Gout is the most common form of inflammatory arthritis and causes painful flares of pain that affect the joints throughout the body. Gout in the foot, (especially the big toe), elbow, knees, fingers, and knees are possible, but gout can occur anywhere in the body. The good news? The Mediterranean diet for gout may help reduce symptoms.
Causes of Gout
When uric acid levels in the blood reach levels too high for the body to remove, they form crystals and collect around the joints. This leads to pain, swelling, and sometimes, the formation of painful bumps (tophi) at the affected joints.
It’s a common misconception that poor diets are the cause of gout. This belief is built around the idea that foods high in purines (a chemical compound made of nitrogen and carbon) lead to excess uric acid in the body. The truth is, diet is not the main cause of gout.
Genetic predisposition, certain medications, and other health conditions are typically associated with the development of chronic gout.
Foods to Avoid For Gout
To better control gout symptoms and lower the number of flares, your doctor may recommend that you avoid the following foods. Many of these food items are not staples in the Mediterranean diet for gout, apart from some types of seafood.
This includes beef, pork, and game meat like venison and lamb. Organ meats (liver, tongue, sweet bread, heart), should also be avoided. Processed meat like hot dogs, sausage, and pepperoni are also naturally high in purines and should be limited in a gout diet.
Certain seafoods are known for their health benefits and high levels of omega-3s and protein. However, sardines, mackerel, tuna, anchovies, and certain shellfish can lead to gout flares. All of these seafoods have higher purine levels than other types of seafood.
Sugar and High Fructose Corn Syrup
Sugary foods, including those containing high fructose corn syrup, are linked to an increased risk of gout flares. Processed, sugary foods contain fructose, which breaks down in the body and produces purines. Unfortunately, high fructose corn syrup is a popular additive in many processed snacks and drinks. Soda, juice, cereal, snack breads, sauces, and candy all frequently use high fructose corn syrup as a sweetener.
Alcohol, regardless of the type, may lead to more gout flares. Beer is especially high in purines, but any type of alcohol affects how the kidneys are able to filter out uric acid.
There are plenty of gout-friendly alternatives that may help lower the frequency of gout flares and limit the production of uric acid. The Mediterranean diet for gout contains the following gout-friendly alternatives for popular high-purine foods.
Red Meat Alternatives
While red meat can increase gout flares, tofu, nuts, and beans are high-protein alternatives. Poultry, like chicken and turkey, can also be OK in moderation. Poultry is not a low-purine food, but it contains less purines than red meat.
If you have gout, it doesn’t mean you have to cut out seafood entirely. Salmon is a great alternative to other types of seafood because it has lower levels of purines and is rich in omega-3s and protein. Limited amounts of Halibut, red snapper, crab, shrimp, and lobster may also have a place in a gout-friendly diet.
If you’re craving a sweet snack, citrus is a great option to prevent gout flares. Grapefruit and oranges are high in vitamin C, which may help lower uric acid levels. Other fruits are typically OK for gout in moderation, including strawberries, blueberries, pineapple, and mango.
Cherry juice with no sugar added is a great beverage for people who suffer from gout. That’s because cherries may help lower levels of serum urate in the body, which reduces inflammation. Coffee is also usually OK to drink in moderation if you have gout.
Mediterranean Diet for Gout?: What the Research Says
Even though diet alone can’t cure chronic gout, changes to your eating habits have been shown to lower the frequency of gout flares and help maintain lower uric acid levels in the blood. Foods with low purine levels are often suggested for people who suffer from recurrent gout flares. Many of these foods are staples in the Mediterranean die.
Studies have suggested the benefits of the Mediterranean diet for gout and weight loss. The Mediterranean diet consists of lots of fruits and vegetables, whole grains, and nuts. Moderate consumption of healthy fat foods like olive oil and fish, as well as dairy and poultry. The Mediterranean diet limits red meats and processed foods.
So what about fish, a staple of Mediterranean diets?
Cutting out purine-heavy seafood like shellfish and some fish may only be necessary for the short term to reduce the risk of gout flares. The high purine levels in these seafoods can trigger gout flares for individuals who suffer from frequent, recurrent flares. But for those who have their gout flares better controlled, moderate consumption of seafood, especially fatty fish like salmon, has dietary value.
In a 2021 study led by Doctor Chio Yokose, MD, and others, findings suggest that not all foods high in purines necessarily lead to an increased risk of gout flares. Specifically, plant-based foods naturally high in purine levels such as spinach, asparagus, lentils, and peas were not associated with a higher risk of flares. Therefore, the Mediterranean diet for gout, which consists of many plant-based foods, may be enjoyed without increasing the risk of gout attacks.
A diet that helps one person with gout may not be as effective for someone else. It’s important to work with your provider to develop a list of gout-friendly foods that will work best for you and fit your lifestyle. If you are interested in the Mediterranean diet for gout, talk with your provider before changing your eating habits.
Our gout specialists at Summit Rheumatology specialize in gout treatment plans that fit each patient’s individual lifestyle and goals. Learn more about our Gout Center of Excellence or schedule an appointment with a gout specialist.
Questions? Give us a call at (480) 494-2770 or submit a form. A member of our team will be in touch with you as soon as possible.
 Zhang Y, Chen C, Choi H, et al. Purine-rich foods intake and recurrent gout attacks. Ann Rheum Dis 2012;71:1448–53. [PMC free article] [PubMed] [Google Scholar]