Gout sufferers and meal packing

I try to watch what I eat when I'm in the city but when I'm on the trail, my body really needs the stuff that I love to eat so very much.
I currently take Allipurinol (I think that is the spelling), it's a generic anti-gout medication (Dr. prescribed) that I have to take once a day. Since I'm been on it, I have not had a flareup at all.
Even though I have dealt with gout on and off for the last several years (more recently) I never let it stop me from getting out into the woods, although it does slow me down quite a bit.

A gout attack can be bad for me. I have a script for allopurinol as well. Cutting way back on red meat proteins, going to lower protein and a semi vegan diet, and increasing my intake of water seems to be working so far. My doctor said a recent uric acid test showed a slightly elevated acid level and gave me a number, but didn't say what range of acidity was normal for me.

I have gout and don't ever want another attack again, they are very painful and will stop me in my tracks. For the last 15 years I have been using Allipurinol along with the following diet suggestions, and so far no more attacks.

Foods low in purines are best, and limit those foods high in purines. I stopped eating organ foods (liver), smoked meats, shellfish and sardines. I limit my meat intake to once a week, and beef to just once a month. For protein I use cheese, soy powder, dried beans, milk powder and nuts. I make most of my own food and add 1 tablespoon of soy protein (10 grams of protein) to granola for breakfast and my dinner, usually pasta. I try to keep my diet on and of the trail as varied as much as possible and eat a mostly vegetarian diet. Drinking extra water is also a good idea.

When not backpacking I keep active as possible and keep my alcohol consumption down to 1 or 2 drinks a day. It took a bit of work to make these changes in my life both on and off the trail but I never want another gout attack.

I too suffer gout but I think you all are missing something here. Gout is hereditary (sp?) and not so much taken from the intake of meat or alcohol. It is a arthiritis condition that can be quite painful. For those that are reading this and chuckle, it feels like a broken bone. Seriously. It invades your joints (for me, it is my knees, big toe, or the top of my foot). I miss work and suffer some severe pain. I too have the meds that you all have mentioned but luckily I only get a flare up now once a year. It sucks. Has it made me miss trips….Hell yeah it has. Again, from what I have been told my a doctor, it is not so much what you eat and drink (alcohol), but your families dispostion to having it.

Interesting post!!! I hope my summation helps.

Oh and water intake can help quite a bit. Seems to wash out the pain so to speak.

I must admit I know little about gout. Is it only meat protein that should be watched or can you have other proteins from vegetable based sources?

I'm thinking of things like quinoa and pulses such as lentils.

Ken is right that gout is hereditary and not caused by diet. It is an arthritus, that can flare up from a number of factors, including stress or diet. Controlling ones diet just helps to keeps the flare ups or attacks to a minimum. Allipurinol a precription drug helps the body to reduce the generation of uric acid. When I was first diagnosed with gout I was given a prescription for colchicine, an anti-inflammatory that helps to reduce the swelling of the joints under attack from the gout. Their is no cure for gout, so all we can do is keep it at bay.

Maintaining a "healthy" lifestyle is recommended to keep the attacks at bay. Overweight, smoking, and diabetics are all bad for us gout victims. We all need to find a personal balance including diet to keep the attacks from not occuring both on and of the trail.

Laurie your suggestions of quinoa and pulses such as lentils are excellent. Although not considered high in purines like organ foods or shellfish they are high enough to be a concern. Beans are also a concern but for me, a serving of 1/3 cup of cooked then re-dried in a food dryer causes no problems. I just dont like quinoa, however I do like lentils. The problem with lentils for me is getting the cooked and re-dried lentils to reconstitute on the trail in a short time with a minimium of fuel. My cooking style is to bring the water to a boil and simmer for two minutes, then let the meal rehydrate for 15 minutes

Getting enough protein while on a trip has never been a problem for me, my daily intake of protein is 75 to 100 grams a day. What is a problem is getting enough fat in ones diet, fat makes the pack heavy. Fortunately for us people with gout, high fat diets are not recommended.

Chris I have the anti inflamatory meds and they do offer some help. My last attack was sooo bad that my doctor gave me a Vikadin. That helped……..a little. Chris is right, diet, healthy living and a reduction of stress can offer some relief. I even had a flare up mid trip once. That was an adventure to say the least. Now I pack some anti inflamatories just in case.

Chris, the local natural food co-op here in Seattle has bulk dried lentil soup that is fantastic. I routinely take it backpacking because it needs no cooking, just add some hot water to a freezer bag of it and wait three minutes. Yum!

Chris it sounds like it makes the diet pretty difficult.

I make a lentil salad that rehydrates well with unheated water. My style tends to be a little different though. I don't mind having 1/2 hour soak time while I set up camp and take some photos and such. Plus if I don't heat up the water I save fuel too.

Lentil soups and the like rehydrate really quickly and so do things like hummus.

I can see what you mean about the fats. Is it all fats that are of issue or can things like olive oil or avocados be used?

Thanks for this discussion everyone. I am currently working on a new project and hearing these stories is quite helpful.

Some more general comments about gout. Its a males disease, females can't usually get gout until twenty years after menopause. Males usually come down with gout in their mid thirties or later. The disease is associated with rich people, but in fact is associated with rich food diets – lots of alcohol, refined and or fast foods, and certain foods high in purines. Asprin, and Soft drinks high in fructose from corn are not good for us humans with gout. The pain of a gout attack is often compared to that of childbirth.

The severity of an attack is different for each person and so is their history of attacks. For me an attack would mean several days of using crutches with a recovery of two weeks, yet I know people that have much less pain in their attacks that would last a day or two. I havn't had an attack in the last 15 years, yet a friend has had attacks over the last thirty years. Repeated attacks can cause long term damage to the joints.

Ken you summed it up best "healthy living" is the overall answer to dealing with gout.

Monty I have started looking for instant lentils soups, thanks for the tip.

Laurie you are right in saying that it makes diet planning difficult, but not as difficult as those people with complicated food allergies or diabetics. Fat consumption can be a problem, and is based more on the total fat consumed from all foods such as milk, cookies and nuts. I add olive oil to my backpacking dinners and this is not a problem. I also make a meal that has miso, olive and sesame oils, plus pine nuts and it has never been a problem. Your suggestion of soaking lentils in cold water is a good one, and something I must try. Laurie inquiring minds want to know whats the new project ?

Hi Chris,

A bit off topic… I notice that you are in Stratford…. I'm not all that far away from you. Perhaps about one hour (driving). I am going to send you a private message through the system here.

The new project is another cookbook… I am obsessed I guess… lol.

I'm not too sure about the hereditary thing, there's no history that I am aware of, on either side of my family who have had it.
Yeas it is a nasty form of arthritis, what happens is that the uric acis builds up to a point where it crystalizes and it collects anywhere there is inflamation in the joints. Typically it goes to feet, but can occur in ankles, knees, wrists and fingers.
There are quite a number of vegetables that should be avoided or cut back on depending upon your sensitivity.
I have had to eliminate carbonated beverages because it causes kidney stones – another aliment which sometimes accompanies gout.
I also have a few food allergies which doesn't help any.
I've read that a diet higher in dairy products, fruits, grains and pasta seems to help, but if you're carb sensitive it's like walking a razors edge.

never heard about vegeteables that need to be avoided. Which ones??? Curious, because I eat quite a bit of veggies. Also, carbonated drinks??

I had to go to a arthrities doctor and that is where I was told about it being hereditary. I was also told, that normal consumption of food in a balanced diet as well as not drinking excessively were ok too. I get one to two attacks a year and they are living hell.

For us gout suffers the following vegetables are considered medium sources of purines, dried beans, peas, lentils, asparagus, mushrooms, spinach, cauliflower, green peas, oats, whole grain breads and cereals. These vegetables should be eaten in moderation

However research from a 2004 study found that purine rich vegetables don't increase the risks of an attack and milk products reduce the build up of uric acid in the joints.

I don't have any problems with any of the vegetables, and I add milk powder to all my meals and hot drinks. Until reading about the study I believed all purine rich foods could bring on an attack, and now veges are okay, in fact veges can reduce the risks of an attack, isn't science wonderful.

I've been suffering with gout flare ups since high school. It is hereditary, but diet DOES affect gout. When I consume alcohol, it sometimes sets me into a flare up. I once on a camp out got the gout and still drank beer with it (not smart) and it swelled up like an elephants foot! I take allopurinol also and I am currently in a flare up. My doc said that my med needs to be upped daily, BUT I have to wait until my flare up resides. I did alot of reading on gout. Eating a daily allowance of cherries helps out alot to prevent flare ups. I was told as mentioned that colchicine helps with my flare up BUT you have to continue to take it until you get diarrhea! So basically I have to take a drug that gives me the runs and hopefully I can limp to the toilet in time :(. This flare up is the worst I have ever had! I've had it for over 5 weeks. It'll subside, then flare back up. I read about a bracelet called a Q-Ray thats supposed to help rid gout…. heck I'm at the point I'll try anything! Sorry I just needed to vent.

> I read about a bracelet called a Q-Ray thats supposed to help rid gout

Scam.

Brian, sorry you are going through a flare-up. I'm sure you have heard the diet stuff below from emedicine.com. Roger is right about the bracelet being a scam. Buy you some good backpacking gear instead ; )

Diet

* Diet modifications can improve the serum uric acid levels by only 1 mg/dL and are rarely able to lower uric acid levels sufficiently to prevent further attacks and accumulation of urate.

* Patients with gout should avoid beer and hard liquor because they elevate levels of uric acid and therefore can precipitate attacks of gout. Indeed, heavy drinkers are much more likely to have recurrent gout attacks, even with allopurinol therapy. Moderate wine intake is not associated with increased gout flares.

* Particularly because of the association of gout with atherosclerosis, the diagnosis of gout may be a good time to advise a low-cholesterol, low-fat diet if otherwise appropriate for the patient. While such a diet may help uric acid levels, such advice should be given primarily to help prevent atherosclerosis.

* Weight reduction in patients who are obese can improve hyperuricemia.

Funny that I am reading this because my knee has swollen and I am in a mild flare up at the moment. I can sympathize with how bad it can hurt. Last May my flare up was soooo bad that it felt like I had broken my leg. My knee swelled 3-4 times the size that it normally would be. Dunno about the alcohol intake theory completely. My rhumatologist told me that hereditary issues account for you have gout more than having a few beers. He then told me that if a flare up did occur that you should not just stop drinking completely to offset the outbreak. That sometimes stopping drinking while having an outrbreak could make it worse. Though he did caution me to not overdrink during the outbreak too. Just wanted to clarify that.

I also had an attack while hiking Mt. Whitney a few years ago and after we had summitted, I had to head back and abort the rest of the trip through Mitre Basin and out to Horshoe Meadows. NOW THAT WAS A BUMMER!!!

Yeah I thought it was too good to be true Roger. I'm just to the point where I'd be willing to try anything.
Thanks John I'm sticking to my gout diet my Doc recommended and drinking tons of water and still no relief. I did use Ben Gay last night and it helped a little, until I had to get up and goto work. At least I slept some.
I will say I the holidays were rough on the waste line. I would get on the treadmill but…. I do have to stick better to my diet though.
Ken on week 2 or so of this flare up it was in my ankle and it went into my knee. I never had it in my knee before and it wasn't severe, but man that was a bizarre feeling. It was sore and had a fluid filled feeling for a day or two. Glad it didn't get worse. It just keeps going from inside of my ankle to outside. I usually just get it in the joint of my big toe. Trust me about the alcohol theory. I'm not a drinker, but when I went to camp with some buds I was just in mild flare up in my toe; by mid day and 5 beers and some fireside stories my foot was huge! The guys couldn't believe it. I have to dig up the photo lol. Yes we are easily amused, at my expense. I did not walk anywhere but to recycle my fluid intake and sit back down.
Ken your Mt. Whitney story is one I am terrified of and so is my hiking buddy. We section hike the AT every May. We don't get much spare time due to families and work and it would ruin everything. Talk about paranoid.

Thanks for replies and sympathy, sometimes whining helps :D

Whine away :-)

Its somewhat comforting to see others can relate & understand what a flare up is like.

Just came from Doc and I have had gout since Dec 3rd! I now have an ulcer from taking endomethacin so often, she wants to run tests on my kidneys and Lord knows what else. This isn't good. She put me on a steroid pack, tramadol to work with the pain, and then go from there… My buddy and I have some day hikes coming up and I need to heal up quick! I want to play and I'm grounded! :D UGH

just hang in there Brian. Hopefully the right medication and eating and drinking right can stop the PAIN!