How much does diet impact gout?

Cohort studies have shown that a typical Western diet (based on a high intake of red and processed meat, refined cereals and sugar-rich foods) is associated with a 42% higher risk of developing gout, while following a Mediterranean-type diet is associated with a lower risk (RR 0.68, 95% confidence) interval (CI). Too much uric acid in the body causes gout. The body produces most of the uric acid naturally, about two-thirds of it. The rest comes from the diet, often in the form of purines.

Purines are substances found in animal and plant foods that the body converts to uric acid. If you can't expel uric acid through your kidneys, it can build up in the bloodstream and be deposited as needle-shaped crystals in the joints. These crystals cause the intense inflammation and severe pain of a gout attack. It's a good idea to drink plenty of fluids, 8 to 16 cups a day.

At least half of what you drink should be water. Vitamin C (think orange juice) may also help lower uric acid, but studies also show that the high fructose content in OJ can increase uric acid levels, so drink it in moderation. Caffeinated coffee can also lower uric acid, as long as you don't overdo it. If you have gout, certain foods can trigger an attack by raising uric acid levels.

Lifestyle measures, such as dietary changes, can help lower levels of uric acid, the chemical substance that is deposited in joints and causes gout. However, for most people, dietary changes alone aren't enough to prevent gout. To lower uric acid levels enough to stop attacks, medications are usually needed. Even so, making changes in what you eat can cause fewer outbreaks of gout.

If you're at risk of developing gout or experiencing another gout attack, it's worth trying a low-purine diet. Others, such as Dr. Hyon Choi, an internationally recognized expert in gout, and a rheumatologist at the University of British Columbia and Vancouver General Hospital and an epidemiologist at Brigham and Women's Hospital in Boston, think that some people can help themselves with diet alone, especially if they have a single mild attack. People with gout can help themselves by adding citrus fruits and other vitamin C-rich foods (such as strawberries and peppers) to their diet.

In addition to diet, there are several lifestyle changes that can help you reduce the risk of gout and gout attacks.