What to Eat When You Have Gout
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A well-balanced gout diet can not only lower your risk of an attack, but it can also slow the progression of gout-related joint damage. The key is to choose foods that are low in purine—a chemical compound that, when metabolized, creates the uric acid that triggers gout attacks. Purine is found in many foods, like organ meats, beer, and soda, so these are avoided. Nutritious foods that help your body eliminate uric acid are at the center of an effective diet for managing gout.
A gout diet is generally part of a comprehensive program recommended after you have been diagnosed with the condition. You'll work together with your healthcare provider to manage several lifestyle factors, including diet, weight control, physical activity, and possibly medication to reduce the frequency and intensity of gout attacks.
Benefits
In the human body, purines are either endogenous (made by the body) or exogenous (consumed in food). When exogenous purines are broken down by the liver, a waste product called uric acid is created. It is normally excreted, but that is not the case when you have gout. The condition, in fact, is defined by the build-up of uric acid.1
For centuries, gout has been associated with the overindulgence of rich foods such as seafood, meat, and alcohol.2 As a result, people were commonly advised to avoid all of these things until symptoms resolved.
With the discovery of purines in 1884, the practice was further endorsed, and people were routinely warned against consuming otherwise healthy foods such as fish, vegetables, and fruit because they contained the chemical as well.3
In recent years, however, understanding of the synthesis of uric acid has expanded considerably, and many of the plant-based high-purine foods once considered off-limits are today deemed safe for consumption.
This knowledge has allowed the gout diet to evolve to be more nutritious while still being helpful in managing this condition.
According to the American Academy of Rheumatology, gout treatment may include medication and lifestyle changes. The organization emphasizes that treatment should be tailored for each individual. What works for one person may be less effective for another.
But studies have shown that following a gout diet can improve the frequency of gout attacks and reduce the severity of symptoms in some people.4 In fact, a study published in Annals of the Rheumatic Diseases found that consuming a purine-rich diet increased the risk of recurrent gout attacks fivefold among gout patients, whereas avoiding or reducing purine-rich foods (especially of animal origin) helped reduce the risk of gout attacks.2
Following a lower purine diet may also help some people achieve and maintain a healthy weight. This is important in relation to gout because it not only can reduce the risk of developing the condition, but it can reduce pressure on the joints, help reduce pain, improve function, and slow the progression of arthritis—issues that those diagnosed with gout are often faced with.
How It Works
On a gout diet, you'll try to avoid most foods that are rich in purines, especially from animal and seafood sources. Purine-rich vegetables do not increase your risk of a gout attack and can be consumed. Moderate portions of foods that are rich in vitamin C, low-fat dairy products, and plant oils should also be consumed to help manage your condition.
Duration
There is no cure for gout.5 As such, adopting the gout diet can be a part of your long-term care plan to help you spend more time in remission and less time managing painful flare-ups.
What to Eat
Compliant Foods
Vegetables
Low-fat dairy
Tofu
Whole grains
Beans and lentils
Plant-based oils
Citrus fruits
Cherries
Coffee
Non-Compliant Foods
Red meat
Organ meats
Coldwater fish
Some shellfish
Yeast extract
Beer, liquor
Sugary foods and beverages
Vegetables: Recent evidence shows that consumption of purine-rich vegetables like asparagus, spinach, and cauliflower does not affect uric acid levels or increase the risk of a gout attack, as was once thought.6 Plus, eating a diet that includes plenty of vegetables helps you to reach and maintain a healthy weight and provides your body with important vitamins and minerals.
Low-fat dairy: Studies have shown that the proteins in dairy products can help reduce uric acid levels.4 Choosing low-fat products such as skim milk or low-fat yogurt will help you to maintain a healthy weight as well.
Tofu, whole grains, beans, and lentils: Plant-based proteins will help you maintain a balanced diet while managing your condition. On the gout diet, you reduce your intake of meat and seafood, but you'll still want to consume about 15% to 30% of your calories from protein to meet U.S. Department of Agriculture (USDA) recommendations. There is some evidence that plant-based proteins and plant-based oils (such as olive, sunflower, and soy) may even protect you against gout attacks.4
Citrus fruit: Evidence has shown that a daily intake of 500 milligrams (mg) of vitamin C may be an effective way to reduce the frequency of gout flare-ups.7 Vitamin C helps your body to excrete uric acid, and citrus fruits are a great source of this essential nutrient. Try to choose lower-fructose fruits such as grapefruit, oranges, or pineapple, as this natural sugar can increase uric acid levels.
Some people with gout take a vitamin C supplement. Speak with your doctor to see if supplementation is needed and whether it fits into your diet and medication plan.
Cherries: Researchers have found that that cherry consumption lowers serum uric acid levels and can reduce the risk of flare-ups in gout patients.8 Cherries and some cherry products (such as tart cherry juice) also contain high levels of anthocyanins—flavonoids with anti-inflammatory and antioxidant properties that are helpful in managing the pain and inflammation associated with gout attacks.
Red meat and organ meat: Red meats are higher in purines than white meat. Higher consumption of red meat (including beef, venison, bison) and organ meats (including liver, sweetbreads, tongue, and kidney) increases the risk of recurrent gout attacks.5
Coldwater fish, shellfish: Certain types of fish are known to be higher in purines and should be limited on a gout diet. Coldwater fish such as tuna, sardines, and anchovies are higher in purine, as are shellfish including shrimp, oysters, crab, and lobster.9
Yeast extract: Certain spreads including Marmite, Vegemite, and Vitam-R contain yeast extract and are known to be high in purine. Avoid these to reduce uric acid levels.2
Beer and liquor: Most alcoholic beverages are not advised on a gout diet. Specifically, beer and liquor slow the excretion of uric acid. However, studies have shown that moderate consumption of wine is not associated with a higher incidence of gout.10
Sugary foods and beverages: Foods and beverages that contain fructose—particularly those that contain high fructose corn syrup—are not advised on a gout diet.11 Keep uric acid levels lower by limiting or avoiding consumption of sodas and other sugary drinks, canned fruit or fruit juice, and other products including snack bars, candy, and breakfast cereals.
Recommended Timing
There is no specific food schedule that you need to follow on a gout diet. You can time your meals and snacks as you normally would to provide steady energy throughout the day. However, if you take medications to manage pain (including over-the-counter or prescription medications), your healthcare provider may suggest that you take the medication with a snack or meal to ease stomach upset.
Also, give yourself time to adjust to the gout diet when you first begin. Working out which foods are safe for you can be a process of trial and error. For example, while some people will have no problem consuming moderate amounts of red meat, others may experience an attack with only a scant helping.
Work with your doctor or a nutritionist who is experienced in the management of gout. Most will advise you to keep a food diary so that you can begin to pinpoint the specific food triggers that place you at greatest risk.
Cooking Tips
There are plenty of foods to enjoy on the gout diet. Organizing your kitchen and following a few basic cooking tips will help you stick to your plan.
Cook grains and dried beans in advance: Whole grains usually take longer to cook than refined grains. And if you buy dried beans (which are often cheaper than canned ones), those take extra time to soak and cook as well. Take one day during the week to cook a big batch, then keep your beans refrigerated in single-serving containers to grab when you need them.
Learn to use plant-based oils: Using oils like olive oil or sunflower oil are associated with a lower risk of gout and better management of uric acid levels. But some of these oils usually have a lower flash point, meaning that they start to smoke at a lower temperature. When using a plant-based oil for the first time, reduce the heat until you are comfortable cooking with it.
Experiment with tofu: Soy-based protein sources, like tofu, are unfamiliar to many consumers. But this versatile food is easy to find in the refrigerated section of the grocery store and easy to use. Consider a tofu scramble for breakfast, or enjoy a crunchy lettuce wrap with tofu, vegetables, and brown rice for a savory lunch or dinner.
Modifications
Almost anyone can follow the gout diet. Vegetarians, vegans, and those who follow a gluten-free diet can adjust the eating plan according to their program. For example, those on a gluten-free diet would choose gluten-free grains such as quinoa. Those who follow a plant-based diet will have an easy time adjusting to the gout diet as it emphasizes vegetables and some fruits.
Those who follow a pescatarian diet or a Mediterranean diet may have a harder time on the gout diet because fish is limited on the plan. However, some experts, including those at the Arthritis Foundation, suggest that consuming certain types of fish (such as salmon) occasionally may be beneficial.9
Considerations
The gout diet is one that will need to become a way of life. Give yourself time to adjust to your new eating plan. As you do, keep these things in mind.
General Nutrition
When following the gout diet, you'll find it easy to meet nutritional recommendations established by the USDA. You are encouraged to fill your plate with healthy vegetables, fruit, lean meat (such as poultry), whole grains, and low-fat dairy, which are standard recommendations for everyone, regardless of whether or not they have your condition.12
If you currently consume red meat as your primary source of protein, it may take some time to learn how to replace it with healthier options. But once you get used to choosing legumes, eggs, chicken, protein-rich grains, or other types of plant-based protein, you may find that following the gout diet allows you to feel full and satisfied. (Reduced gout symptoms and attacks can also be strong motivators for change.)
Weight Loss
Again, many studies have shown that reaching and maintaining a healthy weight is one way to reduce the frequency of gout flare-ups.4 But if you plan to lose weight, avoid crash diets. By losing weight too quickly, you may end up triggering an attack.13
As with all dietary plans, a slow and steady approach is better for your health and something you'll be better able to maintain over the long run.
Support and Community
When first learning how to follow the gout diet, you may find it helpful to connect with a support group in your area. Others with the condition may be able to share recipes, provide helpful tips, and answer questions that arise as you journey through changes. Your healthcare provider may be able to direct you to a group associated with a medical center near you.
You may also find it helpful to check out the resources provided by the Alliance for Gout Awareness. The organization provides helpful videos, offers patient guides, and runs an online support group where members can ask questions, share their experiences, and seek advice from other people who understand what it's like to live with gout.
Exercise and General Health
In addition to following the gout diet, your healthcare provider may recommend that you make other changes to help you live comfortably with gout. The recommendations may include physical activity.
Studies have shown that regular exercise can help to improve joint function and help you to maintain a healthy weight. However, strenuous exercise can do more harm than good and dehydration may raise the level of uric acid in serum and trigger gout.14
A Word From Verywell
A gout diagnosis can feel isolating and intimidating. But learning about the resources available to you, working with your healthcare provider, and making smart lifestyle changes can help you to feel more empowered. Most of all, be patient with yourself and remember that each patient's journey is unique. What works well for one person may not provide any noticeable difference to another. Ask questions, gather information, and see what works best for you.
