Gout and fueling for rides with high carb intake
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Gout and fueling for rides with high carb intake
Despite a healthy diet and lean, muscular physique from a lifetime of riding, running and swimming, I've been dealing with gout for the last decade (now age 53). Genetic connection - inherited from my father. No alcohol except a glass of white wine or a G&T every couple of weeks. I've been taking Allopurinol for the last 5 years (200mg daily), and it has eliminated all attacks, and has been keeping my uric acid level within the "good" range. Depending on what I eat (I've eliminated almost all meat from my diet except a bit of chicken and won't give up seafood - I'm primarily pescatarian), I do occasionally get some mild irritation in the big toe that previously was prone to attacks). Interestingly, I have almost no added sugar in my diet, but if I do something stupid like quaff a can of coke (happens at most once a year), within an hour, that toe is throbbing angrily. Gout's connection to sugar is that fructose is metabolized to purines. The failure to excrete purines, and subsequent crystallization of them, settling into joints is the underlying cause of the inflammatory response in gout.
Here's the connection to cycling - the latest research is saying that 90-120g of carbs an hour is the ideal fueling range for longer rides, and maybe even more grams/hour for performance (depending on your size of course). Most commercial powders are 1:0.8 ratios of maltodextrin (glucose): fructose. Homemade drinks primarily use table sugar (sucrose) which is 1:1 glucose:fructose. I've tried out this high carb riding scheme, and sure enough, my longer and harder performances are definitely better, and my post-ride recovery is also significantly improved. Love it. All good EXCEPT the concern that I have with the fructose and gout connection. I'm wondering what the experience of other cyclists who have gout is with high carb fueling during rides
Here's the connection to cycling - the latest research is saying that 90-120g of carbs an hour is the ideal fueling range for longer rides, and maybe even more grams/hour for performance (depending on your size of course). Most commercial powders are 1:0.8 ratios of maltodextrin (glucose): fructose. Homemade drinks primarily use table sugar (sucrose) which is 1:1 glucose:fructose. I've tried out this high carb riding scheme, and sure enough, my longer and harder performances are definitely better, and my post-ride recovery is also significantly improved. Love it. All good EXCEPT the concern that I have with the fructose and gout connection. I'm wondering what the experience of other cyclists who have gout is with high carb fueling during rides
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90 - 120 grams of carbohydrate every hour is 360 to 480 Calories per hour. If I consumed that much sugar every hour my stomach would be all bloated with indigestion and I'd suffer performance issues during the ride. I ride quite hard usually spend a lot of time in HR zones 3 and 4 even on very long rides. I usually keep about 120 to 150 Calories in my bottles that last me about 50 minutes each. For some extremely hard rides I'll consume about 200 Calories per hour, but even that much leaves my stomach a little queasy.
I realize you aren't complaining about such, but you might just lighten up on the carbs while you ride. Especially if you aren't a professional cyclist that rides a 100 - 150 miles 5 days a week. So less sugar, less of the purines.
I use mostly maltodextrin in my bottles. I get a pound packet of maltodextrin and just add two or three packets of whatever flavor of kool-aid interests me at that moment. The add a little table sugar, stevia or Monk fruit to take the edge off the not so sugary tasting maltodextrin. That usually makes enough mix for around a dozen rides... I think. You can do the math on the actual sugars and figure out 4 grams per calorie plus the weight of any artificial sweetener and determine what amount of Calories you are adding to your bottle per scoop or however you measure.. I also add a half scoop of Hammer Nutrition's Enduralyte powder to each bottle.
I realize you aren't complaining about such, but you might just lighten up on the carbs while you ride. Especially if you aren't a professional cyclist that rides a 100 - 150 miles 5 days a week. So less sugar, less of the purines.
I use mostly maltodextrin in my bottles. I get a pound packet of maltodextrin and just add two or three packets of whatever flavor of kool-aid interests me at that moment. The add a little table sugar, stevia or Monk fruit to take the edge off the not so sugary tasting maltodextrin. That usually makes enough mix for around a dozen rides... I think. You can do the math on the actual sugars and figure out 4 grams per calorie plus the weight of any artificial sweetener and determine what amount of Calories you are adding to your bottle per scoop or however you measure.. I also add a half scoop of Hammer Nutrition's Enduralyte powder to each bottle.
Last edited by Iride01; 04-24-23 at 12:31 PM.
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90 - 120 grams of carbohydrate every hour is 360 to 480 Calories per hour. If I consumed that much sugar every hour my stomach would be all bloated with indigestion and I'd suffer performance issues during the ride. I ride quite hard usually spend a lot of time in HR zones 3 and 4 even on very long rides. I usually keep about 120 to 150 Calories in my bottles that last me about 50 minutes each. For some extremely hard rides I'll consume about 200 Calories per hour, but even that much leaves my stomach a little queasy.
I realize you aren't complaining about such, but you might just lighten up on the carbs while you ride. Especially if you aren't a professional cyclist that rides a 100 - 150 miles 5 days a week. So less sugar, less of the purines.
I use mostly maltodextrin in my bottles. I get a pound packet of maltodextrin and just add two or three packets of whatever flavor of kool-aid interests me at that moment. The add a little table sugar, stevia or Monk fruit to take the edge off the not so sugary tasting maltodextrin. That usually makes enough mix for around a dozen rides... I think. You can do the math on the actual sugars and figure out 4 grams per calorie plus the weight of any artificial sweetener and determine what amount of Calories you are adding to your bottle per scoop or however you measure.. I also add a half scoop of Hammer Nutrition's Enduralyte powder to each bottle.
I realize you aren't complaining about such, but you might just lighten up on the carbs while you ride. Especially if you aren't a professional cyclist that rides a 100 - 150 miles 5 days a week. So less sugar, less of the purines.
I use mostly maltodextrin in my bottles. I get a pound packet of maltodextrin and just add two or three packets of whatever flavor of kool-aid interests me at that moment. The add a little table sugar, stevia or Monk fruit to take the edge off the not so sugary tasting maltodextrin. That usually makes enough mix for around a dozen rides... I think. You can do the math on the actual sugars and figure out 4 grams per calorie plus the weight of any artificial sweetener and determine what amount of Calories you are adding to your bottle per scoop or however you measure.. I also add a half scoop of Hammer Nutrition's Enduralyte powder to each bottle.
If you are using maltodextrin only, you'll hit your absorption limit well before you would if you were using a maltodextrin-fructose mix because glucose and fructose are absorbed using separate, parallel mechanisms in the gut i.e. you can get more total calories in before gut discomfort with X grams of a mix of glucose+fructose than you can for X grams of either glucose or fructose alone. Empirically, I am feeling better during and after rides on a high carb input than I was on more moderate intakes. Everyone's a bit different in metabolism though. I can't ride Z2 fasted in the AM - I bonk super quick (around an hour) while my buddy can ride 3+ hours no problem. I'm super lean, while he's carrying a ton of fat for fuel :-) I also don't have any gut discomfort issues with the carbs.
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I use to make my drinks with fruit juice that was high in fructose. But while I seemed to get a energy boost quickly, it didn't last long. And the maltodextrin alone seems to give me a longer steadier boost between gulps. I feel like I hydrate very well as I take a few gulps every 10 minutes and those 24 fl oz bottles with 150 Calories or so only last 50 minutes. So I'm never really drained of energy needing a quick boost that fructose might give me.
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Colchicine is a great drug. My insurance makes it very expensive, but I can get it cheap using Good Rx. Gets rid of the flares within a day or two.
Can't really speak to dietary controls because mine seems to be more related to level of activity than diet.
Can't really speak to dietary controls because mine seems to be more related to level of activity than diet.
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I use small boxes of raisins and if I was not allergic to bananas, I would snack on them during long rides. You can't eat the bananas but there are other fruit options. I like a high carb breakfast of pancakes and then snack on dried fruit and nuts while riding. Fiber is very important to go along with natural sugars. Huge difference between how your body processes and orange and how it process orange juice with all the pulp missing.
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I’m in ketosis to treat my T2.
95% of my rides are with zero added carbs. I don’t eat 160 carbs a week, and ride 130-160 miles a week.
Long rides, even with intensity - 40/60 per hour max.
That 120 per hour figure is for racers riding at 250-300w for 150 miles on a stage, that have to recover and do it all over again the next day.
We don’t ride like the pro’s, nor do we need to eat like them.
95% of my rides are with zero added carbs. I don’t eat 160 carbs a week, and ride 130-160 miles a week.
Long rides, even with intensity - 40/60 per hour max.
That 120 per hour figure is for racers riding at 250-300w for 150 miles on a stage, that have to recover and do it all over again the next day.
We don’t ride like the pro’s, nor do we need to eat like them.
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Despite a healthy diet and lean, muscular physique from a lifetime of riding, running and swimming, I've been dealing with gout for the last decade (now age 53). Genetic connection - inherited from my father. No alcohol except a glass of white wine or a G&T every couple of weeks. I've been taking Allopurinol for the last 5 years (200mg daily), and it has eliminated all attacks, and has been keeping my uric acid level within the "good" range. Depending on what I eat (I've eliminated almost all meat from my diet except a bit of chicken and won't give up seafood - I'm primarily pescatarian), I do occasionally get some mild irritation in the big toe that previously was prone to attacks). Interestingly, I have almost no added sugar in my diet, but if I do something stupid like quaff a can of coke (happens at most once a year), within an hour, that toe is throbbing angrily. Gout's connection to sugar is that fructose is metabolized to purines. The failure to excrete purines, and subsequent crystallization of them, settling into joints is the underlying cause of the inflammatory response in gout.
Here's the connection to cycling - the latest research is saying that 90-120g of carbs an hour is the ideal fueling range for longer rides, and maybe even more grams/hour for performance (depending on your size of course). Most commercial powders are 1:0.8 ratios of maltodextrin (glucose): fructose. Homemade drinks primarily use table sugar (sucrose) which is 1:1 glucose:fructose. I've tried out this high carb riding scheme, and sure enough, my longer and harder performances are definitely better, and my post-ride recovery is also significantly improved. Love it. All good EXCEPT the concern that I have with the fructose and gout connection. I'm wondering what the experience of other cyclists who have gout is with high carb fueling during rides
Here's the connection to cycling - the latest research is saying that 90-120g of carbs an hour is the ideal fueling range for longer rides, and maybe even more grams/hour for performance (depending on your size of course). Most commercial powders are 1:0.8 ratios of maltodextrin (glucose): fructose. Homemade drinks primarily use table sugar (sucrose) which is 1:1 glucose:fructose. I've tried out this high carb riding scheme, and sure enough, my longer and harder performances are definitely better, and my post-ride recovery is also significantly improved. Love it. All good EXCEPT the concern that I have with the fructose and gout connection. I'm wondering what the experience of other cyclists who have gout is with high carb fueling during rides
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Aren't those numbers high for ride fueling? AFAIK, the human body can handle 30-60 grams of carbs per hour, but some research may have changed that? I'd be interested to have a read of the article/paper that those numbers come from to see how things have changed.
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I believe that figure is for any single form of carb as they have different routes of absorption. I'm extremely skeptical of numbers like that getting tossed around to criticize other people's regimens because I don't think scientific knowledge about individual variance is well-developed at this point.
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Not specific to your question but do you drink? My terrible gout problems vanished when I stopped drinking all types of booze.
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Thx for the input.
If you are using maltodextrin only, you'll hit your absorption limit well before you would if you were using a maltodextrin-fructose mix because glucose and fructose are absorbed using separate, parallel mechanisms in the gut i.e. you can get more total calories in before gut discomfort with X grams of a mix of glucose+fructose than you can for X grams of either glucose or fructose alone. Empirically, I am feeling better during and after rides on a high carb input than I was on more moderate intakes. Everyone's a bit different in metabolism though. I can't ride Z2 fasted in the AM - I bonk super quick (around an hour) while my buddy can ride 3+ hours no problem. I'm super lean, while he's carrying a ton of fat for fuel :-) I also don't have any gut discomfort issues with the carbs.
If you are using maltodextrin only, you'll hit your absorption limit well before you would if you were using a maltodextrin-fructose mix because glucose and fructose are absorbed using separate, parallel mechanisms in the gut i.e. you can get more total calories in before gut discomfort with X grams of a mix of glucose+fructose than you can for X grams of either glucose or fructose alone. Empirically, I am feeling better during and after rides on a high carb input than I was on more moderate intakes. Everyone's a bit different in metabolism though. I can't ride Z2 fasted in the AM - I bonk super quick (around an hour) while my buddy can ride 3+ hours no problem. I'm super lean, while he's carrying a ton of fat for fuel :-) I also don't have any gut discomfort issues with the carbs.
I'm a firm believer that people are the best judges of their nutrition needs during a ride as people's metabolisms vary so much on the individual level. Being super lean, as you put it, is almost certainly an indicator that you're a fast metabolizer.
BTW, I just had a sore big toe that usually signals the beginning of a flare. I took the colchicine and the pain was gone completely in about 2 days. Without it, I have no doubt it would have progressed to the flaming foot stage despite the allopurinol I take daily as that is how it always progressed before I was given a prescription for this .
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Not offering medical advice but... I've a similar history of gout and family history. Things got real bad 8 years back and was prescribed 300 mgs of Allopurinol, higher than the OP's 200 mgs. Have no idea why that was the prescribed dosage but it works well for me with no side effects and I no longer pay any attention to diet. I stopped alcohol a year or so ago, but did go 7 yrs on allopurinol while drinking moderately with no issues. Again,just anecdotal, not meant as medical advice which is better offered by your physician.
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Gout sufferer here. When I got my first attack I was completely off the bike and skiis for the first time in years and this was not good for my overall health - the Type ii diabetes I was able to deny I had came roaring though and I was in the hospital for a week.
Anyhoo, with allopurinol and more reasonable eating habits, there is no direct connection, in my experience, with any reasonable carb-laden food and gout attacks. Maybe if I used beer and liver paté for carb loading this would be different, but bananas and clif bars and fruit gummies and juice and almonds are all safe, in my experience.
Anyhoo, with allopurinol and more reasonable eating habits, there is no direct connection, in my experience, with any reasonable carb-laden food and gout attacks. Maybe if I used beer and liver paté for carb loading this would be different, but bananas and clif bars and fruit gummies and juice and almonds are all safe, in my experience.
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I fuel with a maltodextrin/chocolate flavored whey protein mix, 7:1 by weight. I buy the malto from a homebrew supply house in 50# bags. A bag lasts me about a year. 2c of this mix in a water bottle will last me 3+ house of hard riding. I mix it up the night before, shaking it 100 times, leave it in the fridge overnight and it's good to go in the morning. I forget how many grams that is. One swallow every 15' is about right. For shorter rides, just put less powder in the bottle. For longer rides, I carry extra powder in Ziplock bags. My other bottle is plain water. I carry a squeeze purse with Endurolytes. On long rides, I plan on a pee stop and bottle refresh about every 50 miles. On an event ride, I usually don't eat rest stop food.
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