Ask a Dietitian

Gout is a type of arthritis. It occurs when high levels of uric acid cause crystals to form in your joints and soft tissues, leading to inflammation, pain and swelling. A common location for gout is the joint of the big toe at the ball of the foot. It can also occur in the arch, ankle, knee and hand. The joint may be swollen, red and tender to touch

The amount of uric acid in your body depends on the following:

How much uric acid your body makes and gets rid of, certain medications that cause you to retain uric acid, and the amount of purine that you eat

Uric acid is a normal waste product, formed from the breakdown of compounds in food called purines. It is excreted in the urine. When you have gout, your blood uric acid levels are higher than normal and this causes crystals to form

Gout is usually treated with medications for either the symptoms (pain and inflammation) or to reduce uric acid levels. Diet can also help reduce uric acid levels and the risk for gout

Reduce Purines:

Some food and beverages contain compounds called purines. Purines change to uric acid in the body. Meat and seafood are high in purine and can increase uric acid levels. Purines found in plant foods do not increase uric acid levels and are not a concern

Gout often occurs with the following conditions. It’s important to manage these conditions along with gout:

overweight or obesity

high blood pressure

high blood cholesterol

type 2 diabetes

heart disease

chronic kidney disease

genitourinary (urinary and reproductive) diseases

Dietary Recommendations to lower uric acid levels and reduce risk for gout attacks

1.Follow a healthy diet that is low in saturated and trans fat and rich in unprocessed plant foods.

• Limit portions of meat and seafood to 75g (2.5oz) as they are high in purines.
• Include fish as a protein food at least twice a week as it is high in omega-3 fats and low in saturated fat.
• Consider taking a fish oil supplement for the anti-inflammatory benefits.
• Avoid organ meats (liver, kidney, sweetbreads, etc.) because they contain high levels of purine.
• Choose vegetable protein sources more often: beans, lentils, tofu, and unsalted nuts and seeds. Although some of these foods contain purines, they are not linked with increases in uric acid or risk for gout symptoms.
• Include milk and milk products daily. Consumption of milk products is associated with lower uric acid level and less gout.
• Make vegetables an important part of your diet. Aim to eat at least four servings of vegetables each day. Also, choose vegetables as a snack.
• Choose whole fruit instead of juice. Aim to have at least three servings of fruit each day.
• Avoid sugar and high-sugar foods and beverages such as pop, fruit drinks, specialty coffee and tea drinks, candy, and sugary desserts like pastries, donuts, cake, and cookies.

2. Limit alcohol. Even one or two drinks can increase your risk of a gout attack. One drink equals the following:

¡ 341 mL (12 oz.) bottle of 5% beer, cider or cooler,

¡ 142 mL (5 oz.) glass of 12% wine, or

¡ 43 mL (1.5 oz.) shot of 40% spirits.

All alcohol, and especially beer, can increase your risk of gout attacks. Avoid all alcohol if you have painful gout or you are having a gout attack

3. Stay well hydrated. Aim to drink 2-3 L (8-12 cups) of fluids each day.

Water is your best choice. Drinking plenty of water will also help dilute uric acid in your urine and prevent kidney stones.

4. If weight loss is a goal for you, choose a weight loss plan that encourages slow, steady weight loss. Rapid weight loss or following a diet high in animal protein is not recommended because it could increase uric acid levels in your blood and the chance of a gout attack.

5. Drink Coffee in Moderation. Drinking coffee is linked with lower uric acid levels and reduce risk of gout. (max 4c/day)

6. Eat Cherries. Recent research shows that eating cherries (1/2-1cup/day) can reduce the risk of gout attacks.