Guide To Gout Diet: Foods To Eat and Avoid

What foods to eat and avoid to prevent uric acid buildup, ease symptoms, reduce flare-ups, and improve quality of life. 

Gout occurs when uric acid builds up and forms crystals in your joints, and uric acid is made after the body breaks down purine found in many foods. This is why a gout-friendly diet is so important. In this guide, we’ll cover foods to eat and avoid to prevent uric buildup so you can be armed with the right information and take proactive steps towards easing symptoms, reducing flare-ups, and improving quality of life. 

What is gout?

Gout is an inflammatory arthritis that occurs as a response to the deposition of monosodium urate (MSU) monohydrate crystals (the end product of purine) in joints, bones, and soft tissues. People who suffer from gout may experience different forms of arthritis, such as:

• Gout flares
• Tophaceous gout
• Chronic gouty arthritis
• Renal functional impairment

Gout is usually preceded by hyperuricemia, which causes intense joint pain and frequently attacks joints in the big toe and at night. But it may also attack joints in other toes, the ankle, or the knee.

One of the major modifiable risk factors for developing hyperuricemia and gout is diet.

How diet can impact gout 

Low-purine diet

Uric acid is an end product of purine in humans. Thus, excessive ingestion of purine-rich foods can increase serum uric acid (although not all purine-rich foods have the same effect on serum uric acid levels and gout risk). Take meat and seafood, for example.  Excess consumption of these high-purine foods has been associated with higher levels of uric acid and, in turn, a higher risk of gout.

Rather than consuming purine-rich foods, gout patients should prioritize vegetables and legumes  such as peas, beans, lentils, asparagus, spinach, and mushrooms which do not result in an increased risk of gout. 

Mediterranean diet

Research has shown that the typical Western diet, which usually involves a high intake of red and processed meats, refined grains, and sugar-rich meals, is associated with a 42% higher risk of developing gout, whereas adherence to a Mediterranean-type diet is associated with a lower risk. 

The Mediterranean diet is an anti-inflammatory diet that prioritizes vegetables, fresh fruits, olive oil, legumes, poultry, beans, peas, whole grains, fish, nuts and seeds, and limited amounts of lean red meat. It’s naturally low-carb, low in saturated fat, and high in unsaturated fats like omega-3s.

Low-fat dairy

In a research study of men with new cases of gout, it was discovered that the incidence of gout decreased with an increased intake of dairy products. 

DASH diet 

The DASH diet (Dietary Approaches to Stop Hypertension) helps decrease serum urate levels, particularly among those with hyperuricemia and gout. The DASH diet emphasizes the consumption of nutrient-rich foods that are known to help lower blood pressure, such as fruits, vegetables, and whole grains.

It’s important to note that since obesity increases uric acid and weight gain increases gout risk, weight loss by lifestyle changes and healthy eating is advisable. We recommend consulting your healthcare provider and/or dietitian for personalized advice. 

Foods that help with gout

Low-fat dairy 

Dairy products may help serum uric acid and the risk of gout development. Research shows that those who consumed low-fat milk one or more times per day had a lower serum uric acid level than those who did not consume any milk.

Cherry

Cherries and cherry juice contain antioxidants and anti-inflammatory agents which help reduce the pain associated with gouty arthritis. In one study, it was found that patients who consumed cherries or cherry extract for 2 days had a 35% lower chance of a subsequent gout attack. Also, ingesting cherry juice concentrate helps reduce the incidence of flare-ups in gout patients.

Coffee

The consumption of coffee is associated with a lower serum uric acid level and hyperuricemia frequency (although the association was not noticed in other beverages that contain caffeine). It’s important to note that coffee contains a moderate to high amount of oxalate, so if you have or had renal stones, do not consume a high amount of coffee just to reduce your uric acid level.

Foods to avoid with gout 

Purine-rich foods

A low-purine diet is advisable for managing gout and hyperuricemia since urate is generated through the degradation of purines.

The following foods contain purines: 

• Red meats: beef, pork, venison and lamb
• Organ meats: liver, kidneys and sweetbreads
• Seafood: mussels, scallops, anchovies, sardines, mackerel, shellfish

Fructose 

Fruits and naturally sweet fruit juices that contain fructose should be only moderately consumed or avoided if possible since fructose may lead to an increase in uric acid. Before consuming food and beverages, check the label for high-fructose corn syrup.

Alcohol

Ethanol increases uric acid production and also increases the level of lactic acid in the blood, which results in an increase in serum uric acid. Beer also contains purine, which contributes to an increase in uric acid.

Can vitamins or supplements help with gout?

Some vitamins and supplements can help with gout, including:

Nutrition supplements

A study examined the effect of skim milk powder on the frequency of gout flares in 120 patients who met the American College of Rheumatology (ACR) criteria for gout. In this study, researchers divided the patients into three groups. Each group received a different kind of skim milk: 

1. Regular skim milk
2. Skim milk with added glycomacropeptide (GMP) and G600 milk fat extract
3. Skim milk with added lactose powder

All three groups showed a significant decrease in the frequency of gout flares.

Vitamin C

A 2016 study looked at the effects of taking a daily 500-mg vitamin C supplement on people with high levels of uric acid (hyperuricemia) or gout. The study found that vitamin C might work in two ways to lower uric acid levels. First by helping the kidneys get rid of uric acid by increasing its excretion in urine. Second, by increasing the glomerular filtration rate, which is a measure of how well the kidneys filter and remove waste from the blood.

Another study found that taking 500 mg of vitamin C daily for 2 months reduced uric acid levels by increasing the estimated glomerular filtration rate. Additionally, a meta-analysis of 13 studies showed that vitamin C supplements significantly lowered uric acid levels in the blood.

Tuna extract

In a study that looked at the impact of tuna extract on people with high levels of uric acid, it was found that the high-dose consumption of tuna extract might have a positive effect on lowering uric acid levels in people with asymptomatic hyperuricemia. The rationale behind this supplementation was that imidazole compounds in tuna extract could influence the levels of organic acids related to the reabsorption of urate (a component of uric acid) in the body.

Although supplements can be beneficial, it's important to talk to your healthcare professional and/or a Registered Dietitian first to confirm proper dosage and avoid any potential interactions with other medications.

READ MORE: Best & Worst Exercises For Gout

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