What Is Gout And What Causes It
Before we can look at foods to avoid with gout, it is necessary to briefly understand what it is.
Gout is a form of joint inflammation, caused by excessive uric acid in circulation .
When the bodys natural uric acid threshold is exceeded, painful crystals can form in and around the joints. These crystals trigger the characteristic symptoms and pain.
Not everybody with high uric acid levels will get gout, but those who do always have high uric acid levels. This indicates there are other factors at play, but from a dietary perspective uric acid is the focus.
Excessive uric acid in the blood stream is typically driven by two factors: genetic predisposition and the ingestion of high-purine foods. Obviously, the dietary factor we can control.
When purines we eat are broken down and metabolised by the body, uric acid is formed as a by-product of this process. Its normal and healthy for uric acid to be formed, but excessive amounts are problematic.
Therefore, consuming less purine-rich foods should lower uric acid levels in your blood, lowering gout risk.
At least, in theory.
Its actually not that clear-cut because other nutrients appear to aggravate gout symptoms too
Heres a list of foods to avoid if you have gout, based on real scientific evidence.
Food Loaded With Omega 3 Fatty Acids
When you hear omega 3 fatty acids, you think of fish instantly. This is particularly true. Almost every fish contains plenty of this compound. But, you can get the same from walnuts for example. Add the fact some fish can be consumed despite the fact you have gout and you get a more versatile diet.
You can consume salmon, herring, sardines, and mackerel. Start with small amounts and gradually increase portions. Omega 3 fatty acids dont affect uric acid directly. It will decrease inflammation and swelling which is beneficial during the gout attack.
Gout Treatment And Diet
Avoiding purine-rich foods is only part of your gout treatment. Losing weight can also help your gout symptoms. Just be sure your weight loss is slow and steady if you lose weight too rapidly, the amount of uric acid in your body may increase. Overall, the best diet is one based on foods that are low in fat and sugar and high in fiber. Talk to your doctor about how to create a gout diet thats right for you.
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How Is Gout Affected By Diet
Gout is a type of arthritis that is associated with elevated levels of uric acid in the blood. High levels of uric acid can cause crystals to form in the joints, causing pain and swelling. Uric acid is a normal waste product formed from the breakdown of food, particularly compounds called purines. It is believed that lowering uric acid levels through small changes in your diet may help reduce the chance of future gout attacks.
A healthy, balanced diet may help reduce the risk of gout attacks.
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Organ Meats Are Extremely High In Purines And Should Also Be Avoided
Organ meats, known as Offal, contain by far the most purines of any food in the human diet.
The most common forms of offal in the Western diet include liver , brain, heart, kidneys, and a mixture called Pâté.
Below is the purine content of a handful of foods. Note this is just an example Ive selected, and you can find much more extensive lists on Goutpal or here.
Purine Content of Food :
Consider that values listed are per 100 grams, so portion sizes must be taken into account Meat portions we eat tend to be heaviest.
Previous studies have not differentiated between intake of conventional meat and offal, so recommendations have to be the same. Given the strong link between meat intake and gout which is based on purine content alone offal should definitely be avoided too.
Somewhat contradictory to the purine-gout theory, consumption of purine-rich vegetables is not associated with an increased risk of gout .
Researchers speculate this could be due to a lower bioavailability of purines in vegetabes, as well as other nutrients which may offset the harmful effects of their purines.
Summary: Organ meats are some of the highest purine foods and should be completely avoided if you suffer gout attacks.
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Shopping List For Gout
What to put in your cart and what to pass up when planning your gout diet.
A diet to lower uric acid levels, along with medications prescribed by your doctor, makes gout one of the most controllable forms of arthritis. While you should always discuss the merits and drawbacks of specific foods with your doctor, use this shopping checklist as a general guide to food choices to improve your overall health, lower uric acid levels and reduce your risk of painful gout attacks. Put in Your Cart
- Skim milk.
- Low-fat dairy products .
- Whole-grain products .
- Plant oils .
- Vitamin C supplements .
- Coffee .
- Water bottles .
- Red meat and organ meats .
- Shellfish such as shrimp and lobster.
- Refined carbohydrates .
- Processed foods .
- Sugary beverages.
- Alcohol .
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Foods You Can Eat In Moderation
Aside from organ meats, game meats and certain fish, most meats can be consumed in moderation. You should limit yourself to 46 ounces of these a few times per week .
They contain a moderate amount of purines, which is considered to be 100200 mg per 100 grams. Thus, eating too much of them may trigger a gout attack.
- Meats: These include chicken, beef, pork and lamb.
- Other fish: Fresh or canned salmon generally contains lower levels of purines than most other fish.
Summary: Foods you should eat with gout include all fruits and vegetables, whole grains, low-fat dairy products, eggs and most beverages. Limit your consumption of non-organ meats and fish like salmon to servings of 46 ounces a few times weekly.
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The Cause Of Gout Is More Than Just Diet
While diet is critical, dont overlook other important factors that affect gout. These include family history, sleep apnoea, and lack of physical exercise to name a few.
Further discussion of best treatment for gout is outside the scope of this article. But there are foods thought to be protective namely dairy, cherries, and coffee, in decreasing order of evidence.
And as much as I prefer focusing on what you should eat to prevent health scares, there are just so many clear trigger foods for gout.
Its important to deal with these factors first and foremost.
About Joe Leech, Dietitian
Joe Leech is a university-qualified dietitian from Australia.
He graduated with a Bachelorâs degree in exercise science, followed by a Masterâs degree in Nutrition and Dietetics in 2011.
Avoid Sweets And Sodas
Unlike fruit with its natural sugar, artificial sugars are widely recognized as gout flare dangers. Consuming too many sugary sodas has been found to provoke attacks, but no association has been found with artificially sweetened sodas. Other foods loaded with high-fructose corn syrup can also bring on gout pain.
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Ten Tips For Beating Gout
If you have gout, use these nutrition tips to lower your risk:
See your GP to check or monitor gout risk factors
Drink up to four cups of regular or decaffeinated coffee a day
Have two to three serves of reduced-fat or skim dairy foods daily
Eat cherries regularly . Add to breakfast cereal and snacks, or mix with yoghurt
Avoid fasting and feasting. Both increase purine turnover and blood uric acid
Foods To Be Eaten In Moderation
Foods like asparagus, beans, lentils, mushrooms, shrimp, spinach, poultry, and fish other than those mentioned bellow should be consumed in moderation. In relation to red meat, poultry, and fish, these can be consumed in a 60 to 90 gram portion daily.
Some people have stated that foods such as strawberries, oranges, tomatoes, and nuts can also cause gout crisis, however, these foods are not rich in purine. Up to now, there is no scientific evidence that confirms whether these foods do indeed cause a gout crisis and why. So, it’s important that you pay attention to your diet so that if you have a crisis, you can be aware of what food caused it in order to avoid it in the future.
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Be Choosy About Carbs
Carbs can be helpful or harmful to your gout health. The most helpful carbs are found in whole grains, fruits, vegetables, and legumes. Sweet potatoes, beans, apples, and popcorn can all be served in wholesome and delicious ways as part of a healthy gout diet.
Other carbs come as natural and refined sugars. Candy, sports drinks, some breakfast cereal, and some pasta sauces all contribute to dietary sugar from unhealthy carbs.
What Effect Do Your Weight And Diet Have
Some studies suggest that certain foods are linked to gout attacks. Gout attacks are apparently more common in people who have eaten a lot of meat, fish or seafood a few days before. That matches many peoples experiences. On the other hand, purine-rich plant-based foods such as peas, beans, lentils, spinach, mushrooms, oats, cauliflower and broccoli were found to have little to no effect on the risk of a gout attack. Overall, there hasnt been much good quality research into the link between certain foods and gout attacks.
Eating cherries is sometimes recommended to prevent gout attacks, but theres no scientific proof that it can help prevent gout.
Because not everybody has the same metabolism, its a good idea to try out for yourself what helps you and what doesnt and how much of different foods your body tolerates. Some people feel better after changing their diet, while others successfully lower their uric acid levels with medication and cope just fine without any changes to their diet.
Individual studies also suggest that losing weight can help if youre very overweight. People with gout should be careful not to go without any food, though fasting can itself trigger a gout attack.
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Sodas And Sugary Drinks
Sodas and sugary drinks are considered empty-calorie foods, because they contain no beneficial nutrients while contributing a lot of calories to your diet.
For example, a 12-ounce can of cola contains about 150 calories and 40 grams, or about 9.5 teaspoons, of added sugars. In addition, sugar-sweetened beverages have been associated with an increased risk of heart disease, type 2 diabetes, weight gain, and dental caries.
Instead Of Beer Try Other Alcohol In Moderation
All alcohol is high in purine, but drinking beer is especially risky if you have gout because it contains both purine and yeast, which can cause uric acid levels in the blood to rise. The dehydrating effect of alcohol also makes gout worse. If you want to enjoy an alcoholic beverage, try sipping on a glass of wine or a wine cooler. Drink plenty of water when drinking alcohol to avoid dehydration.
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Instead Of Meat Try Vegetable Sources Of Protein Or Dairy Products
All meat, including beef, poultry, and pork, contains purine. Most experts recommend controlling purine intake by consuming no more than six ounces of meat each day if you have gout. If you crave more protein in your diet, try adding nuts and nut butters, soy, or beans to your diet. Low-fat dairy products such as milk, cheese, and yogurt are also great sources of protein that are low in purine.
Why Do People Get Gout
Gout is a type of arthritis causing pain and swelling in the joints. The symptoms usually occur as flares lasting for a week or two and then go away. Gout flares usually start in the big toe or a lower limb.
The disease happens when the body has high levels of a substance called uric acid or urate. When high levels of uric acid build up, the needle-shaped urate crystals form in and around the joints. This causes inflammation and arthritis of the affected joint. Many people with high serum uric acid, however, may not develop gout.
Some factors may increase a persons risk for gout, including
- Male gender
Gout is a lifelong disease and cannot be cured. The disease, however, is one of the most controllable forms of arthritis. It can be effectively managed with early diagnosis, medications and lifestyle changes.
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What Foods To Avoid
Many of the foods you want to avoid are meats and seafood. Meats such as chicken, pork, beef, or lamb are usually okay in moderation however, if you find they cause symptoms you will want to avoid them altogether. Salmon, as part of a gout diet, is also usually tolerated well in moderation.
- Yeast:beer, nutritional yeast, large amounts of bread, others
- Game meats: venison, veal, bison, others
- Organ meats: liver, tongue, tripe, others
- Fish: including sardines and anchovies
- Other seafood: shellfish, roe, others
- Sugary drinks: sodas, fruit juice, others
- Sugar substances: honey, nectar, high-fructose corn syrup, others
Do I Need To Stop Drinking Alcohol With Gout
Yes, its a good idea to cut out alcohol. Alcohol molecules in your body tend to increase uric acid levels, so drinking can push you over the edge and into a flare-up. If youre newly diagnosed and start taking medication, try cutting out alcohol at first. Your doctor may allow you to add a small amount back into your diet over time as your uric acid levels come down. But even then, its best to avoid beer and liquor and stick to safer choices such as red wine, Dr. Burg says.
All myths aside, the best advice for people with gout is to eat fresh, unprocessed foods. Choose complex carbohydrates over refined carbs from packaged or processed foods. And always drink plenty of water because dehydration is a risk factor for an acute attack.
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Certain Meats And Seafood
Not all sources of purine are equal when managing gout, and research suggests certain purines can make gout worse.
Studies show that hypoxanthine purines, found in meat and fish, have a stronger effect on on purine production compared to other types of purine, says Nichole Dandrea MS, RDN, and author of The Fiber Effect: Stop Counting Calories and Start Counting Fiber For Better Health, referencing research in the BMJ.
Yet not all meats and seafood are off-limits. Some are just worse for gout symptoms than others.
Dr. Siaton recommends people with gout pass on red meats such as lamb, beef, and pork. Organ and glandular meats such as liver, tripe, and sweetbread have high purine content, too.
As for seafood, trout, haddock, codfish, anchovies, sardines, herring, mussels, and scallops are higher-purine options to avoid.
You might be able to tolerate moderately high-purine seafood such as crab, lobster, oysters, and shrimp. But make sure to limit consumption.
You Can’t Avoid All Purines
There are too many sources of purines to eliminate them all from your diet. You will stay healthier overall if you eat some foods with purines. Remember that vegetable purines have never been shown to promote gout attacks, and that low-fat dairy products are protein sources that lower your risk of gout pain. People with gout can still enjoy meat in moderation, but should limit meat, fish, and poultry to 4 to 6 ounces a day.
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Achieve A Healthy Weight
Obesity may be a primary consideration to reduce levels of uric acid in the blood. Insulin resistance is commonly seen in those who are obese and it may be involved in the development of gout. Insulin resistance has been shown to decrease the amount of uric acid that is cleared in the urine. A condition known as the ‘metabolic syndrome’ is a cluster of symptoms which includes insulin resistance, along with tummy obesity, high blood pressure and abnormal blood fats – for example, high cholesterol. This condition is strongly associated with high uric acid levels, which can be improved with slow, gradual weight loss.
Weight loss has been shown to improve insulin resistance and therefore reduce uric acid levels in the blood. However, it is important to avoid strict diets such as low-carbohydrate and high-protein diets. These may increase consumption of purines, a compound that breaks down into uric acid. Additionally, rapid weight loss through strict dieting can result in breakdown of tissue. This can temporarily cause a rise in uric acid levels. A gradual, safe weight loss of 1-2 lbs a week can help to achieve an optimal body weight.
Does Fructose Cause Gout
Fructose is a sugar that is found in fruits and vegetables. It is also found in high levels in foods sweetened with corn syrup, such as bread, cereal, soft drinks and fruit juices. An American study found that men who drank five to six servings of fructose-sweetened soft drinks per week were more likely to have gout. However there is no research showing that fructose actually causes gout. Cutting down the amount of food artificially sweetened with high fructose corn syrup may be beneficial for your overall health. However naturally occurring fructose in fruit and vegetables also provides general health benefits and should not be completely avoided without advice from your doctor or dietitian.
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