GOUT AND DIET
Gout is a painful inflammatory condition that
occurs in a significant number of adult men and women in Australia; and is
increasing in incidence. Gout is related to high uric acid levels in the blood
and can be influenced by genetic factors and diet. The increasing incidence of
gout has been linked to the increasing incidence of obesity in Western society.
Obesity (particularly abdominal obesity) and hypertension may be causal
factors, due to an association between high uric acid levels, glucose intolerance
or insulin resistance (and Type 2 Diabetes), high cholesterol levels and
It is important to address dietary and lifestyle factors
in relation to these diseases for long-term prevention of gout. For short-term prevention
of acute gout attacks, consideration of particular dietary components may assist
in the management of your condition.
Dietary Risk Factors
High intake of protein and purine-rich foods have
long been considered to be risk factors for the onset of gout attacks. New research
reveals that it is more likely to be a high intake of meat and seafood proteins.
Total protein intake does not seem to influence the onset of acute gout
attacks, nor does a high consumption of purine rich vegetables.
Consumption of meat and seafood should be kept to a
moderate level. Most people should consume a palm sized serve (65-100g) of lean
meat, once or twice per day. For people who are prone to gout, aim for a
smaller serving, no more than once, or occasionally twice per day. Alcohol in
any form raises uric acid levels but beer is particularly harmful and should be
strictly limited in those with a history of gout.
Fructose, particularly in the form of high fructose
corn syrup (in soft drinks / sports drinks) will increase uric acid levels. The
consumption of sugar-sweetened soft drinks is also strongly linked with an
increased risk of gout. Intake of soft drinks and sports drinks should be
limited as they are energy dense and nutrient poor.
Water should be your drink of choice for many
reasons. A low hydration status is a risk factor for gout, promoting uric acid
crystal formation in the joints. One way to test your hydration status is the
colour of your urine – aim for almost clear throughout the day. While some
health professionals advocate for 2 litres of fluid per day, the amount your
body requires depends on factors such as environmental temperature, activity
levels and perspiration rate.
Research has demonstrated that a high intake of low-fat
dairy products (3 or more serves per day) can be protective against the
development of gout. Diets high in vitamin C are also associated with a lower
incidence of gout and seem to be protective against the development of gout by lowering
uric acid levels. Some research has shown a compound called anthocyanins found
in cherries, may be protective against gout through a reduction in plasma uric
acid levels. This is a great reason to include a wide variety of fruits in your
Drinks To Limit
Red meat, especially
Fructose sweetened drinks
Low fat milk
Low fat yoghurt
How You Can Help To Manage Your Gout
Enjoy plenty of
low-fat milk and yoghurt and other low fat dairy products
Enjoy plenty of
fruit and vegetables, particularly those high in vitamin C (citrus, capsicum,
Aim to maintain
a healthy body weight and avoid obesity and its related disease states
Lose weight if
necessary (refer to the Weight Loss Fact Sheet on our website)
So, if you suffer from gout you may benefit greatly
by moderating your consumption of meat, seafood and alcohol. For example,
one lean steak, less than the size of the palm of your hand, along with plenty
of fresh vegetables and accompanied by one small glass of wine may mean the
difference between an extremely painful gout attack or not.
For the prevention and management of gout, diet and
lifestyle factors need to be considered, paying particular attention to achieve
a healthy body weight.
References: Choi et al 2004 ‘Intake of
purine-rich foods, protein and dairy products’ Arthritis and Rheumatism vol
52(1). Schlesinger 2005 ‘Dietary factors and hyperuricaemia’ Curr Pharm Des 11(32).
Lee et al 2006 ‘Recent Developments in diet and gout’ Curr Opin Rheumatol
18(2). Choi et al 2004 ‘Purine rich food, dairy & protein intake’ NEJM
350. Wortmann 2002 ‘Gout and hyperuricemia’ Curr Opin in
Rheumatology vol 14(3). Gout Causes. http://www.dietaryfiberfood.com/purine-food.php. McGill N 2009 ‘Treatment of Gout’ Geriatric
Medicine vol 3.