Gout is a form of inflammatory arthritis caused by high levels of uric acid in the blood. This condition often leads to painful swelling in the joints, especially the big toe. Diet plays an important role in gout management, and there are certain foods that can help lower uric acid levels. When it comes to fish, most types are considered safe for gout sufferers. However, there are a few varieties that should be limited or avoided due to their high purine content.
Quick Answer: Fish High in Purines to Avoid with Gout
Fish that are highest in purines and should be avoided or limited with gout include:
- Anchovies
- Herring
- Mackerel
- Mussels
- Sardines
- Scallops
- Trout
Understanding Purines and Gout
Purines are natural substances found in many foods. When purines are broken down in the body, they produce uric acid as a byproduct. A buildup of too much uric acid is what leads to gout and its associated symptoms like joint pain, stiffness, and swelling. People with gout need to follow a low-purine diet to help reduce uric acid levels in the body.
Purines are found in higher concentrations in certain foods, especially organ meats like liver and kidneys. They are also naturally abundant in some types of seafood, including anchovies, herring, mackerel, mussels, sardines, scallops, and trout. These fish are relatively high in purines compared to other protein sources.
While most other fish are considered gout-friendly, the varieties mentioned above should be limited or avoided altogether when following a low-purine diet for gout. Consuming too many high-purine fish can increase the risk of gout attacks and flare-ups in sensitive individuals.
Why Are Anchovies High in Purines?
Anchovies are small, common forage fish that are frequently eaten whole. These tiny fish are nutritious but very high in purines. A 3-ounce serving of canned anchovies contains:
- 389 calories
- 50.4 grams of protein
- 167 milligrams of omega-3 fatty acids
- 467 milligrams of purines
The high natural purine content makes anchovies a food to avoid if you suffer from gout or are prone to high uric acid levels. Just a few anchovies can provide a substantial amount of purines.
Anchovies are often included as a pizza topping or an ingredient in Caesar salad dressing. It’s best to omit anchovies from recipes or limit your intake to a very small portion if you need to follow a low-purine diet.
Why Herring Should Be Avoided with Gout
Herring is another small, oily fish that is high in essential nutrients. However, herring is also quite high in purines. A 3-ounce serving of Atlantic herring contains:
- 216 calories
- 22.8 grams of protein
- 1,050 milligrams omega-3 fatty acids
- 241 milligrams of purines
While the strong omega-3 content provides anti-inflammatory benefits, the high purine levels make herring a poor choice for those with gout. Herring is often pickled, smoked, or salted, which are preparation methods that may increase purine content even further.
Fresh herring can be baked, broiled, or grilled instead of pickled if you want to consume it in moderation. But it’s still best avoided altogether if you experience recurrent gout symptoms and flares.
Mackerel Contains Moderately High Levels of Purines
Mackerel is an oily fish that is common in European and Mediterranean cuisines. A 3-ounce serving of Atlantic mackerel provides:
- 205 calories
- 19.9 grams of protein
- 1,692 milligrams omega-3 fatty acids
- 148 milligrams of purines
While mackerel is not extremely high in purines, it contains a moderate amount and should be limited to a few times per month if you have gout. The healthy omega-3s provide an anti-inflammatory effect, but consuming mackerel too frequently can still trigger gout problems.
Smoked mackerel likely contains even higher purine levels and should specifically be avoided. Opt for fresh mackerel prepared by baking, broiling, or poaching instead of smoked varieties if you wish to consume it in moderation.
Why Mussels Are Not Ideal for Gout
Mussels are a type of small saltwater clam often served steamed or cooked in soups and pasta dishes. A 3-ounce serving of blue mussels contains:
- 146 calories
- 20.2 grams of protein
- 18 milligrams omega-3s
- 240 milligrams of purines
The high natural purine levels make mussels a food to use caution with in a gout diet. Consuming mussels frequently or in large portions is likely to aggravate gout symptoms.
Cooking methods can also influence purine content in mussels. Steaming instead of frying provides a lower-fat preparation, but may also help reduce purines compared to higher-fat cooking methods.
Why Sardines Should Be Eaten in Moderation with Gout
Sardines are tiny, oily fish that come canned, fresh, or frozen. A 3-ounce serving of Atlantic sardines canned in oil contains:
- 177 calories
- 23.8 grams of protein
- 1,362 milligrams omega-3s
- 240 milligrams of purines
The combination of oil and high heat from canning may increase the purine content of sardines. Fresh sardines or those canned without added oil are likely a better choice.
While sardines are very high in anti-inflammatory omega-3s, they contain a moderate amount of purines. People with gout should eat sardines and other small oily fish in moderation by limiting to just 1-2 servings per week.
Scallops Have Moderately High Purine Levels
Scallops are a type of saltwater clam often served broiled, baked, or fried. A 3-ounce serving of cooked scallops contains:
- 94 calories
- 17 grams of protein
- 260 milligrams omega-3s
- 170 milligrams of purines
Scallops contain fewer purines than some other shellfish, but still a moderate amount. It’s best to consume them infrequently or in smaller portion sizes if you have gout.
Broiling, baking, or poaching scallops may potentially help lower purines compared to frying in oil. But scallops will still be moderately high in purines regardless of preparation method.
Why Trout Contains Moderate Purine Levels
Trout is a freshwater fish that comes in several varieties like rainbow and brown trout. A 3-ounce serving of cooked rainbow trout contains:
- 144 calories
- 22 grams protein
- 500 milligrams omega-3s
- 147 milligrams purines
While not extremely high in purines, trout contains a moderate amount. Portion size and cooking method can also influence the purine content.
Frying trout likely increases purines, while baking, broiling, or poaching are lower-fat methods. Limiting portion size to 3-4 ounces can help reduce purine intake as well if you wish to consume trout.
Gout-Friendly Fish Choices
While certain high-purine fish should be limited or avoided, many types of fish can be safely consumed as part of a gout diet. Some of the best fish options include:
- Salmon
- Tuna
- Halibut
- Cod
- Haddock
- Perch
- Pollock
- Flounder
- Tilapia
- Orange roughy
- Snapper
These fish are lower in purines and make healthy, anti-inflammatory additions to the diet. Aim for 2-3 servings per week of these gout-friendly fish varieties.
Tips for Consuming Fish with Gout
If you have gout but don’t want to fully avoid fish, here are some tips for making it work in your diet:
- Consume low-purine fish like salmon or tuna most often
- Eat higher-purine fish only 1-2 times per month
- Limit portion sizes to 3-4 ounces
- Broil, bake, or poach fish instead of frying
- Avoid fish preparations like breaded fish, fish soups, or seafood mixes that may have hidden purines
- Balance fish intake with plenty of low-purine plant foods and lean meats
- Stay well hydrated to help flush uric acid from the body
With some care taken in food choices and preparation methods, most people with gout should be able to still enjoy fish moderately without aggravating symptoms.
Health Benefits of Fish Consumption
Despite some varieties being high in purines, fish provide many nutrients and health benefits. Here are some of the top reasons to include fish in your overall gout diet:
- High-Quality Protein – Fish provides protein that contains all essential amino acids for supporting muscle synthesis and function.
- Anti-Inflammatory Omega-3s – Omega-3 fatty acids like EPA and DHA have potent anti-inflammatory properties to help relieve joint pain and stiffness.
- Vitamin D – Fatty fish like salmon and mackerel are some of the few natural food sources of vitamin D.
- Vitamin B12 – Fish is an excellent source of vitamin B12, which supports nerve function and red blood cell formation.
- Selenium – Fish provides the antioxidant mineral selenium, which protects cells from damage.
- Lean Protein – Most fish is low in saturated fat, providing lean protein for heart health.
The beneficial fats and nutrients in fish make them a valuable addition to an overall healthy, gout-friendly diet. Focus on consuming the right fish in moderation to reap these advantages.
The Potential Risks of Avoiding Fish Entirely
While limiting high-purine fish makes sense for gout management, cutting out fish altogether could mean missing out on important nutrients. Some potential risks of avoiding fish entirely include:
- Inadequate intake of omega-3 fatty acids, which provide potent anti-inflammatory benefits
- Increased inflammation and pain symptoms without anti-inflammatory omega-3s from fish
- Higher risk for heart disease, stroke, and mental decline from lack of fish fats
- Insufficient intake of lean, high-quality protein for muscle health
- Increased gout risk over the long term from following an unbalanced diet
Totally eliminating fish could make it more challenging to meet all your nutritional needs. A gout diet free of all purines is unrealistic long term. With some adjustments, most people with gout can still fit fish into their diet in a way that reduces flare-ups.
Key Takeaways on Fish and Gout
Here are some of the top takeaways to remember about fish consumption with gout:
- Anchovies, herring, mackerel, mussels, sardines, scallops, and trout are highest in purines.
- Salmon, tuna, halibut, cod, and other whitefish are lowest in purines.
- Limit high-purine fish intake to 1-2 times per month.
- Enjoy low-purine fish 2-3 times per week.
- Bake, broil, or poach fish instead of frying to potentially reduce purines.
- Avoid fish soups, seafood medleys, or breaded fish as they likely contain hidden purines.
- Drink plenty of water to help flush out excess uric acid.
Being mindful of the fish you eat and how they are prepared can allow most people with gout to still benefit from moderate fish intake. Focus on low-purine choices and be cautious with very high-purine varieties.
In Conclusion
Fish can be part of an overall gout-friendly diet when chosen wisely. While certain fish like anchovies, herring, and mackerel are very high in inflammatory purines, other varieties like salmon, tuna, and tilapia are low-risk choices. Enjoy fish in moderation as part of a balanced approach for managing gout through diet and lifestyle.
