Purines and Uric Acid
Purines are naturally occurring in humans, animals, and plants. They are part of the basic chemical structure of both RNA and DNA. When cells die, the purine is released and must be processed and eliminated from your body as waste. When consumed in food they are normally also broken down and eliminated by the kidneys.
When purines are broken down by the body, a chemical called uric acid is produced. This crystalline structure is typically eliminated by the kidneys in your urine. If your body produces more of this substance than the kidneys are able to eliminate, it builds up in your system and can cause gout.
A Gout Diet
Reducing the amount of purines in your diet, and thus the amount of uric acid produced, may often help reduce attacks. Previously, gout diets were extremely strict and hard to stick to, but medical advances have helped to reduce the restrictions, making these diets similar to a typical healthy eating plan. Because obesity is another risk factor for this disease, your doctor may recommend that you try to lose weight while also following a low-purine diet plan.
Certain foods are especially high in purines and can contribute to gout. The American College of Rheumatology recommends patients like you avoid these foods altogether:1
- Organ meats, such as sweetbreads, liver, and kidneys
- Alcohol overuse, i.e. more than 2 servings per day for men, or 1 serving per day for women
- Alcohol use at all during a gout attack, or for patients where the disease is poorly controlled
- High-fructose corn syrup, which is found in soda, energy drinks, some sweetened juices, and processed foods
You should limit other foods that are high in purine, such as:
- Red meat (beef, pork, and lamb)
- Shellfish
- Seafood with high purine content such as scallops, sardines, anchovies, and mackerel
- Gravy
- Table salt
- Sweetened beverages and fruit juices
- Alcohol, particularly beer
Hydration is an important aspect of this diet plan. You should drink plenty of fluids, especially water, to help eliminate uric acid from the body, reducing the risk of attacks. Non-fat and low-fat dairy products and a diet rich in fruits and vegetables are recommended as part of the diet. Gout sufferers are also advised to get regular exercise and to not smoke, as part of your healthy lifestyle.
Can Changing your Eating Habits like this Help?
This gout diet is recommended by the American College of Rheumatology, but that does not mean it works for everyone; you and your doctor can decide what’s right for you. Reviews of the literature show a long-standing body of evidence linking diet to gout, leading to these recommendations being made for most patients with this illness.2
Studies have shown that high levels of purine intake can increase the risk of recurrent gout by a factor of 5.3 Reducing dietary purine has been shown to reduce the blood levels of uric acid by 10-18%, which can decrease the risk and severity of episodes of the disease.4
While a gout diet alone is not a sufficient treatment for most sufferers, it can cause a significant decrease in one major aspect of the disease. This can, in turn, assist in the treatment and reduction of symptoms. It is definitely worth putting on your list to discuss with your doctor.
2 Singh JA, Reddy SG, Kundukulam J. Risk factors for gout and prevention: a systematic review of the literature. Curr Opin Rheumatol. 2011;23:192–202. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4104583/. Accessed 4/9/2015
3 Zhang, Yuqing, Chen, Clara, et al. Purine-rich foods intake and recurrent gout attacks. Annals of the Rheumatic Diseases. 2012. http://ard.bmj.com/content/early/2012/05/20/annrheumdis-2011-201215. Accessed 4/9/2015
4 Khanna D, Fitzgerald JD, Khanna PP, Bae S, Singh MK, Neogi T, et al. Accessed April 21, 2016.
