Diets for the gout
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
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Gout is a metabolic disease which results in overaccumulation of monosodium urate in joints and other organ systems. The area where it is most symptomatic is the joints. Gout is one form of arthritis where diet plays a critical role.
The metabolic error that causes gout is an inability to get rid of uric acid. Uric acid is a byproduct of purine synthesis. Purines are chemical compounds found in some foods. These purines are metabolized to uric acid. A diet rich in purines can raise uric acid levels in the body, which leads to gout. A 2004 study reported that meat and seafood increase the risk of gout, while dairy products lower your risk. The study also found that purines in vegetables do not increase the risk of gout.
Foods to eliminate from the diet (very high in purines):
• Yeast (used in beer and bread)
• Alcoholic beverages, particularly beer
Foods that are moderately high in purines, but may not raise the risk of gout:
• Asparagus, cauliflower, mushrooms, peas, spinach
• Whole-grain breads and cereals
• Chicken, duck, ham, and turkey
• Kidney and lima beans
Foods that are safe to eat (low in purines):
• Green vegetables and tomatoes
• Fruits and fruit juices
• Breads and cereals that are not whole-grain
• Butter, buttermilk, cheese, and eggs
• Chocolate and cocoa
• Coffee, tea, and carbonated beverages
• Peanut butter and nuts
Dairy products that may lower the risk of gout:
• Low-fat or skim milk
• Low-fat yogurt
Patients with gout need to reduce their intake of meat and seafood, as well as beer.
Changing diet may help lower the risk of having future attacks of gout. Physicians recommend that overweight people who have gout lose weight if they are overweight or obese.
1. Choi HK, et al. (2004). Purine-rich foods, dairy and protein intake, and the risk of gout in men. New England Journal of Medicine, 350(11): 1093–1103.
2. Choi HK, et al. (2004). Alcohol intake and risk of incident gout in men: A prospective study. Lancet, 363(9417): 1277–1281.
3. Wortmann RL, Kelley WN (2001). Gout and hyperuricemia. In S Ruddy et al., eds., Kelley's Textbook of Rheumatology, 6th ed., pp. 1339–1376. Philadelphia: W.B. Saunders.
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