What is gout?

Gout is a form of arthritis that leads to sudden and severe joint pain. It happens when high levels of uric acid in the blood cause crystals to develop and collect around the affected joint. It’s usually first felt in your big toe, but can affect your hands, wrists, elbows, knees and feet. When gout effects an area, you can often see the skin around it become hot, swollen and red.

An attack of gout can last 5 to 7 days. After this period, it should get better, but lasting joint damage can occur if you don’t seek immediate help and treatment. As soon as you have any symptoms of a gout attack, contact a doctor for an urgent appointment. A gout diet isn’t a cure or form of treatment, but it can be used to reduce uric acid levels in the blood and to prevent future attacks. 

What is Uric acid?

Uric acid is a chemical that is a waste product found in your blood that you usually get rid of when you urinate. This chemical is produced when substances called purines are broken down inside your body. Purines naturally occur in your body, butare also found in certain food and drink. 

Most uric acid will dissolve in the blood while the rest will travel to the kidneys for excretion in urine. If too much uric acid is produced or your body doesn’t remove enough of it, it can make you sick. A blood test can be used to test for high levels of uric acid in the blood (called hyperuricemia). 

How does food affect gout?

Certain food and drink products contain high levels of purines. Some examples include anchovies, beer, dried beans, liver, mackerel and peas. If you eat and drink a lot of purine-rich food, it could increase the build-up of uric acid in the blood which increases the risk of a gout attack. 

As well as preventing gout attacks, a controlled diet could help you lose weight. Being overweight can increase your risk of developing gout and losing weight can lower it. Losing weight can lower levels of uric acid in the blood and reduce strain on the joints. 

Foods to avoid with gout

If you suffer from gout, you should avoid eating purine-rich foods to prevent hyperuricemia and gout attacks. Each attack can lead to irreversible joint damage, increasing pain and discomfort. Choosing to eat the right foods and avoiding others is highly recommended for those suffering from gout. It may not be a cure, but it can be a great preventative. 

What are purine-rich foods? 

Purine-rich foods and drinks contain high levels of purines. When they’re processed, uric acid is produced which is the compound that triggers gout attacks in gout patients. In normal cases, uric acid should be metabolised by the body and excreted or reabsorbed in the blood. 

However, this isn’t always the case. If the number of purines in the body is out of balance with the body’s ability to process them, uric acid can build up in the bloodstream which can lead to joint inflammation (gout) or kidney stones. 

What are purines? 

Purines are naturally occurring molecules that are present in some foods. Purines aren’t necessarily bad for you in moderation, but they break down into uric acid when digested. If your diet has a high purine content, it can cause your uric acid levels to increase. This can cause gout, or trigger gout flare ups.

Foods to avoid if you have gout 

Foods that should be avoided by patients who have gout include: 

Sugary food and drinks - especially those made with high fructose corn syrup e.g., soft and sweetened drinks, breakfast cereals, sweetened dairy products, canned fruit, fast food, candies, bread and baked goods. 

• Seafood - especially anchovies, herring and scallops. 
• Meats - especially organ meat and sweetbreads e.g., liver, game meats and kidneys. 
• Alcoholic beverages - especially beer. 

As well as increasing uric acid levels, alcohol can hinder the body’s ability to process and get rid of it.  

What foods are good if you have gout?

While some foods should be avoided, you shouldn’t avoid all foods with purines or foods that can help control levels of uric acid. ‘Sensible portions of healthy food’ is the best rule to follow. Examples of food you can eat include: 

• Cherries – Some evidence suggests that eating cherries reduce the risk of experiencing gout attacks. 
• Vitamin C – Whether you get it naturally through your diet or through supplements, Vitamin C can help lower levels of uric acid. Talk to your doctor before adding supplements to your gout diet plan. 
• Fruit and vegetables – Most fruit and vegetables are good for gout as they’re high in fibre. 
• Lean meat and poultry - These meats are lower in purine content, so are good alternatives to fattier cuts.
• Low fat dairy - drinking low fat milk or eating low-fat dairy products can reduce the levels of uric acid in your body, which lowers your risk of a gout attack
• Lentils - a good alternative to animal proteins that are high in purines

If you have gout, try to eat your recommended calorie intake to avoid weight gain, as this can lower uric acid levels and gout attacks, while losing weight can reduce the risk of gout. 

You should also eat plenty of fruits, vegetables and whole grains, drink plenty of water (as this can aid digestion and uric acid disposal).

What can I eat in moderation with gout?

Some foods aren’t necessarily good for gout, but they can be enjoyed in moderation and include: 

• High-purine vegetables – Even though they’re high in purines, studies show they don’t increase the risk of gout or recurring gout attacks. Examples include spinach and asparagus. 
• Lean meats – While you should avoid organ meat and sweetbreads, you can incorporate lean meat and poultry into your gout diet.  
• Seafood – Some types of seafood have higher levels of purines than others. However, the overall health benefits of eating fish can outweigh the risks of gout or recurring attacks. 
• Oily or fatty fish – Oily and fatty fish can be high in purines. However, as with seafood, the benefits of oily fish can outweigh the gout risks, so it can be eaten in moderation. 
• Eggs, potatoes, nuts, grains, fats and oils can be enjoyed in moderation when following a gout diet. 

How else can I manage gout?

Following a healthy diet can prevent gout attacks and improve your overall health and wellbeing. However, there is more that you can do to manage gout, including: 

• Resting and raising limbs that are commonly affected and not putting pressure on any affected joints. 
• Staying hydrated by drinking plenty of water, unless advised not to by your GP. 
• Keep your joints cool with an ice pack, or frozen peas wrapped in a towel. This can be applied to the affected area for up to 20 minutes at a time. 
• Trying to keep bed clothes off affected joints at night. 
• Maintaining a healthy weight. People who are overweight put more strain on their joints and are more likely to develop gout and gout attacks. Avoid crash diets to lose weight.
• Exercising regularly, but avoid intense exercise that puts lots of pressure on joints.   
• Taking uric acid-lowering medication prescribed to you by your doctor, even if you feel better and aren’t experiencing symptoms you should continue taking your medicine provided you don’t have any side effects. 
• Quitting smoking and having alcohol free days throughout the week. 
• Talk to your doctor about vitamin C supplements. 
• Check uric acid levels regularly with a home test and with your GP when they ask. 

You can also treat gout with a medication called Colchicine, which is available with Superdrug Online Doctor. To get prescription, you’ll need to fill in a brief questionnaire. This will be reviewed by one of our doctors, who will decide if it’s right for you and prescribe you a suitable treatment. You can also purchase uric acid test kits to monitor levels of the compound in your blood. 

Sources

Gout (2020) NHS [accessed 08/02/2022]

Uric Acid and Plant-Based Nutrition (2019) PMC [accessed 08/02/2022]

Which Foods are Safe for Gout? (2022) Arthritis Foundation [accessed 08/02/2022]

Gout: An old disease in a new perspective – A review (2017) PMC [accessed 08/02/2022]