What You Need to Know About the Gout Diet
I can remember when my father was diagnosed with gout. He went to bed one night, feeling fine. The following morning, he could hardly walk. He came home from the doctor’s office with a new medical diagnosis.
“Gout," he said, matter-of-factly.
I was shocked. My grandfather had gout. How could my father, in his 40s, have gout?
As it turns out, gout has become the most type of inflammatory arthritis in the world. According to the National Kidney Foundation, between the 1960s and the 1990s, the prevalence of gout doubled – affecting upwards of 6.1 million men and 2.2 million women in the United States.
As my dad was left his appointment, he was given a prescription for a new medication, as well as several pamphlets. The pamphlets discussed in-depth dietary and lifestyle modifications that were expected of him.
Luckily, the “gout diet" is much more simplified than it was when he was initially diagnosed.
In this article, we will focus on what the gout diet is, what foods are considered good for gout sufferers, and what type of foods that should be avoided for people living with gout.
What Does a Gout Diet Consist Of?
Gout is a specific type of arthritis that occurs when uric acid crystals form and build up in the joints. When these uric acid crystals build up, it becomes painful to move the joint.
You may be wondering why uric acid is building up in joints in the first place. Uric acid is a byproduct of purine breakdown. Purine is a substance that naturally occurs in the body, but it is also found in the foods that we eat. Typically, when we breakdown purine and uric acid is produced, it is excreted in the urine. However, gout occurs when the uric acid crystals form in joints.
A “gout diet" means eating foods that are thought to reduce the symptoms of gout.
How Does a Gout Diet Help with Gout Symptoms?
By reducing foods that are low in purine, less uric acid typically forms. This typically prevents gout flare-ups from occurring – or at least causes them to occur less frequently.
According to Mayo Clinic, the goals of a gout diet are:
- Attain a reasonable weight
- Consume a diet that is moderate in purine
- Include foods that can control uric acid levels
At a very simple level, the basic principles of the gout diet are as follows:
- Stay well-hydrated. Without the proper amount of water, uric acid levels can climb, and as those uric acid levels increase, the kidney’s abilities to reduce the uric acid levels decreases. Staying properly hydrated minimizes the risk of a gout flare-up.
- Reduce fats in the diet – especially saturated fats, such as high-fat dairy, red meat, and fatty poultry.
- Consume more poultry – especially lean poultry, low-fat dairy, and lentils.
- Enjoy more complex carbohydrates. This includes fruits, vegetables, and whole grains.
- Lose weight if you need to. Mayo Clinic says, “Being overweight increases the risk of developing gout, and losing weight lowers the risk of gout. Research suggests that reducing the number of calories and losing weight — even without a purine-restricted diet — lower uric acid levels and reduce the number of gout attacks. Losing weight also lessens the overall stress on joints."
What Are Some of the Best Foods for Gout?
The foods below are considered low-purine, meaning that they have less than 100mg of purines per 3.5 oz. serving. Some of these foods may even show benefit to their consumption.
- Coffee is one of those beverages that everyone loves to hate – there is so much conflicting research. But no matter the research, we can’t live without it. And if you have gout, you may not need to. Research indicates that people who drink caffeinated coffee may carry a reduced risk of developing gout. In fact, a 2007 study indicated that people who drank four cups per day reduced their risk by 40 percent, six – and those who drank six cups per day reduced their risk by 60 percent! Even decaf coffee seems to help – decaf coffee drinkers had a significant reduction – those who drank three cups of coffee had a 33 percent lower risk of gout.
- Tea is considered a low-purine beverage. Does it carry the same gout-fighting capabilities as its percolated counterpart? It doesn’t appear so – but don’t let that stop you from brewing up a mug of your favorite tea!
- Vegetables are a healthy part of a gout diet. Fill your plate up with the variety of vegetable that suits your taste – even potatoes!
- Legumes can be included, such as soybeans, tofu, and lentils.
- Whole grain foods, such as oats, barley, and brown rice can be consumed.
- Dairy can be consumed, but research indicates that low-fat dairy is the most beneficial to those with gout.
- Cherries also appear to reduce the risk of developing gout. It seems to reduce uric acid levels as well as reduce inflammation in the body.
- Fruit, in general, is thought to be for people with gout.
What Are the Worst Foods for Gout?
We’ve talked plenty about the “rules" and about the foods that are good for gout. But what about the foods that are not so good and should be avoided entirely? Foods that are rich in purines perhaps should be avoided – or at least moderated.
Here are some of the foods to avoid with gout:
- Organ meats, like liver, sweetbreads, and kidneys, are naturally high in purine. As you now know, foods that are high in purine can contribute to high uric acid levels.
- Red meat shouldn’t be consumed, or at least limited. Examples include pork, lamb, and beef.
- Wild game should be minimized. This includes venison, duck, and veal.
- Gravy should also be limited.
- Alcohol may increase the risk of gout – but it depends on the type of spirit selected. Beer and liquor appear to increase the risk of developing gout, as well as subsequent exacerbations. These specific liquors contain purines. However, wine does not seem to carry the same risk. During an attack, all alcohol should be limited. This is because all alcohol can be dehydrating.
- Sugary foods should be limited. This includes many of your favorite breakfast cereals and desserts.
- Sugary beverages should also be limited. If the label says “fructose" do not drink it. These beverages are thought to increase the risk for an exacerbation.
The Gout Diet: Foods That Are Still up for Debate
There are several foods that are up for debate about whether they are good or bad for people living with gout. They are:
- High purine vegetables appear to be fine to eat. Although their purine contact is high, they do not seem to raise uric acid levels. Examples include asparagus and spinach.
- Certain seafood may be high in purine as well. However, the health benefits of seafood may outweigh the risks. Examples include sardines, tuna, and shellfish. Discuss specifics with your physician.
What Else Can Trigger Gout Symptoms?
Consuming a high-purine diet is undoubtedly the biggest “trigger" for gout. However, if you’ve been successfully eliminating food triggers and your symptoms are out-of-control, what else may be causing your symptoms?
As we’ve discussed, proper hydration is important. If you’re not drinking enough water on a regular basis, your uric acid levels can become high regularly. You should drink at least eight 8 oz. glasses of water every day to keep your hydration levels high.
Certain medications are known to trigger an exacerbation. For example, these medications include cyclosporine, diuretics, and beta-blockers. When starting new medications, inform your physician that you have gout to ensure that a new medication does not increase your risk for development of an exacerbation.
Medical stress can increase your risk of an exacerbation drastically. Anything that requires hospitalization – becoming ill or requiring surgery, for example – can increase your risk of a flare-up. Ensure that you discuss this with your physician. If you take preventive medications for gout, ask that they are continued during hospitalization.
The Bottom Line…
Following a gout diet to reduce your gout symptoms and prevent an exacerbation does not need to be hard. Remember that the goal is not to be “perfect" 100 percent of the time!
You can eat what you want – even if you are consuming a food high in purine on occasion. The goal is to follow the guidelines most of the time to prevent an exacerbation from occurring.
If you're unsure on how to begin your gout diet journey, making an appointment with a registered dietitian may help you find ways to incorporate a gout diet slowly into your routine (rather than reinforce it right away), how to swap out your favorite foods for more gout-friendly alternatives, and much more. Registered dietitians may also help keep track of your diet progress and offer advice on where and how you can improve in dietary approach.