Gout Diet (Low Purine): Foods to Avoid and Include in High Uric Acid

Gout is a form of arthritis that occurs when the body is high in uric acid. Gout is painful as the uric acid in the blood will form and accumulate in the form of crystals around a joint 

Our body produces uric acid when it breaks down a substance called purine. It is also found naturally in the human body and are also derived in foods like organ meat and red meat that can trigger gout.  

Usually, the uric acid dissolves in our blood, passes through kidneys, and exits to the body via urine.  

When the body produces too much uric acid due to purine breakdown, and the kidneys cannot excrete uric acid, the remaining acid in the blood will form sharp needle-like crystals that will surround a joint or a tissue that can cause pain and inflammation.  

To understand more about gout, we need to learn about uric acid.  

Uric acid

Uric acid is a waste formed when the breakdown of purines and the breakdown of normal blood cells is observed in your body. Purines are synthesised in the liver. They then enter the bloodstream and get separated from the blood by the kidney’s filters. This uric acid is excreted from the body through urine.

Are you suffering from excess production of uric acid in your body? Don’t know what to eat to prevent gout and kidney stones? Here are a few diet tips for you to follow.  

Causes of uric acid  

Increased uric acid production is caused when your kidneys have low efficiency in eliminating the uric acid from the blood. Increased uric acid production is observed when you are experiencing the following conditions.

• Diabetes
• Diuretics intake
• Drinking alcohol
• Obesity

In rare cases, inherited disorders of purine synthesis and catabolism (breakdown of purine), Allopurinol therapy (Xanthine Oxidase Inhibitor), or liver disease, causes hypouricemia (decrease in uric acid production).   

How does an increase in uric acid results in gout?   

An increase in uric acid in the blood results in certain health concerns like gout and kidney stones. Uric acid crystals accumulated in the joints, particularly in the toes and fingers, are called gout. This condition is observed when there is an excess production of uric acid (hyperuricaemia) in your body.  

This excess uric acid production increases the risk of cardiovascular disease.

Diet goals  

•  Healthy weight  

Keeping up a healthy weight is crucial to reducing uric acid in your body. An NCBI research paper states that most patients affected by hyperuricaemia are overweight. So, reducing weight plays a significant role in bringing down uric acid levels.   

• Eating fibre rich food like whole grains, oatmeals, and nutritious foods like vegetables, fruits, etc., will make you feel full with low quantity.  
• Hydrate yourself to prevent dehydration caused by excess sweat during workouts.
• Protein intake is a very much-needed for cell growth.  
• Restrict purine intake  

Sweetbreads and organ meats like liver and kidney are high in purine levels, so they should be avoided. Drinking alcohol and sugary beverages will also increase the risk of gout.  

•  Inclusion of low purine foods

People with gout must include food that is low in purine. Intake of low-purine food will reduce the uric acid imbalance in the body.  

Reasons for the high uric acid  

Further reasons listed below can also lead to increased uric acid in the blood. So, confirm that you are being safe from such conditions.

Improper diet  

Eating red meat, pork, lamb, organ meats, purine-rich seafood, high fructose products and alcohol will lead to high uric acid production. This improper diet also leads to the risk of obesity and other ailments.

Genetics   

The NCBI research article “The genetics of hyperuricaemia and gout” says that there is a modulation in serum uric acid levels and a high probability of the risk of gout caused by the urate transporter genes SLC2A9, ABCG2 and SLC22A12.  

So, there is a huge chance of the person being genetically prone to gout. Seek a doctor’s appointment as soon as you recognise gout symptoms or hyperuricaemia.

Obesity   

As per the NCBI report, most obesity cases are accompanied by hyperuricaemia. This report says that plasma uric acid was elevated in obese people than in people with normal weight.

This plasma uric acid elevation is caused when the adipose tissue secretes uric acid through xanthine oxidoreductase (an enzyme required to break purine nucleotides to produce uric acid). So, maintaining weight will reduce the risk of excess uric acid production.

Kidney disease  

The blood is purified or waste or excess fluids is separated through glomeruli in the kidneys. One of the NCBI research papers affirms that when there is a kidney disease, there is a decrease in the glomerular filtration rate. It raises the serum uric acid levels in the body. This condition is observed in most patients suffering from chronic kidney diseases (CKD).    

Diabetes   

According to a medical journal report, it is proved that there is a relationship between uric acid production and Diabetes mellitus. When high uric acid is produced in your body, it builds up the insulin resistance. And so, the person with high uric acid may be prone to the risk of Diabetes.     

Hypothyroidism   

Hypothyroidism decreases the glomerular filtration rate (GFR), and hyperthyroidism increases the GFR. It results in an increase and decreases in serum uric acid levels, respectively. This condition is caused due to the efficiency or deficiency of thyroid hormone.  

Cancers or chemotherapy   

Certain cancers are treated with chemotherapy. This treatment causes an increased rate of cell death. Excess uric acid is formed during this process, resulting in increased risk of gout and hyperuricaemia.

Psoriasis   

The sudden systematic inflammation and rapid cell turnover in the skin result in uric acid production as a byproduct. This, in turn, forms needle-like crystals in joints and causes sudden pain and swelling. This condition is called psoriatic arthritis.

A research paper by NCBI says that psoriatic arthritis is associated with several metabolic abnormalities like insulin resistance, hypertension and Diabetes.  

7 Foods to be avoided  

Here are the seven food items that significantly increase uric acid production in the body.

1. High-fructose foods  
2. Organ meats
3. Fish   
4. Other seafoods
5. Added sugars  
6. Yeasts
7. Alcohol

High-fructose foods  

• Apples
• Grapes
• Watermelon
• Asparagus
• Peas
• Zucchini are high fructose food items which may increase uric acid production in a person with hyperuricaemia. Avoid foods containing high-fructose corn syrup, honey, palm or coconut sugar.

Organ meats

Organ meats like liver, kidney, brain, sweetbreads and heart will increase the risk of uric acid in the body as they contain high purine contents.  

Fish   

Fish, in general, contains low, moderate and high levels of purines. Consuming certain types of fish may cause the risk of excess uric acid production and trigger pain in the person affected by gout.

Avoid eating fish like trout, anchovies, haddock, tuna, ocean perch, mackerel, sardines, etc., as they contain high purine content in them.  

Other seafoods

Not only fish contains high purine levels, but also other seafoods like crab, scallops, shrimps and roe contain high purine contents that can increase hyperuricaemia risk.   

Added sugars  

The breakdown of fructose releases an organic compound called purine. The further breakdown of purine nucleotides leads to the production of uric acid.  

So excess consumption of sugary foods will lead to an increase in uric acid production. Less consuming or avoiding sugary foods is advisable to reduce the risk of gout or hyperuricaemia.

Yeasts

Nutritional yeast, Brewer’s yeast and premade yeast alternatives can increase uric acid levels and give rise to gout symptoms.

Alcohol  

High purine contents are observed in some alcohol varieties. Alcohol either increases purine secretion or has high purine contents in it. Consuming alcohol will cause dehydration and leads to an increase in uric acid production.  

Alcohol also increases nucleotide metabolism resulting in uric acid production. So, avoiding alcohol will help you to control uric acid production.

Foods to be included

Fruits   

• Bananas
• Blueberries
• Strawberries
• Avocados
• Lettuce, etc., are low in fructose which will help to maintain uric acid production in the body.

Vegetables

Carrots, green beans, peas, chickpeas, broccoli, pumpkin, etc., can be consumed even though they have high purine levels. The research article of NCBI says that people who followed the vegetarian diet saw a reduction in the risk of gout, hyperuricaemia and serum uric acid. Compared to the western diet, the vegan or vegetarian diet decreased the risk of uric acid crystallisation by 93%.  

A few vegetables that are low and very low in purine are listed here.

• Red bean
• Board bean
• Cooked lentil
• Oats  
• Flaxseeds
• Spinach
• Green peas

Legumes   

According to NCBI’s research article, Legumes are free from saturated fat, dietary cholesterol, and have low glycemic index. Legumes also have minerals like iron and zinc, and nutrients like B vitamin and fibre.

The purine levels in legumes like beans, chickpeas and peas are moderate, whereas the purine levels in soy protein are higher than in any other legumes. The purines in these legumes get reduced when cooked.  

Nuts and seeds  

According to the NCBI research paper,

• Peanuts
• Walnuts
• Almonds
• Hazelnuts
• Pumpkin seeds, etc., are nuts and seeds that help to reduce the risk and symptoms of gout and hyperuricaemia.

Whole grains  

Whole grains, including bran, wheat germ, oatmeal, etc., can be consumed during most meals. They play an important role in reducing gout. Following a healthy dietary pattern that reduces insulin resistance may be preferable for patients suffering from gout and hyperuricaemia.   

Low-fat dairy products  

As per an article of Research Gate, consuming low-fat dairy products has a moderate impact on lowering uric acid levels in the body. Certain dairy products, especially G600 milk fat extract and glycomacropeptide, have anti-inflammatory properties that aid in reducing gout.

Eggs    

As eggs are rich in protein and moderate in purines, people suffering from gout can consume them without any hesitation. Maximum of four eggs are permissible to consume per week.  

Vegan oils  

Using vegan oils like cold-pressed olive oil in your diet will help reduce the pain in your joints. Anti-inflammatory and antioxidant compounds are found in olive oil, which treats gout pain.

Herbs and spices  

Many phytochemicals and other micronutrients in herbs and spices inhibit uric acid synthesis by restraining the enzyme xanthine oxidoreductase. One such herb is ginger. It reduces the pain and swelling caused due to the accumulation of uric acid crystals.  

Vitamin C supplement  

The NCBI research paper titled “Vitamin C intake and gout in men” states that the uricosuric effect (excretion of uric acid) in vitamin C decreases serum uric acid levels within two months.

Boston University School of Medicine’s associate professor stated that vitamin C lowers the serum urate or serum uric acid through the kidney filters (glomeruli) and protects against gout.

Green tea  

According to the U.S. National Library of Medicine, the antioxidant catechins in green tea inhibit the xanthine oxidoreductase and lowers uric acid production in the body.

When to see a doctor?  

When you feel the symptoms of gout and the uneasiness in your body, get a doctor’s appointment to diagnose and get treatment for it in the initial stage.  

Conclusion    

Hyperuricaemia is a condition that must be controlled and treated as it may lead to the formation of gout in your body. Eating foods that are low in purine level is recommended to prevent such risks. Following the tips mentioned earlier will help you maintain your weight and naturally control uric acid production.

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