What to Eat When You Have Gout

A comprehensive approach to managing gout frequently involves careful dietary modifications. A gout diet is specifically designed to minimize the intake of purines, chemical compounds that, upon metabolism within the body, break down to form uric acid. Elevated levels of uric acid are directly associated with the painful attacks characteristic of gout. Adopting a low-purine eating plan emphasizes the consumption of foods such as low-fat dairy products, coffee, and various citrus fruits, all of which can be safely enjoyed. Conversely, certain foods and beverages, including organ meats, beer, and sugary sodas, are known to be high in purines and should be strictly limited or avoided to prevent triggering a gout flare-up.

What Foods Are Safe to Eat?

Managing gout effectively centers on selecting foods that naturally contain low levels of purines, aiming to keep total uric acid levels below 6 mg/dl. Research consistently demonstrates that diligently adhering to a gout-friendly diet can significantly reduce both the frequency and intensity of painful gout attacks for many individuals. This dietary strategy becomes a cornerstone of long-term management, empowering patients to exert control over their condition and improve their quality of life by mitigating the impact of uric acid accumulation within the body. By making conscious food choices, individuals can actively work towards preventing recurrent episodes and lessening the debilitating symptoms.¹

Vegetables: For many years, there was a misconception that individuals with gout should restrict their intake of certain vegetables due to their purine content. However, contemporary research has conclusively shown that even vegetables traditionally considered rich in purines, such as asparagus, spinach, and cauliflower, do not negatively impact uric acid levels or elevate the risk of a gout attack. Incorporating a variety of vegetables into the diet is, in fact, highly beneficial, aiding in the attainment and maintenance of a healthy body weight. This is a crucial aspect of gout management, as achieving a healthy weight is directly linked to a reduced risk of experiencing gout flare-ups.²

Dairy Products: A growing body of scientific evidence highlights the protective role of dairy products in managing gout. Studies indicate that the specific proteins found in dairy can actively contribute to a natural reduction in uric acid levels within the bloodstream. When selecting dairy options, prioritizing low-fat varieties like skim milk or low-fat yogurt offers the dual benefit of supporting uric acid reduction while also assisting in maintaining a healthy body weight. This makes dairy a valuable component of a gout-friendly diet, offering a simple yet effective way to support overall metabolic health and mitigate gout risk.¹

Tofu, Whole Grains, Beans, and Lentils: While a gout diet necessitates a reduction in the consumption of certain meats and seafood, it remains vital to ensure adequate protein intake, typically aiming for 10% to 35% of daily calories, in line with USDA recommendations. Plant-based protein sources, such as tofu, diverse whole grains, a variety of beans, and lentils, are excellent alternatives. These options not only help meet essential nutritional needs without introducing high purine levels but also demonstrate a potential protective effect against the occurrence of gout attacks. Their inclusion supports a balanced diet while actively contributing to gout prevention.^1,3

Citrus Fruit: Emerging research suggests that incorporating adequate vitamin C into the diet may represent an effective strategy for reducing the frequency of gout flare-ups. Vitamin C plays a crucial role in facilitating the body's natural excretion of uric acid, thereby helping to keep levels in check. Citrus fruits are an excellent and natural source of this essential nutrient. However, it is advisable to opt for citrus fruits with lower fructose content, such as grapefruit, oranges, or pineapple. This careful selection is important because high levels of natural sugars like fructose have been observed to contribute to increased uric acid levels in some individuals.⁴

Cherries: Multiple studies have demonstrated a significant link between the consumption of cherries, including 100% tart cherry juice, and a measurable reduction in serum uric acid levels. This beneficial effect is largely attributed to anthocyanins, powerful flavonoids abundantly found in cherries and tart cherry juice. Anthocyanins are renowned for their potent anti-inflammatory and antioxidant properties, which are crucial in mitigating the inflammation typically associated with acute gout attacks. Regular inclusion of cherries or tart cherry juice can therefore serve as a valuable dietary intervention to support gout management and reduce inflammatory responses.^5,6

Coffee: The impact of coffee consumption on gout has been a subject of interest, with current research indicating that moderate coffee intake does not appear to elevate uric acid levels. In fact, some studies suggest that regular coffee consumption may even be associated with a reduced risk of developing gout. This finding is reassuring for coffee drinkers, allowing them to continue enjoying their beverage without concern for adverse effects on their gout condition. It underscores that, unlike some other beverages, coffee can be a safe and potentially beneficial part of a gout-friendly lifestyle.⁷

Avocados: Avocados are an exceptional addition to a gout diet, primarily because they are naturally low in purines. Beyond this key characteristic, avocados are a rich source of monounsaturated fats and vitamin E, both of which possess significant anti-inflammatory and antioxidant properties. These compounds contribute to reducing pain and inflammation, which are common symptoms of gout. Furthermore, diets that are abundant in these beneficial fats and antioxidants have been consistently linked to a decreased risk of joint damage, offering an additional protective benefit for individuals managing gout.⁸

Water: Adequate hydration is a critically overlooked yet profoundly effective strategy in managing gout. Consuming at least eight glasses of water daily plays a vital role in facilitating the kidneys' ability to flush uric acid from the body. This consistent and efficient excretion of uric acid is paramount to preventing its accumulation and subsequent crystallization in the joints. Indeed, studies have indicated that maintaining optimal hydration can reduce the incidence of recurrent gout attacks by a remarkable margin, highlighting water as the simplest yet most powerful beverage choice for gout prevention and management.⁹

What Is Purine?

Purine is a chemical compound that, when metabolized, creates the uric acid that triggers gout attacks. Uric acid is normally excreted, but with gout, it builds up and forms needle-shaped crystals in and around the joint.¹⁰

Avoid These Foods

Specific foods and beverages are known to be significant triggers for gout symptoms and flare-ups, warranting their careful avoidance or strict limitation. A pivotal study revealed that individuals with gout who consumed a diet rich in purines experienced a five-fold increase in the risk of recurrent gout attacks. Conversely, consciously reducing the intake of these purine-rich foods was shown to dramatically lower the risk of such attacks. Understanding and adhering to these dietary restrictions is therefore fundamental for effective gout management and preventing the painful episodes associated with the condition.¹¹

The following are foods to avoid if you have gout or are at risk for developing it:

Red Meat and Organ Meat: Red meats, including beef, venison, and bison, inherently contain higher concentrations of purines compared to white meats. The consumption of these meats, particularly in larger quantities, has been consistently linked to an increased risk of recurrent gout attacks. Furthermore, organ meats such as liver, sweetbreads, tongue, and kidney are exceptionally high in purines. Their rapid metabolism in the body contributes significantly to elevated uric acid levels, making them particularly detrimental for individuals prone to gout flare-ups. Therefore, strict limitation or complete avoidance of these items is highly advised.¹²

Coldwater Fish, Shellfish: While fish generally offers significant health benefits, certain types are notably high in purines and should be consumed sparingly or avoided by individuals on a gout diet. This category primarily includes specific coldwater fish species such as tuna, trout, herring, sardines, and anchovies. Similarly, many varieties of shellfish, including shrimp, oysters, crab, and lobster, are also known to have elevated purine levels. Limiting these particular seafood options is a crucial step in managing dietary purine intake and reducing the likelihood of triggering a gout attack.¹³

Yeast Extract: Certain common spreads and food additives contain significant amounts of yeast extract, which is known to be remarkably high in purines. Products like Marmite, Vegemite, and Vitam-R are prime examples of such items. The high purine concentration in these extracts means that their consumption can lead to a considerable increase in the body's uric acid levels, thereby heightening the risk of gout attacks. To effectively manage gout symptoms and reduce uric acid accumulation, it is strongly advised to avoid foods and spreads that list yeast extract among their ingredients.¹⁴

Beer and Liquor: The majority of alcoholic beverages are generally not recommended for individuals adhering to a gout diet, with specific emphasis on beer and liquor. These particular forms of alcohol have been shown to actively slow down the excretion of uric acid from the body, leading to its accumulation and an increased risk of gout attacks. In contrast, studies have indicated that moderate consumption of wine does not appear to be associated with a higher incidence of gout. This distinction is important, suggesting that while most alcohol should be avoided, wine may be an exception for some in moderation.^15,16

Sugary Foods and Beverages: A critical aspect of a gout diet involves strictly limiting or avoiding foods and beverages that contain high levels of fructose, especially those sweetened with high-fructose corn syrup. Fructose metabolism directly contributes to the production of purines, which in turn elevates uric acid levels. This includes obvious culprits like sodas and other sugary drinks, but also extends to less obvious sources such as canned fruit or fruit juice, and a wide array of high-sugar processed products like snack bars, doughnuts, pastries, candy, and certain breakfast cereals. Diligent avoidance of these items is paramount.¹⁷

White Bread and Honey: Carbohydrates that undergo rapid digestion and absorption, often referred to as refined carbohydrates, can lead to a quick surge in blood sugar levels. This glycemic spike, in turn, has been linked to an increase in uric acid levels in the body, which can exacerbate gout. Therefore, it is advisable to avoid refined carbs such as white bread, white rice, cookies, and cake. Furthermore, while honey is a natural sweetener, it is notably high in fructose. When the body metabolizes fructose, it produces purines, making honey another ingredient to limit on a gout-conscious diet.^18,19

Some people with gout take a vitamin C supplement. Speak with your healthcare provider to see if supplementation is needed and whether it fits into your diet and medication plan.

Sample Menu on the Gout Diet

Designing a well-balanced gout diet involves carefully selecting foods that are low in purines while simultaneously supporting the achievement and maintenance of a healthy weight. This strategic approach helps minimize the risk of gout flare-ups and promotes overall well-being. A typical day's meals, thoughtfully constructed to meet these specific dietary goals, might incorporate a variety of nutrient-dense foods, ensuring satisfaction and adherence to the principles of gout management. Such a menu demonstrates how diverse and appealing a low-purine diet can be.

A day's meals that meet these goals might look like this:

• Breakfast: Oatmeal, a serving of cherries, low-fat cottage cheese, coffee
• Lunch: Crunchy lettuce wrap with tofu, vegetables, and brown rice
• Dinner: Whole wheat pasta with mozzarella cheese and broccoli, citrus fruit salad

The principles of a gout diet are broadly applicable, allowing for adjustments to accommodate various dietary preferences and lifestyles. Individuals following vegetarian, vegan, or gluten-free eating plans can readily adapt this diet to align with their specific requirements, benefiting from the emphasis on plant-based foods. However, those on a pescatarian or Mediterranean diet might find it more challenging due to the limitations on certain types of fish and seafood. Despite these restrictions, some experts, including those at the Arthritis Foundation, suggest that occasional, limited consumption of particular fish varieties may still be permissible and even beneficial.¹³

To optimize the effectiveness of your gout diet, it is highly recommended to collaborate closely with your healthcare provider or a registered nutritionist who possesses expertise in gout management. These professionals can provide personalized guidance tailored to your unique health profile and dietary needs. Furthermore, maintaining a detailed food diary is an invaluable tool they often recommend. This practice allows you to meticulously record your food intake and track any potential triggers, helping to pinpoint specific foods that may heighten your risk of experiencing a gout attack.

Other Ways You Can Manage Gout Flare-Ups

While dietary adjustments form a cornerstone of gout management, they are typically integrated into a more comprehensive treatment plan. Your healthcare provider may recommend a multifaceted approach that combines nutritional strategies with other lifestyle modifications and, when necessary, medical interventions. This holistic strategy aims to reduce the frequency and severity of gout flare-ups, enhance overall joint health, and improve your quality of life. By addressing multiple aspects of gout management, a more stable and pain-free existence becomes achievable.

Weight Loss: Maintaining a healthy body weight is a crucial factor in reducing the frequency of gout flare-ups, as numerous studies have affirmed this connection. Obesity and excess weight are known risk factors for gout, and even modest weight loss can significantly improve symptoms. However, it is paramount to approach weight reduction gradually and sustainably. Rapid or "crash" dieting should be strictly avoided, as an abrupt and drastic reduction in calories or very rapid weight loss can paradoxically trigger an acute gout attack, counteracting the intended benefits.^1,20

Exercise: Regular physical activity plays a vital role in the comprehensive management of gout, contributing significantly to improved joint function and assisting in the maintenance of a healthy target weight. However, it is essential to approach exercise judiciously. Overly strenuous or high-impact activities can sometimes place undue stress on affected joints, potentially doing more harm than good, particularly during or immediately preceding a flare-up. Furthermore, adequate hydration before, during, and after exercise is crucial, as dehydration can elevate uric acid levels in the blood, thereby increasing the risk of a gout attack.²¹

Medication: For individuals experiencing acute gout symptoms, medical intervention often becomes necessary to provide immediate relief and manage the inflammatory response. Your healthcare provider may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) in prescription-strength doses, such as ibuprofen or naproxen, to rapidly alleviate pain and reduce inflammation. In cases of severe or persistent flare-ups, corticosteroid injections may also be recommended. These powerful anti-inflammatory medications are administered directly into the affected joint to quickly suppress the intense inflammation and bring an end to the painful episode.²²

Key Takeaways

• You may be able to manage gout symptoms and reduce flare-ups by eating a low-purine diet of plant-based foods and whole grains.
• Avoid foods with high purine levels such as red meat, alcohol, and sugary treats.
• Incorporating other strategies such as maintaining a healthy weight, exercising, and using medication when needed can also ease flare-ups.

22 Sources
GoutSnap 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. Ragab G, Elshahaly M, Bardin T. Gout: An old disease in new perspective – A review. J Adv Res. 2017;8(5):495-511. doi:10.1016/j.jare.2017.04.008
2. Aihemaitijiang S, Zhang Y, Zhang L, et al. The association between purine-rich food intake and hyperuricemia: a cross-sectional study in chinese adult residents. Nutrients. 2020;12(12):3835. doi:10.3390/nu12123835
3. Wolfe RR, Cifelli AM, Kostas G, Kim IY. Optimizing protein intake in adults: Interpretation and application of the recommended dietary allowance compared with the acceptable macronutrient distribution range. Adv Nutr. 2017;8(2):266-275. doi:10.3945/an.116.013821
4. 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
5. Martin KR, Coles KM. Consumption of 100% tart cherry juice reduces serum urate in overweight and obese adults. Current Developments in Nutrition. 2019;3(5):nzz011. doi:10.1093/cdn/nzz011
6. Lamb KL, Lynn A, Russell J, Barker ME. Effect of tart cherry juice on risk of gout attacks: Protocol for a randomised controlled trial. BMJ Open. 2020;10(3):e035108. doi:10.1136/bmjopen-2019-035108
7. Park KY, Kim HJ, Ahn HS, et al. Effects of coffee consumption on serum uric acid: Systematic review and meta-analysis. Semin Arthritis Rheum. 2016;45(5):580-586. doi:10.1016/j.semarthrit.2016.01.003
8. Arthritis Foundation. Best fruits for arthritis.
9. Kakutani-Hatayama M, Kadoya M, Okazaki H, et al. Nonpharmacological management of gout and hyperuricemia: Hints for better lifestyle. Am J Lifestyle Med. 2017;11(4):321-329. doi:10.1177/1559827615601973
10. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Gout.
11. Danve A, Sehra ST, Neogi T. Role of diet in hyperuricemia and gout. Best Pract Res Clin Rheumat. 2021;35(4):101723. doi:10.1016/j.berh.2021.101723
12. Centers for Disease Control and Prevention. Gout.
13. Arthritis Foundation. Which foods are safe for gout?
14. Zhang Y, Chen S, Yuan M, Xu Y, Xu H. Gout and diet: A comprehensive review of mechanisms and management. Nutrients. 2022;14(17):3525. doi:10.3390/nu14173525
15. Rasheed H, Stamp LK, Dalbeth N, Merriman TR. Interaction of the GCKR and A1CF loci with alcohol consumption to influence the risk of gout. Arthritis Res Ther. 2017;19(1):161. doi:10.1186/s13075-017-1369-y
16. Helget LN, Mikuls TR. Environmental triggers of hyperuricemia and gout. Rheumatic Disease Clinics of North America. 2022;48(4):891-906. doi:10.1016/j.rdc.2022.06.009
17. Caliceti C, Calabria D, Roda A, Cicero A. Fructose intake, serum uric acid, and cardiometabolic disorders: A critical review. Nutrients. 2017;9(4):395. doi:10.3390/nu9040395
18. Juraschek SP, McAdams-Demarco M, Gelber AC, et al. Effects of lowering glycemic index of dietary carbohydrate on plasma uric acid levels: the OmniCarb randomized clinical trial. Arthritis Rheumatol. 2016;68(5):1281-1289. doi:10.1002/art.39527
19. Zhang C, Li L, Zhang Y, et al. Recent advances in fructose intake and risk of hyperuricemia. Biomed Pharmacother. 2020;131:110795. doi:10.1016/j.biopha.2020.110795
20. U.S. Department of Health and Human Services. Gripped by gout. NIH News in Health.
21. Kakutani-Hatayama M, Kadoya M, Okazaki H, et al. Nonpharmacological management of gout and hyperuricemia: Hints for better lifestyle. Am J Lifestyle Med. 2017;11(4):321–329. doi:10.1177/1559827615601973
22. Harvard Health Publishing. Treatments for Gout.