Gout diet: What's allowed, what's not

Gout is a painful form of arthritis that occurs when high levels of uric acid in the blood cause crystals to form and accumulate in and around a joint.

Uric acid is produced when the body breaks down a chemical called purine. Purine occurs naturally in your body, but it's also found in certain foods. Uric acid is eliminated from the body in urine.

A gout diet may help decrease uric acid levels in the blood. A gout diet isn't a cure. But it may lower the risk of recurring gout attacks and slow the progression of joint damage.

People with gout who follow a gout diet generally still need medication to manage pain and to lower levels of uric acid.

Gout diet goals

A gout diet is designed to help you:

• Achieve a healthy weight and good eating habits
• Avoid some, but not all, foods with purines
• Include some foods that can control uric acid levels

A good rule of thumb is to eat moderate portions of healthy foods.

Diet details

The general principles of a gout diet follow typical healthy-diet recommendations:

• Weight loss. Being overweight increases the risk of developing gout, and losing weight lowers the risk of gout. Research suggests that reducing the number of calories and losing weight — even without a purine-restricted diet — lower uric acid levels and reduce the number of gout attacks. Losing weight also lessens the overall stress on joints.
• Complex carbs. Eat more fruits, vegetables and whole grains, which provide complex carbohydrates. Avoid foods and beverages with high-fructose corn syrup, and limit consumption of naturally sweet fruit juices.
• Water. Stay well-hydrated by drinking water.
• Fats. Cut back on saturated fats from red meat, fatty poultry and high-fat dairy products.
• Proteins. Focus on lean meat and poultry, low-fat dairy and lentils as sources of protein.

Recommendations for specific foods or supplements include:

• Organ and glandular meats. Avoid meats such as liver, kidney and sweetbreads, which have high purine levels and contribute to high blood levels of uric acid.
• Red meat. Limit serving sizes of beef, lamb and pork.
• Seafood. Some types of seafood — such as anchovies, shellfish, sardines and tuna — are higher in purines than are other types. But the overall health benefits of eating fish may outweigh the risks for people with gout. Moderate portions of fish can be part of a gout diet.
• High-purine vegetables. Studies have shown that vegetables high in purines, such as asparagus and spinach, don't increase the risk of gout or recurring gout attacks.
• Alcohol. Beer and distilled liquors are associated with an increased risk of gout and recurring attacks. Moderate consumption of wine doesn't appear to increase the risk of gout attacks. Avoid alcohol during gout attacks, and limit alcohol, especially beer, between attacks.
• Sugary foods and beverages. Limit or avoid sugar-sweetened foods such as sweetened cereals, bakery goods and candies. Limit consumption of naturally sweet fruit juices.
• Vitamin C. Vitamin C may help lower uric acid levels. Talk to your doctor about whether a 500-milligram vitamin C supplement fits into your diet and medication plan.
• Coffee. Some research suggests that drinking coffee in moderation, especially regular caffeinated coffee, may be associated with a reduced risk of gout. Drinking coffee may not be appropriate if you have other medical conditions. Talk to your doctor about how much coffee is right for you.
• Cherries. There is some evidence that eating cherries is associated with a reduced risk of gout attacks.

Sample menu

Here's what you might eat during a typical day on a gout diet.

Breakfast

• Whole-grain, unsweetened cereal with skim or low-fat milk
• 1 cup fresh strawberries
• Coffee
• Water

Lunch

• Roasted chicken breast slices (2 ounces) on a whole-grain roll with mustard
• Mixed green salad with vegetables, 1 tablespoon nuts, and balsamic vinegar and olive oil dressing
• Skim or low-fat milk or water

Afternoon snack

• 1 cup fresh cherries
• Water

Dinner

• Roasted salmon (3 to 4 ounces)
• Roasted or steamed green beans
• 1/2 to 1 cup whole-grain pasta with olive oil and lemon pepper
• Water
• Low-fat yogurt
• 1 cup fresh melon
• Caffeine-free beverage, such as herbal tea

Results

Following a gout diet can help limit uric acid production and increase its elimination. A gout diet isn't likely to lower the uric acid concentration in your blood enough to treat your gout without medication. But it may help decrease the number of attacks and limit their severity.

Following a gout diet, along with limiting calories and getting regular exercise, can also improve your overall health by helping you achieve and maintain a healthy weight.