Gout is a type of arthritis caused by too much uric acid in the blood. Excess uric acid can lead to a buildup of fluid surrounding the joints, which can result in uric acid crystals. The formation of these crystals causes the joints to swell, become inflamed, and cause intense pain. The good news is that you can control gout. In addition to taking medications, dietary and lifestyle changes can help prevent painful attacks. A gout-friendly diet involves a specific plan, which is designed to avoid painful gout attacks. Learn more about which foods to include — and those to avoid — to help prevent symptoms.
What Causes Gout?
Gout develops when there is too much uric acid in the blood. This over-abundance of uric acid may be the result a diet high in purines. Or, your body may produce too much uric acid. In some cases, blood uric acid levels may remain normal, yet gout is still the correct diagnosis. This is due to the body excreting excess uric acid in the urine and inflammatory factors.
What Are Purines Anyway?
Purines are chemical compounds that, when metabolized, are broken down into uric acid. Purines are either made by your body, or taken into your body through foods you eat.
In a normal process, purines break down into uric acid. The uric acid is then dissolved in the blood, passed through the kidneys into the urine, and eliminated from the body.
However, this isn’t usually the case in gout. Complications occur when the kidneys don’t get rid of uric acid fast enough, or if there is an increased amount of uric acid production. These high levels build up in the blood, leading to what is known as hyperuricemia. Though not classified as a disease, hyperuricemia can be dangerous if it leads to the formation of uric acid crystals. Gout can develop when these crystals build up around the joints.
What Makes a Gout-Friendly Diet?
The goal of a gout diet is to relieve the painful swelling (inflammation), and to prevent future attacks. Depending on a variety of factors — your age, general health, medical history, and severity of the condition — treatment options will vary.
The good news is gout can be controlled. In addition to taking prescribed medications (which could include anti-inflammatory drugs, or medications to lower levels of uric acid), acute gout attacks can be managed through diet, a healthy lifestyle, weight management, and a proactive approach to signs and symptoms.
What to Avoid Entirely
A gout-friendly diet will help to control uric acid levels in the body while promoting overall health. According to the American College of Rheumatology, a diet that has an excessive amount of the following foods can lead to gout:
- red meat
- sugary beverages
All of these foods have a high purine content. With that in mind, a gout diet should avoid or limit these foods:
- organ meats
- beer, wine, and liquor
- fruit juices
If you do want to include some animal protein in your diet, the Mayo Clinic recommends no more than 4 to 6 ounces per day. Gout-friendly recipes have either none of these animal proteins or only in amounts small enough to help you stay under this limit.
What to Limit
Animal proteins are high in purines. Since the buildup of purines can lead to elevated levels of uric acid, which in turn may result in gout, it’s best to avoid or strictly limit these foods in your diet.
Caution Foods (Moderately High in Purines)
These foods are somewhat high in purines; eat in moderation:
While these proteins are lower in purines than the ones in the earlier list you should still attempt to limit your intake of all animal protein to 4 to 6 ounces per day.
Alcohol disrupts the removal of uric acid from the body. It’s thought that high levels of purine in alcoholic beverages leads to this disruption. While the breakdown of purines into uric acid would normally be flushed out of the body through the urine, this process is interrupted when uric acid levels get too high. Crystals form around the joints, and gout develops. To prevent further gout attacks, stick to these guidelines:
- avoid alcohol when having an attack
- limit wine consumption
- avoid beer
Keep in mind that you should avoid alcohol altogether unless your doctor says otherwise. Gout-friendly recipes take these alcohol restrictions into account as well.
Fructose and Sugary Foods
There is debate about the effects fructose and sugary foods have on uric acid levels in the body. What is known, however, is that sugar and sweets are higher in calories and linked to obesity, a known risk factor for gout. Fructose-rich beverages, like soft drinks, have been shown to increase the risk of developing gout. While these types of drinks don’t have high amounts of purines, they do contain significant amounts of fructose — which increases uric acid levels.
Increasing your daily water intake and cutting soft drink and soda consumption will help to flush your body of uric acid and prevent the formation of kidney stones.
Though they’re tempting, sweets are better left untouched. Make room instead for healthier, gout-friendly foods like plant-based proteins and low-fat dairy products.
Avoid/Limit Refined Carbs
Refined carbohydrates include:
- white bread
- pasta (except for whole grain)
All gout-friendly recipes have either no refined carbs or include them only in very small amounts.
What to Include
A low-purine diet can help lower uric acid levels and work to prevent symptoms of gout. Beans and legumes are excellent protein sources. Eating these plant-based sources can help to meet your daily protein needs, while cutting saturated fat found in high-purine, animal-based proteins.
Foods to Include Daily:
- beans and lentils
- fluids, especially water
- low-fat or fat-free dairy (16-24 oz daily, max)
- whole grains (like oats, brown rice, and barley)
- sweet potatoes
- fruits and vegetables
Some people find that dairy may increase their gout symptoms, while others experience a decrease in uric acid levels with low-fat dairy intake. Fortunately, many plant-based milk alternatives are available if you need to avoid dairy. Vitamin C rich foods and cherries show some evidence of potentially reducing gout attacks. Interestingly, high-purine vegetables have not been found to increase gout attacks, according to the Mayo Clinic. Furthermore, vegetables are high in fiber and low in calories, which can help you manage your weight. You may safely indulge in these high-purine veggies:
- spinach and other dark, leafy greens
Lifestyle Changes Can Help Gout
It’s important to understand that a gout diet is not a treatment. Rather, it is a lifestyle change that can help reduce or eliminate gout symptoms. In addition to following a gout diet, your doctor will likely recommend regular exercise and weight loss, which can, in many cases, help to control gout more than a low purine diet can. Unlike other types of arthritis, gout can be cured. A large part of your success depends upon your eating and lifestyle habits. Be sure to discuss all nutritional concerns with your doctor and dietitian before getting started.