What is gout?
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 and become inflamed, resulting in 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.
Gout develops when there’s too much uric acid in the blood. This overabundance of uric acid may be the result of a diet high in purines, or your body may simply 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 inflammatory factors and the body excreting excess uric acid in the urine.
Purines are chemical compounds that are broken down into uric acid when metabolized. 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
- 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’s an increased amount of uric acid production. These high levels build up in the blood, leading to what’s 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.
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, such as brain, sweetbreads, heart, kidney, and liver
- herring, anchovies, smelt, and sardines
- mackerel, tuna, trout, haddock, and codfish
- mussels and scallops
- beer, wine, and liquor
- fruit juices
If you want to include some animal protein in your diet, only a moderate amount is recommended. It’s advised to avoid eating large portions of purine-rich meats. A typical serving of meat is 3 ounces and fish is 4 ounces.
Gout-friendly recipes either contain none of these animal proteins or have amounts that are small enough to help you stay close to only 1 to 2 servings daily or include meatless days.
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.
These foods are somewhat high in purines and should be eaten in moderation:
- crab, lobster, oysters, and shrimp
While these proteins are lower in purines than the ones in the previous list, you should still attempt to limit your intake of all animal protein to 3 to 6 ounces per day, which is 1 to 2 servings.
Alcohol disrupts the removal of uric acid from the body. It’s thought that high levels of purine in alcoholic beverages lead to this disruption.
Normally, purines would break down into uric acid and get flushed out of the body through urine. However, 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.
In addition, although fructose-rich beverages, such as soft drinks, don’t contain high amounts of purines, they have been shown to increase the risk of developing gout. This is because uric acid is one of the byproducts of fructose metabolism. Evidence has shown consuming high amounts of fructose may increase uric acid levels in the blood.
Though they’re tempting, sweets are better left untouched. Make room instead for healthier, gout-friendly foods such as plant-based proteins and low-fat dairy products.
Avoid or limit refined carbohydrates
Refined carbohydrates include:
- white bread
- pasta, except for whole grain
All gout-friendly recipes either have no refined carbs or only include them in very small amounts.
A low-purine diet can help lower uric acid levels and work to prevent symptoms of gout.
Foods and beverages to consume daily include:
- beans and lentils
- fluids, especially water
- low-fat or fat-free dairy
- whole grains, such as oats, brown rice, and barley
- sweet potatoes
- fruits and vegetables
Beans and legumes are excellent protein sources. Eating these plant-based sources can help you meet your daily protein needs, while cutting the saturated fat found in high-purine, animal-based proteins.
Dairy and non-dairy substitutes
Some people find that dairy may increase their gout symptoms, while others experience a decrease in uric acid levels with low-fat dairy intake.
Many plant-based milk alternatives are available if you need to avoid dairy.
Fruits and vegetables
Interestingly, studies have not shown high-purine vegetables to increase gout attacks. Furthermore, vegetables are high in fiber and low in calories, which can help you manage your weight.
However, being mindful of iron intake may be beneficial for those with gout. Most bioavailable iron is found in meat sources, but plant-based iron foods may have a negative effect on gout.
It’s always important to pay attention to your individual symptoms and modify your diet based on your specific needs.
You may safely indulge in these high-purine veggies:
It’s important to understand that a gout diet isn’t a treatment. Rather, it’s 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. In many cases, this can help to control gout more than a low-purine diet can.
Unlike other types of arthritis, gout can be cured. Treatment options will vary and depend on a variety of factors, such as:
- your age
- your general health
- your medical history
- the severity of your condition
In addition to taking prescribed medications, acute gout attacks can be managed through:
- a healthy lifestyle
- weight management
- a proactive approach to signs and symptoms
A large part of your success in managing your condition depends upon your eating and lifestyle habits. Be sure to discuss all nutritional concerns with your doctor and dietitian before getting started.