Written by Anne Jacobson, MD, MPH | Reviewed by Katie E. Golden, MD Published on August 1, 2022
Key takeaways:
- Gout is a type of arthritis that happens when there’s too much uric acid in the body. Your body produces uric acid when it breaks down purines from food.
- If you have gout, you can reduce your risk of a flare by avoiding foods that are high in purine and foods that affect the way the body breaks down purine.
- Eating a balanced diet and maintaining a healthy weight may be more important than avoiding particular foods.
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A long time ago, gout was considered a sign of wealth and royalty. In fact, so many nobles were periodically laid up with red, swollen joints that gout was known as “the disease of kings.” This is because the condition was related to a diet of rich delicacies, like meat, cheese, and ale. Today scientists know there’s more to gout than what you eat and drink.
Genes and other health conditions play an important role in whether you’ll get gout. But your diet can affect how often you get those painful flares of joint pain. So we’ll explain the connection between diet and gout — and what you can do to decrease your risk of a flare.
How can your diet affect gout symptoms?
Gout happens when uric acid builds up in the body and ends up in your joints. Your body produces uric acid when it breaks down purine. Your body needs purine to make new cells. So purine, and even uric acid, are important parts of your body.
But, as is often the case, you can have too much of a good thing. High uric acid levels can happen if you:
- Consume a lot of foods and drinks that are high in purine
- Naturally produce more uric acid than others
- Don’t excrete uric acid fast enough
So diet alone doesn’t cause gout. But if you’re prone to high uric acid levels, you can make changes in your diet that will help avoid a gout flare.
What foods should people with gout avoid?
If you have gout, the good news is there isn’t anything you need to avoid completely. But eating too many foods that are high in purine can overload your system with uric acid. So moderation is the key. And it’s important to note that every person is a little different, so it can help to pay attention to your diet and the foods that trigger a flare for you.
Here are some foods that you may need to reduce in order to avoid a gout flare:
1. Meat
If you rely on meat for most of your protein, consider incorporating plant-based proteins into your diet. But it’s also helpful to know that some meats have higher purine levels than others. Meats that have a moderate amount of purine include beef, chicken, duck, and pork.
Meats with high levels of purine include:
- Bacon
- Turkey
- Veal
- Venison
- Organ meats, like liver
2. Shellfish and seafood
Fish has many health benefits. So it may be worth trying to keep a few of these in your rotation if you enjoy them and they don’t flare up your gout. Seafoods with moderate purine include crab, lobster, oysters, and shrimp.
Seafoods with the highest amount of purine include:
- Anchovies
- Sardines
- Herring
- Mussels
- Codfish
- Scallops
- Tuna
- Trout
- Haddock
3. Processed and sugary foods
Processed and sugary foods are on every no-no list when it comes to healthy eating. Still, they’re hard to avoid completely. But in the case of gout, it’s the high-fructose corn syrup that seems to be the problem. This is because high amounts of fructose affect the body’s ability to break down purines. And that can lead to an increased level of uric acid.
4. Alcohol
Alcohol’s place on this list probably does not come as a surprise to a lot of people. But, just like meat, some types of alcohol are worse than others. Beer tends to increase your risk of a flare.
What foods are good for gout?
Foods low in purines are a safe bet. But it turns out that the amount of purine in food isn’t the only factor that affects gout flares. There are even some foods high in purine that may be good for people with gout. This is because they help your body process and get rid of uric acid.
Here are a few surprising foods that can be part of a gout-friendly diet for most people:
1. High-purine vegetables
Although these vegetables have higher levels of purine, they don’t seem to be associated with gout flares for most people. These include
- Cauliflower
- Spinach
- Mushrooms
- Peas
2. Beans, lentils, and legumes
Even though beans, lentils, and legumes are rich in purines, their high fiber level binds uric acid in the gut, leading to fewer flares. A few studies suggest there may be a slightly higher risk with legumes. But these are still a much better protein alternative to meat.
3. Soy products
Soy is another protein source that is high in purine. But it’s likely a much better choice than animal products when it comes to avoiding flares.
4. Dairy products
Not all animal products are bad for gout. In several studies, milk and other dairy products were associated with a lower risk of gout.
5. Fruits high in vitamin C
Vitamin C helps the body get rid of extra uric acid. But fruit also contains fructose, which can affect how well the body breaks down purines. Some good fruit choices that are high in vitamin C but lower in fructose include:
- Grapefruit
- Oranges
- Pineapple
- Strawberries
- Tart cherries (these also contain antioxidants, which may lower the risk of gout flares)
6. Water
Water is probably not a surprise. Drinking plenty of water helps keep your kidneys running well. That’s important in gout because the kidneys help get rid of extra uric acid. Aim for 64 ounces (8 large glasses) of water every day, especially if you’re exercising or sweating. Coffee is also associated with a lower risk of gout.
What is the best diet for gout?
When it comes to gout, many people focus on the foods to avoid. But it’s just as important to know which foods to include in your diet to reduce the risk for a flare. A healthy body weight and balanced diet may be even more important than avoiding certain foods.
Diet recommendations for people with gout have similar guidelines as other chronic diseases. And this may provide an added bonus, because many people with gout also have high blood pressure, diabetes, or kidney disease. So these recommendations will help you live a healthier life if you have those conditions, too.
Experts recommend a diet with:
- Plenty of fruits and vegetables
- Whole grains
- Lean protein
- Healthy fats
- Not too much sugar or salt
If you’re looking for a specific diet that incorporates these guidelines, a good place to start is with the DASH diet or the Mediterranean diet.
It’s also worth noting that intermittent fasting may lead to more flares for people with gout, especially if you’re not well hydrated.
The bottom line
The best diet for gout is one that keeps you healthy, active, and free of pain. There are certain foods that, if you eat too much of them, may overwhelm your body’s ability to get rid of uric acid. But it turns out that the best diet for gout is also one that’s going to work for your entire body. Whether or not you have gout, try to include plant-based foods as much as possible, and eat everything else in moderation.
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