This page, about dietary tips for gout prevention was last reviewed or updated on 24 November 2011.
DIETARY TIPS FOR PREVENTING GOUT
These are the dietary tips to follow to maintain normal uric acid levels, which is an important part of preventing gout long term. If you’ve had a gout attack, preventing gout attacks in the future means your application of these ideas needs to be more rigorous.
Avoid or reduce high purine foods. Swap them for medium or low purine foods. A 2001 Brazilian study looked at the effects of a low purine diet, a low purine diet plus Allopurinol, and Allopurinol treatment only, on uric acid levels. Patients in the study did NOT have gout, but they did have hyperuricemia,(high uric acid), hypertension and were overweight or obese.
All three treatments reduced uric acid levels, but after 36 weeks, the low purine diet reduced uric acid levels the most. The low purine diet in the study avoided high purine foods, and allowed medium purine foods in most patients. During the period of the study no patient developed gout.
Reduce alcohol intake to moderate levels, especially beer which is the highest purine beverage. What's moderate ? Probably just one or two glasses of wine daily.
If your body pH is acidic (i.e low pH) ask yourself whether you consume a lot of highly acidic foods and beverages (such as colas). If so consider cutting them down or out. Use pH test strips to find pH levels.
Drink lots of water, especially ionized (alkaline) water or water with alkalizing minerals i.e. hard water and mineral water. Follow the mantra of eight to twelve glasses a day. Less if its alkaline water. But not baking soda in water because there’s so much sodium, and in any case baking soda in water is only a possible natural gout remedy, if your doctor agrees, for treating existing gout.
Drink milk and orange juice Drinking milk has lowered uric acid levels in a number of studies, or shown that the risk of gout is lower if you drink a glass a day. Just one glass a day lowered uric acid levels by 0.25mg/dL, and more milk than this should decrease uric acid by more.
Drinking coffee has been shown in large population studies to lower the risk of getting gout. And to lower uric acid levels a bit Read more about coffee for gout here
Eat the foods (or drink the juices) reputed to help treat or even sometimes cure gout. These are cherries, celery, and strawberries. All contain substances which fight gout. Some people have reported immediate gout pain relief from cherries.
Berries may help in preventing gout – our top four rated berries for gout are elderberries, strawberries, blueberries and bilberries. And in any case these four berries are a five star food for a diet to prevent gout because they contain high levels of antioxidants, are low purine, and are not very acidic. Top berry? Probably strawberries.
At the very least take a multivitamin tablet daily. Select a high strength one, and make sure it also has alkalizing minerals such as calcium, magnesium and zinc, especially if you are over 40. Always buy quality vitamins.
Take Vitamin C. 500 mg of Vitamin C daily has been found in one study to act as a gout preventor. In another, at 500 mg it didn't really lower uric acid, and you may need more. Click on this link to go to our first page about vitamin C for gout.
Can you eat enough Vitamin C to prevent gout? See this page, which describes a study where the highest Vitamin C intake meant the lowest risk for gout.
Refined carbohydrates Reduce refined carbohydrates and simple sugars in your diet.
For gout prevention - monitor these vitamins and nutrients
Niacin is sometimes used to reduce cholesterol and triglyceride levels. The amount you take should be watched because it competes with uric acid for excretion from the body. 50 mg or less of niacin daily should not be a problem.
Molybdenum Although molybdenum is an important mineral for the body, there is more than a suspicion that high levels of molybdenum stimulate uric acid production. Dr.Robert Atkins (the Atkins diet) believed in the connection between molybdenum and uric acid. So much so, that if a patient had low uric acid levels, he prescribed molybdenum.
Molybdenum levels in multivitamin tablets should not be a concern, neither should molybdenum intake from foods. It may only be a concern if you take extra molybdenum for another reason. Exposure to molybdenum at a place of work may lead to increased uric acid levels and may trigger a gout attack.
Brewers Yeast is a dietary supplement taken because it is high in proteins and minerals. However Brewers Yeast is also high purine and should be avoided.
Selenium is a mineral which is a strong antioxidant, but some supplements of it are derived from brewers yeast. Some people take it to deter some kinds of cancers and to produce the very important antioxidant glutathione. If you take selenium, check the label to see from what it's derived. However, selenium supplements are measured in micrograms, not milligrams, so it should not be a problem.
Chlorella is very high in many nutrients, and protein, but also extremely high in purines Japanese research has found. Also spirulina, but not as high as chlorella.
DRUGS TO AVOID FOR GOUT PREVENTION
Loop and Thiazide Diuretics. These are used to treat high blood pressure. They raise uric acid levels. They also lower potassium and magnesium levels which is likely to be undesirable in gout patients. Avoid if possible.
Lasix and gout. Furosemide (one brand name: Lasix) is one of the loop diuretics
that may raise the uric acid level, and thus trigger a gout attack.
Cyclosporine. Used to prevent rejection of organ transplants.
Ethambutol. An anti tuberculosis (TB) medication, can trigger gout attacks.
Pyrazinamide. Another anti tuberculosis (TB) medication. It decreases uric acid excretion.
LIFESTYLE TIPS FOR GOUT PREVENTION
Wrap up warmly in cold weather.
Ensure blood pressure is at normal levels.
Avoid dehydration i.e. drink those eight to twelve glasses of water a day. Add an extra glass of water for every cup of regular coffee, because caffeine is a diuretic. On the other hand, a recent study found that drinking four or more cups of coffee daily helps reduce the risk of gout. That means drinking also an extra four glasses of water or two glasses of ionized (alkaline) water. And add an extra glass of water for a similar amount of alcohol you drink.
Avoid crash dieting.
Avoid going hungry for too long. During the day, a maximum of five hours between meals.
Exercise, but avoid heavy exercise.
Flying is dehydrating. Keep drinking water whilst flying. If you feel any thirst during a plane journey make sure you immediately ask the flight attendants for water. More on this on our flying with gout page.
If you've had a gout flare in a big toe, be careful not to stub it, or hurt it in any way. This could trigger another attack. Wearing good footwear can help avoid this. So what's the best footwear for gout? Read our shoes for gout page.
MEDICAL CONDITIONS LINKED TO GOUT
Kidney disease, because less uric acid is removed and uric acid levels are likely to rise. Diabetes and pre-diabetes (insulin resistance). High blood pressure. Heart disease.