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 may be 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.”
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 may 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 consisting of 80% complex 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, used 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, controlling 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 may be 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 may 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 may 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 may protect you from a heart attack and/or cardiovascular disease including arterial plaque buildup.
Tips for Staying on a Low-Purine Diet
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Know what purine is
The food from purines alone isn’t the problem. The body also naturally produces purines. So on top of what you already have, you’re adding more purines into your body when you eat high purine foods. This breaks down into uric acid which can later lead to a gout attack.
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Focus on whole foods
The great thing about a low-purine diet is that it encourages you to eat whole foods without worrying about the consequence. This includes foods that a typical health obsessed person might balk at like rice, cereal, bread, and pasta. You can eat these foods on a low purine diet because they are considered real foods, and real foods should be part of a balanced meal.
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Avoid the junk
In relation to the point above, you simply need to avoid junk food if you want to stay low on your purine intake. This is because most processed foods raise your uric acid levels –items like chips, candies, soft drinks, and fruit juice. These are not real foods and that distinction alone will make it easy for you to follow this diet.
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Wine over beer
I always warn my readers about the dangers of alcohol for gout but if you must drink for the occasion, opt for the lesser evil, wine. Wine is still alcohol but it doesn’t have as much of a negative effect on your body as beer does. In fact, a small amount of wine might even be beneficial for your heart health.
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Make it fun
Following a purine diet isn’t all about counting the purine content of every single food item you ingest. Remember, certain healthy foods like asparagus are high in purines, but is it as bad as a pint of beer? Absolutely not. This is because plant-based purines still contain powerful vitamins and minerals, meanwhile high purine items like beer are just empty calories. So when contemplating on what your next meal should be, don’t shy away from high purine vegetables but be careful of high purine processed foods.
To make your health journey a little more fun, you can look into a diet like the Mediterranean diet which greatly represents what a low purine diet can be. The great thing about it is that this diet is not new. In fact, it’s quite popular with the health crowd. Consider looking into some recipes for Mediterranean meals and you should be keeping gout at bay.
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Drink lots of water
Last but not the least, make sure you are always hydrated. Whether what you’re eating is low purine or not, you should be drinking enough water to dilute the uric acid concentration that’s in your body. You also want to make a habit of drinking water before every meal. This will prevent you from overeating which is often a cause for gout flares.
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.
50 replies to "Gout and Purines"
Actually, Spinach may indeed trigger gout but not via the purine route. It’s the Oxalates in Spinach that triggers gout. Not only Spinach but also Beets, and Swiss Chard. I know this from painful experience. Leave those above items alone and eat Mustard, Kale, Turnip, Collard greens instead. Always boil or at least blanch and pour off the water. That will reduce the Oxalates. For a Physician to pretend that Oxalates aren’t a factor is borderline malpractice.
[…] all know that gout is a result of too much uric acid. Uric acid is a byproduct of purines which is found in both animal-based food and plant-based foods. The only difference between the two […]
[…] Gout and Purines […]
I just found out I have gout plus I am a diabetic.. everything I read about, what foods to eat for gout most diabetics can’t eat like pastas. Pasta turns into sugar so I’m at a total loss now please help.. ty
Hi Mary!
You can eat 100% whole grain pastas, it doesn’t raise your insulin levels like white refined pasta.
I would like to know if you can include bone broth in diet and how high in purines is it?
Glycine is an amino acid and neurotransmitter that is plentiful in bone broth which helps clear uric acid. It’s not a food that I would worry about.
[…] standard diet makes it hard to avoid purines. To avoid uric acid buildup, you need to avoid foods that are high in purines such as seafood, […]
First time gout sufferer here, my question is can raisins cause gout? I have quite a lot with my porridge, also if I clean my diet up properly, how long would it take for my uric acid levels to come proper, 3 weeks ago they were .56 mmo? Love my exercise but cannot run without pain becoming really depressing. Please help.
Hi Dane!
Thanks for your comment!
Raisins aren’t a direct gout trigger in any way unless you eat pounds of them I guess. Sure there is sugar but adding a few in your porridge is fine. I will eat raisins from time to time too if I have a sweet tooth, it’s way healthier than eating a chocolate bar or other candies for example.
As for your diet and uric acid level coming down, nobody can predict that since everybody is different and eat differently. Weight is also very important, if you are overweight then you do want to lose that excess weight, that will help you. All you can do is experiment with your diet and go do frequent blood tests to see. But if you follow my gout diet of 80% complex carbs, 10% protein and 10% fat intake on a daily basis with the right foods as outlined in my book and website, then you can see a decrease within 60 days. The number is different for everybody.
Good luck!
I love peanuts but I can’t eat it nowadays.
If peanuts are low in purine, how come I get affected a lot by it?
I’m not allergic to peanuts since I can eat a lot of it but NOT since about a decade ago since the gout attacks.
I can eat almonds and cashew nuts, but not peanuts.
Are they salted? Are they sugar coated? Natural peanuts cannot affect you to cause you a direct gout flare-up. They have are similar to almonds and cashews. Strange.
My experience with gout, hope this helps, please stay away from Peanuts they are very bad for gout no matter what the research says, I can say peanuts are bad for gout than anything else, Almonds and Cashew nuts in moderation are OK
I only have 1 kidney and I am seeing more and more that this can also be part of my gout issues? Less kidney function less filtering of the bad things? Also fructose keeps popping up as bad for gout? Fructose seems to be bad for many things. It should be outlawed!
I have suffered with gout for about 4 years and last check on uric acid I was at an 8.4 when I had my gallbladder removed. I am now having an attack and have been worried about taking allopurinol because it can affect the kidneys but I know going untreated can do the same.
My last e gfr was 82 and I’m only 35. Along with purchasing your ebook, following the diet, and natural herbs should I take the blood test challenge after and see where my uric acid is before going for allopurinol? I know it’s kinda of random but I thought I would ask someone who knows more than I about gout.
Thanks!!!
Yes give it a try if you like but since you I am not fully aware of your health situation best to work with your doctor on this, so he can follow your progress.
Good luck!
Spiro
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
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.
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.
Thanks John for the enlightening comment!
John you might be right about beer being low in purines but that is not the issue with alcohol. I am not really on expert on gout or alcohol but I do know one thing. Alcohol dehydrates you and that’s the problem plus your body is too busy processing the alcohol to deal with uric acid excretion. Beer could have no purines and would still be a problem because it interferes with your ability to get rid of the uric acid.
I have learned this the hard way. I actually don’t really care about alcohol but my friends want to drink beer and I just drank with them to hang out with somebody. It took me a couple of times to learn that the alcohol was my main reason for gout. In fact any major attacks I have had was after drinking good amounts of alcohol.
I have nothing against my buddies but I can’t keep hanging out with them if they insist on drinking because my health can’t handle it. Keep talking to them sure but I have to quit hanging out. My gout happens in my feet and just my feet but still when it happens that means no walking unless it’s a bathroom emergency or something extreme
Oh yea forgot to add but it maybe common sense that water is what our bodies use to flush stuff out like uric acid. The alcohol might be dehydrating because your body is using too much water flushing the alcohol so then you get build up of things like uric acid. This information might be common sense but I thought it was worth mentioning
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.
Yes I am on Twitter. My Twitter handle is @GoutandYou
How about eating corn. Is it good or bad for gout sufferer?
Hi Robin!
Yes you can eat corn in moderation, never heard from any gout sufferer causing a flare or gout attack.
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
[…] Unravel the Mystery about Purines […]
Thanks for sharing! +1 for vegetarians ^_^
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
Hi Reynaldo!
See my article on whey protein which is similar to collagen –> https://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.
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.
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!
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.
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
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.
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.
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
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.
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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