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:

  • seafood
  • red meat
  • sugary beverages
  • alcohol

All of these foods have a high purine content. With that in mind, a gout diet should avoid or limit these foods:

  • organ meats
  • brain
  • sweetbreads
  • heart
  • kidney
  • liver
  • beef
  • pork
  • lamb
  • herring
  • anchovies
  • mackerel
  • mussels
  • smelt
  • sardines
  • scallops
  • tuna
  • yeast
  • beer, wine, and liquor
  • fruit juices
  • soda

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:

  • grouse
  • mutton
  • bacon
  • salmon
  • turkey
  • partridge
  • trout
  • goose
  • haddock
  • pheasant

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

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
  • cakes
  • candy
  • 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
  • legumes
  • fluids, especially water
  • low-fat or fat-free dairy (16-24 oz daily, max)
  • whole grains (like oats, brown rice, and barley)
  • quinoa
  • 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
  • peas
  • asparagus
  • cauliflower
  • mushrooms

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.

Read Video Transcript »

Video: Gout Symptoms, Diagnosis and Treatment

Gout is a condition caused by a build-up of uric acid that can affect a variety of joints, including the feet, ankles and knees. Its trademark pain point is typically the big toe.

Unfortunately, symptoms of gout often come suddenly, producing intense pain that can disrupt your life. These episodes are known as flares, and people often describe the pain as if their joints are on fire. Ignoring the painful symptoms of gout can lead to further problems, such as arthritis and damage to the affected joints. Uric acid crystals can also collect, typically on joint surfaces and are called tophi. These typically affect the hands, feet, wrists, ankles, and ears, and can be sites for painful inflammation during a flare.

Fortunately, people who are diagnosed early and actively treat their condition can live normal, full lives. Gout is diagnosed by measuring the levels of uric acid in the blood, as well as a physical examination of your joints.

Two different types of medications—preventative and anti-inflammatory—have proven to be effective to reduce the painful symptoms of a flare, as well as prevent other complications in the future. Preventative medications, such as selective uric acid re-absorption inhibitors, reduce uric acid buildup in the body, while anti-inflammatory medications work to calm the swelling and inflammation during a flare. These may include common over-the-counter medications, but your doctor may prescribe medication that’s more effective and tailored to at managing the symptoms of gout.

While there is no cure yet, new treatments are being developed to be used in conjunction with existing gout medications. A rheumatologist, a doctor who specializes in treating diseases of the joints and connective tissue, can help you discover new therapies for your gout.

Diet also plays an important role for gout patients, as certain foods can trigger a flare. Uric acid is created when your body breaks down an organic substance known as purines.

Foods that are especially rich with purines include organ meats, fish, seafood, whole grains, beer, certain vegetables, and sugars. While it may be difficult to adhere to a purine-free diet, avoiding foods high in purines can help keep acid levels down and prevent a painful flare.

Besides flares, gout is also associated with other health conditions, such as kidney disease, heart disease, and vision impairments. Managing gout symptoms also helps prevent these and other harmful health outcomes.

Avoiding foods high in proteins, taking preventative and anti-inflammatory medication, and communicating with your doctor are three very important steps to managing your condition. If you’d like to learn more about treating gout, take a look at the information we have here at Healthline or make an appointment with your doctor.