You can help manage your gout by reducing your purine intake, avoiding sugar, and eating more alkaline foods. But nutrition plays a critical role in preventing other diseases. So your gout diet has to incorporate a wide range of nutrients to support your overall health position too.
What a Gout Diet Looks Like
A varied, well-balanced, healthy gout diet should contain the following:
Protein is a vital part of every cell in your body. It helps build bones, muscle, cartilage, skin, blood, and helps your body repair itself after injury. It’s also used to make enzymes, hormones, and other chemicals in your body.
A low-purine gout diet means getting most of your protein from plant food sources. So make plant-based foods such as vegetables, beans, nuts, and seeds, your primary source of protein.
But don’t forget about eggs and low-fat / fat-free dairy products such as milk, natural yogurt, and cottage cheese, which are excellent sources of protein.
Some lean meats, poultry and fish have relatively moderate amounts of purines so may be eaten in moderation, for example, beef, lamb, pork, chicken, duck, cod and haddock. So you can still get some animal protein.
Complex carbs provide the energy the body needs, as well as optimizing metabolism, brain and nervous system functionality, aiding digestion and regularity, helping healthy sleeping patterns, and controlling blood sugar.
Complex carbs come from the starch found in foods such as: vegetables (especially leafy greens, pumpkin, potatoes, sweet potatoes, carrots, and corn), fruit (apples, pears, pineapples, blueberries, blackberries, grapes, mango, papaya, nectarines, and oranges), whole grains / whole grain products, and low-fat / fat-free natural yogurt and milk.
Essential Fatty Acids
Fatty acids are essential for good health. Omega-3 fatty acids help to reduce inflammation and promote overall health and wellbeing. However, the body does not produce them, so we have to get them from food.
Essential fatty acid foods are things like; dark green leafy vegetables, eggs, olive oil, whole grains, seeds, and nuts.
The above may be eaten along with moderate amounts of some oily fish such as salmon (wild salmon has more omega-3s than farmed) but not anchovies, herring, sardines, pilchards, tuna, trout, or mackerel which, although rich in omega-3, have high purine concentrations.
Fiber is an important part of a healthy balanced diet but it’s only found in plant foods; it cannot be sourced from meat, fish, poultry, or dairy.
There are two types of fiber your body needs; soluble and insoluble. Most foods contain both types but are usually richer in one than the other.
As its name suggests, soluble fiber dissolves in the digestive system. The main benefits of soluble fiber are it helps to reduce cholesterol and so helps reduce the risk of heart disease and stroke.
It helps to protect against diabetes since it isn’t well absorbed and so doesn’t cause rapid increases in blood sugar. It also helps to regularize healthy bowel movements and may help with IBS (irritable bowel syndrome).
Insoluble fiber passes through your digestive system without being broken down, helping other foods to move through your system more easily, so may help to prevent diverticulitis.
It’s also good for overall digestive health and helps to prevent constipation and hemorrhoids.
Good sources of fiber for your gout diet include vegetables, fresh and dried fruit, beans, peas, nuts, seeds, and whole grains.
In addition, eating high-fiber foods will make you feel fuller for longer which can help stave off hunger pangs and control your weight. Remember, being overweight is a major trigger for gout.
Vitamins and Minerals
Vitamins and minerals are essential nutrients that your body needs for bone health, immune system health, wound healing, damaged cell repair, converting your food into energy, and hundreds of other essential roles.
Here are some of the most important vitamins:
Vitamin A is needed for proper immune function, healthy vision (especially in dim light), proper cell growth, and healthy skin and mucus membranes.
Good sources of vitamin A include vegetables, cheese, eggs, milk, natural yogurt and oily fish.
Liver is another good source but gout patients have to avoid it since it’s high in purines. Some types of oily fish may be eaten in moderation though, e.g., salmon.
Yet another good source is “beta-carotene,” which converts to vitamin A when consumed. Good sources of beta-carotene are spinach, carrots, tomatoes, sweet potatoes, red peppers, peas, broccoli, cantaloupe, mango, papaya, and apricots.
In general, the more intense the color of a vegetable or fruit, especially red / orange / yellow, the more beta-carotene it contains.
The vitamin B family consists of vitamins B1, B2, B3, B5, B6, B7, B9, and B12, each with its own characteristics and health benefits.
Studies have shown that B vitamins help to lower the risk of heart disease and stroke, enhance mood, reduce brain fog, reduce stress, help anxiety and depression, help migraine, boost energy, and strengthen bones, to name but a few.
They are known as the “anti-stress vitamins” which is particularly important for gout sufferers since stress raises the body’s metabolic rate, which increases the rate of uric acid production.
Furthermore, one of the many benefits of vitamin B9 (folic acid) is that it inhibits xanthine oxidase needed to produce uric acid, whilst one of the benefits of vitamin B5 (pantothenic acid) is that it’s an important element in the uric acid excretion process.
Rich food sources are things like leafy green and root vegetables, fresh fruit, low-fat / non-fat dairy produce, fortified cereal and grain products, natural yogurt, poultry, shellfish, and liver.
Liver and shellfish have to be avoided with gout, but some poultry may be consumed in moderation, e.g., chicken.
Vitamin C can help to reduce the pain and inflammation of a gout flare-up. It can also prevent future flares by reducing, and then maintaining, uric acid at healthy levels.
Vitamin C also is a powerful antioxidant and important for immune system function, maintaining healthy blood sugar levels, common colds and asthma prevention, controlling high blood pressure, and protecting against cancer, heart disease, stroke, and many other conditions and diseases.
The vitamin D family consists of vitamins D1, D2, and D3. The most important vitamin D benefit is regulating calcium and phosphorous absorption; vital for healthy teeth and bone development.
However, it also plays an important role in immune, brain, and nervous system functioning, as well as insulin and diabetes management and cardiovascular and respiratory health.
Your body also needs vitamin D to help it absorb calcium (see the section on calcium later in this chapter), so you can see that vitamin D is a very important vitamin.
A recent study has actually linked vitamin D deficiency with high uric acid. And a 1998 study showed that gout attacks (uric acid crystals) were significantly more common in spring, but there was no seasonal variation with pseudogout (calcium salts).
We get most of our vitamin D through exposure to sunlight: our body makes it as a natural reaction to sunlight on bare skin.
We get a much smaller amount through foods such as eggs, cheese, oily fish, artificially fortified foods (e.g. cereals, orange juice, soy milk), and beef liver.
The problem is that some of these, e.g. liver and most oily fish, have to be avoided in a gout diet, so that vitamin D supplements may be required, especially out of summer.
Vitamin E is important for immune and organ function. It’s also a powerful antioxidant that helps to protect your body’s cells from free radical damage, and can aid in the repair of damaged joint cartilage.
It also has a role in the body’s anti-inflammatory processes, so could help to reduce inflammation during a gout flare.
The richest sources of vitamin E are plant oils (e.g. olive oil), nuts, seeds, wheat germ, and fortified foods and cereals.
Vitamin K has an important role in blood clotting so helps wounds to heal properly.
It also helps to prevent heart disease, improve insulin sensitivity, keep bones healthy, and may even help prevent osteoporosis.
And it’s a very important adjunct to vitamin D (a key player in your overall health), so much so that, if you’re deficient in just one, neither performs optimally in your body.
Perhaps the best sources of vitamin K are fermented foods such as miso, Natto (fermented soybean), and sauerkraut, which you can consume in moderation.
Other good sources are beef liver and chicken liver but, of course, these have no place in a healthy gout diet as they’re high in purines.
Your body needs calcium to build and maintain strong, healthy bones and teeth, throughout your lifetime. In addition, it helps various organs in your body, such as the heart, muscles and nerves, to function properly.
Some of the best sources are things like milk, yogurt and cheese. Green leafy vegetables such as broccoli, kale, and spinach are good sources too, as are nuts, seeds, and pulses.
Calcium-fortified products, i.e. things like cereal, milk alternatives, soy products and fruit juices, are also good sources.
It can also be found in some oily fish, particularly canned salmon and sardines. You can have canned salmon in moderation, but sardines, being high in purines, are a definite no-no for someone with gout.
Note: Your body needs vitamin D in order to absorb calcium. (Refer to the earlier section for the best vitamin D food sources.)
Iron is essential for the proper growth and development of your body.
It helps in the production of hemoglobin (transports oxygen around the body) and red blood cells, strengthens your immune system, helps prevent fatigue, treats insomnia, controls your body temperature, and maintains healthy cells, nails, hair and skin.
Rich sources of iron are chicken livers, seafood, red meat, nuts, beans, seeds, dark green leafy vegetables, whole grains, dark chocolate, cocoa powder, dried fruits, and lentils.
Chicken livers and soybeans have to be avoided completely with gout. But lean beef and lamb may be eaten in moderation, as can lentils and chickpeas.
Magnesium is necessary for over 300 chemical reactions in the human body and plays a key role in bone health, heart health, blood sugar management, nervous system balance, energy production, and inflammation control.
It helps to regulate potassium and calcium levels in the body, relieves muscular aches and pains, improves digestion, relieves diarrhea, promotes relaxation and calm, prevents fatigue and insomnia, and helps to prevent migraines.
In terms of gout, magnesium helps to improve circulation and lower blood pressure, which, in turn, helps to lower the risk of crystal formation.
It also has an alkalizing effect, particularly on urine, which helps to maintain the solubility of uric acid, thus promoting uric acid excretion and reducing the risk of uric acid kidney stones.
Magnesium is found in fruit (especially avocados and bananas), dried figs, fish, legumes, nuts, seeds, whole grains, and dark chocolate.
Gout sufferers have to avoid dried legumes and fish like halibut and herring because they’re high in purines. Other fish, such as cod and haddock, may be consumed in moderation.
This is important for gout sufferers because it’s known that a potassium deficiency can raise uric acid levels in the blood. And, it’s an electrolyte, which helps to maintain a healthy fluids balance in the body.
Your body also needs it to help maintain normal growth, build proteins and muscle, breakdown carbohydrates, control heart function, and to maintain normal blood pressure.
So make sure your diet contains a healthy range of potassium-rich foods such as green leafy and root vegetables, squash, avocados, white beans, fat-free / low-fat natural yogurt, bananas, and dried apricots.
Selenium plays a key role in antioxidant protection, normal thyroid function, and immune system health. It also helps to regulate excessive immune response and chronic inflammation.
Rich sources of selenium are things like liver, oily fish, shrimp, beans, leafy greens, Brazil nuts, barley, brown rice, milk, eggs, garlic, seeds, and shiitake mushrooms.
With gout, you’ll need to avoid liver, most oily fish (like herring and sardines), and shiitake mushrooms. Salmon is OK in moderation.
Zinc is important for immune system health, the proper synthesizing of protein and DNA, wound healing, taste and smell perceptions, testosterone production, and promoting healthy growth during childhood.
Foods rich in zinc are things such as almonds, kidney beans, chick peas, spinach, mushrooms, oatmeal, beef, chicken, pork, crab, lobster, oysters, fortified breakfast cereals, and dark chocolate.
Almonds, fortified breakfast cereals, and dark chocolate, are o.k. in a gout diet. But oysters have to be avoided while the others may be consumed in moderation.
Antioxidants are naturally occurring compounds found in some foods. They help to neutralize the free radicals in the body that cause cell damage and diseases such as cancer, asthma, diabetes, atherosclerosis, degenerative eye disease, inflammatory joint disease, and senile dementia. Free radicals also accelerate the aging process.
Some of the best sources of antioxidants are fruit (especially apples and berries), vegetables (particularly spinach, broccoli, squash, bell peppers, cabbage, and eggplant), certain beans (black, red kidney), dark chocolate, and green tea.
According to the Institute of Food Technologists, the presence of color usually indicates there’s a specific antioxidant in that particular food, and a wide array of color in your diet will give you the widest range of beneficial antioxidants.
So try to get as many different colored fruits and vegetables as possible into your diet.
You also need to:
Eat More Alkaline Foods
Studies have shown that an alkaline diet helps to facilitate the removal of uric acid from the body and so reduce the risk of gout.
And alkaline diets have other health benefits since they avoid or reduce red and processed meats while incorporating more vegetables and fruit.
Most vegetables and fruits are alkaline. Other foods, such as, eggs, milk, herbal teas, natural yogurt, and nuts, are also alkaline-forming.
Acid-forming foods are things like, alcohol, red meat, caffeinated drinks, cheese, coffee, and processed foods.
But not all acid-forming foods are unhealthy so a balance has to be struck between their acidity and their nutritional value.
It’s thought that consuming around 70% alkalizing foods and 30% (healthy) acid-forming foods strikes that balance. The idea is that the alkalizing foods effectively neutralize the acid-forming foods but without losing their nutritional value.
And we also know that too much added sugar increases the risk of some chronic diseases, including heart disease, type 2 diabetes, and even some cancers.
Refined sugar also includes sugar that’s been added during the manufacturing process to products, such as, fizzy drinks, jam, cakes, biscuits, canned foods, processed foods, and ready meals.
So these types of foods should be avoided or drastically reduced, not just to reduce your risk of gout, but also to improve your overall health.
But sugar also occurs naturally in carbohydrate-containing foods, such as vegetables, fruits, grains, and dairy.
While refined sugars have little or no nutritional value, foods containing natural sugars like vegetables, fruits, grains, and dairy, certainly do have. So eating these types of foods is okay.
Salt is 40% sodium and 60% chloride (sodium chloride). While your body needs some sodium for fluid balance and muscle and nerve function, too much can lead to high blood pressure, stroke, and heart disease.
And it isn’t all down to salt added to meals. Around 75% of the sodium we consume today comes from processed foods, including baked goods.
In terms of gout, a 2002 study concluded that reducing salt intake significantly lowers the risk of kidney stone reoccurrence in gout sufferers.
So reduce your salt intake. Start by gradually reducing the amount of salt you add to your food, until you can leave it out altogether. And avoid all processed and prepacked foods.
Gout is caused by too much uric acid in the bloodstream out of which monosodium urate crystals can settle in joints and associated tissue.
Uric acid is a byproduct of purine metabolism, which purines are natural chemical compounds found in the cells of all living things, including the food we eat.
It’s reckoned that the food we consume provides around 30% of the uric acid produced in the human body so that someone with gout has to be very careful with their diet.
Since more purines mean more uric acid, people with gout are generally advised to transition to a low-purine diet that eliminates high-purine foods and limits certain moderately-high-purine foods.
Summary of Foods in a Healthy Gout Diet
The following foods are just some examples. You’ll discover fuller listings in Gout Rescue.
Include These Low-Purine Foods
Seafood: crayfish, monkfish, plaice.
Vegetables: all vegetables, especially dark green leafy vegetables and root vegetables (but see exceptions below).
Fruit: all fruits, but especially intensely colored fruits, e.g., blackberries, blueberries, cherries, grapes, kiwi fruit, mandarins, oranges, pineapples, strawberries, etc.
Dairy: eggs, milk, natural yogurt, cheese, cottage cheese, unsalted butter.
Pasta & Rice: egg pasta, ramen noodles, wholewheat pasta, wholewheat rice.
Cereals, etc: bread rolls, crispbread, white bread, wholegrain bread, whole grains.
Beans, Nuts, etc: almonds, Brazil nuts, broad beans, flaxseed, green beans, hazel nuts, peanuts, peanut butter, sesame seeds.
Misc: coffee, green tea, herbs, miso, olive oil, pickles, popcorn, sauerkraut, spices, tea, vegetable soup, vinegar.
Limit These Moderate-Purine Foods
Note: Limit meat (always lean), fish, shellfish, and poultry (skinless) to 1 x 3.5 oz (100 g) serving per day:
Seafood: barracuda, cod, crab, haddock, hake, lobster, pike, salmon.
Cereals, etc: buckwheat, oatmeal.
Beans, etc: baked beans, chickpeas, lentils, soy beans, white beans.
Misc: dark chocolate, raisins, sultanas.
Avoid These High-Purine Foods
Meat: organ meats, game, e.g., heart, kidneys, liver, pheasant, quail, etc.
Vegetables: dried mushrooms (e.g., boletus and shitake).
Beans, etc: dried beans, dried legumes, dried soybeans.
Misc: baker’s yeast, beer, brewer’s yeast, broths, consommé, meat gravies, pâté, stock cubes.
And here’s an example meal plan:
Breakfast: Natural yoghurt with raw honey and fresh berries of your choice.
Mid Morning Snack: 1 slice of whole meal bread with peanut butter.
Lunch: Homemade seasonal vegetable soup with a whole meal roll / bread roll.
Afternoon Snack: 1/3 cup of mixed dried fruit and nuts.
Dinner: Baked or grilled wild salmon with boiled potatoes, steamed broccoli and carrots.
Evening Snack: 2 oatcakes.
Note: You’ll discover more meal ideas here: 42 Healthy Meals for Gout Sufferers.