Foods and Gout

MANISH SUTHAR, M.D. 

Gout is a very common form of arthritis which gets aggravated when sharp crystal shards of uric acid collect between joints and cause painful inflammation. Gout, especially common in men, in which patients may have high uric acid levels in the blood and sudden attacks of severe joint pain and swelling caused by the deposits of uric acid crystals in those joints. The body breaks down foods containing purines into uric acid, usually a neutral but unnecessary chemical that is then filtered out of the bloodstream by our kidneys. Certain proteins, as well as beans and vegetables, contain such high levels of purines that these foods can cause gout.

In general, foods that cause gout are high in fat, which is why dietary recommendations for people with this kind of arthritis advise that less than 30% of their calories come from fat. Proteins with large concentrations of purines include meat and dairy products. Fish, like mackerel, sardines, oysters, mussels, and scallops, should be avoided, as well as red and white meat like poultry, pork, and beef.  Meats (especially organ meat, like kidney, heart, or liver), are especially bad for those suffering from gout. Even foods related to meat, like chicken or beef broth, caviar, and bouillon might produce high levels of uric acid.

Other foods that cause gout are dairy and vegetables, because they have lots of purines as well. High-fat dairy, like whole milk, ice cream, butter, and cheese, must be avoided in favor of low-fat dairy, or soy replacements. Spinach, mushrooms, cauliflower, peas, and asparagus have been shown to be rich in purines. In an unrelated food category, lentil beans and yeast increase one's chance of gout flaring up. For this reason, even beer and alcohol, because they are derived from yeast and grains, can increase the discomfort of gout.

Ingesting purines is not the only way to build up an unusually high concentration of uric acid, called hyperuricemia. Poor kidney function, since the kidneys filter out uric acid, works in conjunction with foods that cause gout. Thus, drinking plenty of water and eating tofu, olive oil, and nuts, actually seems to counteract weakened kidneys to eliminate uric acid from the bloodstream. A diet rich in complex carbohydrates, in the form of vegetables, fruits, and whole grains like bread and pasta, may ease the symptoms of gout. A doctor might combine these diet restrictions with anti-inflammatory medication and an overall weight loss plan.