Cover image for Homage Singapore's article on gout-friendly diet, and what to eat and avoid when you have gout.

Gout-Friendly Diet 101: Foods To Eat & Avoid

A gout-friendly diet can prevent flare-ups and attacks of gout. Find out what are the foods to avoid for gout and what to eat more of.

by Elaine Francis, R.N.

Gout is a painful form of arthritis that affects millions of people worldwide. It causes acute flare-ups of joint pain which can seriously affect mobility and quality of life. It’s not all bad news, though; most cases of gout can be prevented or managed with simple healthy lifestyle changes, particularly through adopting a gout-friendly diet.

What is gout?

Gout is a form of arthritis. It used to be thought of as a ‘wealthy man’s disease’, as it is closely linked to having a diet that is high in purine-rich foods, such as meat, seafood, and alcohol. Changes in eating patterns around the world have meant that this condition now affects more people than ever from all kinds of economic backgrounds.

The link between gout and diet means that we can do a lot to prevent gout by making healthy lifestyle choices.

What causes gout?

Gout is caused by a build-up of uric acid crystals in the joints and tends to follow a pattern of flare-ups with unaffected periods in between. We naturally have uric acid in our blood—it is a by-product of our bodies breaking down certain sorts of foods. Usually, our kidneys filter out uric acid and it leaves our body via our urine. However, sometimes, we make more uric acid in the body than we can filter out. That is when it starts to accumulate in the form of crystals in our joints, causing flare-ups of severe pain.

Foods that are high in compounds called purines increase the amount of uric acid in the blood. As such, knowing which foods are particularly high in purines can help us to prevent gout or manage flare-ups.

Preventing gout with lifestyle changes

An overall healthy lifestyle—a good diet, maintaining a healthy weight, getting exercise and limiting our alcohol intake—are the best things we can do to control gout. 

Following a diet low in purines is a great way to avoid gout or help prevent recurrent flare-ups. Flare-ups might need to be managed with medications, so see a doctor if you are having a severe flare-up or if they happen often.

10 foods to avoid when you have gout

Individuals should avoid foods that are high in purines, the chemical compounds that break down into uric acid and cause gout. This includes:

1. Alcohol

Alcohol seems to be the worst culprit for causing gout. This is because alcoholic drinks break down into uric acid easily in the body. Some drinks are worse than others. 

A higher alcohol intake also makes it harder for the kidneys to filter and excrete uric acid in blood. Hence, alcohol not only increases your levels of uric acid but also makes it harder for your body to get rid of it.

Whether you suffer from gout or not, limiting your intake to one or two small drinks per day, with at least two alcohol-free days per week, is a good idea for everyone.

2. Organ meats

Offal-based foods like kidneys, liver, brain and sweetbreads are extremely high in purines and should be avoided.

3. Game meats

These include meats such as venison (deer), rabbit, or wild-caught birds.

4. Seafood

Crab, shrimp, oysters and other shellfish can cause gout flare-ups. Roe and milt are particularly high in purines and should be the first thing you cut out if you suffer from gout. 

5. Fish

Some fish can increase uric acid levels, and certain types of fish contain higher amounts of purines than others. For instance, anchovies, mackerel, sardines and ikan bilis, which are often used in various dishes in Singapore, contain about twice as much purine as other types of fish. Cutting out seasonings and stocks such as ikan bilis and seafood stock cubes, powders, and broths from your diet can make a remarkable difference.

Fish such as salmon can be consumed in moderation as they have a relatively lower purine content.

6. Drinks with high sugar content

High-sugar corn syrups and other sugar syrups in drinks are some of the worst products that can contribute to increased uric acid levels. Sweetened drinks are bad for health in lots of different ways. They are high in calories without any beneficial nutrients, and a significant contributor to tooth decay, so it’s a good idea to avoid them or strictly limit your intake. 

7. Foods that contain high amounts of processed sugar

Sweets, biscuits, cakes and puddings, as well as baked goods and desserts, all usually contain high levels of simple sugars, which can increase uric acid. 

8. Products that contain high amounts of yeast

Yeast products, particularly nutritional yeast or yeast extracts like vegemite or marmite, are a good way to get B vitamins into your diet, especially if you follow a mainly vegetarian or vegan diet. However, it’s a good idea to be cautious with them if you have gout.

9. Some types of vegetables

There are a few vegetables that are relatively high in purines, but do not seem to trigger attacks of gout in the same way that meat and alcohol do. Mushrooms, asparagus, peas and some soy-based products contain purines but are usually well-tolerated when eaten in moderation. If you are keeping a food diary to try and work out triggers for flare-ups, these could be worth watching out for.

10. Oats

Oats have lots of health-giving properties and are especially good for people watching their cholesterol. However, they are one of the higher plant-based sources of purine. Although they are still lower in purines than meat, alcohol, and processed sugar, oats and oat-related products, such as oat milk or bread, should be taken in moderation for those with gout.

7 foods that are beneficial if you have gout

Following a sensible, healthy diet is the best way to cope with gout. Fill your plate with healthy, nutritious foods like:

1. Fruits

Although many fruits are high in sugar, the sugars in fruit do not seem to raise uric acid, partly because they are digested in a slower, steadier way than refined sugars. Some fruits even actively fight gout; cherries and cherry extract are often used as a natural remedy for gout.

2. Vegetables

A salad containing a variety of vegetables as an example of a food that is gout-friendly.

Source: Pexels

Fresh, frozen or tinned vegetables should make up the bulk of your diet, with huge health benefits that go beyond a remedy for gout. Eating lots of vegetables actually lowers your risk of many serious health conditions and obesity-related diseases like stroke, heart disease, and type 2 diabetes.

3. Legumes

Plant-based proteins like lentils and beans are a healthy and nutritious way to get protein into a low-purine diet.

4. Low-fat dairy products

Dairy products are fine for gout and low-fat dairy actually seems to help reduce the number of flare-ups people experience. Eggs are also a good source of protein and good for a low-purine, gout-fighting diet.

5. Nuts and seeds

Nuts and seeds are a good way to get good fats, protein and fibre into your diet.

6. Drinks

In general, drinking plenty of water is good for your kidneys (unless you’ve been told that you should limit your fluid intake due to a medical condition or other reasons). Tea and coffee are also fine in a gout diet, and there has been evidence that coffee is actually good for preventing gout.

7. Whole grains

Switching from processed carbohydrates like foods made from white flour or white rice to a diet rich in whole grains is great for your all-round health, and can help improve some of the triggers for gout. Whole grains include brown rice and wholemeal bread. Oats, on the other hand, are relatively high in purines and should be taken in moderation.

What are good diets for gout? 

Do note that while some foods are better than others in preventing a gout attack, it is still important to ensure a balanced and nutritious diet. It is not recommended to avoid eating a particular food completely, but to watch and limit your intake. For example, lean meats like poultry and some fish can be an important part of a healthy diet, but should be eaten in moderation.

While most people would have a good idea of the sorts of foods and drinks they should and shouldn’t be eating, it can be helpful to follow a specific diet plan. Two of the most well-known diets for gout are the DASH diet and the Mediterranean diet

The DASH – Dietary Approaches to Stop Hypertension – Diet

The DASH diet is designed for lowering high blood pressure and can also help with maintaining overall health. On top of managing blood pressure, weight and the risk of some diseases, the DASH diet is also great for those with gout.

The DASH diet prioritises whole grains, vegetables and fruit as the main part of a healthy diet, with importance also placed on low-fat dairy, lean meats, fish, and plant-based proteins like nuts, seeds, and legumes in smaller portions. Those on a DASH diet are recommended to stick to small amounts of plant oils and minimise animal-based fats.

Following a healthy diet is just about the best thing you can do for your health, but it is also true that highly restrictive diets can be hard to stick to. Unhealthy foods like sweets, puddings, alcohol and sugary drinks are discouraged, but having small amounts of them purely for pleasure rather than health is usually okay. 

Some people with gout find it helpful to keep a food diary to work out if there are particular triggers for flare-ups and help manage their condition naturally.

The Mediterranean Diet

The ‘Mediterranean’ style diet is another pattern of eating that is generally thought to be healthy and good for most health conditions including gout. The Mediterranean diet is high in fresh vegetables and fruit, whole grains, plant oils and lean meat, with little processed sugars or simple carbohydrates. However, following the Mediterranean diet will need a little adjustment for those with gout as some of the game meats and seafood that are common in the diet may increase uric acid levels and worsen gout.

A good diet for gout can help reduce the frequency and severity of attacks, but it is also important to get medical treatment for acute flare-ups. Untreated gout can cause long-term problems, and it is best to get flare-ups under control as quickly as possible.

A gout attack can be debilitating, and it can be helpful to have a house-call doctor visit you at your home instead of making your way down to a clinic. Dedicated and professional home carers can also support you through difficult times, especially when you just need a little extra help at home or to get outside. High-quality care in the comfort of your home means that you can maintain the healthy, active and enjoyable lifestyle that you deserve.

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About the Writer
Elaine Francis, R.N.
Elaine Francis is a registered nurse with 17 years’ experience in healthcare. She turned to writing to follow her passion for realistic medical communication. She loves translating medical jargon into accessible language for the people who need to understand it most. When she’s not writing or working on a busy cardiology unit, she spends her time telling her children to hurry up.
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