Purine-rich foods: Foods to avoid to reduce the risk of gout

By: Devon Andre | Arthritis | Sunday, April 09, 2017 - 04:30 AM

Purine-rich foods: Foods to avoid to reduce the risk of goutGout risk is higher in people who eat purine-rich foods as they increase uric acid levels. Purines are a chemical compound found in some foods, and gout is a condition that affects the joints and the musculoskeletal system. It is a form of inflammatory arthritis caused by an excess of uric acid—the product of metabolic processes. When purines are metabolized, they create uric acid, so a diet rich in purines can create an excess amount of uric acid and contribute to gout.

Gout is often referred to as the rich man’s disease because foods high in purine, such as red wine and red meat, are deemed “rich.” Gout can very well be prevented if you are mindful of the foods you are eating. It can be very painful, and even a bed sheet on top of an infected joint can cause severe pain. Numerous studies link a purine-rich diet to gout.

Key studies show risk of gout and gout recurrence with purine-rich foods

One study examined new cases of gout among 47,150 men with no prior history of the condition. The men were followed for 12 years. A questionnaire was used to determine if the men fit the criteria of gout based on an American College of Rheumatology survey. Every four years, diet was assessed with a food-frequency questionnaire.

The end results of the study revealed 730 of the 47,150 men developed gout. The highest risk factors for the development of gout were meat and seafood consumption. Low risk was found in those who consumed dairy products. Although purine-rich foods increase the risk of gout, no increased risk was seen in men who consumed vegetables rich in purines.

In another study, researchers conducted a case-crossover to determine the risk of purine-rich foods as they contribute to gout. This study followed individuals who were already diagnosed with gout for one year online. Participants were asked questions about gout attacks, such as when they occurred, symptoms and signs of the attack, and medications they may be on, to name a few.

The results uncovered that even moderate consumption of purine-rich foods is enough to cause nearly five times as many reoccurring gout attacks. The researchers suggest that to avoid ongoing gout attacks, patients with gout should avoid and minimize their intake of purine-rich foods.

Food recommendations in diet for reducing gout risk

Whether you already have gout or you’re looking to prevent the painful form of arthritis, there are food recommendations for your diet to reduce future attacks or lower your risk. Here is what you need to keep in mind.

Lose weight: Being overweight increases the risk of developing gout, so losing weight can lower your chances. Reducing calories and avoiding purine-rich foods are both good ways to lose weight.

Complex carbohydrates: Avoid complex carbohydrates. Instead, incorporate more fruits, vegetables, and whole grains into your diet.

Water: Staying hydrated will prompt urination, which can help expel extra uric acid. Furthermore, staying hydrated has also been linked with fewer gout attacks.

Fats: Minimize saturated and trans fats found in processed foods and red meat.

Protein: Protein should be consumed in the form of lean meat, fish, and poultry. There are vegetable sources of protein that you should also consider.

High-purine vegetables: Studies showed that vegetables high in protein do not increase gout risk: therefore, you can still consume foods such as spinach, beans, and mushrooms.

Organ and glandular meat: Avoid meats such as liver and kidney, which are high in purines.

Selected seafood: Research showed only some seafood can increase the risk of gout. Avoid seafood such as mussels, trout, scallops and tuna, which are higher in purines.

Alcohol:
Metabolization of alcohol can contribute to uric acid which causes gout.

Coffee: Some research shows that moderate coffee consumption can reduce the risk of gout. Speak to your doctor about coffee consumption if you have other medical conditions.

Cherries: Some research has linked cherry consumption with reduced gout attacks.

List of daily foods in diet grouped by risk level

The below lists daily foods in our diet grouped by their risk of increasing gout and gout attacks.

Low Gout Risk: Foods with low purine levels (safe)

  • Green vegetables
  • Tomatoes
  • Fruit
  • Bread and cereal that are not whole-grain
  • Butter, buttermilk, cheese, and eggs
  • Chocolate and cocoa
  • Coffee, tea, and carbonated beverages
  • Peanut butter and nuts
  • Low-fat or non-fat milk
  • Low-fat yogurt

Moderate Gout Risk: Foods with moderate purine levels (eat occasionally)

  • Fish and seafood (aside from those listed in the high-purine section)
  • Oatmeal, wheat bran, and wheat germ

High Gout Risk: Purine-rich foods (avoid)

  • Organ meats, liver, kidney, sweetbread, and brains
  • Meat, bacon, beef, pork, and lamb
  • Any meat in large quantities
  • Anchovies, sardines, herring, mackerel, and scallops
  • Gravy
  • Beer

List of foods that are high and low in purine

Food Sources of Purine Total Purine Content(mg/100g)
Liver 286.4
Kidney 230.8
Poultry 130.7
lamb, roasted, chop 127.5
Pork, roasted, chop 119.0
Fish, white, fresh 115.9
Mushroom, fresh 46.9
Bread, crusted 15.7
Bread, white 12.2
Wheat flour 11.5
Cottage cheese 8.0
Plain yogurt 7.0
Rice, cooked 5.9


Purine Sources Total Purine Content(mg/100g)
Chicken organs and parts
chicken, liver 243
chicken, liver 236.1
Chicken, heart 223
Chicken, drumstick 132.3
Chicken, breast 130.7
Chicken, gizzard 130.5
Chicken, thigh 126.5
Chicken, skin 104.6
Pork, beef, and lamb organs
Pork, liver 289
Beef, kidney 213
Beef, liver 197
Beef, heart 171
Lamb, heart 171
Beef, brain 162
Lamb, liver 147


Meat products Total purine content(mg/100g)
Liver, raw 202.2
liver, boiled 237.0
liver, broiled 236.1
Steak, raw 105.9
Steak, boiled 107.8
Steak, broiled 121.0
Haddock, raw 101.7
Haddock, boiled 94.7
Haddock, broiled 118.7


Purine food sources Total purine content(mg/100g)
Fresh seafood
Anchovies 411
Sardines 345
Salmon 250
Mackerel 194
Clams 136
Squid 135
Canned seafood
Sardines 399
Herring 378
Anchovies 321
Mackerel 246
Shrimp 234
Tuna 142
Oysters 107
Salmon 88
Clams 62


Alcohol Total Purine Content(mg/1 Liter)
Traditional British beers 20.3 – 27.5
Guinness 23.8
Lager beer 17.7
Home-brewed beer 3.9
Cider 0.4


Dried Legumes Total Purine Content(mg/100g)
Blackeye peas 230
Lentils 222
Great northern bean 213
Small white bean 202
Split peas 195
Pinto bean 171
Red bean 162
Large lima bean 149
Baby lima bean 144
Cranberry bean 75
Garbanzo bean 56


Seasonings and Supplements Total Purine Content (mg/100g)
Barbecue sauce 14.9
Honey 68.7
Oyster sauce 134.4
Rice bran 100.2
Soy sauce, dark color 45.2
Soy sauce, light color 55.3
Beer yeast 2995.7
Spirulina 1076.8

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Related Reading:

Gout diet: What to eat and what to avoid

Gout vs. bursitis, differences in symptoms, causes, and treatments

Sources:

http://www.webmd.com/arthritis/tc/diet-and-gout-topic-overview
http://www.nejm.org/doi/full/10.1056/NEJMoa035700#t=abstract
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3889483/
http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/gout-diet/art-20048524
https://www.dietaryfiberfood.com/purine-and-uric-acid/purines-food-and-gout.php

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