Gout is a type of arthritis that occurs when uric acid crystals build up in joints, such as the big toe, wrist or knee. Purines—compounds found in your cells and some foods—are broken down into uric acid in the body. Uric acid is then excreted in the urine via the kidneys.
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If you produce too much uric acid or your kidneys can't efficiently remove it, the levels can become too high and lead to deposits of needle-like crystals in joints. These deposits cause pain, redness, swelling and inflammation.
About 4 percent of adults in the United States have gout, and more men have it than women. The following factors can increase your risk of developing gout:
• Genetics—you are more likely to get gout if someone in your family has it.
• Drinking alcohol, especially beer
• Eating meats and seafood high in purines (e.g. wild game, organ meat, shellfish)
• Consuming high-fructose corn syrup
How Can Diet Affect Gout?
Purines naturally occur in red meat, seafood and some vegetables. For decades, health care professionals thought people with gout should avoid all foods high in purines. That's not the case anymore. You can say goodbye to long lists of eat-this-and-not-that foods. New research shows that not all high-purine foods must be nixed to control gout.
It is common for people with gout to have other conditions that are a part of "metabolic syndrome"—high blood pressure, high blood sugar, high cholesterol or triglycerides, and excess body fat around the waist. Therefore, a gout diet now looks very similar to a heart-healthy diet. A focus on vegetables, nuts, legumes, whole grains and fatty fish like salmon will not only prevent gout flares but will also keep you at a healthy weight and protect your heart.
Who Should Follow a Gout Diet?
If you get diagnosed with gout, your doctor will prescribe medication and lifestyle changes to help control uric acid levels. You should follow the gout diet long-term to reduce flare-ups from gout.
What's Allowed on a Gout Diet?
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The gout diet is no longer about all of the foods you can't have. Research shows that some foods, such as dairy products, may actually help reduce the number of gout flares.
"It is important to include a variety of fruits, vegetables, whole grains and beans or legumes into your diet," says Molly Cleary, R.D., dietitian at New York Presbyterian Hospital. "Even vegetables high in purines, which did not used to be recommended, should be safe to consume with gout," she says.
The American Association of Family Physicians (AAFP) also recommends eating vegetables, as well as consuming low-fat dairy products.
Foods You Can Eat
• Whole grains
• Some seafood
• Low-fat dairy products
What's Not Allowed on a Gout Diet?
"No foods need to be avoided altogether, but there are certain foods that should only be consumed in limited portions," Cleary says. "Limiting organ meats and certain types of seafood—anchovies, tuna, sardines, haddock and more—may help to decrease gout attacks. Other types of seafood, including salmon, shrimp and lobster, are lower in purines and should be fine in moderate amounts. Red meat and poultry should be limited to no more than 6 ounces per day."
The cardiovascular benefits from eating heart-healthy fish like salmon and tuna might outweigh the rise in uric acid they cause.
Cleary recommends replacing the protein you would be getting from meat "with nuts and nut butters, eggs, low-fat dairy, beans and soy-based products." It is safe to eat up to two daily servings of low-fat dairy.
The AAFP suggests restricting fruit juices and soft drinks with high-fructose corn syrup. Fructose can increase uric acid production. Refined carbohydrates should also be limited.
Finally, pay attention to the booze. "Alcohol can also increase uric acid production, so alcohol consumption should be limited as much as possible," Cleary says. According to a 2016 review in The American Journal of Medicine, wine is OK in moderation, but liquor and beer should be avoided as much as possible.
Foods to Limit
• Purine-rich meat and seafood (organ meats, shellfish, salmon, sardines, tuna, herring)
• Alcohol (especially beer and liquor)
• Beverages sweetened with high-fructose corn syrup
• Refined carbohydrates (including sugar)
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Other Considerations for People Living with Gout
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Some foods and lifestyle factors may reduce your risk of getting gout and help manage gout flares if they occur.
• Vitamin C: Vitamin C may help reduce uric acid levels. Talk to your doctor and ask if you should take a vitamin C supplement.
• Weight loss: "Gout is often associated with obesity, diabetes and kidney disease," Cleary says. "Therefore, it is important to achieve and maintain a healthy weight and follow dietary guidelines related to these conditions. Weight loss can also relieve stress on the joints."
• Water: Drinking water can reduce the number of gout flares. Water helps flush uric acid our of your body.
• Cherries: Eating cherries could reduce the number of gout attacks. In a 2012 study, participants who ate cherries over the course of two days had a 35 percent lower risk of gout flares following cherry intake than those who ate no cherries. Cherries might help gout flares by reducing uric acid levels.
• Coffee: Drinking six or more cups of coffee per day is associated with a 59 percent reduced risk of getting gout.
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