Seafood and gout. Why eating fatty fish delivers less risk of a gout attack

This page about seafood and gout attacks – eating it lowers the risk of them - was last reviewed or updated on 14 January 2016.

On our fish oils for gout pages, which begin here, we state the case that fish and fish oil are anti-inflammatory and can help you deal with gout. So does the often repeated exhortation to eat fish for gout stack up with any scientific research on seafood and gout? It seems so. Research published in 2015 (1) showed that there is less risk of a gout attack if gout sufferers eat fatty fish. And the study was among gout sufferers.

However eating fatty fish does not mean you would never get a gout attack. That would be too much to hope.

But the study did conclude that, after adjusting for other gout flare triggers, the risk of an attack, if fish was eaten 48 hours before an attack, by those who had suffered them, fell 22-23%.

Which seafood were beneficial?

Fish eaten in the study were - anchovies, mackerel, salmon, sardines, cod, trout, herring, tuna, squid. All except squid are on our lists of the best fish for gout. Squid isn’t there because of contradictory numbers for its purines’ amount.

Not included in the study, but also on our best fish for gout tables were -  real caviar, herring roe and oysters. Our best seafood for gout were - real caviar, herring and mackerel.

Many of our best fish for gout are high purine. The ranking is based on the least amount of created uric acid per the amount of omega -3 in 100 grams of fish. Another of our tables, possibly more relevant, compares uric acid created to EPA in fish (EPA is one of the omega 3’s. The other is DHA. EPA is the most anti-inflammatory one).

More science about seafood and gout

In one of the few really detailed studies of the effect of a diet on uric acid, and gout flares in gout sufferers  (3),  gout attacks fell about 70% and serum (blood) uric acid fell by a useful amount. Uric acid  normalised in 7 of the 12  patients with a  raised level at the start of the trial. Fish was eaten at least four times a week and this fish may have been among the reasons why uric acid fell and normalised, as did gout flares.


The study that learnt gout flare risk fell 22-23% found another reason for eating more omega – 3 to reduce the risk of gout flares. On our fish oils for gout page  we discuss the importance of boosting the omega 3 you eat whilst reducing your omega -6 intake. This study also came to this  conclusion. There was a higher risk of gout attacks when more omega -6 to omega -3 was eaten But less risk when more omega -3 was eaten.

Could it be that eating more omega -3 reduces the possibility that purines in fish trigger gout or raise uric acid, or both? That high purine fish are not as risky as is thought ? Maybe. But still be careful of eating too much high purine seafood.


Science is tracking down why fish and fish oil are anti-inflammatory in gout and other inflammatory diseases. Many of the fish that reduced the risk of gout are high purine. But something else in the fish seemed to be more important. As mentioned above this could have been the omega -3.

It is scientifically believed that gout attacks’ inflammation is driven by the NLRP3 inflammasome, which activates the Interleukin-1b (IL-1b) inflammatory cytokine when gout’s MSU crystals form. The consequent inflammation of the attacked joint, and its surroundings, is caused when IL-1b secretes. Amazingly, Omega 3 fatty acids (mainly EPA and DHA and especially EPA in fish and their oils) limit IL -1b. This amelioration is most used anti-inflammatory route, but studies have found others too, even by DHA as well as EPA.


Fish oil did not affect gout attacks in this study. But there were insufficient respondents supplementing with fish oil to reach any definite conclusion. We think fish oil is beneficient against gout attacks. It is very important to take high quality fish oil, just as high 

quality (black) tea, but not ordinary tea, may be positive against hyperuricemia (high uric acid) too. After all, fish oil contains the positive omega fatty acids.


Fish was eaten at least four times a week on this diet that had much success with gout sufferers

Our pages about fish oils for gout begin here

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Seafood and gout references

(1)         Abstract. Zhang M, Zhang Y, Terkeltaub R, Chen C, Neogi T. Do Omega-3 Fatty Acids Reduce Risk of Recurrent Gout Attacks? Arthritis Rheumatology. 2015; 67 (suppl 10).

(2)         United States Dept. of Agriculture’s  National Nutrient Database.

(3)         P H Dessein, E A Shipton, A E Stanwix, B I Joffe, J Ramokgadi  Beneficial effects of weight loss associated with moderate calorie/carbohydrate restriction and increased proportional intake of protein and unsaturated fat on serum urate and lipoprotein levels in gout: a pilot studyAnn Rheum Dis 2000;59:539–543

(4)         Abstract  Yiqing Yan, Wei Jiang, Thibaud Spinetti, Aubry Tardivel, Rosa Castillo, Carole Bourquin, Greta Guarda, Zhigang Tian, Jurg Tschopp, Rongbin Zhou. Omega-3 fatty acids prevent inflammation and metabolic disorder through inhibition of NLRP3 inflammasome activation. Immunity  2013 Jun 27;38(6):1154-63. doi: 10.1016/j.immuni.2013.05.015.

Alternative Health Research/Flamasil™


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