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3rd December, 20205 min read

Foods to avoid with gout

Medical reviewer:Healthily's medical team
Author:Georgina Newman
Last reviewed: 12/11/2020
Medically reviewed

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Gout is a type of arthritis caused by having too much uric acid in your blood. Uric acid is formed when your liver breaks down a protein called purine, found naturally in many foods and drinks. When purines are broken down, what’s left is uric acid.

If you consume a lot of food and drinks with a high purine content, your uric acid levels will rise and your kidneys may not be able to get rid of it all in your pee.

And if your uric acid levels remain high for some time, this may cause crystals of uric acid to form in the soft tissue (cartilage) around your bones and in your joints. It’s these crystals that cause the pain and swelling associated with an attack of gout, as they build up around the joints and under the skin.

If you have gout, you may need to make changes to your diet to reduce the risk of a flare-up. This typically involves limiting food and drinks that are high in purines. However, it’s still important to follow a balanced diet.

You may also need to lose weight if you have a body mass index (BMI) above 25, as being overweight increases the amount of uric acid produced in your body. Losing weight will also reduce stress on your joints.

List of foods to avoid with gout

It’s not always safe to cut certain foods from your diet and you should speak to a doctor before doing so. However, if you have gout, limiting high-purine foods is generally recommended. These include:

  • oily fish, such as mackerel, herring or sardines
  • shellfish, such as scallops, mussels, crab or prawns
  • other seafood, such as trout, haddock, fish roe or caviar
  • game meats like venison or rabbit
  • offal (organ meats), such as kidney, heart or liver
  • foods containing yeast extract, such as pretzels or Marmite, or meat extracts, such as stock cubes or gravy granules
  • refined sugar foods — this includes biscuits and cookies, or cereal bars. Eating these foods can increase your risk of weight gain

Some vegetables, like asparagus and spinach, have a relatively high purine content. However, studies suggest a diet containing these vegetables doesn’t increase the chance of a flare-up of gout.

You don’t need to limit foods that are low or moderately low in purines.

Drinks to avoid with gout

Certain drinks also contain a high concentration of purines. You may not need to avoid these altogether, rather limit how much you drink. These include:

  • all alcoholic drinks — especially beer, which contains both alcohol and yeast. Wine and spirits contain purines, but drinking these doesn’t appear to increase your risk of gout as much as beer
  • sweetened drinks — try to avoid drinks containing glucose-fructose syrup or corn syrup, such as soda and energy drinks, as these can raise your risk of a flare-up of gout. You should also avoid fruit juices from concentrate and other soft drinks as these tend to contain added sugars and sweeteners

Alcohol is processed by the liver where it’s turned into lactic acid. The presence of lactic acid can make it harder for the kidneys to get rid of uric acid, causing it to build up in your blood and make it more likely you’ll have an attack of gout.

What else should you do to avoid gout?

As well as limiting foods high in purines, you should:

  • follow recommended alcohol guidelines that suggest drinking no more than 14 units per week, spread across the week, with at least 2 days a week where you don’t drink alcohol. However, if you have gout or you’re at higher risk, try to restrict how much alcohol you drink — be guided by a doctor
  • avoid binge drinking as this has been known to trigger attacks of gout in some people
  • stay hydrated as this will help your kidneys to function effectively and water down uric acid in the blood to help remove it from your body. Aim for 6 to 8 glasses of water a day, though other fluids do count, including tea or milk
  • get regular exercise to help you maintain a healthy body weight or lose weight if you need to. Try to do low-impact sports like swimming or cycling, as these place less pressure on your joints
  • avoid dieting or fasting as this can make it harder for your kidneys to get rid of uric acid

By doing this you should be able to reduce your risk of further attacks of gout, but you may still require medication to help control the condition.

Key points

  • gout is caused by having too much uric acid in your blood. Uric acid is formed when your liver breaks down purines, a type of protein found in many foods and drinks. The waste substance is uric acid
  • a diet high in purines can increase your risk of developing gout or a flare-up of gout
  • if you have gout, you should limit your intake of high-purine foods, follow a balanced diet and lose weight if you need to
  • food and drinks high in purines include offal, game meats, shellfish, refined sugar foods, alcohol (especially beer), and sweetened drinks and juices
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