bull NYU.Hosp Jt.Dis. 2008;66(3):231-9.

5 Choi HK, Atkinson K, Karlson EW, Willett W, Curhan G. Purine-rich foods, dairy and protein intake, and the risk of gout in men. N Engl J Med. 2004;350(11):1093-103.

6 Choi HK, Liu S, Curhan G. Intake of purine-rich foods, protein, and dairy products and relationship to serum levels of uric acid: the Third National Health and Nutrition Examination Survey. Arthritis Rheum. 2005;52(1):283-9.

7 Choi HK, Atkinson K, Karlson EW, Willett W, Curhan G. Alcohol intake and risk of incident gout in men: a prospective study. Lancet. 2004;363(9417):1277-81.

8 Choi HK, Gao X, Curhan G. Vitamin C intake and the risk of gout in men: a prospective study. Archives of Internal Medicine. 2009;169(5):502-7.

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