Back in 2010, I was aware that I had been misled. Because I realized my quest to avoid “Food High in Uric Acid” was based on a myth. 10 years later, the myth prevails. So I’ve retained my story below. With slight updates to reflect some modern views on gout diet management.

Food High In Uric Acid Audience

This article supports the Purpose of Because it helps you discuss gout diet with your doctor and other health professionals. My view on gout diet management is that you and your health advisers need to follow a logical gout diet plan. Then at step 3, you learn about purines and other factors that you need to consider. So that you can subsequently make diet changes that suit your unique history and objectives.

If you are new to GoutPal management plans, you should start with Questions for Gout Sufferers. Or continue to read why food high in uric acid is a myth.

Food High In Uric Acid: The Mythical Beast That Still Haunts Gouties

Back in the mists of time (OK – 2005), I began my quest for food high in uric acid.

Sages spoke of the Land Of Plentiful Purines where gouties were banished to live out their days in exquisite swollen torture.

Then, came wise men from the East proclaiming that all was not as it seemed in GoutWorld…

To put it another way.

When most medics practicing today were in med school, the dietary control of gout was very simple: no high purine foods; limited medium purine foods; and unlimited low purine foods.

Then research in the 1970s and 80s began to question the simplicity of this view:

purine sources differ in their absorption rates, a fact not taken into account in our food tables.

[…] In summary it can be concluded that dietary purines are absorbed to a variable extent, depending on the degree of hydrolysis to nucleosides and/or nucleotides, and that they are oxidized to uric acid in the gut and excreted as uric acid, which is bad for gout but without influence on purine metabolism.

That was from Zöllner[1] in 1982, who concludes:

Supplements of dietary purines produce dose-proportional increases in plasma uric acid concentrations, uric acid pool size and renal uric acid excretion. The magnitude of these increases depends on the type of purine compound administered, which may limit the value of food tables for human dietetics. Purine content of food must be related not only to weight but also to energy and to protein, particularly if new foodstuffs or a vegetarian diet are ingested.

It is worth noting at this point, that foods never contain uric acid. Many do contain purines, which are a source of uric acid, but as Zöllner points out, there are different types of purine, and they metabolize to uric acid at different rates. He also points out that we do not really need to digest purines for uric acid, as we can make our own by reprocessing dead cells.

A turning point in our understanding of food high in uric acid came about in 2004. Choi and colleagues compiled statistics from a 12-year study of over 40,000 men. Though this statistical review adds nothing to our knowledge of how different purines affect gout in different ways, it certainly changed the way gout experts view diet.

Their conclusions set the foundation for today’s more effective gout diet plans:

Higher levels of meat and seafood consumption are associated with an increased risk of gout, whereas a higher level of consumption of dairy products is associated with a decreased risk. Moderate intake of purine-rich vegetables or protein is not associated with an increased risk of gout.

Though not the total story, as they do not factor in risks such as obesity and excess iron, those words should be tattooed on the hearts of all gout nutritionists. My simple view of purine control is to balance small portions (up to 4 oz) of meat or fish with low-fat dairy products. Fill the plate with whatever vegetable foods you enjoy. Simple and effective.

Finally, though we can see that some form of purine control may help gout, it is absolutely pointless to attempt this if you do not monitor your uric acid numbers. There is no correlation between gout pain and purines. You might still experience gout pain when uric acid is lowering because old urate crystals can cause a gout reaction before they dissolve completely. Make sure that you know and understand your uric acid level.

Leave Food High In Uric Acid to return to Step 3 of your GoutPal Plan for Gout Dieters

Food High In Uric Acid Comments

GoutPal visitor responses and associated research include:

Purines vs Free Fatty Acids

Research published by Joosten in 2010 has led to suggestions that free fatty acids might be more important than purines in gout diet management[1]. Certainly, uric acid and gout are affected by more dietary factors than purines alone. Leading me to publish What are your 5 Bad Gout Foods?

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Food High In Uric Acid References

  1. Zöllner, N. “Purine and pyrimidine metabolism.” Proceedings of the Nutrition Society 41, no. 3 (1982): 329-342.
  2. Choi, Hyon K., Karen Atkinson, Elizabeth W. Karlson, Walter Willett, and Gary Curhan. “Purine-rich foods, dairy and protein intake, and the risk of gout in men.” New England Journal of Medicine 350, no. 11 (2004): 1093-1103.
  3. Joosten, Leo AB, Mihai G. Netea, Eleni Mylona, Marije I. Koenders, RK Subbarao Malireddi, Marije Oosting, Rinke Stienstra et al. “Engagement of fatty acids with toll-like receptor 2 drives interleukin-1β production via the ASC/caspase 1 pathway in monosodium urate monohydrate crystal–induced gouty arthritis.” Arthritis & Rheumatism 62, no. 11 (2010): 3237-3248.

See more articles related to food high in uric acid in the Gout Diet section.

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