Best Diet for Gout: What to Eat, What to Avoid

by Marixie Ann Obsioma, MT, undergrad MD on March 14, 2024
Last updated on March 14, 2024

Gout represents a complicated type of inflammatory arthritis, often impacting the big toe. It’s reported that about 4% of adults in the United States suffer from this ailment. Research indicates that worldwide, the incidence of gout has risen in the last half-century. (1) (2)

Best Diet for Gout: What to Eat, What to Avoid

However, research also shows that the prevalence of gout varies greatly among different ethnic groups. The symptoms of gout can be non-specific sometimes, so the diagnosis of gout is made difficult. Once diagnosed, treatment involves relieving the symptoms as well as preventing future attacks.

Prevention of further episodes is important because if left untreated, gout can result in severe damage to the affected joint, which can cause disability. In case you suspect that you have gout or are already diagnosed with the condition, keep reading to learn more about gout.

What Is Gout?

Gout is a type of inflammatory arthritis caused by the buildup of too much uric acid crystals in the joints as a result of elevated blood levels of uric acid. Certain medical conditions, dietary habits, and genetic factors can all make it harder for your body to eliminate uric acid which can, later on, lead to gout. Gout is different from other forms of arthritis in that it can happen suddenly, which is known as a gout attack.

However, medical experts have noticed that gout actually comes in stages, not all of which are noticeable. The first stage of gout is asymptomatic hyperuricemia which is the period preceding a gout attack. It is characterized by elevated levels of uric acid in the blood and by the formation of needle-like crystals in the joints.

However, this stage is usually symptom-free. The second stage of gout is actual gout attacks characterized by deep, burning pain in the big toe. The third stage is called interval gout, which is characterized by low-level inflammation which can damage the joints. The last stage is chronic gout which can be prevented with proper treatment.

The Symptoms of Gout

As already mentioned, the main symptom of gout is burning pain in the big toe. People often report waking up in the middle of the night feeling like their big toe is on fire. The pain is mostly severe enough to prevent the person from standing, and even the lightest pressure on the affected joint becomes unbearable. The pain of gout is also followed by swelling and redness in the affected area.

The affected joint will often feel warm and tender. These symptoms often occur with the first gout attack and the majority of people experience it in just one of their big toe joints. This is the joint connecting your big toe with your foot. If left untreated, gout can start to occur in other joints in the lower extremities, such as the ankles and knees.

Over time, gout can become chronic and impair one’s ability to move normally. But when treated, joint pain caused by gout dies down in a matter of a few weeks, although most people will still experience constant but mild pain.

The Causes of Gout

Gout is caused by elevated levels of uric acid in the bloodstream. Uric acid is a byproduct of the breakdown of a compound found in many foods we eat called purine. Usually, the body is able to eliminate most uric acid through urine, but sometimes, this ability is impaired.

A diet high in meat as well as drinking too much alcohol, can interfere with the elimination of uric acid. Kidney diseases, hemolytic anemia, and hyperthyroidism also increase a person’s risk of developing gout. According to MedlinePlus, some groups are at a higher risk of developing gout than others. (3)

For instance, men are more likely to develop gout than women, but women are more likely to develop gout after menopause. Gout is also recognized as a hereditary disorder, with an estimate of 20-80% of people with gout showing a family history of the disease.

A study published in the American College of Rheumatology found that people on the Marshall Islands had a gout prevalence of 85% while Papa New Guinea had a 1% prevalence of gout which proves the genetic component of gout. (4)

Diagnosing and Treating Gout

Diagnosing gout can be difficult because the symptoms are similar to other forms of arthritis. A doctor may have to take a sample of the synovial fluid from your joint, which will be examined under the microscope to see if there are any uric acid crystals present. Doctors may also look for these crystals in other joint tissue before making a definitive diagnosis.

Once you are diagnosed with gout, doctors will help you get relief through pain medication such as Non-steroidal anti-inflammatory drugs (NSAIDs). You will also be prescribed corticosteroids to help reduce the inflammation and a drug made specifically for gout called Colchicine that should be taken within 12 hours of a gout attack. Treatment for gout also entails making dietary and lifestyle choices that will help prevent future attacks. Avoiding foods high in purine such as anchovies, asparagus, liver, mackerel, scallops, mushrooms, and others will help lower uric acid levels in your blood.

Best Diet for Gout That You Should Start With

Being overweight increases uric acid production and hinders the amount that can be removed from the kidneys. Obesity and being overweight can also impact the way the body breaks down sugar. This, in turn, can cause spiking uric acid levels. There is no quick solution that will immediately get rid of the pain. That’s why doctors suggest watching what you eat with gout.

A gradual drop in weight should curb the severity and frequency of gout flare-ups. Patients are advised to avoid yo-yo dieting, crash diets, and fasting. That’s because options such as these can make the kidneys hold onto uric acid and exacerbate the symptoms. A properly-balanced gout diet can help turn the tide. Here is what that looks like.

Decreasing the Purine Levels

To stabilize the flares, you should know the gout triggers. You really don’t want them causing havoc to your system. Foods that cause gout problems are meat, particularly organ meats, and sweetened beverages. Using crash diets or fasting can drop the weight too quickly and spike the chances of a gout attack. (5)

When it comes to selecting a beneficial gout food list, patients are advised to enjoy a balanced and healthy diet. But decrease the number of high purine foods they munch on. The goal is to aid the body in preventing sudden gout attacks and curb the odds of flare-ups. At the same time, a low purine diet can be highly beneficial.

High-purine consumables include:

  • Foods packed with refined sugar (such as cakes and biscuits)
  • Sweetened beverages (i.e. fruit juices, fizzy drinks, and various soft drinks)
  • Offal (for example kidney and liver)
  • Alcohol (mainly fortified wine, ale, beer, and port)
  • Seafood (for instance clams, mussels, and prawns)
  • Game (such as venison, rabbit, and pheasant)

Low-purine consumables include:

  • Veggies and fruits
  • Eggs
  • Dairy and dairy-free alternatives
  • Cereals and bread
  • Noodles, rice, and pasta

When it comes to eating fish, red meat, and poultry, experts advise that these consumables should be eaten in moderation. It is necessary to avoid overeating, particularly overindulging in red meat. The high-purine options are the foods to avoid with gout. (6)

Options like tofu, coffee, cherries, citrus fruits, lentils, and beans are considered compliant foods. And yeast extract, liquor, and Coldwater fish are seen as non-compliant foods. Focusing on plant-based proteins can come a long way. They are a great option for managing the condition.

  • A gout diet means decreasing the intake of seafood and meat. But, still getting roughly 15% to 30% of the calories from protein.

Data indicates that plant-based oils, like soy, sunflower, and olive oil could protect the body against gout attacks. Vitamin C was also found to boost renal excretion of uric acid. Thus, it could be considered as a viable supplement for managing this condition. (7)

That’s where citrus fruits packed with vitamin C come into play. They make for a practical addition to any gout diet and can be effective in decreasing the frequency of flare-ups. The reason why many experts recommend vitamin C is that this vitamin helps the system excrete uric acid naturally.

It is also packed with nutrients and benefits overall health. Research shows that increased vitamin C intake is linked with lower gout risk. And supplemental vitamin C might offer some benefit in preventing this condition. Eating cherries can also help. (8)

One study that evaluated 633 patients with gout studied the effect of this food on this condition. After two days, there was a 35% decreased risk of gout attacks compared to those who didn’t eat cherries. However, the effect of cherry intake has a lot to do with your current health state, obesity, and purine intake. So, cherries alone can’t fix the damage caused by unhealthy eating habits and alcohol abuse. Therefore, it is essential to build a long-term balanced eating pattern to reap the benefits. (9)

Is Corn Bad for Gout?

Gout flare-ups require an excessive amount of purine to get out of hand. So, eating corn shouldn’t be that big of a problem. But, some foods that you do eat with corn can lead to flare-ups. Many people with gout react to alcohol and pork, all of which are super popular on barbeques with corn. When deciding to eat corn, know what you are eating.

For example, if it is canned corn, read the ingredients. Some canned products are packed with sugar or fructose syrup. So you might want to refrain from eating those with gout. Overall, enjoying corn on the cob is very unlikely to be causing gout issues. But, if you are worried about what you should or shouldn’t eat, then talk to a specialist. They can offer you a detailed guideline of the foods that work well for your current health state.

What Foods Help Gout Go Away?

What can I eat for breakfast with gout? This is a common question among those struggling with the condition. Experts suggest you enjoy low-fat yogurt with some berries to create that healthy and gout-friendly meal. Eating some citrus fruits on the side can really be of use. Since they can decrease uric acid levels. However, if you are taking colchicine for gout management, then avoid grapefruit. It could interact with the medication you are taking. (10)

Avocados can be advantageous with gout. They are packed with vitamin E and feature an abundance of minerals, vitamins, and antioxidants. Avocado is naturally low in purines, meaning you can depend on this food in the long run. Bananas can work as well. They are rich in vitamin C and low in purines. They are fruits that won’t trigger gout in people and are healthy to eat.

But, not all fruits will make for a worthwhile choice. So, what fruits are not good for gout? Fructose supplies some veggies and fruits with a natural sweetness. There is a clear link between gout problems and foods high in fructose. Experts believe they can get in the way of chronic pain. For example, dates, prunes, plums, and peaches. It’s alright to be eating these fruits with gout. But that’s best done in moderation. If you are limiting the intake to 1 to 2 cups a day, then it can be easier to mitigate the gout symptoms. (11)

Choosing Fluid to Curb Gout

Experts are still trying to identify the exact cause for the overnight flare-ups with gout. But, more research is necessary to study this health issue. Overall, there could be one or a combination of factors. One of them is dehydration.

People who don’t get enough water during the day can experience a problem with their joints at night. That’s primarily due to the fact that dehydration causes higher uric acid concentration in joint fluid. When we are asleep, a portion of the water in the joint’s fluid gets reabsorbed into the system. But, uric acid stays in the joint. The bigger its concentration, the higher the odds of it spurring uric acid crystal formation.

When asleep, the body can sweat. This causes a loss of moisture, which means that the blood loses a bit of its water content. Dehydration in the joints and blood could prompt a gout attack. As the body loses water, its uric acid concentration amplifies. Meaning that it can lead to or worsen hyperuricemia. (12)

So, what you can do is drink plenty of water the entire day. At least 2 liters (68 ounces) a day. Ideally, you should be drinking more in summer and when doing physical activities. The body will quickly deplete its water sources at that time. Therefore, it is critical to keep replenishing them. It’s also important to keep the joints lubricated to prevent the pain from getting worse.

Smoothies and freshly squeezed juices may not be a good idea with gout. They can spike the uric acid level and trigger a flare-up. What you can do is drink coffee, tea, and water without added sugar. Patients with chronic kidney disease or those on dialysis should consult a specialist about their fluid levels.

Conclusion

Gout is a painful form of arthritis initially affecting one joint but that can also affect other joints if left untreated. Luckily, most people diagnosed with the condition are able to retain their functioning and joint mobility with the help of current treatment options. If you suspect that you have gout, don’t wait for your pain to spontaneously resolve. The buildup of urine crystals caused by elevated uric acid can affect other joints soon on and even irreversibly damage your affected joint. This is why the treatment of gout is so important. But, what shouldn’t be ignored with gout is the food you eat. Your dietary choices have a major role to play. And in this guide, you can learn how to eat the right way. Talk to your healthcare provider to know which dietary option is tailored to your needs.

References

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