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Gout: Foods to Include and Foods to Avoid

The holistic management of gout can be effective.

General Medicine

patient handouts

by Adele Schenoy, M.D., Madeleine Beckman MA, MFA, and

Rich Strongwater, M.D.


Historically, gout was known as “the disease of kings”. It was believed to be due to overindulgence – in food and alcohol. Today gout, which affects more men than

Foods to Include and Foods to Avoid when you have gout

women, is known to be a form of both acute and chronic arthritis. It’s characterized by excess uric acid in the blood, resulting in painful, swollen joint(s). At times, the condition can be debilitating, and, in severe cases, gout can lead to permanent joint damage.


You’re not Henry VIII


Henry VIII, who suffered from gout, probably would have rejected lifestyle changes to his indulgent diet even if it helped relieve his painful, swollen joints, but recent findings indicate strong connections between improved lifestyle and reduction in gout flare-ups. For instance, by limiting purine-rich foods (ie, red meat and shellfish), alcohol, and sugar-laden beverages, patients can reduce their uric acid levels and help manage their gout. It doesn’t stop there: losing weight, daily exercise, and stress-reduction exercises also are effective. This will not stop gout from occurring but will decrease the number of flares and more likely the duration of the attacks.


In place of red meat and other uric acid-producing foods and beverages, experts recommend that affected people follow a diet of whole grains, some dairy, vegetables, nuts, legumes, and fruits. Patients with gout who consumed cherries over 2 days in are cent study had a 35% lower risk of experiencing gout attacks than did those who did not eat the fruit. In addition, coffee consumption seems to lower blood levels of urate, a salt of uric acid. Thus, including cherries, cherry juice, or cherry extract in the diet and drinking moderate levels of coffee may help to lower urate levels and help patients to better manage their gout symptoms.


Role of Patient and Practitioner

It is vital for both the patient and practitioner to understand how gout can present, have the condition diagnosed correctly, and then work together to promote urate-lowering holistic strategies.


Patients with gout should avoid:

  • Certain varieties of fish (eg, sardines, anchovies, scallops)

  • Certain varieties of meat (eg, venison, turkey, bacon, and organ meats like liver)

  • Red meat

  • Processed foods (eg, chips)

  • Refined carbohydrates (eg, white bread)

  • Fructose

  • Alcohol (more than two drinks each day)

  • Multitasking

  • Stressful situations

  • A sedentary lifestyle

Patients with gout should consume:

  • Omega-rich, cold-water fish (eg, tuna)

  • Eggs (in moderation)

  • Nuts

  • Vegetables (non-starchy)

  • Whole grains

  • Legumes (in moderation)

  • Cherries, tart cherry juice, or cherry extract

  • Coffee (in moderation)

Gout Patients should be encouraged to:

  • Lose weight

  • Exercise and practice stress-reducing activities like meditation

  • Maintain good hydration

  • Apply ice, not heat, to joints affected by gout

 

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References

Hainer BL, Matheson E, Wilkes RT. Diagnosis, treatment, and prevention of gout. Am Fam Physician. 2014 Dec 15;90(12):831-6.


Nielsen SM, Zobbe K, Kristensen LE, Christensen R. Nutritional recommendations for gout: An update from clinical epidemiology. Autoimmun Rev. 2018 Nov;17(11):1090-1096.

Li R, Yu K, Li C. Dietary factors and risk of gout and hyperuricemia: a meta-analysis and systematic review. Asia Pac J Clin Nutr. 2018;27(6):1344-1356.

Choi HK. A prescription for lifestyle change in patients with hyperuricemia and gout. Curr Opin Rheumatol. 2010 Mar;22(2):165-72. doi: 10.1097/BOR.0b013e328335ef38.

Nielsen SM, Zobbe K, Kristensen LE, Christensen R. Nutritional recommendations for gout: An update from clinical epidemiology. Autoimmun Rev. 2018 Nov;17(11):1090-1096. doi: 10.1016/j.autrev.2018.05.008. Epub 2018 Sep 10.

Abhishek A, Doherty M. Education and non-pharmacological approaches for gout. Rheumatology (Oxford). 2018 Jan 1;57(suppl1):i51-i58. doi: 10.1093/rheumatology/kex421. Published by Oxford University Press on behalf of the British Society for Rheumatology.

Arthritis Rheum. 2007 Jun 15;57(5):816-21. Coffee, tea, and caffeine consumption and serum uric acid level: the third national health and nutrition examination survey by Choi HK and Curhan G.

2BMJ Open 2016 Rheumatology Is coffee consumption associated with a lower risk of hyperuricaemia or gout? A systematic review and meta-analysis by Yi Zhang et al.

Keuhl KS, Elliot DL, Sleigh AE, Smith JL. Efficacy of tart cherry juice to reduce inflammation biomarkers among women with inflammatory osteoarthritis. J Food Studies. 2012:1:14-25.

Howatson G1, Bell PG, Tallent J, Middleton B, McHugh MP, Ellis J. Effect of tart cherry juice (Prunus cerasus) on melatonin levels and enhanced sleep quality. Eur J Nutr. 2012;1;909-916.

Kelley DS, Adkins Y, Laugero KD. A review of health benefits of cherries. Nutrients. 2018;10:368.

Zhang Y, Neogi T, Chen C, Chaisson C, Hunter DJ, Choi HK. Cherry consumption and decreased risk of recurrent gout attacks. Arthritis Rheum. 2012;64:4004-11.

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