Gout is a type of painful arthritis that can affect one or more joints, but typically occurs in the feet. According to the Centers for Disease Control and Prevention (CDC), over 8 million people in the United States have gout, making it one of the most common forms of inflammatory arthritis. It’s traditionally treated with anti-inflammatory medications and pain relievers.

Attacks are caused when uric acid crystallizes and builds up in the joints. Uric acid, which serves as an antioxidant and protects the lining of our blood vessels, is created during the breakdown of an organic substance found in foods called purines.

While genetics play a role in whether or not you develop gout, lifestyle changes can help prevent pain. Being mindful of what you eat and avoiding foods high in purines can help ward off symptoms.

Organ meats, including liver, sweetbreads, kidneys, brains, tongue, and tripe, have the highest levels of purines. All organ meats should be completely avoided. All other meats should be limited to 4 ounces per day.

These meats should be eaten in moderation:

  • pork
  • chicken
  • duck
  • goose
  • rabbit
  • lamb
  • turkey
  • lamb
  • veal
  • venison

Other animal-based foods, such as gravy, bouillon, and chicken soup, are also high in purines.

Fish and seafood are also common sources of purines. The worst offenders if you have gout are scallops, sardines, herring, anchovies, and mackerel.

Other fish moderately high in purines include:

  • tuna
  • carp
  • codfish
  • halibut
  • perch
  • salmon
  • snapper
  • trout

Seafood such as oysters, lobster, crab, and shrimp should be consumed in small amounts because they contain high levels of purines.

Whole grains such as wheat germ, bran, and oatmeal all contain moderate amounts of purines, but for those with gout, the benefits of eating whole grain foods far outweigh the risks. Whole grains can help reduce the risk of heart disease, stroke, type 2 diabetes, and obesity.

A 2016 study found that reducing the glycemic index lowered uric acid levels in participants. Limiting foods with a high glycemic index such as white bread, pasta, and white rice may help to reduce uric acid levels and possibly prevent gout onset or flares.

The authors concluded that future studies should be performed to further this understanding.

Keep in mind that overindulging in whole grains can possibly be risky for gout sufferers, so watch portion sizes.

Sugars are low in purines, but a diet high in refined sugars is linked to other conditions that may worsen gout symptoms, such as obesity and diabetes. Avoid soda and other products sweetened with high-fructose corn syrup, because it can increase uric acid.

If you need to get your sweet on, choose fresh fruits. While some have high amounts of natural sugar, they also contain other vital nutrients that your body needs.

Beer contains purines, and brewer’s yeast is particularly high in purine content. Studies have shown that drinking beer during a gout attack can significantly increase the intensity of symptoms.

While other alcoholic beverages may not contain very many purines, they can increase purine production in the body. This, in turn, leads to higher uric acid levels. Excessive alcohol use (more than two drinks per day for men or one drink per day for women) can increase your risk of a gout attack.

Some vegetables are rich in purines such as asparagus, cauliflower, and spinach. However, studies have not shown high-purine vegetables to be associated with high uric acid levels or to increase gout attacks. In fact, vegetables, including those with high amounts of purines, may even decrease the risk of gout.

Sticking to a strict diet can help ease symptoms of gout. But because purines are present in so many foods, it may be difficult to adhere to. Still, avoiding certain foods is an important part of an overall gout treatment plan.