Nuts for gout. How good are they?

This  page about nuts for gout was last reviewed or updated on 4  February 2015


Quite a lot of folk wonder if nuts cause gout.  But if you are among these, let me give you some reassurance - it's not likely.

To cause initial and subsequent gout attacks nuts have to be high purine. But they aren't. Or, if they are to raise uric acid another way, (via the insulin resistance route), it's hard to see that their quantity of sugars or carbohydrates could do this with the amount people usually eat.

One exception might be cashews which are medium purine, and I suppose a spurge or addiction to them might be a cause of hyperuricemia, (high uric acid). But this would also depend on what else you’d been eating, whether you behaved in a gout trigger way, drank water and so forth.

And in a cashew and walnut eating study of 64 participants (1) cashew nuts did not raise serum (blood) uric acid when compared to a control diet. Same was true for walnuts.


The purine content of nuts numbers I have managed to gather from various purines tables show that most nuts are low purine.

Amounts in mg/100 grams. And per 100 grams of uric acid

Numbers in brackets are a second purines’ tables’ figures.


Low purine 0 – 49 mg/100 grams

purines        31   (15) 
uric acid       37   (37)

Brazil nuts 
purines          9     
uric acid       22   (23)

purines         15 
uric acid        37


purines          10    
uric acid         25

Medium Purine 50 - 150mg /100 grams

Cashew nuts 
No numbers but listed on one table as medium purine

purines      49   (33)  
uric acid     57   (79)

Purines numbers not found for - macadamia, pecans, cashews, pine nuts, chestnuts. The hazelnuts’ figures probably also apply to filberts and Kent cobnuts, the hazelnut's other names.


Seeds however appear to be somewhat more likely to raise uric acid because some at least contain more purines. However none are high purine. The small, oval sunflower seeds are one example. One purines' table rates sunflower seeds as medium purine.

But would you eat enough to make a difference? I snack on sunflower seeds almost daily because they are healthy food, quite tasty and low carb, but the packet I buy has only 30 grams. So the purines amount (numbers below) in a single pack is 18 mg or 43-45 mg of uric acid.  In other words, they may be medium purine but you'd only eat a low purine amount. Other tables list poppy seeds as medium purine, and pumpkin and sesame seeds as low purine.

Numbers in brackets are from a second purines’ table listing the seeds.

Low purine:         0 - 49mg/per 100 grams.

Sesame seeds 
purines         26 
uric acid        62

Medium purine:  50 -149 mg/per 100 grams

Poppy seeds  
purines            71   
uric acid         170

Pumpkin seeds 
purines            36   
uric acid          85

Sunflower seeds (dry)
purines           60  
uric acid        143  (149)


In a study of the Mediterranean diet among a large population (4,449), a few years ago (2) eating three or more servings of nuts a week did not raise the risk of the participants developing high uric acid (hyperuricemia). Nor did they lower the risk.

Nuts were a special addition to one of three Med diets examined in a nut eating study population of 1,407 among the total study of 4,449 participants. Participants were men and women in their later years with a high risk of heart attack. Their uric acid was also measured.

Among those study participants who developed high uric acid after 5 years and ate nuts, (3 plus servings weekly), those who developed high uric acid were no more numerous than those in the other 2 groups. The other two groups were a control group eating a basic Med diet and another group eating a Med diet plus extra virgin olive oil.

In fact in this study quite a number of participants managed to reverse their high uric acid just by the diets over 5 years. Again all three groups also delivered similar numbers of participants who managed to reverse it. So nuts did not help any more than olive oil or the control Med diet. But these participants ate nuts and they managed to reduce their uric acid. However, success came from the diet, not because of the added nuts.


A leading gout scientific researcher Hyon K. Choi MD. Dr.Ph., recommends nuts for gout sufferers. Over the years he has been involved in umpteen scientific studies about gout and gout related issues, some of which have been the basis of many current beliefs about gout diets.


Nuts of course contain fats. Macadamias, almonds, peanuts (and peanut butter), were eaten on the diet of a widely quoted gout study - a diet  where it restricted carbohydrates and calories, but boosted monounsaturated and polyunsaturated fats. (The nuts were part of the boost of fats). Uric acid fell - it did not rise - and the fall contributed to the subsequent reduction of gout attacks. You can read our page about this study here.


Are nuts bad for gout? Except for the possibility that medium purine nuts and seeds just might trigger a gout attack, if you ate a lot and behaved in a gout trigger way, it’s really not likely. Neither will they have any positive or negative effect on gout pain.

If you use a low calorie diet, nuts may be a problem because they are high calorie. Their fats boosts their calories (fat is high calorie). So if you eat high calorie nuts you’ll have to find calorie savings from other things you eat. Same goes for low carb dieting.

Nuts are considered healthy foods for a number of reasons. Among these are  that they are good sources of vitamins, including some that are anti-oxidants, gout positive minerals (e.g. potassium), and fibre (fiber).

So with nuts, maybe you exercise some caution, but not much, unless you are allergic to them of course or a low calorie dieter, or a low carb dieter. Or interested in other special factors such as salt.

Get nuts' complete nutrition profile here, at the USDA National Nutrient Database Enter the name of the nut.


Which foods are high, medium and low purine? Visit our purines list, one of the biggest on the Internet.

How good are berries for gout?

Nuts for gout references

(1)          Effects of a high walnut and high cashew nut diet on selected markers of the metabolic syndrome: a controlled feeding trial. Mukuddem-Petersen J1, Stonehouse Oosthuizen W, Jerling JC, Hanekom SM, White Z.    British Journal of Nutrition 2007 Jun;97(6):1144-53. Epub 2007 Mar 7

(2)          Mediterranean Diet and Risk of Hyperuricemia in Elderly Participants at High Cardiovascular Risk Marta Guash-FerreMònica Bulló, Nancy Babio, Miguel A. Martínez-González, Ramon Estruch, María-Isabel Covas ,Julia Wärnberg, Fernando Arós, José Lapetra, Lluís Serra-Majem, Josep Basora and Jordi Salas-Salvadó Gerontol A Biol Sci Med Sci (2013) 68 (10): 1263-1270.doi: 10.1093/gerona/glt028

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