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Oct 2

The Gout diet — simplified

Gout in toe, painful toe, gout diet

Most people who have ever had a gout attack are interested in learning about the gout diet. After all, gout attacks are so painful we want to avoid them if at all possible. But many recommended gout diets are so confusing, listing so many foods that can cause gout, that you’re soon left with nothing to eat. So I decided to make this a little simpler.

 

Why a diet at all?

Gout is caused by excess levels uric acid in the blood. The extra uric acid can precipitate in the joint in form of crystals, causing a lot of inflammation and pain. Uric acid is produced in the body from the breakdown of purines, which are components of DNA, and present in our bodies as well as the foods we eat. Naturally, we all have some level of uric acid in our blood. In fact, it is thought that uric acid may have antioxidant properties that is useful for our health, at low levels.

 

Balance between purine production and excretion in gout
Balance between purine production and excretion in gout

There is normally a fine balance between production of uric acid and its excretion through the kidneys. When this balance is offset- either from excess production from foods rich in purines, or from  kidney disease leading to decreased excretion- there may be a buildup of uric acid, causing gout. In addition, genetics also pay a role, causing gout to be more common in some families than in others. We may not have much control over our genetics or our kidney function, but we can control what we eat. Hence, the gout diet.

 

The diet at a glance

Now that we know that purine-rich foods are the culprit, let’s divide common foods we consume into purine-rich and purine-poor categories:

    Purine-rich

  • Red meat (beef, pork, lamb)
  • Organ meat (kidney, liver, brain)
  • Beer
  • Poultry
  • Scallops
  • Mussles
  • Tuna
  • Herring
  • Anchovies
  • Mackerel
  • Yeast
  • Sardines
  • High-fructose corn syrup (soda, fruit-juices)
  • High fat dairy

 

Purine-poor

  • Vegetables
  • Refined grains (bread, cereal)
  • Coffee and tea
  • Low fat dairy
  • Nuts
  • Peanut butter

 

 

 

 

 

 

Foods that can help prevent gout:

  • Cherry juice
  • Dark berries
  • Omega-3

 

 

 

 

 

 

 

 

I thought you said this was going to be simple!

I usually advise my patients to be aware of the top 3 offenders: Red meats, Shellfish, and Beer.

I think it is impossible (and quite frankly, cruel) to ask patients to remember all the foods that can potentially cause gout. Eliminating the variety can also really affect one’s lifestyle and pleasure in food. I think the best course of action is to limit the top offenders. Beyond that, we do have medications that can also help.

 

Lose weight!

Obesity has been linked to gout and high levels of blood uric acid. So losing those extra pounds may help control or eliminate your gout.

Firooz, Dr. Nazanin

Dr. Firooz is board-certified in Rheumatology and Internal Medicine. She is an active member of the American College of Rheumatology, and is affiliated with the Department of Rheumatology at Cedars Sinai Medical Center.

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