Gout Food and Diet

Our podiatry patients often seek our advice about how best to avoid gout.  This guide provides general information about reducing the risk of gout attacks by changing your diet. It is general advice only.  Please seek individual advice if you have other medical conditions such as diabetes or food allergies.

What is Gout ?

You may also like to read our Gout and Your Feet Info Sheet.

To recap briefly, the word ‘arthritis’ literally means inflamed joint.  Gout is, therefore, a type of arthritis as it causes the affected joint to become very, very inflamed during an attack.  It happens when you have an elevated level of a chemical called uric acid in your blood. When this happens, the uric acid can ‘fall out of suspension’ meaning that some of it stops being dissolved in the blood and forms crystals instead. To understand how this looks, imagine a cup of tea. There is only so much sugar that can be dissolved into it.  Go beyond this and the sugar will return to crystal form and be deposited in the bottom of the cup. In the body, the crystals most commonly form in the joints but can also appear in the skin, earlobes and other tissues. The number one joint affected by gout is the big toe joint.

Does diet cause gout ?

Diet can play a big part in the frequency of gout attacks. Uric acid is a waste product made when certain foods are digested in your body. This is especially true of food components ‘purines’. It is likely that lowering your blood’s uric acid levels via small changes in your diet will help to reduce the future gout attacks.

Can losing weight help avoid gout ?

Yes, if you are overweight – but you need to take some precautions.  If you fast or cannot eat for other reasons, your body can start to break down your own proteins in your muscles to keep you going which can precipitate an attack of gout.  A healthy diet and regular physical exercise is the most reliable way to lose weight safely. Talk to your doctor or dietitian for advice.

Do certain foods cause gout ?

There are many old wives’s tales about diet and gout. What is fairly universally accepted is that foods containing high levels of purines can cause a gout attack.  Purines are substances that can easily be transformed into uric acid in the body. Purine-rich foods include:

• Meat – particularly red meat and offal, such as liver, kidneys and heart.  The denser packed the cells, usually the more purines it contains.
• Seafood – particularly shellfish, scallops, mussels, herring, mackerel, sardines and anchovies.
• Foods containing yeast – such as Vegemite and beer.
• Fructose (also known as fruit sugar) which is obviously found in fruit but in much, much higher concentrations in fruit juices which should be avoided. Fructose powder is sometimes sold as an alternative sweetener, particularly for those with diabetes who are intolerant to cane sugar / sucrose.
• Corn syrup.  Much more common in parts of the world other than Australia where it is used to sweeten soft drinks

What foods should I avoid to reduce attacks of gout?

Much of the current thinking on gout and diet is anecdotal – which means that it hasn’t been scientifically proven but is thought to be correct. What you should not do without advice, is cut out entire food groups which may lead to malnutrition.  Make smaller dietary changes such as:

• reduced portion sizes of red meat,
• avoid offal, shellfish and oily fish,
• substitute chicken or a white-fleshed fish for red meat,
• refrain from drinking fruit juices (which might contain six ‘pieces’ of fruit and eat one instead,
• opt for bananas, pears and a variety of other fruit where possible,
• sugary softdrinks don’t seem to trigger gout directly but can contribute to excess body weight which is a risk factor,
• diet softdrinks also do not seem to trigger gout on current evidence,
• alcohol consumption raises uric acid in the blood.  Drinking to excess should be avoided, especially in combination with the other ‘risky’ foods,
• note what you have eaten if you have an attack – it may not ‘agree’ with you.

What foods should I increase?

Not all high purine foods are thought to bring on an attack of gout. Some vegetables such as mushrooms, cauliflower, asparagus and spinach are high in purines without seeming to cause problems. The following tips are thought to provide some protection against attacks:

• Vitamin C supplements
• Low fat dairy foods such as skim milk
• Adequate water,
• A varied diet selecting foods from a wide variety of food groups.

Are some kinds of alcohol better?

Gout is thought (but not proven) to be more common in beer and spirits drinkers than in those who drink wine. Beer often contains large amounts of purines due to the yeast content.  Spirits (rum, scotch, etc) also seem to be a problem and the effect of all varieties are worsened in’ binge’ quantities. Remember too that drinking alcohol will have a dehydrating effect on your body. Talk to your doctor or go to  www.alcohol.gov.au to see the Australian government guidelines on recommended alcohol intake.

How much is enough water?

Dehydration is thought to be a common risk factor for developing an attack of gout. For the ‘average’ person, drinking 1 to 1.5 litres of water per day is recommended in general.  If you are taking diuretics (fluid tablets) or have heart or kidney issues, seek specific advice from your doctor about what is right amount of fluid for you.

Where can I get professional dietary advice?

Use an Accredited Practising Dietitian (APD) who can provide you with personalised advice by visiting the website www.daa.asn.au or calling 1800 812 942. In Australia, your visits may be able to attack Medicare rebates under an Enhanced Primary Care plan.  Ask your doctor for more information.  Thanks to the Victorian Arthritis Org for some additional information. Use this link to browse to our Gout and Your Feet Info Sheet.