Despite all the wonders of moving towards a high-fat, low-carb — ketogenic — diet, those who suffer from gout or other kidney problems are well advised to seek medical consultation before experimenting with this nutritional regime.

Over the past several days, I have cited Rocco Stanzione’s informative Low Carb For Health. Stanzione wrote about the ketogenic diet in 2010. He also suffers from gout.

Gout and the ketogenic diet

In his article, ‘Gout’, he explains and advises (emphases mine):

if you’re getting plenty of fluids, your kidneys are generally active enough to get rid of the excess uric acid produced by your diet.  And if you’re getting plenty of exercise, the crystals likely won’t have a chance to form in the joints in the first place.

There also seem to be some specific foods you can consume to lower your riskDairy products, for example, tend to decrease the amount of uric acid in your blood.  Coffee has been shown to decrease your risk of getting gout in the first place, but no one seems to know why.  Anecdotally, I’m pretty sure I can vouch for coffee as an effective treatment and preventative even after getting it, and this is possibly explained by the effects of caffeine on uric acid levels.

And still other foods further increase your risk.  These include organ meats such as liver and kidneys, which are very high in purines, and alcohol.  The flare-up I’m presently suffering from happened to occur after an expense-account night at the bar, but I’m sure that’s completely unrelated.

More dairy products, more coffee, less alcohol.  Milk, by the way, has lactose, a sugar that’s not compatible with a low-carb diet in high doses, so I recommend regular coffee with lots of heavy cream for two powerful nearly-carb-free preventatives at once.

When you are in ketosis for any length of time, you are unlikely to be able to consume too much alcohol. You will feel more relaxed quicker. I notice that this was one of Stanzione’s first posts from January 2010, so perhaps he was still approaching a state of full ketosis at the time this episode took place.

Increasing fat intake, drinking plenty of fluids and reducing carbs dramatically are probably the three key principles to remember with the ketogenic diet. You will also feel much more energetic and willing to tackle those pesky household projects which have been in abeyance for so long; therefore, exercise is not a problem. Believe me, you’ll want to move around.

This is an ideal time to buy yourself a bag of pork scratchings. Mine are mostly fat, with roughly 33% protein and only 3.3% carbohydrate — perfect for the ketogenic diet.

Tips for success

Stanzione has written about success with and criticism of the ketogenic diet.

If you’re discussing this topic with a health specialist, ‘Top 10 Myths about the Ketogenic Diet’ is indispensable.

His ‘Top 10 Mistakes on a Low Carb Diet’ is also mandatory reading. Many novices fall down in one of these areas, which has sent them to hospital! There really isn’t anything too complicated about this diet, which millions around the world have used successfully.

Here are excerpts from Stanzione’s Top 10 Mistakes (emphases in text mine):

10. Jumping right in

If you’ve never eaten this way before, it can be hard.  When I say don’t jump right in, I don’t mean “don’t go cold turkey.”  I mean prepare first.  Sit down and make a grocery list that will get you through a week, ideally.  It should have enough meat, cheese, eggs and optionally green vegetables and sugar-free drinks for as many meals as you’ll eat at home during that time.  And don’t skimp on the snacks.  Lunch meat is one of my favorites. 

9. Worrying about dietary cholesterol

A lot of people start a diet like this and avoid things like eggs.  Eggs!  I can’t think of a more perfect food.  Except maybe ribeyes.  Anyway if you’re still convinced that dietary cholesterol is harmful or risky, I won’t be changing your mind in this post, but you absolutely must get down to the library or the book store and get your hands on this book.  It will square you away.  In the meantime, I’m comfortable asking you to take my word for it: you’ll do more harm by avoiding cholesterol than by eating it

5.  Drifting too far

I was guilty of this one more than once.  Out of convenience or necessity, or just because, you eat something you shouldn’t.  You’re out of ketosis, or think you might be … Odds are you didn’t do as much harm as you think, and it’ll be a lot harder in a few days (or weeks, or worse) than it will be at your next meal.

4.  Replacing too much

There’s a low-carb or sugar-free version of just about everything.  And far be it from me to condemn those things.  But a lot of folks try to go low carb mostly by replacing cereal with low-carb cereal, bread with low-carb bread, sweets with sugar-free sweets, and so on.  If you do this, you will not succeed, for several reasons.  First, in most of these foods they don’t replace the carbohydrates with anything you can even digest.  Complex carbohydrates are typically replaced with fiber, an indigestible carbohydrate with no usable calories.  Sugar is replaced by artificial sweeteners, including sugar alcohol.  Many of these can give you gas and/or diarrhea, and none of them will satisfy you because they provide little or no energy.  As much as possible, you should replace what you used to eat with foods high in fat and protein.

 1.  Not eating enough fat

I confess, the rest of the items on this list are in no particular order, but I saved this for number one.  The most common and most harmful mistake you can make is to avoid fat.  You must unlearn what you think you know about fat.  See #2 [Not informing yourself].  Once you eliminate carbohydrates, you must have plenty of fat to maintain any semblance of health.  Avoiding fat will not accelerate your weight loss – again, see #2.  If you try to stay away from fatty foods, you will feel miserable, be unhealthy, and very likely fail.  Eat all the bacon you want.  The same goes for butter, steak, hamburger, eggs and so on. 

Tomorrow, I’ll look at another ketogenic diet site, one from a physician.

In the meantime, past articles in this series — all available on my Recipes / Health / History page under ‘Low-fat, high-carb diets increase depression’ — are as follows. My original intention was to give ideas for home relief from depression. However, this is a holistic way of eating:

Does low animal fat intake increase hostility or depression? (a hypothesis)

Fat and a balanced mind (low-fat diets can imbalance serotonin and nerves)

Depression and anxiety: the perils of a low-fat, high-carb diet

High carbohydrate intake and depression

Depression and cancer: more evidence against a low-fat diet

High carbohydrate intake and depression (also epilepsy related [Dr Richard A Kunin’s paper])

High-carb, low-fat diets might cause Western diseases (cancer related)

Low-carb diet a migraine remedy

Low-carb, high-fat diets regulate testosterone, cholesterol levels