If you’ve got gout pain your favorite foods and drinks can be your worst enemies. Fortunately, there are plenty of anti-gout foods that help prevent attacks of this inflammatory arthritis condition. Ready to trade beer and shellfish for coffee and nuts? Read on to learn what to eat more of and what to keep off your plate to avoid pain and discomfort…
After a satisfying feast the night before, you wake up with a really grouchy big toe – inflamed, throbbing and red. Your life with gout pain has begun. This form of inflammatory arthritis is largely hereditary and strikes mostly men over 30. But women are also at risk, especially after menopause.
Gout is caused by excess uric acid, a useless byproduct of dead cells. Once uric acid builds up in blood, it forms needle-like crystals that lodge around joints and even in soft tissue. The result? Excruciating pain. Uric acid is also formed from purines, compounds in certain foods, especially organ meats.
Dietary changes alone won’t banish gout pain attacks, but it’s still important to eat gout-fighting foods and avoid those that may sabotage your body.
Doing so not only lowers the risks and severity of gout attacks but can also help other conditions that accompany gout, including obesity, high blood pressure and diabetes, says Kelly O’Connor, R.D., diabetes educator at Mercy Medical Center in Baltimore.
But first you need to identify your problem foods.
“Most patients have their own set of foods that trigger attacks,” says Dr. Harris H. McIlwain, M.D., a rheumatologist in the Tampa Medical Group in Tampa, Fla., and co-author of Diet for a Pain-Free Life (Diversion Books).Knowing which foods are most likely to cause gout and which can help reduce your risk will help you choose wisely. Here are the ones you need to know about:
Food to Avoid: Alcohol, especially beer
“Alcohol is worse than most foods,” says rheumatologist Frank Arnett, Jr., M.D., a professor at the University of Texas Medical School in Houston. That’s because all alcohol lowers the blood’s pH level, or its acid-alkaline balance, which encourages uric acid to crystallize.
“More than two drinks a day are likely to precipitate a gout attack,” says Zorba Paster, M.D., clinical professor in the University of Wisconsin’s School of Medicine and Public Health in Madison.
Alcohol is also dehydrating, which limits excretion of uric acid and increases the risk of kidney stones, which are more common in those with gout, adds Lanah J. Brennan, R.D., certified diabetes educator with a private practice in Lafayette, La.
If you do drink, stick to wine. Beer is much more likely to cause gout attacks because its yeast is high in purines. (For that reason, don’t overdo yeasty breads either.)
Foods to Avoid: Organ meats
For some, foods like liver pâté and calves’ sweetbreads (the thymus gland, pancreas and kidneys) are delicacies. But they’re bad news for gout sufferers because they’re loaded with purines. While there’s little research on women, men who ate meats with the highest purine content had a 40% higher risk of gout than those who ate the least, according to a large 12-year study at Massachusetts General Hospital and Harvard University.
Foods to Avoid: Beef and pork
Although organ meats are worst, most meats are moderately high in purines, Dr. Arnett adds. Eat no more than 4 to 6 ounces of lean meat or fish per day, O’Connor recommends. “A standard serving of red meat is about 3 to 4 ounces, [about the size of] a deck of cards,” she says.
Food to Avoid: Shellfish
It’s best to take high-purine items like shrimp, lobster and scallops off your menu. Men who ate the most seafood were 50% more likely to develop gout than those who ate the least, the same Harvard study found.
Food to Avoid: Fatty fish
Other finned creatures should be limited as well. Anchovies, herring, redfish (ocean perch), sardines and tuna are among proteins that cause gout pain and should be limited to 4 to 6 ounces per day.
Food to Avoid: Sugary soda
Gout risk was 74% higher among women who drank one serving of sweetened soft drinks daily compared to those who drank less than a serving per month, a 2010 analysis of the 79,000-participant Nurses’ Health Study found. Diet soda didn’t cause gout risk to rise.
Fruit juice and high-fructose fruits, such as apples and pears, also raise the risk of gout pain. Fruit has many health benefits, but go for lower-fructose items such as berries and stone fruits like apricots and nectarines.
What You Should EatFood to Add: Tofu
“For those who are carnivores and miss meat, consider tofu instead,” suggests Nathan Wei, M.D., director of the Arthritis and Osteoarthritis Treatment Center of Maryland in Frederick, Md.
Or add other soy-protein meat substitutes (veggie burgers, soy dogs), soy nuts, soy protein shakes, soy milk or edamame (steamed soybeans) to your plate.
Food to Add: Water
Drink at least 12 cups of fluids per day, which helps flush out uric acid and reduces the risk of kidney stones, Dr. Brennan advises.Water’s your best bet since it’s calorie-free and almost always available, Dr. Brennan adds. For a touch of flavor, add lemon and lime slices to a pitcher you keep in the fridge.
Food to Add: Cherries
“Dark berries have a powerful anti-inflammatory effect and the best are cherries,” Dr. Wei says.Like blueberries and strawberries, they contain anthocyanins, anti-inflammatory plant pigments – and the darker the berry, the more you get.Wei recommends eating one-half to 1 cup of cherries or dark berries per day. You can also drink cherry juice or take cherry supplements in capsules.
Food to Add: Nuts
A small handful of almonds or walnuts is a good meat substitute for those at risk for gout pain, says O’Connor. Unlike meat, nuts don’t contain any purines but give you some protein.Although nuts are high in fat, it’s mostly the healthy, unsaturated kind. And both the fat and whole grains satisfy you longer, which keeps weight in check.
Foods to Add: Low-fat dairy foods
“Dairy products like skim or 1% milk, low-fat yogurt and low-fat cottage cheese may play a role in decreasing gout risk,” O’Connor says.A 2012 study, published in the British Medical Journal, found that low-fat dairy consumption significantly lowers uric acid levels. Researchers speculate that two dairy proteins – casein and lactalbumin – increase uric acid secretion.
Food to Add: Legumes
Lentils, peas and beans are high in purines, but — surprisingly — they don’t cause gout risk to rise, according to the large Harvard study.Beans are low in fat and high in protein and fiber, but don’t have saturated fat, which could be partly responsible for gout attacks.
Food to Add: Coffee
Drinking coffee may lower your gout risk, according to a 12-year Canadian and American study of 46,000 men.In fact, the more coffee the men in the trial drank, the more their uric acid levels fell; those who drank 4 to 5 cups a day had levels that were 40% lower.Although no one’s recommending you gulp coffee by the gallon, your morning habit could help prevent gout pain.
Food to Add: Vitamin C-rich vegetables and fruits
Most fruits and vegetables are low in purines, O’Connor says. What’s more, men who took in at least 1,500 milligrams (mg) of vitamin C per day had a 45% lower risk of gout than those who got less than 250 mg daily, according to the Canadian-American research.Foods high in vitamin C include oranges, grapefruit, broccoli and red peppers.Popping a supplement might be easier, but talk to your doctor about the dose. Too much vitamin C could increase uric acid levels or even trigger a gout attack by causing rapid shifts in uric acid, Dr. Wei cautions.
Food to Add: Pineapple
Pineapple has bromelain, an enzyme that reduces inflammation and pain, Dr. Wei says. Eating a half-cup per day can help when gout pain ratchets up.
Foods to Add: Foods high in omega-3 fatty acids
It may sound contradictory — because people who have gout or are at risk should avoid eating too much fatty fish like salmon and mackerel — but moderate amounts of fish (no more than 4 to 6 ounces per day) provide plenty of omega-3 fatty acids, which are powerful anti-inflammatories, Dr. Wei says.You can also get omega-3s from flaxseeds; sprinkle a tablespoon a day on cereal or in a stir-fry.