Gout is a common type of arthritis. If you have gout or are at risk for it, you need to know about purines and uric acid.
Your body makes purines. They're also in some foods. Uric acid is a byproduct of digesting purines.
Managing uric acid levels is key. High uric acid levels raise your risk of developing gout. If you have gout, uric acid can lead to flares.
In this article, you'll learn what gout is, whether you're at risk, and how to eat to keep uric acid levels low.
Gout is a chronic joint condition. It's caused by a build-up of uric acid in the bloodstream. That forms urate crystals in your joints. The crystals cause inflammation, swelling, and severe pain.
Your body filters uric acid through the kidneys. It then comes out in your urine. But you can have too much uric acid if:
- You eat a diet high in purines
- Your body over-produces them
- Or you can't excrete it fast enough
Gout flares come on suddenly and the pain is often excruciating.
High purine levels lead to uric acid crystals in the joints. This causes gout flares. Flares involve sudden severe pain and inflammation.
Gout has several risk factors. Some you can't control, like age and genetics. You may have some control over others.
Risk factors include:
- Diet: A diet high in purines, fructose (fruit sugar), and alcohol increase your risk of gout.
- Obesity: Research suggests gout is more common in people who are overweight or have obesity.
- Sex: Under age 50, biological males tend to have higher uric acid levels and more frequent gout. Menopause levels the playing field.
- Medical conditions: Kidney disease, diabetes, metabolic syndrome, and high blood pressure (hypertension) all increase your risk of gout.
- Family history: Having relatives with gout means you're more likely to develop it.
- Age: Biological males most often develop gout between 30 and 50. Biological females' risk goes up after menopause.
The most common cause of gout is an impairment in how the body excretes uric acid. Conditions affecting the kidneys are usually to blame for this.
Research has looked at the relationship between diet and your ability to secrete uric acid.
One study found that a plant-rich diet can lower the acidity of your urine. That appeared to help the body get rid of uric acid through urination.
Studies also suggest a relationship between vitamin C and gout. Vitamin C-rich foods (citrus, peppers, strawberries, and broccoli) or supplements also help your body get rid of uric acid.
Many factors contribute to your gout risk. Some (like diet) can be modified. But others (such as age) can't be. Your diet and conditions affecting the kidneys can change how well your body eliminates uric acid.
Do Eat
Grains
Fruit and most vegetables
Low-fat dairy
Eggs
Tofu
Don't Eat
Alcohol
Red meat
Organ meat
Gravy
High-purine seafood
Limiting purine-rich foods in your diet can help to reduce gout flares. But diet alone can’t usually prevent gout flares. That's because multiple factors go into flares, including:
- Purine production: How much your body naturally produces.
- Taking diuretics: Drugs that make the kidneys produce more urine.
- Problems excreting uric acid: How efficiently your body gets rid of it.
The type of food also makes a difference in the risk of gout flares. Foods linked to high uric acid levels and more frequent flares include:
- Processed foods
- Animal products
- High-purine seafood
Plant-based purines are less likely to raise your uric acid levels.
Pay attention to how different foods affect you. Everyone has different limits and different foods that trigger gout flares.
High-purine foods should be avoided or eaten sparingly with gout. These include:
- Alcohol: All types
- Red meat: Beef, pork, lamb, venison, and other wild mammals
- Seafood and shellfish: Shrimp, mussels, anchovies, sardines, and lobster
- Organ meats: Liver, kidney, heart, tongue, tripe, etc.
You should also avoid meat-based gravies.
These foods should be eaten in moderation:
- Oatmeal
- Wheat bran
- Mushrooms
- Green peas
- Spinach
- Asparagus
- Cauliflower
- Kidney beans
- Dried peas
- Beans
- Lentils
Foods low in purine are safe for a gout diet. These are foods to focus your diet on:
- Rice
- Barley
- Pasta
- Vegetables (other than those listed above)
- All fruits
- Low-fat dairy
- Eggs
- Tofu
The development of gout and gout flares are tied to uric acid crystals in the joints. That causes sudden, severe pain and inflammation. Uric acid crystals come from high purine levels.
Your risk of gout is determined by several factors, including age, diet, obesity, kidney function, and genetics. Diet is the most important way to lower your risk.
A diet low in purines can help manage your risk of gout and gout flares.
If you have gout or are at high risk, talk to your healthcare provider about how to prevent uric acid crystals from forming. Diet alone may not be enough.
If you're struggling with a low-purine diet, it may help to see a nutritionist who can help you design a diet that's right for you.
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