Purines Should Be Cut Back if You Have Gout

Diet Can Help Prevent Gout Attacks

Reducing Purine to Treat Gout
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Purines are part of all human tissue and they are found in many foods. The ingestion of foods high in purines can raise uric acid levels in the blood and precipitate gout attacks in some people. That's why a diet that is low in purines is important for people with gout.

Considered one of the most painful of the rheumatic conditions, gout afflicts an estimated 840 out of 100,000 people, accounting for about 5% of all cases of arthritis.

Since it is typically recommended that people who have gout symptoms or recurring gout attacks reduce their intake of purine-rich foods, it's important to know which foods are rich in purines. Actually, purines are found in all protein foods. It is not recommended that all purines be eliminated from your diet. You should simply cut back enough to control gout attacks.

Gout attacks are characterized by sudden severe joint pain—often with redness, swelling, and tenderness of the joint. Although a gout attack typically involves a single joint, sometimes a few inflamed joints are affected at the same time. The pain and inflammation are most intense within the first few hours of an attack, and generally improve over days to weeks. Cutting back on purine-rich foods is just one way to try to manage gout and prevent the recurrence of gout attacks. Medications are also typically prescribed to help people manage gout.

Foods High in Purines

According to NIAMS (National Institute of Arthritis and Musculoskeletal and Skin Diseases), purine-containing foods include:

  • Beer, other alcoholic beverages
  • Anchovies, sardines, fish roes, herring, mackerel, scallops
  • Yeast
  • Organ meat (liver, brain, kidneys, sweetbreads)
  • Legumes (dried beans and peas)
  • Game meats
  • Meat extracts, consomme, gravies
  • Mushrooms, spinach, asparagus, cauliflower

Beneficial Foods for People With Gout

Here are some examples of foods that may be beneficial for people with gout.

  • Dark berries may contain chemicals that lower uric acid and reduce inflammation.
  • Tofu, which is made from soybeans, may be a better choice than meats.
  • Fatty acids found in certain fish (such as salmon), flax, olive oil, or nuts may possess some anti-inflammatory benefits.

While avoiding purine-rich foods is one aspect of gout management, it is also important to take prescribed medications as directed, maintain a healthy and balanced diet, drink plenty of fluids (especially water), exercise, and maintain your ideal body weight. Be aware that diets designed for quick or extreme weight loss can work against you. Quick weight loss diets increase uric acid levels in the blood.

A balanced diet for people with gout include foods that are high in complex carbohydrates (whole grains, fruits, vegetables), low in protein (soy, lean meats, poultry), and no more than 30 percent of calories from fat.

The Bottom Line

At this point, you may be wondering how significant the association is between recurrent gout attacks and purine-rich foods. According to study results published in 2012 in the Annals of the Rheumatic Diseases, "study findings suggest that acute purine intake increases the risk of recurrent gout attacks by almost five-fold among gout patients."

Sources:

Schumacher, H. Ralph, MD. Gout. American College of Rheumatology. April 2015.

Questions and Answers About Gout, NIAMS. April 2016.

Zhang Y. et al. Purine-rich foods intake and recurrent gout attacks. Annals of the Rheumatic Diseases. 2012 Sep; 71(9): 1448–1453.

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