Gout is a type of arthritis that causes pain in your joints, often in the big toe. This condition is triggered by high levels of uric acid in your blood.

Uric acid is a natural compound in your body. However, if you have too much of it, sharp crystals of uric acid can collect in your joints. This causes a gout flare-up. Symptoms include:

  • pain
  • swelling
  • tenderness
  • redness
  • warmth
  • stiffness

Gout can be very painful. This condition is treated with medications prescribed by your doctor. Lifestyle factors, including changing your daily diet and managing stress levels, can help prevent or reduce gout pain and attacks.

Purine-rich foods

Foods that are high in purine can set off gout symptoms. Since, your body breaks purines down into uric acid, some of these foods should be avoided. However, not all foods with purines should be eliminated. The main ones to avoid are organ and glandular meats, and some seafood, such as:

  • cod
  • scallops
  • shellfish
  • sardines
  • anchovies
  • mussels
  • salmon
  • trout
  • haddock
  • organ meats

Other purine-rich foods that should be limited include:

  • pork
  • turkey
  • bacon
  • duck
  • mutton
  • veal
  • venison

Some vegetables are high in purines, but studies have shown that they do not increase the risk of gout or gout attacks. Even though the following may be listed as high in purine, they are a part of a healthy diet and not restricted.

  • asparagus
  • cauliflower
  • green peas
  • kidney beans
  • lima beans
  • lentils
  • mushrooms
  • spinach

Here are some tips for following a low-purine diet.

Alcohol

All types of alcohol may increase your risk of gout and worsen symptoms. When you drink alcohol, your kidneys must work to get rid of the alcohol rather than uric acid. This may cause uric acid to build up in the body, triggering gout.

Some types of alcohol — such as beer — also contain purines. If you’re prone to gout, avoid all types of alcoholic beverages including:

  • beer
  • wine
  • cider
  • liquor

Sugary beverages

Sugary drinks may cause gout flare-ups. This is more common in adults who are overweight or obese. Sugary beverages like fruit juices flood your body with sugars called fructose. High blood sugar is linked to higher amounts of uric acid collecting in your body.

If you have gout, avoid or limit sugary beverages, such as:

  • soda
  • sugary-flavored drinks
  • orange juice
  • energy drinks
  • fruit juice from concentrate
  • freshly squeezed fruit juice
  • sweetened lemonade
  • sweetened ice tea

Some medications can trigger gout symptoms. This includes common pain medications. Even small amounts of these drugs can impact gout. Your doctor may recommend changing these medications if you notice more gout symptoms.

Aspirin or acetylsalicylic acid raises uric acid in your blood. Even low doses of aspirin can trigger gout. Research shows that this effect of aspirin is more common in women than in men.

Diuretics or water pills help to treat conditions such as high blood pressure and edema or swelling in the legs. These medications work by getting rid of excess water and salt from the body. However, they can also cause a side effect of too much uric acid in the body, triggering gout. Diuretic drugs include:

  • chlorothiazide
  • chlorthalidone
  • hydrochlorothiazide
  • indapamide
  • metolazone
  • spironolactone

Other medications may also trigger symptoms:

  • ACE inhibitors
  • beta blockers
  • angiotensin II receptor blockers
  • cyclosporine
  • chemotherapy drugs

Dehydration

When you’re dehydrated, your body doesn’t have enough water and your kidneys can’t get rid of excess uric acids as well as they normally do. This can give you more gout symptoms. One reason alcohol is not good for gout is that it’s dehydrating. Drink plenty of water to help flush out uric acid.

Arsenic

Even low levels of arsenic exposure may be linked to gout in women. This chemical is found in some pesticides and fertilizers. It’s also found naturally in soil, water, and some shellfish.

Diabetes and prediabetes

Adults with diabetes or prediabetes may have high levels of the hormone insulin. This can cause too much uric acid in the body, triggering gout symptoms in your joints.

Injury and inflammation

Injury to some joints, especially your big toe, can also trigger a gout attack. This may happen because it causes inflammation and attracts uric acid crystals to the joint.

Obesity

Weight gain and obesity can raise levels of uric acid in your blood, worsening gout symptoms. There are several reasons why this may happen. Fat cells may make more uric acid. The more you weigh, the harder it is for your kidneys to remove excess uric acid from your blood. Additionally, excess weight may raise insulin levels in your body, which also increases uric acid.

Other factors

Other factors can cause your uric levels to spike, leading to a gout attack:

  • stress
  • infections
  • sudden illness
  • hospitalization
  • surgery
  • extreme weather changes

Remember that not all triggers will affect your gout symptoms. You know your body best; you can gauge which lifestyle factors worsen or cause a gout attack.

Take all medications as prescribed. Your doctor may also recommend pain medications to help you manage your symptoms.

Keep a daily food diary. Track what you eat and drink and whether you have any gout symptoms. Also record any medications and supplements you’re taking. This may help you find out what sets off your gout attacks. Discuss your triggers with your doctor.

Talk to your doctor or nutritionist about making changes in your diet to avoid foods that may cause a flare-up.