A gout diet is aimed at cutting out or reducing foods that are high in purines, like meat, alcohol and seafood. These can cause a further build-up of uric acid, which can worsen symptoms.

This diet also incorporates food that contain diuretic properties, such as fruits and vegetables to help flush our accumulated uric acid. High uric acid levels and cause form crystals which deposit along the joints and cause tissue damage.

Gout, also called gouty arthritis, is a condition characterized by the body’s inability to properly metabolize purines. This results in an increase of uric acid levels in the blood and leads to the formation of crystals that can damage tissues in the joints, causing arthritis. These crystals usually accumulate in regions like the toes, ankles, and knees, and are associated with inflammation and pain. Learn more abut gout and how to identify it.

What to avoid

Food that should not be eaten during a gout crisis are:

Alcoholic drinks, especially beer;
Organ meats, especially heart, kidneys, and liver;
Processed seasonings;
Baking powder and brewer's yeast as a supplement;
Goose meat;
Excess red meat;
Seafood such as shellfish, muscles, and scallops;
Fish like anchovies, herring, mackerel, and sardines;
Processed products with fructose, such as sodas, juice mixes or powder drink mixes, mayonnaise, mustard, processed sauces, artificial honey, caramel, chocolate, cakes, desserts, fast food, some types of bread, sausage, and smoked ham.

If you are not having a gout crisis, these foods are not forbidden, but they should be limited. Therefore, please eat these in moderation, preferably according to a nutritionist guidelines.

Food that can be consumed in moderation, like chicken, red meat and eggs, may need to be eliminated from the diet temporarily, when uric acid levels are very high or if you are experiencing a gout crisis.

Although tomatoes are not recommended as they are associated with higher uric acid levels, there are no studies to confirm this relation. Tomatoes are a healthy food that is rich in vitamin C and antioxidants, which help to regular uric acid levels. Therefore, people who do not experience worsening of symptoms with tomatoes can continue to eat them.

What to eat

When maintaining a gout diet, you should opt for foods that are low in purines, and high in water, vitamins and fiber, such as:

Fresh vegetables, such as watercress, carrots, tomatoes, pumpkin, onions, cucumbers, broccoli, cauliflower, spinach, asparagus, tomatoes and lettuce;
Fresh fruits, such as apples, oranges, watermelon, lemon, passion fruit, strawberries, melon;
Low-fat dairy products, such as skim milk, low-fat yogurt and white cheeses, such as ricotta or cottage cheese;
Legumes, such as chickpeas, beans, lentils and soybeans;
Whole wheat grains, such as brown rice, corn, whole-grain pasta or whole-grain bread.

Furthermore, foods such as olive oil, flaxseeds, sesame seeds and pumpkin seeds have anti-inflammatory and antioxidant properties, helping to eliminate toxins from the body, reducing pain and inflammation in the joints.

Some foods, such as cauliflower, asparagus, beans and chickpeas, are high in purines, however, these foods do not increase uric acid. This happens because the types of purines present in greater quantities in vegetable foods, such as adenine and guanine, do not cause an increase in uric acid levels in the body.

Foods to eat in moderation

Foods like asparagus, beans, lentils, mushrooms, shrimp, spinach, poultry, and fish other than those mentioned bellow should be consumed in moderation. In relation to red meat, poultry, and fish, these can be consumed in a 60 to 90 gram portion daily.

Other foods to consume in moderation include:

Legumes like peas, peans, soybeans, corn, lentils, chickpeas
Cruciferous vegetables, like cauliflower and spinach
Whole grains like whole wheat bread and rice, oatmeal
White meat, like chicken and turkey, fish like sardines, tuna, and anchovies, eggs
Natural fruit juices, like freshly squeezed orange juice

Some people have reported that foods such as strawberries, oranges, tomatoes, and nuts can also trigger a gout flare-up, however, these foods are technically not rich in purine. Currently, there is no scientific evidence to confirm whether these foods do indeed cause a gout crisis. Therefore, it's also important that you monitor the type of food you consume and be weary of foods that trigger flare-ups.

One myth is that citric fruit can make blood more acidic and contribute to high uric acid levels. However, fruit acid is neutralized by stomach acid which is much stronger in comparison. Although they are absorbed into the blood, acid from citric fruits do not influence blood pH and do not worsen uric acid levels.

Gout meal plan

The following table brings an example of a 3-day menu to help decrease excess uric acid in the body:

Meal	Day 1	Day 2	Day 3
Breakfast	1 cup of strawberry smoothie + 2 slices of bread + 2 slices of white cheese	1 cup of natural orange juice + 2 oat and banana pancakes + 2 slices of white cheese	1 cup of pineapple juice + 2 scrambled eggs with cheese and oregano
Morning snack	10 grapes + 3 graham crackers	1 pear + 1 tablespoon of peanut butter	1 natural yogurt with 1 tablespoon flaxseed
Lunch/ Dinner	90 g of chicken + 1/2 cup of rice + lettuce, carrot, and cucumber salad seasoned with a tablespoon of olive oil	1 fish fillet + 2 medium potatoes + 1 cup of boiled vegetables + 1 tablespoon of olive oil	Pasta with 90 g of pan-fried turkey with vegetables
Afternoon snack	1 natural yogurt with a tablespoon of chia seeds	1 baked apple with a tablespoon of cinnamon	1 medium slice of watermelon

The quantities included in this meal plan can vary according to age, gender, physical activity, or if you have another health condition. You are advised to see a registered dietitian for a more thorough assessment so that a meal plan can be created based on your health status and preferences.

How to decrease uric acid

To help decrease uric acid, there are some tips you can incorporate into your daily routine, such as:

Drink 1.5 to 2 L of water per day
Increase your intake of fresh fruits and vegetables
Decrease your consumption of meat, chicken and fish
Opt for more diuretic foods, like watermelon, cucumber and parsley. Check out a list of naturally diuretic teas.
Avoid eating foods that are rich in purines, like livers, kidneys and gizzards
Avoid drinking alcohol
Reduce your intake of processed foods that are high in sugar, like sodas, cookies, ice cream or pre-made food
Increase your intake of vitamin C foods, like oranges, pineapple and cherries.
Lose weight or maintain an ideal weight, as obesity and being overweight are one of the causes of elevated uric acid levels
Exercise regularly, as this is essential for maintaining an ideal weight and keep uric acid levels normal

To treat gout, it is important to consult a registered dietitian and a personal trainer, to help incorporate diet and physical activity into your treatment.