Dear Dr. Gourmet,
I am diabetic and hypertensive.
I wanted to shift to a vegetarian diet and eventually vegan, because I understand that this would alleviate my dyslipidemia (high cholesterol and triglycerides) and lower my blood sugar. I also suffer from hyperuricemia and I have GERD and hperacidity.
Is there a way I can adopt a vegetarian/vegan diet without elevating my serum uric acid. I know that a vegetarian/vegan diet primarily relies on lentils, beans, legumes for protein but as far as I know they can aggravate and cause gout and GERD. I fear getting gout because I had undergone 3 surgeries for kidney stones (uric acide) removal within the last 10 years.
A: Dr. Gourmet Says...
We will be offering a vegetarian option for The Quality Calorie Diet Software in the next few weeks. The code has been written into the software and we are working on testing this fully before implementation. It will be some time before we are able to offer a vegan option but during your transition you should be able to use the software by adding your own recipes since we will be adding a Favorites feature that lets you select your own recipes for the menu plans.
Eating vegetarian should be safe for your gout. While many vegetables including those that you mention do contain purines a recent research article in the New England Journal of Medicine indicates that the vegetables that contain purines are less likely to provoke gout. The conclusion of that article was:
"Higher levels of meat and seafood consumption are associated with an increased risk of gout, whereas a higher level of consumption of dairy products is associated with a decreased risk. Moderate intake of purine-rich vegetables or protein is not associated with an increased risk of gout." (NEJM 2004;350:1093-103)
You can read more about gout here:
http://www.drgourmet.com/column/dr/032706.shtml
This link has information on purine levels in foods that you might find useful:
http://www.drgourmet.com/md/gout.shtml
Interestingly, there is a lot of research on gout and we've reported on that in a few columns:
Gout and Coffee
http://www.drgourmet.com/bites/2007/053007.shtml
Gout and Heart Disease
http://www.drgourmet.com/bites/2007/082907.shtml
Gout and Soft Drinks
http://www.drgourmet.com/bites/2008/021308.shtml
I didn't realize until your email just how many questions we have had about gout I think that it's time for us to build a page dedicated to just this.
Here's an ask Dr. Gourmet question about guidelines for kidney stones:
http://www.drgourmet.com/askdrgourmet/kids-kidneystones.shtml
Thanks for writing,
Timothy S. Harlan, MD
Dr Gourmet