Purines and gout

Gout and Purines

What are purines and which foods are to be avoided in a gout diet

When I was diagnosed with gout, I remember researching on the net about it and coming across this keyword that kept popping up article after article, this word was “purines”. When reading or hearing this word, my brain has this strange association with Purina Cat Chow even to this day! So what is this “purines”, what does it consist of and why must gout sufferers cut down on it, if they want to lower their uric acid levels.

A great article explains this natural substance very well:

Purines are natural substances found in all of the body’s cells, and in virtually all foods. The reason for their widespread occurrence is simple: purines provide part of the chemical structure of our genes and the genes of plants and animals. A relatively small number of foods, however, contain concentrated amounts of purines. For the most part, these high-purine foods are also high-protein foods, and they include organ meats like kidney, fish like mackerel, herring, sardines and mussels, and also yeast.

It then goes on to explain how purines are metabolized into uric acid:

When cells die and get recycled, the purines in their genetic material also get broken down. Uric acid is the chemical formed when purines have been broken down completely. It’s normal and healthy for uric acid to be formed in the body from breakdown of purines. In our blood, for example, uric acid serves as an antioxidant and helps prevent damage to our blood vessel linings, so a continual supply of uric acid is important for protecting our blood vessels.

Uric acid levels in the blood and other parts of the body can become too high, however, under a variety of circumstances. Since our kidneys are responsible for helping keep blood levels of uric acid balanced, kidney problems can lead to excessive accumulation of uric acid in various parts of the body. Excessive breakdown of cells can also cause uric acid build-up. When uric acid accumulates, uric acid crystals (called monosodium urate crystals) can become deposited in our tendons, joints, kidneys, and other organs.

A low purine diet is beneficial for us gout sufferers:

Because uric acid is formed from the breakdown of purines, low-purine diets are often used to help treat conditions like gout in which excessive uric acid is deposited in the tissues of the body. The average daily diet for an adult in the U.S. contains approximately 600-1,000 milligrams of purines.

Recent research by Choi and others has shown that the impact of plant purines on gout risk is very different from the impact of animal purines, and that within the animal food family, purines from meat and fish act very differently than purines from dairy. Choi’s work has demonstrated that purines from meat and fish clearly increase our risk of gout, while purines from vegetables fail to change our risk. Dairy foods (which can contain purines) actually appear to lower our risk of gout. In summary, this epidemiological research (on tens of thousands of men and women) makes it clear that all purine-containing foods are not the same, and that plant purines are far safer than meat and fish purines in terms of gout risk.

NutriGout Dietary Supplement for Gout


These are the foods to avoid that contain the highest purine levels (up to 1000mg per 3.5 ounce serving):


  • Mincemeat (cut down on those burgers!)
  • Anchovies
  • Brains, Kidneys, Liver, Animal hearts (my advice is not too even touch organ meats)
  • Gravies
  • Sardines
  • Sweetbreads
  • Yeasty foods
  • Mackerel
  • Mussels
  • Herring
  • Beer and other alcoholic beverages

These foods are to be limited since they contain moderately high purine levels (5-100mg per 3.5 ounce serving):


  • Asparagus
  • Beef
  • Chicken
  • Chicken soup
  • Lobster
  • Lima Beans, Navy beans, Kidney beans, lentils & peas
  • Mushrooms
  • Pork
  • Oatmeal
  • Tuna
  • Turkey
  • Shellfish
  • Bacon
  • Rabbit
  • Veal
  • Oysters
  • Cauliflower
  • Duck
  • Goose
  • Ham
  • Lamb
  • Snapper, Trout & Halibut fish
  • Perch
  • Spinach

So what do you notice from these foods that are high in purines? What they all have in common is that most of the foods are very high in protein, mainly meat and fish. So limit your meat intake mostly cause fish is healthier for you since it is considered the best source of protein and has very little fat, consisting of 3-5% of its calories as fat, whereas meat has 70-75% of its calories as fat. When we eat too much protein, its metabolism produces ammonia, urea and other waste products, that take seven to eight times more water to flush out through the kidneys than carbohydrates. The more meat you eat, the more stress you cause to your kidneys in trying to filter out the waste. As a gout sufferer, I strongly recommend a high carbohydrate diet rich in fruits and vegetables composing 80% carbs, 10% protein  and 10% fat.

As a side-note, when it comes to the moderately high-purine vegetables like asparagus, beans or spinach, there is no reason for you to avoid them in raw form, provided you keep your portion sizes down. That’s the key with the meats and fish on the list, is to keep the portions small, we all heard the general rule for meat portion sizes should be  the size of the palm of your hand.  I personally use to buy rib steaks cause it obviously had more flavor from the marbled fat that juiced it while cooking it but now I mostly choose leaner red meats with less marbling, while they are harder to chew and taste more rubbery, they have less fat and are metabolized easier by your kidneys, lowering your risk of increasing your uric acid levels. But more than that, a high protein meat based diet has proven that it will kill you earlier. We will be examining that in a future post.

Finally here are low purine foods:


  • Peanuts, walnuts, almonds
  • Peanut & almond butter
  • Milk, cheese & ice cream
  • Whole wheat bread
  • Pasta
  • Rice
  • Apples, bananas, pineapple, grapes, strawberries, pumpkin
  • Lettuce, romaine
  • Coffee and tea
  • Chocolate
  • Eggs
  • Non-green veggies

Which foods are beneficial for gout sufferers?

One of the best fruits to eat when suffering from gout is cherries. Research has shown that consuming about 250 grams of cherries each day lessens or eliminates gout attacks by reducing blood uric acid levels. Drinking cherry juice is just as beneficial to gout sufferers as eating cherries. If you find it hard to drink so many glasses of water each day, substitute cherry juice for 2 or 3 glasses of water instead.

Dark berries may contain chemicals that lower uric acid and reduce inflammation. All berries that are dark red or blue contain flavonoids and anthocyanidins, beneficial antioxidants that enhance the collagen content of tendons and cartilages surrounding affected joints.

Tofu which is made from soybeans may be a better choice than meats. I like to cook it with basmati rice which is lower on the Glycemic Index and add various vegetables like broccoli, carrots, dried tomatoes etc…

Fatty acids found in certain fish such as salmon, flax or olive oil, or nuts  possess some anti-inflammatory benefits. The famous Omega 3 and 6 fatty acids that are soooo good for us…I use olive oil every day and my doctor has personally told me when doing my blood tests couple of years back, that he has never seen HDL cholesterol so high in years in any of his patients which can protect you from a heart attack and/or cardiovascular disease including arterial plaque buildup.

In conclusion,  a low purine diet is key to maintaining low uric acid levels for all gout sufferers. Purines are found in all protein foods and it is not recommended that all purines should be eliminated from your diet. Cut back on purines to control recurring gout attacks and if you notice that you get an attack after eating a certain type of food, experiment by cutting it completely from your diet, talk to your doctor about it too, to see if you might be allergic to that food.

Posted by Spiro Koulouris

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  • Zandri

    Reply Reply October 15, 2016

    I have read a few articles now and I’m still confused. My husband has gout. When he does eat red meat will four flair up less if he eats it well done? Or does it not matter how rare or well cooked the meat is? Please someone help cuz I am so tired of seeing him in pain

    • Spiro Koulouris

      Reply Reply October 15, 2016

      Meat must always be eaten well done. By eating it well done, you get rid of most of the fat, it burns off in the fire if you are barbecuing. Eating blood is truly bad for your health, yes I know it tastes great, been there done that myself but is bad for you. So by eating it well done, you’re eating the meat with less fat since the fire has burned most of it. Hope this makes sense.

  • John

    Reply Reply July 31, 2016

    I think it’s important to point out that purine levels alone are not wholly relevant.
    Beer is very low in purines, but is fairly well known to affect flair ups. There are different types of purines and not all affect gout. Some suggest Xanthine and Hypoxanthine may be the more relevant purines.
    Recent research also strongly suggests free fatty acids in conjunction with uric acid influence gout flair ups.

  • Smithb455

    Reply Reply July 22, 2016

    Hello! Do you use Twitter? I’d like to follow you if that would be okay. I’m undoubtedly enjoying your blog and look forward to new posts.

  • Robin ario

    Reply Reply July 17, 2016

    How about eating corn. Is it good or bad for gout sufferer?

    • Spiro Koulouris

      Reply Reply July 18, 2016

      Hi Robin!

      Yes you can eat corn in moderation, never heard from any gout sufferer causing a flare or gout attack.

  • Bartman

    Reply Reply May 18, 2016

    Reads to me as a good article. I searched the internet to find out if almonds contribute to gout. My doctor says peanuts contribute to gout and I believe that because for a few years now I have been eating raw unsalted peanuts as I feed them to the birds and squirrels. As I look back I can see a connection between peanut bird season and some of my gout flares.
    I’ve search for info on many foods to see their gout connection. But for every web page that says one can eat them I can find a web page that says don’t. I’m literally lost in a sea of food and I don’t know what’s safe. One mistake eating the wrong thing and I’ll pay dearly for it within hours. It’s actually better to fast/starve than endure another gout flare. I had a gout flare last January and it hasn’t gone away in 5 months. It’s subsided somewhat and smoldering in the background, jumping from one leg joint to another. I’m on allopurinol and colchicine.
    I see some key words of interest like spinach and monosodium urate. Never would have suspected spinach. However I have long suspected food preservatives and flavoring like monosodium glutamate (MSG) and the whole Nitrate family of preservatives. Also strike dairy from the list since they cause me acne. Strike eggs since I’m allergic to egg whites according to an allergy test years ago. Also strike coffee and nuts from my list.
    A sudden switch to a near vegetarian diet is making me sick. I’m just not used to eating like this. I read somewhere that I have to acquire a different set of stomach bacteria to digest this stuff. I wish bacteria would digest the uric acid instead.
    -Thanks for being here

  • D.

    Reply Reply January 29, 2016

    Thanks for sharing! +1 for vegetarians ^_^

  • Reynaldo "Rey" Pernia

    Reply Reply January 17, 2016

    Hi! iam rey. i used to suffer from arthritis until i stumbled upon Collagen and have been taking it for 2 years already. However, i was wondering if it could help my friend who has gouty arthritis since Collagen is basically protein. i need your advice Spiro…many thanks! Rey

    • Spiro Koulouris

      Reply Reply January 18, 2016

      Hi Reynaldo!

      See my article on whey protein which is similar to collagen –> http://goutandyou.com/gout-and-whey-protein/
      Truth is you don’t need collagen, all you need is to eat 3 to 5 ounces of meat in one day and this is more than enough protein. Your body doesn’t need that much protein in the first place. You can take collagen but don’t go eating meat for lunch afterwards, it’s going to worsen your gout or arthritis.

  • mick symonds

    Reply Reply January 13, 2016

    Cherry Juice…??? Dark cherries…???

    These bring on an attack of gout imminently in my case…!

    It’s all subjective; and if it’s going to attack then it’s going to attack.

    Acupuncture works well; drinking lots of water ; and I find naproxen 500mg twice daily clears the attack up in a couple of days.

  • Trevor R.

    Reply Reply December 22, 2015

    Hi being a new victim to gout I have been looking around gathering as much information about what and what not to eat! I’m coming to the conclusion that if it grows naturally then it normally does not have a harmful effect, what however do you think is correct about spinach, the website has cleared my concerns with mushrooms, beans and tomatoes already! I’m also painfully aware that my gout was brought on through my own greed over the years with meat and beer and should have noticed warning signs over the past few years……..Popeye looked good on the spinach!

    • Spiro Koulouris

      Reply Reply December 22, 2015

      Hi Trevor! The day spinach causes someone a gout attack is the day when pigs fly! Listen, sure there’s a little more purines than other vegetables but it doesn’t compare the purines found in seafood and meat, so enjoy spinach once in a while, it won’t harm you and don’t be a glutton, meaning eating spinach all the time, it is important to eat in moderation, cause too much of a good thing can still be harmful in other ways.

  • charlie

    Reply Reply June 16, 2015

    I’m so confused,eat chicken don’t eat chicken,eat oatmeal don’t eat oatmeal,you get a different response in every web site,this is the first time I had gout for 5 months,i’m on colchisine,stpo eating almost everything,losing a ton of weight feeling crappy,so confused

    • Spiro Koulouris

      Reply Reply June 21, 2015

      Hi Charlie!

      If you want to avoid confusion, the website is beyond the scope of explaining it all to you Charlie, best is to read my book so you can clearly understand how to eat properly in a gout diet.

  • Dorian

    Reply Reply June 12, 2015

    Spiro thank you for your quick and helpful reply. That makes me feel much better. Just to let you know I am in the middle of researching the available research on herbs that act in the same way allopurinol does in interrupting xanthine oxidase in order to prevent purine conversion into uric acid. Will keep your blog a breast of any potentially helpful info.

  • Dorian

    Reply Reply June 12, 2015

    In your list of foods to moderate due to purines certain beans were listed. Lima , kidney, navy, lentils, greenpeas. Is that the only ones, are say chick peas or black beans lower in purines or were they not tested

    • Spiro Koulouris

      Reply Reply June 12, 2015

      Dorian it’s very simple eat all the beans you like but don’t eat meat on top of that for the day. Protein is protein either have 4 ounces of meat or eat any bean you like. There’s a bit more purines than other foods but not enough to harm you in any way gout-wise of course. I would prefer to eat beans over meat in order to get my protein and feel full and so should you.

  • Mary

    Reply Reply April 7, 2015

    Foods mainly meat is what I avoid which is really high in purines generally speaking. I recently read your ebook and find it very informative and have taken you up on the advice. Thank you for those delicious recipes as well!

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