About Gout
The root cause of gout is having too much uric acid in the body. A condition called hyperuricemia is classified by high uric acid levels, which are above 6.8 mg/dL—though, those who have too much uric acid don’t always have gout and vice versa.
Beyond this, the biggest factor for developing gout is genetics or a family history of the disease. Other risk factors can also play a role in developing gout—such as alcoholism, being overweight or having other health issues, like kidney disease, heart disease, high blood pressure, or diabetes. Certain medications may play a role too.
One of the most common connections with gout is diet. Many ask, can certain foods trigger gout flares? Is there such thing as a diet for gout?
Read on to learn more.
The Disease of Kings
Gout was once known as the “disease of kings” because of the incorrect assumption that the condition was caused simply by overindulgence in rich foods and lack of physical activity. In fact, many believed that those who suffered from gout flares must have inflicted them upon themselves due to gluttony and laziness.
This has contributed to the considerable stigma surrounding gout and gout symptoms. Research from the Gout Education Society found that those who have gout are often embarrassed they have the disease.
While gout itself remains widely misunderstood by the general public, in recent years, there is much more education available on the causes of gout and gout symptoms.
The Gout Diet Connection
While some foods and drinks trigger gout flares, the truth is that diet plays just a minor role in overall gout risk and development.
Additionally, dietary changes alone have only been found to lower uric acid by up to 1 mg/dL—not typically enough to avoid the need for daily medications to control uric acid levels, since the target range is below 6.0 mg/dL for those with the disease.
That said, while there is no “gout diet,” some foods are more likely to trigger gout attacks. For those at increased risk for gout, there are health benefits associated with making diet modifications and limiting certain foods and drinks.
To reduce risk of gout and recurrent gout flares, these are some of the foods and beverages that you may want to avoid.
Reduce High Purine Foods
About Purines
Purines occur naturally in our bodies. At the same time, when the foods and drinks you consume break down inside your body, more purines can be formed. These natural chemicals are made up of nitrogen and carbon.
These purines break down further as the body makes uric acid inside the liver and digestive system.
Usually, uric acid then dissolves in the blood and passes into the kidneys. It is then eliminated from the body through urine.
However, when the body does not properly eliminate excess uric acid, it can accumulate in the bloodstream and lead to trouble, especially in someone who has a risk of gout.
Avoid a High Purine Diet
Removing purines entirely from your diet to reduce gout risk can be difficult, but there are ways to cut back to reduce gout flare ups and take other steps toward a healthy weight and better lifestyle.
There are several foods and beverages to help lower uric acid levels naturally and lower your overall risk of gout.
Certain Meats
Red meat, such as beef and lamb, are high in purines. Eating these foods often may trigger a gout flare. Limit serving sizes of these meats and focus on lean meats and poultry.
Organ meats also contain high purine content and should be avoided to help prevent risk of gout attacks. Types of organ meats include liver, kidneys and sweetbreads. Eating these organ meats have become popular in certain diets such as Keto diets. If you follow a Keto diet, avoid lots of red meat and especially avoid organ meats.
Good Fish, Bad Fish
Some seafood and shellfish—such as shrimp, lobster, mussels, oysters, clams, anchovies and sardines—are high in purines and best avoided in those wanting to lower their uric acid levels. Excessive intake often triggers future gout attacks.
The health benefits of eating fish are well known. Moderate portions of fish such as salmon are high in omega-3 fatty acids, which are considered healthy fats. Choose these instead as part of a low-purine diet.
Alcohol
As the kidneys work to process alcohol, their ability to expel more uric acid can be affected. This is why it is often recommended to avoid or limit alcohol intake.
Moderate alcohol use is usually defined as one drink per day for women and two drinks per day for men. However, for someone with gout, even moderate alcohol use may be too much, and could cause them to suffer future gout attacks.
Some alcoholic beverages are known to have higher purine content than others. Beer and grain alcohol have the highest purine content. This means these alcoholic drinks could be more likely to raise uric acid levels and trigger a gout flare.
While wine has lower purine content, depending on how your body processes it, those trying to decrease uric acid levels may still be triggered.
Avoid High-Fructose Corn Syrup
Research suggests that limiting certain sweets can improve overall health, particularly for those who have gout and pre-existing risk factors for other conditions associated with gout, like diabetes, heart disease and chronic kidney disease.
Fructose is a sugar that naturally occurs in fruit and honey. Moderate amounts of whole fruits are healthy. However, try to eliminate high-fructose corn syrup, which is a corn-based, man-made sweetener added to many processed foods and sodas.
High-fructose corn syrup can cause uric acid levels to rise substantially, leading to future gout attacks.
Therefore, anyone with gout should avoid foods that contain this.
Fruit Juices & Fruits
Intake of fruit juices, especially those with added sugar, should be limited because of the high sugar content.
Some raw, whole fruits and their subsequent fruit juice should also be limited because they are high-fructose foods—even though the fruit includes naturally occurring sugar.
Want to know what to eat instead? Citrus fruits are low in purines while high in vitamin C, making them a healthier option. So are bananas, blueberries, strawberries and kiwifruits.
Sweets and Sodas
To avoid triggering a gout attack, many doctors will also recommend limiting sweets, sodas, sugar-sweetened beverages and other fructose intake as part of a gout friendly diet—or even as a way to lose weight naturally, while lowering glycemic index.
Sugar from Processed Foods
The body breaks down elements of sugar as a dietary carbohydrate in your body called glucose. Glucose is a type of sugar that provides energy to your body’s cells, tissues and organs.
Refined carbs are the sugars in processed foods, which can contribute to gout attacks.
If you have gout, watch for hidden sugars in foods and drinks you might not expect, such as your daily coffee consumption. Read labels for added fructose or high fructose corn syrup.
From Bad to Worse
The effects of sugar on your body are exacerbated if you already have conditions such as Type 2 diabetes. This is caused when the body can’t use the hormone called insulin, produced in your pancreas, to break down glucose in your blood.
When insulin continues to build up, it causes insulin resistance.
Weight loss and exercise, as part of a long-term gout management plan, can help reverse this.
Stay Hydrated
Water helps the body transport nutrients and waste, aid in kidney function, regulate body temperature, and cushions joints.
Research also suggests that drinking enough water may help in preventing kidney stones and constipation. These deposits of uric acid or other forms can cause severe pain, so staying hydrated is critical for those with gout or other related health issues.
What Foods Help Lower Uric Acid?
A healthy diet for those with gout is comprised of many foods to eat that are often recommended in a balanced diet.
Colorful fruits and vegetables—such as oranges, bananas, peppers and broccoli—have plenty of nutrients, such as vitamin C or vitamin A.
Whole grain rice, pasta and bread are also recommended. Non-fat and low fat dairy products, like milk, cheese and yogurt should be chosen instead of high fat dairy products.
Chicken and certain fish, including salmon, as discussed above, are good sources of protein.
Fruits are still encouraged, but because of the naturally high fructose levels, they should be limited to one or two cups per day.
High purine vegetables still have lower purine content than most fruits and should be safe as part of a gout friendly diet.
It is also recommended, in general, to follow a well-balanced, low fat diet.
Can Cherry Juice Help Gout?
While no one food can “cure” gout or completely eradicate hyperuricemia and its effects of uric acid crystals in someone’s joints, a common misconception is that drinking enough cherry juice will keep gout flares at bay.
Some research has shown that participants who regularly drank cherry juice saw a decrease in their serum uric acid levels.
However, most types of cherry juice contain enough fructose, either naturally or added during processing, that the benefits of drinking it regularly to lower your gout risk are most likely outweighed by the side effects of the excess sugar intake.
Instead, simply taking 500-1000 milligrams of Vitamin C per day—in addition to your daily medications—may have the same effect.
A Few Helpful Diets to Follow
Three main diets promote foods that are low in purines, fat, and sodium.
Remember to talk to your healthcare provider before radically changing your diet or lifestyle.
DASH Diet
Short for “Dietary Approaches to Stop Hypertension,” the DASH diet focuses on foods that help to lower blood pressure (hypertension), are low in sodium and include low-fat dairy, vegetables, fruits and whole grains.
Mediterranean Diet
When researchers noticed that the people in countries bordering the Mediterranean—France, Spain, Greece and Italy—were exceptionally healthy and had a low risk of chronic conditions, the Mediterranean diet was developed.
It typically encourages fruits, vegetables, whole grains, legumes, nuts, seeds and heart-healthy fats.
Plant-Based Diet
Similarly, a plant-based diet can be beneficial for cardiovascular and gastrointestinal health.
It can include fruits and vegetables, and also nuts, seeds, oils, whole grains, legumes and beans.
While those who follow a plant-based diet don’t need to be completely vegetarian or vegan, they proportionately choose more foods from plants.
Coming Up with a Plan
Tracking the specific foods that you believe trigger your gout flares may be helpful since each person has unique experiences and triggers.
It is important to speak with a clinician who is familiar with gout. They can give you professional medical advice and help you with other recommendations about meal planning—especially taking into account other health issues you may have that could further impact your choices.
It is important to realize that changing your diet alone, like taking steps to eliminate high purine foods, may only lower your uric acid levels slightly—as little as 1.0 mg/dL.
This means a gout attack could still happen, and you could still risk long-term damage.
A healthy lifestyle that includes a balanced diet is helpful, but most people with gout will need to talk with their healthcare provider about a long-term uric acid-lowering therapy to improve serum uric acid concentration and reach the target level of 6.0 mg/dL or below.
In advanced cases, a healthcare provider may recommend that uric acid levels are even lower, depending on other underlying health conditions. Levels should be checked every six months.
Be sure to only trust information about gout medically reviewed by trusted resources.
Weight Management
In addition to taking steps to lower levels of uric acid, losing weight can benefit your overall health immensely.
Excess weight is a risk factor for recurrent gout attacks, as well as other adverse side effects.
Even when not following a strict, low-purine diet or a diet that is low in sugars and processed foods, reducing the number of calories you eat and losing weight can help to reduce your overall number of gout flares, as well as lessen stress on joints affected by gout crystals.
