Diet and gout. What foods to avoid and what to eat?

FORBIDDEN PRODUCTS: WHAT SHOULD YOU AVOID IF YOU HAVE GOUT?

Gout is a metabolic disease that occurs due to the accumulation of uric acid in the body. This acid is formed when the body breaks down purines, naturally occurring chemicals found in many foods. When the level of uric acid in the blood becomes too high, it begins to crystallize in the joints, causing severe pain and inflammation. For this reason, it is very important to avoid foods high in purines if you have gout.

Some foods are extremely high in purines, so they should be avoided or at least severely limited. Below, we will discuss the main food groups that can increase the level of uric acid in the blood and provoke a gout attack.

Red meat and offal

Red meat and offal are among the largest sources of purines in food.

• Beef, pork, lamb – these types of meat contain an average of 120–150 mg of purines per 100 g of product. Although this concentration is not the highest, frequent consumption of red meat can contribute to excess uric acid in the body.
• Offal (liver, kidneys, heart, tongue, brain) – these products are particularly high in purines: in the liver they are about 250 mg/100 g, and in the kidneys – even up to 300 mg/100 g. This significantly increases the level of uric acid in the blood and can cause a gout attack.

Although meat is rich in protein, if you have gout, it is recommended to choose leaner meat, such as chicken or turkey, and consume them in moderation.

Seafood and oily fish

Seafood and some types of oily fish are also high in purines and can worsen gout symptoms.

• Sardines, anchovies, sprats - these small fish are very high in purines, up to 400 mg/100 g.
• Mackerel, tuna, cod, salmon - although the purines in these fish are slightly lower than in sardines, their consumption should still be limited.
• Shellfish (shrimp, crab, lobster, clams, mussels, scallops) - these products can also increase uric acid levels in the blood, so they should be avoided or consumed only very rarely.

Although fish is a valuable source of omega-3 fatty acids, which reduce inflammation, people with gout are advised to choose fish with a lower purine content, such as trout or flounder.

Alcohol

Alcohol is one of the most dangerous gout triggers because it interferes with the excretion of uric acid through the kidneys and can cause a sudden increase in its concentration in the blood.

• Beer – contains not only alcohol, but also a large amount of purines, so it is especially harmful for gout sufferers. Studies show that beer consumption can double the risk of a gout attack.
• Strong alcoholic beverages (vodka, whiskey, cognac, rum, tequila) – also increase the amount of uric acid in the blood and interfere with its excretion.
• Wine – wine has less of an effect on the accumulation of uric acid than beer or strong drinks, but it should be avoided during gout flare-ups.

Alcohol not only contributes to the accumulation of uric acid, but can also promote dehydration, which further worsens the situation.

Sugar-sweetened beverages and fructose

Fructose is a natural sugar found in fruit, but excessive amounts can promote the production of uric acid.

• Sweetened carbonated beverages – sodas, energy drinks, artificially sweetened juices and fruit juices – are associated with a higher risk of developing gout.
• Processed foods high in fructose – candy, cookies, cakes, ice cream and other processed foods can increase the production of uric acid in the body.

Studies show that people who frequently consume fructose-containing beverages have up to an 80% higher risk of gout compared to those who avoid such beverages.

Additional foods to limit

In addition to the main food groups that are prohibited, there are other foods that should be consumed in very moderation or completely avoided if you have gout:

• White flour and refined carbohydrates (white bread, white rice, pasta). Although they are low in purines, they promote obesity and insulin resistance, which can negatively affect the elimination of uric acid.
• Fried and fatty foods - too much saturated fat can interfere with the elimination of uric acid by the kidneys.
• Cheese and high-fat dairy products - some types of high-fat dairy products can promote the accumulation of uric acid.

ALLOWED FOODS: WHAT CAN YOU EAT WITH GOUT?

Proper nutrition for gout is not only about what to avoid, but also about what foods to include in your daily diet. Certain foods can help your body eliminate uric acid more effectively, reduce inflammation, and prevent gout attacks.

Vegetables - a healthy choice without restrictions

It has long been believed that some vegetables, such as asparagus, spinach, cauliflower and mushrooms, can increase uric acid levels in the blood due to their higher purine content. However, recent studies show that plant-based purines do not have the same effect as animal-based purines.

• Leafy vegetables (spinach, cabbage, lettuce, kale) - rich in vitamins, minerals and antioxidants.
• Root vegetables (carrots, beets, potatoes) - a good source of complex carbohydrates and fiber, which do not affect uric acid levels.
• Cruciferous vegetables (broccoli, cauliflower, Brussels sprouts) - have anti-inflammatory properties and help fight oxidative stress in the body.

Important: People with gout should consume vegetables rich in fiber, as they help regulate insulin levels in the blood, which can affect uric acid levels.

Fruits - natural antioxidants and a source of vitamins

Fruits are a very important part of the diet of people with gout, as they are rich in vitamins, antioxidants and fiber. Of particular value are those fruits that help reduce uric acid levels and inhibit inflammatory processes.

• Cherries - studies show that cherries can reduce the frequency of gout attacks by up to 35%, as they contain anthocyanins - powerful antioxidants that reduce inflammation and help the body eliminate uric acid faster.
• Citrus fruits (oranges, lemons, grapefruit) - are rich in vitamin C, which has been shown to help reduce uric acid levels.
• Apples, pears, plums - rich in fiber, which supports good digestive system function and helps remove unnecessary substances from the body.
• Berries (strawberries, raspberries, blueberries) - have strong anti-inflammatory properties that help protect joints from inflammation.

Important: Although fruit is beneficial, excessive fructose intake should be avoided as it can increase uric acid production. This is especially true for artificially sweetened juices and dried fruits, which are very high in fructose.

Low-fat dairy products - a safe source of protein

Low-fat dairy products such as skim milk, low-fat yogurt and cottage cheese are good choices for people with gout. Studies show that these products can help reduce uric acid levels and even have a protective effect against gout attacks.

• Skim milk - is low in fat and is a good source of protein and calcium.
• Low-fat yogurt - helps maintain good gut microflora, which is important for overall health.
• Cottage cheese - an excellent source of easily digestible protein that does not worsen uric acid levels in the blood.

Important: Fatty dairy products such as butter, full-fat sour cream or full-fat cheese should be avoided, as they can stimulate inflammatory processes in the body.

Whole Grains - a source of healthy carbohydrates

Whole grains, such as oatmeal, brown rice, whole wheat bread, and pasta, are better than refined carbohydrates because they reduce inflammation and keep blood sugar levels stable.

• Oatmeal - contains slow-digesting carbohydrates that help maintain stable energy levels.
• Brown rice - is rich in minerals and fiber, which help absorb nutrients better.
• Whole grain bread is a good source of complex carbohydrates that promote a feeling of satiety and do not raise blood sugar levels as sharply as white bread.

Plant-based protein - an alternative to meat

Since most animal protein sources are rich in purines, it is worth choosing plant-based protein if you have gout.

• Beans and lentils - although they contain some purines, their effect on the body is minimal, and they provide a lot of protein and fiber.
• Tofu and soy - are a great alternative to meat, especially if you use organic, unprocessed soy products.
• Nuts and seeds - almonds, walnuts, sunflower and pumpkin seeds are a good source of protein and healthy fats.

Healthy Fats - important in an anti-inflammatory diet

Healthy fats help reduce inflammation and are essential for overall body function.

• Olive oil - has strong anti-inflammatory properties and is a great alternative to animal fats.
• Avocados - rich in good fats, vitamins and fiber.
• Nuts and seeds - a good source of omega-3 fatty acids.

ADDITIONAL RECOMMENDATIONS

• Drink plenty of water: Fluid intake (at least 2-3 liters per day) helps the body excrete uric acid through the kidneys.
• Maintain a stable weight: Being overweight can increase uric acid production, so a healthy diet and regular physical activity are recommended.
• Avoid overeating and prolonged periods of fasting: Regular meals help maintain stable insulin and uric acid levels in the blood.

Proper nutrition is essential for the prevention and management of gout. Avoiding foods high in purines, reducing alcohol and sugar intake, and including plenty of fruits, vegetables, whole grains, and healthy fats in your diet can reduce the frequency of gout attacks and improve your quality of life.

SOURCES OF INFORMATION

1. Mayo Clinic. (2023). Gout diet: What’s allowed, what’s not?
2. Arthritis Foundation. (2022). Gout diet dos and don’ts.
3. Harvard Health. (2022). Gout and diet: What’s safe to eat?

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