The Gout Diet: Foods to Enjoy and Foods to Avoid

Gout is a type of arthritis that develops when someone has too much uric acid in the body. This condition, called hyperuricemia, occurs when uric acid builds up and leads to joint pain.

While there are a range of possible causes, including genetic influences and underlying medical conditions, your diet can have a direct impact on gout and its severity. Foods high in purines tend to result in more gout symptoms and problems.

This article tells you what purines are and what they do. It will help you to know the foods to avoid with gout, and how to identify "gout diet" foods that may limit your gout flare-ups.

What Is Gout?

Gout is a form of inflammatory arthritis, a term describing a group of conditions that typically lead to joint pain and related symptoms. These conditions are similar but arise from different causes.

Researchers in both the United Kingdom and United States have identified gout as the most common type of inflammatory arthritis affecting their populations.

These findings point to the role that diet, and foods that cause gout, play in the development of the disease. Higher rates of gout tend to be found in cultures known for having high amounts of red meat, processed foods, sugars, and other foods high in purine as part of their cuisine.

Gout may affect one joint, commonly the big toe, or multiple joints at the same time. This pain is caused by small crystals that form due to the excessive uric acid in the blood. These crystals enter into the joints, fluids, and tissues in your body.

Gout doesn't always cause symptoms, but that doesn't mean the condition isn't building over time and causing damage of which you're not aware. Symptoms of gout may include:

• Sudden, severe joint pain
• Joint stiffness or swelling
• Redness and warmth at the affected site
• Mild fever
• Fatigue

How Foods Can Lead to Gout

Purines are chemical compounds found naturally in foods and in your body. When they come from the foods you eat, they are called exogenous purines, meaning that they come from outside your body.

Purines that come from the foods you eat are broken down by your digestive system. Uric acid is created as a byproduct during this process. Your body then reabsorbs most of the uric acid, with the rest excreted, or passed from the body, in your urine and feces.

When purine levels are too high, your body is unable to fully process it. Uric acid then builds up in the blood. This hyperuricemia can happen on its own because of high-purine foods, but it also may be more likely if you eat these foods when you have certain underlying health conditions.

Some of these medical conditions include:

• Chronic kidney disease
• Diabetes
• Hypertension (high blood pressure)
• Psoriatic arthritis
• Recent infection, injury, or surgery

Many people with gout also have high blood pressure, with some researchers reporting numbers as high as 70% of people diagnosed with gout. A number of studies continue to explore the relationship between gout and related medical conditions, including how the presence of one condition may predict the diagnosis of another.

Foods to Avoid

If you have hyperuricemia or gout, ask your healthcare provider if you should avoid or limit high-purine foods. These foods include:

• Some sugary foods
• Red meat
• Organ meat, such as liver
• Seafood
• Yeasts
• Alcoholic beverages

Sugars and Fruit

Sugar, including fructose, seems to increase uric acid levels in your blood.

Fructose is a natural form of sugar found in some foods. It's added to many products as high-fructose corn syrup. Avoiding or limiting high-fructose foods may help lessen gout symptoms.

Some fruits are naturally high in fructose. The association between fruit and gout is unclear, though.

If you have gout, you don’t have to avoid all fruit. But it might help to:

• Avoid or limit some fruit juices
• Only eat one serving of fruit at a time
• Pay attention to how it affects your gout symptoms

Sugar in Beverages

Sodas and sugary drinks are considered empty-calorie foods. They contain no beneficial nutrients but can add a lot of calories to your diet. They also may add to your risk of gout flare-ups.

One 2020 research review explored several studies of sugar-sweetened beverages, looking at the relationship between the fructose in them and gout development. It found the drinks were significantly associated with an increased risk of gout and hyperuricemia.

It may help to avoid these beverages, including:

• Soda
• Energy drinks
• Sports drinks

Processed Foods

The modern Western diet is often high in processed foods and refined carbohydrates. These elements have been linked to a higher risk of gout as well as other health conditions, including:

• Type 2 diabetes
• Heart disease
• Weight gain and obesity

By avoiding highly processed and refined-carb foods and beverages, you can help to limit the development of gout and its symptoms. Foods to avoid include:

• Candy
• Baked goods, including white bread
• Chips and crackers
• Ice cream
• Some frozen meals

Red Meat and Organ Meat

Red meat and organ meats are high-purine foods. Researchers have demonstrated that these foods can raise the risk of high uric acid levels and gout episodes.

To limit your risk, keep your intake of these red meats and organ meats low. These meats include:

• Beef
• Bison
  
• Venison and other wild game
• Liver
• Heart
• Sweetbreads
• Tongue
• Kidney

Chicken has moderate purine levels and may be eaten in moderation. Keep in mind that many meat-based soups, gravies, and processed meats like salami and pepperoni can raise the risk of gout flare-ups.

Fish and Seafood

Certain types of seafood are high in purines. These should be avoided on a gout-friendly diet, although other types of seafood may be included in your gout diet. They have moderate levels of purine and can be limited to less than 6 ounces per day in your meal plans.

Fatty fish, such as tuna and salmon, are good sources of omega-3 fatty acids and generally thought of as healthy. They also are high-purine foods. Some research suggests that fish high in omega-3 fatty acids (but not omega-3 supplements) are linked to a lower risk of gout flare-ups. More research is needed to understand these findings.

Alcohol

Alcohol use has long been associated with gout, and it's recommended that you avoid alcohol when choosing a low-purine diet. Beverages to avoid include:

• Beer
• Hard liquor
• Other grain alcohols

Wine has long been associated with lower purine levels and considered "safe" in moderation for people with a history or risk of high uric acid levels.

However, a recent study of 724 people with gout histories who consumed alcohol found that wine, beer, and hard liquor were each associated with a higher risk of gout flare-up. This was true even with potentially moderate amounts, although more so in people who ate high-purine foods and were on certain medications.

Yeasts

Certain yeasts and yeast extracts are high in purines. You should avoid foods and supplements that contain them. Yeast extract is found in some foods, such as:

• Some soy sauces
• Canned soups and stews
• Frozen dinners
• Salty snacks

Foods to Eat

A low-purine diet is based on healthy foods that limit the development of gout or its symptoms, while also boosting your overall health. This may help you to manage your weight and reduce the risk of other health conditions, such as diabetes, as well.

Foods that may benefit people on a gout diet include:

• Vegetables
• Low-fat dairy
• Whole grains
• Beans and lentils
• Citrus fruits
• Cherries
• Coffee

Some vegetables high in purine will still offer benefits to people seeking to limit foods that cause gout. A vegetable-rich diet, regardless of purine levels, may actually lower your risk of gout.

High-purine vegetables include:

• Peas, beans, and lentils
• Spinach
• Mushrooms
• Cauliflower

Sample Meal Plan

It's not always easy to change your diet or know where to begin. One option is to learn the principles of the DASH diet and build your meal choices and menus around the foods that are included.

That's exactly the approach used in a study of menu plans for people with gout living in Baltimore, Maryland. Their groceries were approved by dietitians, ordered, and then delivered to their homes, with researchers evaluating the foods they ate and any changes in their uric acid levels.

The 49 people included in this study stayed on meal plans that included:

• 5–7 servings per day of healthy grains
• 4 servings per day of fruit
• 4 servings per day of vegetables
• 1–2 servings per day of lean poultry (chicken, turkey) or fish
• 2 servings per day of low fat dairy, such as milk or cheese
• A limited amount of nuts, seeds, and legumes each day
  

The meals also limited sodium (salt), cholesterol, and fats, while restricting the foods to avoid on a low-purine diet. Results showed some reduction of uric acid levels, but also found that 80% of the group found the diet easy to follow.

Three-fourths of the participants said they were likely to continue eating in a new way after the study, indicating that they had a positive experience with their changes in diet and behavior.

Lifestyle Recommendations

Changes in your diet may bring benefits when managing gout but also in your overall health. So can other lifestyle changes, including:

• Exercise and physical activity
• Weight loss
• Avoiding smoking and tobacco use
• Community support
  

Summary

Some foods contain natural chemicals called purines. Purines raise uric acid levels, which leads to a type of inflammatory arthritis called gout. Unlike many of these conditions, it's strongly influenced by the choices you make about diet.

These choices also affect related health conditions, such as high blood pressure and kidney disease. A low-purine diet can reduce the risk of gout symptoms and gout flare-ups, with less red meat, alcohol consumption, processed foods, and other high-purine options.

A Word From Verywell

Keep in mind that the foods that lead to gout flare-ups will depend on each individual. You'll want to keep in touch with your healthcare provider as you make changes in your diet, and set yourself up with small, encouraging "wins" as you follow your dietary journey.