The best diet for gout: what to eat and what to avoid
Gou Gout occurs when urate
crystals accumulate in your joints, causing the inflammation and intense pain
of a goua attack.
Gout is a type of
arthritis that is an inflammation of the joints. An estimated 8.3 million
people are affected in the united states alone (1).
Patients with gout
suddenly experience severe joint pain, swelling, and inflammation (2).
Fortunately, gout can
be controlled with medications, gout-friendly diets, and lifestyle changes.
This article reviews
the best diets for gout and the foods to avoid and is supported by research.
What is gout?
Gout is arthritis that
involves sudden pain, swelling, and inflammation of joints.
Nearly half of all
gout cases affect the big toe, while others affect the fingers, wrists, knees,
and heels (3, 4, 5).
When there is too much
uric acid in the blood, gout symptoms or "attacks" occur. Uric acid
is a waste product produced by the human body when digesting certain foods.
When uric acid levels
are high, its crystals accumulate in your joints. this process can trigger
swelling, inflammation, and severe pain (5).
Gout attacks usually
occur at night and last 3 to 10 days (6).
Most people with this
disease experience these symptoms because their bodies are unable to
effectively remove excess uric acid. This allows uric acid to accumulate,
crystallize and precipitate in the joints.
Other patients with
gout have too much uric acid due to genetic or dietary reasons (7, 8).
Summary: gout is arthritis that causes sudden
pain, swelling, and inflammation of the joints. This happens when there is too
much uric acid in the blood, causing it to be deposited in the joints in the
form of crystals.
How does food affect gout?
If you have gout,
certain foods may trigger seizures by raising your uric acid levels.
Trigger foods are
often rich in purines, a substance that occurs naturally in food. When you
digest purines, your body treats uric acid as a waste product (9).
This is not a problem
for healthy people because they can effectively remove excess uric acid from
the body.
However, patients with
gout do not effectively remove excess uric acid. Therefore, a high-purine diet
may allow uric acid to accumulate and cause gout attacks (5).
Fortunately, studies
have shown that restricting high-purine foods and taking appropriate
medications can prevent gout attacks. （10）。
Foods that usually
trigger gout attacks include organ meat, red meat, seafood, alcohol, and beer. They
contain moderate to large amounts of purines (11, 12).
However, there is one
exception to this rule. Studies have shown that high purine vegetables do not
trigger gout attacks (13).
Interestingly,
fructose and sugary drinks increase the risk of gout and gout attacks, even
though they do not contain purines (14).
Instead, they may
raise uric acid levels by speeding up several cellular processes. （15, 16）。
For example, a study
of more than 125,000 participants found that those who consumed the most
fructose had a 62 percent higher risk of gout. （17）。
On the other hand,
studies have shown that low-fat dairy products, soy products, and vitamin C
supplements may help prevent gout attacks by lowering blood uric acid levels. （11, 18）。
Full-fat and high-fat
dairy products do not appear to affect uric acid levels (13, 19).
Summary: foods can raise or lower your uric acid
levels, depending on their purine content. However, fructose can raise your
uric acid levels, even if it's not rich in purines.
What foods should you avoid?
If you are prone to
sudden onset of gout, avoid the main culprit – homopurine foods.
These foods contain
more than 200 mg of purine per 3.5 ounces (100 grams). （20）
You should also avoid
fructose-high foods, as well as moderately high-purine foods that contain
150-200 mg of purines per 3.5 ounces. These may trigger gout attacks.
Here are some of the
main foods to avoid for high-purine, medium-high-purine, and high-fructose
foods (6, 11, 20):
- all internal organs: including the
liver, kidneys, sweet bread, and brain
- game: e.g. pheasant, veal, and venison
- fish: herring, salmon, mackerel, tuna, sardines,
anchovies, cod, and more
- other seafood: scallops, crabs, shrimp, and roe
- sugary drinks: especially juices and sugary sodas
- added sugars: honey, agave nectar, and high fructose corn syrup
- yeast: nutritional yeast, brewer's yeast, and other
yeast supplements
In addition, refined
carbohydrates such as white bread, cakes, and biscuits should be avoided. Although
they are not high in purines or fructose, they are low in nutrients and may
raise your uric acid levels (21).
Summary: if you suffer from gout, you should
avoid foods such as offal, game, fish and seafood, sugary drinks, refined
carbohydrates, added sugars, and yeast.
What foods should you eat?
Although a
gout-friendly diet can eliminate many foods, you can still enjoy plenty of
low-purine foods.
Foods are considered
low purines when they contain less than 100 mg of purine per 3.5 ounces (100
grams).
Here are some
low-purine foods that are generally safe for patients with gout (20, 22):
- Fruit: all fruits are usually suitable for gout. Cherries
can even help prevent attacks by lowering uric acid levels and reducing
inflammation (23, 24).
- Vegetables: all vegetables are fine, including potatoes,
peas, mushrooms, eggplants, and dark green leafy vegetables.
- Pulses: all legumes are acceptable, including lentils, legumes,
soybeans, and tofu.
- Nuts: all nuts and seeds.
- Whole grains: includes oats, brown rice, and barley.
- Dairy: all dairy products are safe, but low-fat dairy
products appear to be particularly beneficial (11, 18).
- egg
- Beverages: coffee, tea, and green tea.
- Vanilla & spices: all vanillas and spices. plant-based
- Oil: includes oils of rapeseed, coconut, olives, and
flax.
Foods you can eat in moderation
Except for offal,
game, and certain fi, sh, most meats can be eaten in moderation. You should
limit yourself to the 4-6 ounces (115-170 grams) range per week (20).
They contain an
appropriate amount of purine and are considered 100-200 mg per 100 g.
therefore, eating too much of them may trigger gout attacks.
- Meat: includes chicken, beef, and lamb.
- Other
fish: fresh or canned salmon
typically have lower purine levels than most other fish.
Summary: foods that gout sufferers should eat include
all fruits and vegetables, whole grains, low-fat dairy products, eggs, and most
beverages. Limit intake of non-organ meat and fish (such as salmon) to 4-6
ounces (115-170 grams) several times a week.
Gout-friendly menu for the week
Eating a gout-friendly
diet will help you reduce pain and swelling while preventing future episodes.
This is a sample of a
gout-friendly menu for the week.
Friday
- Breakfast: French toast with strawberries.
- Lunch: a whole-wheat sandwich with boiled eggs and
salad.
- Dinner: sautéed tofu and vegetables with brown rice.
Saturday
- Breakfast: mushrooms and
zucchini omelet.
- Lunch: leftover fried tofu and brown rice.
- Dinner: homemade chicken burger with fresh salad.
-
Sunday
- Breakfast: two egg omelets
with spinach and mushrooms.
- Lunch: whole grain wrapped chickpeas and fresh
vegetables.
- Dinner: scrambled egg tacos – spinach and bell pepper
scrambled eggs on whole wheat tortillas.
Monday
- Breakfast: oats, Greek
yogurt, and 1/4 cup (about 31 g) of berries.
- Lunch: quinoa salad with boiled eggs and fresh
vegetables.
- Dinner: whole-wheat pasta with roast chicken, spinach,
bell peppers, and low-fat feta cheese.
Tuesday
- Breakfast: smoothie plus 1/2
cup (74 g) blueberries, 1/2 cup (15 g) spinach, 1/4 cup (59 ml) Greek
yogurt, and 1/4 cup (59 ml) low-fat milk.
- Lunch: a whole-wheat sandwich with eggs and salad.
- Dinner: sautéed chicken and vegetables with brown rice.
Wednesday
- breakfast: overnight oats -
1/3 cup (27 g) rolled oatmeal, 1/4 cup (59 ml) Greek yogurt, 1/3 cup (79
ml) low-fat milk, 1 tablespoon (14 g) chia seeds, 1/4 cup (approx. 31 g)
berry, and 1/4 teaspoon (1.2 ml) vanilla extract. Let's sit overnight.
- Lunch: whole grain wrapped chickpeas and fresh
vegetables.
- Dinner: vanilla grilled salmon with asparagus and cherry
tomatoes.
Thursday
- breakfast: overnight chia
seed pudding — 2 tablespoons (28g) of chia seeds, 1 cup (240 ml) Greek
yogurt, and 1/2 teaspoon (2.5 ml) vanilla extract, and sliced fruit of
your choice. Let's sit in a bowl or Mason jar for the night.
- Lunch: leftover salmon with salad.
- Dinner: quinoa, spinach, eggplant, and feta cheese salad.
Summary: there are many options for a diet that
is beneficial for gout and can provide a healthy and delicious menu. The
section above provides an example of a gout-friendly menu for the week.
Other lifestyle changes you can make
In addition to your
diet, some lifestyle changes can help you reduce your risk of gout and gout
attacks.
Weight loss
If you have gout,
being overweight increases the risk of a gout attack.
That's because being
overweight makes you more resistant to insulin, which leads to insulin resistance.
In these cases, the body is unable to use insulin properly to remove sugar from
the blood. Insulin resistance also promotes high uric acid levels (25, 26).
Studies have shown
that weight loss helps reduce insulin resistance and lower uric acid levels (27, 28).
That said, avoid fast
dieting – that is, try to lose weight quickly by eating less. Studies have
shown that rapid weight loss increases the risk of gout attacks (29, 30, 31).
Exercise more
Regular exercise is
another way to prevent gout attacks.
Exercise cannot only
help you maintain a healthy weight, but also keep your uric acid levels low (32).
A study of 228 men
found that people who ran more than 5 miles (8 kilometers) a day had a 50
percent lower risk of gout. This is also partly due to the lighter weight
carried (33).
Stay hydrated
Staying hydrated can
help reduce the risk of gout attacks.
This is because
adequate water intake helps the body remove excess uric acid from the
bloodstream, which is excreted from the urine (34, 35).
If you exercise
regularly, it's even more important to stay hydrated, as you may lose a lot of
moisture from sweating.
Limit alcohol intake
Alcohol is a common
trigger for gout attacks (36, 37).
That is because the
body may prioritize removing alcohol over uric acid, allowing uric acid to
accumulate and form crystals (38).
One study of 724
people found that drinking wine, beer or liquor increased the risk of gout
attacks. Drinking one to two cups a day increases the risk by 36%, and drinking
two to four cups a day increases by 51% (39).
Try a vitamin c supplement
Studies have shown
that vitamin C supplements can help prevent gout attacks by lowering uric acid
levels (40, 41, 42).
It seems that vitamin
C achieves this by helping the kidneys clear more uric acid from the urine (42, 43).
However, one study
found no effect of vitamin C supplementation on gout (44).
Research on gout
vitamin c supplements is new, so more research is needed before strong
conclusions can be drawn.
Summary: Weight loss, exercise, staying hydrated,
limiting alcohol consumption, and taking vitamin C may also help prevent gout
attacks.
Conclusion
Gout is arthritis that
involves sudden pain, swelling, and inflammation of joints.
Fortunately, a
gout-friendly diet can help relieve its symptoms.
Foods and beverages
that often trigger gout attacks include organ meat, game, certain types of
fish, juices, sugary sodas, and alcohol.
Fruits, vegetables,
whole grains, soy products, and low-fat dairy products, on the other hand, can
help prevent gout attacks by lowering uric acid levels.
Other lifestyle
changes that can help prevent gout attacks include maintaining a healthy
weight, exercising, staying hydrated, drinking less alcohol, and possibly
taking vitamin C supplements.