An introduction
Your diet is likely to have the greatest influence over how gout affects you, and it is therefore important to examine what you eat, and devise a suitable meal plan.
This is because gout is caused by an excess of uric acid in your bloodstream. Certain foods contain high amounts of a substance known as purines. When the body breaks down purines, it produces uric acid. So, being aware of what these purine-rich foods are is important in managing gout.
Altering your diet so that you are eating foods low in purines, and avoiding those which aggravate the condition, will help to manage your symptoms.
Maintaining a healthy weight
Your weight will have an influence over your condition, as the more overweight you are, the more uric acid your body has to produce.
Additionally, being overweight is often associated with insulin resistance which can make it difficult to excrete uric acid in the urine. Finally, those who are overweight are also at greater risk of developing high cholesterol, which in turn can worsen gout.
If you need to lose weight, it is advisable that you do this gradually, as rapid weight loss may result in a sudden increase in uric acid as tissue breaks down. A doctor or dietician will be able to outline a suitable weight loss programme for you if this is necessary.
Foods to avoid
Good as they may be, foods which are high in purines are going to have a negative effect on your gout due to the fact that as the body breaks down purines, it produces uric acid.
The primary culprits of this are red meat and game, fish, and some other sources. In particular:
- Liver
- Kidneys
- Sardines
- Anchovies
- Crabs
- Asparagus
- Spinach
- Yeast
You should not have these foods in more than one meal per day, and if you can exclude them from your diet for a couple of days each week, then replacing them with other sources of protein such as lentils and pulses is likely to be beneficial.
Foods to consume
There are some foods which it is important to include in your diet each day. A daily intake of fruit and vegetables, particularly cherries, strawberries, blueberries, celery and carrots, will increase your level of vitamin C, and there is some evidence to suggest this may help in lowering uric acid levels. Additionally, vegetables can bulk out stews and casseroles to reduce your intake of purine rich meats.
Rice, potatoes, pasta and other such starchy carbohydrates contain low levels of purines and the wholegrain varieties in particular, contain a good source of fibre and nutrients. They should be included in each meal.
Some dairy products, such as low-fat milk and yoghurt, are low in uric acid, but high in protein, making them useful additions to meals containing fish or meat.
Drinks to avoid
Top of the list here is alcohol. The association between alcohol consumption and gout has been recognised for many years, largely due to the high purine content, particularly in beer. Additionally, alcohol is highly calorific, so maybe linked with becoming overweight, an indirect cause of gout.
It has been found that regular consumption of sugar-sweetened or fizzy drinks increases the chances of developing gout, and will worsen the condition, although some believe that diet drinks do not have this link with gout.
Energy drinks in large quantities may also worsen your symptoms. Energy drinks are high in fructose, a sugar, which when concentrated and used as a sweetener, carries a higher risk of gout with it than in its naturally occurring form, for example, in fruit.
Drinks to consume
If you are a gout sufferer, (or even if you’re not!) it is highly important to keep hydrated. Being dehydrated increases the chances of crystals forming in the joint and may bring on a gout attack. Drinking water is ideal and you should try to drink about 2 litres per day. This is of particular importance during warm summer months, when dehydration is a more pressing concern.
If water is getting a bit tedious, then drinking pineapple or cherry juice will keep you hydrated and should not have detrimental effects on your condition. Pineapples contain an enzyme called bromelain, which has been shown to reduce inflammation, and cherries are thought to reduce levels of uric acid in the bloodstream. You should drink these juices in their purest form, with no added sugars or sweeteners.
