Introduction

1. Gout is a form of acute arthritis that causes severe pain and swelling in the joints. It is caused by the build up of too much uric acid in the body.
2. Uric acid is produced when the body breaks down a chemical called purine. Purine occurs naturally in the body, but it is also found in certain foods. Normally, uric acid dissolves in the blood and eliminated from the body in urine.
3. A gout diet may help decrease uric acid levels in the blood. A gout diet is not a cure, but it may lower the risk of recurring gout attacks and slow the progression of joint damage.
4. People with gout who follow a gout diet generally still need medication to manage pain and to lower levels of uric acid.

Goals of dietary management for gout :

1. Achieve healthy weight and good eating habits
2. Avoid some, but not all foods with purines
3. Include some foods that can control uric acid levels.

The general principles of a gout diet :

1. Weight loss – being overweight increases the risk of developing gout. Research suggests that losing weight, even without a purine-restricted diet, lower uric acid levels and reduce the risk of gout attacks. Losing weight also lessens the overall stress on joints.
2. Complex carbohydrate – eat more whole fruits, vegetables and whole grains, which provide complex carbohydrates. Avoid foods and beverages with high-fructose corn syrup, and limit consumption of naturally sweet fruit juices.
3. Water – drink enough water to stay well-hydrated.
4. Fats – cut back on saturated fats from red meat, fatty poultry and high fat dairy products.
5. Proteins – focus on lean meat and poultry, low-fat dairy and lentils as source of protein.

Recommendations for specific foods or supplements include :

1. Organ meats – avoid meats such as liver, kidney and sweetbreads, which have high purine levels and contribute to high blood levels of uric acid.
2. Red meat – limit serving sizes of beef, lamb and pork.
3. Seafood – some types of seafood such anchovies, shellfish, sardines and tuna are higher in purines than are other types. But the overall health benefits of eating fish may outweigh the risks for people with gout. Moderate portions of fish can be part of a gout diet.
4. High-purine vegetables – Studies have shown that vegetables high in purines, such as asparagus, spinach, cauliflower, mushroom, lentils and beans do not increase the risk of gout or recurring gout attacks.
5. Alcohol – Beer and distilled liquors are associated with an increased risk of gout and recurring attacks. Moderate consumption of wine does not appear to increase the risk of gout attacks. Avoid alcohol during gout attacks, and limit alcohol especially beer, between attacks.
6. Sugary foods and beverages – Limit or avoid sugar-sweetened foods such as sweetened cereals, bakery goods and candies. Limit consumption of naturally sweet fruit juices.
7. Vitamin C – Vitamin C may help lower uric acid levels. Talk to your dietitian/doctor about whether a 500 mg vitamin C supplement fits into your diet and medication plan.
8. Coffee – some research suggests that drinking coffee in moderation may be associated with a reduced risk of gout. But, drinking coffee may not be appropriate if you have other medical conditions. Discuss with your dietitian about how much coffee is right for you.

Conclusion

Dietary intervention can help limit uric acid production and increase its elimination. A gout diet is not likely to lower the uric acid concentration in your blood enough to treat your gout without medication. But it may help decrease the number of attacks and limit their severity.

Following a gout diet, along with limiting calories and getting regular exercise can also improve your overall health by helping you achieve and maintain a healthy weight.

References

1. Becker MA. Lifestyle modification and other strategies to reduce the risk of gout flares and progression of gout. https:www.uptodate.com/contents/search.
2. AskMayoExpert. Gout. Rochester, Minn. : Mayo Foundation for Medical Education and Research; 2018.
3. Beyl RN, et al. Update on importance of diet in gout. The American Journal of Medicine. 2016;129:1153.