What to Eat (and What to Skip) If You’ve Got Gout

Gout has been making headlines lately, and the news isn’t so good: Experts have noted that this painful form of arthritis is making a comeback, and even young people are susceptible. Here’s a quick primer on the condition, plus a gout-friendly diet that can help prevent its agonizing flare-ups.

What causes gout?

In a nutshell, gout pain is caused by high levels of uric acid in the blood. When the body cannot remove the excess acid efficiently, crystals form, and collect in and around joints. This build-up leads to sudden pain and swelling, often in the big toe—but heels, ankles, wrists, knees, elbows, and fingers can also be affected. The pain typically comes on at night; it’s more severe during the first 12 hours, but can last up to 10 days.

Your genes may make you more prone to gout, but certain foods are known to increase your risk: These include sugary drinks and sweets (especially those high in fructose), refined carbs (such as bread and pasta), and foods high in chemical compounds called purines. When purines are digested, uric acid is created as a waste product.

Purine-rich foods include red meat, organ meats, game meats (like veal and venison), some types of seafood (including shellfish, tuna, mackerel, sardines, anchovies, and trout), and alcohol, specifically beer and liquor. (Fortunately, high-purine plant foods do not trigger gout attacks, so there is no need to avoid spinach, beans, lentils, broccoli, and the like.)

Foods that are good for gout

In addition to avoiding common triggers, reaching for certain foods may also help ward off gout attacks:

Cherries: The fruit’s anti-inflammatory compounds may provide a protective effect. In one study, which tracked over 600 people with gout, cherry consumption over a two day period was associated with a 35% lower risk of gout attacks.

Dairy: Milk proteins have been shown to decrease blood levels of uric acid. So if you’re a dairy lover, go ahead and enjoy your grass-fed yogurt and milk.

Coffee: Good news for java fans. A review of nine studies found that in both men and women, coffee can significantly lower uric acid levels. And drinking one cup per day or more was tied to a reduced gout risk.

Water: Staying well-hydrated is an important tactic for preventing gout because water is needed to help the kidneys flush out waste products, including excess uric acid. A good rule of thumb is to aim for 64 ounces of water, spread out throughout the day.

The best gout diet

You’ve probably heard of the DASH (Dietary Approaches to Stop Hypertension) diet. It’s an eating pattern designed to help people reduce their blood pressure—but it appears to be good for gout too. Largely based on the Mediterranean diet, it emphasizes produce, whole grains, beans, nuts, low-fat dairy, and healthy fats, while limiting animal protein and sweets. A large, 26-year study published in the British Medical Journal  found that men who followed the DASH diet had a lower risk of developing gout.

Finally, shedding a few pounds healthfully can help prevent gout. Insulin resistance is commonly associated with being overweight, and it causes uric acid levels to increase. However, its important to note that quick weight loss may actually trigger a gout attack, so focus on a lifestyle approach that allows for gradual, sustainable weight loss.

The principles of the DASH plan—eating more beans instead of meat; snacking on fruit and nuts over sweets or processed foods; replacing refined starches with whole grains; consuming plenty of veggies; and making water your beverage of choice—may be all you need to slim down and simultaneously slash your gout risk.

Cynthia Sass, MPH, RD, is Health‘s contributing nutrition editor, a New York Times best-selling author, and a consultant for the New York Yankees and Brooklyn Nets.

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