Nearly 4 percent of adults are affected by gout, which can harm joints if left untreated (1). Since diet and lifestyle are important factors for managing this painful problem, it’s important to talk to your doctor before you make any big changes, such as starting a new eating plan or losing weight.

What is gout?

Gout is an inflammation of the joints that occurs when the level of uric acid in the blood is too high. Uric acid is produced by your body as part of normal metabolism, but it only causes problems when levels become elevated. When uric acid levels are elevated, sharp, needle-like crystals of uric acid can form within the joints and cause severe pain, redness, and swelling.

For many people, the first sign of gout appears as an excruciating pain in the big toe or other joint, usually in the lower body. These painful symptoms are referred to as a gout flare or gout attack. They appear suddenly and resolve over several weeks in most cases.

Some of the risk factors for developing high uric acid levels and gout are things you can’t control, such as age, gender, and family history. However, there are important risk factors that you can control including your diet and your body weight.

How does diet affect gout?

Some foods and beverages have been linked to an increased risk for gout, while other foods may decrease risk. A study published in the New England Journal of Medicine aimed to identify the impact of different foods on gout risk by analyzing the diets of over 47,000 men over 12 years (2). The results of this large study identified meat and seafood as the foods linked to the greatest increase in risk for gout. Interestingly, the researchers found that the total amount of protein the men consumed had no effect on gout risk, even for those consuming relatively high-protein diets.

Alcoholic beverages and sugary drinks are also strongly associated with increased gout risk (2-4). Foods linked to decreased risk for gout and improvements in uric acid levels include dairy, vegetables, fruit, and whole grains (2, 5).

If you are concerned about gout and are considering a significant change to your diet, you should ask your doctor to monitor your uric acid levels to help determine which changes may be most beneficial for you.

How does body weight affect gout?

Obesity is strongly linked with a greater risk of developing gout (6). Weight loss has been shown to help manage gout symptoms and help to reduce the number of attacks (7). However, the process of losing weight may lead to a temporary increase in risk for gout flares, particularly for those who lose weight rapidly.

In one example, researchers monitored uric acid levels in a group of participants with gout for over a year. These participants experienced rapid weight loss after undergoing weight loss surgery (8). On average, the study participants’ uric acid levels increased in the weeks immediately following surgery. After the short-term increase, the participants’ uric acid levels began to fall and remained significantly reduced through the end of study to provide an overall reduction in gout risk.

If you have gout and are considering weight loss, you should ask your doctor to monitor your progress. You may benefit from a gradual approach to weight loss, since rapid weight loss has been linked to a short-term increase in risk for gout flares, even though weight loss may improve gout risk in general.

Why should you talk to your doctor if you have gout?

For anyone who takes medication or has a health condition, it’s always a good idea to talk to your doctor before you make any significant changes to your diet or lifestyle. This is also true for someone who has concerns with gout, since diet and lifestyle choices can have an impact on gout symptoms.

Making positive changes in your diet and lifestyle or losing weight may have benefits for improving gout risk, but it’s important to work with your doctor so that you can make a choice that is right for you.

References

  1. Zhu Y, Pandya BJ, Choi HK. Prevalence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey 2007-2008. Arthritis Rheum. 2011 Oct;63(10):3136-41.
  2. Choi HK, Atkinson K, Karlson EW, Willett W, Curhan G. Purine-rich foods, dairy and protein intake, and the risk of gout in men. N Engl J Med. 2004 Mar 11;350(11):1093-103.
  3. Choi HK, Atkinson K, Karlson EW, Willett W, Curhan G. Alcohol intake and risk of incident gout in men: a prospective study. Lancet. 2004 Apr 17;363(9417):1277-81.
  4. Batt C, Phipps-Green AJ, Black MA, Cadzow M, Merriman ME, Topless R, Gow P, Harrison A, Highton J, Jones P, Stamp L, Dalbeth N, Merriman TR. Sugar-sweetened beverage consumption: a risk factor for prevalent gout with SLC2A9 genotype-specific effects on serum urate and risk of gout. Ann Rheum Dis. 2014 Dec;73(12):2101-6.
  5. Rai SK, Fung TT, Lu N, Keller SF, Curhan GC, Choi HK. The Dietary Approaches to Stop Hypertension (DASH) diet, Western diet, and risk of gout in men: prospective cohort study. BMJ. 2017 May;357:j1794.
  6. Choi HK, Atkinson K, Karlson EW, Curhan G. Obesity, weight change, hypertension, diuretic use, and risk of gout in men: the health professionals follow-up study. Arch Intern Med. 2005 Apr 11;165(7):742-8.
  7. Dessein PH, Shipton EA, Stanwix AE, Joffe BI, Ramokgadi J. Beneficial effects of weight loss associated with moderate calorie/carbohydrate restriction, and increased proportional intake of protein and unsaturated fat on serum urate and lipoprotein levels in gout: a pilot study. Ann Rheum Dis. 2000 Jul;59(7):539-43.
  8. Dalbeth N, Chen P, White M, Gamble GD, Barratt-Boyes C, Gow PJ, Orr-Walker B. Impact of bariatric surgery on serum urate targets in people with morbid obesity and diabetes: a prospective longitudinal study. Ann Rheum Dis. 2014 May;73(5):797-802. doi: 10.1136/annrheumdis-2013-203970.