Gout and grapes: Choose the Right Foods to Avoid a Gout Attack

18.08.202311.06.2023 by alexxlab

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Gout Diet: Foods to Eat and Avoid

Certain foods may trigger gout attacks, and some people claim cherry juice might help.

By Lindsey KonkelMedically Reviewed by Samir Dalvi, MD

Reviewed: September 24, 2022

Medically Reviewed

Choosing whole grains, vegetables, and fruits — especially cherries — may help gout.Getty Images

Gout causes swelling and inflammation in the joints. It’s a painful form of arthritis caused by too much uric acid in the body.

A Look at How You Get Gout

Uric acid is a normal waste product in the blood that comes from the breakdown of certain foods. It’s processed in the kidneys before being eliminated from the body in urine.

Excess Body Weight and Gout

Being overweight is associated with higher-than-normal uric acid levels. Since this is a major risk factor for gout, losing weight is often the goal of a gout diet.

Dieting and Weight Loss to Prevent Gout

Losing weight may help lower your uric acid levels and reduce your risk of future gout attacks. A 2017 review of studies suggested that a weight loss of about eight pounds or more led to long-term reductions in uric acid levels and gout attacks in overweight or obese people. (1)

An Overview of Dietary Approaches to Manage and Prevent Gout

The main principles of a gout diet are usually the same as those of any healthy, balanced diet.

They include:

If you’re overweight, reduce the number of calories you consume.
Choose unrefined carbohydrates like fruits, vegetables, and whole grains.
Limit your intake of sugar-sweetened beverages and foods.
Limit your intake of red meats and organ meats (such as kidney, liver, or sweetbreads).
Cut back on saturated fats.

Dietary Causes of Gout and Gouty Arthritis

Some people with gout find it helpful to eliminate specific high-purine foods from their diet. (2) Certain high-purine foods may trigger gout attacks in some people.

Most people with gout will still need medication even if they follow a diet for gout.

Dietary changes alone can lower your uric acid levels by up to 15 percent, according to the Institute for Quality and Efficiency in Health Care, an independent scientific institute that evaluates the benefits and harms of medical interventions. (2)

It’s not necessary to avoid all high-purine foods if you have gout. Studies have shown that purine-rich vegetables don’t trigger gout. (3) And certain high-purine foods can be a good source of lean protein to incorporate into your diet.

Purine-rich vegetarian foods to include in your diet are:

Peas
Beans
Lentils
Spinach
Mushrooms
Oats
Cauliflower
Broccoli

Foods to Avoid to Control or Prevent Gout

The following foods may trigger gout attacks in some people:

Red meat
Organ meats
Certain types of seafood (anchovies, sardines, herring, mackerel, scallops)
Products containing high-fructose corn syrup

Drinks that can trigger gout include:

Alcoholic beverages, especially beer, whiskey, gin, vodka, or rum
Sugary drinks, including sodas, juices, energy drinks
Coffee and other caffeinated beverages. While some studies show that caffeine can actually protect against gout pain, others find that sudden spikes in caffeine intake can trigger a gout attack.

Dietary Supplements for Gout Management and Prevention

Talk to your doctor about any supplements or vitamins you take or may want to take. Supplements and other remedies may interfere with medication.

Vitamin C supplements (up to 500 mg daily) are sometimes recommended for people with gout. (4)

One study found that taking 500 mg of vitamin C per day had a mild uric-acid–lowering effect. (5) Yet it’s not clear whether vitamin C helps relieve gout symptoms.

A 2013 study showed that supplementing with 500 mg of vitamin C for eight weeks did not significantly lower uric acid levels in patients with gout. (6)

Cherry Juice for Gout Management?

Cherries and cherry juice are a popular folk remedy for gout, but the scientific evidence to support their supposed benefits is still coming in.

In 2005, the U.S. Food and Drug Administration (FDA) sent warning letters to several cherry product manufacturers for overselling the health benefits of their products in advertisements. (7)

Nonetheless, there’s reason to believe that cherries may help fight gout. They contain chemical compounds called anthocyanins, which have been shown to help reduce inflammation. (8)

Cherries may also have a beneficial effect on uric acid levels.

One large study of people with recurrent gout found that eating cherries was associated with a lower risk of gout attacks, especially when cherry consumption was combined with taking a common uric acid-lowering drug. (9)

Despite these findings, experts say that more research is needed before any definitive recommendations can be made about cherries or cherry juice for gout.

Gout Cookbooks and Gout-Friendly Eating Plans

Martin K. The Gout Diet and Cookbook: An Introduction to Low Purine Foods and Meals for People With Gout. 2016.
Preston C. Gout Diet: The Anti-inflammatory Gout Diet. 2015.
Shah M. Gout Cookbook: 85 Healthy Homemade and Low Purine Recipes for People With Gout (A Complete Gout Diet Guide and Cookbook). 2016.

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Editorial Sources and Fact-Checking

Nielsen S, Bartels E, Henriksen M, et al. Weight Loss for Overweight and Obese Individuals With Gout: A Systematic Review of Longitudinal Studies. Annals of the Rheumatic Diseases. October 9, 2017.
Gout. Institute for Quality and Efficiency in Health Care. May 17, 2018.
Gout Diet: Dos and Don’ts. Arthritis Foundation.
Neogi T. Lifestyle Modification and Other Strategies to Reduce the Risk of Gout Flares and Progression of Gout. UpToDate. August 31, 2022.
Huang HY, Appel L, Choi M, et al. The Effects of Vitamin C Supplementation on Serum Concentrations of Uric Acid: Results of a Randomized Controlled Trial. Arthritis & Rheumatism. June 2005.
Stamp L, O’Donnell J, Frampton C, et al. Clinically Insignificant Effect of Supplemental Vitamin C on Serum Urate in Patients With Gout: A Pilot Randomized Controlled Trial. Arthritis & Rheumatism. May 30, 2013.
Cherry Companies Warned by FDA Against Making Health Claims. The Produce News. November 1, 2005.
Do Cherries Prevent Gout? Arthritis-health.com. February 19, 2020.
Terkeltaub R. Are Cherries Now Ripe for Use as a Complementary Therapeutic in Gout? Appraisal of the State of Evidence. BMJ Evidence-Based Medicine. December 2013.

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Uric acid crystals can form kidney stones, a complication that occurs in about 15 percent of people with gout.W.D. Auer/Alamy

Gout is a painful form of arthritis that occurs when too much uric acid builds up in the body. Uric acid is a normal waste product in the blood that comes from the breakdown of certain foods. Having too much uric acid in the body is called hyperuricemia. (1)

For some people, gout can be chronic, which means multiple, severe gout attacks several times a year.

Some people who have repeated gout flares or overly high levels of uric acid for several years develop a form of gout called tophaceous gout.

Chronic gout, sometimes called gouty arthritis, can lead to a number of serious complications if left untreated. (2)

Complications of gout and hyperuricemia can include:

Joint damage
Joint deformity
Loss of mobility or range of motion
Bone loss
Tophi deposits throughout the body
Kidney stones
Chronic kidney disease

What Is Tophaceous Gout? What Are Tophi Deposits?

People with tophaceous gout can get tophi, which are hard uric acid deposits that form beneath the skin. Tophi look like chalky lumps under the skin.

They can be found on or near the elbow, finger, or toe joints. Tophi can also appear on the outer part of the ear.

Tophi can destroy bone and cartilage, leading to joint damage and deformity. (3)

They can swell during a gout attack and pop through the skin and become infected.

With treatment, tophi can dissolve and eventually disappear.

Not everyone with gout develops tophi.

Certain groups share a higher risk for tophaceous gout, including: (4)

Organ transplant recipients who receive certain types of medication to prevent transplant rejection
People who can’t take uric-acid-lowering medicines (because of kidney failure or drug allergy)
Postmenopausal women, especially those taking a diuretic. (Diuretics, used to treat high blood pressure, can raise uric acid levels.)

Treatment for Tophaceous Gout and Tophi

Treatment for tophaceous gout typically involves long-term therapy with one or more uric-acid-lowering medications. (5)

Achieving and maintaining a uric acid level of 6 milligrams per deciliter (mg/dl) or below can help reduce the risk of future gout flares. (6) These medications will also cause tophi to dissolve and disappear.

Uric-acid-lowering medications take time to work. It may take several months of treatment before uric acid levels start to go down.

Some uric-acid-lowering medications for gout include:

probenecid (Benemid)
losartan (Cozaar)
allopurinol (Zyloprim)
febuxostat (Uloric)
pegloticase (Krystexxa)

Drinking plenty of water, exercising, maintaining a healthy weight, and avoiding foods and beverages that trigger gout attacks (alcoholic and sugar-sweetened drinks, red meats, organ meats, certain kinds of seafood) can also help lower uric acid levels.

Treating Gout and Tophi With Surgery

Uric-acid-lowering drugs can reduce the size of tophi over time. Some people may opt to have tophi surgically removed for cosmetic reasons. (7)

Your doctor may recommend surgical removal for tophi if they are causing mechanical problems with your joints.

Surgery for gout can help to reduce joint problems caused by tophi, including difficulty walking or nerve damage from tophi pressing against a nerve.

Tophi can erode through the skin, causing chronic ulcers that can become infected. These may require surgical removal.

Tophi removal is a relatively simple procedure. Your doctor will make a small incision on the skin over the tophi, remove the mass, and then suture the wound.

People with severe joint damage or bone loss around the joint may need additional joint replacement surgery.

The Link Between Gout and Kidney Stones

Excess uric acid can build up in the blood and form crystals. This may happen if the body is making too much uric acid or if the kidneys are having a hard time filtering it out.

These spiky, urate crystals may also cause a stone to form in the kidney or other parts of the urinary tract.

Kidney stones can get stuck in the urinary tract and cause severe pain in the side of the abdomen or back. They pass out of the body in urine.

Kidney stones caused by uric acid crystals occur in about 15 percent of people living with gout. (4)

Uric acid gets excreted by the kidneys. Some medications aim at lowering uric acid levels by increasing the amount of uric acid excreted by the kidneys. These medications may increase the risk of kidney stones in some people. (4)

Talk with your doctor if you are using a uric-acid-lowering drug and are developing kidney stones. Your doctor may opt to put you on a different medication.

The Link Between Gout and Chronic Kidney Disease

There’s a relationship between gout and chronic kidney disease.

Chronic kidney disease is a condition in which you slowly lose kidney function over time. The kidneys are important because they help remove waste products (such as uric acid) and urine from the body. (8)

People with chronic kidney disease are at an increased risk for gout, and people with gout are at an increased risk for chronic kidney disease. (9)

If the kidneys aren’t working properly, uric acid can build up in the body. That’s why kidney disease sometimes leads to high uric acid in the blood. High uric acid can cause gout.

One way that gout may contribute to chronic kidney disease is through kidney stones. People with recurrent kidney stones are at an increased risk for chronic kidney disease.

The National Kidney Foundation recommends that people with gout get checked for chronic kidney disease. (9) Your doctor may take blood and urine samples to test for it.

Doctors can use different methods to determine if kidney damage is present. For example, a GFR test assesses your glomerular filtration rate, measuring how well your kidneys filter fluid each minute. And an ACR test measures your albumin-creatinine ratio — substances in the urine that help determine if kidney damage is present. (9)

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