Dr. Scott Friedberg
Gout, a painful form of arthritis, has long been associated with diet, particularly overindulgence in meat, seafood and alcohol. As a result, gout treatment used to include severe dietary restrictions, which made the gout diet hard to stick to. Fortunately, newer medications to treat gout have reduced the need for such a strict diet.
Newer diet recommendations resemble a healthy-eating plan recommended for most people. Besides helping you maintain a healthy weight and avoid several chronic diseases, this diet may contribute to better overall management of your gout.
Gout occurs when high levels of uric acid in your blood cause crystals to form and accumulate around a joint. Your body produces uric acid when it breaks down purines. Purines occur naturally in your body, but you also get them from eating certain foods, such as organ meats, anchovies, herring, asparagus and mushrooms.
A gout diet helps to control the production and elimination of uric acid, which may help prevent gout attacks or reduce their severity. The diet isn't a treatment for gout, but may help you control your attacks. Obesity also is a risk factor for gout, so losing weight can help you lower your risk of attacks.
A gout diet reduces your intake of foods that are high in purines, such as animal products, which helps control your body's production of uric acid. The diet also limits alcohol, particularly beer, which has been linked to gout attacks. If you're overweight or obese, lose weight. However, avoid fasting and rapid weight loss because these can promote a gout attack. Drink plenty of fluids to help flush uric acid from your body. Also avoid high-protein weight-loss diets, which can cause you to produce too much uric acid.
To follow the diet:
- Limit meat, poultry and fish. Animal proteins are high in purines. Avoid or severely limit high-purine foods, such as organ meats, herring, anchovies and mackerel. Red meat (beef, pork and lamb), fatty fish and seafood (tuna, shrimp, lobster and scallops) are associated with increased risk of gout. Because all meat, poultry and fish contain purines, limit your intake to 4 to 6 ounces (113 to 170 grams) daily.
- Cut back on fat. Saturated fat lowers the body's ability to eliminate uric acid. Choosing plant-based protein, such as beans and legumes, and low-fat or fat-free dairy products will help you cut down the amount of saturated fat in your diet. High-fat meals also contribute to obesity, which is linked to gout.
- Limit or avoid alcohol. Alcohol interferes with the elimination of uric acid from your body. Drinking beer, in particular, has been linked to gout attacks. If you're having an attack, avoid all alcohol. However, when you're not having an attack, drinking one serving a day of wine is not likely to increase your risk.
- Limit or avoid foods sweetened with high-fructose corn syrup. Fructose is the only carbohydrate known to increase uric acid. It is best to avoid beverages sweetened with high-fructose corn syrup, such as soft drinks or juice drinks. Juices that are 100 percent fruit juice do not seem to stimulate uric acid production as much.
- Choose complex carbohydrates. Eat more whole grains and fruits and vegetables and fewer refined carbohydrates, such as white bread, cakes and candy.
- Choose low-fat or fat-free dairy products. Some studies have shown that low-fat dairy products can help reduce the risk of gout.
- Drink plenty of fluids, particularly water. Fluids can help remove uric acid from your body. Aim for 8 glasses a day. A glass is 8 ounces.
Following a gout diet can help you limit your body's uric acid production and increase its elimination. It's not likely to lower the uric acid concentration in your blood enough to treat your gout without medication, but it may help decrease the number of attacks and limit their severity.
Implementing the gout diet and limiting your calories — particularly if you also add in moderate daily exercise, such as brisk walking — can also improve your overall health by helping you achieve and maintain a healthy weight. There are many people who do it, and so can you!