Gout

Gout is a painful form of inflammatory arthritis that is closely linked to a diet rich in red meat, seafood, alcohol, and sugary drinks. Lifestyle interventions can address some of the root causes of gout and reduce reliance on medications. Discover the foods and lifestyle changes scientifically proven to help below. 

Cases per year

Gout affects approximately 9.2 million people in the US 1

General frequency

Affects about 3.9% of the US adult population 1

Risk

Gout can be excruciatingly painful and may cause kidney stones. 

Manage gout with a plant-based diet and lifestyle medicine

Patients suffering with gout can benefit from increasing their consumption of plant foods and lowering their intake of red meat and seafood. Along with other lifestyle changes, this can help to reduce uric acid levels and may reduce painful flares.

Dr Yashoda Bhaskar

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Here are some top scientific studies that support the results our clinicians have seen first-hand:

A plant-based diet significantly reduces the risk of gout.

Vegetarian diet and risk of gout in two separate prospective cohort studies

This study involved 13,935 people followed for an average of over eight years. The researchers investigated the effect of a plant-focused (vegetarian) diet on the incidence of gout and found that people eating a vegetarian diet were just a third as likely to suffer from gout compared with non-vegetarians 2

Eating meat and seafood is linked to developing gout.

Purine-rich foods, dairy and protein intake, and the risk of gout in men

Researchers followed 47,150 men over a period of 12 years and compared animal protein consumption between men who developed gout with those who remained healthy. They found that those eating the highest amount of meat were 41% more likely to develop gout than those eating the least amount, and those eating the most seafood were 51% more likely to develop gout than those eating the least amount of seafood 3

A healthy diet could prevent gout flares 

Effects of the Dietary Approaches to Stop Hypertension (DASH) Diet and Sodium Intake on Serum Uric Acid 

A plant-rich diet, known as the DASH diet, that focuses on increasing consumption of plant-foods and reducing the consumption of saturated fat, total fat, and cholesterol was tested against uric acid levels, a known trigger of gout, in 103 adults. The healthy diet significantly lowered uric acid by an average of 0.35 mg/dL. In individuals with uric acid levels greater than 7 mg/dL, which is common among patients with gout, the healthy diet lowered uric acid by more than mg/dL 4

General information about gout and management with a plant-based diet

What is gout?

Gout is a common form of inflammatory arthritis caused by the buildup of uric acid crystals in the body 1.  

Gout can affect anyone, and a number of joints, but usually affects one joint at a time. Gout is most common in the foot and this typically affects the big toe joint. It causes swelling of the affected area and can be very painful. 

Gout affecting the big toe joint and a zoomed in display of uric acid crystals building up in the joint
Gout commonly affects the big toe

What is the main cause of gout? 

The human body makes uric acid when it breaks down a chemical called purines in certain foods and drinks (such as red meat, seafood, alcohol, and sugary drinks) 1. Normally, the uric acid is filtered out by the kidneys and leaves the body when we wee. 

If the body produces too much uric acid or it doesn’t get removed by the kidneys, the levels of uric acid in the body builds up, known as hyperuricemia. In this case uric acid can form sharp crystals in the joints, which causes gout. 

Not everyone that has high levels of uric acid will get gout . 

What increases my risk of gout? 

Whilst gout can affect anyone, there are several risk factors that increase your chances of having gout. People are more likely to have gout if they have: 

  • Overweight or obese 
  • Heart failure 
  • Diabetes 
  • High blood pressure 
  • Kidney disease 
  • Members of the family have gout 

Gout is also more common in men and older people. 

You are at an increased risk of gout if you eat a diet high in animal proteins, consume high levels of alcohol, and are on diuretics. 

Almost all of these risk factors can be reduced or even reversed by following a plant-based diet, getting enough exercise, and taking care of yourself with enough sleep and stress management. 

Symptoms 

The symptoms of gout go into flares and remission. Flares are periods where symptoms get worse and tend to last several days 1. In periods of remission someone may have no symptoms at all.  

The symptoms in the affected joint include: 

  • Pain
  • Swelling 
  • Redness
  • Stiffness 
  • Warmth
  • Tenderness

Diagnosis 

If you are experiencing joint pain, you should talk to your healthcare provider and get a proper diagnosis. You may be referred to a rheumatologist as they specialize in this area. If your healthcare provider suspects it may be gout, there are a range of diagnostic tests they may use. 

They may ask about your symptoms and conduct a physical exam of the joints to look for redness and swelling. They may then conduct tests including: 

  • Blood work: to measure the amount of uric acid in your blood 
  • Imaging tests: X-rays, MRIs, or ultrasounds so your healthcare provider can look more closely at the affected joints 
  • Aspiration: Your healthcare provider may pull fluid from the joint to detect uric acid crystals that would confirm gout, or look for other conditions that may be causing the symptoms. 

Treatment and prevention 

Treatment options for gout typically aim to decrease inflammation and lower the uric acid levels in the blood 1. Lifestyle medicine for gout can be extremely effective.

Lifestyle interventions, such as dietary changes, can help lower levels of uric acid in the body and lead to fewer gouty flares. The 2020 American College of Rheumatology Guidelines for the Management of Gout recommend lifestyle changes as a treatment option for gout, which include 1

  • Avoiding alcohol and sugary drinks 
  • Avoid eating seafood and red meat
  • Get regular exercise 
  • Staying well hydrated 

Interestingly, a study has found that unlike meat and seafood, high purine vegetables were not associated with an increased risk of gout 3

A plant-based may be the best gout treatment diet, and gout prevention diet. Eating a diet high in legumes, whole grains, fruit, and vegetables and low in red meat and saturated fats can significantly reduce serum uric acid and may reduce flares in patients with gout 5. Plant foods such as fruits, vegetables and legumes are encouraged alongside limiting animal products for patients with gout. Studies have found that vitamin C may lower uric acid levels 6. People with gout may therefore benefit from adding foods rich in vitamin C into their diet, such citrus fruits, strawberries and peppers. Evidence also suggests that eating cherries can reduce gout attacks and improve pain 7

A lifestyle medicine treatment for gout should focus on a healthy diet as a whole alongside other aspects of lifestyle medicine to reduce the risk of developing gout and reduce flare-ups in existing gout cases. 

Losing excess weight if you’re overweight or obese can significantly help gout, as evidence shows losing weight can lower your uric acid levels 8. A healthy diet that emphasizes plant-foods along with exercise, sleep, and stress management promotes healthy and sustainable weight loss. 

You don’t have to make these changes alone. Guidance from our lifestyle-focused medical team that are empathetic and supportive of your unique situation can make all the difference. 

Think you may be struggling with this and need help? Talk to us today to make a change. 

References 

1. FitzGerald, J. D. et al. 2020 American College of Rheumatology Guideline for the Management of Gout. Arthritis Care Res. 72, 744–760 (2020).

2. Chiu, T. H. T., Liu, C.-H., Chang, C.-C., Lin, M.-N. & Lin, C.-L. Vegetarian diet and risk of gout in two separate prospective cohort studies. Clin. Nutr. 39, 837–844 (2020).

3. Choi, H. K., Atkinson, K., Karlson, E. W., Willett, W. & Curhan, G. Purine-Rich Foods, Dairy and Protein Intake, and the Risk of Gout in Men. N. Engl. J. Med. 350, 1093–1103 (2004).

4. Juraschek, S. P., Gelber, A. C., Choi, H. K., Appel, L. J. & Miller, E. R. Effects of the Dietary Approaches to Stop Hypertension (DASH) Diet and Sodium Intake on Serum Uric Acid: TRIAL OF DIET, DIETARY SODIUM, AND URIC ACID. Arthritis Rheumatol. 68, 3002–3009 (2016).

5. Mayor, S. Healthy diet could prevent gout flares, study finds. BMJ i4464 (2016) doi:10.1136/bmj.i4464.

6. Brzezińska, O., Styrzyński, F., Makowska, J. & Walczak, K. Role of Vitamin C in Prophylaxis and Treatment of Gout—A Literature Review. Nutrients 13, 701 (2021).

7. Zhang, Y. et al. Cherry consumption and decreased risk of recurrent gout attacks. Arthritis Rheum. 64, 4004–4011 (2012).

8. Zhu, Y., Zhang, Y. & Choi, H. K. The serum urate-lowering impact of weight loss among men with a high cardiovascular risk profile: the Multiple Risk Factor Intervention Trial. Rheumatology 49, 2391–2399 (2010).

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