Your complete guide to managing gout with diet

Reviewed by our expert panel
Person with gout holding their sore foot

Once labelled the disease of kings, due to its association with rich foods and alcohol, gout is a painful joint condition affecting over 41 million people worldwide. Dietitian Brooke Delfino shares simple diet tips to ease the pain.

These days, socioeconomic status has little bearing on gout, a painful form of arthritis caused by a build-up of uric acid in the blood. High levels of uric acid cause crystals to form in the joints, particularly the big toe. These crystal deposits cause swelling, heat, pain and stiffness, and flare-ups can last for days or weeks.

The condition affects men more than women, but some people have a genetic predisposition to developing gout, where they either overproduce uric acid or their kidneys cannot properly eliminate it.

The good news is that gout is one of the most treatable forms of arthritis, and what you put on your plate can make a difference.

What to eat to help manage gout inflammation

Research confirms a healthy diet and lifestyle play a big part in the management of gout.

Try these tips to reduce your risk of a flare-up.

1 Enjoy more meat-free meals

Most of us could do with a little less meat and a lot more veg, but if you suffer from gout, there’s even more reason to make a few vegetable swaps. Uric acid is a normal waste product from food, particularly compounds called purines. Purine-rich foods include:

  • Meat, particularly red meat, liver and kidney
  • Seafood, such as shellfish, sardines and anchovies
  • Yeast-based foods, like beer and Vegemite/Marmite.

You don’t have to eliminate these foods from your diet completely, but eating them in moderation may help. Limit red meat to three or four times a week and up your daily intake of anti-inflammatory foods, such as leafy green vegetables, colourful fresh fruit, unsalted nuts, whole grains and olive oil.

2 Cut back on booze

All forms of alcohol are linked to elevated blood levels of uric acid, especially beer and spirits. You may be happy to hear that wine is a somewhat better choice, but you should still limit yourself to drinking only one standard glass of wine a day if you’re female and two per day if you’re male. Aim for two alcohol-free days a week.

3 Lose excess weight

Dropping a few kilos appears to ease all forms of arthritis. Carrying less weight lightens the pressure on joints and lowers uric acid levels, alleviating painful symptoms.

Avoid fasting or drastic ‘crash’ dieting, where you skip meals and drop weight rapidly, as this can actually increase uric acid levels and trigger a gout attack. For healthy, advice that can help with gradual weight loss head here.

4 Drink more water

Dehydration can trigger a painful flare-up. When you don’t drink enough water, your kidneys can’t get rid of uric acid efficiently, leading to raised uric acid levels. This is why taking diuretics or having kidney disease also increases your risk of developing gout.

Unless you have been advised by your doctor to restrict your fluid intake, aim to drink eight to 10 glasses of water a day, especially when you are at risk of dehydration, such as while travelling or on a hot day.

There is some evidence to suggest fructose-rich drinks, such as fruit juice, can contribute to gout. Swap juice and other sugary drinks for water flavoured with fresh lemon, lime or berries instead.

5 Keep a food diary

Ask anyone who has gout about what they think aggravates their symptoms, and they’re likely to give you a long list of foods. The usual suspects include red meat, alcohol, citrus fruit, sugar, fats, salt, food and drinks that contain caffeine, and nightshade plants (such as tomatoes and eggplant).

Keeping track of what you eat and the severity of your pain will help you make some clear food-symptom connections. But, before you ban anything for good, talk to a health professional, such as an accredited practising dietitian.

Myths about gout

We reveal the facts behind some of the common food myths surrounding gout.

Myth 1 Gout only affects overweight men

Fact: Men are more likely to develop gout than women, until women hit menopause and the incidence of new cases tends to even out. Although being overweight is a risk factor for gout, people of all sizes can develop the disease. Genes play a bigger part than what you weigh. If your parents had gout, you’re more likely to have it as well.

Myth 2 Cherry juice is effective for treating gout

Fact: Vitamin C has been shown to help lower levels of uric acid, however the role of cherry juice is overstated. Instead, aim to eat a wide range of colourful fruit and vegetables to help meet your daily vitamin C needs.

Myth 3 There’s a strict gout diet people should follow

Fact: While there’s no specific gout diet, we do know people with gout are more likely to eat certain foods, particularly ones rich in purine (red meat, Vegemite and beer).

If you notice certain foods trigger your gout attacks, you may benefit from cutting down the amounts of those foods in your diet. However, not all purine-rich foods cause gout.

Am I at risk of gout?

You’re more likely to suffer from a gout attack if you:

  • are male
  • have a family history of gout
  • drink too much alcohol (particularly yeast-based beer)
  • eat a diet high in purines, such as meat, offal and shellfish
  • are overweight or obese
  • take diuretics
  • have type 2 diabetes, high blood pressure or high cholesterol
  • have kidney disease
  • crash diet or fast.
First published: May 2021

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