Gout, a type of arthritis characterized by sudden, severe attacks of pain, redness, and tenderness in joints, often the joint at the base of the big toe, arises from elevated uric acid levels in the bloodstream. When these levels are too high, uric acid crystals can form and deposit in joints, triggering inflammation and intense pain. Understanding the connection between diet and gout is crucial for managing this condition. While a gout diet isn’t a standalone cure, it plays a significant role in reducing uric acid levels, minimizing the risk of gout flare-ups, and slowing down joint damage progression. For individuals with gout, dietary adjustments are often recommended alongside medication to effectively manage symptoms and improve quality of life.
Understanding Gout and Uric Acid
Uric acid is a natural byproduct of purine breakdown. Purines are chemical compounds found in our bodies and various foods. Normally, uric acid dissolves in the blood and passes through the kidneys into urine. However, when the body produces too much uric acid or the kidneys don’t excrete enough, it can build up, leading to hyperuricemia. This excess uric acid can then crystallize and accumulate in joints and surrounding tissues, causing the painful condition known as gout. Therefore, managing purine intake through diet is a cornerstone of gout management.
Key Goals of a Gout Diet
A well-structured gout diet aims to achieve several important goals:
- Achieve and Maintain a Healthy Weight: Excess weight is a significant risk factor for gout. Weight loss, even moderately, can effectively lower uric acid levels and reduce overall stress on joints. Calorie reduction and weight management are beneficial even without strict purine restriction.
- Limit High-Purine Foods: While not all purine-rich foods need to be entirely eliminated, significantly reducing the intake of those with very high purine content is essential. This helps lower the amount of uric acid the body produces.
- Incorporate Foods that Help Control Uric Acid Levels: Certain foods and beverages can promote uric acid excretion or have other beneficial effects in managing gout. Including these strategically can complement the diet’s effectiveness.
The foundation of a gout diet is built upon general healthy eating principles, emphasizing moderation and balance.
Foods to Avoid with Gout: The Definitive List
Navigating the grocery store with gout requires knowing which foods can exacerbate your condition. Here’s a detailed breakdown of foods to limit or avoid:
Organ Meats: A Strict No-Go
Organ meats, including liver, kidneys, and sweetbreads, are exceptionally high in purines. These should be strictly avoided in a gout diet. Consuming organ meats can dramatically increase uric acid levels, significantly raising the risk of gout attacks.
Red Meat: Limit Your Portions
Red meats such as beef, lamb, and pork are also relatively high in purines. While they don’t need to be completely eliminated, portion control is key. Opt for smaller servings and reduce the frequency of red meat consumption. Choose leaner cuts and consider alternatives like poultry or fish for your protein needs.
Certain Seafood: Choose Wisely
Certain types of seafood contain higher purine levels than others. Anchovies, shellfish (like shrimp, lobster, and mussels), sardines, and tuna are among those higher in purines. While fish generally offers significant health benefits, moderation is important for individuals with gout. Smaller portions of these high-purine seafood options can be included occasionally, but they shouldn’t be dietary staples.
Sugary Foods and Beverages: Watch Out for Fructose
Foods and beverages high in sugar, particularly fructose, are linked to increased uric acid production. High-fructose corn syrup, often found in sodas, candies, and processed foods, is especially problematic. Limit or avoid sugar-sweetened beverages, sweetened cereals, bakery goods, and candies. Even naturally sweet fruit juices should be consumed in moderation due to their fructose content.
Alcohol: Especially Beer and Liquor
Alcoholic beverages, particularly beer and distilled liquors, are strongly associated with an increased risk of gout attacks. Alcohol can interfere with uric acid elimination from the body. Beer is especially high in purines. While moderate wine consumption might have a less pronounced effect, it’s generally advisable to avoid alcohol during gout flare-ups and significantly limit intake, especially beer and liquor, between attacks.
Foods to Include in Your Gout Diet: Focus on Healthy Choices
While limiting certain foods is crucial, a gout diet is also about incorporating beneficial options:
Complex Carbohydrates: Embrace Fruits, Vegetables, and Whole Grains
Focus on complex carbohydrates from fruits, vegetables, and whole grains. These provide essential nutrients and fiber without contributing to high uric acid levels. Choose whole-grain breads, pasta, and cereals over refined grains. A wide variety of colorful fruits and vegetables should form the foundation of your daily diet.
Lean Proteins: Opt for Poultry, Low-Fat Dairy, and Lentils
Lean protein sources are important for overall health and can be included in a gout diet. Skinless poultry, low-fat dairy products, and lentils are good choices. Low-fat dairy, in particular, may have a beneficial effect on uric acid levels.
Low-Purine Vegetables: Enjoy Asparagus and Spinach
Despite some misconceptions, studies have shown that vegetables naturally higher in purines, such as asparagus and spinach, do not increase the risk of gout or gout attacks. These nutrient-rich vegetables can be safely included in your diet.
Water: Stay Hydrated
Adequate hydration is crucial for everyone, and especially beneficial for those with gout. Drinking plenty of water helps flush out uric acid and supports kidney function. Aim for at least eight glasses of water per day.
Vitamin C: Consider Supplementation
Vitamin C may help lower uric acid levels. Discuss with your doctor whether a 500-milligram vitamin C supplement is appropriate for you, considering your overall health and medication plan.
Coffee: Moderate Consumption May Be Beneficial
Some research suggests that moderate coffee consumption, particularly regular caffeinated coffee, may be associated with a reduced risk of gout. However, coffee may not be suitable for everyone, especially those with other medical conditions. Consult your doctor to determine if coffee is appropriate for you.
Cherries: A Natural Ally
Cherries and cherry juice have shown promise in reducing the risk of gout attacks in some studies. Including cherries in your diet may be a tasty and potentially beneficial addition.
Sample Gout-Friendly Menu
Here’s an example of a daily menu plan that aligns with gout dietary recommendations:
Breakfast
- Whole-grain, unsweetened cereal with skim or low-fat milk
- 1 cup fresh strawberries
- Coffee
- Water
Lunch
- Roasted chicken breast slices (2 ounces) on a whole-grain roll with mustard
- Mixed green salad with vegetables, 1 tablespoon nuts, and balsamic vinegar and olive oil dressing
- Skim or low-fat milk or water
Afternoon Snack
- 1 cup fresh cherries
- Water
Dinner
- Roasted salmon (3 to 4 ounces)
- Roasted or steamed green beans
- 1/2 to 1 cup whole-grain pasta with olive oil and lemon pepper
- Water
- Low-fat yogurt
- 1 cup fresh melon
- Caffeine-free beverage, such as herbal tea
Conclusion: Diet as Part of Your Gout Management Strategy
Adopting a gout diet is a valuable step in managing gout. By limiting high-purine foods and making healthy dietary choices, you can help reduce uric acid production and promote its elimination. While diet alone is unlikely to replace medication in treating gout, it can significantly contribute to fewer and less severe gout attacks, and improve your overall well-being. Combining a gout-friendly diet with regular exercise and maintaining a healthy weight offers a holistic approach to managing gout and enhancing your quality of life.
References
- Firestein GS, et al., eds. Etiology and pathogenesis of hyperuricemia and gout. In: Kelley and Firestein’s Textbook of Rheumatology. 10th ed. Philadelphia, Pa.: Elsevier; 2017. https://www.clinicalkey.com. Accessed May 1, 2018.
- Becker MA. Lifestyle modification and other strategies to reduce the risk of gout flares and progression of gout. https://www.uptodate.com/contents/search. Accessed May 1, 2018.
- AskMayoExpert. Gout. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018.
- Beyl RN, et al. Update on importance of diet in gout. The American Journal of Medicine. 2016;129:1153.
- Zeratsky KA (expert opinion). Mayo Clinic, Rochester, Minn. May 9, 2018.
