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Gout is a form of arthritis caused by high levels of uric acid in the blood. Your body produces uric acid when it breaks down an organic compound called purine that is produced in your body and found in certain foods.
A gout diet may help with managing symptoms of the condition. Following a gout diet involves consuming foods that are low in purines, such as citrus fruits and lentils, and avoiding some foods that have high purine levels, such as organ meats, beer, and soda.
This article discusses the goals and benefits of a gout diet. It also covers how it works and what to consider before starting it.
Purine is a chemical compound that, when metabolized, creates the uric acid that triggers gout attacks. Uric acid is normally excreted, but with gout, it builds up and forms needle-shaped crystals in and around the joint.
Gout diet goals may include:
Purine-rich vegetables do not increase your risk of a gout attack and can be consumed. Moderate portions of foods rich in vitamin C, low-fat dairy products, and plant oils should also be consumed to help manage your condition.
Starting a well-balanced gout diet can not only lower your risk of an attack but can also slow the progression of gout-related joint damage. Studies have shown that following a gout diet can reduce the frequency of gout attacks and the severity of symptoms in some people.
One study found that consuming a purine-rich diet increased the risk of recurrent gout attacks five-fold among those with gout, whereas reducing purine-rich foods helped reduce the risk of gout attacks.
Certain foods and beverages are more likely to cause symptoms and gout flare-ups.
Red meat and organ meat: Red meats are higher in purines than white meat. Higher consumption of red meat (including beef, venison, and bison) and organ meats (including liver, sweetbreads, tongue, and kidney) increases the risk of recurrent gout attacks.
Coldwater fish, shellfish: Certain types of fish are known to be higher in purines and should be limited on a gout diet. Coldwater fish such as tuna, trout, herring, sardines, and anchovies are higher in purines, as are shellfish including shrimp, oysters, crab, and lobster.
Yeast extract: Certain spreads including Marmite, Vegemite, and Vitam-R contain yeast extract and are known to be high in purines. Avoid these to reduce uric acid levels.
Beer and liquor: Most alcoholic beverages are not advised on a gout diet. Specifically, beer and liquor slow the excretion of uric acid. However, studies have shown that moderate consumption of wine is not associated with a higher incidence of gout.
Sugary foods and beverages: Foods and beverages that contain fructose—particularly those that contain high fructose corn syrup—should be avoided on a gout diet. Keep uric acid levels lower by limiting or avoiding the consumption of sodas and other sugary drinks, canned fruit or fruit juice, and other high-sugar products including snack bars, doughnuts, pastries, candy, and some breakfast cereals.
White bread and honey: Carbs that are quickly digested and absorbed can raise blood sugar levels, which in turn can increase uric acid levels. Avoid refined carbs like white bread, white rice, cookies, and cake. Although honey is a natural sweetener, it is high in fructose. When the body breaks down fructose, it releases purines.
A gout diet is generally part of a comprehensive program recommended after you have been diagnosed with the condition. You'll work together with your healthcare provider to manage
several lifestyle factors, including diet, weight control, physical activity, and possibly medication to reduce the frequency and intensity of gout attacks.
Following a gout diet plan that includes foods that help clear up gout-related symptoms and avoids foods that are high in purines can help you manage this condition.
Vegetables: With gout, it was previously thought that you should avoid certain veggies. However, recent evidence shows that consumption of purine-rich vegetables like asparagus, spinach, and cauliflower does not affect uric acid levels or increase the risk of a gout attack. Plus, eating veggies can help you to reach and maintain a healthy weight and provides your body with important vitamins and minerals.
Dairy products: Studies have shown that the proteins in dairy products can help reduce uric acid levels naturally. Choosing low-fat products such as skim milk or low-fat yogurt will help you maintain a healthy weight as well.
Tofu, whole grains, beans, and lentils: Plant-based proteins will help you maintain a balanced diet while managing your condition. On the gout diet, while you reduce your intake of meat and seafood, you should still consume about 15% to 30% of your calories from protein to meet the U.S. Department of Agriculture (USDA) recommendations. There is some evidence that plant-based proteins and plant-based oils (such as olive, sunflower, and soy) may even protect against gout attacks.
Citrus fruit: Although more research is needed, some studies have shown evidence that vitamin C may be an effective way to reduce the frequency of gout flare-ups. Vitamin C helps your body flush uric acid, and citrus fruits are a great source of this essential nutrient. Cchoose lower-fructose fruits such as grapefruit, oranges, or pineapple, as this natural sugar can increase uric acid levels.
Some people with gout take a vitamin C supplement. Speak with your healthcare provider to see if supplementation is needed and whether it fits into your diet and medication plan.
Cherries: Researchers have found that cherry consumption and 100% tart cherry juice lower serum uric acid levels and can reduce the risk of flare-ups in gout patients.
Coffee: Drinking a moderate amount of coffee does not seem to raise uric acid levels, and may actually lower the risk of developing gout.
Avocados: Avocados are naturally low in purines and contain monounsaturated fat and vitamin E. These components have anti-inflammatory and antioxidant effects that may help reduce pain and inflammation. Diets high in these compounds are also linked to a decreased risk of joint damage.
Get our printable guide for your next healthcare provider's appointment to help you ask the right questions.
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There is no cure for gout. As such, adopting the gout diet can be a part of your long-term care plan to help you spend more time in remission and less time managing painful flare-ups.
There is no specific food schedule that you need to follow on a gout diet. You can time your meals and snacks as you normally would to provide steady energy throughout the day. However, if you take medications to manage pain (including over-the-counter or prescription medications), your healthcare provider may suggest that you take the medication with a snack or meal to ease stomach upset.
Also, give yourself time to adjust to the gout diet when you first begin. Working out which foods are safe for you can be a process of trial and error. For example, while some people will have no problem consuming moderate amounts of red meat, others may experience an attack with only a scant helping.
Work with your healthcare provider or a nutritionist who is experienced in the management of gout. Most will advise you to keep a food diary so that you can pinpoint specific food triggers that place you at the greatest risk.
There are plenty of foods to enjoy on the gout diet. Organizing your kitchen and following a few basic cooking tips will help you stick to your plan.
Almost anyone can follow the gout diet. Vegetarians, vegans, and those who follow a gluten-free diet can adjust their eating plan according to their program. For example, those on a gluten-free diet would choose gluten-free grains such as quinoa. Those who follow a plant-based diet will have an easy time adjusting to the gout diet as it emphasizes vegetables, some fruits, and plant-based protein.
People who eat a pescatarian diet or a Mediterranean diet may have a harder time on the gout diet because fish is limited on the plan. However, some experts, including those at the Arthritis Foundation, suggest that occasionally consuming certain types of fish, such as salmon, may be beneficial.
Water is always the best drink. It has been shown that consuming at least eight glasses of water daily can reduce recurrent gout attacks by as much as 46%.
Tart cherry juice is also helpful for reducing uric acid levels. Anthocyanins—flavonoids with anti-inflammatory and antioxidant properties—found in cherries and tart cherry juice may help reduce inflammation associated with gout attacks.
Coffee in moderation is also acceptable as it does not seem to raise uric acid levels.
The gout diet will need to become a way of life. Give yourself time to adjust to your new eating plan. As you do, keep these things in mind.
When following the gout diet, you'll find it easy to meet nutritional recommendations established by the USDA. You are encouraged to fill your plate with healthy vegetables, fruit, lean meat (such as poultry), whole grains, and low-fat dairy, which are standard recommendations for everyone, regardless of whether or not they have gout.
If you currently consume red meat as your primary source of protein, it may take some time to learn how to replace it with other options. But once you get used to choosing legumes, eggs, chicken, protein-rich grains, or other types of plant-based protein, you may find that following the gout diet allows you to feel full and satisfied.
Many studies have shown that reaching and maintaining a healthy weight is one way to reduce the frequency of gout flare-ups. But if you plan to lose weight, avoid crash diets. By losing weight too quickly, you may end up triggering an attack.
As with all dietary plans, a slow and steady approach is better for your health and something you'll be better able to maintain over the long run.
When first learning how to follow the gout diet, you may find it helpful to connect with a support group in your area. Others with the condition may be able to share recipes, provide helpful tips, and answer questions that may arise. Your healthcare provider may be able to direct you to a group associated with a medical center near you.
You may also find it useful to check out the resources provided by the Alliance for Gout Awareness. The organization provides helpful videos, offers patient guides, and runs an online support group where members can ask questions, share their experiences, and seek advice from other people who understand what it's like to live with gout.
In addition to following the gout diet, your healthcare provider may recommend that you make other changes to help you live comfortably with gout. This may include physical activity.
Studies have shown that regular exercise can help to improve joint function and help you maintain a healthy weight. However, strenuous exercise can do more harm than good and dehydration may raise the level of uric acid in the blood and trigger gout.
A gout diet may help with managing symptoms and reducing flare-ups. Following a gout diet involves consuming foods that are low in purines, such as citrus fruits and lentils, and avoiding some foods that have high purine levels, such as beef, seafood, beer, and sweet drinks.
What works well for one person may not provide any noticeable difference for another, so trial and error is often needed. Taking advantage of available resources, working with your healthcare provider, and making smart lifestyle changes can help you feel more empowered.
Following a low-purine diet is not a cure for gout, but it can certainly reduce the risk of flares and minimize the need for prescription medications. Working with a nutritionist can be helpful in adhering to a new eating plan.
