Gout

Diet and self-management for gout

People commonly think that gout is caused by eating rich foods or drinking too much alcohol. Gout occurs when people have higher than normal levels of uric acid in their blood. A small amount of uric acid in the bloodstream comes from the breakdown of purines in food, but most comes from the natural breakdown of purines in cells in the body.

It is not always possible for people to prevent gout attacks by changing their diet. This is because their gout may be caused by other factors such as inherited genes or medical conditions such as kidney problems or high blood pressure (see ‘Causes of gout’).
Most people are not able to reduce their uric acid levels enough to prevent attacks and/or long-term damage without medication. However, there are a number of changes that people can make to help reduce their uric acid levels.

•    Losing weight (if overweight) is an effective dietary treatment for gout

Being overweight means that the kidneys are not as effective at getting rid of uric acid, so gradual weight loss combined with exercise can improve this. Extreme or rapid weight loss is not advised because it can raise uric acid levels. 

Several people we spoke to believed that it was important to stay healthy by exercising. 
Audio onlyText only
Read below
•    Drinking less alcohol

It is possible for people with gout to stay well without becoming teetotal. However, excessive alcohol consumption – particularly beer – can increase the risk of developing gout and can cause attacks for people who have gout. 

The purines in some alcohol (e.g. beer) can increase the amount of uric acid in the body. Alcohol binges can also result in a build-up of lactic acid in the body which can make the kidneys less effective at removing uric acid. Doctors do not think that drinking wine in moderation increases the risk of developing gout but It is important for many reasons that people make sure their alcohol consumption is below the recommended healthy limit of 3-4 units a day for men and 2-3 units a day for women. 
•    Drinking fewer sugary soft drinks

Many soft drinks contain a lot of fructose (sugar) (also called glucose-fructose syrup or corn syrup). This is likely to increase the levels of uric acid in the blood, so these drinks should be kept to a minimum. Diet soft drinks do not appear to increase the risk of gout. 

•    Eating less foods that are high in purines

Research on diet and gout suggests that it is only excessive consumption of high purine foods (e.g. red meat, offal and seafood) and alcohol (particularly beer) that should be avoided. These foods can be eaten in moderation and there is no evidence that it is necessary to avoid them entirely. Eating less of these foods may be helpful but most people are not able to reduce their uric acid levels enough to prevent attacks and/or long-term damage without medication.
Some people we spoke to had started to make changes to their diet as soon as they were diagnosed. Many people had tried to identify foods that might be triggering their attacks. Some noticed that they had attacks after eating certain foods (though this may have been coincidence) but other people did not find any particular foods that made a difference. A few people bought gout recipe books to give them ideas about how to eat fewer foods that were high in purines. Jonathan bought a kit to test his own levels of uric acid. He did not find any differences in his levels when he ate different foods. 

Some people found that the dietary advice for their other health conditions conflicted with information on gout. They found it hard to work out what they could eat that would not cause problems. Several thought that it would be helpful to discuss gout with a dietician (for more see ‘Finding information on gout’).
 
Jeff X cut down on alcohol and red meat. His family were happy to eat less red meat, and he noticed that he felt ‘brighter’ in the mornings when he drank less alcohol in the evening. Val found it difficult to eat less red meat because her family enjoy it, but she started having smaller portions. 

Many people agreed that the best option was to eat in moderation and cut down on any foods that they knew triggered attacks in them. Some people were pleased to discover that they did not eat many high purine foods anyway, so did not need to consider reducing them. Others found it easy to make changes to their diets, though some missed eating certain foods. Hazel finds it difficult to eat out. 
Carole wanted to avoid taking medication – she tried managing her gout by diet for about 10 years. It did not stop her attacks but did make her feel like she was in control. Not everyone believed it was necessary to change their diet. Jonathan and Ian found that medication stopped their attacks. Jeff Y did not believe that diet was important in managing gout compared to genetic factors. Other people did not want to have so many restrictions that they felt they were not leading a normal life. 
John Z believes that making too many unnecessary dietary changes could be unhealthy and cause other problems. He believes that it is important for people to know that diet is only one factor that can contribute to attacks so that they do not excessively restrict what they eat and drink.

•    Other dietary changes

There is a small amount of evidence that eating cherries might reduce the frequency of attacks, but more research is needed to find out whether this is the case. 

Jonathan found that cherries made no difference to his uric acid levels. Other people found it difficult to know whether eating cherries had made a difference or not. Some people found it hard to find fresh cherries or cherry juice in their local shops.
There is not yet enough evidence to show whether increasing consumption of coffee or foods rich in vitamin C can decrease the risk of getting attacks. However, some people tried these things and believed that they had reduced the number of attacks.

Although some people believe that drinking plenty of water will help, there is no evidence that this makes a difference to the risk of getting attacks. Several people had decided to drink more water, particularly if the weather was warm or they were visiting a hot country.

•    Complementary treatments and therapies

Many people had tried eating or drinking things that they had heard might help with gout, like natural or herbal remedies. Michael wore a magnetic bracelet that he hoped would prevent attacks. There is no clear evidence that any of these treatments reduce the risks of gout attacks, and most people noticed no difference when using them.

Some people preferred to rely on advice from their doctors. Some GPs had told people that complementary products were unlikely to work. Others had warned them to be careful when buying remedies on the internet. Several people thought products were expensive and did not work. Others were so desperate to prevent attacks that they would ‘try anything’ that they heard might help.
Audio onlyText only
Read below
Jeff V had tried acupuncture when he had his first attack. He found that it reduced the pain and swelling at first but it came back the next day. Jacqui tried reflexology but did not find it very helpful. Jill found that energy therapies like reiki helped her to cope with the pain.


Donate to healthtalk.org
Last reviewed December 2016
Last updated December 2016

Feedback

Please use the form below to tell us what you think of the site. We’d love to hear about how we’ve helped you, how we could improve or if you have found something that’s broken on the site.

Make a Donation to healthtalk.org





Find out more about how you can help us.

Send to a friend

Simply fill out this form and we'll send them an email