This gout sufferers diet, tested in a South African study, had significant success against gout

This page about a gout sufferers diet, based on The Zone Diet, was last reviewed or updated on 9 January 2016. 

Here's a very encouraging diet to prevent gout study. A successful gout diet that achieved good results in a scientific study. Does it have to be a low purine gout diet? Not necessarily. Is it the Atkins diet ? Not in the example I am going to now describe.

Insulin Resistance and gout  There is another theory of gout not connected with the idea that excessive uric acid is caused by abnormalities of purine metabolism, or excessive purine intake over a number of years.

This theory explains that excess uric acid is associated with, and caused by, insulin resistance, a pre type 2 diabetes condition. It also means that gout and diabetes are associated. In other words, if you're heading for diabetes, you could be heading for gout too. 

Insulin resistance is the condition where the cells become more resistant to allowing insulin to deliver glucose (broken down from carbohydrate in foods) to them for the purpose of energy creation. The result is too much insulin. So glucose stays in the blood. It is not fuel for energy, as it should be.

Studies have demonstrated that insulin inhibits the amount of uric acid that can be excreted by the kidneys.

A study conducted in South Africa in 1999 attempted to find out if diets that are reported to be useful for insulin resistance – for example carbohydrate reduced, or carbohydrate switched diets –  would bring about lowered blood levels of uric acid, cholesterol and triglycerides in patients with gout. 

And find out whether following three Zone Diet (from Enter the Zone by Barry Sears PhD) rules below, would be a gout sufferers diet. 


1.  Calories were limited to 1,600 a day – 40% from carbohydrates, 30% from protein and 30% from mono and poly unsaturated fats. This meant 640 calories from carbohydrate, 480 from protein and 480 from fat. It translates to a daily 160 carbohydrate grams, 120 protein grams and 53 fat grams. 160 grams of carbohydrate a day is not the Atkins diet, or another low carb diet, but it is less than most people eat.

2.  Refined carbohydrate foods were swapped for complex carbohydrate foods. i.e. participants ate complex carbohydrates instead of refined carbohydrates. Complex carbohydrates are usually lower on the Glycemic Index (GI) scale than refined carbohydrates. Complex carbohydrates have a slower (perceived as better) effect on blood glucose and so the response of insulin to it. That means their Glycemic Load (GL) is also beneficially low. But make sure you lookup the numbers

3.  Saturated fats – the fats found in meat, dairy products, beef tallow (beef dripping) and lard were swapped for monounsaturated fats (e.g. olive oil, canola oil), and polyunsaturated fats, which come from oils such as corn, sunflower and soybean oils. 

However, participants ate polyunsaturated fats from fish – fish was eaten at least four times a week during the study, even fish that are high purine. They also ate the amount of meat they usually did. There was no meat restriction, but no doubt it was lean meat since saturated fats were excluded. 


The study's 13 white male participants were overweight or obese, at an age when people often get gout (38-62) and they could remember at least two gout attacks in the four months before the study began. So they were ideal for a gout sufferers diet. Twelve of the thirteen patients had elevated uric acid levels. Patients were not taking uric acid lowering drug medications. They were moderate alcohol drinkers and there were no alcohol rules for them to follow. 

There were no measured attempts to reduce purine intake although it's possible this happened. We do not know whether they consumed the amount of water normally recommended, nor attempted to change their body pH. They were not asked to eat other gout positive foods described elsewhere on this website.


Lost weight The results were expressed as a mean (a statistical term meaning an average). Weight loss over four months was almost 17lbs (7.7kg) i.e. at a rate of about 1lb a week, the amount Dr.Sears says he expects on the Zone Diet. All but one of the patients lost weight. Triglycerides and most measurements of cholesterol fell. 

Falling uric acid  Trialists uric acid fell 1.7 mg/dL, from 9.7 mg/dL down to 7.9 mg/dL. This is a good reduction, as reductions go with diets and natural remedies. And it normalised in 7 of 12 trialists who had elevated uric acid at the outset. And a more elevated blood uric acid level at the start of the study, meant a large fall of blood uric acid at the end.

Gout attacks fell  This diet had significant success as a gout sufferers diet. Monthly gout attacks fell from 2.1 to 0.6 (about 70%). Weight loss, and the fall in the number of gout attacks occurred, in all except one patient – the exception participant had shorter and less severe attacks. 

Eight of the 13 did not have a gout attack during the four month study period, although as mentioned, they had all had at least two in the previous four months.


About a year later (range 3–14 months, median 12 months) five of nine patients had no more gout attacks and three had just one attack – a further decrease in attack frequency overall. More than a suggestion that it is a gout prevention diet too. 

One patient gained weight after the end of the study. He must have given up on the diet. He suffered three gout attacks over three months. His blood uric acid levels rose with his weight.


All this speaks volumes about improving your odds of defeating gout by using this gout sufferers diet. Two snags were that the study was a small one, and single sex.

Moreover, it was not clear in the study, whether losing weight alone, or the proportions of protein, fats and carbohydrate used, caused the fall in uric acid levels and the beneficial effects on gout attacks. 

Fish was eaten at least four times a week. Since this study, a 2015 one has learnt that eating fish reduces the risk of a gout attack.

Neither was it clear whether the use of mono and polyunsaturated fats and the switch to complex carbohydrates, contributed to the beneficial effects on uric acid levels.                  

                                                                                                           There were no restrictions on the amount of 
                                                                                                         meat trialists could eat, but uric acid levels fell

However, the researchers quoted from other studies which suggest, to put it simply, that if insulin works better, (which they expected from this anti gout diet), more uric acid will be removed in the urine. As noted above, studies have shown that insulin inhibits uric acid excretion.

If you try this diet for gout sufferers, lose weight, and it ends your gout attacks, you really won't care precisely what the reasons were!

Reading on.....Learn more about this gout sufferers diet ! If you wish to read this study (six pages) you can download it here, free, courtesy of the British Medical Journal

The study is called: 

"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 study."

You may need to register with It requires only your name, email address, country, a user category and an indication of your health interests. To download it, you need Adobe Reader on your computer. Or you can read the hmtl version.

It was recommended fish be eaten at least
four times weekly but uric acid levels fell

In addition to the Zone Diet,  you can take fish oils and gamma linolenic acid (GLA) to improve your chances of success. Click on this link to begin reading more


Eating fish reduces the risk of a gout attack

Click here to read about a mineral which may help to burn fat and reduce insulin resistance, and our tip for the best form of it to achieve results.

Go to the first of our two pages about the Mediterranean diet for gout - it lowered uric acid in studies.

What do our readers think of this gout sufferers diet? This is our testimonials page for it.

Tips for what to do when you reach your ideal weight, and how to avoid putting it on again.

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Read more about, or purchase, the Zone Diet (Aka Enter the Zone) and related books by Barry Sears PhD by clicking on the advertisement, below left. This takes you to the home page of There is a 'Learn More' tab for his books on the home page.

Remember, the study we have described above used rules explained in the Dr. Sears' book Enter The Zone.  His companion book, Mastering The Zone, gives more tips on how to understand and use the Zone diet successfully. Use one, or both, to get a good understanding of what The Zone Diet is all about.

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