Do you suffer from gout? Did you know that your diet can cause a flare-up of gout? Have you ever wondered if there are any lifestyle changes that you could make to reduce the amount of times you are experiencing gout? This article will focus on answering these questions and address some of the dietary changes that could be made to help either prevent gout or reduce the progression of gout and improve symptoms.
What is gout?
Gout is a type of arthritis, a condition which can cause sudden pain and swelling in the joints, particularly the toes, knees, ankles and fingers (CKS).1 Gout is caused by a build-up of small crystals, known as uric acid, within the joint. Certain people may be more likely to have gout than others. risk factors for gout include diet, family history, and certain medical conditions such as obesity, high blood pressure and kidney disease.2 Further, some medications can increase gout risk, such as diuretics and aspirin.2
A correlation has been found between the number of gout flare-ups and diet.3 Examples of foods and drinks which commonly cause gout to flare up include high-purine foods, sugary foods, alcohol and red meats.
What are the aims of dietary changes for gout?
Altering the diet in order to reduce the number of flare-ups of gout aims to encourage weight loss, avoid purine-containing foods and reduce the amount of uric acid production within the body (4).
Examples of food types associated with gout
High-purine foods
Purines are chemical compounds which are broken down in the body to form uric acid and are found in higher levels in certain foods.4 Following a low-purine diet means reducing the amount of purine-containing foods in order to reduce the uric acid levels in your blood. Examples of foods high in purines include:
- Seafood – such as anchovies, sardines, tuna and shellfish
- Organ meats - such as liver, kidney and sweetbread
- Certain vegetables – such as asparagus and spinach
It is important to note that these high-purine vegetables have not been found to significantly increase the risk of gout.5
High-fructose foods and sugary beverages
Fructose is a type of sugar that is found naturally in various food sources, such as fruit. When you consume excess fructose, it can increase the amount of purine production within the blood.4 As previously mentioned, this results in increased uric acid production, which can cause gout to flare. Further mechanisms include increased obesity and insulin resistance, which cause inflammation in the body.
Examples of high-fructose foods include:
- Sodas, sweetened fruit juices, sports and energy drinks
- Foods containing high-fructose corn syrup which is usually found in many types of packaged food.
Alcohol
Drinking alcohol may increase the risk of gout through two main ways. Firstly, some alcohols have higher levels of purines than others, and secondly, alcohol affects the kidneys and may reduce the amount of uric acid, which is eliminated in the urine.6 Examples of alcohol which may pose a higher risk include:
- Beer
- Spirits
- Wine – particularly red wine
Consuming alcohol in large quantities, or binge drinking, has a larger association with gout flare-ups, even when people are taking medications to prevent a gout flare.7 Although it is not necessary for people who suffer from gout to completely cut out all alcohol, simply limiting alcohol intake is advisable. Avoiding alcohol during a gout attack may be beneficial.4 Ensuring you stay well hydrated and drinking plenty of water can help promote the removal of uric acid through the kidneys.
Processed and red meats
Red meats, such as beef, venison and bison, are higher in purines than white meats and so it is recommended that these be limited.3 Additionally, processed meats such as hotdogs, sausages and bacon are high in purines and may trigger a gout flare.
High-fat foods
Foods that contain higher levels of fat have been linked to gout due to increased uric acid production, as well as the risk of obesity and weight gain, which has been linked to increased rates of gout (8). Examples of high-fat foods include:
- Fried foods
- Full-fat dairy
- Foods high in trans fats
Benefits of following a gout-friendly diet
As already alluded to, following a diet which aims to reduce the number of purines and uric acid levels in the body can reduce the symptoms of gout in people who suffer from gout symptoms, but can also work by preventing gout in people who have high uric acid levels.9 Following dietary advice may also have the benefit of reduced weight and associated diseases, such as obesity and cardiovascular disease. Finally, reducing the amount of gout flare-ups that you have may reduce the amount of required medication in order to manage the condition.
Limitations of following a gout-friendly diet
Despite the various benefits that have been mentioned, making lifestyle changes can be difficult and requires commitment, and finding motivation can be challenging. Additionally, there are some risks that reducing certain foods can result in reduced sources of necessary nutrients, such as omega-3 - a type of healthy fat which can support heart health.9 It is important to take into consideration that although making dietary changes can help, everyone is different, and what works for one person may not be applicable to another. Following a specific diet is not necessarily going to prevent gout, and in some people, medication may be necessary.
Summary
Gout is a type of inflammatory arthritis which results from the build-up of uric acid levels within the body. Diet plays an important role in reducing the number of gout flare-ups and making the condition more manageable. Gout can be a painful and distressing disease, but making lifestyle changes, alongside taking medication, can help. If you are suffering from gout, you may benefit from limiting the following food types: sugary foods, alcohol, processed and red meats, and high-fat foods. Patients who follow the recommended dietary guidelines may be able to reduce their gout flare-ups, lead a better quality of life, and improve their general well-being. However, one diet is not applicable to everyone. If you are concerned about gout, it is important to get in touch with a healthcare professional to develop a plan in order to reduce your flare-ups.
References
- Gout. NICE CKS n.d. https://cks.nice.org.uk/topics/gout/ (accessed September 14, 2023).
- Branch NSC and O. Gout. National Institute of Arthritis and Musculoskeletal and Skin Diseases 2017. https://www.niams.nih.gov/health-topics/gout (accessed September 14, 2023).
- Zhang Y, Chen S, Yuan M, Xu Y, Xu H. Gout and Diet: A Comprehensive Review of Mechanisms and Management. Nutrients 2022;14:3525. https://doi.org/10.3390/nu14173525
- Can the foods you eat help to control gout? Mayo Clinic n.d. https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/gout-diet/art-20048524 (accessed September 14, 2023).
- Jakše B, Jakše B, Pajek M, Pajek J. Uric Acid and Plant-Based Nutrition. Nutrients 2019;11:1736. https://doi.org/10.3390/nu11081736
- Levey DK. The Connection Between Alcohol and Gout: How Does Drinking Alcohol Affect Gout? CreakyJoints 2019. https://creakyjoints.org/about-arthritis/gout/gout-diet/alcohol-and-gout/ (accessed September 14, 2023).
- UK Gout Society n.d. https://www.ukgoutsociety.org/ (accessed September 14, 2023).
- Gout Diet Dos and Don’ts | Arthritis Foundation n.d. https://www.arthritis.org/health-wellness/healthy-living/nutrition/healthy-eating/gout-diet-dos-and-donts(accessed September 14, 2023).
- Gout (Low Purine) Diet: Best Foods to Eat & What to Avoid. Cleveland Clinic n.d. https://my.clevelandclinic.org/health/treatments/22548-gout-low-purine-diet (accessed September 14, 2023).