Gout, a painful form of arthritis, occurs when high levels of uric acid in the blood cause crystals to form and accumulate around a joint.
Uric acid is produced when the body breaks down a chemical called purine. Purine occurs naturally in your body, but it's also found in certain foods. Uric acid is eliminated from the body in urine.
A gout diet may help decrease uric acid levels in the blood. While a gout diet is not a cure, it may lower the risk of recurring painful gout attacks and slow the progression of joint damage. Medication also is needed to manage pain and to lower levels of uric acid.
The general principles of a gout diet are essentially the same as recommendations for a balanced, healthy diet:
Weight loss. Being overweight increases the risk of developing gout, and losing weight lowers the risk of gout. Research suggests that reducing the number of calories and losing weight — even without a purine-restricted diet — lowers uric acid levels and reduces the number of gout attacks. Losing weight also lessens the overall stress on joints.
Complex carbs. Eat more fruits, vegetables and whole grains, which provide complex carbohydrates. Avoid foods such as white bread, cakes, candy, sugar-sweetened beverages and products with high-fructose corn syrup.
Water. Keep yourself hydrated by drinking water. An increase in water consumption has been linked to fewer gout attacks. Aim for eight to 16 glasses of fluids a day with at least half of that as water. A glass is 8 ounces (237 milliliters). Talk to your doctor about appropriate fluid intake goals for you.
Fats. Cut back on saturated fats from red meats, fatty poultry and high-fat dairy products.
Proteins. Limit daily proteins from lean meat, fish and poultry to 4 to 6 ounces (113 to 170 grams). Add protein to your diet with low-fat or fat-free dairy products, such as low-fat yogurt or skim milk, which are associated with reduced uric acid levels.
Recommendations for specific foods or supplements include the following:
High-purine vegetables. Studies have shown that vegetables high in purines do not increase the risk of gout or recurring gout attacks. A healthy diet based on lots of fruits and vegetables can include high-purine vegetables, such as asparagus, spinach, peas, cauliflower or mushrooms. You can also eat beans or lentils, which are moderately high in purines but are also a good source of protein.
Organ and glandular meats. Avoid meats such as liver, kidney and sweetbreads, which have high purine levels and contribute to high blood levels of uric acid.
Selected seafood. Avoid the following types of seafood, which are higher in purines than others: anchovies, herring, sardines, mussels, scallops, trout, haddock, mackerel and tuna.
Alcohol. The metabolism of alcohol in your body is thought to increase uric acid production, and alcohol contributes to dehydration. Beer is associated with an increased risk of gout and recurring attacks, as are distilled liquors to some extent. The effect of wine is not as well-understood. If you drink alcohol, talk to your doctor about what is appropriate for you.
Vitamin C. Vitamin C may help lower uric acid levels. Talk to your doctor about whether a 500-milligram vitamin C supplement fits into your diet and medication plan.
Coffee. Some research suggests that moderate coffee consumption may be associated with a reduced risk of gout, particularly with regular caffeinated coffee. Drinking coffee may not be appropriate for other medical conditions. Talk to your doctor about how much coffee is right for you.
Cherries. There is some evidence that eating cherries is associated with a reduced risk of gout attacks.
A sample menu
Here's a look at what you might eat during a typical day on a gout diet:
Whole-grain, unsweetened cereal with skim or low-fat milk
1 cup fresh strawberries
Roasted chicken breast slices (2 ounces) on a whole-grain roll with mustard
Mixed green salad with balsamic vinegar and olive oil dressing
Skim or low-fat milk
1 cup fresh cherries
Roasted salmon (3-4 ounces)
Roasted or steamed green beans
1/2 cup whole-grain pasta with olive oil and lemon pepper
1 cup fresh melon
Caffeine-free beverage, such as herbal tea
Dos and do nots
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According to the University of Maryland Medical Center, adding foods high in dietary fibre may help lower uric acid levels in your blood. Dietary fibre may help absorb uric acid in your bloodstream, allowing it to be eliminated from your body through your kidneys. Increase the consumption of dietary soluble fibres such as Isabgol, Oats, Spinach, Broccoli to name few.
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Cold-pressed olive oil
Use cold-pressed olive oil in cooking instead of shortening, butter or vegetable oils. Oils that have been subjected to heat or processing turn rancid quickly. Rancid fats destroy vitamin E in your body - this vitamin is necessary for controlling uric acid levels. Olive oil helps you avoid the production of excess uric acid, which is associated with the consumption of rancid fats.
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Take in a healthy dose of vitamin C
To help reduce the amount of uric acid in your system, regularly taking 500 milligrams of vitamin C will decrease your uric acid levels in a month or two.
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Avoid bakery products
Avoid cakes, pastries, cookies and other sugary delights which are rich in saturated fats and trans fats.
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Celery seed extract
This is also a popular natural remedy for gout and uric acid problems. The seeds of the celery plant have long been used to treat gout, rheumatism and arthritis. Celery possesses sedative, antioxidant and mild diuretic action and is considered a urinary antiseptic. In rare cases, this herb is also used to treat sleeplessness, anxiety and nervous breakdown. Although the seeds of this plant are often used in herbal supplements, the roots may also be used.
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Fruits and vegetables such as red bell peppers, tomatoes, blueberries, broccoli and grapes are rich sources of antioxidant vitamins. Antioxidants which are vitamins that prevent free radical molecules from attacking your organ and muscle tissue cells may help lower uric acid levels.
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Cherries contain chemical compounds that may help neutralise uric acid allowing your body to eliminate this acid as waste. Some researchers recommend consuming 30 to 40 cherries every four hours during an attack.
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Apple cider vinegar
It is believed that raw, apple cider vinegar can help alleviate high uric acid levels by changing the pH values of your blood. But it has to be raw, un-distilled, un-pasteurised apple cider vinegar; the kind you get from your local health food store. Dr. Sharad advices a simple home remedy" Add 2 teaspoons of vinegar to a large glass of water and stir thoroughly. Drink a glass between 2 and 3 times every day. You can also use it topically: half a cup added to three cups of hot water and soak the affected area for 30 minutes. Reheat and repeat as necessary.
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Saturated fat, trans fat, sugar and alcohol
All these affect your triglycerides, a type of fat that can clog your arteries and increase your risk for heart attacks and strokes.
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High-fructose corn syrup
This is a type of sweetener in soft drinks and other processed foods that can elevate your levels of triglyceride and uric acid - a chemical associated with diabetes, gout, alcoholism, kidney disease and other health problems.
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Drink plenty of fluids to help flush uric acid from your body
Drink a minimum of 3 and 1/2 liters of water daily. Water is a medium that aids the kidney to'strain' the impurities from your body.
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Also avoid high-protein weight-loss diets which can cause you to produce too much uric acid (hyperuricemia).
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Limit meat, poultry and fish - animal proteins are high in purine and this will result in high uric acid levels in the body
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Limit or avoid alcohol
Alcohol interferes with the elimination of uric acid from your body. Drinking beer in particular has been linked to gout attacks. If you are prone to uric acid attacks, limit alcohol consumption to one drink three times a week.
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Choose complex carbohydrates
Eat more whole grains, fruits and vegetables and fewer refined carbohydrates such as white bread, cakes and candy. Because foods rich in complex carbohydrates promote feelings of fullness, and prevent overeating and are useful in maintaining a healthy weight.