This page about spinach for gout was first reviewed or updated on 22 October 2016
Popeye was right! And this is not spin. Spinach isn’t just a superfood. It’s a super superfood, in the top segment of the superfoods table and up there with kale and ahead of broccoli. But like the parsley which is used as a garnish, restaurants have a habit of dumbing spinach down too by using it as a bed on which to serve entrées. Both parsley and spinach deserve better than this – they are very nutritious. (But parsley is high in purines).
Since your gout diet should be as healthy as you can make it, spinach should be a regular in yours. Maybe you wouldn’t need a daily multi, or at least not every day.
What makes spinach more appealing for a gout diet is that, despite being full of nutrients (see below), it is also low calorie (only 23 kcals per 100 grams) and it has only a smidgeon of carbohydrate (just 1.4 grams of net carbs per 100 grams). So this vegetable is ideal for low calorie and low carb diets. It is also very alkaline, handy for those trying to improve their pH as part of their gout treatment.
Do spinach’s flavonoids make spinach for gout a good idea ? In addition to its vitamins minerals and other nutrients (see below) spinach also contains three flavonoids – kaempferol. myricetin and quercetin - which studies in test tubes, and in mice and rats. have found lower uric acid. But not a lot - the amount of these three in spinach is not particularly high.
There is 6.38 mg/100g of kaempferol; 0.35 mg/100 grams of myricetin and 3.97 mg/100 grams of quercetin. The best source of quercetin are red onions, which contains 39.2 mg/100 grams, and kale has 22.58 mg/100 grams.
But in 2016 a better study – this one of humans taking quercetin to lower uric acid, and the first such study among humans I think – found that quercetin lowered uric acid
PURINES IN SPINACH
But is spinach bad for gout?
Spinach was one of the vegetables tested for its effect on blood uric acid in Purine rich foods, dairy and protein intake and the risk of gout in men, reported in the March 2004 issue of The New England Journal of Medicine. It found there was no increased risk of gout from eating purine rich vegetables (1)
How many purines in spinach ? According to one purines table it makes 57mg of uric acid /100 grams of spinach. Another table has the purines in spinach at 21 mg/100 grams = uric acid 50 mg/100 grams.
These amounts put spinach at the lowest end of the moderate purines group of foods. According to a Japanese purines table, it produces 61mg/100 grams of uric acid and contains none of the purine, (there are four), most likely to metabolise into uric acid – hypoxanthine. It also has zero xanthine and of the other two, guanine and adenine, guanine has been reported to not affect uric acid levels at all. So its uric acid only comes from adenine.
CoQ10 IN SPINACH
This page is about spinach for gout but I have to add that spinach is the richest vegetable source of a vital nutrient, coenzyme Q10 or CoQ10. Only one other vegetable, broccoli, has it. Few foods are a source of CoQ10. Spinach contains 1-3 mg per cup of CoQ10 (one cup of spinach is about 30-40 grams 1.4 ounces). That is attractive in itself, but spinach is a cheap source of CoQ10, which is very desirable but expensive. The more bioavailable CoQ10, the reduced form Ubiquinol, costs even more.
Coenzyme Q10 is primarily found in seafood and meat. And especially in high purine offal (organ meat) which gout sufferers should not eat.
CoQ10 declines as we grow older and become more prone to gout. That isn’t a cause of gout, but boosting your CoQ10 is de rigeur.
Acquiring a new taste for spinach If you didn’t like spinach before, why not have another go ? That could have been many years ago, and maybe your tastes have changed. Eating spinach would give a real boost to your health. Its purines are not likely to have an effect on your uric acid. Milligram for milligram green veggie purines have less of an effect on your uric acid, than the purines in fish, meat and beer. Or you could purchase dietary supplement spinach leaf extract or even organic spinach powder.
In the U.S., washed and cellophane packed is the most popular spinach purchase. So too is baby (young leaves) spinach. But young leaf spinach has many more purines than regular spinach – over three times more. Gout sufferers be careful !
Most population studies link eating
spinach with the lowest levels of cancer, heart disease, and in the eyes,
cataracts and macular degeneration. Gout patients are more prone to heart
disease, because of their gout.
Other benefits of spinach In addition to its CoQ10, spinach is also a food source of alpha lipoic acid, glutathione, and it is a rich source of lutein and zeaxanthin, thought to prevent cataracts and macular degeneration in eyes
SPINACH raw - compared to kale and broccoli. Nutrient amounts per 100 grams
Spinach is slightly behind kale here, but its CoQ10 (absent in kale) must make it equal
Spinach Kale Broccoli
28 mg 120
mg 89 mg
Calcium 99 mg 150 mg 47 mg
Potassium 558 mg 491 mg 316 mg
Magnesium 79 mg 47 mg 21 mg
Zinc 0.53 mg 0.56 mg 0.410 mg
Phosphorous 49 mg 92 mg 66 mg
Iron 2.71 mg 1.47 mg 0.730 mg
Thiamin 0.078 mg 0.110 mg 0.070 mg
Riboflavin 0.159 mg 0.130 mg 0.117 mg
Niacin 0.724 mg 1.0 mg 0.639 mg
Vitamin B6 0.195 mg 0.271 mg 0.175mg
Folate (folic acid) 144 mcg 141 mcg 63 mcg
Vitamin A 469 mcg 500 mcg 31 mcg
Vitamin E 2.03 mg 1.5 mg (2.235 IU) 0.78 mg
Vitamin K 482.9 mcg 704.8 mcg 101.6 mcg
SPINACH FOR GOUT SUMMARY
Spinach is not likely to cause gout, not only because it doesn’t have so many purines, but because of the type of them. Of the four purines, only one of the four in spinach has the purines which create uric acid. Another doesn’t create it, and two are zero in spinach. But neither are its flavonoids’ quantities big enough to lower uric acid, nor is its vitamin C amount, which could help lower it, exceptionally large.
But for general health you should eat it if you can. If purines are a concern eat it in moderation, say once opr twice a week.
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(1) Purine rich foods, dairy and protein intake and the risk of gout in men, Hyon K. Choi, M.D., Dr.P.H., Karen Atkinson, M.D., M.P.H., Elizabeth W. Karlson, M.D., Walter Willett, M.D., Dr.P.H., and Gary Curhan, M.D., Sc.D. New England Journal of Medicine 2004; 350:1093-1103