What to Eat and Avoid for Gout

Food choices plays an important role in managing gout, the most common form of inflammatory arthritis in the United States. Gout occurs when uric acid builds up in the blood (instead of being excreted) and gets deposited as crystals in one or more joints, triggering sudden swelling and pain. Uric acid is a by-product of the breakdown of purines, naturally occurring compounds in the body and in certain foods, which is why diet can be important for controlling gout attacks.

We asked rheumatologist Hyon K. Choi, MD, a gout expert and Professor of Medicine at Harvard Medical School, what people with gout should know about diet.

What foods can trigger a gout attack?

[Excess] alcohol and purine-rich foods, particularly red meat and seafood.

If I have gout, should I avoid high-purine foods or are they OK in moderation?

Generally, moderation is sufficient, particularly if you are effectively treated with a uric acid-lowering medication.

What is a healthy diet for people with gout?

We recommend the DASH (Dietary Approaches to Stop Hypertension) diet, which involves high intake of fruits, vegetables, nuts and legumes, low-fat dairy products and whole grains, and low intake of sodium, sweetened beverages and red and processed meats. The DASH diet helps lower uric acid levels in individuals with high levels and is associated with a reduced risk of developing gout. Our team is currently conducting a clinical trial to evaluate the effects of the DASH diet on individuals with existing gout. The DASH diet also is recommended to prevent cardiovascular disease, which often accompanies gout.

Are there specific foods or nutritional supplements I should add to my diet if I have gout?

The foods in the DASH diet are all expected to have an antigout as well as cardiovascular benefit. A piecemeal approach to modifying dietary factors has often been ineffective and impractical. In contrast, a healthful dietary pattern, such as the DASH diet, reflects the way foods are consumed. Moreover, unlike the conventional low-purine approach, another important advantage of the DASH diet is its palatability, which is important for sustainability.

What has surprised you most in your research about gout and diet?

High levels of hypertension [high blood pressure] are present in 74 percent of gout patients, and that is concerning. The DASH diet could improve both hypertension and gout in many patients.

What else should people with gout know?

Reducing weight with daily exercise also reduces uric acid levels and the risk of gout flares.

Author: JENNIFER DAVIS