Dietitian Recommended Diet for Gout

Get to know the essential information on how diet can impact gout!

Gout can be a pain, literally! Gout is a type of inflammatory arthritis that occurs when uric acid builds up in the body and forms crystals that deposit in joints, causing pain. Joint pain often shows up in the feet, but can also occur elsewhere in the body.

Risk Factors for Gout

A few factors that increase the risk for gout include:

• Genetics (some people produce more uric acid and metabolize it differently than others)
• Reduced estrogen levels
• High blood pressure
• Heavy drinking
• Chronic kidney disease
• Overeating
• Prolonged fasting
• Certain medications such as diuretics

The first line of treatment for gout is starting medication prescribed by your medical provider, however, diet may also play a role.  

What does diet have to do with gout?  

Purines are typically the target of dietary management for gout because they are broken down into uric acid in the body. Purines are compounds that make up DNA and are found in all foods and all cells in our body. Because of this, they cannot be completely eliminated from our diet.

It is important to note that 2/3 of purines in the body are produced by the body itself. The remaining 1/3 comes from our diet. When we look at food, meat (organ meats in particular) and seafood are highest in purines and appear to have some impact on uric acid levels when consumed in high amounts. It is interesting as purines in plant-based foods such as beans, legumes, vegetables, and soy have not been shown to impact uric acid levels in comparison to animal protein. This may be due to their fibre content. Because of this, it is recommended to include more plant-based meals and be mindful of your portions of meat and seafood.

To follow a “gout diet” or for a list of gout foods, here are some practical recommendations: 

• Try a vegetarian chili that uses only beans and/or lentils instead of using ground meat. Here is a great recipe to try!  
• Try using canned lentils in place of ground meat in recipes such as tacos or burritos.  
• Use tofu in a stir fry instead of meat. 
• When meat and seafood are included, aim for reasonable-sized portions- which would be around the size of the palm of your hand. 
• For more plant-based meal ideas, click here. 

It is important to note that it is impossible to completely eliminate dietary purines and there is no recommended amount of purines to consume per day to avoid gout. Dietary changes have the potential to lower uric acid levels by 15%, however gout attacks can still happen and it is important to follow your medical provider’s recommended treatment plan.  

Are there foods to avoid for gout?

Gout triggers seem to vary person-to-person with some individuals unable to identify any triggers at all! A common trigger for a gout attacks is alcohol, particularly heavy or binge drinking. Beer in particular appears to be a gout trigger for some individuals as it is high in purine content. Reducing alcohol intake is not only beneficial for gout, but also has other health benefits.

Another potential trigger is high intake of high-fructose corn syrup, particularly from sugar sweetened beverages such as regular pop and juice. This has been shown to increase uric acid levels for some individuals and can potentially lead to a gout attack. Including alternative drinks such as water, sparkling water, or milk is recommended to reduce high-fructose corn syrup intake.  

Remember it does not need to be all or nothing! Aiming for a generally balanced diet with variety is key. Changing diet alone is only thought to lower blood urate levels by about 15% so it is important to follow your medical provider’s treatment plan for your gout.

Good food for gout

There is some mixed evidence that vitamin C may help gout attacks, but according to the American College of Rheumatology, vitamin C supplements are not recommended due to the lack of evidence supporting their benefit for gout. Vitamin C does have additional benefits such as supporting our immune system so it doesn’t hurt to include some vitamin C-rich foods in your diet such as oranges, grapefruits, kiwi, strawberries, broccoli, white potatoes, and bell pepper.

Dairy has also been shown to potentially help with gout flares, but the evidence is not clear. Including 2-3 servings of dairy per day may provide benefits outside of gout including providing calcium for bone health and protein for general nutrition. Adding dairy to your day may look like having 1 cup of milk or fortified milk alternative in cereal, including cheese with fruit as a snack, and having 1 container of yogurt at lunch.

Tart cherry juice has been studied for gout and has been shown to reduce uric acid levels in healthy individuals, but this has not been shown in those in a gout flare so it is not routinely recommended.  

How can a Dietitian help?

If you are feeling confused with how to manage your diet related to gout connecting with a registered dietitian is the best place to start! A registered dietitian (RD) can help you figure out what foods to eat if you have gout to lower purine levels. They offer personalized advice specific to your lifestyle, tastes, conditions and more. Connect with a Registered Dietitians on our team today. 

The bottom line

Gout triggers can vary person to person but generally to follow a “gout diet” it is considered helpful to limit alcohol, sugar sweetened beverages, and large amounts of meat and seafood. Meat and seafood can be included, but it is recommended to be mindful of portion size and to implement a few vegetarian options in the week for variety. Remember it does not need to be all or nothing! Aiming for a generally balanced diet with variety is key. Changing diet alone is only thought to lower blood urate levels by about 15% so it is important to follow your medical provider’s treatment plan for your gout.

If you are feeling confused with how to manage your diet related to gout connecting with a registered dietitian is the best place to start! 

References:

• Frank, J. (2020, September 28). What are purines? Arthritis-health. 
• FitzGerald, J.D., Dalbeth, N., Mikuls, T., Brignardello-Petersen, R., Guyatt, G., Abeles, A.M., Gelber, A.C., Harrold, L.R., Khanna, D., King. C., Levy, G., Libbery, C., Mount. D., Pillinger, M.H., Rosenthal, A., Singh. J.A., Sims, J.E., Smith B.J., …Neogi, T. (2020). 2020 American College of Rheumatology guidelines for the management of gout. Arthritis Care & Research, 0 (0), 1-17.
• Perez-Ruiz, F. (2021, December 13). Patient education: Gout (beyond the basics). UpTo Date.
• Pfiffner, M. (2022, September 29). Gout. Examine.