HEALTH

Gout diet, explained: Foods to eat and avoid

17 July, 2024 . 0

Diet plays a significant role in managing gout. Learn which foods can trigger flare-ups and which can help reduce uric acid levels.

About 224,000 Australians were estimated to be living with gout in 2022.

Australian Rheumatology Association vice president Dr Helen Keen says gout is one of “the most common forms of inflammatory arthritis worldwide”.

Men are more likely to develop gout, but it can also affect post-menopausal women.

Accordingly, those affected will seek out a range of management options, one of which may be to follow a gout-friendly diet.

What is gout?

Gout is a chronic disease caused by high uric acid levels, leading to painful joint inflammation.

“When there’s an excess of uric acid in the blood, it leads to the formation of sharp urate crystals in the joints,” explains The Longevity Remedy’s nutritionist Michaela Sparrow.

“These crystals can cause sudden, severe episodes of pain, swelling, redness, and tenderness in the affected joints.”

Dr Keen says gout is characterised by intermittent episodes of arthritis with “the most typical presentation being an acutely inflamed big toe”.

How to manage gout?

“The good news is that gout can be easily treated with lifestyle changes and medications,” says Dr Keen, who is based at Western Rheumatology Perth.

“This involves maintaining a healthy weight, following a gout-friendly diet and taking uric acid-lowering medications prescribed by a healthcare provider,” Michaela says.

Dr Keen explains the most important action is to speak to your healthcare provider about medications called “urate lowering therapies (ULTs)” to reduce uric acid levels in the long term.

In the short-term, the inflammation that occurs in gout can be managed by anti-inflammatory medications.

Aside from that, the rheumatologist says, “reducing alcohol intake and maintaining a healthy weight might reduce the risk of gout flares”.

Do certain foods make gout worse?

Another approach to gout management is to reduce dietary intake of purine-rich foods.

The reasoning is that the body metabolises purines into uric acid, which is precisely what you’re seeking to lower when trying to reduce the chance of gout flares.

“One study has suggested that intake of foods high in purine, especially from animal sources, may increase the risk of gout flares,” Dr Keen says.

“Many people who have gout report that they can even identify foods that are associated with a gout flare – and these are generally foods high in purine, such as beer, corn syrup or some meats like offal or oily fish,” adds the expert.

Michaela says other high-purine animal foods include “organ meats like liver, kidneys, heart and game meats such as venison and rabbit”.

The nutritionist adds that meats such as beef, lamb and pork are also high in purines and although fine to consume moderately, “should be limited during a gout flare”.

Is there a gout diet?

There isn’t a specific eating regimen to follow for a gout-friendly diet.

Instead, Dr Keen advocates that people with gout follow a general healthy eating plan, like the Mediterranean or DASH (Dietary Approaches to Stop Hypertension) approach, while remaining mindful of any known gout-trigger foods.

Accordingly, Michaela says “a gout-friendly diet should closely resemble any healthy diet”.

“It should be based on vegetables and fruits, particularly cherries, which have been shown to lower uric acid levels,” says Michaela.

“It should also include whole grains like brown rice, oats and quinoa.”

Since many protein-rich animal foods fall into the high purine category, Michaela suggests consuming “lean white meats such as chicken” along with “low-fat dairy products”.

“I’d also recommend embracing anti-inflammatory foods such as olive oil, nuts and seeds, purple vegetables, ginger and turmeric,” the naturopath and nutritionist says.

“These foods help maintain lower uric acid levels and support overall health.”

Listen to Dr David Bursill discussing the effects of alcohol on gout flares and The House of Wellness Radio show, and how to manage symptoms through diet.

Alcohol and gout management

“Of all things we ingest, alcohol has the biggest impact on blood urate levels,” Dr Keen says.

“Beer has the highest impact, followed by spirits, then wine.”

There’s also evidence to suggest a connection between higher levels of alcohol consumption and gout flares.

“Generally, it’s recommended that alcohol intake should be limited to moderate amounts to reduce the risk of gout flares,” Dr Keen says.

Does staying hydrated improve gout symptoms?

In addition to food and alcohol intake awareness, water intake potentially plays a role to prevent gout flares.

“Theoretically, maintaining good water intake may decrease the risk of a gout flare related to dehydration, as it could encourage the kidneys to wash out the blood urate,” Dr Keen says.

“Drinking plenty of water supports the kidneys,” Michaela says. “Aim to drink between two to three litres of water a day.”

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Written by Sharon Hunt.