Recently, Best Food Facts received a question from a reader asking for advice on a good diet for gout. WebMD.com defines gout as a kind of arthritis. It can cause an attack of sudden burning pain, stiffness, and swelling in a joint, usually a big toe. These attacks can happen over and over unless gout is treated. Over time, they can harm your joints, tendons, and other tissues. Gout is most common in men.
To answer this question, we reached out to Dr. H. Ralph Schumacher, Jr., Professor of Medicine at the University of Pennsylvania.
Dr. H. Ralph Schumacher, Jr.
Dr. Schumacher: “We might start by asking exactly what is motivating this question. Does he get flares after certain foods or is he not tolerating the medications that virtually all patients need to control the gout? If he notices that certain foods seem to precipitate flares, he should try to avoid them whether they are on our list or not.
“Patients often find that alcohol, high purine foods (organ meats, herring, anchovies and mackerel), any overeating, or especially fatty meals precipitate attacks.
“A slightly separate question is, what foods may affect serum uric acid levels? Uric acid is a chemical normally found in your body, measured by a blood test called serum uric acid. It's harmless in balanced amounts, but elevated levels are associated with several conditions.
"Although there are always new studies coming out, a reasonable consensus is that red meats, seafood, shellfish, high fructose beverages, alcohol (especially beer and whiskey but less so wine), and weight gain in general can raise the serum uric acid levels. Vegetables, even if high in purines, have little effect. Low-fat milk and possibly coffee can even lower serum uric acid levels. These dietary factors generally only produce a small difference in uric acid levels, which may be all that is needed for people with mild gout that is addressed very quickly. However, most sufferers still need medications to keep that serum uric acid at the target rate that will eventually dissolve the crystals caused by excess, and prevent flares.
“Interestingly, there are a few reports that tart cherries or tart cherry juice may prevent attacks of gout, which might be worth a try, but will not help normalize the serum uric acid.
“Aside from avoiding things that you know cause flares, most people need not absolutely avoid anything but instead, exercise reasonable temperance and keep their weight normal, or if overweight, gradually lose weight. Many people with gout also have diabetes or heart disease so diet factors for those diseases also need attention.”