What is Gout? [1]

Gout is a type of arthritis which is an inflammatory condition that affects the joints. It is caused by high levels of uric acid in your blood causing crystals to be formed in your joints. Due to this, joints may become swollen, red, tender and cause severe pain. This pain is most commonly felt in the big toe and other areas such as the ankles, knees, wrists, fingers. Nevertheless, gout can be treated and managed through medical interventions along with a healthy diet and lifestyle changes.  

The importance of diet for Gout [2,3]

Uric acid is commonly found in foods containing purines. So, reducing purines in your diet can help to manage gout. Uric acid is a by-product of the breakdown of food. Therefore, reducing the amount of uric acid containing food may reduce the uric acid build up in the blood.

• Purines are mostly found in protein-rich foods:
• Meat – mostly red meat and organ meats (e.g. kidney, liver, offal)
• Seafood – mostly shellfish like shrimp, lobster, oily fish, sardines, anchovies, herring, trout
• High-fructose corn syrup – soft drinks, soda, sweetened juices, breakfast cereals, ice cream, candy, fast food
• Alcohol – beer, spirits
• Yeast – marmite

Vegetable intake

Vegetables such as spinach, cauliflower, mushroom, lentils also contain purines but these do not appear to have the same association with gout compared to the animal sources of purines. Vegetable intake is encouraged as part of a healthy diet as well as to manage your weight.

Should meat and seafood be avoided

Organ meats, offal, shellfish should be avoided as it is very high in purines. However, fish contains many essential nutrients that can be included in small portions occasionally.

Dairy products 

There is some evidence that suggests a benefit of including low fat dairy products to reduce the risk of gout. Choose low fat or non-fat milk, low-fat yoghurt (unflavoured) and small portions of cheese in your diet.

Lifestyle changes and Gout [4,5]

• Maintain a healthy body weight

Gout is more common in people who are overweight. Losing weight can assist in gout management. However rapid weight loss may increase uric acid levels so it is important to aim for gradual weight loss of 0.5-1kg per week.

• Limit alcohol intake

Alcohol can severely increase uric acid levels. Reducing the amount of alcohol, you drink especially beer and spirits may reduce the risk of gout attacks. Avoid alcohol during a gout attack.

• Water intake

Staying hydrated throughout the day may help dilute the uric acid levels in your body. Aim to drink 2-2.5L of water per day. Avoid sugary drinks, fruit juices, soda, soft drinks as it may increase the risk of gout and contribute to weight gain.

References

1. Towiwat P, Chhana A, Dalbeth N. The anatomical pathology of gout: a systematic literature review. BMC Musculoskeletal Disorders. 2019;20(1).
2. Rongrong L, Kang Y, Chunwei L. Dietary factors and risk of gout and hyperuricemia: a meta-analysis and systematic review. Asia Pac J Clin Nutr. 2018;27(6):1344-1356.
3. Yokose C, McCormick N, Choi H. The role of diet in hyperuricemia and gout. Current Opinion in Rheumatology. 2021;33(2):135-144.
4. Saag K, Choi H. Epidemiology, risk factors, and lifestyle modifications for gout, Arthritis Research & Therapy. 2006;8(Suppl 1):S2.
5. Gout [Internet]. nhs.uk. 2020 [cited 7 February 2022]. Available from: https://www.nhs.uk/conditions/gout/