What to Eat on a Gout Diet and Foods to Avoid

A gout diet involves consuming foods that are low in purines, chemicals that break down to form uric acid, which is associated with gout attacks. Low-fat dairy, coffee, and citrus fruit are among the foods you can enjoy. However, organ meats, beer, and soda are types of foods high in purines that should be avoided.

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What Foods Are Safe to Eat?

Because uric acid levels trigger painful gout flare-ups, you want to choose foods that are low in uric acid and keep your total intake to below 6 mg/dl. Studies have shown that following a gout diet can reduce the frequency of gout attacks and the severity of symptoms in some people.

• Vegetables: Previously, researchers thought that people with gout should avoid certain vegetables. However, recent evidence shows that even eating vegetables rich in purine (like asparagus, spinach, and cauliflower) will not affect uric acid levels or increase the risk of a gout attack. Plus, eating veggies can help you reach and maintain a healthy weight, which lowers your risk of gout flare-ups.
• Dairy products: Studies have shown that the proteins in dairy products can help reduce uric acid levels naturally. Choosing low-fat products such as skim milk or low-fat yogurt will help you maintain a healthy weight as well.
• Tofu, whole grains, beans, and lentils: While you'll want to reduce your intake of meat and seafood on the goit diet, you should still consume about 10% to 35% of your calories from protein to meet the U.S. Department of Agriculture (USDA) recommendations. Plant-based proteins will help you meet those goals and may even protect against gout attacks.
• Citrus fruit: Although more research is needed, vitamin C may be an effective way to reduce the frequency of gout flare-ups. Vitamin C helps your body flush uric acid, and citrus fruits are a great source of this essential nutrient. Choose lower-fructose fruits such as grapefruit, oranges, or pineapple, as this natural sugar can increase uric acid levels.
• Cherries: Researchers have found that cherry consumption and 100% tart cherry juice lower serum uric acid levels. Anthocyanins—flavonoids with anti-inflammatory and antioxidant properties—found in cherries and tart cherry juice may help reduce inflammation associated with gout attacks.
• Coffee: Drinking a moderate amount of coffee does not seem to raise uric acid levels and may actually lower the risk of developing gout.
• Avocados: Avocados are naturally low in purines and contain monounsaturated fat and vitamin E. These components have anti-inflammatory and antioxidant effects that may help reduce pain and inflammation. Diets high in these compounds are also linked to a decreased risk of joint damage.
• Water: Water is always the best drink. Consuming at least eight glasses of water daily can reduce recurrent gout attacks by as much as 46%.

Avoid These Foods

Certain foods and beverages are more likely to cause symptoms and gout flare-ups. One study found that consuming a purine-rich diet increased the risk of recurrent gout attacks five-fold among those with gout, whereas reducing purine-rich foods helped reduce the risk of gout attacks.

The following are foods to avoid if you have gout or are at risk for developing it:

• Red meat and organ meat: Red meats are higher in purines than white meat. Higher consumption of red meat (including beef, venison, and bison) and organ meats (including liver, sweetbreads, tongue, and kidney) increases the risk of recurrent gout attacks.
• Coldwater fish, shellfish: Certain types of fish are known to be higher in purines and should be limited on a gout diet. These include coldwater fish (tuna, trout, herring, sardines, and anchovies) along with shellfish (shrimp, oysters, crab, and lobster).
• Yeast extract: Certain spreads, including Marmite, Vegemite, and Vitam-R contain yeast extract and are known to be high in purines. Avoid these to reduce uric acid levels.
• Beer and liquor: Most alcoholic beverages are not advised on a gout diet. Specifically, beer and liquor slow the excretion of uric acid. However, studies have shown that moderate consumption of wine is not associated with a higher incidence of gout.
• Sugary foods and beverages: Foods and beverages that contain fructose—particularly those that contain high fructose corn syrup—should be avoided on a gout diet. Limit or avoid sodas and other sugary drinks, canned fruit or fruit juice, and other high-sugar products, including snack bars, doughnuts, pastries, candy, and some breakfast cereals.
• White bread and honey: Carbs that are quickly digested and absorbed can raise blood sugar levels, which in turn can increase uric acid levels. Avoid refined carbs like white bread, white rice, cookies, and cake. Although honey is a natural sweetener, it is high in fructose. When the body breaks down fructose, it releases purines.
  

Sample Menu on the Gout Diet

A well-balanced gout diet reduces or eliminates purine-rich foods and supports maintaining a healthy weight. A day's meals that meet these goals might look like this:

• Breakfast: Oatmeal, a serving of cherries, low-fat cottage chees, coffee
• Lunch: Crunchy lettuce wrap with tofu, vegetables, and brown rice
• Dinner: Whole wheat pasta with mozzarella cheese and broccoli, citrus fruit salad

Almost anyone can follow the gout diet. Vegetarians, vegans, and those who follow a gluten-free diet can adjust their eating plan according to their program. People who eat a pescatarian diet or a Mediterranean diet may have a harder time because fish is limited on the plan. However, some experts, including those at the Arthritis Foundation, suggest that occasionally consuming certain types of fish may be beneficial.

Gout Doctor Discussion Guide

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Other Ways You Can Manage Gout Flare-Ups

A gout diet is generally part of a comprehensive treatment plan for gout. Other recommendations your provider may make include:

• Weight loss: Studies show that maintaining a healthy weight can reduce the frequency of gout flare-ups. However, do not crash diet since losing weight too quickly may trigger an attack.
• Exercise: Regular exercise can improve joint function and help you stay at a target weight. However, keep in mind that strenuous exercise can do more harm than good, and dehydration may raise the level of uric acid in the blood and trigger gout.
• Medication: For immediate relief from gout symptoms, your provider may recommend prescription-strength nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen. Corticosteroid injections may also be recommended to end a flare-up.
  

Key Takeaways

• You may be able to manage gout symptoms and reduce flare-ups by eating a low-purine diet of plant-based foods and whole grains.
• Avoid foods with high purine levels such as red meat, alcohol, and sugary treats.
• Incorporating other strategies such as maintaining a healthy weight, exercising, and using medication when needed can also ease flare-ups.

A Word From Verywell

Following a low-purine diet is not a cure for gout, but it can certainly reduce the risk of flares and minimize the need for prescription medications. Working with a nutritionist can be helpful in adhering to a new eating plan.

— ANITA C. CHANDRASEKARAN, MD, MEDICAL EXPERT BOARD