Gout Diet: Foods to Eat and Avoid

What Purine Is and Why You May Need to Avoid It

The foods you eat can play a huge role in the frequency and severity of your gout symptoms. The main culprit is an organic substance known as purine found in many foods which, when metabolized, creates the uric acid that triggers a gout attack. While not a cure, a well-balanced gout diet may lower your risk of an attack and slow the progression of your joint damage.

Understanding Purine

For centuries, gout has been associated with the overindulgence of rich foods such as seafood, meat, and alcohol. As a result, people were commonly advised to avoid all of these things until symptoms resolved. With the discovery of purine in 1884, the practice was further endorsed, and people were routinely warned against consuming otherwise healthy foods such as fish, vegetables, and fruit.

In recent years, our understanding about the synthesis of uric acid has expanded considerably, and many of the foods once considered off-limits are today deemed safe for consumption. These include high-purine vegetables such as such as asparagus, spinach, peas, cauliflower, and mushrooms.

Foods to Eat

Dietary guidelines have changed over time in regards to the management of gout. Current evidence suggests the following foods can be a valuable part of a gout diet:

  • Vegetables, even those with high-purine levels
  • Low-fat or non-fat dairy products
  • Tofu (as an alternative to meat protein)
  • Complex carbohydrate foods, such as whole grain bread, brown rice, and oatmeal
  • Dark berries, especially cherries
  • Coffee (in moderation)

A daily intake of 500 milligrams of vitamin C may also be beneficial to reduce your uric acid levels. Speak with your doctor to see if vitamin supplementation is needed and whether it fits into your diet and medication plan.

Foods to Limit or Avoid

2012 study from Boston University School of Medicine investigated the impact of purine-rich foods in 633 people with gout. What they found was that even when using anti-gout medications, the intake of these foods was associated with a five-fold increase in the risk of recurrent gout attacks. 

To this end, there are certain foods you will need to avoid if you suffer from gout, including:

  • Beer and liquor
  • Cold water fish such as tuna, salmon, and trout
  • Some shellfish
  • Organ meats such as liver, sweetbreads, and kidneys
  • Yeast extract spreads such as Marmite (yeast breads are fine)

While beer and liquor are generally considered no-nos for a gout diet, the verdict is still out on whether wine is also on the list. As such, speak with your doctor to determine whether wine may be acceptable to your treatment plan.

Other Considerations

In addition to purines, you would need to avoid or limit your intake of high-fructose drinks and sodas, which inhibit the excretion of uric acid from the body. While some have suggested that the excessive consumption of fruit may also be a problem (since they, too, contain fructose), they don't pose anywhere near the same risk as concentrated fructose drinks, especially those made with corn syrup.

How to Plan Your Diet

Working out which foods are safe for you can be a process of trial and error. While some people, for example, will have no problem consuming moderate amounts of red meat, others may experience an attack with only a scant helping.

To find your right balance, work with your doctor or a nutritionist experienced in the management of gout. Most will advise you to keep a food diary, so that you can begin to pinpoint the specific food triggers that place you at greatest risk.

If you plan to lose weight, avoid crash diets. By losing weight too quickly, you may end up triggering an attack.

As with all dietary plans, a slow and steady approach is better for your health and something you'll better able to maintain over the long run.

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