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Harvard Commentaries
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Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School


Food for Thought Food for Thought
 

Update on Gout


January 16, 2013


By Jill Pluhar, R.D.
Brigham and Women's Hospital

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What Is Gout?

Gout is the most common form of inflammatory arthritis in men. It is caused by too much uric acid in the blood, which may form hard crystals. These crystals can cause pain, stiffness and swelling in a joint, usually the big toe. Over time, gout attacks can become more painful, last longer, and occur more frequently.

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What Can I Do To Prevent a Gout Flare?

For years, people with gout have been told to avoid all foods containing high amounts of a particular amino acid called purine. It was thought that eating a lot of purine-rich foods would lead to an increase in uric acid, which would increase a person's risk of developing a gout flare. Research now shows that this is not 100% accurate.

Here are the most up-to-date nutrition and lifestyle recommendations to help prevent gout flares.

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Weight Loss

Losing weight, even just 7% to 10% of your body weight, can drastically improve your health. Obesity is a major risk factor for high blood pressure, high cholesterol and diabetes. These increase your risk for heart attack and stroke.

When it comes to gout, excess body fat is associated with higher uric acid levels and an increased future risk of gout. Losing weight can lower uric acid levels and reduce your risk of gout. Check your weight and health risks using waist circumference and body mass index (BMI).

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Physical Activity

Leading health officials recommend adults get at least 30 minutes of moderate-intensity exercise 5 days a week. (Read the full guidelines.) Here are some ways to become more physically active.

  • Get off the bus a few stops early and walk the rest of the way.
  • Try taking the stairs instead of the elevator.
  • Park your car at the far end of the parking lot when running errands.
  • Try walking or biking to work instead of driving.
  • Exercise while watching TV (ride a stationary bike or lift weights, for example).
  • Take a brisk 10 minutes walk in the morning, at lunch and after dinner.
  • Use your manual wheelchair.
  • Rake your leaves instead of using a leaf blower.
  • Try shoveling snow this winter instead of using a snow blower.

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Healthy Eating

To decrease your risk of gout, try the following:

  • Drink plenty of water. Fluids like water help flush uric acid from your blood, which helps reduce your risk of developing gout.
    • Carry a water bottle with you throughout the day to help encourage you to drink more fluid.

     

  • Eat or drink low-fat dairy products once or twice a day. Low-fat dairy has been shown to decrease gout attacks.
    • Use skim milk in your cereal.
    • Try a creamy nonfat yogurt for an afternoon snack.
    • Add low-fat cottage cheese to a fresh crisp salad.

     

  • Drink alcohol in moderation. Beer and liquor have been shown to increase the risk of gout.
    • Limit alcohol to two drinks per day for men and one drink per day for women.
    • Wine does not appear to increase a person's risk for developing gout; however, wine should still be drunk in moderation.

     

  • Avoid drinking sugar-sweetened soft drinks and juices. The fructose in these beverages can increase the risk of gout.
    • Eat a piece of fresh fruit rather than drinking fruit juice. You will get more fiber, vitamins and minerals, and less fructose.
    • Switch to naturally sugar-free beverages, such as water or coffee.
    • Try a drink with an alternative sweetener — Crystal Light, diet soda or flavored water.

     

  • Limit the amount of red meat you eat, especially beef, pork, lamb or organ meats (liverwurst, kidney, brain). These meats can increase your risk of developing gout.
    • Try chicken or turkey, instead.

     

  • Tip: a serving size of poultry should be 3 to 4 ounces, or roughly the size of your palm without your fingers.

  • Limit all types of seafood. Seafood seems to increase uric acid levels and increase the chances of a gout attack.
    • Some types of seafood contain a healthy type of fat know as omega-3 fatty acids. To make sure you are getting enough of these healthy fats from non-fish sources, you may consider taking an omega-3 supplement that is made from a plant.

     

  • Don't limit your intake of vegetables, nuts or legumes. These foods do not increase the risk of gout.
    • Keep walnuts, pecans, almonds and hazel nuts on hand for snacks.
    • Try adding chopped nuts to your salad.

    Tip: a serving of nuts is equal to ¼ cup.

Medications to help reduce uric acid levels can also reduce the incidence of gout.

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Jill Pluhar, R.D., is a clinical dietitian in the Nutrition Consultation Service at Brigham and Women's Hospital.

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