A common form of inflammatory arthritis, gout affects more than 8 million Americans — or about 4% of the U.S. population. More common in men than women, it’s caused by a combination of genetic and environmental factors. And while everything from a joint injury to major surgery can trigger gout, what you drink and eat may also raise your risk of developing the condition.
Gout is caused by a condition called hyperuricemia, characterized by too much uric acid in the body, which is made in the breakdown of purines, a colorless chemical compound found in the body and in foods. When there’s too much uric acid in the body, uric acid crystals, or monosodium urate, can build up in joints, fluids and tissues, the Centers for Disease Control and Prevention notes. Excess uric acid in the body can cause gout attacks or flares, which can last days or weeks.
“The classic case of gout is often in the big toe, known as podagra, and it’s a very painful episode (where it) often hurts even just to have the bedsheet on the toe; this is how inflamed the area becomes,” says Dr. Ken Saag, a rheumatologist and a professor of medicine at the University of Alabama at Birmingham. But gout can become more widespread over time and flares can affect other joints, “particularly in the lower extremities and the feet and ankles, occasionally in the knees.” But really, any joint in the body can ultimately be affected by gout, he says.
When uric acid levels in the body are chronically high it can lead to the development of hard deposits beneath the skin called tophi and kidney stones. What’s more, if flares occur often, the condition can worsen, becoming what’s known as gouty arthritis.
But it’s possible to manage gout so that flares are reduced and, in some cases, you don’t experience symptoms for long periods or even indefinitely. “This tends to be a chronic disease, albeit manageable,” says Dr. Roberto Caricchio, chief of rheumatology at the Lewis Katz School of Medicine at Temple University in Philadelphia and director of the Temple Lupus Clinic at Temple University Hospital.
That’s done primarily with medication. However, making changes to what you eat and drink may help lower uric acid levels and reduce flares as well.
What’s more, gout tends to occur along with other issues ranging from obesity — which is associated with a higher risk of gout — to diabetes and kidney disease, making eating well all the more important.
Along those lines, if you have gout, clinicians often recommend avoiding, or at least consuming in moderation, certain foods and drinks that are high in purines. Those include:
— Sodas and other high-fructose corn syrup-infused products.
— Red meat.
— Organ meats like liver.
Beer, for example, is high in purines; and “alcohol makes it hard for your kidneys to get rid of uric acid, so that’s a double whammy for gout,” explains Dr. Rebecca Tuetken, a rheumatologist and clinical professor of internal medicine at the University of Iowa Hospitals & Clinics in Iowa City.
While there’s some indication that beer and distilled liquors may be worth watching due to high purine content — and wine tends be lower in purines by comparison — research that evaluated consumption of wine, beer and liquor suggests it’s a good idea to limit alcohol consumption of any kind to reduce risk for recurrent gout attacks. At the very least, clinicians generally recommend drinking in moderation — say no more than a drink or two in a given day, and abstaining altogether when experiencing a flare.
Take a Pass on Soda
While you’re surveying what you drink, consider abstaining from the fizz too, or at the very least switching to a diet soda or sugar– and calorie-free seltzer water. “High-fructose corn syrup-containing soft drinks such as soda, sports drinks and fruit juices, along with certain foods are not good for people with high uric acid levels, Tuetken says.
While there’s much debate about whether artificial sweeteners in diet soda are actually better than sugar, at least in this case if you can’t kick a soda habit, it’s preferable to drink diet soda over the real thing that’s loaded with high-fructose corn syrup.
Given how common HFCS is in drink and food products, it can be hard to avoid. But experts recommend doing your best to have less of it, whether that’s in soda, ice cream or candy.
Eat Modest Amounts of Meat
You can still have a steak now and again. But maybe when you do, have a 6-ounce steak rather than a 12-ounce one, “and only doing it every once in a while, not three times a week,” Tuetken suggests.
Don’t go whole hog with overly large portions of pork either. And consider avoiding or really limiting organ meat, such as liver, kidney and sweetbread, due to its very high purine content. Other lean proteins from poultry to nuts are also suggested as an alternative to red meat.
Shellfish as well as some other seafood like sardines and scallops are also high in purines, and moderation of those foods can help too. But the overall health benefits of seafood, experts say, reinforce keeping it in the diet.
If you’ve been diagnosed with gout, just as you should talk with your doctor about medications that may be appropriate, it’s also good to discuss any possible dietary changes.
What You Should Eat and Drink
Besides limiting some foods and drinks, it’s also helpful, of course, to think about what you actually should eat and drink.
Notably, clinicians emphasize that medical management of gout — mostly with medication — is central to reducing flares. And 2018 research published in the journal BMJ suggests genetics plays an outsized role in flares, compared with diet, though some gout experts dispute the findings.
Still while more study is needed to understand if or how components of a healthy diet might affect risk for gout attacks, clinicians say there are some things that may be worth including on your plate or in your cup.
The point isn’t to drink so much water that you’re constantly dashing to the bathroom. But you definitely want to stay hydrated. “Getting dehydrated is one thing that can spike your uric acid levels,” Tuetken says. Drinking water can aid your body in processing purines in the foods you eat, too. “It helps with the kidney clearance of uric acid,” she says.
Eating and drinking lots of simple sugars can be taxing for the body and ultimately contribute to not only a rise in blood sugar but an increase in uric acid levels. However, complex carbohydrates with a low glycemic index — like those found in veggies and most fruits as well as beans and nuts — are different. They’re slowly digested, and “you don’t get the big spikes of uric acid,” Tuetken points out.
Low-Fat or Non-Fat Dairy
While you’re filling up on the good stuff, you might consider grabbing a glass of skim milk or low- or no-fat yogurt as well. “Consumption of skim milk is actually associated with having relatively low uric acid levels,” Tuetken says. Low-fat dairy is also a good source of protein. “You get the protein without the uric acid, and that’s a benefit,” she says.
Some research indicates that eating cherries or drinking tart cherry juice may lower uric acid levels, and perhaps even decrease the chances of a flare. The findings of a study published in the journal Arthritis & Rheumatology suggest that the risk of gout attacks tended to decrease further as subjects ate more cherries — up to three servings of a half cup, or about 10 to 12 cherries, each — over the prior two days.
However, there’s no definitive data to know how much cherries or tart cherry juice may be beneficial towards prevention of gout flares. It’s also important to keep in mind that tart cherry juice may contain added sugars like high fructose corn syrup, which may actually predispose one to a gout flare. Be sure to read all nutrition labels for the list of ingredients.
In the meantime, experts say while there’s no magic bullet in the pantry that’s proven to stop flares, a well-rounded diet is always a safe bet to provide an overall health edge.
Clinicians emphasize that it’s critical to work closely with a health provider who’s well-versed in treating gout to properly manage the condition, which left alone can lead to complications ranging from joint damage and deformity to kidney disease and failure. “Gout is a very treatable form of arthritis,” Saag says. “It’s not just a nuisance, but it can lead to serious problems if it’s not managed or if it’s ignored.”
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Food and Drink to Avoid — or at Least Limit — With Gout originally appeared on usnews.com
Update 11/09/21: This story was previously published at an earlier date and has been updated with new information.