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

When managing gout, understanding the intricate relationship between your diet and uric acid levels is paramount. Gout is a debilitating form of arthritis characterized by the accumulation of excess uric acid in the joints, leading to painful inflammation and sudden, severe flare-ups. Certain foods are known to significantly elevate uric acid, while others can help regulate it. This article, informed by years of medical and nutritional expertise, offers clear, actionable guidance on which foods to approach with caution and which to embrace, helping you gain better control over your condition and improve your overall well-being.

Foods to Eat and Avoid With Gout
Verywell / Alexandra Gordon

How Foods Affect Gout

Gout is a distinct form of arthritis that manifests when the body experiences hyperuricemia, a condition marked by excessively high levels of uric acid. This inflammatory joint disease is notably prevalent, with researchers in both the United Kingdom1 and the United States identifying it as the most common type of inflammatory arthritis affecting their respective populations. While genetic predispositions and underlying medical conditions certainly play a role in gout's development and severity, dietary choices exert a direct and often profound impact on its progression and the frequency of flare-ups.

Observations across various cultures reveal a strong correlation between dietary patterns and gout rates. Societies with higher consumption of red meat, heavily processed foods, refined sugars, and other purine-rich items tend to exhibit increased incidences of gout. A compelling 2017 study highlighted this connection, comparing the impact of a typical Western diet against the Dietary Approaches to Stop Hypertension (DASH) diet on gout risk. The findings clearly indicated that adherence to the DASH diet was associated with a reduced risk of gout, whereas the Western diet significantly elevated it. This underscores the power of nutritional choices in managing or preventing this painful condition.4

Purines are naturally occurring chemical compounds found in both the human body and in many foods. When your digestive system processes these purine-containing foods, uric acid is produced as a metabolic byproduct. Normally, the body efficiently reabsorbs the majority of this uric acid, with any excess being excreted through urine and feces. However, when the intake of purines is excessively high, or when the body's ability to process them is compromised, it struggles to fully manage these elevated levels.

This inability to effectively process high purine loads leads to an accumulation of uric acid within the body, resulting in hyperuricemia. While a diet rich in high-purine foods can independently trigger this buildup, the risk is considerably heightened when combined with certain pre-existing health conditions. These underlying medical issues can impair the body's natural mechanisms for uric acid regulation, making dietary management an even more critical component of gout prevention and control.

Underlying health conditions that can exacerbate hyperuricemia and increase the likelihood of gout flare-ups include chronic kidney disease, which impairs the kidneys' ability to filter uric acid; diabetes, a metabolic disorder that can affect uric acid metabolism; and hypertension, or high blood pressure, which is frequently co-occurs with gout. Additionally, conditions such as psoriatic arthritis, a type of inflammatory arthritis, and recent infections, injuries, or surgeries can also contribute to elevated uric acid levels, underscoring the multifaceted nature of gout risk.

What Foods Should You Avoid With Gout?

For individuals living with hyperuricemia or diagnosed with gout, it is crucial to consult with a healthcare provider regarding specific dietary recommendations. Generally, a core strategy for preventing and managing gout flare-ups involves significantly limiting or entirely avoiding foods known to be high in purines. These dietary culprits include sugars and fruits abundant in fructose, sugary beverages, highly processed foods, red and organ meats, certain types of fish and shellfish, alcoholic drinks, and yeast-containing products.

Systematically removing or reducing these items from your daily diet can play a pivotal role in maintaining lower uric acid levels, thereby reducing the frequency and intensity of painful gout attacks. This proactive dietary management forms a cornerstone of effective gout control, offering a tangible way to mitigate symptoms and enhance overall joint health. Adopting these changes can dramatically improve quality of life for those affected by gout.

Sugars and Fruit

Sugar, particularly fructose, has been clearly implicated in increasing blood uric acid levels, posing a significant concern for individuals managing gout. Fructose, a natural sugar present in many foods, is also a primary component of high-fructose corn syrup, widely used in processed products. Consequently, judiciously limiting or avoiding high-fructose foods may contribute meaningfully to alleviating gout symptoms and reducing the frequency of attacks. This dietary adjustment is a practical step in managing the condition.

Fruit juices and sugar-sweetened beverages have a well-established association with both hyperuricemia and gout. Research consistently demonstrates their capacity to elevate uric acid levels, making their avoidance a key recommendation. While some fruits are naturally rich in fructose, more investigation is needed to definitively determine if they exert the same detrimental effects on gout as their concentrated juice and sweetened drink counterparts. For gout management, it is advisable to limit fruit juices, moderate intake of high-fructose fruits such as apples, pears, mangoes, figs, watermelon, and dried fruits, and closely monitor how these dietary modifications influence your gout symptoms.

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 drinks are commonly categorized as "empty-calorie" foods because they offer minimal, if any, beneficial nutrients while contributing a substantial amount of calories to one's diet. Beyond their general impact on weight and nutritional balance, these beverages are particularly problematic for individuals with gout, as they significantly heighten the risk of painful flare-ups. Their high sugar content, especially fructose, directly impacts uric acid levels.

A comprehensive 2020 research review meticulously analyzed numerous studies investigating the correlation between fructose from sugar-sweetened beverages and the development of gout. The consolidated findings unequivocally demonstrated a significant association, indicating that these drinks are strongly linked to an increased risk of both gout and hyperuricemia. Alongside fruit juices, it is strongly recommended to eliminate or severely restrict consumption of sodas, energy drinks, sports drinks, and overly sweet coffee concoctions to effectively manage gout symptoms and prevent attacks.

Processed Foods

The typical modern Western diet is characterized by a high intake of processed foods and refined carbohydrates, a dietary pattern that has been consistently linked to an elevated risk of gout. Beyond its specific impact on uric acid levels, this dietary approach is also implicated in the development and progression of numerous other serious health conditions. These include an increased susceptibility to type 2 diabetes, a heightened risk of heart disease, and a significant contribution to weight gain and obesity.

By consciously avoiding highly processed foods and beverages rich in refined carbohydrates, individuals can take a crucial step towards preventing the onset of gout and mitigating its painful symptoms. This dietary shift not only supports gout management but also fosters broader health benefits by reducing the risk of chronic diseases associated with unhealthy eating patterns. Common examples of foods to avoid include candy, baked goods (like muffins, pastries, cookies, and cakes), white bread, chips and crackers, ice cream, many frozen meals, and fast food.

Red Meat and Organ Meat

Red meat and organ meats are recognized as significant sources of purines, making them a primary dietary concern for individuals with gout. Extensive research has consistently demonstrated that the consumption of these foods can substantially elevate the risk of high uric acid levels and trigger acute gout episodes. The purines in these meats are readily converted into uric acid, which can then crystalize in joints, leading to intense pain.

To effectively manage and limit the risk of gout flare-ups, it is strongly advised to keep the intake of specific red and organ meats to a minimum. This includes beef, bison, venison, liver, heart, sweetbreads, tongue, and kidney. Furthermore, it is important to be mindful of hidden purines in many meat-based soups, gravies, and processed meats such as salami and pepperoni, as these can also increase the risk. While chicken contains moderate purine levels, it is generally considered acceptable in moderation as part of a balanced, gout-friendly diet.

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, the approach to fish and seafood is nuanced, as certain types are considerably higher in purines and should be largely avoided, while others can be included in moderation. A strategic selection of seafood is crucial for maintaining lower uric acid levels. Among the varieties to definitively avoid due to their high purine content are anchovies, codfish, haddock, halibut, herring, jack mackerel, mussels, sardines, trout, and tuna. These can significantly contribute to hyperuricemia and subsequent gout attacks.

For other seafood options, moderation is key. Lobster, crab, shrimp, oysters, clams, and salmon have moderate purine levels and should be limited to less than 6 ounces per day. Interestingly, fatty fish like tuna and salmon are celebrated for their omega-3 fatty acids, which are generally considered beneficial for heart health. However, their higher purine content introduces a complexity for gout patients. While some research suggests a potential link between omega-3-rich fish (but not supplements) and a lower risk of gout flares, more extensive research is needed to fully clarify this intriguing finding and provide definitive dietary recommendations.

Alcohol

Alcohol consumption is widely recognized as a significant risk factor for gout, making its avoidance or strict limitation a key recommendation for individuals following a low-purine diet. Specifically, beverages like beer, hard liquor, and other grain alcohols are known to elevate uric acid levels and increase the likelihood of gout attacks. These alcoholic drinks can interfere with the body's ability to excrete uric acid, leading to its accumulation in the blood.

Historically, wine was often considered a "safer" choice for individuals with a history or risk of high uric acid levels, believed to have lower purine content. However, more recent and comprehensive research challenges this long-held perception. A study involving 724 individuals with a history of gout revealed that all types of alcohol—wine, beer, and hard liquor—were independently associated with a higher risk of gout flare-ups. This increased risk was observed even with seemingly moderate amounts, though it was further exacerbated in individuals consuming high-purine foods or taking certain medications. This suggests that for optimal gout management, a cautious approach to all forms of alcohol is warranted.

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.15

Yeasts

Certain yeasts and yeast extracts are notable for their high purine content, making them important to avoid for individuals managing gout. These ingredients, often used as flavor enhancers or thickeners, can contribute to elevated uric acid levels and increase the risk of flare-ups. It is advisable to carefully check food labels and steer clear of products that list yeast or yeast extract among their ingredients, whether in food or supplements.

Common food items where yeast extract can be found include some varieties of soy sauce, which is often used in Asian cuisine and marinades; canned soups and stews, where it enhances savory flavors; various frozen dinners designed for convenience; and a range of salty snacks, including certain crackers or chips. Being vigilant about reading ingredient lists can significantly help in adhering to a low-purine diet and reducing gout risk.

What Foods Can You Eat With Gout?

Beyond knowing which foods to avoid, understanding what you can eat is equally empowering for managing gout. Several foods possess properties that can actively help lower uric acid levels, thereby mitigating the severity and frequency of gout flare-ups, and even preventing future attacks. Incorporating these beneficial foods into your daily diet can serve as a powerful natural intervention, complementing medical treatments and significantly improving your quality of life.

The following food categories have been identified as potentially helpful in easing gout symptoms by either directly lowering uric acid or reducing overall purine intake: fresh or tart cherries, foods abundantly rich in vitamin C, moderate coffee consumption, a wide array of low-purine foods such as whole grains and plant-based proteins, low-fat dairy products, and, crucially, ample water intake. Embracing these dietary choices provides a proactive strategy for maintaining lower uric acid levels and fostering better joint health.

Cherries

Cherries have garnered significant scientific attention for their remarkable potential in preventing and managing gout. Their distinctive deep red hue is attributed to natural compounds called anthocyanins, potent antioxidants that also exhibit strong anti-inflammatory properties. These unique characteristics are believed to be central to cherries' beneficial effects. Although cherries naturally contain fructose, research indicates that their consumption may paradoxically help reduce uric acid levels, subsequently decreasing inflammation and lowering the likelihood of future gout attacks.

Tart cherry varieties, such as Montmorency or Balaton, are the most frequently studied types for their positive impact on gout, suggesting specific beneficial compounds. Cherries can be consumed in various forms—fresh, frozen, as juice, or as an extract—all of which have been explored in research. While there isn't a universally defined daily amount for gout prevention, studies typically investigate servings ranging from 1/2 cup of fresh cherries to 1 cup of cherry juice per day. For cherry extract supplements, adhering to the suggested dosage on the nutrition label is always recommended for safe and effective use.

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.16
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 celebrated for its robust antioxidant properties, but its potential role in the dietary management of gout by lowering blood uric acid levels is a lesser-known, yet significant, benefit. This essential vitamin may play a crucial role in enhancing the excretion of uric acid, thereby helping to prevent its harmful accumulation in the body. Research has explored this connection, providing valuable insights into its efficacy.

A notable prospective study published in 2009 meticulously followed nearly 47,000 men over two decades, examining the relationship between their vitamin C intake and gout risk. The compelling conclusion indicated that higher vitamin C consumption was consistently associated with a lower risk of developing gout, with individuals consuming 1,500 milligrams or more per day demonstrating up to a 45% reduced risk. Further, a 2011 analysis of 13 randomized controlled clinical trials, involving individuals with elevated blood uric acid levels, found that vitamin C supplementation (at a median dose of 500 milligrams daily for 30 days) modestly reduced serum uric acid levels. While these findings are promising, further research is needed to definitively determine the precise amount required to significantly reduce gout risk.

Excellent dietary sources of vitamin C include citrus fruits like oranges and grapefruit, kiwifruit, strawberries, and cantaloupe. Vegetables such as sweet bell peppers, cruciferous vegetables (broccoli, cauliflower, Brussels sprouts, and cabbage), baked potatoes, and tomatoes are also rich in this beneficial nutrient. However, a crucial caution: if you have an increased risk for kidney stones, particularly calcium oxalate stones, consuming high doses of supplemental vitamin C on a regular basis is generally not recommended, as it can contribute to stone formation.

Coffee

Coffee, one of the most widely consumed beverages globally, has been the subject of extensive research into its diverse health effects, including its potential role in gout management. Early studies have suggested that regular coffee consumption may contribute to a decreased risk of developing gout. However, the precise impact appears to vary, with research indicating differences based on sex and the amount consumed.

A comprehensive 2015 review of multiple studies provided valuable insights into this relationship. It found that men who drank four to five cups of coffee daily experienced a 40% decreased risk of gout, with this reduction increasing to 59% for those consuming six or more cups per day, compared to non-coffee drinkers. For women, the benefits were also notable: one to three cups daily lowered the gout risk by 22%, and four or more cups daily by 57%. Based on this review, researchers concluded that drinking at least four cups of coffee per day appears to lower uric acid levels and reduce the incidence of gout. However, it is important to note that current research has not yet explored coffee's effects on the risk of recurrent gout attacks.

Low-Purine Foods

One of the most foundational and widely endorsed dietary strategies for managing gout is to significantly reduce the intake of purines from foods. By consciously prioritizing and choosing low-purine food options over those with higher purine content, individuals can effectively prevent their blood uric acid levels from becoming excessively elevated, a primary trigger for gout attacks. This dietary adjustment is a cornerstone of proactive gout management, aiming to keep uric acid within a healthy range.

Furthermore, adopting dietary patterns rich in low-purine foods offers broader health advantages. The Dietary Approaches to Stop Hypertension (DASH) diet, for instance, naturally emphasizes many low-purine foods and has been consistently associated with a lower risk of gout. Examples of beneficial low-purine foods include certain fruits like cherries, berries, and citrus fruits; nonfat and low-fat dairy products such as milk, cheese, and yogurt; plant-based protein sources like nuts, peanut butter, seeds, and legumes; eggs (in moderation); and whole grains, bread, pasta, rice, and a wide variety of vegetables.

Plant-Based Foods

Many plant-based foods are inherently low in purines, making them an excellent cornerstone for a gout-friendly diet. Beyond their low-purine profile, these foods are nutritional powerhouses, packed with an abundance of health-promoting nutrients, including essential vitamins, vital minerals, and dietary fiber. Incorporating a rich variety of plant-based foods can significantly contribute to overall health and well-being, complementing gout management strategies.

Examples of highly beneficial plant-based foods include various beans and other legumes, a wide array of fresh fruits, diverse nuts, oils derived from nuts and vegetables, numerous seeds, and a spectrum of soy-based proteins such as tofu, tempeh, soy nuts, and soy milk. A comprehensive range of vegetables and whole grains also fall into this category. Studies have consistently demonstrated that diets rich in plant-based foods are associated with a decreased risk of gout, reinforcing their protective role.

While it is true that some vegetables contain higher purine levels than others, the human body processes plant-based purines differently than those derived from animal sources. Research indicates that purines from plant foods do not increase the risk of gout and may even offer protective benefits. A 2019 review on plant-based diets and gout suggested that moderate consumption of even higher-purine plant foods can be safely tolerated in healthy individuals. However, researchers noted the need for additional studies specifically in people with high uric acid levels, particularly those with chronic kidney disease, to fully understand the implications for these vulnerable groups.

Low-Fat Dairy

Dairy products, particularly low-fat or non-fat varieties, have been consistently identified as beneficial in reducing the risk of gout. This protective effect may be attributed to their capacity to decrease uric acid levels in the blood, potentially through mechanisms that enhance uric acid excretion. Furthermore, low-fat dairy contains certain anti-inflammatory properties that can help mitigate the inflammatory response triggered by monosodium urate crystals within the joints, which is the hallmark of a gout attack.

The Dietary Guidelines for Americans advocate for three servings of dairy per day for healthy adults, suggesting that incorporating low-fat milk, yogurt, cheese, and cottage cheese can be a valuable part of a balanced diet for gout management. This recommendation supports both general nutritional needs and provides a specific strategy for individuals seeking to minimize gout risk and manage symptoms. Consistent inclusion of these dairy options can contribute significantly to a gout-friendly eating plan.

Water

Staying adequately hydrated is a fundamental and critical aspect of managing gout effectively. Sufficient water intake plays a vital role in regulating uric acid levels within the body. A prospective study conducted in 2017 investigated the association between water consumption and uric acid levels in individuals with gout. Researchers found a clear connection: higher water intake was associated with lower uric acid levels, likely due to increased uric acid excretion through urine. While more direct research is still needed to fully elucidate the exact mechanisms, the observed correlation strongly supports hydration as a key dietary intervention.

A review published in the American Journal of Lifestyle Medicine further highlighted the importance of hydration, noting that excessive sweating, such as during strenuous exercise or sauna use, can decrease the urinary excretion of uric acid, leading to its buildup in the bloodstream. Consequently, researchers recommend drinking plenty of water to counteract this effect and prevent increased serum uric acid levels after activities that induce heavy sweating. Furthermore, this review also found that adequate water consumption in the 24-hour period immediately preceding a gout flare was significantly associated with a notable decrease in recurrent gout attacks, underscoring its role as an immediate preventative measure.

While water is undoubtedly the best source of hydration, other beverages like coffee and certain fruits and vegetables also contribute to your overall fluid intake. The best approach is often to drink to thirst, allowing your body's natural cues to guide your hydration. However, some experts suggest a general guideline of drinking half of your body weight in ounces each day to ensure optimal hydration, supporting healthy uric acid metabolism and overall bodily functions.

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Sample Meal Plan

Transitioning to a gout-friendly diet, or any new eating pattern, can seem daunting, but establishing clear principles and practical examples can make the process much more manageable. One highly effective and accessible approach is to adopt the principles of the Dietary Approaches to Stop Hypertension (DASH) diet. This dietary framework offers a structured way to build meal choices and menus around foods known to be beneficial for overall health, and particularly for gout management, making the transition less complex and more intuitive.

The effectiveness and practicality of the DASH diet for gout management were notably demonstrated in a study conducted in Baltimore, Maryland, involving individuals living with gout. In this study, dietitians meticulously approved participants' grocery lists, with the food then ordered and delivered directly to their homes. Researchers rigorously evaluated the dietary intake of the participants and monitored any subsequent changes in their uric acid levels. This structured approach provided tangible evidence of the diet's impact in a real-world setting, offering valuable insights into its feasibility and benefits.

The 49 study participants followed meal plans meticulously designed to align with DASH principles while specifically restricting high-purine foods. Their daily intake included 5–7 servings of healthy grains, 4 servings of fruit, and 4 servings of vegetables, emphasizing a plant-forward approach. Protein sources were carefully chosen, with 1–2 servings of lean poultry (chicken, turkey) or fish, and 2 servings of low-fat dairy like milk or cheese. Additionally, a limited, controlled amount of nuts, seeds, and legumes were included each day, ensuring balanced nutrition without exceeding purine thresholds.

Beyond purine management, the carefully constructed meals also strictly limited sodium (salt), cholesterol, and fats, reflecting the broader health benefits of the DASH diet. The results of this study were encouraging: participants showed some notable reduction in their uric acid levels. Furthermore, a remarkable 80% of participants reported finding the diet easy to follow, highlighting its practical applicability. Crucially, three-fourths of the participants expressed a strong likelihood of continuing to eat in this new way even after the study concluded, demonstrating a positive and sustainable behavioral change due to their positive experience with the dietary modifications.

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.23

Summary

The risk of painful gout flare-ups is profoundly influenced by the dietary choices and beverages you consume. Gout, a debilitating form of inflammatory arthritis, is triggered by elevated uric acid levels, which are often exacerbated by natural compounds called purines found in certain foods. Effectively managing gout therefore necessitates a thoughtful approach to nutrition, recognizing that what you eat directly impacts your body's uric acid metabolism and inflammatory response.

Beyond gout, these specific food choices also have significant implications for other critical health conditions, including high blood pressure and kidney disease, underscoring the holistic benefits of a mindful diet. A cornerstone of gout management is a low-purine diet, which typically restricts foods such as red meat, alcoholic beverages, processed foods, sugary items, and specific types of seafood. While these general guidelines are highly effective, it is important to remember that the precise foods that trigger gout flare-ups can vary from person to person. Maintaining open communication with your healthcare provider is essential as you embark on dietary changes, allowing for personalized guidance and the celebration of small, encouraging "wins" throughout your journey to better health.

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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.

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