Gout diet: What's allowed, what's not

By Mayo Clinic Staff
Gout, a painful form of arthritis, has long been associated with diet, particularly overindulgence in meat, seafood and alcohol. As a result, gout treatment used to include severe dietary restrictions, which made the gout diet hard to stick to. Fortunately, newer medications to treat gout have reduced the need for such a strict diet.
 
Newer diet recommendations resemble a healthy-eating plan recommended for most people. Besides helping you maintain a healthy weight and avoid several chronic diseases, this diet may contribute to better overall management of your gout.
 
Purpose
 
Gout occurs when high levels of uric acid in your blood cause crystals to form and accumulate around a joint. Your body produces uric acid when it breaks down purines. Purines occur naturally in your body, but you also get them from eating certain foods, such as organ meats, anchovies, herring, asparagus and mushrooms.
 
A gout diet helps to control the production and elimination of uric acid, which may help prevent gout attacks or reduce their severity. The diet isn't a treatment for gout, but may help you control your attacks. Obesity also is a risk factor for gout, so losing weight can help you lower your risk of attacks.
 
Diet details
 
A gout diet reduces your intake of foods that are high in purines, such as animal products, which helps control your body's production of uric acid. The diet also limits alcohol, particularly beer, which has been linked to gout attacks. If you're overweight or obese, lose weight. However, avoid fasting and rapid weight loss because these can promote a gout attack. Drink plenty of fluids to help flush uric acid from your body. Also avoid high-protein weight-loss diets, which can cause you to produce too much uric acid (hyperuricemia).
 
To follow the diet:
•Limit meat, poultry and fish. Animal proteins are high in purine. Avoid or severely limit high-purine foods, such as organ meats, herring, anchovies and mackerel. Red meat (beef, pork and lamb), fatty fish and seafood (tuna, shrimp, lobster and scallops) are associated with increased risk of gout. Because all meat, poultry and fish contain purines, limit your intake to 4 to 6 ounces (113 to 170 grams) daily.
•Cut back on fat. Saturated fat lowers the body's ability to eliminate uric acid. Choosing plant-based protein, such as beans and legumes, and low-fat or fat-free dairy products will help you cut down the amount of saturated fat in your diet. High-fat meals also contribute to obesity, which is linked to gout.
•Limit or avoid alcohol. Alcohol interferes with the elimination of uric acid from your body. Drinking beer, in particular, has been linked to gout attacks. If you're having an attack, avoid all alcohol. However, when you're not having an attack, drinking one or two 5-ounce (148-milliliter) servings a day of wine is not likely to increase your risk.
•Limit or avoid foods sweetened with high-fructose corn syrup. Fructose is the only carbohydrate known to increase uric acid. It is best to avoid beverages sweetened with high-fructose corn syrup, such as soft drinks or juice drinks. Juices that are 100 percent fruit juice do not seem to stimulate uric acid production as much.
•Choose complex carbohydrates. Eat more whole grains and fruits and vegetables and fewer refined carbohydrates, such as white bread, cakes and candy.
•Choose low-fat or fat-free dairy products. Some studies have shown that low-fat dairy products can help reduce the risk of gout.
•Drink plenty of fluids, particularly water. Fluids can help remove uric acid from your body. Aim for 8 to 16 glasses a day. A glass is 8 ounces (237 milliliter). There's also some evidence that drinking four to six cups of coffee a day lowers gout risk in men.
 
A sample menu
 Here's a look at what you might eat during a typical day on a gout diet:
Breakfast
•Whole-grain, unsweetened cereal with skim or low-fat milk, topped with fresh fruit
•Whole-wheat toast with trans-free margarine
•100 percent fruit juice
•Coffee
 
Lunch
•Lean meat, poultry or fish (2 to 3 ounces) sandwich on whole-wheat bread, with lettuce, tomato and low-fat spread
•Carrot and celery sticks, side salad or vegetable soup
•Fresh fruit, such as apple, orange or pear
•Skim or low-fat milk
 
Dinner
•Baked or roasted chicken (2 to 3 ounces)
•Steamed vegetables
•Baked potato with low-fat sour cream
•Green salad with tomatoes and low-fat dressing
•Fresh fruit, such as berries or melon
•Nonalcoholic beverage, such as water or tea
 
Snacks can be added to this menu as long as you make healthy choices — such as fruits, vegetables and whole grains, and occasional nuts — and you are at a healthy weight or stay within your calorie limit.