This study, which used the Zone diet, had a positive effect on markers of insulin resistance but in this article I am going to describe its direct effect on uric acid levels and gout attacks.
Study participants were on this diet for four months. They were all gout sufferers. The effects on uric acid levels and gout attacks were significant.
Falls in Weight and Uric Acid
Weight loss was about 17lbs (7.7kg), that is around 1lb a week. Only one patient did not lose weight. The median uric acid (UA) reduction was 1.7mg/dL. Another useful finding was that if the blood uric acid level at the start of the study was high, there was a large blood (serum) uric acid fall at the end. Uric acid levels became normal in 7 of the 12 participants who had raised levels of uric acid (UA) before the study began.
One participant did not have a raised uric level before the study began. His UA level was about 5.9mg/dL. This was not unusual because we already know that gout may occur in people who have normal uric acid levels.
Gout Attack Reductions
Before the study began, participants had suffered at least two attacks in the preceding four months. Median (results overall were expressed as a statistical median) attacks per month before the study were 2.1 across all patients. After the study, attacks fell to 0.6 a month. This drop occurred in all except one patient. The exception patient had shorter and less acute attacks. Over half did not have a gout attack during the study, although they had all suffered at least two in the previous four months.
One Year Later
Around a year later, five of nine patients had no further gout attacks and three had only one attack. One patient gained weight after the end of the study. He probably ended the diet. What happened to him? He had three attacks over three months and his blood UA levels rose.
Another interesting result was that the mean uric acid (UA) fall was 1.7mg/dL. In two cases it fell by 2.2 mg/dL- 2.5mg/dL. Hyperuricemia, (too much uric acid), which often leads to gout, is thought to exist if the UA levels are more than 7.2 mg/dL in males, and 6.0 mg/dL in females. The common UA target in gout treatment is 6.0 mg/dL (somewhat less in women). At this level the pesky MSU crystals, which are formed mainly from uric acid, may dissolve.
The fall of 1.7 mg/dL, given the numbers mentioned above, is quite significant. But you should recall that many gout sufferers have uric acid levels much higher than 7.2 mg/dL, and of course some gout sufferers do not have excess uric acid.
The study patients were not taking long term gout medications such as Allopurinol. They were only taking medications during attacks. We don't know how much water they drank during the study. Gout sufferers know that drinking plenty of water helps to remove uric acid and sometimes to reduce attack severity.
In gout treatment there are always qualifications. The study had just 13 male gout sufferers and lasted only four months, although there were follow-up results at the end of one year (median). The researchers noted a connection between weight loss and a fall in uric acid levels in another study as well as their own, and weight loss is known to induce UA level falls. They thought the nutrient proportions of the Zone diet (40% carbohydrate, 30% protein and 30% fat) contributed to the uric acid fall. And they thought that the diet caused the improvement in insulin sensitivity which was another of its results.
This is all sufficiently notable to give encouragement and some hope to anyone suffering from gout who attempts this diet. More details about the Zone diet here.
The study was conducted in 1999. It's a shame it has not been followed up by a larger gout study, based on the Zone diet, to see if the same results, or better, are achieved. This would increase our understanding of natural gout treatment.
