Diet for gout: Simple tips for a symptom-free life

Everything was fine in the evening – but in the middle of the night, you suddenly wake up with a start: Your big toe or another joint is terribly painful, red, and perhaps even swollen. "Oh dear, a gout attack ," you might sigh.

How often flare-ups occur also depends on your diet . Here, you'll learn which diet is good for you if you have gout and why you don't have to worry about completely abstaining. We'll also provide you with a printable food chart: for a symptom-free life .

Gout is a metabolic disease associated with elevated uric acid levels in the blood ("hyperuricemia"). If left untreated, uric acid crystals ("urates") accumulate in the joints and trigger painful inflammation . Tendons and internal organs—especially the kidneys—can also be affected.

Because gout is associated with a lavish lifestyle , it has long been considered a disease of royalty and wealth. Indeed, diet plays a crucial role – some foods increase uric acid levels , while others have no effect or even reduce them.

Nevertheless, the actual cause lies elsewhere. Due to genetics or illness, the body either produces too much uric acid – or it excretes too little in the urine. A rich diet alone therefore does not trigger gout. However, with a predisposition to gout, the attack is often preceded by a large meal .

Some sufferers stumble from one attack to the next, while others experience long periods of pain-free relief. What you eat determines how frequently your attacks occur. The following five principles can help prevent outbreaks and prevent long-term damage.

Purines are found in every cell as a building block of genetic material. They participate in the formation of enzymes and energy metabolism —they are vital substances found in almost all foods. Purines are also produced by our bodies.

The problem: During cell renewal or digestion, the body breaks down these purines—a process that produces uric acid . Therefore, a diet rich in purines can increase your uric acid levels by 1-2 mg/dl.

If the value exceeds 6 mg/dl (in women) or 7 mg/dl (in men), hyperuricemia is present. Meat and fish, in particular, contain high levels of purine—so much so that each additional portion of meat increases your risk of gout by 21%. (1)

The breakdown of fat produces metabolic products that negatively impact the excretion of uric acid . (4) Therefore, try not to consume more than 30% of your daily energy needs from fat—that's about 600 calories, or five tablespoons of oil, for example. Otherwise, this can encourage a relapse of gout.

Alcohol increases uric acid production and simultaneously inhibits its excretion. It also increases appetite for fatty foods.

The combination of alcohol and rich, hearty foods is especially likely to trigger the next attack. Therefore, try to reduce your consumption as much as possible – this is especially true for beer , as brewer's yeast is one of the foods richest in purines.

Fructose stimulates the body's purine production and inhibits the excretion of uric acid . (2) However, this applies primarily to beverages sweetened with fructose, such as corn syrup—fresh fruit can still be consumed. According to recent findings, fruit juice may also be safe . (3) Therefore, you can rest assured that you only consume small amounts of fruit juice concentrates .

The risk of gout increases with a body mass index of over 25. (5) If you lose excess weight, the likelihood of a recurrence decreases. This is because as the weight melts away, uric acid levels also decrease. Furthermore, kidney function may improve. (6)

But beware: Crash diets and fasting regimes put your metabolism into ketosis. If your body is deprived of carbohydrates for an extended period, it must obtain energy from fats and proteins. This can simultaneously decrease urine output . (7)

This means that radical starvation provokes exactly what you're trying to prevent: the next attack. Therefore, lose weight slowly – a maximum of 2-3 kilos per month is optimal.

If you don't feel like counting purines, the DASH diet is an excellent option for people with gout. It's based on the Mediterranean diet and was originally developed to treat high blood pressure . However, studies show that it also lowers uric acid levels . (12)

The DASH diet prioritizes natural and plant-based foods . The menu focuses on:

• Whole grain products: 7 to 8 portions spread throughout the day, for example whole grain bread, pasta or rice.
• Vegetables: At least 3 servings daily. Feel free to try varieties like spinach, asparagus, salsify, or mushrooms, which are normally considered high in purines. According to recent studies, plant-based purines do not appear to have any effect on uric acid levels. (13)
• Fruit: At least two servings daily. Here, too, there are no restrictions on the variety. It should be fresh only – enjoy candied dried fruit or sugared preserves only as a sweet treat.
• Nuts, seeds and legumes: 4 to 5 servings per week.
• Lean meat and fish: 1 to 2 portions per week, for example salmon or chicken breast.

You should largely avoid processed, red, and fatty meats, fast food, sweets, convenience foods, and salty snacks. Furthermore, food preparation plays an important role: Add flavor to meals with herbs, if possible, and use salt sparingly.

Even if it seems complicated at first, it's worth it to prevent further gout attacks with the right diet – otherwise, you risk long-term damage. This article has shown you that some foods are more advisable than others: