If you have gout, your diet could be making it worse. This painful form of arthritis is caused by the build-up of uric acid crystals in the joints. Uric acid is formed when the body breaks down purine, a substance that occurs naturally in plants and animals.

If too much uric acid accumulates in the blood, gout can occur. While diet alone is not enough to fully control this disease, it is an important tool for managing your symptoms.

These are some foods to avoid with gout, to minimize your risk of attacks.

Organ meats

Kidneys, liver, brain, and sweetbreads are all nutrient-rich protein sources, often considered a delicacy. However, they are some of the most important foods to avoid with gout, because they contain extremely high levels of purines. A single serving of pork liver can contain as much as 300 mg of the compound, which is nearly 3 times the amount recommended per day on this type of diet.

Anchovies and sardines

These small fish contain a lot of purine and should be avoided if you have gout. Whether fresh or canned, a 3.5 oz serving of anchovies or sardines typically contains 300-400 mg of this substance. Other types of seafood that have high levels include scallops, clams, shrimp, salmon, and mackerel. While not all seafood needs to be strictly avoided, you should take care to limit your intake to reduce your symptoms.

Alcohol

Alcohol, especially beer, is strongly associated with an increase in flare ups, making it one of the foods to avoid with gout. In general, it is recommended that you not consume more than 2 drinks per day, especially beer, and avoid all alcohol when you have an active attack or poorly controlled symptoms. If you have gout, you should be very cautious about drinking beer, though wine appears to be generally safe in moderation.

Soda

Sweetened soft drinks carry a high risk of gout. Researchers have discovered that drinking 2 or more sweetened soft drinks per day can increase your risk of gout by 85%.1 They believe that this is due to the high fructose corn syrup, which can also be found in a number of other foods. Fructose raises the level of uric acid in the blood, which can contribute to gout. Because soda has no nutritional benefits and is so strongly associated with this disease, sufferers should avoid these sweetened beverages. If you must drink soda, choose diet sodas, which are not associated with an increase in symptoms.

Gravy

Cooking meat releases purines into the pan drippings used to make gravy. Meat gravies, broths, and extracts contain concentrated amounts of this compound, making them important foods to avoid with gout. They are also typically high in sodium, which can make it harder for the kidneys to dispose of uric acid through urine. If you have this illness, you should avoid eating meat gravies and extracts, and even be cautious with meat broth and stock.

Meats

Both red meat and poultry contain moderate levels of purine, at around 100-150 mg per serving. This is around the maximum range that a gout patient should have per day. Game meats contain as much, or more, of this compound than beef and chicken. While you don’t have to avoid meat altogether, it should be eaten in moderation, without gravy, and with the rest of the meal consisting of low purine foods.

These are some of the most important foods to avoid with gout. If you have this disease, you should eat these foods in moderation, and discuss any symptoms with your doctor in order to determine if you need to further restrict your diet as part of your treatment.