Gout and women – where are studies?

[GoutPal Seeker]

I am a 54-year-old woman with gout just professionally diagnosed.

Can I ask why all the studies, diets, so for and so on seem to be based on men and their health issues? It seems that I’m seeing and hearing that more n more women having gout nowadays.

This is confusing how do I know how many glasses of skim milk I need a day and so on? Just an example. Would like some studies and info based on women.

Thank you so much for your help.

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Men have higher risk of gout than women

[Keith Taylor]

I can absolutely promise you Betsy. There is no deliberate gender discrimination on my websites.

Mostly, it’s a non-issue. Well, it is for me. But, I want to make sure that I understand exactly what you want. I don’t wish to sound critical, but your complaint is mostly quite vague. Please don’t take that the wrong way. I’ll examine your diet question in a moment. But when you say “all the studies…” I’m not sure what you are referring to.

Officially, this forum exists to improve my guidelines on GoutPal.com, and to provide personal help interpreting those guidelines. The first word of that sentence really deserves some “quote marks”. This is a forum that does things friendly, not official. I’m just here to help.

I think you are complaining about the rest of the Internet. In case I’m wrong, have I unconsciously introduced gender bias on GoutPal.com? If I have, I really didn’t mean to. Give me the specifics, and I’ll change them.

Let me, for now, assume you are talking about the Internet, in general. I started GoutPal a few years after I was diagnosed with gout. I was incensed by the poor quality of information. There is a lot of misleading information by doctors and other professionals, who should know better. There are many, many more exploitative lies from people with hidden agendas. It’s a jungle out there.

I like to think of my little gout project, first and foremost, as a safe haven from exploitation. I really have never thought “Who gets exploited most in the world of gout, men or women?” If that’s your point – that I’ve disregarded women – then I ask you to help me get it right.

Anyway, Betsy, you specifically mention studies and diets, so I’ll examine those.

Gout Studies Gender Bias
I don’t know where you go for your gout studies. For me, the absolute best source is PubMed. I don’t even have it bookmarked, because it’s permanently open in my browser. I’ve drifted a little way towards ResearchGate. But, old habits die hard.

Here are some PubMed Numbers, search term followed by count of studies:

• gout + women – 493
• gout + men – 605
• gout + men + women – 341
• (gout and women) not men – 152
• (gout and men) not women – 264

So, Betsy, if I were still a marketing manager, I’d campaign about the outrage on behalf of women gout sufferers. 605 studies about men. But, only a quarter of that, 152, exclusively about women.

Spot that little marketing trick? But, even like-for-like comparisons show significant bias in favor of men. Total is 493:605, and exclusive is 152:264.

Can I pretend to be a man for a moment, and push the male argument?

According to the American CDC (Centers for Disease Control and Prevention), incidence of gout among US adults in 2007-2008 was:

• women – 2.2 million
• men – 6.1 million

WTF! Women are way overrepresented in those gout studies. It’s not fair. I want my mom!

[Pause for the voice of reason to return.]

As far as those studies are concerned, I still believe gender is a non-issue. There are a total of 15,133 studies about gout. Gender is a tiny aspect of gout.

That population analysis also gives percentages. 5.9% men, and 2% women. Just like “normal uric acid”, statistics like that cause my hackles to rise. There are medical reasons for the differences in gout rates between genders. Why produce meaningless statistics that mask the facts?

It’s interesting, for some people, to discuss gender and gout. My view is simpler – you’ve either got gout or you haven’t.

Gout Diet Gender Bias
Now, I’m moving into an area where I need your help, Betsy.

Immediately prior to reading your message, I was thinking if I should provide a general purpose diet plan for gout sufferers. I do not want to do that, because I believe that gout diet should be part of an individual treatment plan. Diet should be based on individual needs and tastes. I don’t even like the word “diet”. I prefer to think of healthy eating styles.

But, if I do provide a “standard diet” this is the first time I’ve ever considered gender.

To me, a good diet must be based on healthy food balance and on eating the right amount. I’ve never understood statements like “2500 calories for men, and 2000 for women”. Surely my stepdaughter, who is 2″ taller and considerably more active, needs more calories than me?

Anyway, I’ll leave that discussion now, to see what you think about it. I’ll finish with your skim milk question.

The amount of skim milk you need per day has nothing to do with gender. Skim milk is what I think of as a gout diet “tweaker”. On an individual basis, you can assess if a person’s diet matches their uric acid control plan. Then, you can look at a range of dietary adjustments that might make the plan work better. Skim milk is a good potential adjustment, but pointless if the basics are wrong.

Now, I’m going to jump right out of my comfort zone for an analogy. Laugh at me if you wish. If you could see my search history you’d be wetting yourself! 😀

Let’s view skim milk as the accessories that complete the outfit. The best gloves in the world won’t fix a size 14 dress on a size 18 body.

Sorry, Betsy.

Seriously, tell me practical ways I can help you better. If I’ve misunderstood what you are asking of me, tell me. I would seriously appreciate your help in making sure I am not getting GoutPal wrong for women.

[GoutPal Seeker]

Hi Keith no I didn’t mean gout pal..I’m so sorry if I didn’t make myself clear..I guess I just needed to vent for a minute about the sites I’ve been to they all seem to start out the same way” is it gout?” Here are the symptoms ECT.. I have been on my gout diet for months and I’m also diabetic so some of the things that would be healthy for that I can’t eat with gout I realize that each gout sufferer is different but I’m so confused about good gout food and bad gout foods..I’m afraid to try very many foods right now because I’ve been down with this attack for over 2 weeks now both feet swelled and hurting so bad that every step I take like walking on broken glass but you know how that is..if you could would you email me a list of some menus? I would really appreciate that..and I’m so thankful that you are here to help ok..god bless you.

[Keith Taylor]

Betsy, there’s very few bad foods for gout. But most gout sufferers make their diet worse by thinking that avoiding certain foods will avoid gout.

It doesn’t work that way.

Gout attacks are caused by what you ate many months, or years ago. So, fiddling with diet today is like working on the roof when your house has rising damp.

You have to address the fundamental issues that started your gout, in the past. For most gout sufferers, it’s your parents, or grandparents. Most gout is genetic. Where gout is hereditary, bad diet can make it worse. But, good diet does not necessarily make it better. That’s why I can never believe in general purpose gout diets. Because it’s personal.

However, I see many, many questions about food that don’t make sense. So, my thoughts about a standard diet are to help people make a healthy start. Personally, I hate diets. But, I love healthy eating styles. My mantra is EFSEP. Eat Food. Sufficient. Especially Plants.

It’s based on a similar sounding guide to nutrition. I simply want to use it for a base to show gout sufferers how to start eating healthy. So:
Eat Food – means avoiding additives, and factory-processed food-like substances. Additives often raise uric acid. Specifically, nitrites added to bacon and other processed meat raise uric acid.

Sufficient – eat enough to match your activity levels. Gout increases when you are overweight.

Especially Plants – Vegetable purines do not raise uric acid in humans. In fact, since a plant based diet is normally alkalizing, vegetables and fruit are generally good for gout.

That would be my starting point if I ever decided to produce a gout diet. But, I still don’t think one diet is good enough. I think a range is better. Something that considers different types of gout sufferer. We’ve already spoken about gender. Do we need a gout diet for men, and one for women? I definitely think it would be wise to have a weight-loss gout diet, and a weight-maintenance diet.

Now, I’m thinking about other diseases that gout sufferers commonly have. Heart disease, high blood pressure, high cholesterol, etc. Perhaps I should start with diabetes.

If you let me know what a good diabetic diet is, with explanations of why it is good, I can probably adapt it to be gout-friendly.

For the reasons I mentioned, I don’t have menus or eating plans. But, I’m happy to help compile menus based on personal needs. I’m also happy to review existing eating plans to assess there gout-friendliness.
I’m definitely not going to use it to give advice to a diabetic. I have no ideas about best nutrition for diabetes. But, I am willing to learn.

[Keith Taylor]

I’ve just seen an interesting study about gout and women. So, I used a chart from it to illustrate this topic above. Also, I added the study to the Gout and Uric Acid PDF files here. But, I haven’t done a review of this study.

If you want me to add a review of this gout and women study, please let me know.

Gout and Women Reference
Bhole, Vidula, Mary de Vera, M. Mushfiqur Rahman, Eswar Krishnan, and Hyon Choi. “Epidemiology of gout in women: Fifty‐two–year followup of a prospective cohort.” Arthritis & Rheumatology 62, no. 4 (2010): 1069-1076. Gout In Women PDF.

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