Gout diet: What’s allowed, what’s not

Diet choices can affect gout, a painful form of arthritis. Gout happens when high levels of uric acid cause crystals to form in the blood. The crystals build up in and around a joint.

Uric acid is made when a chemical called purine is broken down. Purine occurs naturally in the body. But it’s also in some foods. Purine from the body or food is broken down into uric acid and leaves the body as urine.

Changing your diet isn’t a cure for gout. But it may lower the risk of new gout attacks and slow damage to the joints.

People with gout who follow a diet to help with gout most often still need medicine to manage pain and to reduce levels of uric acid.

A diet to help manage gout includes a few main goals.

• Be at a healthy weight.
• Have good eating habits.
• Cut down on foods with purines.

Eating to manage gout includes moderate portions of healthy foods. It’s like other healthy diets, including the Mediterranean diet, the Mayo Clinic diet, and the Dietary Approaches to Stop Hypertension, also called DASH diet.

A diet for managing gout focuses on:

• Weight loss. Being overweight may raise the risk of getting gout. Losing weight may lower the risk Research suggests that cutting calories and losing weight may lower uric acid levels and cut the number of gout attacks. This is true even without a purine-restricted diet. Losing weight also lessens the stress on joints.
• Complex carbs. To get more of these, eat more fruits, such as berries, apples, peaches and cantaloupe. Also eat more vegetables and whole grains. Limit fruit juices, even those with no added sugar.
• Staying hydrated. Drink enough water to keep your body working well.
• Healthier fats. Cut back on fats that are most often solid at room temperature. These are saturated fats. They come from red meat, the skin on poultry and high-fat dairy products.
• Lean proteins. Focus on lean meat and poultry, low-fat dairy, and legumes such as beans, chickpeas and lentils as sources of protein.

Foods to limit when you have gout include:

• Organ and glandular meats. Don’t eat meats such as liver, kidney and sweetbreads. They have high purine levels and add to high blood levels of uric acid.
• Red meat. Limit serving sizes of beef, lamb and pork.
• Most seafood. Some types of seafood are higher in purines than are other types. These include anchovies, shellfish, sardines and codfish. But because seafood is healthy, even people with gout can include small amounts of fish in their diets.
• Alcohol. Beer and distilled liquors are linked with a higher risk of getting gout and having more attacks. Don’t drink alcohol during gout attacks. Limit alcohol, especially beer, between attacks.
• Sugar, especially high-fructose corn syrup. Limit or don’t eat foods sweetened with high-fructose corn syrup. These may include cereals, baked goods, salad dressings and canned soups. Too much sugar of any type may increase the risk of gout. So limit all sweetened foods.

Ask your healthcare professional about:

• Vitamin C. Vitamin C may help lower uric acid levels. Talk to your healthcare professional about whether a 500-milligram vitamin C supplement would be good for you.
• Coffee. Some research suggests that coffee may be linked with a lower risk of gout. Drinking coffee may not be OK if you have other medical conditions. Talk to your healthcare professional about how much coffee is right for you.

Some foods have no effect on gout, or may lower the risk of gout, including:

• High-purine vegetables. Studies have shown that vegetables high in purines don’t raise the risk of gout. Vegetables include green peas, asparagus and spinach.
• Cherries. Some studies show that eating cherries may lower the risk of gout attacks.

Here’s what you might eat if you have gout:

Breakfast

• Whole-grain, unsweetened cereal with skim or low-fat milk.
• Fresh or frozen strawberries with no added sugar.
• Coffee.
• Water.

Lunch

• 2 ounces roasted chicken breast 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

• Fresh or frozen cherries with no added sugar.
• Water.

Dinner

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

Following a diet designed to manage gout can help limit the amount of uric acid the body makes and can help your body get rid of it. Diet isn’t likely to lower uric acid level in your blood enough to treat your gout without medicine. But it may help lower the number of attacks you have and limit how bad they are.

Following a gout-focused diet, cutting calories and getting regular exercise also can help you get to and stay at a healthy weight. This can improve your overall health.