Fermented Foods and Gout: Do Fermented Foods Cause Gout?

Fermented Foods and Gout
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Fermented foods contain probiotics that help restore the natural balance of bacteria in your gut. But can fermented foods actually cause gout? Read on to discover why, although they don’t cause gout and may actually help your gout, you might want to be very careful about which ones you eat.

Fermented Foods and Gout

Gout is a type of inflammatory arthritis caused by a build-up of crystals of monosodium urate (uric acid) in the joints, tendons and surrounding tissue.

Uric acid is a byproduct of the breakdown of natural chemical compounds called “purines” that exist in our bodies’ cells and the food we eat (at varying concentrations).

So the more purines there are, the more uric acid is being produced, and the higher the potential for gout.

Around 30% of the uric acid produced in our body comes from the food we consume. So we gout sufferers always need to be mindful of the foods (and drinks) we add into our gout diet.

Today we’re looking at the impact of fermented foods both on gout and our general health…

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What Are Fermented Foods?

We’ve been fermenting foods for thousands of years: the earliest archaeological evidence being the residue of a 13,000-year-old beer discovered in a cave near Haifa, Israel.

Our ancient ancestors used the fermentation process to preserve foods, enhance their taste, and to make wine, beer and leavened bread.

According to Wikipedia:

Fermentation in food processing is the process of converting carbohydrates to alcohol or organic acids using microorganisms—yeasts or bacteria—under *anaerobic conditions. Fermentation usually implies that the action of microorganisms is desired.

*Anaerobic means occurring or existing without oxygen; the opposite of aerobic (occurring or existing only with the presence of oxygen).

Several living microorganisms, such as yeast, lactic acid bacteria and even molds, are regularly used today to convert raw foods into fermented products. In addition to preserving the food itself the process also helps to promote friendly bacteria as well as things like B vitamins, omega-3 fatty acids and beneficial enzymes.

And it’s not just the well known sauerkraut, kimchi, tempeh, miso, natto, kombucha, etc., that are fermented. The list of the types of foods and drinks that are, or can be, fermented may surprise you:

  • yogurt
  • buttermilk
  • cultured milk
  • cheese
  • olives
  • vegetables (e.g., cabbage, beets, radish, carrots, broccoli, green beans, okra, and ginger, etc.)
  • fruit (both fresh and canned can be fermented)
  • sourdough bread
  • pickles
  • tofu
  • fish
  • fish sauce
  • soy sauce
  • salami
  • beer
  • wine
  • apple cider vinegar
  • vinegar
  • and many more

But why are we interested in fermented foods at all? Why are they increasing in popularity? Why are so many extolling their health benefits?

Answer: fermented foods are a source of important probiotics for the human gut.

What are Probiotics?

Probiotics (meaning “for life” in Greek) are all the beneficial bacteria that live in your gut. They help your body break down the food you eat and extract the nutrients it needs to survive and prosper. They also aid immune response and help prevent infections caused by pathogens in your intestines.

And they can kill the harmful bacteria in your gut and so help to achieve a healthy balance of good to bad bacteria. This is generally considered to be 85% good : 15% bad bacteria, although everyone’s gut microbiome — the totality of the trillions of different microbes in your gut — is unique.

But when the bad bacteria starts to gain ground, your gut microbiome becomes imbalanced. Your health suffers because your body isn’t getting all the nutrients it needs and the proliferating bad bacteria can cause illness by themselves.

An out-of-whack microbiome may cause things like:

  • ongoing fatigue
  • digestive problems
  • irritable bowel syndrome (IBS)
  • food intolerance’s
  • sudden weight gain/loss
  • skin conditions
  • disrupted sleep patterns
  • mood swings
  • migraines
  • etc.

Some studies have even associated an unhealthy microbiome with heart disease, cancers, and a compromised immune system (with all the bad stuff that goes with that).

You can see, then, that probiotics are important for your health and wellbeing. So you need to ensure you have enough to maintain your gut at optimal functionality.

This is especially important nowadays as we consume more and more commercially processed foods under ever stricter hygienic conditions. And we’re constantly showering, washing and using hand sanitizers.

So we aren’t being exposed to the dirt, soil and other contaminates that allows for a natural build-up of the immune system in the way we have in the past.

Couple this with our increasing reliance on antibiotics that kill the good bacteria, as well as the bad, and you can see why fermented foods are getting more and more attention.

The two most common types of probiotics in your digestive tract are lactobacilli and bifidobacteria. Lactobacilli are one of the most abundant probiotics in sourdough bread, yogurt, cheese, kimchi, sauerkraut, and kefir, to name but a few. Bifidobacteria are particularly prevalent in things like buttermilk, yogurt, kefir, cured meats, sourdough, some vinegars and even some wines.

Consuming these types of fermented foods and drinks can help keep your probiotic numbers up and your gut in balance.

But keeping your microbiome in healthy balance isn’t just about eating fermented food for their probiotics. You have to look after the probiotics in your gut.

Probiotics need nutrients called prebiotics in order to survive and flourish in your digestive tract. Without food they die off.

What are Prebiotics?

Prebiotics are a type of fiber that our bodies can’t digest. Their main role is as a source of food for probiotics, so they can reproduce and multiply in your intestines.

Although some fermented foods, like sauerkraut, kefir, and cheese, can contain both probiotics and prebiotics, prebiotics are widely found in vegetables, fruits, legumes, and whole grains.

They are particularly prevalent in high-fiber foods, such as apples, asparagus, bananas, cabbage, chicory root, dandelion greens, flaxseed, garlic, Jerusalem artichokes, leeks, and onions.

It’s important, then, to support probiotics in the gut with a healthy, balanced diet containing lots of fresh vegetables, fruits, legumes, nuts, seeds, and whole grains.

So far, so good. But the question for we gout sufferers is: are fermented foods safe with gout?

Do Fermented Foods Cause Gout?

Not only do fermented foods not cause gout they may actually help your gout…

Probiotics in fermented foods are able to degrade purine compounds in food. Several small studies (using mice and rats) found that lactobacilli and bifidobacteria probiotics helped to lower blood uric acid levels. In addition, they found that bifidobacteria helped to reduce inflammation.

And an 8-week randomized, double-blind, placebo-controlled, parallel study of 44 patients concluded that probiotic yogurt consumption significantly decreased blood uric acid in patients with metabolic syndrome.

Note: Nearly 75% of gout patients exhibit metabolic syndrome; the medical term for a group of conditions associated with the development of cardiovascular disease (i.e. coronary heart disease, heart attack, congenital heart disease, angina, and stroke) and type 2 diabetes.

Now, whilst these studies seem rather promising, you still have to be careful…

Fermented Food Concerns

People on certain medications (e.g., MAO inhibitors) or with a compromised immune system should contact their doctor before consuming any fermented foods.

And, as histamine is plentiful in fermented foods, those with a histamine intolerance should avoid them.

Furthermore, research has found that some probiotic strains can carry resistance to some common types of antibiotics. So, if you’re on antibiotics, speak to your doctor before eating fermented products.

Perhaps most worryingly of all, a number of meta and case-control studies have associated high intakes of fermented foods with a higher risk of gastric, laryngeal, and breast cancers.

However, cultured milk products, such as yogurt, cheese, and sour cream, etc., were not found to raise the risk of cancer. In fact, at least one study showed that fermented dairy foods were associated with an overall decrease in cancer risk.

This is interesting too because probiotic yogurt is considered by many to be the ideal source of probiotics and its flavor is perhaps more palatable to the Western taste than some other fermented foods (which can have unusually strong tastes and smells).

But not all yogurts contain live cultures and many contain unhealthy additives. So look for a non-fat or low-fat plain, unflavored yogurt, with no added sugars, and a Live and Active Cultures seal on the label.

Or you can make your own…

Concluding Remarks

Although fermented foods contain large numbers of probiotics, their potential health benefits, including for gout, have to be weighed against their potential risks.

Now, we could be in trouble if fermented foods were the only source of probiotics and prebiotics, but they aren’t…

Remember, the human race didn’t die out for lack of friendly bacteria before fermentation was discovered.

And recent studies have found that  fresh produce contains lots of friendly bacteria too. In fact, one study showed that the average apple contains around 100 million bacteria, most being inside, not on the skin.

So a wide-ranging, healthy, balanced diet containing lots of fresh veggies, fruit, nuts, seeds, and whole grains, should give you plenty friendly bacteria, without having to depend solely on large amounts of fermented foods or probiotic supplements.