What are the dietary recommendations for someone with gout?

A low-purine diet has long been the mainstay of dietary therapy for gout. Foods with high purine levels should be omitted entirely. These include organ meats, yeast (brewer's and baker's), herring, sardines, mackerel, and anchovies. Intake of foods with moderate levels of protein should be reduced to one serving every two to three days as well. These include dried legumes, spinach, asparagus, fish, poultry, and mushrooms. Low-purine foods may be eaten in smallamounts.

Alcohol increases uric acid production by accelerating purine breakdown. It also reduces uric acid excretion by increasing lactate production, which impairs kidney function. For many individuals, elimination of alcohol is all that is needed to reduce uric acid levels and prevent gouty arthritis. Obesity is associated with an increased rate of gout. Weight reduction in obese individuals significantly reduces serum uric acid levels.

High-fat and high-protein foods are usually foods that are high in purines. High-fat animal foods also promote inflammation and should be avoided, regardless of purine content. High-proteinfoods that are not high in purines should be eaten only in small amounts to avoid taxing the kidneys, which are burdened with excreting excess uric acid.

Liberal fluid intake keeps the urine diluted and promotes the excretion of uric acid. Furthermore, dilution of the urine reduces the risk of kidney stones. Drink at least 48 ounces of water each day. Celery and cherries appear to be very effective in lowering uric acid levels and preventing attacks of gout. Celery contains the compound 3-n-butylpthalide, while cherries are a rich source of flavonoids. Both of these compounds are beneficial in gout via several mechanisms, including the ability to inhibit the formation of uric acid by inhibiting the enzyme xanthine oxidase.

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