Arthritis Gout What Foods to Avoid With Gout Why You Should Limit Seafood, Yeast, Red Meat, and More By Brittany Poulson, MDA, RDN, CD, CDCES linkedin Brittany Poulson, MDA, RDN, CDCES, is a registered dietitian and certified diabetes care and education specialist. Learn about our editorial process Brittany Poulson, MDA, RDN, CD, CDCES Published on December 22, 2020 Print Table of Contents View All Table of Contents What Are Purines? Sugars Processed Foods Red Meat and Organ Meat Fish and Seafood Beer and Liquor Yeasts High Purine Vegetables OK Weight Management Gout is one of the oldest recognized forms of arthritis, with a medical history dating back to the Middle Ages. It was originally known as a “rich man’s disease” because it was associated with rich foods and alcohol, which were generally unavailable to the lower classes. Today it affects people of all socioeconomic statuses. The types of foods you eat can have a direct impact on gout symptoms and severity. More specifically, foods high in purines tend to result in more symptom flare-ups. Among people with gout, acute purine intake increased the risk of recurrent gout attacks nearly fivefold, according to a 2014 study. Verywell / Alexandra Gordon What Is Gout? Gout is a form of inflammatory arthritis that affects one joint (commonly the big toe joint) or multiple joints at a time. It occurs when there is too much uric acid in the blood, causing a buildup of uric acid crystals in joints, fluids, and tissues throughout the body—often causing severe swelling, redness, and pain. What Are Purines? Purines are chemical compounds found naturally in foods, as well as in your body. Natural purines in your body are called endogenous purines, whereas purines found in foods you eat are called exogenous purines. Exogenous purines are broken down in the body by the digestive system. Uric acid is created as a byproduct when either exogenous and endogenous purines are processed by the body. The majority of uric acid is reabsorbed by the body, with the remainder being excreted in the urine and feces. If the amount of purines in the body is more than it can process, uric acid builds up in the blood, in a condition called hyperuricemia. Hyperuricemia results in a buildup of uric acid crystals in the body, often leading to kidney stones or gout, though some people have no signs or symptoms at all. It’s recommended that people with hyperuricemia or gout avoid or limit eating foods that are high in purines to help reduce the purine load in the body. Foods high in purines include some sugary foods, red meats, organ meats, seafood, yeasts, and alcoholic beverages. What to Eat When You Have Gout Sugars Sugar seems to increase uric acid levels. Fructose is a natural form of sugar found in some foods. Fructose, as well as the high-fructose corn syrup added to some foods, can increase serum uric acid levels. Avoiding or limiting foods high in these sugars may help lessen the symptoms of gout. Some fruits are naturally high in fructose, though the association between fruit and gout is unclear. If you have gout, you don’t have to avoid all fruit. However, some fruit juices may need to be avoided or limited. Be sure to consume only one serving of fruit at a time, such as a small apple or orange, 4 ounces (1/2 cup) of juice, 1 ounce (a palm-full) of dried fruit, or a half-cup of fresh fruit. Gout triggers can be individual, so pay attention to the fruits (and amounts) you eat and if they seem to set off a gout attack. Sugar-sweetened beverages can increase uric acid levels in the blood. A 2020 review of studies found that consumption of sugar-sweetened beverages was significantly associated with an increased risk of gout and hyperuricemia in adults. Avoid sugar-sweetened beverages, such as soft drinks or soda, energy drinks, and sports drinks. Sodas and Sugary Drinks Sodas and sugary drinks are considered empty-calorie foods, because they contain no beneficial nutrients while contributing a lot of calories to your diet. For example, a 12-ounce can of cola contains about 150 calories and 40 grams, or about 9.5 teaspoons, of added sugars. In addition, sugar-sweetened beverages have been associated with an increased risk of heart disease, type 2 diabetes, weight gain, and dental caries. Processed Foods and Refined Carbs The modern Western diet is often high in processed foods and refined carbohydrates. In addition, processed foods and refined carbohydrates have been linked to an increased risk of type 2 diabetes, heart disease, and weight gain. A 2017 study looked at gout incidence in people who followed either a Western diet or the Dietary Approaches to Stop Hypertension (DASH) diet. The researcher found the DASH diet was associated with a lower risk of gout, whereas the Western diet was associated with a higher risk of gout. To help prevent gout symptoms, it’s best to limit highly processed foods and beverages and foods high in refined carbohydrates, such as sweets, baked goods and pastries, chips, crackers, cookies, candies, soda, ice cream, white breads, and some pre-made frozen meals. Eating highly processed foods and refined carbohydrates in moderation will not only help with your gout, but your overall health as well. Red Meat and Organ Meat Red meat and organ meats are high in purines. Eating these foods increases the uric acid levels in the blood and the risk of gout and gout attacks. Keep your red meat (including beef, venison, and bison) and organ meats (including liver, heart, sweetbreads, tongue, and kidney) intake low. Chicken has moderate amounts of purines, and therefore should be eaten in moderation. Protein is important for the body, and though you may need to limit protein from some animal sources, you can still get protein from other sources. Low-fat dairy seems to decrease the risk of gout and is a good source of protein in the diet. Other protein foods you can eat include eggs, nuts and nut butters, beans, and tofu. Meats to avoid: Beef, pork, and chicken livers Other organ meats, such as kidney or heart Wild game Meats to limit: Red meat (beef, pork, lamb) Poultry Meat-based soups and gravies Processed meats, such as salami and prosciutto Fish and Seafood Certain types of seafood are high in purines, and therefore should be avoided on a gout-friendly diet. Other seafood are moderate in purines and should be limited to one to two, 2- to 3-ounce servings daily. Fatty fishes, such as tuna and salmon, are generally considered a healthy, nutritious addition to the diet, mostly due to the heart-healthy omega-3 fatty acids they contain. However, due to their higher purine content, it is currently recommended to limit these foods if you have gout. With that said, a 2019 study found that eating fish high in omega-3 fatty acids was associated with lower risk of recurrent gout flares, but supplemental omega-3 fatty acids were not. More research is needed to clarify these effects. Seafood to avoid: Sardines Anchovies Jack mackerel Herring Mussels Codfish Scallops Trout Haddock Seafood to limit: Lobster Crab Shrimp Oysters Clam Salmon Beer and Liquor Alcohol consumption has long been associated with gout. As a result, it's recommended to avoid alcohol with gout. In particular beer, hard liquor and other grain alcohols. Frequent alcohol intake is known to cause chronic hyperuricemia, increasing the risk of gout and gout attacks. Because of this, it is recommended to avoid some alcohol, such as beer, altogether and consume others, like wine, only in moderation. Alcohol to avoid: Hard liquor Beer Other grain alcohols Alcohol to limit: Wine Gout and Wine Though it was previously considered best to avoid all types of alcohol with gout, recent research has shown that wine, in moderation, may not contribute to increased risk of gout. A study looking at the effect of wine on gout found that wine, when consumed with meals and in moderation, did not cause chronic hyperuricemia. Moderate wine consumption is considered one 5-ounce drink per day for women and two 5-ounce drinks per day for men. Yeasts Certain yeasts and yeast extracts are high in purines and should be avoided with gout. Supplements and foods with these should be avoided to keep uric acid levels down. Yeast extract can sometimes be found in foods, such as some soy sauces, canned soups and stews, frozen dinners, and salty snacks. High Purine Vegetables Are OK Some vegetables and plant foods, such as peas, beans, lentils, spinach, mushrooms, oats, and cauliflower, are high in purines. However, several studies have shown that they do not increase the risk of gout. In fact, the opposite seems to be true, with a vegetable-rich diet being associated with a lower risk of gout compared with the lower consumption of vegetables. Therefore, you do not need to limit or avoid any vegetables on a gout-friendly diet. Weight Management Besides reducing gout symptom flare-ups, following a gout-friendly diet may have other health benefits as well. Following a diet with less processed foods, sugar, and alcohol, and that is rich in vegetables, whole grains, and other plant-based foods may help you reach and maintain a healthy weight. Research published in Annals of the Rheumatic Diseases suggests that a higher body mass index is a risk factor for gout and that people who were overweight and obese were at significantly higher risk of incident gout. In addition, people with diabetes, high cholesterol, or both were at higher risk of incident gout and of gout flares in those with prevalent gout. Being at a healthy weight may also be less taxing on your joints, thereby slowing the progression of joint damage. If you desire to lose weight, a slow and steady approach is best for your health, as you'll be more likely to maintain this healthy lifestyle change over the long run. A Word From Verywell Following a gout-friendly diet may seem difficult or unrealistic to some people, especially if the foods to avoid are ones you frequently consume. Work with your healthcare providers and start by making small changes to help you to feel more empowered. Remember that gout triggers can be individual, and what causes a flare-up for one person may not make noticeable difference to another. Have patience and keep your long-term goal of living a healthy life free of gout symptoms in mind. Was this page helpful? Thanks for your feedback! Dealing with chronic inflammation? An anti-inflammatory diet can help. Our free recipe guide shows you the best foods to fight inflammation. Get yours today! Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Johnson RJ, Rideout BA. Uric acid and diet--insights into the epidemic of cardiovascular disease. N Engl J Med. 2004;350(11):1071-1073. doi:10.1056/NEJMp048015 Li R, Yu K, Li C. Dietary factors and risk of gout and hyperuricemia: A meta-analysis and systematic review. Asia Pac J Clin Nutr. 2018;27(6):1344-1356. doi:10.6133/apjcn.201811_27(6).0022 Zhang Y, Chen C, Choi H, et al. Purine-rich foods intake and recurrent gout attacks. Ann Rheum Dis. 2012;71(9):1448-1453. doi:10.1136/annrheumdis-2011-201215 El Ridi R, Tallima H. Physiological functions and pathogenic potential of uric acid: A review. J Adv Res. 2017;8(5):487-493. doi:10.1016/j.jare.2017.03.003 Ayoub-Charette S, Liu Q, Khan TA, et al. Important food sources of fructose-containing sugars and incident gout: a systematic review and meta-analysis of prospective cohort studies. BMJ Open. 2019;9(5):e024171.doi:10.1136/bmjopen-2018-024171 Ebrahimpour-Koujan S, Saneei P, Larijani B, Esmaillzadeh A. Consumption of sugar sweetened beverages and dietary fructose in relation to risk of gout and hyperuricemia: a systematic review and meta-analysis. Crit Rev Food Sci Nutr. 2020;60(1):1-10. doi:10.1080/10408398.2018.1503155 Valenzuela MJ, Waterhouse B, Aggarwal VR, Bloor K, Doran T. Effect of sugar-sweetened beverages on oral health: a systematic review and meta-analysis [published online ahead of print, 2020 Aug 23]. Eur J Public Health. 2020;ckaa147. doi:10.1093/eurpub/ckaa147 Malik VS, Hu FB. Sugar-sweetened beverages and cardiometabolic health: An update of the evidence. Nutrients. 2019;11(8):1840. doi:10.3390/nu11081840 Mozaffarian D. Dietary and policy priorities for cardiovascular disease, diabetes, and obesity: a comprehensive review. Circulation. 2016;133(2):187-225. doi:10.1161/CIRCULATIONAHA.115.018585 Rai SK, Fung TT, Lu N, Keller SF, Curhan GC, Choi HK. The Dietary Approaches to Stop Hypertension (DASH) diet, Western diet, and risk of gout in men: Prospective cohort study. BMJ. 2017;357:j1794. doi:10.1136/bmj.j1794 Singh JA, Reddy SG, Kundukulam J. Risk factors for gout and prevention: A systematic review of the literature. Curr Opin Rheumatol. 2011;23(2):192-202. doi:10.1097/BOR.0b013e3283438e13 Kaneko K, Aoyagi Y, Fukuuchi T, Inazawa K, Yamaoka N. Total purine and purine base content of common foodstuffs for facilitating nutritional therapy for gout and hyperuricemia. Biol Pharm Bull. 2014;37(5):709-721. doi:10.1248/bpb.b13-00967 Zhang M, Zhang Y, Terkeltaub R, Chen C, Neogi T. Effect of dietary and supplemental omega-3 polyunsaturated fatty acids on risk of recurrent gout flares. Arthritis Rheumatol. 2019;71(9):1580-1586. doi:10.1002/art.40896 Boban M, Modun D. Uric acid and antioxidant effects of wine. Croat Med J. 2010;51(1):16-22. doi:10.3325/cmj.2010.51.16 Jakše B, Jakše B, Pajek M, Pajek J. Uric acid and plant-based nutrition. Nutrients. 2019;11(8):1736. doi:10.3390/nu11081736