Gout is a form of inflammatory arthritis caused by high levels of uric acid in the blood. This painful condition causes swelling, redness, heat, and pain in the joints. Gout most commonly affects the big toe, but can also occur in the ankles, knees, wrists, fingers, and elbows. While gout is not curable, it is manageable through medication and lifestyle changes like diet. Making smart food choices can help reduce the frequency and severity of gout attacks. Certain foods are recommended for people with gout, while other foods should be limited or avoided.
What is gout?
Gout occurs when urate crystals build up in the joints and soft tissues. These needle-like crystals cause inflammation and intense pain. Urate (uric acid) results from the breakdown of purines, which are natural substances found in some foods. Purines get converted into uric acid, which is normally dissolved in the blood and excreted via urine. However, if there is too much uric acid in the blood, it can saturate and crystalize. Some factors that increase the risk of gout include:
- Genetics – some people are genetically predisposed to gout.
- Gender – men are more likely to develop gout than women.
- Obesity
- Diet high in purines
- Dehydration
- Excess alcohol consumption
- Certain medications like diuretics
- Underlying health conditions such as hypertension, kidney disease, and metabolic syndrome
Gout can go through cycles of flare-ups followed by remission. Attacks of gout are extremely painful and debilitating. While gout itself is not life-threatening, it can lead to potentially serious complications like joint damage and kidney stones if left untreated. Making dietary modifications is one of the key ways to manage gout attacks.
How does diet impact gout?
Diet plays a central role in gout as certain foods can either alleviate or exacerbate the condition. Foods that are high in purines and raise uric acid levels in the body are more likely to trigger gout flare-ups. Such foods include:
- Red meat and organ meats like liver, kidney, and sweetbreads
- Seafood like sardines, anchovies, shellfish, tuna, trout, and haddock
- Game meats
- Yeast extracts
- Beer and grain liquors
- Sugary drinks like soda and fruit juice
- Refined carbohydrates like white bread and pasta
On the other hand, certain foods may help lower uric acid levels and reduce gout symptoms. A gout diet should emphasize complex carbs, plant-based protein, dairy products, hydrating foods, nuts and seeds, olive oil, and spices like turmeric and ginger. Here are some of the top foods to eat for gout relief:
Complex carbohydrates
Complex carbs like whole grains, beans, and starchy vegetables have a low glycemic index, meaning they do not cause spikes in blood sugar. Consuming low GI foods is beneficial for gout patients as research indicates links between hyperglycemia and elevated uric acid levels. Fiber-rich complex carbs also promote satiety and weight management. Excellent choices include oats, brown rice, quinoa, barley, bulgur wheat, lentils, kidney beans, sweet potatoes, and butternut squash.
Plant-based proteins
Plant proteins are less likely to increase uric acid than animal proteins. Swapping meat for vegetarian protein sources a few times a week can make a difference. Legumes like beans, chickpeas, and lentils are great options. Tofu, nuts, seeds, and low-fat dairy also provide protein without raising purine levels.
Cherries
Cherries contain antioxidants like anthocyanins that help lower uric acid and curb inflammation. Eating 1⁄2 cup fresh or canned cherries daily, or drinking tart cherry juice, provides gout relief.
Berries
Like cherries, berries such as strawberries, blueberries, and blackberries are rich in antioxidants called anthocyanins. These compounds fight inflammation and reduce uric acid. Eat a cup of mixed berries a day.
Green leafy vegetables
Dark leafy greens are low in purines and high in fiber, vitamins, and minerals. Greens like spinach, kale, chard, collards, watercress, and arugula aid gout by promoting excretion of uric acid. Have a green salad every day.
Broccoli and asparagus
Cruciferous veggies broccoli and asparagus are associated with lower levels of uric acid. Eat them roasted, steamed or stir-fried.
Celery
Celery may help clear uric acid thanks to its high water and electrolyte content. Make a daily habit of snacking on celery sticks.
Tart cherry juice
Drinking tart cherry juice made from Montmorency cherries provides anti-inflammatory benefits for gout. Consume 8 to 16 ounces of tart cherry juice daily.
Milk and yogurt
Dairy is linked to reduced gout risk as the protein casein boosts uric acid excretion. Opt for low-fat or nonfat versions. Have a few servings per day.
Lemon juice
The citric acid and vitamin C in lemon juice support the kidneys in removing uric acid. Squeeze fresh lemon juice into water or tea.
Apple cider vinegar
Raw, unfiltered apple cider vinegar contains acetic acid that may help lower uric acid levels. Mix 1 to 2 teaspoons into water and drink once or twice a day.
Coconut water
The hydrating potassium and magnesium in coconut water promotes the passing of uric acid through urine. Drink one cup per day.
Olive oil
Olive oil contains oleocanthal, an anti-inflammatory compound that relieves gout pain. Use for cooking and drizzle over salads.
Ginger and turmeric
These aromatic spices have anti-inflammatory properties beneficial for gout. Use ginger and turmeric liberally in recipes and tea.
Foods to avoid with gout
In addition to eating gout-friendly foods, it is equally important to limit or avoid foods that raise uric acid levels and instigate flare-ups. These include:
- Organ meats like liver, kidneys, sweetbreads
- Red meat like beef, lamb, pork
- Shellfish, sardines, anchovies
- Fatty fish like trout, salmon, mackerel
- Beer and liquor
- Sugary beverages
- Sugars and high fructose corn syrup
- Refined carbs – white bread, pasta, rice, baked goods
- Processed foods
- Salty foods
- Yeast extract spreads
- Deli meats with preservatives like nitrates
- Dried beans and peas
When a gout attack flares up, avoid all purine-rich foods for a few days until the symptoms subside. Work closely with your doctor or dietitian to identify problem foods and create a personalized gout diet plan.
Sample menu for gout
Here is a sample one-day gout-friendly menu:
Breakfast
- 1⁄2 cup oatmeal cooked with low-fat milk, topped with 1⁄2 cup mixed berries and slivered almonds
- 1 cup low-fat plain Greek yogurt
- 1 cup freshly squeezed orange juice
Lunch
- Tuna salad sandwich on whole grain bread with lettuce, tomato, avocado
- Side salad of spinach, bell peppers, carrots
- 1 whole pear
Dinner
- Broiled salmon
- 1 cup quinoa
- Roasted brussels sprouts and butternut squash
- Tossed salad with mixed greens, chickpeas, olive oil, and lemon dressing
Snacks
- Low-fat cottage cheese with pineapple chunks
- Trail mix with unsalted nuts and dried tart cherries
- 8 oz tart cherry juice
Lifestyle changes for gout
In conjunction with diet, making certain lifestyle adjustments can further help manage gout:
- Stay hydrated – Drink at least 8 to 12 glasses of fluids daily, especially water.
- Limit alcohol – Avoid beer and liquor which contain high purines.
- Maintain ideal body weight – Obesity stresses the joints and worsens gout.
- Exercise regularly – Low-impact activities like walking, cycling, and swimming improve joint mobility.
- Stop smoking – Smoking worsens inflammation.
- Manage medications – Work with your doctor regarding medications that affect uric acid like diuretics.
The takeaway
Diet plays a key role in gout management. Focusing on foods that lower uric acid production while limiting intake of purine-rich foods can significantly reduce gout attacks. A gout diet should emphasize plant-based proteins, complex carbs, dairy, vegetables, nuts, seeds, cherries, and tart cherry juice. Avoid organ meats, seafood, sugary foods, and alcohol. Making smart food choices along with staying hydrated, exercising, and losing weight if needed can keep gout under control. Work with a doctor or dietitian to develop a customized meal plan that meets your health goals.
