Gout
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Gout (Low Purine) Diet – Best and Worst Foods – Lower Uric Acid Levels

Written by Sindy Hoxha

July 18th, 2024

Gout is one of the most common forms of arthritis. According to the Global Burden of Disease (GBD), gout affects around 41 million people around the world (1). In the United States alone, gout affects around 3.9% of the population, which is around 9.2 million people (2).

What Is Gout?

Gout is a form of inflammatory arthritis and is usually associated with intense pain around the joints. The pain is a result of the accumulation of crystals around the joint area, which is caused by high levels of uric acid present in the bloodstream.

Gout starts forming during the breakdown of purine levels, which is a natural chemical that is usually found in the human body but also present in many foods that we eat. When purine is broken down in the digestive system, it turns to uric acid, which eventually gets flushed out of our system through urine. However, when uric acid levels are high, this may eventually lead to gout (3).

What Is The Gout Diet?

The Gout Diet is a diet that focuses on keeping uric acid levels low in order to prevent or manage the symptoms which are associated with gout. The gout diet is not a cure, but rather acts as a way to slow down joint damage and ease gout attacks (4).

The gout diet’s main focus is to reduce purine intake, which are found in higher amounts in some foods and beverages. Studies reveal that low purine diets slow down the formation of new crystals which decrease the amount of gout attacks an individual experiences (5).

Who Might Find A Gout Diet Beneficial?

People who suffer from high levels of uric acid in their bloodstream, also known as hyperuricemia, may benefit from a gout diet. Being on a low purine diet also helps those that are at high risk of gout by lowering the chances of developing the condition later in life.

Another benefit of the gout diet is that it lowers the likelihood of other complications that arise in people suffering from hyperuricemia, such as the risk of developing kidney stones (6, 7).

Worst Foods – Avoid if You Have Gout

There are specific foods to avoid if you or your loved ones suffer or are at risk of gout. Here are some foods to stay stay away from in order to manage gout:

Purine-rich Animal Proteins

Some animal proteins contain high levels of purine which may worsen gout symptoms (8). Some animal proteins to keep an eye out for are:

  • Red meats (lamb and beef) (9)
  • Seafoods (sardines, mussels, anchovies, trout, tuna and scallops) (10)
  • Organ meats (kidneys and liver) (11)

Alcohol

Consuming excessive amounts of alcohol, especially beer and hard liquor, has been linked to worsen gout symptoms and a higher risk of gout flares (12, (13).

High Fructose Corn Syrup (HFCS)

Foods that contain the ingredient High Fructose Corn Syrup (HFCS) may lead to lower levels of adenosine triphosphate in the body. This promotes the overproduction of uric acid levels (14).

High Fructose Corn Syrup is not to be mistaken with natural fructose which is present in honey and fruits. A moderate intake of natural fructose sources is acceptable. The foods gout sufferers should avoid are:

  • Processed foods containing high fructose corn syrup as an ingredient (15)
  • Sodas and other sugary drinks (16, 17)

Refined Carbohydrates

Upon consumption, carbohydrates are turned into sugar for the body to store or use as fuel. Consuming foods high in carbs can impact blood sugar levels and create insulin resistance (18), which as a result may increase uric acid levels. The gout diet often limits all processed foods with a high glycemic index like white bread, sugary cereal, etc.

Fasting

Fasting is often applauded for its numerous health benefits, but can worsen symptoms for those that suffer from gout (19). Occasional fasting for weight loss and religious purposes is often allowed under the supervision of a healthcare provider. However, it’s often not recommended as gout sufferers need to fast with caution. The main problem with fasting lies in the risks of dehydration, which may worsen gout symptoms.

The Gout Diet is all about staying informed and being mindful of the food you’re eating. Balance, moderation and keeping purine intake low are the key to managing gout symptoms and keeping gout attacks on the low. However, it’s always a wise idea to get in touch with your doctor before making any drastic changes to your diet.

Best Foods to Eat if You Have Gout

The down side of the gout diet is that it cannot cure gout, it just helps ease the symptoms. People suffering from gout can help manage painful symptoms by consuming the foods listed below:

  • Cherries: Studies have found that cherries possess anti-inflammatory properties that might help lower high levels of uric acid in the bloodstream (20).
  • Skim milk: Research has found that skim milk helps flush out excessive uric acid through urine. It may also lower joint inflammation caused by the uric acid crystals (21).
  • Water: Staying hydrated is highly important as it helps the kidneys flush out uric acid more often. It also helps prevent the formation of kidney stones (22).
  • Coffee: Caffeine helps breakdown purine more effectively and also helps in flushing it out from the body (23).

Following specific dietary patterns such as the DASH diet, may also help in managing gout (24).

The foods listed above may help with gout, but maintaining a balanced diet is also important to minimize gout symptoms. General guidelines for gout sufferers are to:

  • Choose gout-friendly grains: Whole grains like brown rice, whole wheat pasta and sugar-free cereal consumed in moderation are generally tolerated for those suffering from gout.
  • Stick to fruits and vegetables: Most fruits and vegetables are generally safe to eat for people with gout.
  • Diversify protein sources: Consuming protein foods that are low in purines is a great way to keep gout symptoms at bay. Eating different types of gout-friendly meats and seafood helps you reach your daily protein intake and may help with weight management.

Following these three simple dietary recommendations may often lead to lower uric acid levels over time which will help with gout flare ups in the long run. Always remember to talk to your healthcare provider for dietary advice and tips on how to better manage your condition.

Benefits of a Gout Diet

For those that suffer from hyperuricemia, a gout diet may help in managing uric acid levels effectively and also reduce the likelihood of developing kidney stones. Individuals that already are diagnosed with gout and kidney stones can also reap the benefits of a gout diet by preventing their condition from worsening over time. Down below we have a list of some of the benefits that come with a gout diet:

  • May minimize the need of some medication: A gout diet isn’t a definite cure for gout, but it may serve as a strategy to help lower dosages of some medications needed for those with gout (25). This helps lower the potential side effects medications hold as well as the side effects that may arise from the combination of certain medications.
  • May help with weight management: One potential benefit that the gout diet offers is weight management. This is because this diet recommends staying away from processed foods, red meats, refined carbohydrates and high fructose corn syrup. These foods often usually come hand in hand with weight gain, obesity and even diabetes. The gout diet may help people lose excessive weight, which in return further helps with joint pain and minimizing gout symptoms.

By being more aware of the gout diet and the conditions related to hyperuricemia, gout sufferers can make lifestyle changes that can help them live a healthier, more fulfilled life.

Disadvantages of a Gout Diet

Like most diets out there, even the gout diet comes with some drawbacks you should be aware of. Here are some of the most notable disadvantages of a gout diet:

  • Low in Omega-3 Sources: A low purine diet is often associated with a restriction of omega-3 fatty acids. This is because of the wide range of seafood that you have to stay away from. Omega-3 fatty acids have a ton of benefits for our bodies, such as lowering inflammation and even easing joint pain (26). One way to overcome this is to take fish oil supplements. They aren’t only rich in omega-3 fatty acids, they also hold some amazing benefits for heart health..
  • Not a Panacea: The bad news about this diet is that it doesn’t fully lower uric acid levels. So, it’s practically less effective than medication (27). Keep in mind that the opposite also remains true when it comes to those suffering from high uric acid levels. Medication alone may not fully aid in managing gout. The best approach for those suffering from gout is to combine the gout diet and their prescribed medication together to see the best results.

By avoiding high purine foods and sticking to healthy whole foods rather than processed food, you can reap all the benefits that the gout diet has to offer. Just keep in mind to take your prescribed medication and talk to your doctor before taking fish oil supplements.

Diet and lifestyle changes

According to the Arthritis Foundation, the best way to start managing gout symptoms is to maintain a healthy weight. Being overweight or obese may not only increase the risk of developing gout, but also worsen the symptoms for those that already suffer with the condition (28). Some of the benefits that come from losing weight are:

  • Reducing pressure on the joints (29)
  • Lower uric acid levels in the bloodstream (30)
  • Improved flexibility and strength (31)

Those who smoke are also at risk for worsening symptoms. If you are an active smoker and suffer from gout, talk to your doctor to create a plan and the needed assistance for quitting.

Duration and Timing

Gout doesn’t have an exact cure. Because of this, the gout diet should be a life-long strategy for those suffering from gout. Keeping this diet long term reduces the chances and frequency of flare ups and other complications that come from the condition.

The good news is that the gout diet isn’t a strict diet. Individuals can eat whenever they find best fitting to their schedule. The best advice for starting the gout diet is to take it easy and not push yourself too hard on it. Take it slow and initially make some dietary adjustments while also informing yourself about it consistently.

Starting anything as a beginner always will require some trial and error. Also, keep a journal for what worsens your symptoms. There are many people with gout that don’t have a problem consuming some foods (red meat, for example), while others experience gout flare ups even after consuming a small portion of the trigger food (32).

It’s always recommended to talk to your healthcare provider or a nutritionist to figure out what foods are the worst for your flare-ups and which ones you can actually tolerate.

Cooking Tips for a Gout Diet

By keeping gout-friendly foods in your kitchen, you will end up making better food choices in the long run. Here are some amazing cooking tips if you suffer from high uric acid levels.

  • Use plant-based oils: Olive oil is the best choice to use in your kitchen. This is because it holds many anti-inflammatory properties (33) which may improve uric acid and reduce gout symptoms.
  • Always keep a storage of grains and legumes: Dried beans and whole grain food are the staples of a gout diet. Their only downside is that they take a bit longer to cook than other canned or half-prepared options. If you don’t like cooking everyday, prepare large batches of beans or brown rice and store them in the fridge in meal size portions for up to 3-5 days.
  • Add more protein with tofu varieties: Tofu is a soy-based protein that can be added in many dishes. You can try tofu scrambles, add them in soup or even in wraps!

There are also other options for different dietary preferences.

  • Pescatarians and Mediterranean Dieters: If you are a pescatarian or eat a mediterranean diet, the limitations on fish may be a big problem for you. But the good news is that experts from the Arthritis Foundation suggest that people on a gout diet may continue to consume salmon in moderation.
  • Vegetarians, Vegans, and Gluten-Free Dieters: Vegans and vegetarians can maintain a healthy and balanced diet by eating plant based proteins such as tofu, dried beans, lentils and more. Those that follow a gluten-free diet can get their daily dose of whole grains by consuming quinoa (34).

By being creative and planning your meals ahead of time, the gout diet can become simple and easy to keep on a long-term. With all the possibilities, you can cook gout-friendly dishes that are both nutritious and delicious!

Tips for Gout Relief

With time and commitment, keeping a gout diet will become easier until it just becomes second nature, Here are some great tips to keep in mind when starting:

  • Keep your eye on nutrition: A balanced diet includes consuming carbs, protein and fats along with vitamins and minerals. The daily dietary recommendation for both macronutrients and micronutrients are outlined by the USDA. You can always go over them online. Also keeping a journaling app can help you see if you are meeting all your dietary requirements.
  • Finding support and community: Learning how to manage gout symptoms and live with the condition can be overwhelming and a lonely road at the beginning, that’s why finding a support group is the best option to keep you with a positive mindset. Support groups online can provide guidance, recipes, and tips for those suffering from gout. Organizations such as the Alliance for Gout Awareness can assist people that want to know more about living with gout.
  • Maintain a healthy weight: Being a healthy weight may offer relief for many gout symptoms. However, losing weight should happen in a healthy and gradual manner. This is done by staying lightly active and being in a slight caloric deficit throughout the day. This will ensure that the results are sustainable and that you won’t gain all the weight back rapidly. Crash diets are not a good idea to use as a method of weight loss. They often trigger gout attacks, are low in nutrition, and are unsustainable.

To manage gout, it’s important to make sure that you are opting for healthier lifestyle choices. Keeping a gout diet, maintaining a healthy weight, taking prescribed medication and exercising 2-3x a week will increase your quality of life and reduce gout complications in the long run.

Conclusion

The gout diet’s main focus is to avoid foods high in purines such as red meat, seafood and high fructose corn syrup while consuming foods low in purines such as tofu, dried beans, citrus fruits and lentils.

Keep in mind that we are all different. There is not one size fits all for this diet. That’s why it’s important to keep a journal and talk to a nutritionist to better pinpoint the foods that cause gout flare ups to you.

Sindy Hoxha

Sindy Hoxha is a writer and editor with years of experience in the field. She has worked as a writer for several...Read more

Evidence Based

This article is based on scientific evidence, and written, fact-checked & medically reviewed by health experts.

Throughout this article, you’ll find scientific references (highly trusted peer-reviewed scientific papers, links denoted by the numbers in the parentheses (1, 2, 3)).