Best Diet for Gout: What to Eat, What to Avoid

Gout is a type of arthritis, an inflammatory condition of the joints. It affects an estimated 9.2 million people in the US alone (1).

People with gout experience sudden and severe attacks of pain, swelling and inflammation of the joints (2).

Fortunately, gout can be controlled with medications, a gout-friendly diet and lifestyle changes.

This article reviews the best diets for gout and what foods to avoid, backed by research.

What is gout?

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Gout is a type of arthritis that involves sudden pain, swelling and inflammation of the joints.

Most cases of gout affect the big toe, but the condition can also affect your other toes, foot, knee or heel. Other parts of your body can also be affected, but it’s less common (3, 4, 5).

Gout symptoms or “attacks” occur when there is too much uric acid in the blood. Uric acid is a waste product that your body makes naturally. It’s also produced when you digest certain foods.

When uric acid levels are high, crystals of it can accumulate in your joints. This process triggers swelling, inflammation and intense pain (5).

Gout attacks typically occur at night and last 3–10 days (6).

Most people who have the condition experience these symptoms because their bodies can’t remove the excess uric acid efficiently. This lets uric acid accumulate, crystallize and settle in the joints.

Research suggests that gout is caused by several different genes. Other factors such as diet also play a role (7, 8).

Summary

Gout is a type of arthritis that involves sudden pain, swelling and inflammation of the joints. It happens when there is too much uric acid in the blood, causing it to deposit in the joints as crystals.

How does food affect gout?

If you have gout, your doctor can help you develop a treatment plan to manage your flares. This may include making changes to your diet and taking medications that can help prevent gout attacks (9).

Some foods may trigger a flare by raising your uric acid levels. Following a diet that limits certain meats, alcohol, beer, and sugar may help you manage gout.

Many trigger foods are high in purines, a substance found naturally in foods. When you digest purines, your body makes uric acid as a waste product (10).

This is not a concern for people without gout, as they efficiently remove excess uric acid from the body.

However, people with gout can’t efficiently remove excess uric acid. Thus, a diet high in foods that increase uric acid levels may let uric acid accumulate. This can increase the chance of having a gout attack (5).

Foods with moderate-to-high amounts of purines include organ meats, red meats, certain types of seafood, alcohol and beer (11, 12).

Some vegetables, legumes, and beans also contain purines. However, research shows that high-purine plant foods do not trigger gout attacks. Eating plenty of vegetables, legumes, and beans is good for your health and may help you lower your uric acid levels (4, 13).

Fructose and sugar-sweetened beverages can also increase the risk of gout and gout attacks, even though they’re not purine-rich (14).

Instead, they can raise uric acid levels by accelerating several cellular processes (15, 16).

For instance, a study including 655 participants found that consuming sugar-sweetened beverages was the largest risk factor for developing gout at an early age. Sugary drinks were also associated with a higher uric acid load (17).

On the other hand, research suggests that low-fat dairy products, soy products and vitamin C supplements could potentially prevent gout attacks by reducing your uric acid levels (18, 19).

If you’re interested in vitamin C supplements, talk with your doctor first to make sure they’re safe for you to try.

High-fat dairy products don’t seem to affect uric acid levels (20).

Summary

The foods you eat can either raise or lower your uric acid levels. Some foods such as red meat and beer contain high amounts of purines, which turn into uric acid during digestion. Consuming foods high in added sugars can also cause your body to make more uric acid.

What foods should you avoid?

It may be tempting to focus on specific foods as “the enemy,” but when it comes to managing gout, the truth may be more complicated.

Many people with gout can benefit from following a balanced diet that’s low in saturated fat and added sugars, and rich in vegetables and fruits. Much of the time, avoiding specific foods may be less important than your overall dietary pattern (4, 21).

That said, there are a handful of foods that people commonly associate with gout flare-ups. Most of these fall into a few main categories: high-purine animal foods, alcohol, and foods high in added sugars.

Foods you may need to limit include (6, 11, 12, 22):

• Organ meats: These include liver, kidneys, sweetbreads, and brain
• Game meats: Examples include boar and venison
• Red meat: Beef, pork, and lamb are the most common
• Some types of seafood: Shellfish, oily fish, and canned fish
• Sugary beverages: Especially fruit juices and sugary sodas
• Sugary snacks: Cakes, cookies, candy, and similar items
• Yeast extracts: These are found in frozen dinners, canned soups, bouillon cubes, and other foods

Your doctor or a registered dietitian can help you choose an eating plan that meets your needs.

If you consume alcohol, they’ll likely recommend avoiding beer and hard liquor, and limiting your intake in general (6).

They may also recommend other dietary changes to support the health of your cardiovascular and metabolic systems. These changes can help you manage gout.

You may see benefits from limiting refined carbs such as white bread and items made with white flour, and choosing whole grain foods instead (21).

It can also be helpful to reduce your intake of saturated fat that’s found in foods like butter, full fat cheeses, shortening, and palm oil. Instead, try cooking with unsaturated fats like olive oil and other liquid vegetable oils (21).

Summary

Certain foods tend to be associated with gout flares. These include red meat, organ meats, game meats, and sweet drinks and treats. Shifting to an eating pattern that’s low in saturated fats and refined carbs may make gout more manageable.

What foods should you eat?

To help manage gout, your doctor or dietitian may suggest you try making a shift to a healthier eating pattern.

For most people, a healthy diet for gout will feature plenty of vegetables, fruits, whole grains, and legumes. There are many different foods to choose from in these categories (23).

Shifting to a new diet may be more effective than trying to add a handful of gout-friendly foods to your existing diet, especially if you regularly eat foods that are high in saturated fat and refined carbs (23).

In particular, diets that are known to support your heart health may help you manage gout. These include the DASH diet and Mediterranean diet.

These diets involved choosing vegetables, fruits, and whole grains instead of foods that are high in saturated fat and refined carbs (21).

DASH diet

The DASH diet — Dietary Approaches to Stop Hypertension — is an eating pattern that’s designed to help people lower their blood pressure. It’s also used to manage gout (21).

DASH encourages you to build your meals and snacks around (24):

• Fruits, vegetables, and whole grains
• Lean protein from meat, poultry, fish, nuts, and legumes
• Vegetable oils
• Low-fat or non-fat dairy

This diet limits saturated fats and foods high in added sugar.

Some types of fish may be associated with gout flares. Depending on how well your gout is controlled, your doctor may recommend that you limit your intake of fish on the DASH diet.

You can view a sample DASH meal plan here.

Mediterranean diet

The Mediterranean diet is associated with numerous health benefits, including improved cardiovascular health. It has some similarities to the DASH diet. This diet features (21, 25):

• Fruits, vegetables, and whole grains
• Lean protein from fish and seafood, nuts, and legumes
• Healthy fat from extra virgin olive oil

Fish and seafood are usually central to the Mediterannean diet. These foods can be associated with gout flares, so depending on your condition, your doctor may recommend other protein sources or suggest a different diet.

You can view a sample Mediterranean diet meal plan here.

Foods to focus on

Although a gout-friendly diet eliminates some foods, there are still plenty of foods you can enjoy.

Here are some foods that are generally safe for people with gout (4, 11, 21, 22):

• Fruits: All fruits are generally fine for gout. Cherries may even help prevent attacks by lowering uric acid levels and reducing inflammation (26, 27).
• Vegetables: All vegetables are fine, including potatoes, peas, mushrooms, eggplants and dark green leafy vegetables.
• Legumes: All legumes are fine, including lentils, beans, soybeans and tofu.
• Nuts: All nuts and seeds.
• Whole grains: These include whole wheat, oats, brown rice and barley.
• Dairy products: Low-fat dairy appears to be especially beneficial (18).
• Eggs
• Beverages: Coffee, tea and green tea.
• Herbs and spices: All herbs and spices.
• Plant-based oils: Including canola, olive and flax oils.

Foods you can eat in moderation

Your dietary needs may change based on on your gout symptoms and any other health conditions. Your doctor or dietician can make specific recommendations for you.

In general, lean animal proteins can be eaten in moderation, with up to 2 daily servings. Poultry is usually a safe option. Some people may also be able to include fish in this category, if their gout is well-managed (22).

Red meat, butter, sweets, and refined carbs should not be part of your regular diet and should only be eaten occasionally (21).

Summary

Foods you should eat with gout include all fruits and vegetables, whole grains, low-fat dairy products, eggs and unsweetened beverages. Your doctor may suggest that you limit your consumption of lean protein to 2 or fewer servings per day. Following the DASH diet or Mediterranean diet can help you shift to a healthier eating pattern.

A gout-friendly menu for one Week

Eating a gout-friendly diet will help you relieve the pain and swelling, while preventing future attacks.

Here is a sample gout-friendly menu for one week.

Monday

• Breakfast: Oats with Greek yogurt and 1/4 cup (about 31 grams) berries.
• Lunch: Quinoa salad with boiled eggs and fresh veggies.
• Dinner: Whole wheat pasta with roasted chicken, spinach, bell peppers and low-fat feta cheese.

Tuesday

• Breakfast: Smoothie with 1/2 cup (74 grams) blueberries, 1/2 cup (15 grams) spinach, 1/4 cup (59 ml) Greek yogurt and 1/4 cup (59 ml) low-fat milk.
• Lunch: Whole grain sandwich with eggs and salad.
• Dinner: Stir-fried chicken and vegetables with brown rice.

Wednesday

• Breakfast: Overnight oats — 1/3 cup (27 grams) rolled oats, 1/4 cup (59 ml) Greek yogurt, 1/3 cup (79 ml) low-fat milk, 1 tbsp (14 grams) chia seeds, 1/4 cup (about 31 grams) berries and 1/4 tsp (1.2 ml) vanilla extract. Let sit overnight.
• Lunch: Chickpeas and fresh vegetables in a whole wheat wrap.
• Dinner: Herb-baked salmon with asparagus and cherry tomatoes.

Thursday

• Breakfast: Overnight chia seed pudding — 2 tbsp (28 grams) chia seeds, 1 cup (240 ml) Greek yogurt and 1/2 tsp (2.5 ml) vanilla extract with sliced fruits of your choice. Let sit in a bowl or mason jar overnight.
• Lunch: Leftover salmon with salad.
• Dinner: Quinoa, spinach, eggplant and feta salad.

Friday

• Breakfast: French toast with strawberries.
• Lunch: Whole grain sandwich with boiled eggs and salad.
• Dinner: Stir-fried tofu and vegetables with brown rice.

Saturday

• Breakfast: Mushroom and zucchini frittata.
• Lunch: Leftover stir-fried tofu and brown rice.
• Dinner: Homemade chicken burgers with a fresh salad.

Sunday

• Breakfast: Two-egg omelet with spinach and mushrooms.
• Lunch: Chickpeas and fresh vegetables in a whole wheat wrap.
• Dinner: Scrambled egg tacos — scrambled eggs with spinach and bell peppers on whole wheat tortillas.

Summary

A gout-friendly diet has plenty of options for a healthy and delicious menu. The chapter above provides a sample gout-friendly menu for one week.

Other lifestyle changes you can make

Aside from your diet, there are several lifestyle changes that can help you lower your risk of gout and gout attacks.

Manage weight

Having obesity or excess visceral fat is associated with an increased risk for developing gout (3, 28).

This is because excess weight can affect your kidney function and increase inflammation in your body (28).

If you have gout, exercise and weight loss can help lower your uric acid levels. Plus, losing weight can help people with overweight and obesity have fewer gout attacks, according to a 2017 review (28, 29).

However, in the short term, weight loss can sometimes trigger an increase in gout flares. You can help prevent this side effect by avoiding extremely restrictive “crash diets” or low-carb, high-protein diets (6, 29).

Exercise more

Regular exercise is another way to prevent gout attacks.

Not only can exercise help you maintain a healthy weight, but it can also keep uric acid levels low (28).

However, your doctor may recommend that you avoid intense exercise or putting too much strain on your joints. These activities can make gout symptoms worse (30).

Stay hydrated

Staying hydrated can help reduce the risk of gout attacks.

That’s because adequate water intake helps your kidneys remove excess uric acid from the blood, flushing it out in the urine. When you’re dehydrated, it can be easier for uric acid to build up in your body (31, 32).

If you exercise a lot, then it’s even more important to stay hydrated, because you may lose a lot of water through sweat.

Limit alcohol intake

Alcohol is a common trigger for gout attacks (33).

Many types of alcohol contain purines, with beer having the highest levels (12).

While processing alcohol, your body also produces more uric acid, and excretes less of it in your urine (34).

One study including 724 people found that drinking wine, beer or liquor increased the risk of gout attacks. One to two beverages per day increased the risk by 36%, and two to four beverages per day increased it by 51% (35).

Consider a vitamin C supplement

Research suggests that vitamin C may help prevent gout attacks by lowering uric acid levels (36, 37).

It’s possible that vitamin C may help uric acid crystals to dissolve more easily, which could help your body expel uric acid (38).

However, evidence to support the use of vitamin C supplements to manage gout is less robust. One study found that vitamin C supplements had no effect on gout (36, 39).

Research on vitamin C supplements for gout is relatively new, so more studies are needed before strong conclusions can be made.

Summary

Managing weight, exercising, staying hydrated, limiting alcohol and possibly taking vitamin C may also help prevent gout attacks.

The bottom line

Gout is a type of arthritis involving sudden pain, swelling and inflammation of the joints.

Fortunately, a gout-friendly diet can help relieve its symptoms.

Foods and drinks that often trigger gout attacks include red meats, organ meats, some types of fish, fruit juice, sugary sodas, and alcohol.

While you may need to limit some specific foods, taking a look at your overall eating habits may be even more beneficial for managing gout.

Many people with gout can benefit from making the shift to a healthier diet rich in vegetables, fruits, and whole grains. Your doctor may recommend trying the DASH diet or Mediterranean diet.

A few other lifestyle changes that can help prevent gout attacks include maintaining a healthy weight, exercising, staying hydrated, drinking less alcohol and possibly taking vitamin C supplements.