From the Guidelines
To lower serum uric acid levels and prevent gout flares, it is essential to focus on reducing purine-rich foods in your diet, limiting intake of red meat, organ meats, seafood, and alcoholic beverages, and avoiding high-fructose corn syrup and sugary drinks. The most recent and highest quality study 1 suggests that nutritional recommendations for gout are generally based on low-quality evidence, but emphasizes the importance of weight loss for overweight gout patients, reducing fructose intake, and seeking low-fat dairy products. Some key dietary changes to consider include:
- Limiting intake of red meat, organ meats (liver, kidneys), seafood (especially shellfish, anchovies, and sardines), and alcoholic beverages (particularly beer)
- Avoiding high-fructose corn syrup and sugary drinks, as fructose increases uric acid production
- Emphasizing low-fat dairy products, which have been shown to reduce uric acid levels, and complex carbohydrates like whole grains, fruits, and vegetables
- Staying well-hydrated by drinking 8-10 glasses of water daily to help flush uric acid from your system
- Maintaining a healthy weight, as excess weight increases uric acid production, but avoiding rapid weight loss which can temporarily raise levels
- Considering vitamin C supplements (500-1000mg daily) to increase uric acid excretion, as supported by low-quality evidence from a systematic review 1. These dietary changes work by either reducing the intake of compounds that convert to uric acid in the body or by enhancing the body's ability to eliminate uric acid through the kidneys. While these modifications can significantly reduce uric acid levels, they should complement rather than replace any prescribed medications for gout management.
From the FDA Drug Label
Clinical experience suggests that patients with recurrent calcium oxalate stones may also benefit from dietary changes such as the reduction of animal protein, sodium, refined sugars, oxalate-rich foods, and excessive calcium intake, as well as an increase in oral fluids and dietary fiber The recommended evidence-based dietary changes to lower serum uric acid and avoid gout flare include:
- Reducing animal protein
- Reducing sodium
- Reducing refined sugars
- Avoiding oxalate-rich foods
- Avoiding excessive calcium intake
- Increasing oral fluids
- Increasing dietary fiber 2, 2
From the Research
Dietary Changes to Lower Serum Uric Acid
To avoid gout flare-ups, several dietary changes can be made to lower serum uric acid levels. These changes include:
- Reducing intake of purine-rich foods such as meat and seafood, as they can increase serum uric acid levels and the risk of gout 3
- Increasing consumption of dairy products, especially low-fat types, which are associated with a lower risk of gout 3
- Limiting intake of sweet fruits and soft drinks containing fructose, as fructose can raise uric acid levels and increase gout risk 3
- Adopting a Mediterranean diet, which may help prevent hyperuricemia and reduce the risk of gout 3
- Considering coffee and vitamin C supplementation, as they may help lower serum uric acid levels and reduce the risk of gout 3
Lifestyle Modifications
In addition to dietary changes, lifestyle modifications can also help lower serum uric acid levels and prevent gout flare-ups. These modifications include:
- Maintaining a healthy weight, as obesity can increase uric acid levels and the risk of gout 3
- Engaging in regular exercise, but avoiding strenuous exercise that can raise uric acid levels 3
- Staying hydrated, as dehydration can raise uric acid levels and trigger gout 3
- Limiting alcohol consumption, as heavy drinking can raise uric acid levels and increase the risk of gout 3
Treatment and Management
While dietary changes and lifestyle modifications can help lower serum uric acid levels and prevent gout flare-ups, medication may also be necessary to manage gout. Treatment options include:
- Colchicine, nonsteroidal anti-inflammatory drugs, and corticosteroids to relieve pain during acute gout episodes 4, 5, 6
- Urate-lowering therapies such as allopurinol and febuxostat to prevent gout flare-ups 4, 5, 6
- Novel therapies such as IL-1β antagonists and uricosurics, which may be effective for arresting flares and lowering serum uric acid levels 4, 5