Gout is among the oldest known types of arthritis, or inflammation of the joints.
The condition causes sudden, severe attacks of pain, stiffness, and swollen joints, most often in the big toe or other area of the foot.
While medications are commonly prescribed for treating gout, diet may also play an important role in both the prevention and management of the condition.
This article explains how gout is influenced by diet and provides a list of foods to eat and avoid as well as a sample menu of a gout diet.
What is gout?
Gout is an inflammatory disease that results from hyperuricemia, or high levels of uric acid in the blood.
The global prevalence of the condition ranges between 1% and 4% percent. The prevalence is much higher in adults 80 years and older, affecting up to 10% of men and 6% of women (1).
Gout attacks are triggered when uric acid crystals become deposited in and around your joints causing severe swelling, pain, redness, and tenderness.
These attacks often affect one joint — usually the big toe — but can also occur in the foot and ankle joints, knees, elbows, wrists, and knuckles.
The attacks may be triggered by a variety of factors, such as stress or illness, and normally subside within 3-10 days. Subsequent attacks may not occur for months or even years.
Overtime gout can worsen and cause the joints to become disfigured, making it harder to move them.
Causes and risk factors
Gout occurs when there is too much uric acid in the bloodstream, but not everyone with hyperuricemia develops gout (2).
The levels of uric acid in your body depend on the balance between its production and excretion.
Hyperuricemia results from uric acid overproduction, underexcretion, or a combination of the two.
The majority of uric acid is naturally produced by your body while the rest comes from your diet in the form of purines. Purines are natural substances in foods that your body converts to uric acid.
There are several risk factors linked with hyperuricemia, including:
- Medications: Certain diuretics, or water pills, increase the reabsorption of uric acid in your bloodstream (3).
- Chronic disease: Diabetes, heart disease, and obesity can negatively affect your kidney’s ability to excrete uric acid (4)
- Genetics: Certain genes may increase the reabsorption of uric acid and decrease its release in urine (5).
In addition to these risk factors, diet and excess body weight are also linked with an increased risk of gout.
Diet and weight as a risk factor
Several foods and dietary patterns are associated with a reduced risk of gout whereas others are associated with a higher risk.
In fact, one study showed that the DASH diet lowered uric acid levels within just 30 days with a sustained effect at 90 days (9).
The DASH diet emphasizes fruits, vegetables, lean proteins, low-fat dairy, and nuts and legumes, while limiting sweets and foods high in saturated fats.
In contrast, the Western diet, or standard American diet, is low in fruits and vegetables, and high in red and processed meats, pre-packaged foods, refined-grains, and sugary beverages.
Alcohol consumption, especially beer, is also associated with an increased risk of gout because it increases your body’s production of uric acid and limits its excretion.
A review of 17 studies found that moderate drinking — defined as one drink per day for women and two for men — was associated with a 58% higher risk of gout (10).
The same review also demonstrated that heavy drinking — defined as three or more drinks per day — was associated with a 164% higher risk of gout.
In addition to diet, a higher body mass index (BMI) and waist circumference is associated with an increased risk of gout (13).
That said, if you are overweight and have gout, losing weight can help you reduce uric acid levels and better manage the condition (14).
Foods to eat, foods to avoid
Several foods and beverages have been associated with an increased risk of gout, particularly those high in purines.
Purines are a natural component of many foods and are metabolized by your body to uric acid.
By limiting your intake of purines, you can lower the amount of uric acid your body produces, which may help reduce gout attacks.
But not all foods high in purines increase the risk of gout. Purine-rich vegetables, for example, are not associated with an increased risk of gout because the purines are poorly absorbed (15).
Foods that contain low to moderate amounts of purines, include:
- Fruits: Apples, apricots, avocado, bananas, berries, cherries, grapes, melons, oranges, etc.
- Vegetables: Arrowroot, asparagus, beans, beets, broccoli, cabbage, cauliflower, kale, lettuce, mushrooms, peppers, etc.
- Grains and legumes: Breads, pastas, rice, peas, lentils, and oats.
- Dairy: Low- and fat-free milk, yogurt, and cheese.
- Beverages: Water, tea, and coffee
Foods that contain high amounts of purines, include:
- Vegetables: Potatoes and tomatoes
- Seafood: Anchovies, sardines, tuna, scallops, trout, and shellfish
- Meat: Beef, pork, lamb, and bacon
- Poultry: Chicken and turkey
- Beverages: Beer, liquor, and wine
It’s not productive or worthwhile to completely avoid foods high in purines, but you should consume less of them.
Sample one-day gout diet menu
Here is a sample of a 1-day gout diet:
- 2 whole eggs
- 1 cup (80 grams) of oatmeal
- 1 medium-sized banana
- 1 cup (237 mL) of coffee
- 1 cup (227 grams) of Greek Yogurt
- 1 ounce (28 grams) of almonds
- 4 oz (112 grams) salmon
- 1 cup (174 grams) of white rice
- 10 spears of asparagus
- 1 apple, sliced
- 2 tbsp (32 grams) of peanut butter
- 2 cups (70 grams) of lettuce for salad
- 1/2 cup (130 grams) garbanzo beans
- 1/4 cup (28 grams) shredded cheese
- 1/4 avocado, chopped
- 2 tbsp (32 grams) of raw sunflower seeds
- 2 tbsp (17 grams) vinaigrette dressing
The bottom line
Gout is an inflammatory — and painful — condition that often affects your joints.
The condition typically occurs when there is too much uric acid in your bloodstream.
You may relieve some of the symptoms of gout by including mostly low-purine foods in your diet, such as fruits, most vegetables, grains and legumes, and dairy.