What Foods Should You Avoid With Gout?

Living with gout often requires careful attention to dietary choices, as certain foods can significantly influence the body's uric acid levels. Elevated uric acid, a condition known as hyperuricemia, is the primary driver behind gout, a painful form of inflammatory arthritis. To effectively manage gout and mitigate the frequency and severity of flare-ups, it is generally recommended to limit or avoid foods rich in purines, such as red meat, alcoholic beverages, and specific types of fish and shellfish. These dietary components contribute to the buildup of uric acid crystals in the joints, leading to the characteristic excruciating pain and swelling of a gout attack.

Conversely, a gout-friendly diet emphasizes foods that are low in purines or can help lower uric acid levels. This includes incorporating a variety of whole grains, fresh vegetables, and low-fat dairy products. Foods abundant in vitamin C are also beneficial due to their potential to aid in uric acid excretion. This article will delve into the intricate relationship between diet and gout, providing a comprehensive guide on which foods to approach with caution and which to embrace, along with practical strategies for managing gout symptoms through informed nutritional choices.

Verywell / Alexandra Gordon

How Foods Affect Gout

Gout is a distinct form of arthritis characterized by the accumulation of uric acid crystals within the joints, leading to sudden, severe episodes of pain, swelling, redness, and tenderness. This debilitating condition arises from hyperuricemia, where the body contains an abnormally high concentration of uric acid. Epidemiological studies from both the United Kingdom and the United States highlight gout as the most prevalent type of inflammatory arthritis affecting their respective populations. While genetic predispositions and various underlying medical conditions can contribute to gout development, dietary habits play a profoundly direct and impactful role in its onset and progression.

The influence of diet on gout is evident in cultural patterns, where higher incidences of the condition are observed in populations consuming large quantities of red meat, processed foods, and sugary items—all known to be high in purines. A notable 2017 study underscored this connection by comparing individuals adhering to a typical Western diet with those following the Dietary Approaches to Stop Hypertension (DASH) diet. The findings revealed that the DASH diet, rich in fruits, vegetables, and whole grains, was associated with a reduced risk of gout, whereas the Western diet, characterized by its processed and high-purine content, was linked to an increased risk. This compelling research reinforces the significant link between dietary choices and gout management.

Purines are naturally occurring chemical compounds found within the cells of both your body and the foods you consume. When your digestive system processes foods containing purines, uric acid is generated as a metabolic byproduct. Although the majority of this uric acid is reabsorbed by the body, the remainder is typically eliminated through urine and feces. However, when the body's purine load is excessively high, or when there are underlying health issues, its ability to fully process and excrete uric acid becomes overwhelmed. This leads to an undesirable accumulation of uric acid in the bloodstream, resulting in hyperuricemia.

While dietary intake of high-purine foods can independently trigger hyperuricemia, the risk is significantly amplified in individuals who also contend with certain medical conditions. These conditions can impair the body's ability to efficiently process and excrete uric acid, making them more susceptible to gout flare-ups even with moderate purine consumption. Such underlying health concerns include chronic kidney disease, diabetes, hypertension (high blood pressure), psoriatic arthritis, and recent instances of infection, injury, or surgery. Understanding these contributing factors is essential for a holistic approach to gout management and prevention.

What Foods Should You Avoid With Gout?

If you have been diagnosed with hyperuricemia or gout, a critical step in managing your condition involves discussing dietary modifications with your healthcare provider. It is generally advisable to significantly limit or, in some cases, completely eliminate foods that are known to be high in purines. These dietary components can directly contribute to elevated uric acid levels, increasing the likelihood of painful gout flare-ups. Key categories of foods and beverages to reconsider include excessive sugars and fruits high in fructose, sugary drinks, heavily processed foods, most red and organ meats, certain types of fish and shellfish, alcoholic beverages, and specific yeasts. Making these conscious dietary adjustments can be instrumental in preventing and effectively managing gout episodes.

Sugars and Fruit

Research consistently indicates that sugars, particularly fructose, play a role in elevating uric acid levels within the bloodstream. Fructose, a natural sugar found in many foods, is also a primary component of high-fructose corn syrup, which is widely added to processed products. Therefore, consciously avoiding or significantly limiting foods and beverages high in fructose may be a beneficial strategy for individuals aiming to reduce the frequency and intensity of gout symptoms. This dietary modification can directly impact the metabolic pathways that contribute to uric acid production, offering a proactive approach to managing the condition.

Fruit juices and beverages sweetened with sugar have been strongly linked to both hyperuricemia and gout. While some fruits naturally contain high levels of fructose, ongoing research is needed to definitively determine if they exert the same uric acid-raising effect as their processed juice counterparts and other sweet drinks. If you live with gout, a complete avoidance of all fruit is generally unnecessary. However, incorporating certain strategies can be helpful: limiting or avoiding fruit juices, being mindful of high-fructose fruits like apples, pears, mangoes, figs, watermelon, and dried fruit, and observing how these changes impact your specific gout symptoms to tailor your diet effectively.

What's One Serving of Fruit?

• A small apple or orange
• A small banana (less than 6 inches long)
• 4 ounces (1/2 cup) of juice
• 1 ounce (a palmful) of dried fruit
• A half-cup of fresh fruit

Sugar in Beverages

Sodas and other sugary beverages are commonly referred to as "empty-calorie" foods because they offer minimal, if any, beneficial nutrients while significantly contributing to one's daily caloric intake. Beyond their nutritional deficit, these drinks can also exacerbate the risk of gout flare-ups. A comprehensive 2020 research review, analyzing multiple studies, consistently identified a significant association between fructose found in sugar-sweetened beverages and an increased risk of both gout development and hyperuricemia. This reinforces the importance of scrutinizing liquid calories when managing gout.

In addition to fruit juices, it is highly advisable for individuals with gout to minimize or eliminate other types of sugar-sweetened beverages. These include common culprits such as sodas, energy drinks, sports drinks, and sweetened coffee concoctions. By consciously choosing to limit or avoid these high-sugar liquids, you can significantly reduce your intake of fructose, which in turn can help manage your uric acid levels. Prioritizing plain water or unsweetened alternatives is a simple yet effective strategy for supporting gout management and overall health.

Processed Foods

The typical Western diet, often characterized by its abundance of highly processed foods and refined carbohydrates, has been consistently linked to an elevated risk of gout. Beyond its association with gout, this dietary pattern is also implicated in the development and progression of numerous other serious health conditions, including type 2 diabetes, heart disease, and the pervasive challenges of weight gain and obesity. The detrimental impact of processed foods extends far beyond just uric acid levels, affecting multiple facets of metabolic and cardiovascular health.

By proactively eliminating highly processed and refined-carb foods and beverages from your diet, you can significantly contribute to both the prevention and effective management of gout and its associated symptoms. These types of foods offer little nutritional value and often contain ingredients that can disrupt metabolic balance. Specifically, it is beneficial to avoid items such as candy, a wide array of baked goods including muffins, pastries, cookies, and cakes, white bread, chips and crackers, ice cream, certain frozen meals, and most fast food options. Embracing a diet rich in whole, unprocessed foods can greatly support your health journey.

Red Meat and Organ Meat

Red meats and organ meats are widely recognized as high-purine foods, making them significant contributors to elevated uric acid levels and an increased risk of gout episodes. Numerous studies have consistently demonstrated that regular consumption of these particular meats can trigger or exacerbate gout flare-ups. To effectively minimize this risk, it is crucial to keep the intake of these specific red meats and organ meats at a low level, adhering to dietary recommendations that prioritize lower purine alternatives.

This category includes common red meats such as beef, bison, venison, and other forms of wild game, all of which contain substantial purine content. Furthermore, organ meats like liver, heart, sweetbreads, tongue, and kidney are particularly rich in purines and should be largely avoided by individuals managing gout. It is also important to recognize that many meat-based soups, gravies, and processed meats such as salami and pepperoni can contribute to the risk of gout flare-ups due to their purine content. While chicken has moderate purine levels, it is generally considered acceptable in moderation, unlike its higher-purine counterparts.

Getting Enough Protein Without Meat

You can still get enough protein in your diet while limiting the amount of animal protein you eat. Eggs, beans, nuts, low-fat dairy, tofu, and some (but not all) seafood are good choices.

Fish and Seafood

When managing gout through diet, it's essential to understand that certain types of seafood are considerably high in purines and should be largely excluded from your eating plan. However, not all seafood falls into this high-risk category; other varieties contain moderate purine levels and can be consumed in limited quantities, typically less than 6 ounces per day. This nuanced approach allows for some flexibility while prioritizing gout management.

Fish and Seafood to Avoid:

• Anchovies
• Codfish
• Haddock
• Halibut
• Herring
• Jack mackerel
• Mussels
• Sardines
• Trout
• Tuna

Fish and Seafood in Moderation:

• Lobster
• Crab
• Shrimp
• Oysters
• Clams
• Salmon

Fatty fish, such as tuna and salmon, are widely celebrated for being excellent sources of omega-3 fatty acids, which are generally associated with numerous health benefits. However, it's important to note that these fish also contain higher levels of purines. While some research suggests a potential link between omega-3-rich fish (though not omega-3 supplements) and a reduced risk of gout flare-ups, further extensive research is necessary to fully comprehend these findings and provide definitive dietary recommendations. Therefore, moderation remains key even for these otherwise healthy choices.

Alcohol

The consumption of alcohol has a well-established association with gout flare-ups, making its avoidance a key recommendation when adhering to a low-purine diet. Alcoholic beverages, particularly those fermented from grains, contain purines and can also interfere with the body's ability to excrete uric acid, leading to a buildup. Consequently, it is generally advised to eliminate or severely restrict the intake of specific types of alcohol to minimize the risk of triggering painful gout attacks.

Beverages to avoid or strictly limit include beer, hard liquor, and other grain alcohols, as these have been consistently linked to increased gout risk. Historically, wine has sometimes been perceived as having lower purine levels and thus considered "safer" in moderation for individuals prone to high uric acid. However, more recent and comprehensive research paints a different picture. A study involving 724 individuals with a history of gout revealed that wine, beer, and hard liquor were all associated with a higher risk of recurrent gout attacks, even at potentially moderate consumption levels, with the risk amplified in those consuming high-purine foods or on certain medications. This underscores the need for caution across all alcohol types.

Is There a Genetic Link to Developing Gout?

Studies have shown that genetics may contribute to your risk of gout, including how alcohol consumption may affect you. A study of 114,540 adults in Taiwan suggests that alcohol use, combined with a specific genetic profile, raises the risk of high uric acid levels. More research is needed to understand how genetics is at work in these cases.

Yeasts

Certain types of yeasts and yeast extracts are notably high in purines, making them a category of food and supplement that individuals managing gout should actively avoid. The purine content in these products can contribute to elevated uric acid levels in the bloodstream, increasing the risk of gout flare-ups. Therefore, it is important to carefully check food labels for the presence of yeast extract, which can often be a hidden ingredient in many processed items.

Yeast extract can be found in a surprisingly wide array of common foods. This includes certain soy sauces, which are often used as a flavor enhancer; canned soups and stews, where it contributes to savory notes; various frozen dinners designed for convenience; and many salty snacks, which rely on it for an umami flavor boost. By becoming vigilant about identifying and avoiding products containing yeast or yeast extract, individuals with gout can further reduce their dietary purine intake, thereby supporting their overall management strategy and minimizing the potential for uric acid buildup.

What Foods Can You Eat With Gout?

Beyond understanding which foods to avoid, it's equally important to identify dietary choices that can actively support gout management. Certain foods possess properties that can help lower uric acid levels in the body, which, in turn, can effectively alleviate existing gout flare-ups and significantly contribute to preventing future attacks. Embracing a diet rich in these beneficial foods can be a powerful tool in maintaining joint health and overall well-being for individuals with gout.

The following food categories are recognized for their potential to ease gout symptoms by either directly lowering uric acid levels or by reducing overall purine intake. Incorporating these into your daily meal plan can foster a more balanced and therapeutic dietary approach. These include specific fruits like cherries, foods naturally abundant in vitamin C (such as oranges, spinach, and kale), coffee, a wide range of low-purine options including whole grains, vegetables, and plant-based proteins like nuts and legumes, low-fat dairy products, and crucially, an adequate intake of water.

Cherries

Cherries have garnered considerable scientific interest for their potential role in both preventing and managing gout. The distinctive deep red hue of cherries is attributed to natural compounds known as anthocyanins, which are potent antioxidants and possess significant anti-inflammatory properties. Despite cherries containing naturally occurring fructose, research indicates that their consumption may help reduce uric acid levels, thereby mitigating inflammation and lowering the likelihood of future gout attacks. This makes specific cherry varieties a promising dietary inclusion for gout sufferers.

Among the various types, tart cherries, particularly Montmorency or Balaton varieties, are the most frequently studied for their beneficial effects on gout. These can be consumed in various forms, including fresh, frozen, as juice, or as an extract. While there isn't a universally defined daily amount for gout prevention, studies have explored a wide range of servings, such as 1/2 cup of fresh cherries or 1 cup of cherry juice per day. For cherry extract supplements, it is always best to adhere to the dosage guidelines provided on the nutrition label to ensure appropriate intake.

Using Tart Cherry Juice for Gout

Tart cherry juice may help decrease uric acid levels and inflammation in gout. Research is limited, with often small numbers of study participants and short-term follow-up.
Nevertheless, a 2019 review of six studies analyzed the effect of cherry juice or cherry extract intake on gout and concluded that cherry intake was associated with a reduced risk of gout attacks. Researchers did note that larger, more long-term studies are needed to clarify this association.
When choosing tart cherry juice, be sure to look for unsweetened varieties to help reduce the amount of added sugar in your diet.

High-Vitamin C Foods

Vitamin C is widely recognized for its robust antioxidant properties, playing a vital role in immune function and overall health. Less commonly known, however, is its significant potential in the treatment of gout through its capacity to lower blood uric acid levels. This unique benefit makes incorporating vitamin C-rich foods a strategic dietary choice for individuals looking to manage their gout.

A prospective study published in 2009 meticulously tracked nearly 47,000 men over two decades, investigating the correlation between their vitamin C intake and gout risk. The researchers concluded that a higher intake of vitamin C was significantly associated with a reduced likelihood of developing gout, with those consuming 1,500 milligrams or more per day experiencing up to a 45% lower risk. Further analysis in 2011, reviewing 13 randomized controlled clinical trials, found that vitamin C supplementation (at a median dose of 500 milligrams daily for 30 days) modestly lowered serum uric acid levels. While these findings are promising, more research is needed to fully confirm the precise amount of vitamin C required to significantly reduce gout risk.

Foods rich in vitamin C offer a delicious and natural way to incorporate this beneficial nutrient into your diet. Citrus fruits, such as oranges and grapefruit, are classic examples, alongside kiwifruit, strawberries, and cantaloupe. Colorful sweet bell peppers, cruciferous vegetables like broccoli, cauliflower, Brussels sprouts, and cabbage, and even baked potatoes and tomatoes are also excellent sources. It is important to note, however, that if you have an increased risk for kidney stones, particularly calcium oxalate stones, consistently consuming high doses of supplemental vitamin C is generally not recommended without medical guidance, due to its potential to increase oxalate excretion.

Coffee

Coffee, a globally consumed beverage, has been extensively studied for its diverse effects on human health. Early research suggests that regular coffee consumption may contribute to a decreased risk of gout. Interestingly, studies indicate that the protective effect of coffee might vary between sexes, highlighting the nuanced impact of this popular drink on uric acid levels.

A comprehensive review of studies conducted in 2015 revealed compelling data regarding coffee's influence on gout risk in men. It was observed that men who consumed four to five cups of coffee daily experienced a 40% reduction in gout risk, and those drinking six or more cups per day saw an even greater decrease of 59% compared to non-coffee drinkers. For women, the benefits were also evident: one to three cups daily lowered gout risk by 22%, while four or more cups reduced it by 57% when compared to no coffee consumption. Based on this review, researchers concluded that drinking at least four cups of coffee per day can effectively lower uric acid levels and decrease the incidence of gout. However, further research is still needed to explore coffee's effects on recurrent gout attacks.

Low-Purine Foods

One of the most widely accepted and consistently recommended dietary strategies for managing gout is to actively reduce the intake of purine-rich foods. By consciously choosing low-purine alternatives, individuals can effectively prevent their blood uric acid levels from becoming excessively high, thereby mitigating the risk of gout flare-ups. This targeted approach forms a cornerstone of dietary management for the condition, directly addressing the root cause of crystal formation.

Moreover, the Dietary Approaches to Stop Hypertension (DASH) diet, which naturally emphasizes many low-purine foods, has been positively associated with a reduced risk of gout. This further reinforces the benefits of adopting a broader, healthy eating pattern. Low-purine foods that should be prioritized include certain fruits like cherries, berries, and citrus varieties. Nonfat and low-fat dairy products such as milk, cheese, and yogurt are also excellent choices. Additionally, plant-based protein sources like nuts, peanut butter, seeds, and legumes, along with eggs (in moderation), whole grain bread and pasta, rice, and potatoes, and a wide array of vegetables form the basis of a gout-friendly diet.

Plant-Based Foods

Many plant-based foods naturally contain low levels of purines, making them an excellent cornerstone for a gout-friendly diet. Beyond their favorable purine profile, these foods are also rich in a multitude of health-promoting nutrients, including essential vitamins, minerals, and dietary fiber, contributing to overall well-being. A diverse intake of plant-based options can significantly support a balanced and therapeutic approach to managing gout.

Key components of a plant-based diet beneficial for gout include various beans and other legumes, a wide assortment of fruits, nuts, and healthy nut and vegetable-based oils. Seeds, soy-based proteins such as tofu, tempeh, soy nuts, and soy milk, and an abundance of vegetables, alongside whole grains, are all highly recommended. Observational studies, specifically two separate prospective cohort studies, have consistently demonstrated that adopting plant-based diets can indeed decrease the overall risk of gout.

It is noteworthy that while some vegetables may contain higher levels of purines, the body processes plant-based purines differently from those found in animal sources. Research indicates that purines derived from plants do not increase the risk of gout and may, in fact, contribute to a decreased risk. A 2019 review of plant-based diets and their association with gout suggested that a reasonable consumption of higher-purine plant foods, when part of a broader plant-based diet, can be safely tolerated by healthy individuals. However, researchers highlighted the need for additional studies specifically in people with pre-existing high uric acid levels, particularly those with chronic kidney disease, to fully ascertain the effects in these populations.

Low-Fat Dairy

Dairy products, particularly low-fat or non-fat varieties, have been consistently identified as beneficial in reducing the risk of gout. There is growing evidence to suggest that consuming low-fat dairy may offer a protective effect against recurrent gout flares. This makes incorporating such dairy products a valuable strategy for individuals managing their condition and seeking to minimize painful episodes.

The protective mechanism of low-fat dairy is believed to involve several factors. It may help in decreasing uric acid levels in the bloodstream. Furthermore, these dairy products contain certain anti-inflammatory properties that can help mitigate the inflammatory response triggered by monosodium urate crystals within the joint. Adhering to general dietary guidelines, such as the Dietary Guidelines for Americans, which suggest three servings of dairy per day for healthy adults, can be a practical approach. This includes choices like low-fat milk, yogurt, cheese, and cottage cheese, all contributing to a gout-supportive diet.

Water

Maintaining adequate hydration is a fundamental and critical aspect of managing gout effectively. A significant 2017 prospective study investigated the relationship between water intake and uric acid levels, yielding important insights. Upon analyzing the collected data, researchers determined a clear association: higher water intake was linked to lower uric acid levels in individuals with gout. This beneficial effect is likely due to increased uric acid excretion from the body when hydration levels are optimal. However, further research is ongoing to pinpoint a more direct and precise effect of water intake on gout mechanisms.

A review published in the American Journal of Lifestyle Medicine further emphasized the importance of hydration by noting that excessive sweating, such as that occurring after intense exercise or sauna bathing, can diminish the urinary excretion of uric acid, subsequently leading to an increase in uric acid levels in the blood. Therefore, researchers strongly recommend consuming ample amounts of water to prevent this post-activity rise in serum uric acid. They also found that sufficient water consumption within the 24-hour period preceding a gout flare was significantly associated with a decreased risk of recurrent attacks.

While water is undoubtedly the best source of hydration, other beverages like coffee, and even certain foods such as fruits and vegetables, contribute to your overall hydration status. The general recommendation is to drink to thirst, but some experts suggest aiming for half of your body weight in ounces of water each day for optimal hydration. Prioritizing consistent and sufficient water intake is a simple yet powerful tool in your gout management strategy, helping your body efficiently process and eliminate uric acid.

Gout Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Download PDF

Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life.
Email Address
Sign Up
You're in!
Thank you, , for signing up.
There was an error. Please try again.

Sample Meal Plan

Transitioning to a gout-friendly diet can initially seem daunting, but it doesn't have to be. One highly effective and accessible approach is to familiarize yourself with the core principles of the Dietary Approaches to Stop Hypertension (DASH) diet and then build your meal choices and menus around its recommended food categories. This strategy has proven successful in practical settings, as demonstrated by a specific study involving individuals with gout residing in Baltimore, Maryland.

In this insightful study, dietitians meticulously approved participants' grocery lists, with the added convenience of having the food ordered and delivered directly to their homes. Researchers then carefully evaluated the participants' dietary intake and monitored any corresponding changes in their uric acid levels. The 49 study participants adhered to structured meal plans that were thoughtfully designed to align with DASH principles, while also limiting high-purine foods.

The meal plans in the study emphasized a balanced intake of various food groups: 5–7 servings per day of healthy grains, 4 servings daily of fruit, and 4 servings daily of vegetables. Protein sources included 1–2 servings per day of lean poultry (chicken, turkey) or fish, along with 2 servings per day of low-fat dairy, such as milk or cheese. Additionally, a limited amount of nuts, seeds, and legumes was incorporated each day. These meticulously planned meals also strictly controlled sodium (salt), cholesterol, and fats, while explicitly restricting high-purine foods. The positive outcomes were evident, showing a notable reduction in uric acid levels, and remarkably, 80% of participants found the diet easy to follow. A strong indicator of long-term adherence, three-fourths of the participants expressed a likelihood of continuing their new eating habits after the study, reflecting a positive experience with their dietary and behavioral changes.

Are there any vitamins or minerals that help with gout?

Vitamin C, in particular, may offer benefits when seeking to prevent gout or reduce symptoms. Higher levels of vitamin C appear to help lower the uric acid levels in your body, but it's not entirely clear why. Researchers continue to work to clarify the relationship between vitamin C intake and gout.

Summary

The likelihood of experiencing gout flare-ups is profoundly influenced by the specific foods and beverages chosen as part of one's diet. Certain dietary components contain natural compounds known as purines, which, when metabolized, can lead to an increase in uric acid levels in the bloodstream. This elevation is the direct cause of gout, a painful type of inflammatory arthritis characterized by crystal formation in the joints. The impact of these dietary choices extends beyond gout, affecting other significant health conditions such as high blood pressure and kidney disease, underscoring the importance of a holistic nutritional approach.

A low-purine diet is a cornerstone of gout management, strategically restricting foods that are known to elevate uric acid. This typically includes red meat, alcoholic beverages, processed foods, sugary items, and certain types of seafood. It is crucial to remember that the specific foods that trigger gout flare-ups can vary from person to person, emphasizing the importance of individualized observation and management. Therefore, maintaining open communication with your healthcare provider is essential as you implement dietary changes. By setting achievable small, encouraging goals and consistently following your personalized dietary journey, you can significantly improve your quality of life and minimize gout symptoms.

Read more:

• Health A-Z
• Arthritis
• Gout

23 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. Kuo CF, Grainge MJ, Mallen C, Zhang W, Doherty M. Rising burden of gout in the UK but continuing suboptimal management: a nationwide population study. Ann Rheum Dis. 2015;74(4):661-7. doi:10.1136/annrheumdis-2013-204463
2. Edwards NL, Schlesinger N, Clark S, Arndt T, Lipsky PE. Management of gout in the United States: A claims-based analysis. ACR Open Rheumatol. 2020;2(3):180-187. doi:10.1002/acr2.11121
3. Li R, Yu K, Li C. Dietary factors and risk of gout and hyperuricemia: A meta-analysis and systematic review. Asia Pac J Clin Nutr. 2018;27(6):1344-1356. doi:10.6133/apjcn.201811_27(6).0022
4. Rai SK, Fung TT, Lu N, Keller SF, Curhan GC, Choi HK. The Dietary Approaches to Stop Hypertension (DASH) diet, Western diet, and risk of gout in men: Prospective cohort study. BMJ. 2017;357:j1794. doi:10.1136/bmj.j1794
5. El Ridi R, Tallima H. Physiological functions and pathogenic potential of uric acid: A review. J Adv Res. 2017;8(5):487-493. doi:10.1016/j.jare.2017.03.003
6. Li R, Yu K, Li C. Dietary factors and risk of gout and hyperuricemia: a meta-analysis and systematic review. Asia Pac J Clin Nutr. 2018;27(6):1344-1356. doi:10.6133/apjcn.201811_27(6).0022
7. Ayoub-Charette S, Liu Q, Khan TA, et al. Important food sources of fructose-containing sugars and incident gout: a systematic review and meta-analysis of prospective cohort studies. BMJ Open. 2019;9(5):e024171.doi:10.1136/bmjopen-2018-024171
8. Monash University. High and low FODMAP foods.
9. Ebrahimpour-Koujan S, Saneei P, Larijani B, Esmaillzadeh A. Consumption of sugar sweetened beverages and dietary fructose in relation to risk of gout and hyperuricemia: a systematic review and meta-analysis. Crit Rev Food Sci Nutr. 2020;60(1):1-10. doi:10.1080/10408398.2018.1503155
10. Mozaffarian D. Dietary and policy priorities for cardiovascular disease, diabetes, and obesity: a comprehensive review. Circulation. 2016;133(2):187-225. doi:10.1161/CIRCULATIONAHA.115.018585
11. Arthritis Foundation. Safe foods for gout.
12. Kaneko K, Aoyagi Y, Fukuuchi T, Inazawa K, Yamaoka N. Total purine and purine base content of common foodstuffs for facilitating nutritional therapy for gout and hyperuricemia. Biol Pharm Bull. 2014;37(5):709-721. doi:10.1248/bpb.b13-00967
13. Zhang M, Zhang Y, Terkeltaub R, Chen C, Neogi T. Effect of dietary and supplemental omega-3 polyunsaturated fatty acids on risk of recurrent gout flares. Arthritis Rheumatol. 2019;71(9):1580-1586. doi:10.1002/art.40896
14. Neogi T, Chen C, Niu J, Chaisson C, Hunter DJ, Zhang Y. Alcohol quantity and type on risk of recurrent gout attacks: an internet-based case-crossover study. Am J Med. 2014;127(4):311-8. doi:10.1016/j.amjmed.2013.12.019
15. Chen IC, Chen YJ, Chen YM, et al. Interaction of alcohol consumption and ABCG2 rs2231142 variant contributes to hyperuricemia in a Taiwanese population. J Pers Med. 2021;11(11):1158. doi: 10.3390/jpm11111158
16. Chen PE, Liu CY, Chien WH, Chien CW, Tung TH. Effectiveness of cherries in reducing uric acid and gout: a systematic review. Evid Based Complement Alternat Med. 2019;2019:9896757. doi:10.1155/2019/9896757
17. Juraschek SP, Miller ER 3rd, Wu B, et al. A randomized pilot study of DASH patterned groceries on serum urate in individuals with gout. Nutrients. 2021;13(2):538. doi:10.3390/nu13020538
18. National Institutes of Health. Vitamin C.
19. Towiwat P, Li ZG. The association of vitamin C, alcohol, coffee, tea, milk and yogurt with uric acid and gout. Int J Rheum Dis. 2015;18(5):495-501. doi:10.1111/1756-185X.12622
20. American Academy of Family Physicians. Low-purine diet.
21. Jakše B, Jakše B, Pajek M, Pajek J. Uric acid and plant-based nutrition. Nutrients. 2019;11(8):1736. doi:10.3390/nu11081736
22. Igel TF, Krasnokutsky S, Pillinger MH. Recent advances in understanding and managing gout. F1000Res. 2017;6:247. doi:10.12688/f1000research.9402.1
23. Brzezińska O, Styrzyński F, Makowska J, Walczak K. Role of vitamin C in prophylaxis and treatment of gout-a literature review. Nutrients. 2021;13(2):701. doi:10.3390/nu13020701

Additional Reading

• Zhang Y, Chen C, Choi H, et al. Purine-rich foods intake and recurrent gout attacks. Ann Rheum Dis. 2012;71(9):1448-1453. doi:10.1136/annrheumdis-2011-201215