While medications are key factors in the management and treatment of gout, dietary factors can also play an important role. Following dietary advice may or may not accompany medications, but can help to stabilise levels of uric acid in the blood, which can reduce the risk of gout attacks.
What can you do to prevent attacks of gout?
Achieve a healthy weight
Obesity may be a primary consideration to reduce levels of uric acid in the blood. Insulin resistance is commonly seen in those who are obese and it may be involved in the development of gout. Insulin resistance has been shown to decrease the amount of uric acid that is cleared in the urine. A condition known as the ‘metabolic syndrome’ is a cluster of symptoms which includes insulin resistance, along with tummy (abdominal) obesity, high blood pressure and abnormal blood fats (lipids) – for example, high cholesterol. This condition is strongly associated with high uric acid levels, which can be improved with slow, gradual weight loss.
Weight loss has been shown to improve insulin resistance and therefore reduce uric acid levels in the blood. However, it is important to avoid strict diets such as low-carbohydrate and high-protein diets. These may increase consumption of purines, a compound that breaks down into uric acid. Additionally, rapid weight loss through strict dieting can result in breakdown of tissue. This can temporarily cause a rise in uric acid levels. A gradual, safe weight loss of 1-2 lbs a week can help to achieve an optimal body weight.
Drinking too much alcohol has been associated with gout for many years. However, it is uncertain how it may be related. Some types of alcohol, particularly beer, contain high levels of purines, which could be an indirect cause of gout. Alternatively, alcohol’s association with gout could be due to it’s contribution to obesity through excessive consumption. Alcohol contains 7 calories per gram and so drinking too much alcohol can lead to weight gain.
There is more risk of developing gout attacks from drinking beer compared to spirits, and wine drinking in moderation has no associated risk. If you choose to drink alcohol, drinking in moderation is advisable. Both men and women should drink no more than 14 units of alcohol per week. These units should be spread out through the week and there should be at least two alcohol-free days each week.
A unit of alcohol is:
- One 25 ml shot of spirits.
- Half a pint of standard-strength lager/beer (3-4% alcohol by volume).
- One small 125 ml glass of wine (11% alcohol by volume).
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Higher-strength alcoholic beverages will contain more units. For example, a pint of a higher-strength beer (5.2% alcohol by volume) is 3 units, and a small 125 ml glass of wine (12% alcohol by volume) is 1.5 units.
Ensuring a sufficient fluid intake helps to reduce the risk of crystals forming in joints. Keeping hydrated and avoiding lack of fluid in the body (dehydration) can lessen this risk and help to prevent gout attacks. Aim to drink at least 2 litres per day. However, you may need as many as 3-3.5 litres per day depending on your weight, whether it is hot, or whether you exercise.
Reduce your purine intake
Purines are natural compounds found in many foods. When purines are metabolised, they are broken down and their end product is uric acid. Therefore, reducing purine-rich foods, particularly if they are regularly consumed, may help to prevent attacks of gout.
Reduce red meat (particularly beef, pork and lamb), poultry meat and seafood, as these are primary sources of purines. Aim to have no more than one serving of any meat (including poultry) or fish per day, and it may be helpful to have 1-2 meat-free days each week. To make sure you are getting enough protein, include meat-free sources of protein such as eggs, low-fat dairy products, tofu, cheese, nuts or beans with lower purine content such as haricot beans. Evidence suggests that plant foods aren’t associated with increased risk of gout, even if they have a higher purine content.
There are certain foods that are very high amounts of purines and should be considerably limited, if not avoided completely. These include:
Limit sugary foods/sweetened foods
Overindulging in these foods can lead to weight gain and obesity. Additionally, sugary foods, sugary soda drinks and snacks often contain fructose or what might be labelled as high-fructose corn syrup/glucose-fructose syrup. A high intake of fructose can increase uric acid levels in the blood and may increase insulin resistance. These are both risk factors for developing gout, so aim to limit these foods.
As well as biscuits, cakes, sweets, fruit juices and sugary drinks, high-fructose corn syrup can be found in unexpected foods. These include:
- Frozen pizzas.
- Cereals and cereal bars.
- Jarred sauces.
- Some condiments such as jams, ketchup, mayonnaise or salad dressings.
Check labels to compare products and choose fresh ingredients rather than processed foods when possible.
Although fruit contains fructose it should not be limited. This is because fruit is not a concentrated form of fructose. When eaten whole it contains fibre, and protective vitamins and minerals such as potassium, vitamin C and other antioxidants, which are otherwise lost in processing.
Which foods are the best to eat for gout?
A healthy balanced diet can help to achieve and maintain a healthy weight. It can also provide energy and nutrients sufficient for optimal health and reduce risk of gout attacks.
Plenty of fruit and vegetables
The recommendation for people with gout is five portions per day, but try to include as many as possible. Bulking out meals, such as Bolognese, casseroles and stews with vegetables can help to reduce the meat content. Fruit, vegetables contain vitamin C. Although evidence is unclear, high intakes of vitamin C (500 mg or more) may help to reduce uric acid levels in the blood. Cherries may be particularly useful to include in the diet, as they have also been found to reduce levels of uric acid in the blood.
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Plenty of starchy carbohydrates
These may include rice, potatoes, pasta, bread, couscous, quinoa, barley or oats, and should be included at each meal time. These foods contain only small amounts of purines, so these along with fruit and vegetables should make up the basis of your meals. Wholegrain varieties are better choices as they contain more fibre and nutrients.
Some meat, fish, eggs, beans and pulses
Eat these foods in moderation. Having vitamin C with meals can help to improve the absorption of iron, so drink a small glass of orange juice, have a piece of fruit for dessert, or serve up meals with plenty of vegetables. Keep your portions of meat controlled by using your hands as a serving size guide. A serving is about the size and thickness of the palm of your hand.
Some milk and dairy products
Including low-fat dairy products (such as skimmed milk, low-fat yoghurt and low-fat cottage cheese) may help to prevent high levels of uric acid in the blood. These foods are a good source of protein and also have a low purine content so are useful additions to meals if you are trying to reduce meat (including poultry) and fish intake.
Reducing the amount of uric acid levels in the blood can help to prevent gout attacks. This can be done by:
- Achieving a healthy weight.
- Limiting alcohol.
- Avoiding/reducing foods high in purines.
- Drinking plenty of fluid.
- Limiting foods sweetened with fructose.
- Eating plenty of fruit and vegetables.
- Consuming low-fat dairy products.
— Update: 02-02-2023 — cohaitungchi.com found an additional article Gout Diet: Foods to Eat and Avoid from the website www.everydayhealth.com for the keyword diet to treat gout.
Gout causes swelling and inflammation in the joints. It’s a painful form of arthritis caused by too much uric acid in the body.
A Look at How You Get Gout
Uric acid is a normal waste product in the blood that comes from the breakdown of certain foods. It’s processed in the kidneys before being eliminated from the body in urine.
Excess Body Weight and Gout
Being overweight is associated with higher-than-normal uric acid levels. Since this is a major risk factor for gout, losing weight is often the goal of a gout diet.
Dieting and Weight Loss to Prevent Gout
Losing weight may help lower your uric acid levels and reduce your risk of future gout attacks. A 2017 review of studies suggested that a weight loss of about eight pounds or more led to long-term reductions in uric acid levels and gout attacks in overweight or obese people. (1)
An Overview of Dietary Approaches to Manage and Prevent Gout
The main principles of a gout diet are usually the same as those of any healthy, balanced diet.
- If you’re overweight, reduce the number of calories you consume.
- Choose unrefined carbohydrates like fruits, vegetables, and whole grains.
- Limit your intake of sugar-sweetened beverages and foods.
- Limit your intake of red meats and organ meats (such as kidney, liver, or sweetbreads).
- Cut back on saturated fats.
Read more Gout Diet: Foods to Eat and Avoid
Dietary Causes of Gout and Gouty Arthritis
Some people with gout find it helpful to eliminate specific high-purine foods from their diet. (2) Certain high-purine foods may trigger gout attacks in some people.
Most people with gout will still need medication even if they follow a diet for gout.
Dietary changes alone can lower your uric acid levels by up to 15 percent, according to the Institute for Quality and Efficiency in Health Care, an independent scientific institute that evaluates the benefits and harms of medical interventions. (2)
It’s not necessary to avoid all high-purine foods if you have gout. Studies have shown that purine-rich vegetables don’t trigger gout. (3) And certain high-purine foods can be a good source of lean protein to incorporate into your diet.
Purine-rich vegetarian foods to include in your diet are:
Foods to Avoid to Control or Prevent Gout
The following foods may trigger gout attacks in some people:
- Red meat
- Organ meats
- Certain types of seafood (anchovies, sardines, herring, mackerel, scallops)
- Products containing high-fructose corn syrup
Drinks that can trigger gout include:
- Alcoholic beverages, especially beer, whiskey, gin, vodka, or rum
- Sugary drinks, including sodas, juices, energy drinks
- Coffee and other caffeinated beverages. While some studies show that caffeine can actually protect against gout pain, others find that sudden spikes in caffeine intake can trigger a gout attack.
Dietary Supplements for Gout Management and Prevention
Talk to your doctor about any supplements or vitamins you take or may want to take. Supplements and other remedies may interfere with medication.
Vitamin C supplements (up to 500 mg daily) are sometimes recommended for people with gout. (4)
One study found that taking 500 mg of vitamin C per day had a mild uric-acid–lowering effect. (5) Yet it’s not clear whether vitamin C helps relieve gout symptoms.
A 2013 study showed that supplementing with 500 mg of vitamin C for eight weeks did not significantly lower uric acid levels in patients with gout. (6)
Cherry Juice for Gout Management?
Cherries and cherry juice are a popular folk remedy for gout, but the scientific evidence to support their supposed benefits is still coming in.
In 2005, the U.S. Food and Drug Administration (FDA) sent warning letters to several cherry product manufacturers for overselling the health benefits of their products in advertisements. (7)
Nonetheless, there’s reason to believe that cherries may help fight gout. They contain chemical compounds called anthocyanins, which have been shown to help reduce inflammation. (8)
Cherries may also have a beneficial effect on uric acid levels.
One large study of people with recurrent gout found that eating cherries was associated with a lower risk of gout attacks, especially when cherry consumption was combined with taking a common uric acid-lowering drug. (9)
Despite these findings, experts say that more research is needed before any definitive recommendations can be made about cherries or cherry juice for gout.
Gout Cookbooks and Gout-Friendly Eating Plans
- Martin K. The Gout Diet and Cookbook: An Introduction to Low Purine Foods and Meals for People With Gout. 2016.
- Preston C. Gout Diet: The Anti-inflammatory Gout Diet. 2015.
- Shah M. Gout Cookbook: 85 Healthy Homemade and Low Purine Recipes for People With Gout (A Complete Gout Diet Guide and Cookbook). 2016.