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Common Foot Problems FOOT HEALTH

List of Foods to Avoid With Gout (And What to Eat Instead)

What Is Gout and What Causes It?

Gout is a type of arthritis that can cause severe pain, redness, and swelling in the joints of the feet. Gout can occur in any joint but is most commonly seen in the great toe joints of the feet. Gout can also occur in the small toe joints, knees, elbows, and even fingers. 

Gout is extremely painful. When you have a gout attack, the affected joint becomes very inflamed.  That’s why gout is characterized as “inflammatory” arthritis. Symptoms include sharp, throbbing pain in the affected joint. 

Normally, uric acid is processed and passes through the kidneys. When there is high uric acid in the body, or there’s decreased excretion of uric acid in the kidneys, “hyperuricemia” occurs, and can trigger an attack.

Foods play an important role in relation to gout attacks because certain foods can contribute to increased levels of uric acid in the body. Diets high in purines, which are natural substances found in many foods, can lead to a higher production of uric acid. 

Purines are broken down into uric acid during the digestion process, and some foods are richer in purines than others.

In this article, you’ll learn what foods to avoid with gout and foods that you should eat instead. 

List of Foods to Avoid With Gout

red meat

Red Meat and Organ Meat

Red meats and organ meats should be avoided or limited if you have gout. They are high in protein and are broken down into uric acid. This can trigger a gout attack. 

Red meat, such as beef, venison, and lamb, contains high levels of purines. Eating these meats in large amounts can contribute to the development of gout and worsen foot pain. 

Organ meats like liver, kidneys, sweetbreads, and tongue are even higher in purines than red meat and should be avoided altogether if you have gout.

Although red meat and organ meats are a good source of protein, they are not the only source of protein. 

You can replace red meat/organ meat with white meat such as chicken.

Chicken also has purine, but lower amounts of it. You’ll want to avoid parts of the chicken that have high protein in it, like the liver.

It’s important to note that not all people with gout will be affected by red meat and organ meats in the same way. One person may be able to tolerate small amounts of these foods, while another may not.

seafood

Fish and Seafood

Certain seafood products are high in purines and should be avoided or at least limited. Avoid foods like shrimp, lobster, and crab that are high in purines. So are oily fish such as sardines, tuna, and anchovies. 

Other foods to avoid include herring, mussels, halibut, trout, and haddock. 

However, not all seafood needs to be avoided if you have gout. Some types of seafood like salmon, which is high in omega-3 fatty acids, can actually be beneficial for managing gout symptoms due to their anti-inflammatory effects. 

When choosing seafood, it’s important to focus on options that are low in purines. Japanese eel, sablefish, catfish, flounder, and tilapia are examples of seafood that are low in purines and can be included in your diet.

deli meat turkey

Processed Deli Meats

Avoid processed deli meats like pepperoni and salami. These foods have high purine content in them. 

Additionally, processed meats often contain added preservatives and nitrates, which can worsen gout symptoms. 

If you enjoy deli meat, opt for fresh, unprocessed varieties like turkey. 

beer

Alcohol

Alcohol consumption should be avoided or limited if you have gout. Beer, in particular, is high in purines and should be avoided. Wine and liquor should also be consumed in small amounts. 

Alcohol affects the kidneys’ ability to excrete uric acid from the body, leading to higher uric acid levels in the blood. 

Dehydration is also a common side effect of alcohol consumption, which can limit uric acid removal from the body and put you at a higher risk of developing kidney stones.

Diana Levey’s article in Creakyjoints.org suggests that when starting a new medication to manage hyperuricemia, alcohol intake should be limited for 6 months after starting the medication for maximum benefit.

Avoid alcohol completely if you suffer from severe, recurring attacks.

yeast

Yeasts

Foods that contain yeasts and yeast extracts can contain high amounts of purine in them. Canned soup and frozen dinners contain yeast extract to enhance their taste. 

These foods should be avoided with gout. It’s best to stick with fresh ingredients.

Processed Foods That Contain High Fructose Corn Syrup

High fructose corn syrup is a sweetening agent used in many foods and drinks to enhance flavor. It is commonly found in candy, sodas, fruit juices, ice cream, cookies, cupcakes, and pancake syrups. 

Consuming these foods and drinks can increase uric acid levels in the body, which can trigger gout attacks.

Even certain canned fruits and vegetables can contain excess sugars. When selecting canned foods, choose options that are low in sodium and added sugars.

foods to avoid and eat gout

Foods You Can Eat With Gout (Low Purine Foods)

A healthy diet is crucial and helps prevent gout attacks. 

Listed below are a variety of foods that you can eat safely eat with gout:

Low-Fat Dairy

Eat foods like low-fat dairy products. Low-fat dairy products like milk, cheese, and yogurt are a good source of calcium and vitamin D, which are important for bone health. These products also contain low amounts of purine. 

A study published in the New England Journal of Medicine found that eating low-fat dairy decreased the incidence of gout attacks.

One theory behind why low-fat dairy may be beneficial for gout is that it contains compounds that can help lower uric acid levels in the body. For example, low-fat milk contains orotic acid, which has been shown to help increase uric acid excretion from the body.

When incorporating low-fat dairy into your diet, it’s important to choose options that are low in fat and added sugars. 

For example, choose skim or 1% milk instead of whole milk. 

Plant-Based Foods

Adopting a plant-based diet can be beneficial for people who have gout. Plant-based diets are typically low in purines and high in fiber, antioxidants, and anti-inflammatory compounds, all of which can help reduce the risk of gout attacks.

Plant-based diets include whole, unprocessed foods such as fruits, vegetables, legumes, whole grains, and nuts. All of these foods have low purine content in them. 

These foods are also high in fiber, which can help with uric acid excretion. 

fruits and vegetables

Fresh Fruit and Vegetables

Fresh fruits and vegetables are a good choice for people who suffer from gout. 

According to a study published by the Published Library of Science (PLOS), there was no evidence to suggest that eating vegetables causes elevated urate levels. The study showed that eating a vegetarian diet was actually beneficial.

Vegetarian diets are usually high in fiber and low in purines, which can help reduce uric acid levels in the body. They also have anti-inflammatory effects. Some vegetables, such as mushrooms, and asparagus, are moderately high in purines and should be consumed in moderation. 

However, the benefits of consuming a variety of fruits and vegetables far outweigh the risks. 

Spinach, for instance, is low in purines. Spinach also contains antioxidants, vitamins, and minerals that can help reduce inflammation in the body, which is a key factor in gout.

cherries

Cherries

According to a study published by the Arthritis & Rheumatology Journal, cherries were found to be beneficial in patients with gout.

Tart Cherry Juice

The study was done on 633 individuals. They found that cherry intake over 2 days resulted in a 35% lower risk for developing gout. Both intake of cherries and cherry extracts were found to be beneficial.

coffee

Coffee

Coffee is a beverage that can be beneficial for managing gout symptoms. According to a study published in the American Journal of Clinical Nutrition, long-term consumption of coffee was found to lead to a lower incidence of gout. This is due to the antioxidant effect of coffee.

One reason coffee may be beneficial for gout is that it contains caffeine, which can help increase uric acid excretion from the body. Caffeine can also help reduce the inflammation, and thus can help with pain relief. 

vitamin c

Vitamin C

Consuming foods high in vitamin C can be beneficial for managing gout. Foods like citrus fruits, kiwi, strawberries, and bell peppers are all high in vitamin C and can help reduce inflammation and pain associated with gout.

Whole Grains

Whole grains like brown rice, quinoa, barley, and whole wheat pasta are low in purines and can help lower uric acid levels in the body. They are also rich in fiber, which can help with uric acid excretion. 

Also, whole grains contain essential vitamins and minerals. 

eggs

Eggs

Eggs are generally a healthy protein source with low amounts of purine in them and can be safely eaten with gout.

spices

Spices

Certain spices, such as turmeric, have an anti-inflammatory effect. This can be beneficial for patients who suffer from gout.

physical activity

Additional Lifestyle Modifications for Gout

Weight Loss

Losing weight can actually help reduce uric acid levels and thus reduce gout attacks. That’s why taking care of yourself and maintaining a healthy weight is so important. 

Avoid Drinking Excessively

As mentioned previously, alcohol consumption can increase uric acid levels and trigger gout attacks. Take care to limit the amount of alcohol you consume. 

Avoid Smoking

Smoking can increase the risk of gout. Not only that, smoking can make gout symptoms feel worse. Quitting smoking can improve overall health and reduce the risk of gout.

Stay Hydrated

Drinking plenty of water and other fluids can help flush out excess uric acid from the body. It is recommended to drink at least eight glasses of water per day.

Increase Physical Activity

Physical activity can help with weight loss, improve overall health, and thus reduce the risk of gout. Aim to do low impact exercises such as swimming or biking. These exercises are less likely to cause damage to your joints.  

Sample Menu of a Gout Diet (Foods to Eat With Arthritis)

There are many gout diet plans available online that you can follow. 

Here’s a sample of a non-vegetarian diet plan that includes a list of low purine foods:

Breakfast
  • Oatmeal made with low-fat milk/water
  • Fresh fruit (strawberry or banana)
  • Whole grain toast with a small amount of butter or jam
  • Coffee or tea
Lunch
  • Grilled chicken breast 
  • Brown rice or quinoa
  • Steamed or roasted vegetables 
  • Water or unsweetened iced tea
Afternoon Snack
  • Low-fat yogurt with fresh fruit
  • A handful of unsalted nuts
  • Hummus with vegetables
  • Water or herbal tea
Dinner
  • Grilled or baked fish, such as salmon or trout
  • Whole grain pasta with tomato sauce and vegetables (such as mushrooms and bell peppers)
  • Steamed or roasted vegetables 
  • A green salad
  • Water or coffee

Here is a list of a vegetarian diet plan that includes a list of low purine foods:

Breakfast
  • Oatmeal made with low-fat milk 
  • Whole grain toast with avocado 
  • Tea or coffee
Lunch
  • Lentil or vegetable soup
  • Whole grain bread or crackers
  • Raw or steamed vegetables 
  • Low-fat yogurt for dessert
  • Water 
Afternoon Snack
  • Raw veggies with hummus or salsa
  • A handful of unsalted nuts or seeds
  • Water or herbal tea

Dinner
  • Grilled or roasted vegetables, such as eggplant, zucchini, and peppers
  • Whole grain pasta 
  • Vegetable stir-fry with tofu or tempeh
  • Whole grain rice or quinoa
gout pain joint

Conclusion

Living with gout can be incredibly difficult, especially if you experience repeat attacks. Avoiding certain foods when you have gout and substituting them with healthier options can be beneficial in preventing repeat gout attacks and gout flare-ups. Less gout attacks will allow you to live more comfortably. 

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References

  1. Choi, Hyon K. M.D. Purine-Rich Foods, Dairy and Protein Intake, and the Risk of Gout in Men. The New England Journal of Medicine. 350;11. https://5280functionalmed.com/wp-content/uploads/2020/05/Purine-Rich-Foods-Dairy-and-Protein-Intake-and-the-Risk-of-Gout-in-Men-2004.pdf
  2. Zgaga, L., Theodoratou, E., Kyle, J., Farrington, S. M., Agakov, F., Tenesa, A., Walker, M., McNeill, G., Wright, A. F., Rudan, I., Dunlop, M. G., & Campbell, H. (2012). The association of dietary intake of purine-rich vegetables, sugar-sweetened beverages and dairy with plasma urate, in a cross-sectional study. PloS one, 7(6), e38123. https://doi.org/10.1371/journal.pone.0038123
  3. Zhang, Y., Neogi, T., Chen, C., Chaisson, C., Hunter, D. J., & Choi, H. K. (2012). Cherry consumption and decreased risk of recurrent gout attacks. Arthritis and rheumatism, 64(12), 4004–4011. https://doi.org/10.1002/art.34677
  4. Choi, H. K., & Curhan, G. (2010). Coffee consumption and risk of incident gout in women: the Nurses’ Health Study. The American journal of clinical nutrition, 92(4), 922–927. https://doi.org/10.3945/ajcn.2010.29565
  5. Reginato, A. M., Mount, D. B., Yang, I., & Choi, H. K. (2012). The genetics of hyperuricaemia and gout. Nature reviews. Rheumatology, 8(10), 610–621. https://doi.org/10.1038/nrrheum.2012.144
  6. Lanaspa, M.A., Andres-Hernando, A. & Kuwabara, M. Uric acid and hypertension. Hypertens Res 43, 832–834 (2020). https://doi.org/10.1038/s41440-020-0481-6
  7. Jeong, H., Jeon, C.H. Clinical characteristics and risk factors for gout flare during the postsurgical period. Adv Rheumatol 59, 31 (2019). https://doi.org/10.1186/s42358-019-0075-7

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Vaishnavi Bawa
Dr. Vaishnavi Bawa is a Podiatrist who specializes in treating foot and ankle pathology. LifesLittleSteps mission is to educate the public about foot health in an easy-to-understand manner using evidence-based medicine.
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