The Paleo Diet And Gout

This is a subject that I’ve touched on before in previous articles, but even though it’s been in the back of mind for some time, I’ve never actually dedicated an entire article to gout. gout is actually a widespread

condition, that causes a lot of pain for the people who suffer with it.

What is Gout?

“Gout is a disease that results from an overload of uric acid in the body.

This overload of uric acid leads to the formation of tiny crystals of urate that deposit in tissues of the body, especially the joints. When crystals form in the joints, it causes recurring attacks of joint inflammation (). Gout is considered a chronic and progressive disease. Chronic gout can also lead to deposits of hard lumps of uric acid in the tissues, particularly in and around the joints and may cause joint destruction, decreased kidney function, and (nephrolithiasis).

Gout has the unique distinction of being one of the most frequently recorded medical illnesses throughout history.” –

According to those wonderful, informative uloric commercials, gout’s root cause is high uric acid…..but of course, that sounds like one of those “we know what causes the problem, and we know that you can fix it with diet, but we’d much rather sell you a pill” kind of statements.

What about the Paleo Diet and Gout?

As luck would have it, my friend Mark Sisson decided to post a blog article about gout on the 23rd of April, over on his Mark’s Daily Apple blog. Check out the whole blog post entitled “Dear Mark: Risk of Gout?”.

“In previous centuries, gout was described as a “rich man’s disease” or “the disease of kings.” Ambrose Bierce called it “A physician’s name for the rheumatism of a rich patient.” Basically, it primarily affected the upper class, the royalty, the aristocracy – those who could afford “rich” foods like meat, sugar, and port. In the mid-19th century, uric acid was identified as the causative agent in gout. Where does uric acid come from? Purines.

The Gout Demon….maybe HE causes Gout?

Purines are in pretty much every cell – plant and animal alike – because they provide some of the chemical structure of both DNA and RNA. When cells are broken down and recycled (like in digestion – yum, love those delicious cells!), their purines get metabolized right along with everything else. Uric acid is a major product of purine metabolism, and this is a good thing; uric acid acts as an antioxidant in our blood, protecting blood vessels from damage. But if for some reason an excessive amount of uric acid (hyperuricemia) is produced, enough to crystallize and lodge in joints and other tissues, you might get gout.

And so the standard tale goes like so:

Since we get uric acid from breaking down purines, the natural solution is to reduce one’s intake of purine-containing foods – right? That seems sensible. Reduce purines, which turn into uric acid, and you reduce hyperuricemia, which causes gout. Boom. Problem solved.

The problem for a Primal eater given this advice, however, is that the richest sources of purines also happen to be some of our most treasured foods: organ meats like sweetbreads, kidneys, liver, and brain; seafood like sardines, anchovies, herring, mackerel, scallops, and mussels; and wild game meat. Even beef and pork are moderate sources of purines. In short, everything we talk about eating on MDA is apparently contraindicated for gout prevention. How do we reconcile without destroying our brains with cognitive dissonance?

Easy. We look for the real problem. What’s more logical? That purines, which appear in all foods and particularly in some of the most nutrient-dense foods (like organs and seafood), are the problem? Or that hyperuricemia, an excess of uric acid, is the problem?

Let’s table the purine talk for awhile, given the importance of purine-rich foods in the ancestral human diet, to look at some other causes of high uric acid. What else causes uric acid to rise?”

Exactly! Isn’t that always the way it goes? Are we really supposed to believe that the purines in the natural foods that we’ve been eating for thousands of years, are to blame for this? I don’t think so. It sounds like a product of the S.A.D diet to me. The following is just a summary, so make sure you head over to Mark’s blog to read the rest.

Mark goes on to list the following as causes for the high uric acid associated with gout:

  • Too Much Fructose
  • Insulin


  • Metabolic Syndrome
  • Dehydration
  • Alcohol Intake

He also addresses the fact that eating purine rich foods doesn’t cause or make gout worse:

“There is growing evidence that a low energy, calorie restricted, low carbohydrate (40% of energy), high protein (120 g/day, or 30% of energy) diet, with unsaturated fat (30% of energy) and high dietary fiber, is more beneficial in terms of lowering serum urate, insulin, LDL-C, and triglyceride levels, and hence reducing CAD risk, than the conventional low purine diet…”

Furthermore, research shows that eating purines actually increases uric acid excretion in order to maintain balance, almost like the body knows what it’s doing or something. Nah, couldn’t be.

It’s also worth noting that dietary protein has also been shown to increase uric acid excretion and lower serum uric acid. Hmm. It’s starting to sound like a low-carb Primal eating plan might just help, isn’t it?”

The Paleo Diet and Gout

As per usual, people who eat a healthy Primal or Paleo style diet, are definitely not raising their risk of developing many chronic diseases, and gout is no exception. If anything, it will help a person avoid gout, and/or make it better if someone already has it.

If you or someone you know has gout, pass this message along to them, and have them read the entire article over at Mark’s Daily Apple.


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Barry Cripps is a Paleo-based, Certified Nutrition and Wellness Consultant, who operates out of Bowling Green, Kentucky.

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4 Responses to The Paleo Diet And Gout

  1. Duane Wood April 24, 2012 at 1:01 pm

    I have Gout and was getting attacks more and more frequently until last July when I went Primal (75 -80%), I Have not had one attack since!

    • Lila Solnick April 24, 2012 at 4:25 pm

      That is terrific Duane. I’m glad going primal has made such a difference. There is hope for others who suffer.
      Thanks for commenting.

  2. HeatherT April 24, 2012 at 4:28 pm

    High purines might be yet another condition that results from high iron levels too High iron levels just were not a problem in primal times, thanks to the ubiquitous parasites and common injuries. However, in the US, iron levels are quite high, partly from meat but also from white potatoes and iron-fortified cereals. Iron is known to trigger Type 2 diabetes, but it also triggers high uric acid levels:

    It’s also worth noting that “rich men” in older times were the ones that could actually afford cast iron pans, which add a lot of iron to foods, and molasses.

    Some people are treating gout with iron-lowering foods (IP6, green tea, turmeric).

    • Lila Solnick April 24, 2012 at 5:54 pm

      That is fascinating. I hadn’t seen that connection before between iron and gout AND diabetes. But it’s making me rethink using my cast iron pans! Maybe I should go in for blood letting. :)
      Thanks for commenting.