Healthy Eating Guidelines for People with Gout

Gout is a type of arthritis, caused by crystals of uric acid forming in joints such as the big toe. The joint may be swollen, red and very tender. Moving the joint may cause agonising, stabbing pain. Uric acid is a normal waste product, formed from the breakdown of compounds in food known as purines. It is excreted by the kidneys. When you have gout, your blood level of uric acid is higher than normal, and this causes crystals to form.

How is gout treated?

Gout is usually treated by a range of medications. Some drugs are used to treat acute gout attacks. Others reduce blood uric acid levels in the long-term, and so decrease the risk of further attacks.

Several lifestyle factors are also known to reduce uric acid levels and the risk of gout:

• Keep your weight within the normal range
  Gout is far more common in people who are overweight. Losing some excess weight can reduce the risk of further gout attacks. If you want to lose weight, take it slowly: one to two kg per month. Rapid weight loss can increase your uric acid level and may actually trigger an attack of gout.
  Eat small to moderate meals or snacks regularly through the day. If you skip meals or fast, your uric acid level will increase.
   
• Limit alcohol
  Alcohol can increase uric acid levels in your blood, and increase risk of gout. Its effect seems to be even worse if you are overweight.
  Beer and spirits seem to be more of a problem than wine.
  If you do choose to drink alcohol, keep within the recommended limit of 1 to 2 standard drinks each day.
   
• Drink low fat milk
  Have at least 2 to 3 cups of low fat milk or milk products such as yoghurt each day. Studies suggest that this is linked with lower uric acid levels and less risk of gout.
   
• Limit food that are high in sugar and fructose
  Fructose raises uric acid.  Limit honey and table sugar to 5 tsp per day.
  Avoid or limit normal soft drinks, cordials and fruit juice.
  Although fruit is nutritious, some fruits (such as apples and oranges) are rich in fructose and should not be eaten in excess.
  Recent studies suggest that eating one to two serves of cherries each day can reduce the risk of gout attacks. Don’t overdo it: 1 serve is ½ cup (10 to 12 cherries).
   
• Limit high purine foods
  Purines in food break down into uric acid, but it is not clear whether this significantly affects risk of gout. It may be wise to limit your intake of meat, poultry and fish to 130g to 160g per day (about the size of the palm of your hand).
  Some people find it helpful to limit or avoid the following very high purine foods:
  • meat extracts such as Bovril®
  • offal meats such as heart, kidney and liver (including pate)
  • seafood such as anchovies, herring, mackerel, sardines, caviar, mussels, prawns, shrimps and scallops
  • brewer’s yeast and yeast extracts such as Marmite®
     
• Drink coffee in moderation
  Drinking coffee is linked with lower uric acid levels and reduced risk of gout. Keep to a regular daily maximum of 4 to 6 cups.
   
• Keep active
  People who exercise regularly are less likely to get gout. Exercise can also help you lose weight.
  Try to walk for at least 30 minutes on most days. Wear supportive, well-fitting shoes, because hurting your foot could trigger an episode of gout.
   
• Keep your kidneys happy too
  Too much uric acid in your urine can increase your risk of kidney stones. Make sure to drink enough fluid each day to keep your urine light-coloured. This helps dilute the uric acid that’s excreted in your urine.
   
• Gout and other health issues
  People with high blood uric acid levels also seem to be at greater risk of heart disease, stroke and diabetes. It is important to make sure you have adequate management of high blood pressure, high blood fat levels and blood glucose. Losing excess weight, healthy eating and keeping physically active can all help reduce your risk of developing these other health problems.