Eating Guidelines for Gout

Introduction

Gout is a type of arthritis. It occurs when high levels of uric acid cause crystals to form in your joints and soft tissues, leading to inflammation, pain and swelling.

The amount of uric acid in your body depends on the following:

• The amount of uric acid your body makes and gets rid of.
  • Your body may naturally make a higher amount of uric acid or have more difficulty getting rid of it.
  • Certain medications (e.g. diuretics) and medical conditions (e.g. high blood pressure) can affect how much uric acid your body makes or passes (mostly through urine). It's important to keep taking your medications. Talk to your doctor before you stop taking any medications.
• The amount of purine that you eat.
  • Some food and beverages contain compounds called purines. Purines change to uric acid in the body. Meat and seafood are high in purine and can increase uric acid levels. Purines found in plant foods do not increase uric acid levels and are not a concern.

Gout is treated by taking medications that lower the uric acid levels in your blood and by diet and lifestyle changes. Gout often occurs with the following conditions. It's important to manage these conditions along with gout:

• overweight or obesity
• high blood pressure
• high blood cholesterol
• type 2 diabetes
• heart disease
• chronic kidney disease
• genitourinary (urinary and reproductive) diseases.

Talk to a registered dietitian if you need help with your diet for any of these conditions.

The focus of this handout is to give you ways you might lower your uric acid levels with diet and, therefore, lower your risk of gout flares or attacks.

Steps You Can Take

1. Follow a healthy diet that is low in saturated and trans fat. A diet rich in unprocessed, plant-based foods can help to decrease your risk of gout attacks and maintain your best overall health. Use the following information to help guide your food choices:
   • Keep portions of meats and seafood small. A serving is 75 g (2 ½ oz.). Since many people usually eat much larger portions, this can significantly lower the amount of purine you eat.
     • Fish is a healthy choice because it is high in omega-3 fats and low in saturated fat. If your fish intake is less than two servings per week, discuss the use of a fish oil supplement with your doctor, pharmacist, or registered dietitian.
   • Avoid organ meats (liver, kidney, sweetbreads, etc.) because they contain high levels of purine.
   • Choose vegetable protein sources more often: beans, lentils, tofu, and unsalted nuts and seeds. Although some of these foods contain purines, they are not linked with increases in uric acid or risk for gout symptoms.
   • Choose low fat milk (skim, 1%, 2%) and milk products. Examples include low fat yogurt (0%, 1%, 2%) or lower fat cheese (less than 20% M.F.). These foods have little to no purines and may help lower uric acid levels and risk of gout attack.
   • Make vegetables an important part of your diet. Aim to eat at least four servings of vegetables each day. Also, choose vegetables as a snack.
   • Choose whole fruit instead of juice. Aim to have at least three servings of fruit each day.
   • Avoid sugar and high-sugar foods and beverages such as pop, fruit drinks, specialty coffee and tea drinks, candy, and sugary desserts like pastries, donuts, cake, and cookies.
2. Limit alcohol. Even one or two drinks can increase your risk of a gout attack. One drink equals the following:
   • 341 mL (12 oz.) bottle of 5% beer, cider or cooler,
   • 142 mL (5 oz.) glass of 12% wine, or
   • 43 mL (1.5 oz.) shot of 40% spirits.

   All alcohol, and especially beer, can increase your risk of gout attacks. Avoid all alcohol if you have painful gout or you are having a gout attack. Talk with your doctor if you are unsure about alcohol use.

3. Stay well hydrated. Aim to drink 2-3 L (8-12 cups) of fluids each day. Water is your best choice.
4. If weight loss is a goal for you, choose a weight loss plan that encourages slow, steady weight loss. Rapid weight loss or following a diet high in animal protein is not recommended because it could increase uric acid levels in your blood and the chance of a gout attack. Your doctor or registered dietitian can help develop a plan that is tailored to you.

Last updated: November 2015