Recent studies associate low-fat milk and low-fat dairy products, like yogurt and cheese, with lower uric acid levels and a reduced risk of gout. But what about full-fat milk and full-fat dairy products?
When I had my first gout attack, very many years ago, as well as being told to avoid organ meats and limit red meat, I was told to reduce my consumption of dairy products, especially cheese.
Since then, however, studies have shown that consuming low-fat dairy products, such as skim milk, cheese, and yogurt, can actually lower uric acid and help reduce the risk of gout flares.
This is good news for gout sufferers since milk provides many other health benefits that would be sorely missed if excluded from one’s diet.
For example, as well as promoting teeth and bone health and reducing the risk of osteoporosis, dairy products have been linked to a reduced risk of hypertension (high blood pressure) and cardiovascular disease.
Milk and Gout
Milk has a healthy balance of high-quality protein, fats and carbs.
It’s also a rich source of essential vitamins and minerals, such as vitamin B1 (thiamin), vitamin B2 (riboflavin), vitamin B12 (cobalamin), calcium, and phosphorus.
It has smaller amounts of vitamin B3 (niacin), vitamin B5 (pantothenic acid), vitamin B6 (pyridoxine), vitamin B9 (folate), and vitamins C, E and K.
Cow’s milk doesn’t naturally contain vitamin D, but the milk you buy may well be fortified with vitamin D as a result of voluntary or mandated public health initiatives, e.g. as in the United States, Canada and many other countries.
As well as supporting the immune system, muscles, and nerves, the added vitamin D in fortified milk helps to increase calcium and phosphorus absorption in the body.
Calcium and phosphorus are important for building strong bones and teeth as well as maintaining heart rhythm and muscle and nerve function.
So one can see why milk (and dairy products in general) is considered to be an important element of a well-balanced, healthy diet.
But what if you have gout?
Gout is a type of inflammatory arthritis that manifests as very painful gout flare-ups (gout attacks) in the joints, mostly in the big toe although any joint can be affected.
Its root cause is high uric acid levels in the bloodstream — a condition called “hyperuricemia” — from which tiny, needle-shaped, uric acid crystals settle in the joints. This, in turn, triggers the body’s natural inflammatory response that causes the classic gout symptoms of inflammation, swelling, shiny red skin, heat, stiffness, and agonizing pain.
Uric acid is produced during purine metabolism; which purines are natural chemical compounds found in the cells of all living things, including the food we consume.
High-purine foods produce more uric acid than low-purine foods, so it’s usually recommended that gout patients move to a low-purine diet by avoiding or limiting purine-rich foods.
Another dietary risk factor for gout is fructose, a natural sugar found in varying concentrations in fruit, fruit juice, vegetables and honey.
Of particular concern is high fructose corn syrup (made from corn starch) found in many commercial foods and sugar-sweetened beverages. For example, studies have associated sugary soft drinks and sodas with high levels of uric acid and an increased risk of gout.
Purines and Fructose in Milk
Cow’s milk has no fructose and is low in purines so milk consumption, in and of itself, does not increase serum uric acid. Milk is safe in a gout diet.
But, not only is milk safe for gout, it has constituents that may actually lower uric acid levels and reduce the risk of gout…
Milk May Reduce Your Risk of Gout
Studies associate low-fat dairy with a lower risk of gout flares…
A long-term study, reported in the New England Journal of Medicine in 2004, concluded that regular consumption of low-fat milk is associated with a significant decrease (up to 43%) in the risk of gout attacks.
And at the American College of Rheumatology Annual Scientific Meeting in Philadelphia in October 2009, researchers presented the results of a study of 16 gout patients in New Zealand.
The results showed that drinking skim milk had beneficial effects in all 16 participants. There was an average 10% reduction in serum uric acid levels, with corresponding reductions in the frequency of gout flares.
Although the exact mechanism for milk being able to lower uric acid in the bloodstream isn’t precisely known, researchers opine that certain proteins and other milk constituents help the kidneys to excrete uric acid more readily and also prevent uric acid reabsorption back into the bloodstream.
The net result is to reduce serum uric acid levels and, therefore, the risk of gout attacks.
- It’s thought that the milk proteins casein and lactalbumin have an uricosuric effect on the kidneys which promotes uric acid excretion.
- And orotic acid in milk is thought to decrease the reabsorption of uric acid back into the bloodstream and aid its removal by the kidneys.
- Calcium and lactose have also been associated with lower serum uric acid concentrations.
So low-fat milk and low-fat dairy products, like low-fat yogurt and cheese, may help reduce serum uric acid levels and lower the risk of recurrent gout attacks.
In addition, a 2017 review of 52 clinical studies concluded that dairy has anti-inflammatory properties.
Gout is an inflammatory condition, so milk may help to moderate the body’s natural inflammatory response that causes gout flares.
Is it any wonder, then, that milk is increasingly being recognized as an important constituent of a healthy gout diet.
As a minimum, drink 1 glass of skim or low-fat milk every day. You might even want to consider drinking a glass with each meal.
But what about full-fat milk?
Is whole milk good for gout too?
Full-fat milk and full-fat dairy products are not associated with an increased risk of gout, according to studies.
However, neither are they associated with a reduced gout risk, unlike low-fat milk and skim milk.
Furthermore, an 8 ounce glass of whole milk contains 8 grams of fat, whilst a similar serving of low-fat milk contains 2.5 grams of fat. Skim milk has no fat.
It should also be noted that low-fat and skim milk still contain the same amount of high-quality protein, vitamins, and minerals as whole milk.
So, although whole milk is safe with gout, skim milk and low-fat milk are perhaps better options in a healthy gout diet.
Whatever you decide, stay clear of flavored milks as these can have unhealthy added sugars, including high fructose corn syrup.
Frequently Asked Question
Q: Is soy milk safe with gout?
The New Zealand study, mentioned previously, also tested soy milk. It showed that soy milk increased uric acid blood levels by around 10%.
And a 2018 Chinese study concluded that different soy products produced different concentrations of uric acid in the blood, with soy beans and soy milk “considerably increasing serum uric acid”.
The evidence is mixed though: some other studies have found no such association, i.e., that consuming soy milk increases uric acid.
We do know, however, that soy milk is low in purines (although other soy bean products range from moderate to high). So, as far as its purine content goes, soy milk should be safe to consume with gout.
But, although the jury’s still out, we shouldn’t totally ignore the possibility that it could increase the risk of gout.
If you wish to drink soy milk, then, it may be a good idea to do so in moderation.