5 Foods Patients With Gout Should Avoid

SourcesBatt C, Phipps-Green AJ, Black MA et al. Sugar-sweetened beverage consumption: a risk factor for prevalent gout with SLC2A9 genotype-specific effects on serum urate and risk of gout. Ann Rheum Dis. 2014;73:2101-2106.Choi HK, Atkinson K, Karlson EW, Willett W, Curhan G. Alcohol intake and risk of incident gout in men: a prospective study. Lancet. 2004;363:1277-1281. Choi HK, Curhan G. Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study. Br Med J. 2008;336:309-312.Choi HK, Willett W, Curhan G. Fructose-rich beverages and risk of gout in women. JAMA. 2010;304:2270-2278.Flynn TJ, Cadzow M, Dalbeth N, et al. Positive association of tomato consumption with serum urate: support for tomato consumption as an anecdotal trigger of gout flares. BMC Musculoskel Disord. 2015;16:196.Hainer BL, Matheson E, Wilkes RT. Diagnosis, treatment, and prevention of gout. Am Fam Physician. 2014;90:831-836.Kedar E, Simkin PA. A perspective on diet and gout. Adv Chronic Kidney Dis. 2012;19:392-397.Vroomen Durning M. Should gout patients avoid tomatoes? Rheumatology Network. Published September 15, 2015. Accessed October 23, 2018.Wang M, Jiang X, Wu W, Zhang D. A meta-analysis of alcohol consumption and the risk of gout. Clin Rheumatol. 2013;32:1641-1648.

Hyperuricemia is in part driven by modifiable dietary habits. Reducing or eliminating the 5 foods discussed in this slide show may help control gout and minimize frequency of attacks.

Dietary triggers for gout come from 3 main sources.

RR, relative risk.

A 2013 meta-analysis of 17 studies involving 42,924 patients with gout found significantly higher risk of gout in people who had more than 3 drinks per day (RR = 2.64), compared with those who had less than 1 drink per day (RR = 1.16).

Evidence indicates that genetically (SLC2A9) mediated renal uric acid excretion is increased by intake of simple sugars from sugar-sweetened beverages.

Other studies showed that exposure to 2 or more sugar-sweetened beverages per day increased gout risk by 1.78 in men, and 3.05 in women.

Reduced consumption of purine-rich protein sources is recommended.

Pork has lower levels of purines than other types of meat but should still be eaten in moderation. Similarly, chicken has lower levels than turkey and duck, but moderate consumption is advisable.

Other types of fish and shellfish, such as salmon, crab, shrimp, oysters, and lobster, have lower levels of purine, and can be eaten in moderation.

A 2015 study of gout triggers created a stir when it reported an increase in serum urate levels with each weekly serving of tomatoes. It was conducted among the New Zealand Maori, Ngati Porou Maori, and New Zealand Pacific Island people, who have a high rate of gout.

[Editor’s note: For more details about the study by Flynn and colleagues, please refer to Should Gout Patients Avoid Tomatoes?]

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