This is not entirely true.

Gout is caused by excessive levels of uric acid, which is an end-product of purine metabolism. You can get uric acid via two pathophysiologic mechanisms: under-excretion of uric acid, or over-production.

Under-excretion is by far and away the most common cause of gout (think ~90% of cases). Causes for this include things like chronic kidney disease or an inborne/hereditary problem (like you mentioned), but can also be caused by extrinsic factors such as some medications (common ones include cyclosporine, most diuretics, a few of the TB drugs) as well as more general problems (alcohol decreases UA excretion by itself, dehydration can contribute)

Over-production is a whole other kettle of fish. This is most commonly secondary to some problem of increased cell turnover (think leukaemia, lymphoma, haemolytic anaemia etc.), Again alcohol and obesity can contribute.

You'll note alcohol was in both groups. Alcohol excess (especailly beer) can lead to gout without any other contributing factor. Excess alcohol + excess red meat is an especially bad combo which can lead to gout without any other contributing health issues.

So, gout can certainly be caused by what you eat. It's not the ONLY cause of gout, though.

>Excess alcohol + excess red meat is an especially bad combo

My buddy was a beer drinker and had an almost 100% beef diet, on his bi-yearly checkup they found out that the uric acid levels were too high. He switched to turkey/chicken meat and wine, got rid of the occasional brawn (as in meat jelly), and he is pretty much okay now.

Not to disagree but can you define nebulous terms like excess and put those in context for us who may not be professionals with underlying knowledge of quantity of what acceptable levels and excess are.

Anecdotally, I drink a lot of beer but only twice a week. The rest of the week I may very well be a monk. Not a drop. Does the quantity I consume on weekends count as excess? On what scale or timeline?

Not OP, but his description lines up with my experience. Short answer is, probably imo. Long answer is, every person is different, and if you don't have gout, you may never get it.

In my case, I had what I thought was a persistent toe sprain for years and only later realized it was gout. I'm sure alcohol contributed, as did dehydration, poor running form, the keto diet I was on, and sudden weight loss.

> most diuretics

Does that include caffeine and phenylalanine?

Phenylketonurics - this comment contains phenylalanine

Wait a minute, how did red meat make its way into this post?

From the Mayo Clinic:

>Purines are also found in certain foods, such as steak, organ meats and seafood. Other foods also promote higher levels of uric acid, such as alcoholic beverages, especially beer, and drinks sweetened with fruit sugar (fructose).

Red meat (especially rare-medium) for me is a no. I can feel the low-level gouty effects for days after in my left foot, and I have to back off the beer to compensate.

Red meats contain a lot of purines, which often metabolize into uric acid. They are on the list of products whose consumption gout sufferers should minimize.

Red meats (beef, venison, bison) in general are higher in purines than white meats and should be eaten only occasionally. https://www.arthritis.org/health-wellness/healthy-living/nut...

Gout cannot be caused by your diet.

You can temporarily increase your uric acid levels by eating purine rich food/drink beer etc. But if your body is excreting it, as it should be - the levels won't remain high enough to build up crystals.

It takes years of persistent high levels, it's always caused by your body. But you can reduce attacks by changing diet, loosing weight or taking medication.

If your body was functioning properly it wouldn't matter how terrible your diet was.

Bad analogy, but you can run your car without an oil change for a damn long time. The eventual breakdown isn't just an innate action taken by your car.

Diabetes can also cause damage to the kidneys in turn causing the inability to extract uric acid, and nowadays this is the leading cause, not a genetic issue anymore. That might not apply to you personally, but to most people it does.

Do you suffer gout? I do, and what I eat very much matters.

You already have gout, what you eat makes it worse. And yes I have it extremely badly, I'm on high dose allopurinol.

I explained all of this in my original post.

While true, I can't edit my kidneys/liver/body yet, so for now I need to edit diet. My experience: Keto eliminated my gout flareups (eliminating fructose/beer, but gorging on beef), and Vegan has done the same (eliminate meat, add back in some fruits, still not much beer). The standard American diet is a pox...

Apparently only something like < 15% of gout cases are diet related.

Certainly can imagine other cases can be aggravated by diet choices.

How is something diet aggravated but not diet related? Seems like all these people who claim there's no _meaningful_ correlation here are just setting goalposts in a way where they don't feel compelled to change their diets.

> Seems like all these people who claim there's no _meaningful_ correlation here are just setting goalposts in a way where they don't feel compelled to change their diets.

Bingo. People would rather find anything to blame but themselves. Change is also hard. People can change; most wont. You see it far too often in "fat acceptance" and "healthy at every size" communities.

It's not caused by diet in 85% of cases.

It can be aggravated by diet if you have it.

You can't seriously tell me you don't see the difference?

Easy, tiger. So you meant to say 15% of cases were primarily caused by diet? That's a much more sensible statement.

My original statement was in a comment thread that had already asserted that, I was adding a statistic and both comments are still correct.