Discussion of Gout Nutrition Issues

What are Purines?   Foods to Favor   Foods to Avoid

Purines

Purines are aromatic organic compounds naturally occuring primary in organ meats and some fish, and less in most meats, fish, and vegetables and least in dairy products. Gout is a disorder of purine metabolism. High purine foods increase the risk of gout by raising the body's uric acid level. High levels of uric acid tend to crystalize and form deposits in tendons and joints and the tissues around them. Patients can reduce risk of gout attacks by reducing consumption of high purine foods.

  • High purine foods include organ meats such as liver, kidney, anchovies, sardines, meat extracts, mackeral, scollops, game, and beer.
  • Moderate purine foods include meat such as beef, port and poultry, fish and seafoods, vegetables such as asparagus, spinach, cauliflower, mushrooms, beans, oatmeal, wheat bran and germ.
  • Low purine foods include various dairy products.

Favor these foods, nutrients and herbs

Cherries & Cherry Juice

Although sugars in fruit juice can increase uric acid and the risk of gout, research has demonstracted that consumption of cherries - both the fruit and the juice - can prevent gout attacks. The amount required to be consumed is 20 cherries daily of black, red, or yellow and either sweet or sour cherries or the same amount of cherry juice. 4 Reportedly, driinking cherry juice is also an good treatment for a gout attack. there have been many anecdotal reports of cherry juice as an effective treatment for the pain and inflammation of gout. Cherries contain anthocyanins which are antioxidants creating the red or purple pigments in many fruits and vegetables. These antioxidants fight free radicals and reduce inflammation.

Folic Acid

Supplementing with folic acid (to 80mg/daily) can be helpful6 although the research is contradictory. 7

Vitamin C

Research suggests that vitamin C may be helpful, but should start at a low level and gradually build up. One study examined patients receiving at least 4 grams/daily vitamin C and who experienced more urinary excretion of uric acid within a few hours. The study also looked at patients receiving 8 grams/daily who had reduced levels of serum uric acid.8 It is felt that supplemting with vitamin C might lessen the risk of gout, but taking too large amounts could trigger attacks because levels of uric acid would suddenly change. Medical professionals therefore recommend starting with only 1gram/daily in order to reduce levels of uric acid.

Quercetin

In test tube research the flavonoid (yellow pigment in plants) quercetin has been demonstrated to restrict an enzyme (xanthine oxidase) which controls uric acid creation rate in the body. 9 10 Quercetin also reduces inflammation in test tube research. In animal research quercetin reduces uric acid levels, but not necessarily more than the drug allopurinol. Research is needed to confirm its effectiveness in the human physiology. Some medical professionals recommend 150-350mg/daily.

Autumn crocus

Colchicine is a potent inflammation reducing substance that comes from autumn crocus. It is frequently utilized as a treatment for gout, but since it does have toxicity, should only be used under the supervision of your medical professional.

Avoid these foods

Alcohol

Beer, due to its yeast component is especially high in purines, but reducing all alcohol to 1 drink a day may lessen gout. Less may reduce the number of attacks of gout.1, 2.

Sugar

All refined sugars which include both white table sugar (sucrose) and sugars from fruit juice (fructose) also raise uric acid levels and so should be avoided.3

Organ Meats

Organ meats, ie liver, kidney, anchovies, sardines, meat extracts, meat broth concentrates, mackeral, scallops, and game birds and animals - are high purine foods which contribute to gout.

Studies

See the following for footnote references.

Related diseases: gout